Our hair grows in cycles which are influenced by several factors, both environmental and genetic. It is estimated that every day, we shed 100 hairs and those are replaced with 100 new follicles. Androgen hormones, or male related hormones such as testosterone, dihydrotestosterone (DHT), and androstenedione, play an important role in regulating hair growth. In genetically predisposed people, hair loss is due to several reasons. It's often the case that in many genetic disorders, an environmental trigger can be found.
Understanding hair loss
In hair follicles on the scalp, a hormone called dihydro-testosterone (DHT) binds to the receptors that should be activated by androgen hormone (such as testosterone). By connecting to these receptors, the other male hormones cannot connect to the follicle receptors and activate the growth of new hairs. (Price, 1999) According to the American Hair Loss Association, “it's not the amount of circulating testosterone that's the problem but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.” This process of hormonal thinning of the hair is called Andogenetic Alopecia and can effect both men and women.
1) Hormonal imbalances
Hormonal imbalance is main cause of hair loss in men. The presence of increased 5a-reductase activity and dihydrotestosterone levels in hair follicles can result in hair loss. 5a-reductase is an enzyme which converts testosterone to DHT. Research found that men with balding scalps had significantly higher numbers of 5a-reductase in their scalp. (Kaufman, 1996)
Low thyroid function (hypothyroidism) was found to be associated with hair loss. Your thyroid controls your metabolic rate and the production of energy in your cells. (Freinkel, 1972)
3) Chronic inflammation of the hair follicle is also considered to be a contributing factor in the development of hair loss. Chronic inflammation can potentially cause damage to all cells in your body, including your hair. (Chittur, Parr, & Marcovici, 2011)
4) Emotional stress was found to play a role in hair loss. A study found that chronic stress can trigger an inflammatory process that will contribute to androgenic hair loss. (Thornfeldt, 2008)
5) Nutritional deficiency can cause hair loss. A study found that supplementation of omega 3+6 and antioxidants, as a daily dose of 460 mg fish oil, 460 mg blackcurrant seed oil, 5 mg Vitamin E, and 30 mg Vitamin C, led to reduction in hair loss with 89.9% of participants, as well as an improvement in hair diameter and hair density. (Le Floc'h, 2015) Another study found deficiencies of amino-acids (protein) among men and women with all types of hair loss. (Gowda, 2017)
6) In women, hair thinning and loss can also be caused by iron deficiency. A study published in 2009 found that serum ferritin (your body’s iron storage) levels below or equal to 30 ng/mL are strongly associated with hair loss. (Moeinvaziri et al., 2009).
What else can hormonal deficiency do?
In the long term, excessive conversion of testosterone to DHT can cause additional problems (please see table below). Among them are growth of prostate, and an increase of risk for developing heart conditions. A study that evaluated the association between heart conditions and male type baldness found vertex baldness is associated with an increased risk of Coronary Heart Disease (CHD). Frontal baldness was not associated with CHD. (Yamada, 2013)
How do I reverse hair loss?
Blocking the conversion of testosterone to DTH should reduce hair loss, the risk of prostate cancer, and other problems caused by excess DTH. Lipidosterolic extract of was found to effectively inhibit both type 1 and type 2 isoenzymes of 5α-reductase. This means that it will block the action of the enzyme that converts testosterone to DTH. Saw palmetto was also found to inhibit binding of DHT to androgen receptors.
How much should I take?
Studies on the use of Saw Palmetto, show that the levels in blood reduce by 50% after 1.5 hours of consumption. (Plosker & Brogden, 1996) This indicates that it should be consumed several times a day for maximum results. I recommend to take 500mg three times a day.
I recommend the following supplements:
For men: Use Saw Palmetto (Serenoa Repens) to prevent the conversion of testosterone to Dihydrotestosterone (DHT). As I recommended above, using 500mg three times a day between meals should work for most people.
High quality protein, preferably collagen protein. Use minimum 5g daily in smoothies.
