The cells of the hair follicle have a very high degree of metabolic activity. They are some of the most active cells in the body, dividing rapidly and producing many products such as keratin. This exceptional rate of activity mean hair follicles are particularly sensitive to vitamin and mineral supply. A deficiency in one or more products that hair follicles use can lead to telogen effluvium, or even anagen effluvium some extreme cases of deficiency. The hair follicle is a hair fiber making production line. If one key component part is not available, hair fiber cannot be made and the whole production line grinds to a halt.

Iron deficiency is believed by some European and Australian dermatologists to be relatively common with a typical western style diet and a common cause of telogen effluvium type hair loss. It is suggested that women in particular are susceptible to iron deficiency due to the regular loss of iron rich blood in menstruation. Blood donation is also involves a significant loss of iron. The idea that iron deficiency is a common cause of hair loss is less popular with United States based dermatologists. Chronic iron deficiency also leads to symptoms of anemia, spoon shaped nails, depression and general lethargy.

Much dietary iron is supplied from liver, kidney, lean red meat, poultry, fish and shellfish so vegetarians are most at risk of having a diet deficient in iron. Iron from meat is called "haem iron" (presumably "hem iron" is the US spelling?) because the iron is in the blood contained in meat. "Non-haem iron" can be obtained from rice, bread, broccoli, and beans. Absorption of iron depends on other components of the diet. Vitamin C helps iron absorption, while calcium (dairy products), bran, tea, and unprocessed whole grain products can reduce absorption. Vitamin C deficiency can in turn lead to an iron deficiency. Other individuals who may be at risk of iron deficiency include those who are heavy consumers of caffeine rich tea, coffee, and other caffeine drinks. Caffeine reduces the net availability of iron supplied from food. Alcohol abuse also reduces the availability of iron in the body.

Getting ferritin levels up is difficult and will take several months of treatment. For some it may involve a couple of years takng supplements. The level of iron absorption may vary greatly from one individual to another, some absorbing much lower levels. 100 mg elemental iron per day will increase iron stores by a maximum of 2 ng/mL (4.4 pmol/L) per week. It is not a good idea for an adult to take more than 100 mg of iron a day as iron is toxic at high doses. Indeed, the most common cause of toxic deaths in children in the USA is an excessive intake of iron supplement pills. So keep iron supplements out of the reach of young children.

Note that iron excess can also cause a toxic telogen effluvium. See hemochromatosis for details.

Extreme zinc deficiency is associated with multiple symptoms including diarrhea and eczema-like skin problems. Zinc is important in hair fiber production and a deficiency of the metal results in diffuse telogen effluvium of the scalp and body hair. Vegetarians are particularly susceptible to zinc deficiency as dietary zinc is most commonly supplied in meat and fish. Zinc deficiency can also occur in individuals who have chronic gastrointestinal diseases or who have undergone bowel resection surgery.

Note that chelated zinc in nutrient supplement pills is easier to absorb and less likely to cause gastrointestinal distress compared to inorganic zinc sulfate. Also note that excessive zinc supplement intake may also induce hair loss.

Copper is necessary for the absorption and utilization of iron, it helps oxidize vitamin C and it works in conjunction with Vitamin C to form elastin, a chief component of muscle. It also helps with the formation of red blood cells and bone structure.

Copper deficiency may indirectly promote telogen effluvium through its involvement in iron absorption. Low copper levels reduces iron absorption and that can lead to telogen effluvium.

Lack of copper in the diet may also directly affect hair quality. Hair fiber becomes thin and easy to break. Hair follicles reduce their anagen growth phase resulting in a type of mild telogen effluvium where hair can still be present, but it does not grow very long.

Too much copper can be toxic and may cause a form of anagen effluvium. It has been suggested that an excess of copper ingestion might occur from drinking acidic tap water drawn from copper pipes. Alternatively, when electrical earth wires have been connected to copper water pipes and defective electrical appliances are causing a prolonged electrical current flow through the pipes, the metal may be ionized and dissolved in the drinking water.

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Mineral associated effluvium references