Chronic telogen effluvium in women: role of micronutrients, a case–control study in north of Iran

Background Chronic telogen effluvium (CTE) is a form of diffuse hair loss in middle-aged women in whom telogen hair loss continues more than 6 months without obvious etiology. Disturbance in growth hair cycle may result in increased hairs in the telogen phase. Micronutrient deficiency, such as iron, zinc, and vitamin D, has been incriminated in acute telogen effluvium but its role in chronic phases is challenging. Objective To measure the levels of serum ferritin, zinc, and 25-hydroxy vitamin D (25OH vitamin D) in females with CTE and controls to verify their role in hair-loss pathogenesis. Patients and methods A case–control study was conducted on 166 female participants: 83 patients with CTE and 83 age-matched healthy controls. Blood samples were taken from all participants for evaluation of serum ferritin, zinc, and 25OH vitamin D levels. Ferritin and 25OH vitamin D levels were measured with chemiluminescence method and zinc level was measured with colorimetric method. The study was done during 6 months (autumn and winter). Results There was no significant difference in serum ferritin, zinc, and 25OH vitamin D levels in two groups. The median of ferritin level was suboptimal in both groups (≤40 μg/l). Interestingly, zinc and 25OH vitamin D levels in healthy participants were lower than patients with CTE, but with considering the significance level of 0.01, this difference was not significant. The frequency of suboptimal levels of ferritin, 25OH vitamin D, and zinc was not significantly different in two groups. Conclusion We found no significant difference in ferritin, 25OH vitamin D, and zinc levels in two groups, but the role of these micronutrients in CTE could not be ignored. It seems that suboptimal levels of ferritin and 25OH vitamin D in women are common and may have led this non significant difference.