The Causes of Hair Loss

This month our blog will address a common medical issue which is hair loss and hair thinning. Hair loss has become a frequent concern among men and women alike as we age. Alopecia is the medical term used to qualify it.

The Various Patterns of Hair Loss

Male or female pattern baldness:

These are the most common forms of alopecia. They present as the progressive loss of scalp hair and can become permanent if not treated early on. Both have a hormonal component and were called “androgenic alopecia” referring to a relative excess of male hormones in each sex. The difference between the two is the location where the loss begins. Men usually start seeing a receding hairline and decreased hair density on the frontal and the vertex (top) parts of their head. For women, the thinning occurs at the temples as well as the top and crown of the scalp leaving the front line unaffected. There is a genetic component to this type of hair loss and some variations in the androgen receptors in the scalp have been linked to it.

Alopecia aerata:

This is an acute “brutal” loss of hair that starts with one or more circular patches distributed all over the scalp that can later overlap. An overactive immune system attacks the hair follicles. This happens suddenly, mostly after a stressful event. It is more frequent in children and young adults, but it can start at any age. The hair can regrow after the initial episode. However, the loss frequently relapses over time.

Telogen effluvium:

This is an excessive stimulation of the shedding of the hair during the resting phase of the hair growth cycle before a new thread grows back in the follicle. This causes a temporary and reversible hair thinning on the top of the head. It can be triggered by various conditions implying some stressful change to the body. This includes severe illnesses (COVID in particular), pregnancy and childbirth, rapid weight loss with diet low in protein, thyroid issues, major surgery with anesthesiology, depression, and psychological issues. Various medications or cosmetic products can also induce this type of hair loss such as retinoids (Accutane) and retinol, chronic use of NSAIDs drugs (Advil, Aleve), blood thinner medications, beta blockers and even some birth control pills.

Anagen effluvium:

This is an abrupt shedding of the hair occurring during the first phase of the hair growth cycle. It is usually caused by chemotherapy drugs, a few other drugs including colchicine, or exposure to toxins (mercury, thallium, arsenic).

Nutrition, Supplements and Hair Loss

It is interesting to note that many patients who start suffering from hair loss rush to purchase hair-loss supplements online or at the drugstore without looking at their food intake first. A regular intake of essential nutrients is the base for good strong hair and an easy way to avoid hair thinning.

PROTEIN

As Dr. Dominique Fradin-Read often says, “amino acids from protein are the building blocks of the hair.” Adequate daily amount of protein is therefore essential to sustain normal hair growth. Protein levels in blood should be checked as we are surprised to see how many patients complaining of hair loss have low protein levels in their blood. A particular amino acid L- Cysteine a constituent of Keratin with high affinity for the hair follicle and has proven to be helpful in case of hair loss. It is abundant in many foods such as beef crab, beans and mushrooms. Adding a protein shake daily might be the answer for those who have difficulties reaching their daily intake goal.

IRON

Iron deficiency is one of the most frequent causes of nutritional deficiency and a well-known cause of hair loss. Long before a patient becomes anemic, the storage of iron in the body, called ferritin, can decrease and indicate iron deficiency. The populations at risk include menstruating premenopausal women, vegans, and vegetarians (as the iron found in plants has lower bioavailability than that found in animal products), as well as patients taking regular intake of acid blocker medication (due to pH changes that decrease iron absorption) or aspirin (which can cause chronic gastrointestinal blood loss). Diets should be rich in spinach and greens and should include some animal products such as yogurt, eggs, chicken, turkey, small fish, and even a few days of meat for those who like it. A minimum level of ferritin in the blood of at least 50 ng/mL should be targeted to favor hair growth. This level is usually hard to reach with food only, especially for patients who do not eat meat, and this is when adding iron supplements becomes necessary.

OMEGA 3 FATTY ACIDS

Several animal and human studies have now shown the benefits of unsaturated fatty acids on hair growth. One particular study in 2015 clearly demonstrated that taking omega fatty acids increased the thickness and density of the hair during the hair growth cycle by enhancing hair follicle proliferation. Another mechanism of action of omega fatty acid is similar to Finasteride a drug used to modulate androgen production.

As for the protein levels in the blood, we were surprised to find how many patients have low omegas in their blood. Their diet should have an increased level of fish knowing that any kind of big fish that could be contaminated with mercury should be eliminated from the list (tuna, yellow tail, swordfish and Chilean seabass. Adding chia seeds and flaxseed to the diet might help. Brussels sprouts, eggs and some enriched food with fatty acids can help too. A good source of natural omega supplements is often handy for those who do not eat fish. Dr Dominique Fradin-Read recommends omega-3 from anchovies and sardines which assure the absence of mercury in the product.

VITAMIN D

Vitamin D is intricately involved in various signaling pathways of growth and differentiation of hair follicles. Most studies show that low levels of Vitamin D in the blood are associated with various forms of hair loss. A specific Vitamin D receptor (VDR) has been identified on the hair follicles. Although the mechanism of action of Vitamin D has not yet been identified, the activation of the receptor by an adequate amount of Vitamin D is essential for the homeostasis of the hair follicle, and its deficiency induces hair loss. Vitamin D levels should therefore be carefully monitored yearly to avoid the risk of hair loss. As contents of Vitamin D are not very prominent in food, and sun exposure does not allow patients to reach an adequate level (due to the use of sunscreens and air pollution in most big cities, which impact the diffusion of the sun's UVBs), it has become necessary to add a supplement to the regimen of most patients residing in these areas.

OTHER ESSENTIAL NUTRIENTS

Antioxidants are essential elements in our food, capable of neutralizing the free radicals generated by our bodies that could damage our cells. Many substances are classified in this category, including zinc, selenium, Vitamins A and E, vitamin C, and plant polyphenols. Dietary antioxidants play an important role in protecting our cells—particularly the hair follicles—against the deleterious effects of free radicals and endotoxins generated by our metabolism. However, high doses of these antioxidants added to our food in the form of natural supplements can disrupt the balance of the redox system and have the opposite effect, becoming pro-oxidant. For example, excess Vitamin A taken orally is well-known to cause hair loss. Therefore, obtaining daily intake of antioxidants through foods such as fruits, vegetables, grains, beans, and nuts will be safer and healthier than substituting them with isolated high doses of these supplements.

The case of Biotin

Biotin, also known as Vitamin H, has shown its benefits primarily in vitro, particularly in isolated sheep hair follicles, where it resulted in increased protein synthesis. Biotin deficiency is extremely rare, and no clinical human trials have demonstrated any benefits in treating hair loss in the absence of deficiency. Despite this fact, it is widely marketed to the public for hair loss in numerous products.

Now you understand the importance of good nutrition and the benefit of adding natural supplements to have optimal nutrient support for hair growth. When ordering takeout or dining at a restaurant, use Dr. Read’s plan on the Goldi App, Everyday Health by Dr. D, for customized dish recommendations.

In the next post, we will review what can be done on the medical and cosmetic side to prevent and/or treat hair thinning and hair loss. Stay tuned!

For a customized hair restoration program, consult your VitaLifeMD provider.