Supplementing Your Diet to Help Slow Hair Loss : Eating healthy to preserve and protect your hair , Exploring alternative hair loss treatments: Oils and herbs and Staying informed about unproven hair loss treatment ingredients

Supplementing Your Diet to Help Slow Hair Loss

In This Chapter

• Eating healthy to preserve and protect your hair
• Exploring alternative hair loss treatments: Oils and herbs
• Staying informed about unproven hair loss treatment ingredients

Everything in your body — including your hair — maintains its health and vitality thanks to what you put into it. Can you

avoid baldness forever by consuming enough protein, vitamins, and minerals? Probably not (forever is a tall order, after all), but you may be able to slow or avoid hair loss caused by nutritional deficiencies — and you can keep the hair you have looking healthy and at its best.

In this chapter, we start with the big picture of how diet and nutrition affect hair. Then we explain the affects of various vitamins and minerals and look at ancient remedies for hair loss and the treatments still used today in traditional Chinese and Indian medicine.

Although there hasn’t been a great deal of scientific research into whether herbs and oils delay or prevent hair loss, the treatments we describe have been used for many years in alternative medicine. We also warn you about treatments that don’t work — and that could be harmful to your health.

Eating Your Way to Healthy Hair

Everybody knows that eating well is essential for a healthy heart, bones, and other key body systems, but you may not realize that a

lack of protein, good fat, vitamins, and minerals can affect what

grows out of the top of your head as well. Hair needs to be fed — and fed well — to keep growing and to stay put. A steady diet of junk food isn’t healthy fodder for your hair.

People who don’t eat meat or dairy products may be missing out on important vitamins and minerals necessary for hair health.

Pumping up calories and proteins

It’s well documented that a diet deficient in calories or protein can contribute to hair loss or hair that doesn’t look healthy and vibrant. For example, patients with anorexia nervosa, a disease in which the patient consumes too few calories to sustain good health, often experience hair loss. Hair without good luster doesn’t feel good when you run your fingers through it, or it may be brittle and break off easily — all may reflect a nutritional problem with your diet.

You can get most of the amino acids your body needs from a proper, well-balanced diet, but others are harder to absorb from the diet, especially as you get older. For some people, protein supplements may have a beneficial affect on hair growth.

Adequate protein intake is critical for hair growth including amino acids, which include lysine, arginine, cystine, cysteine, and methionine. These amino acids are created by the body from the proteins we eat. If you eat protein rich foods, you get enough of these essential amino acids, but if you don’t, supplements may provide some of them. The essential amino acids are found in lean meats, nuts, grains, soy, fish, eggs, and dairy products.

Two sulfur-containing amino acids, methionine and cysteine, are most important for maintaining hair health because human hair requires sulfur for normal growth. (The body also requires sulfur for healthy connective tissue formation.)

•  Methionine: Methionine is an essential amino acid that your body doesn’t produce, so it must come from your diet or from supplements. Foods rich in methionine include sesame seeds, fish, meats, and some other plant seeds.

The current recommended dose of methionine is 250 milligrams per day. Taking too much of this amino acid can cause toxicity because methionine is broken down into homocysteine, which can lead to heart disease.

•  Cysteine: Cysteine supports hair growth by providing sulfur to replicating hair follicle cells. It’s a non-essential amino acid, which means that your body can make it on its own. Cysteine also is found in most high-protein foods, including eggs, milk, whey protein, some cheese, chicken, turkey, and duck. Vegetarian sources include red peppers, garlic, brussel sprouts, oats, and wheat.

The recommended dose of cysteine is 100 milligrams per day. Supplementing your diet with cysteine has the affect of increasing the sulfur percentage in hair, which has been reported to increase the thickness and the strength of the hair.

Fitting in the good fats

“Good fats,” or essential fatty acids such as omega-3 and omega-6 oils, are essential for your body’s functioning but are only obtained through your diet — your body can’t manufacture these. You can get these essential fatty acids from fish (salmon, sardines, tuna), plant (flaxseed, soybeans, pumpkin seeds), and nut (walnut) oils, as well as in fish oil capsules.

After two to four months of essential fatty acid deficiency, people report hair dryness, change of hair color, scalp redness, and flakes. Consuming unsaturated fatty acids, for example fish oil or evening primrose oil, has been found to improve hair texture and scalp red- ness after a few months.

