Most Gastric Bypass patients experience some hair loss after surgery. For some, it just a few more hairs on the brush, while others report that it comes out in clumps. It typically starts around three to five months after surgery and is at its worst between months six and nine. However, after the first year, your hair begins to grow back and is typically back to normal around 2 years after surgery. Those with longer hair may report an even longer time before it returns to normal. Also, those who start with thick hair typically have less problems than those with thin or fine hair to begin with.
The exact cause of the hair loss is unclear, however most of us suspect that it is the result of rapid weight loss and poor nutrition during the first few months after surgery. While I typically push a “vegetables first” approach to postoperative eating, I suspend this in the first few months to ensure that patients in the immediate postoperative period get adequate protein intake. During these first few months, I encourage patients to “eat their protein first” to minimize hair loss.
The most common nutritional cause of hair loss is iron deficiency. If I see hair loss in a patient more than one year out from surgery, their iron level is almost always low when I check it. While I don’t start most patients out on iron, if you have history of anemia or want to do everything possible to minimize hair loss, then taking a bariatric specific, chelated iron supplement starting immediately after surgery is a reasonable approach. Also, starting a high dose biotin supplement (10,000 micrograms) immediately after surgery may minimize hair loss. While zinc has often been cited as a cause of hair loss, I do not recommend patients empirically take zinc supplements since they can interfere with iron absorption and may actually worsen your hair loss by predisposing you to iron deficiency. While hair loss is a very troublesome side effect of the surgery, it is almost always temporary and can be minimized by taking a proactive approach during the first few months of increased protein, biotin and iron supplementation.