Antioxidants, vitamins, and minerals from a ‘whole-food’ supplement, NOT a synthetic product. I recommend Super-food by Amazing Grass 2 spoons daily.
Biotin is also recommended, as studies show that biotin deficiency is associated with hair loss. (Trüeb, 2016)
Check your thyroid using the FULL panel, not just the basic panel offered by most doctors. For more information on what to check, read my article about checking your thyroid.
Manage stress properly. Stress can induce inflammation which is harmful for the hair. Use yoga, meditation, rest, and doing things that you love to reduce stress.
Supplement with omega 3 fish oil (or from seaweed for vegans or vegetarians). The daily dosage is 2g minimum. Omega 3 is beneficial to reduce inflammation and to nourish the cells.
Get enough sleep. This is very important since our hormonal cycles is connected to our biological clock. Going to sleep on time, meaning from 9pm to 11pm, and getting 7 to 8 hours of sleep is important to support your hormonal system.
Chinese herbal medicine has been used for thousands as part of Asian medicine. Several herbs have been prescribed by doctors of Chinese medicine for the treatment of hair loss. One of the these herbs is Polygonum Multiflorum, also called He Shou Wu (or Fo-Ti). He Sou Wu contain high levels of resveratrol, a powerful antioxidant. Animal studies showed that topical application of He Sou Wu is effective in promoting hair growth. (Finney-Brown, 2011)
Please note that although some Chinese herbs can be bought online, they can be harmful if used incorrectly. Although high quality He Sou Wu is safe in the hand of an experienced provider, several cases of liver damage were reported in China after the use of this herb. (Xiang, 2015) Therefore, I recommend to use He Shou Wu only under the supervision of an experienced healthcare provider.
Other Chinese herbs that are recommended from my experience to help with hair loss:
Ganoderma lucidum or Reishi mushroom
Schisandra chinensis or Wu Wei Zi
Ligustrum lucidum or Nu Zhen Zi
Salvia miltiorrhiza or Dan Shen
Codonopsis pilosula or Dang Shen
Rehmannia glutinosa or Shu Di Huang
Cortex Cinnamomi or Rou Gui
Radix Albus Paeoniae Lactiflorae or Bai Shao (White Peony Root)
Remember that some people will need several supplements and some people will need herbs, supplements, and lifestyle change to see results.
How much time will it take to see results?
Most of the research that I reviewed and was successful in reversing hair loss was conducted over several months, usually 3 to 6 at least. From my clinical experience, given the right protocol, supplements, and herbs, you should see a noticeable reduction in hair loss within 2 to 4 weeks. Remember to use all the treatment protocols that I give you, with the supervision of a healthcare provider that has experience with treating hair loss. Picking just one from the list, for example, just consuming omega 3 or supplementing with Saw Palmetto might not be enough to support the growth of new follicles of hair.
NOTE: This article is not intended to diagnose or treat anybody. Please consult a licensed healthcare provider before using any of this information.
American Hair Loss Association. Causes of Hair Loss. Accessed online: http://www.americanhairloss.org/women_hair_loss/causes_of_hair_loss.asp
Chittur S, Parr B, Marcovici G. Inhibition of inflammatory gene expression in keratinocytes using a composition containing carnitine, thioctic Acid and saw palmetto extract. Evid Based Complement Alternat Med 2011; 2011: 985345.
Finney-Brown, T. (2011). Polygonum and hair growth. Australian Journal Of Medical Herbalism, 23(4), 184-185.
Freinkel RK, Freinkel N. Hair Growth and Alopecia in Hypothyroidism. Arch Dermatol. 1972;106(3):349–352.
Gowda, D., Premalatha, V., & Imtiyaz, D. B. (2017). Prevalence of Nutritional Deficiencies in Hair Loss among Indian Participants: Results of a Cross-sectional Study. International Journal Of Trichology, 9(3), 101-104. doi:10.4103/ijt.ijt_48_16
Kaufman K. Androgen metabolism as it affects hair growth in androgenetic alopecia. Dermatol Clin 1996;14:697-711.