On the other hand, some people believe that a diet too heavy in saturated animal fat may contribute to hair loss. Evidence comes from the effects of dietary change seen in Japanese men. After World War II, more Japanese men started consuming greater amounts of saturated animal fats, and they also started complaining of hair loss. Although this interesting relationship doesn’t prove cause and effect, it does show one possible effect of diet on your hair.

In traditional Indian medicine, body weakness is believed to cause hair loss, and so one treatment consists of a diet rich in proteins, including meat, fish (source of essential fatty acids), and dairy products. Avoidance of fried foods (source of saturated fats) is also recommended.

Getting your daily vitamins

Vitamins are organic compounds necessary to sustain life. You need to get your vitamins from food or dietary supplements, because you can’t make them yourself. Most vitamins work to speed up critical chemical reactions in the body.

Vitamins are important nutrients for healthy hair. Don’t start taking vitamins by the handful to make sure you’re getting your daily requirement, though; doctors have linked hair loss to both deficiencies of some vitamins and excesses of others, and some vitamins can be dangerous to your overall health if you take too many.

The following sections run through the vitamins you need and the quantities that are helpful for your hair — and the rest of you!

Vitamin A

Vitamin A protects hair follicles from damage by free radicals, which are atoms with an unpaired electron. A diet deficient in vita- min A is also known to cause dry hair.

Too much vitamin A has been linked to hair loss. Vitamin A is a fat- soluble vitamin, which means that excess amounts are stored in the body and not washed out in urine, so it’s essential to keep vita- min A intake within normal limits.

Foods high in vitamin A include carrots, broccoli, and liver. The current recommendation of daily vitamin A intake is 900 micro- grams (mcg) (3,000 IU) for men and 700 micrograms (2,300 IU) for women.

B- complex vitamins

The B vitamins include thiamin, riboflavin, niacin, pyridoxine, cobalmin, and pantothenic acid. B vitamins are believed to con- tribute to the nourishment of the hair follicle.

You can get B vitamins from foods such as potatoes, bananas, tuna, and turkey. Deficiency in B vitamins has been associated with anemia and neurologic problems.

•  Biotin: Also known as vitamin H or B7, biotin is a water- soluble B-complex vitamin that’s required for cell growth, the production of fatty acids, and the metabolism of amino acids. An adequate amount of biotin is about 30 to 100 mcg daily. Biotin is found in many foods including beans, bread, fish, and legumes.

Biotin deficiency has been strongly linked to hair loss and, when severe, can even lead to loss of the eyebrows and lashes. Deficiency is rare but can be caused by excessive con- sumption of raw eggs, which contain high levels of the protein avidin, which strongly binds biotin.

•  Folic acid: This is the synthesized form of folate, which is important to maintain hair follicle cell division and growth. Rich sources of folate include leafy vegetables such as spinach, lettuce, dried beans, and other fruits and vegetables. The current recommendation for folate intake is 400 mcg per day. However, if you’re pregnant or nursing, you should ask your doctor for a recommended dosage.

Signs of folic acid deficiency include anemia, increased fatigue, sore tongue, and graying hair. There’s evidence that exposure to ultraviolet light, including the use of tanning beds, can lead to a folic acid deficiency. In addition certain medicines, such as methotrexate used to treat severe psoriasis and some forms of cancer, can lead to deficiency.

Vitamin C

Vitamin C is required to maintain healthy collagen in the connective tissue in your body and also around hair follicles. It also protects your cells because it’s a strong antioxidant (a substance that reduces damage caused by free radicals, which contribute to aging changes and can cause problems in many body systems).

Citrus fruit is a rich source of vitamin C. Currently, the recommended dose of vitamin C is 90 milligrams per day and no more than 2 grams per day.

The most famous condition associated with vitamin C deficiency is scurvy, which results when collagen stops functioning properly. Symptoms of scurvy include bleeding gums, nose bleeds, sunken eyes, dark purplish spots on the legs, pinpoint bleeding around hair follicles, as well as unique “corkscrew hairs.” Fortunately, this disease is rare in industrialized countries where fruits and vegetables are plentiful in the diet.

Vitamin E

Vitamin E is the collective name for a set of eight related fat-soluble vitamins with antioxidant properties. Vitamin E provides physical stability to cell membranes, including cell membranes of hair follicles. Nuts, corn, and asparagus are just a few foods with high vita- min E levels. The daily recommendation of vitamin E for adults is 8 to 10 mg.

Vitamin E deficiency is rare and usually manifests first with neurologic deterioration, such as loss of reflexes.

