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Alopecia Areata
Alopecia areata is autoimmune patchy hair loss. We look at thyroid and other autoimmunity, gut, nutrients, stress, and immune triggers, alongside dermatology care.
What you may be noticing
Round, smooth patches of hair loss that appear suddenly on the scalp, beard, eyebrows, or elsewhere. Short broken hairs at the edges. Nails with small pits or ridges. Patches may regrow and then appear in a new place. In some people hair loss spreads across the whole scalp or body.
Why it is rarely one thing
Alopecia areata occurs when immune cells attack the hair follicle. Normally, follicles are shielded by a state called immune privilege. In alopecia areata, that protection collapses, and immune cells surround the follicle and stop it from growing. The follicle itself survives, which is why hair can regrow. JAK inhibitor medications, now approved for severe cases, target this immune pathway.
Alopecia areata often travels with thyroid autoimmunity, vitiligo, atopic conditions such as eczema and asthma, and other autoimmune conditions. Stress, illness, and hormonal changes are commonly reported triggers.
My stance is that autoimmunity can often be turned down when we find what keeps provoking it. I picture a toxic burden bucket: a recent virus, gut permeability, food reactivity, chemicals, and chronic stress each add load until the immune system loses its restraint around the follicle. The nervous system sets how that load is handled. A body held in survival mode shifts immune signaling and diverts resources from repair, which is why calming stress physiology is part of the plan. Lowering total load is a working clinical hypothesis; stress and illness as triggers are commonly reported.
Small, limited patches often regrow within a year, sometimes on their own. More extensive loss is harder to predict, and newer medications have opened real options.
Patterns we look for
- Thyroid function and antibodies.
- Iron, ferritin, zinc, and vitamin D.
- Celiac disease and gluten sensitivity.
- Gut barrier and microbiome balance.
- Atopic patterns: eczema, asthma, and allergies.
- Recent infections, including viral illness, and immune activation.
- Toxic burden and personal care chemicals.
- Stress physiology, HPA axis output, and sleep.
How I evaluate it
The comprehensive functional neurological exam assesses autonomic balance and stress physiology, which influence immune activity.
Functional labs may include a full thyroid panel with antibodies, ferritin and iron studies, zinc, vitamin D, B12, celiac antibodies, a complete blood count, inflammatory markers, intestinal permeability markers, and a comprehensive stool analysis. I coordinate with your dermatologist on medication and local treatments. A history of what preceded each patch, and photographs every few months, track triggers and regrowth objectively.
How we address it
- Coordinate with your dermatologist on treatment options.
- Screen for and support associated autoimmunity.
- Replete iron, zinc, and vitamin D where low.
- Open drainage pathways, then lower toxic burden and chemical exposures.
- Repair the gut barrier and address gluten reactivity where present.
- Calm the stress response, restore sleep, and support the nervous system out of survival mode.
- Support scalp circulation and gentle hair care, along with the emotional side of hair loss.
The follicle is waiting, not gone. We work to restore the conditions that let it grow.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.