Handfuls of hair in the shower drain 4 months post sleeve. Is this ever going to STOP?

Right, new panic, and it's a vain one so bear with me. Sleeved last November, down about three and a half stone, genuinely thrilled with all of it. Except my HAIR.

It started maybe a fortnight ago. I noticed the shower drain and thought, that's a lot. Then I ran my fingers through the front and came away with actual strands, not one or two, a little bundle. The pillow has hair on it now. My wife swears she can't see a difference and I half believe her, but I can feel it thinner at the temples and I am not imagining the drain.

Here's what's doing my head in. I've done EVERYTHING right. Protein first, taking the vitamins, walking, the lot. So why now, four months in, when I've been the model patient? Is it because I lost the weight too fast? Is it the sleeve itself doing something to me? And the big one, the 3am one: is it going to grow back or is this just what I look like now? Somebody who's been here please talk sense at me.

Alan W said:

is it going to grow back or is this just what I look like now?

Grow back. It grows back, Alan. Write that on your bathroom mirror and go to bed.

Mine started almost exactly your timing, month four, and I lost enough over the following couple of months that I stopped wearing my hair up because I could see the scalp at my parting in bad light. I cried about it, I will be honest, on top of everything else it felt like the final insult. And then around the eight or nine month mark I started getting this halo of daft little short hairs sticking straight up all round my hairline, the regrowth coming through, and now two years on you would never know. It is the single most common thing this forum panics about after the scale stalls, and the single most reliable to sort itself out.

Same club here, mine kicked off around month three or four too. Can confirm the drain horror.

One thing though, and I say this having wasted money on it: I went straight out and bought the big tub of biotin gummies that all the influencers push for hair, convinced it was the fix. My dietitian at follow up basically said save your money, that unless you are actually deficient in it (and almost nobody is) it does nothing for this particular kind of shedding, and megadosing it can even mess up some blood test results. What she DID want me on top of was my iron and protein, which is a much more boring answer than a nice gummy but there we are. It came back for me the same as Donna, the little sticky-up bits at the front were my sign it was turning.

A moderator note, because this thread appears in some form every few months and the reassurance above is well placed.

What almost everyone is describing here is telogen effluvium. In plain terms, hair grows in cycles, and at any moment most of your follicles are actively growing while a smaller proportion are resting (the telogen phase) before they release the old hair and start again. A big physiological shock, and both major surgery and rapid weight loss count as exactly that, can push an unusually large batch of follicles into that resting phase all at the same time. They then let go together a few months later, which is why the timing is so consistent: the shedding typically starts around three to four months after the operation, not straight away, which catches people off guard because by then they feel well.

The reassuring part is structural. Telogen effluvium is a shedding of hairs whose follicles are still alive and intact; it is not the follicle dying. Shedding is diffuse, meaning thinner all over rather than bald patches, and for most people it peaks and then settles, with regrowth visible and the density recovering somewhere in the six to twelve month range from when it began. A normal scalp sheds in the region of 100 hairs a day anyway; in this phase that can run several times higher for a while, which is alarming to see but self-limiting.

Where nutrition genuinely comes into it, and where it is worth a conversation with your own team rather than the internet, is that inadequate protein and low iron stores can prolong or worsen the shed. On the bloods, ferritin (your iron stores) is the usual culprit and is often flagged when it drops below roughly 30 to 40 micrograms per litre; zinc and overall protein intake matter too, which is why the standard advice sits around 60 to 80 grams of protein a day once you can manage it. That is the useful version of "eat more protein". The biotin point above is correct: supplementing it does little unless you are truly deficient, which is rare, and high doses can interfere with certain laboratory assays including some thyroid and cardiac tests, so it is worth mentioning to whoever takes your blood. The site's overview of hair loss after the sleeve walks through the same ground, and the piece on vitamins and supplements covers why the iron and protein side is the part that actually earns its place.

Two honest exceptions, and this is where I hand you back to your own clinicians who have your notes and can examine you. If the shedding is still going strong past twelve months, or if it is patchy and defined rather than diffuse, or if it comes with other things such as fatigue, feeling cold, or changes that do not fit, that is no longer a tidy post-surgical story and deserves proper investigation, thyroid function being one obvious thing to check. I cannot tell any individual here which of those they are; that assessment belongs with your GP or bariatric team.

That is genuinely the first thing I've read that made the timing make sense, the "months later, when you already feel fine" bit is exactly it. Rang my team and I've got bloods booked, ferritin included, so at least I'll know if the iron side needs poking rather than just guessing.

Putting the biotin tub down slowly and backing away.

Update for the search-engine ghosts who find this at 3am like I did. Bloods came back, ferritin was on the low side so my team adjusted things, nothing dramatic. And the shed has clearly slowed, the drain is back to normal-person levels and I've got a fringe of ridiculous short bits coming through at the temples exactly like Donna and Tracey said I would. Still here, still have hair, still lighter. Panic over. Leaving this up for the next worried soul.