Hair disorder, especially when severe, often profoundly affects the lives of those afflicted. Severe hair loss evokes not only cosmetic concerns but may also evoke feelings of vulnerability (nakedness), loss of self-esteem and alterations in self-image.
Each hair follicle produces hair in phases. There is a growing (anagen) phase, which lasts from 2 to 6 years, a resting (catagen) phase which lasts for about 3 months, and finally the shedding of the hair (telogen) phase which allows the follicle to begin pushing a new hair to the surface.
By far the most common form of hair loss is determined by our genes and hormones: Also known as androgen-dependent, androgenic, or genetic hair loss. It is the largest single type of recognizable alopecia to affect both men and women. It is estimated that around 30% of Caucasian females are affected before menopause. Other commonly-used names for genetic hair loss include common baldness, diffuse hair loss, male or female pattern baldness.
Most modern medical research leans toward the position that a male hormone called dehydrotestosterone (DHT), which is converted from testosterone, binds to sites on hair follicles and is a primary instigator of hair loss. DHT appears to make the follicles go into their “resting” phase faster which in turn starts to cause the hairs produced by those follicles to become thinner and thinner with each growth cycle. Studies show that while balding men don’t have higher than average circulating testosterone levels, they do possess above-average amounts of DHT in the scalp follicles.
Genetics and hormones have a part to play in this: each hair follicle appears to have a predetermined number of sites that DHT can bind to. In one study which compared the follicles between hairy and bald human male scalps, the bald scalps had twice as many binding sites for DHT as did their hairy counterparts.
Poor circulation and nutrition can also hamper hair growth. A study of young men diagnosed with male pattern baldness showed that the blood flow to their scalps was on average 2.6 times lower than in a control group. In many individuals the extremities, including the top of the head, are the most difficult places in the body for blood to reach. Follicles which are constantly deprived of blood, and therefore nutrients, cannot produce hair properly.
Male Pattern Baldness
Beginning as early as the late teens or early twenties, by age 35 to 40 two thirds of Caucasian men experience some hair loss. This type of baldness is largely hereditary. Hair becomes finer and does not grow as long as it once did. The hair on the crown of the head begins to thin out and over time there develops a horse-shoe pattern of hair around the sides of the head. Any remaining hair in the balding areas usually manifests some miniaturization – it is thinner and grows at a below-normal rate, changing from long, thick, coarse, pigmented hair into fine, unpigmented sprouts.
One plausible theory to explain some of the difference between men and women is based on the angle of follicles and resultant sebum build-up. The angle at which hairs come out of a female scalp allow the sebum (oil produced by the scalp) to “run off” whereas the angle of hairs on a male scalp (straight up) can lead to oil blockage.
Recently, a group of Japanese researcher reported a correlation between excessive sebum in the scalp and hair loss. Excessive sebum often accompanying thinning hair is attributed to an enlargement of the sebaceous gland. They believed excessive sebum causes a high level of 5-alpha reductase, the enzyme which converts testosterone into dihydrotestosterone (DHT), and pore clogging, thus malnutrition of the hair root and a shift into the resting phase.
Although this condition could be hereditary, they believe diet is a more likely cause. The researchers note that Japanese hair was thick and healthy, with a small gland and little scalp oil, until large amounts of animal fat crept into their diet after World War II. This change has led to a significant height increase in the Japanese population, but it has also resulted in more Japanese men losing hair. To some extent, their observation makes sense: problems with greasy hair have often been noted as much as six months to a year prior hair thinning becoming noticeable. However, this might just be one of the symptoms instead of an underlying cause, so more research is needed.
Most doctors agree that if you have a oily scalp with thinning hair, frequent shampooing is advised. shampooing can reduce surface sebum, which contains high levels of testosterone and DHT that may reenter the skin and affect the hair follicle.
Specific foods or vitamins don’t regrow hair, although good nutrition is essential for healthy hair.
Signs, symptoms & indicators of Male Hair Loss
No hair loss
Risk factors for Male Hair Loss
Lupus, SLE (Systemic Lupus Erythromatosis) / Risk
Alopecia occurs in 27 to 50% of patients. Typically manifested as reversible hair thinning during periods of disease activity, it is demonstrated by the ease with which hair can be plucked from the scalp and the development of “lupus hairs” (i.e. short strands at the scalp line). Following an acute attack of SLE, usually with fever, patients may experience much generalized hair loss. This results from a period of arrested hair growth during the acute episode.
Mercury Toxicity / Amalgam Illness
Mercury toxicity can cause hair loss.
Hypothyroidism
In rare cases, diffuse hair loss may be the only symptom of hypothyroidism, but in many people with hypothyroidism the hair is not affected. Once thyroid hormone is administered, regrowth of hair occurs in approximately 2 months.
Hypothalmus / Pituitary / Pineal Function
Any condition that upsets the adrenal or pituitary gland may result in hair loss.
Vitamin A Toxicity
Vitamin A toxicity symptoms include skin that has a rough and dry appearance, hair loss and brittle nails.
Zinc Requirement
See the link between Hair Loss and Manganese.
