Good nutrition, low stress and invigorating scalp massages may help you keep your locks longer.
The men in my family have stoically accepted their early hair loss. Finding no suitable alternative, my father and brother compensate by sporting dashing beards. But when my mother’s once thick hair began to thin, around age 50, she anxiously searched for a solution. “My doctor told me my thyroid medication would take care of it, but it didn’t,” she says. “So I picked up a bottle of Rogaine; but after reading the label for possible side effects, I said, ‘No thanks, I’ll leave the facial hair [a potential side effect] to the men.’”
The most common form of hair loss is hereditary (androgenetic alopecia), so my family’s fate could eventually affect me—and more likely my two sons. While men have a 50 percent chance of losing their hair by age 50, up to 25 percent of premenopausal women and 38 percent of postmenopausal women will lose some, too. Men typically lose it from the temple and crown, known as male pattern baldness (MPB), while women lose it diffusely over the front and top of the scalp, known as female pattern baldness (FPB).
New research published in the American Journal of Human Genetics finally identified the culprit—a gene variant related to male sex hormones that is located in the X chromosome, so we really can blame mothers, at least
partially. “The problem is that even if you are in perfect health, you can still lose your hair from MPB or FPB because, no matter what you do, it’s genetically programmed to happen,” says Ted Daly, MD, dermatology director at Nassau University Medical Center in East Meadow, N.Y.
If balding is part of your family history, take heart. Hereditary hair loss happens gradually, so attacking the problem early can sometimes slow the process. In addition, not all hair loss is hereditary, so hair loss that looks like MPB or FPB may actually have a combination of causes—many of them reversible. For example, the root cause of my mother’s thinning hair could be heredity, or it could be her hypothyroidism coupled with certain medications she takes. Dietary deficiencies could also exacerbate it.
Hair loss is a common side effect of prescriptions like oral contraceptives, acne medications, antidepressants, blood thinners and a host of others. Trauma and deep-rooted stress can cause hair to fall out by the handfuls (called telogen effluvium), and an autoimmune condition called alopecia areata causes hair to fall out in patches. In addition, tight hairstyles like cornrows and over-processing such as frequent straightening can damage hair follicles or fibers, resulting in hair loss. Different causes call for different solutions, so see a health practitioner well-versed in hair loss issues for an accurate diagnosis (see “Tress Tests” below).
Feed your follicles
While no one solution exists for every type of hair lossa well-balanced diet is key for normal growth. “If you’re eating too much or too little protein, or if you’re eating bizarrely, like peanut butter and jelly sandwiches all day, all the time, that by itself can lead to hair loss,” Daly explains. After testing for deficiencies, Daly often recommends supplemental zinc, copper, iron, vitamin B-12, biotin (vitamin B-7, also known as vitamin H) and/or calcium.
“We know that in certain types of hair loss the zinc level is normal, but a low normal,” Daly says, although scientists have yet to clarify the link. The typical dosage (what is known as the dietary reference intake or DRI) for zinc is 15 mg but, when hair loss is an issue, Daly often recommends 50 to 80 mg per day for six months.
A copper deficiency can also cause hair loss. “We don‘t usually screen for copper, but if you take high doses of zinc to help with your hair, it can actually induce a copper deficiency,” Daly adds. The DRI for copper is 3 mg, but for people taking zinc for more than six months, he often prescribes a zinc supplement with added copper (1.5 mg of copper per day). Iron, too, is important: “Often the cause is low ferritin, and I‘ve seen good growth in two months for many people after improving iron stores,” Daly says. His prescription usually contains the standard iron DRI (10 to18 mg). “People with hair-loss problems also tend to be deficient in vitamin B-12, even though they don‘t show other symptoms,” he adds. Along with the DRI of B-12 (3 to 4 mcg), Daly recommends a multivitamin thatcontains the DRI of other B vitamins for balance.
“Biotin, part of the vitamin B complex known for thickening nails, has never been scientifically measured for thickening hair, but nails and hair are the same type of keratin (a cellular protein), so it‘s becoming standard practice to add biotin for hair growth—it‘s safe, water soluble and has no side effects, even at extremely high doses,” Daly says. The DRI is 300 mcg, but Daly often prescribes as much as 2,400 mcg per day.
