Alopecia (Hair Loss)

the top of a bald man's head

Loss of hair or baldness is referred to as alopecia. Your head has about 10,000 follicles, growing hair at a rate of about 1 millimeter every 3 days. Hair growth often goes in “spurts” that are regularly interrupted by a rest period. It is believed that an average of fifty hairs fall out each day. Why do hair follicles eventually stop growing hair and leave us balding Often, a lack of blood flow to the hair follicles leads to the thinning of hair. Certain types of alopecia are specific for hair loss on the body, such as eyebrows (alopecia universalis). Hair falling out in patches is called (alopecia areata). The most common form of hair loss (alopecia totalis) refers to loss of scalp hair.

Hair is mostly made of keratin — a fibrous protein.  Healthy hair depends on a good supply of nutrients in the blood supplying the hair follicle and scalp. Various causes (listed below) can eventually begin to clog and weaken hair roots, resulting in thinning hair, balding, and eventually no hair growth at all.

CAUSES

There are many causes of hair loss: genetics, aging, hormonal imbalance, thyroid irregularities, nutritional deficiencies, heavy metal toxicity, short or long periods of severe stress (adrenal exhaustion), strict dieting (causing malnutrition), severe illness (autoimmune diseases), smoking, pollution, pharmaceutical medications, topical (skin) diseases, and iron deficiency. The most common cause, especially in women, is a poorly functioning thyroid gland (hypothyroidism). It may be advisable to get a full thyroid hormone test, which will reveal TSH levels and the uptake of T-3 and T-4.

Women entering menopause can experience increased hair loss, possibly as a result of stress, low estrogen levels, high androgen (male hormone) levels, or metabolic problems. Teenage girls and younger women may also experience thinning of their hair. Nutrient deficiency is usually involved, although hormones also play a role. Dr. John Lee, author of What Your Doctor Never Told You about Pre-Menopause, suggests using progesterone cream topically (may apply directly to the scalp) for two weeks every month.

Excessive stress, anxiety, worry, or depression can cause the adrenal glands to fatigue. The adrenal glands excrete a hormone called cortisol to respond to stress in the body. If the stressors do not abate over time, the adrenals secrete additional cortisol to respond to stress in the body. Excessive cortisol release can cause sodium (salt) retention over time. Sodium retention in body tissues enables the sodium to accumulate around and in hair follicles resulting in reduction of vital nutrients required for healthy hair.

DIET

Healthy hair needs good nutrition. Protein is essential for the development of hair, and quality protein sources such as legumes, nuts, seeds, and cold-water fish may improve hair quality and quantity. Many vitamins and minerals are involved in hair growth, and so plenty of vegetables, fruits, and grains should be included in the diet.

Several nutrient deficiencies can contribute to hair loss or thinning. A lack of iron is the most common deficiency causing hair loss in women, and a blood test from a physician can confirm this condition. B complex vitamins are also important in the regeneration of nerve and hair cells (especially Biotin), thus this is another important nutrient to supplement with.

Japanese researchers have reported that excessive sebum (oil) production in the scalp is another cause of hair loss, and animal fat in the diet is believed to increase sebum production.

AVAILABLE DRUG THERAPY

Minoxidil is sold over the counter as a topical solution under the brand name Rogaine. Drug research does not know how it works.  It was first used on patients with heart disease who reported an increased growth in their hair. About two-thirds of the men who use it regularly see some improvements in hair growth, ranging from minimal to moderate.  If hair starts to grow it is usually reported to be light and barely viable.

Finasteride is an oral tablet marketed in the U.K. and U.S. as Propecia. It is a prescription drug and not available over-the-counter. It works by inhibiting the action of an enzyme called 5-alpha reductase. This enzyme is responsible for converting the male hormone testosterone into dihydrotestosterone (DHT). It is believed that DHT can damage hair follicles and can lead to hair loss for men who are genetically sensitive to it. Propecia has been reported to be effective in up to eighty percent of users, however it needs to be taken continually. Side effects include sexual dysfunction.

Hair graft surgery is another choice. This surgery takes the hair from the back of the scalp and transplants it to the bald patches. It is a minor operation done under local anesthetic. Effectiveness is mixed, and the best results depend entirely on the surgeon’s skill. Grafts can costs thousands of dollars.