Manganese Requirement
Mineral metabolism of 19 patients with hair loss was examined. The analysis showed manganese deficiency in all 19. Eighteen patients showed considerable problems with calcium absorption, and twelve patients had problems with their zinc metabolism. Specific nutritional and mineral therapy resulted in improved hair growth after 2-3 months of treatment. [Blaurock-Busch, E. Wichtige Nahrstoffe fur Gesunde Haut und Haare, Kosmetik Internat. 3/87]
Calcium Requirement
See the link between Hair Loss and Manganese.
EFA (Essential Fatty Acid) Requirement
Essential fatty acid deficiency can results in dry, brittle hair and hair thinning or loss.
History of severe hair loss
Male Hair Loss suggests the following may be present
Vitamin A Toxicity
Vitamin A toxicity symptoms include skin that has a rough and dry appearance, hair loss and brittle nails.
Increased Risk of Coronary Disease / Heart Attack
A Harvard study found that male-pattern baldness may be a marker for increased risk of coronary heart disease. Severe hair lose on the top of head resulted in a 36% increased risk. The risk became lower with less hair loss. [Archives of Internal Medicine, Jan. 24, 2001]
Recommendations for Male Hair Loss
Saw Palmetto (Serenoa repens)
This extract has been found to counteract the conversion of testosterone to DHT by inhibiting DHT binding to cellular and nuclear receptor sites, thereby increasing DHT breakdown. The dosage of fatty acids from saw palmetto is 270-300mg daily. This can be obtained from 320mg of a standardized extract or 3gm of dried saw palmetto berry. These doses have been found to be safe in many studies.
Grape Seed Extract / Resveratrol
A mouse study has shown improved hair growth with the use of topical procyanidins (grape seed extract). [J Invest Dermatol 1999 Mar;112 (3): pp.310-6]
The active ingredients of Revivogen are natural compounds proven to inhibit of 5-alpha-reductase (the enzyme that produces DHT), block the androgen receptors and stimulate hair growth. These active ingredients include Gamma Linolenic acid (GLA), Alpha Linolenic acid (ALA), Linoleic Acid, Oleic Acid, Azaleic acid, Vitamin B6, Zinc, Saw Palmetto Extract, Beta-Sitosterol and Procyanidin Oligomers.
Green / Oolong / BlackTea (Camellia sinensis)
Of interest to those with androgenetic alopecia is evidence that green tea can influence serum concentrations of hormones. High intake of green tea has been associated with higher levels of sex hormone binding globulin (SHBG) and lowered levels of serum estradiol (estrogen) concentration in women. Increased SHBG may be of help in reducing the effects of androgenetic alopecia (pattern baldness).
Radix Urticae
It is possible that radix urticae influences the activity of sex hormone binding globulin and its binding to testosterone. [Blutplasmas 1983] Because of this small amount of evidence some people have taken radix urticae as an alternative treatment for androgenetic alopecia. The true potential of radix urticae to treat pattern baldness is unknown.
Animal/Saturated Fats Avoidance
Researchers in one study noted that Japanese hair was thick and healthy, with a small gland and little scalp oil, until large amounts of animal fat crept into their diet after World War II.
Pumpkin Seeds
Pumpkin seed oil may affect the activity of testosterone in the body in similar fashion to saw palmetto. While pumpkin seed products are under investigation for their beneficial properties so far, no experiments have been reported that directly relate to androgen activity in disease.
Conventional Drugs / Information
A 5-year clinical study demonstrated that 9 of 10 men on Propecia had visible results (either regrowth of hair (48%), or no further hair loss (42%) compared to 25% on placebo, according to an assessment of photographs by an independent panel of dermatologists.
2 of 3 men on regrew hair, as measured by hair count. All the men in the study who were not taking Propecia lost hair.
A majority of men on Propecia were rated as improved by doctors – 77% vs 15% with placebo.
A majority of men on Propecia reported their bald spot getting smaller, their hair loss slowing down, and the appearence of their hair improving.
In the first year of the study, 86% of men on Propecia maintained hair or increased the number of visible hairs vs 42% on placebo.
Less than 2% of men experienced less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen. When the men who had these side effects stopped taking Propecia, the side effects went away.
Keep in mind that hundreds of different prescription drugs have been linked to hair loss!
Test / Monitor Hormone levels
There have been several reports that supplemental DHEA has accelerated hair loss in susceptible men and women. Hormone level testing is advised prior to hormone use.
Colloidal Silver
Colloidal silver is believed to increase the effectiveness of Serenoa Repens.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
Glossary
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Alopecia
Loss of hair.
Menopause
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
DHT
Dihydrotestosterone - a highly active form of testosterone, which influences many aspects of manly behavior, from sex drive to aggression. The conversion from testosterone to DHT is driven by an enzyme called 5-alpha reductase, which is produced in the prostate, various adrenal glands, and the scalp.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Sebum
The oily liquid covering the skin surface.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Hypothyroidism
Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.
Thyroid
Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Vitamin A
A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.
Manganese
An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.
Mineral
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Essential Fatty Acid
(EFA): A substance that the human body cannot manufacture and therefore must be supplied in the diet.