Calcium is also a component of nails and hair. “There is some thought that a hormone made by the thyroid, called calcitonin gene-related peptide (CGRP), helps hair to grow. Taking calcium helps keep your thyroid in good shape because the cells that make CGRP also make calcitonin, which is a hormone that regulates calcium,” Daly says. The DRI for calcium is 800 to 1,500 mg. Daly prescribes 600 mg twice per day along with the DRI for vitamin D, 400 IU per day, for absorbency.
When low thyroid is the problem, the minerals iodine and selenium may help, according to Phyllis Light, an herbalist in Birmingham, Ala. Iodine is not assimilated easily, so Light suggests getting iodine from the sea vegetable kelp. “People with low thyroid also generally have problems with digestion, so they can also benefit from a good digestive enzyme, too,” Light says.
A pinch of prevention
Good thyroid function also depends on a healthy liver. “When our livers aren’t healthy, we don’t metabolize thyroid hormones,” says Light, who recommends supporting the liver with 350 mg to 425 mg milk thistle (Silymarin) three times per day and 500 mg yellow dock (Rumex crispus) once a day. “These herbs will also help moderate low blood sugar, which can increase energy levels,” she adds.
Other organs also play a role in hair health. Long-term stress can weaken the kidneys and adrenals. According to Light, “During deep and long-standing stress, the body’s resources get diverted to the organs and hair comes way down on the priority list for nutrients and energy.” Mineral-dense herbs that support the kidneys and adrenals are ashwagandha (Withania somnifera); chickweed (Stellaria media); cleavers (Galium aparine); horsetail (Equisetum arvense); parsley root (Petroselinum crispum); queen of the meadow (Filipendula ulmaria); and eleuthero (Eleutherococcus senticosus), formerly known as Siberian ginseng.
Herbs also can prevent hair loss in men and women by balancing hormones. Saw palmetto (Serenoa repens), which protects the prostate, may have a strong ability to slow the progression of MPB. “How strong is unknown, but clearly it does have an effect similar to finasteride [with the brand names of Propecia and Proscar], the FDA-approved hair loss drug for men,” Daly says. Light also recommends stinging nettles (Urtica dioica), another mineral-rich herb that supports the prostate and helps balance male hormones (in both men and women).
For women, phytoestrogen herbs like black cohosh (Actaea racemosa) and dong quai (Angelica sinensis) can help ease menopausal discomforts, including thinning hair. “In menopause, the ovaries stop making estrogen and the adrenals and fatty tissue start making it, so if you’re going into menopause all stressed out or with adrenal insufficiency, hair loss is a real possibility,” Light says.
Massage your mane
The Indian medical system of Ayurveda looks at hair health in terms of balancing the life energies within the three body constitutions or doshas, Vata, Pitta and Kapha. “Ayurveda identifies the problem as excessive Pitta dosha, and its hair loss prevention strategy is aimed toward reducing Pitta dosha in the hair follicles,” explains Scott Gerson, MD, PhD, medical director of the National Institute of Ayurvedic Medicine in Brewster, N.Y. Gerson suggests pacifying Pitta dosha with a scalp massage before bedtime, both for healthy hair and to prevent common hair loss. Mix either oil of bhringaraj (Eclipta alba, E. erecta) or brahmi, commonly known as water hyssop (Bacopa monnieri) with a small amount of coconut oil; massage and leave on until morning (you can wear a cotton bandana or woolen cap to protect the pillow).
Whether a simple scalp massage, a change in diet or a way to manage stress and chronic diseases can help return anyone’s hair to its former glory depends on a lot of factors, but Daly suggests keeping an open mind when it comes to alternative therapies. Everyone’s hair loss is different, so you may have to try a few things to see what works for you.
A detailed health history and exam may be all that’s needed for diagnosis, but a dermatologist or health practitioner who treats hair loss may perform a combination of the following tests:
• Hormone levels (testosterone)
• Thyroid stimulating hormone (T3, T4, TSH)
• PTH (parathyroid)
• Ferritin (iron)
• Vitamin B-12
• Hair pull (one to three hairs per pull is normal)
• VDRL (for syphilis; a secondary symptom of syphilis is a type of hair loss known as moth-eaten alopecia)
• CBC (Complete blood count)
• Densitometry (for hair shaft miniaturization)
• ANA (for lupus, which often causes diffuse hair loss)