Supplements For Hair Loss That Research Suggests Are Effective

Hair loss is on the increase. Especially in young women.

In ladies, loss of hair is a catastrophe.

Female pattern hair loss is a common form of hair loss in women that increases in incidence with age. Did you know that female pattern hair loss may also be viewed as a marker for an increased risk of cardiovascular and metabolic disease?

Androgenetic alopecia (AGA) is the most common form of alopecia. It affects up to 80% of men and 50% of women in the course of their lives.

AGA is caused by a progressive reduction in the diameter, length, and pigmentation of the hair. In other words, your hair is not what it used to be. Looking in the mirror becomes scary.

Hair thinning can result from the effects of the most powerful testosterone metabolite called dihydrotestosterone (DHT). DHT, when elevated, damages androgen-sensitive hair follicles.

I measure DHT in my female hair loss patients. Many of them do NOT have higher levels of this very active metabolite of testosterone.

Iron deficiency and thyroid issues are the next most common causes of hair loss.

But hair loss is not easy to reverse, even with fixing these wrongs.

Continued hair loss causes significant suffering and loss of self-esteem.

What works besides identifying issues and fixing them with iron, thyroid, androgens, and digestion?

A systematic review of nutritional supplements published online in JAMA Dermatology on November 30, found that “Twelve of the 20 nutritional interventions had high-quality studies suggesting objectively evaluated effectiveness.”

This means they identified some supplements that did, in fact, help regrow hair! In some patients. Nothing works for everyone. Especially with this issue.

It is “ground-breaking,” in part due to its breadth and depth, said Eva Simmons-O’Brien, MD, a dermatologist in Towson, Maryland, who often recommends supplements for her patients with hair loss.

“It basically kind of vindicates what some of us have been doing for a number of years in terms of treating hair loss.”

“It should hopefully make it more commonplace for dermatologists to consider using nutritional supplements as an adjuvant to treating hair loss,” added Simmons-O’Brien.

Saw Palmetto

The review begins with a look at studies of saw palmetto (Serenoa repens), a botanical compound thought to inhibit the enzyme 5-alpha reductase (5AR), which converts testosterone to dihydrotestosterone (DHT).

DHT is a mediator of androgenic alopecia (AGA), as I said above.

The studies suggest that the compound might stabilize hair loss, “although its effect is likely less than that of finasteride.”

There are potential side effects associated with finasteride, such as sexual dysfunction. These were also observed with saw palmetto, “but to a lesser extent.”

Pumpkin Seed Oil

For AGA, pumpkin seed oil was found to be a “potential alternative” to finasteride for AGA.

Forti5, a nutritional supplement that includes botanical 5AR inhibitors and other ingredients, had favorable effects in one study.

The review also examined micronutrients such as vitamin D, zinc, B vitamins, and antioxidants.

Anti-oxidants

Low levels of vitamin D have been associated with alopecia areata (AA), AGA, and telogen effluvium (TE) in some studies, and zinc deficiencies have been associated with TE, hair breakage, and thinning.

A single-arm vitamin D study showed improved results at 6 months for women with TE, but there was no control group, and TE is self-resolving.

Studies in patients with normal zinc levels at baseline who had AA or hair loss showed significant hair regrowth and increased hair thickness and density, but the trials were a mishmash of controls and no controls, and relied on self-perceived hair loss data.

This showed that giving zinc to those not deficient in it helped some regrow hair.

Larger, more rigorous studies should be done to evaluate zinc’s effectiveness with AA, the authors’ comment.

Biotin

Many patients take vitamin B7 (biotin) for hair loss. It has not been studied on its own, but was an ingredient in some supplements in the review. Biotin does not promote new hair growth but helps strengthen the new hairs that grow as a result of other therapies.

So biotin should be added to other hair growth therapies!

Biotin supplementation interferes with troponin and other thyroid blood tests (so needs to be out of the bloodstream for two weeks before thyroid tests are done but this is not possible when testing for troponin, which is usually a more acute scenario).

Immune Modulators

Natural immunomodulators — such as Chinese herbal extracts from paeony and glycyrrhizin — were effective in severe AA.

Growth hormone modulators targeting deficiencies in insulin growth factor 1 or growth hormone are also promising.

Studies of the modulators capsaicin and isoflavones (from soy or botanicals) — used topically — induced hair growth.

Protein

Products containing marine protein supplements, including Viviscal and Nourkrin, appeared effective in increasing hair counts in men and women, but the studies were funded by the manufacturer and were not well-controlled. Viviscal-induced bloating.

Multi’s

The multi-ingredient supplements Nutrafol, Omni-Three, Apple Nutraceutical, and Lambdapil were also included in the review. Only Omni-Three showed no effectiveness, but studies of the other supplements had various limitations, including a lack of controls and small sample sizes.

It’s Just Not Easy

In practice, hair loss is not easy to help. We learned this past month that certain medications can cause hair loss after being on them long-term, like many antidepressants. Are Anti-depressants Causing You To Lose Hair/Eyelashes?

Results with supplements for hair loss are inconsistent.

Stabilizing thyroid and iron are extremely important. But still, results on promoting hair loss or regrowth are inconsistent.

But these authors say to encourage patients to replace nutrients like vitamin D or zinc, or other vitamins or minerals if patients are deficient, but if they are not, then results seem less likely. Yet one article above found that giving zinc was helpful even if blood levels were normal.

Hair loss is not easy to treat.

Aging has a huge effect, as hair follicles contain many sex steroid receptors. Some women get a bit more hair growth over one to two years with hormone replacement. Have not seen this work in gents.

Hair loss is not easy. But since excessive hair loss is also associated with an increased risk of heart health issues, tackling it makes sense.

Tracking blood levels of glucose, insulin, and lipoprotein, little (a), the most aggressive of all the fractionated lipids, makes sense since there is this hair-heart link.

Knowledge is power, but with hair loss, this is not always the case, darn it.

Dr. B.

Originally posted to Dr. Berkson’s Agile Thinking Substack: Supplements For Hair Loss That Research Suggests Are Effective