The GP appointment
When the GP says it’s normal: what to do next
The GP was not being unkind. In a ten-minute appointment with a woman who is not unwell, whose bloods are inside the reference range and whose hair loss is not the patchy kind, “it is very common and it usually settles” is what the system is set up to say. The trouble is that it is often wrong about the “settles”, and it leaves you nowhere to go.
First, get the numbers
“Your bloods are normal” means every result fell inside the lab’s reference range. It does not mean they are good for hair. Ask the receptionist or the online system for a printout of the actual results, and look at three: ferritin (hair wants above 70; the range starts around 15), TSH (hair is happier under 2.5; the range goes to 4 or more) and vitamin D (hair wants above 75 nmol/L; “sufficient” starts at 50). If any of those is in the low-normal zone, you have something to fix, and the GP will usually agree to treat a ferritin of 20 or a vitamin D of 30 if you ask specifically. This article walks through each.
If any of them was not tested — ferritin often is not; vitamin D often is not — ask for them by name in a follow-up.
Second, check the diagnosis fits
“Normal” usually means the GP has decided this is postnatal shedding or ordinary female pattern thinning. Both are normal in the sense of common. Neither is normal in the sense of nothing to be done. Ask yourself whether the picture fits: a shed is diffuse, has a trigger two to four months earlier, and eases by six to nine months; pattern thinning is at the temples, parting and crown, has been slowly progressing, and does not ease. If yours is the first and it has been more than nine months, or the second and it is getting worse, the reassurance was premature.
Not sure which one is you?
Take the two-minute hair quiz
Twelve quick questions. We tell you what we think is going on, what to do about it, and we say so if it is something we cannot help with.
Start the quiz →Third, know what a GP can and cannot offer
A GP can test and treat iron, thyroid and vitamin D; review contraception or HRT for a hair-friendlier progestogen; treat scalp conditions; refer to dermatology if there is a patch, scarring or a suspected autoimmune cause; and in some areas prescribe spironolactone or minoxidil. A GP cannot prescribe anything for ordinary pattern thinning that the NHS funds, because the NHS does not fund treatment for it. That is the real reason the conversation ends where it does, and it is worth knowing so that you do not take the ending personally.
Fourth, ask the right follow-up
If you go back, go with the photographs and the ponytail number — the protocol is here — and say: “It has been going on for X months, it is progressing, here is the evidence, and I would like to rule out the treatable causes properly: ferritin, thyroid including antibodies, vitamin D, and a look at my scalp.” Evidence and a specific request change the conversation. If there is a patch, scaling, scarring or hair loss with other symptoms, ask for a dermatology referral in those words.
Fifth, act on what is left
If the bloods are genuinely good, the scalp is calm and the pattern is temples, parting or crown, you have had the useful part of the GP appointment: you have ruled out the things a product cannot fix. What remains is a follicle-level process with a mechanism — androgen sensitivity, lost oestrogen shielding, reduced supply, missing growth signals — and that is addressed at the follicle, not at the surgery. This article explains what that takes, and the quiz will tell you which pattern you have.
Ready to read your own pattern?
Take the two-minute hair quiz
Twelve questions. We tell you what we think is going on for you, and we say so if it is something a GP should see first.
Start the quiz →