SUPPLEMENT PROTOCOL

For Women

a woman with mildly thinning hair

  1. B-COMPLEX VITAMINS
    B-complex vitamins help to rejuvenate nail, hair, and skin cells, and are essential for healthy skin and hair growth. Deficiencies of B vitamins have been linked to hair loss and skin disorders. B vitamins help with the healthy growth of hair and aid in the production of keratin-a protein that is a major component of hair. Dosage: 50-150 mg daily. Take extra vitamin B6 (50-150 mg daily) and inositol (100mg daily).  If hair loss is related to a sub-clinical low thyroid, supplementing with a THYROID herbal/vitamin supplement may help to nourish and support the gland.  Dosage: see a qualified practitioner for thyroid supplements.
  2. BIOTIN
    Biotin is a nutrient used to improve both nail and hair quality (particularly brittle hair). Biotin is part of the B-complex family. Food sources include brewer’s yeast, soybeans, eggs, mushrooms, and whole wheat. Dosage: 3,000-8,000 mcg daily for at least 4 months. Biotin mixed with Horsetail may promote hair growth.
  3. MULTI-VITAMIN/MINERAL FORMULA
    Taking a multi-vitamin/mineral formula to correct low levels of Magnesium, Calcium, Selenium, and other needed minerals are especially important for the vitality of the hair. The anti-oxidant vitamins such as C, E, A, and Bioflavonoids decrease free-radical damage to hair, improve circulation, and may help to produce keratin and sebum which are our hair’s natural oils to prevent hair loss. Dosage: As directed on package.
  4. COLLAGEN and SILICA (HORSETAIL)
    Collagen is an essential part of hair, and makes our hair more elastic so that there is less breakage. Silica is an essential trace element that plays an important role in synthesizing and maintaining our connective tissue and supports the structure of blood-vessel walls that supply nutrients to follicles and hair roots. Silica aids in the growth and strength of bones, skin and hair. Dosage: As directed on label.
  5. OMEGA 3, 6 ESSENTIAL FATTY ACIDS (EFA’s)
    Essential fatty acids improve circulation and alleviate dry, scaly skin, and improve hair texture. A lack of these nutrients often contributes to dry, lifeless hair. A combination of omega 3 (flaxseed, fish) and omega 6 (Borage and/or Evening primrose oil) may work best. Good food sources include walnuts, eggs, fish, olive oil, flaxseeds, and flax oil. Dosage: 1,000 mg up to 3 times a day over a course of 2-3 months. If using Flaxseed Oil, 15ml 1-2 times a day with vitamin E 400 IU daily; Omega 6 500-2,000 mg daily.
  6. MSM (METHYLSULFONYLMETHANE)
    MSM is a valuable supplement that may improve the strength and sheen of the hair. It is a great source of sulfur, which is an integral part of amino acids, the building blocks of hair protein. There is significant improvement in the health of the hair. Dosage: 1,000-3,000 mg daily.
  7. ZINC and IRON
    Zinc is a mineral that stimulates hair growth by enhancing immune function. Zinc is also necessary to enable vitamin A to get to skin level to improve skin health. Zinc also helps to prevent the conversion of testosterone to DHT. Low levels of iron and conversely high levels of iron in the blood may be associated with alopecia.  A recent study done at the Cleveland Clinic found that iron deficiency may be linked to the most common kinds of hair loss, even in children. If anemia is present, supplement with appropriate doses of iron tablets. Dosage: Zinc 35-100 mg daily; Iron as directed by a qualified practitioner.
  8. PROGESTERONE CREAM
    Application topically of progesterone cream may help to regulate hormones and prevent possible estrogen dominance that can be associated with early hair loss. Pre-menopausal women should use this supplement two weeks a month. Menopausal women should use it 25 days a month. Rotate sites on palms, scalp, inner thighs, and above breasts and wrists. Dosage: Only as prescribed by a qualified health practitioner.
  9. ROSEMARY and other ESSENTIAL OILS
    A variety of essential oils can give hair the nourishment it needs for healthier growth. Small amounts of the essential oil can be added to shampoo to improve scalp circulation. Rosemary has been used for centuries for hair integrity. Other essential oils that may be beneficial include Ylang-ylang, cedarwood, and Chamomile. Dosage: Apply once daily as instructed on the bottle. Be careful of skin irritation and possible allergic reactions.
  10. SAW PALMETTO and GINKGO BILOBA
    The common herb Saw palmetto has historically been used for hair growth by both men and women. Saw palmetto is believed to inhibit the enzyme that converts testosterone into the destructive dihydrotestosterone. Ginkgo biloba increases blood flow to the scalp’s capillaries. Dosage: Saw palmetto, 320-400 mg or as 85 percent liposteroic extract taken daily. Gingko, 60-120 mg daily.
  11. ALOE VERA
    Aloe for alopecia? Aubrey Hampton, author of Natural Organic Hair and Skin Care says that aloe pulp gel contains 96% water, a great moisturizer, and 4% biogenic stimulators that heal and regenerate the skin. She also reports that Egyptian scientists report aloe gel useful for acne, dandruff and even hair regrowth in seborrheic baldness. Dosage: As directed.
  12. CHLORELLA
    Chlorella, or the green blood of plants, may stimulate hair growth and keep hair follicles healthy. Dosage: As directed on package.
  13. MELATONIN
    In addition to the well-known hormonal influences of testosterone and DHEA on the hair cycle, melatonin has been reported to have beneficial effects on hair growth. The mode of action is unknown but it is believed that melatonin increases the anagen hair rate in women with androgenic alopecia. Topically applied melatonin seems to positively influence hair growth. Dosage: 2-10 mg daily orally, or see a qualified compounding pharmacist for topical treatment.
  14. AROMATHERAPY
    This technique involves massaging ESSENTIAL OILS into the skin. The most effective massage oils are thyme, sage, lavender, cedar, and rosemary (in a blend of jojoba and grape seed). One double-blind study of 84 patients with alopecia areata found that 44 percent of those who rubbed their scalp with a mixture of essential oils daily for seven months, 44 percent saw an improvement in bald patches.
  15. SHOU WU PIAN and FO TI
    This is a commonly prescribed traditional Chinese herbal remedy containing natural compounds. Dosage: as directed on package. Fo Ti extracts are popular in hair care products especially in China and Hong Kong.

