The no-carb approach of ketogenic diets may trigger hair loss along with weight loss. Should you be worried? Here’s some food (pun intended!) for thought.

Ketogenic (keto) diet essentially pushes your body to use a different kind of fuel.

In absence of carbohydrate intake, your body is forced to convert dietary and reserve fats into ketone bodies as a source of energy to the cells. You, therefore, end up burning fat that may result in weight loss. However, keto diet requires you to completely get off carbohydrate-rich foods, which often results in nutrient deficiency .

One of the symptoms of nutrient deficiency is hair loss. Hair loss is one of the many side effects associated with your body transitioning into ketosis. How can keto diet cause hair loss? Is it irreversible? Can you prevent it?

How does Keto Diet Cause Hair Loss?

The keto diet aims to force your body into using ketone bodies that the liver produces from stored fat instead of relying on glucose that comes from carbohydrates such as grains, legumes, vegetables, and fruits.

In a daily 2,000-calorie keto diet, you eat 165 g of fat, 40 g of carbs, and 75 g of protein.

(Note: the exact ratio varies person-to-person).

You eat relatively high levels of saturated fats and high-protein meats. Vegetables like kale, broccoli, spinach, cauliflower, cucumber, garlic, onions, and others with no carb traces are allowed. Except very few like avocados that are fat-dense, most fruits and vegetables are taken off your list in keto diet.

This causes a significant imbalance in nutrition leading to nutrient deficiency. The most common deficiencies are that of vitamins-A, D, E, niacin, folic acid, and biotin; minerals like iron, zinc, and selenium.

These micronutrients along with proteins are essential for multiple mechanisms- as crucial as digestion, brain development, kidney functioning and secondary processes like hair and nail growth. Therefore, when your body is transitioning into ketosis, you experience issues with all or most of these processes.

What Causes Hair Loss when on Keto Diet?

One of the reasons for hair loss is the sudden/extreme changes you make in this diet. As a result, you may face the following deficiencies that are directly linked to hair loss-

• Biotin: A mice study on the keto diet demonstrates that the ketogenic diet increases biotin bioavailability and consumption. It, on the other hand, creates biotin deficiency in biotin-deficient mice. They showed typical symptoms of biotin deficiency like hair loss and dermatitis.
• Iron: Studies reveal the role of iron in gene regulation and DNA synthesis in actively-dividing hair follicles. In case of iron deficiency, especially in women, hair follicles fail to divide and grow into hair strands, thus causing hair loss.
• Zinc: Zinc plays an important role in hair follicle morphogenesis. Insufficient levels of zinc or disturbances in its metabolism can trigger hair loss in men and women. This is proved by a study on patients diagnosed with Alopecia areata, pattern hair loss, and telogen effluvium.
• Selenium: Selenium protects hair fibres from free radical damage and is involved in hair follicle development. Rat studies show selenium-deficient subjects display sparse hair growth and progressive hair loss after birth.
• Omega Fatty Acids: The levels of polyunsaturated fatty acids like linolenic acid, linoleic acid, and arachidonic acid have a direct impact on hair growth. These acids inhibit the production of growth-boosting enzymes and follicle proliferation. Studies also showed that applying linoleic acid-rich oils to the scalp promotes hair growth in subjects with alopecia.
• Vitamins-A, D, and E: These vitamins activate hair stem cells and participate in the follicle proliferation cycle. They also regulate processes like thyroid hormone secretion that have a direct effect on hair growth. They delay the onset of hair loss, condition the scalp, and promote new hair development when supplemented in the right amount.
• Amino acids and Proteins: These macromolecules are involved in multiple pathways that regulate hair development- directly and indirectly. Amino acids like L-lysine help in the uptake and assimilation of iron and zinc. L-cysteine is an integral part of keratin, the protein abundant in hair fibres.

Often in high-fat and low-carb diets like keto, you deprive your body of many such amino acids and proteins which come together with carbohydrates. The effect of protein deficiency inevitably shows on hair growth and scalp health, according to mice and human studies.

So how do you deal with this? Is there a way to prevent hair loss due to ketosis?

How to Manage Keto Diet-associated Hair Loss

To reduce the risk of hair loss when on the keto diet, it is best to compensate for the nutrient deficiency. This can be done by either using dietary supplements or introducing foods rich in micronutrients.

The nutrients necessary for hair growth include vitamins-A, D, and E, biotin, folic acid, iron, zinc and selenium. Including lean protein in the diet can also relieve hair thinning and shedding. Here are a few foods and their nutrients you should consider adding to the keto diet to reduce hair loss-

Biotin-rich Foods

In healthy adults, the concentration of biotin is 133–329 pmol/L in serum and 18–127 nmol/24 hours in urine. To compensate for ketosis-caused biotin deficiency, we need to have an adequate intake of about 30 mcg of biotin. Foods high in biotin are:

1. Beef liver
2. Eggs
3. Salmon
4. Pork
5. Sunflower seeds, roasted
6. Sweet potato
7. Almonds, roasted
8. Tuna, canned
9. Spinach, boiled
10. Broccoli

Iron-rich Foods

Iron deficiency affects the micronutrient balance that in turn leads to hair loss. Therefore, having iron-rich foods is mandatory in any diet you follow. Recommended intake of iron through diet about 15–18 mg for women/girls and 8–11 mg for men. Try adding the following foods to maintain serum ferritin levels above 30 mcg/L-

1. Breakfast cereals
2. Oysters, cooked
3. White beans
4. Dark chocolate, 45%–69%
5. Spinach
6. Tofu, firm
7. Potatoes
8. Cashew nuts, roasted
9. Chicken, roasted (meat and skin)

Zinc-rich Foods

Zinc is crucial for several metabolic cycles that support growth and development. It is involved in cell division and protein synthesis in all organ systems. And hence, severe zinc deficiency causes hair fall along with weight loss. Since our body cannot store zinc, it is mandatory to supply via food and supplements to maintain 9–11 mg in adult men and women. Here are a few options-

1. King crab
2. Lobster
3. Pork loin
4. Chicken, dark meat
5. Pumpkin seeds, dried
6. Low-fat yogurt
7. Chickpeas
8. Swiss cheese
9. Oatmeal
10. Low-fat milk

Foods Rich in Vitamins-A, D, E

These fat-soluble vitamins are indirectly essential for hair follicle development and scalp health. They play important roles in the absorption of other micronutrients and protect hair from chemical and physical damages. You can provide these vitamins by adding-

1. Almonds
2. Sunflower seeds
3. Hazelnuts
4. Peanuts
5. Spinach
6. Milk
7. Tomatoes
8. Salmon
9. Cod liver oil
10. Eggs

You can also use dietary supplements to bridge nutrient deficiency and control hair fall. However, consult your nutritionist/doctor to know the right dosage for you. This is because some of the minerals and vitamins can be toxic when accumulated in the blood/body.

The ketogenic diet may cause severe nutrient deficiency and lead to kidney failure, GI disorders, and hair loss. The good news is you can prevent further damage to hair by consuming foods and supplements rich in biotin, zinc, niacin and vitamins A, D and E.

So, quit stressing about hair fall and focus on nurturing your body and mind– because that is all that matters.

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