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November, 2003
Decreased serum ferritin is associated with
alopecia in women.
Kantor J, Kessler LJ, Brooks DG, Cotsarelis G.
Department of Dermatology, University of Pennsylvania School of
Medicine, Philadelphia, Pennsylvania, USA.
Alopecia in women is a common problem, and conflicting observational
data have failed to determine whether an association exists between
alopecia and iron deficiency in women. We therefore utilized an
analytical cross-sectional methodology to evaluate whether common
types of alopecia in women are associated with decreased tissue iron
stores, as measured by serum ferritin. We studied patients with
telogen effluvium (n = 30), androgenetic alopecia (n = 52), alopecia
areata (n = 17), and alopecia areata totalis/universalis (n = 7). The
normal group consisted of 11 subjects without hair loss from the same
referral base and source population as those patients with alopecia.
We analyzed the data utilizing the unpaired Student's t test assuming
unequal variances with an alpha adjustment for multiple comparisons to
assess whether the mean ages, ferritin levels, and hemoglobin levels
of women without hair loss differed from the means in each alopecia
group. The mean age of patients and normals did not differ
significantly. We found that the mean ferritin level (ng per ml [95%
confidence intervals]) in patients with androgenetic alopecia (37.3
128.4, 46.1]) and alopecia areata (24.9 [17.2, 32.6]) were
statistically significantly lower than in normals without hair loss
(59.5 [40.8, 78.1]). The mean ferritin levels in patients with telogen
effluvium (50.1 [33.9, 66.33]) and alopecia areata totalis/universalis
(52.3 [23.1, 81.5]) were not significantly lower than in normals. Our
findings have implications regarding therapeutics, clinical trial
design, and understanding the triggers for alopecia.

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