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Hair Loss Causes and Treatment Options

Not a day goes by without at least one patient reporting significant hair loss. Hair loss can be very distressing for both men and women, often associated with a decrease in self-confidence and sometimes requiring a change of hair style to try to compensate for the loss. If you're looking for hair loss treatments in Minneapolis, please reach out to learn more.


So, let’s talk about hair loss.


What is considered an abnormal amount of hair loss? Average daily hair loss is anywhere from 70-100 hairs/day. (Keeping in mind, in people with longer hair it will look like they are losing more hair since those 70-100 hairs can make a huge hair ball in the shower!) But hair loss becomes abnormal when someone is consistently losing greater than 100 hairs a day.


Causes of Hair Loss


There are numerous causes of hair loss. Most non-traumatic hair loss is related to nutritional deficiencies, hormone imbalances, and aging.


Adequate nutritional status is needed for healthy hair growth. Protein malnutrition can cause hair to become brittle and fragile. The sulfur containing amino acids cysteine and methionine in protein are needed to build hair keratin. Fats are needed to support hormone synthesis (important for hair growth) and are also important for hair hydration. However, excessive intake of saturated and omega 6 fatty acids, as well as simple carbs, can be pro-inflammatory for skin and hair, increasing sebum production and potentially causing keratinization disorders of the hair. Regarding vitamins, there are several vitamins that play important roles in hair growth and hair maintenance. Vitamin A, B vitamins (B3/niacin, B5/pantothenic acid, B6/pyridoxal phosphate, B7/biotin, B9/folate, and B12/cobalamin), vitamin C and vitamin D are all important for hair health. Minerals that support hair growth include iron, zinc, copper, selenium, magnesium, calcium, and silicon. Additionally, the antioxidant polyphenols (ex. green tea and various herbs) can also boost hair’s condition. *Keep in mind, vitamins A and D are fat soluble and accumulate in the body, iron excess is pro-inflammatory, and selenium toxicity can cause hair loss, so it is important to discuss all your supplements and dosages with your physician.


No doubt, significant hair changes occur around puberty, pregnancy, postpartum, middle age, menopause, and older age. These milestones in life are accompanied by hormonal shifts. Androgens (testosterone, dihydrotestosterone, DHEA, androstenedione) are responsible for changing our baby soft hairs into dark, course hairs on the face, axilla, chest, and pubic areas during puberty. However, those same androgens unfortunately have an inhibitory effect on scalp hair. The very potent androgen, dihydrotestosterone, is responsible for much of male-pattern baldness and is converted from testosterone by an enzyme called 5-alpha reductase. This is the enzyme that the hair loss medication finasteride (Propecia) blocks. There are also several herbal supplements that are mild 5-alpha reductase inhibitors as well. Although testosterone is best known for its effects on hair, both estrogen and progesterone also affect hair growth. Estrogen effects are still being studied, but we know decrease in estrogen post-partum and during menopause cause hair loss, and progesterone decreases androgen synthesis and 5-alpha reductase activity at the hair follicle, supporting hair growth.

Hair loss is one of the many frustrating symptoms that can accompany hypothyroidism. Thyroid hormones can length the growing phase of hair, as well as support the pigmentation of hair.


And of course, no hair loss talk would be complete without talking about stress. We all have heard the statement “I’m so stressed my hair is falling out!”. Unfortunately, there is some truth to that. Corticotropin-releasing hormone (CRH), a hormone the brain releases to drive the stress response, inhibits the growth of keratinocytes and pushes hair prematurely into the resting state.


Aging is one aspect of our health that we cannot control, and although much of hair loss with aging is related to hormonal shifts, there is an incremental decrease in body hair with age that cannot be solely explained by hormone changes.




Treatment Options for Hair Loss


So, what can be done about hair loss? I like to approach hair loss with patients by looking at all the above factors and see if one or more may be contributing to their hair loss. It is always best to start with the underlying root cause(s). Depending on the cause of the hair loss, there are supplements, both oral and topical, that can help support hair growth. There are also medications, both commercially available, as well as compounded medications, to support hair growth. One of my favorite approaches is to personalize a combination of supplements and tailored medications to address hair loss from multiple angles. And for substantial, permanent hair loss, there is always the option to consult with a hair transplant physician.


*And one last note! Keep in mind, the entire hair cycle lasts from 2-8 years, with the resting phase prior to shedding lasting about 3 months. So, you need to give any treatment at least 3 months, and preferably longer, before any improvement can be seen.


If you would like to discuss non-surgical hair loss treatment options in Maple Grove, Minnesota, please reach out to me at Twin Cities Integrative Medicine.


Resources


Goluch-Koniuszy ZS. Nutrition of women with hair loss problem during the period of menopause. Prz Menopauzalny. 2016 Mar;15(1):56-61. doi: 10.5114/pm.2016.58776. Epub 2016 Mar 29. PMID: 27095961; PMCID: PMC4828511.


Grymowicz M, Rudnicka E, Podfigurna A, Napierala P, Smolarczyk R, Smolarczyk K, Meczekalski B. Hormonal Effects on Hair Follicles. Int J Mol Sci. 2020 Jul 28;21(15):5342. doi: 10.3390/ijms21155342. PMID: 32731328; PMCID: PMC7432488.


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