For Men

  1. VITAMIN B COMPLEX with extra BIOTIN. Dosage: Same as above.
  2. MULTI-VITAMIN/MINERAL FORMULA with COENZYME Q10 (60-100 mg)
  3. ZINC (30-60 mg a day), SILICA and ESSENTIAL FATTY ACIDS (See above).
  4. SAW PALMETTO
    Saw palmetto is thought to inhibit the enzyme that converts testosterone into a destructive form, dihydrotestosterone (DHT). One recent study found that saw palmetto and a plant component called Beta-sitosterol may increase hair growth in men Dosage: 1-3 capsules daily.
  5. GINKGO BILOBA
    Ginkgo biloba will increase blood flow to the scalp’s capillaries. Dosage: 60-180 mg daily
  6. ANDROGEN REPLACEMENT
    Androgen supplementation may be necessary in some instances, along with prescription TESTOSTERONE.  Dosage: See a qualified practitioner before starting therapy.
  7. MSM (METHYLSULFONYLMETHANE)
    MSM is a sulfur-rich amino acids help bring protein to the hair follicles. Other sulfur-rich amino acids include Cysteine, Methionine and Glutathione. Dosage: As directed.
  8. SHOU WU PIAN
    A commonly prescribed traditional Chinese herbal remedy with natural compounds. It has been used in TCM for thousands of years, No toxicity or side effects reported. Dosage: As directed on label.
  9. AROMATHERAPY, ACTIVATED OXYGEN SERUM, and TOPICALS OILS (Algae, Grape seed oils).
  10. LICORICE (GLYCYRRHIZA GLABRA)
    Licorice contains a compound that prevents the conversion of testosterone to the problematic DHT.

 

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Gaby, AR, Wright, JV. Lecture notes at Natural Medicine Conference. Seattle, WA. 1996

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Hay, IC, Jamieson, M, and Ormerod, D. Randomized trial of Aromatherapy: Successful Treatment for Alopecia Areata. Archives of Dermatology, November 1998. (134): 1349-1352.

Karst, K. Ask the Experts. Alive #285. July 2006. P. 40.

Low Iron Could Promote Hair Loss. Pharmacy Times, August 2006. 72(8): 73.

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