If you have been told your bloods are normal while your hair falls out, this article is the one we wrote first. It is the single most common experience women describe to us, and it is the one that does the most damage — because it does not just fail to help, it makes you doubt yourself.
Here is what is usually going on.
"Normal" is a range, and the range is wide
A laboratory reference range is built from a population. It describes where most people sit. It does not describe where you function well.
This matters most with iron. A ferritin result can sit at the very bottom of the normal range, be reported without comment, and still be low enough that your body is quietly deprioritising things it considers non-essential. Hair is very much on that list. Your body will keep your heart and brain supplied long before it worries about your parting.
So "within range" and "optimal for you" are not the same statement. A result at the bottom of a range is a data point worth discussing, not a closed case.
The standard panel does not look at very much
A routine blood test is usually a general screen. Unless someone specifically asks for them, it may not include:
- Ferritin — your iron stores, as opposed to the iron currently in your blood. This is the one that matters for hair, and the one most often left off.
- Full thyroid function — often only TSH is run, which can miss things.
- Vitamin D — frequently not tested unless requested.
- Androgens — testosterone, free testosterone, DHEA-S, SHBG.
If nobody ordered these, nobody ruled them out. "Your bloods were fine" can honestly mean "the handful of things we measured were fine."
Being functional works against you
This is the uncomfortable one. If you are young, upright, holding down a job and not obviously unwell, you are a low-priority case in a system with finite time. The threshold for investigating further is higher for you than it should be, and the more competently you cope, the less urgent you appear.
That is not a conspiracy and it is usually not indifference. But it does mean that getting a proper look often requires you to be specific and persistent, which is an unfair thing to ask of someone who is already exhausted.
What to do with this
Go back. Ask for the specific tests by name. Ask for your actual numbers rather than the word "normal", because a result at the bottom of a range and a result in the middle are different situations and only one of them gets described to you differently.
We wrote a separate piece on exactly what to ask for and how to phrase it, which you can read here.
And if you have been told for years that nothing is wrong: you are not imagining it, and you are not being difficult. You are the only person in the room with access to how your body actually feels.