A recent study from Johns Hopkins University showed that taking vitamin E supplements in amounts greater than 400 IU a day may actually be harmful to your health, increasing your risk of death from a number of causes.

IU is dependent on the potency of the substance, and each sub- stance would have a different IU to milligram conversion. For example, 1,000 IU of Vitamin C would have a different weight than 1,000 IU of Vitamin A. Because each substance would have a differ- ent conversion ratio, we cannot state a conversion for IU to mil- ligrams that covers everything, or even most things. There are just too many different substances.

The Helsinki Formula failure

In the 1980s, niacin was combined with polysorbate 80 and vitamin B6 and marketed under the name Helsinki Formula. Heavy promotion led to the first large market for a hair loss product. The concoction proved to be ineffective, though, and the Helsinki Formula lost its $100 million market. But its marketing efforts opened eyes to a marketing field ripe with people willing to try anything to keep or replace their hair, which has spurred the development of hundreds of hair loss products and a billion-dollar business in the 21st century.

Minding your mineral intake

Minerals are inorganic elements that are essential to the functioning of the human body and are obtained from foods. Minerals necessary to maintain hair health include copper, iodine, iron, selenium, silica, and zinc. Table 10-1 lays them all out for you.

Oils, Herbs, and Extracts: Alternative Hair Loss Remedies

Concern over hair loss has plagued men and women for thousands of years, and hair loss remedies go back almost as far. The ancient Egyptians applied concoctions directly to the scalp or consumed them to try to combat the balding process. The famous Greek physician Hippocrates is rumored to have applied pigeon drop- pings to his scalp in hopes to regrow hair. And in colonial times, America’s balding forefathers donned white wigs to cover shiny scalps. There has been no lack of creative cover-ups or attempts to save rapidly receding hairlines over the years.

Here, we review some alternative, but not scientifically proven, methods of keeping hair where it belongs, including ancient Chinese and Indian oils and herbs.

Oiling it up

Oiling your hair may seem a little out of date, but over the years, many people have used oils to stimulate hair growth. For example, the ancient Egyptians were very concerned about maintaining thick hair and believed that castor oil applied to the scalp could stimulate hair growth. (They sometimes mixed it with sweet almond oil to improve the smell.) Ancient Indians and Polynesians used coconut oil, and ancient Africans used olive oil, all applied to the hair and scalp in an attempt to stimulate hair growth.

At least one current study shows that oil application can help with some specific types of hair loss. In 1998, researchers from Scotland published their results of a randomized, double-blind controlled study investigating aromatherapy in patients with alopecia areata, a condition in which the body’s immune cells start attacking healthy hair-producing cells. (We cover it in Chapter 5.)

In this study, 86 patients were placed into two different groups. One (the active group) massaged their scalps daily with four essential oils (thyme, rosemary, lavender, and cedar wood) in a mixture of jojoba and grape seed oils. The other group (the control group) massaged only jojoba and grape seed oils into their scalps daily. Each group massaged the oils into their scalps for a total of seven months.

Interestingly, 19 of 43 patients (44 percent) in the active group showed improvement compared with only 6 of 41 patients (15

percent) in the control group. The authors concluded that aromatherapy with these essential oils may be a safe and effective treatment for alopecia areata.

Helping hair with herbs

In recent years, growing concern about potential short- and long- term side effects of pharmaceuticals and conventional medical treatments have led to an increase in popularity of alternative medicines and herbal therapies. This trend affects all aspects of medicine, including increased interest in seeking herbal remedies for hair loss.

It’s important to remember that “natural” doesn’t always mean “harmless.” Also, there’s no way to be sure exactly how much herbal remedy is in a purchased product. Herbal products supposedly containing the same amount of medication have been found to vary considerably under testing.

Herbals aren’t like FDA-approved medicines, and few herbal remedies have been studied in a controlled fashion for hair loss. Many are advertised as miracle treatments with little evidence to sup- port the claims that they’re either safe or effective. This doesn’t mean that they don’t work to regrow hair, just that there’s not enough scientific evidence to support that claim.

The bottom line is this: Before you decide to ingest or topically apply something to any part of your body, including your head, don’t assume that product is safe just because it’s labeled “natu- ral.” The following sections get into a number of alternative medicines. Our goal in sharing this information isn’t to advocate the use, or disuse, of these products but merely to present them in as scientific a manner as possible.

Saw palmetto

Saw palmetto is a small plum plant endemic to the southeastern United States. It’s believed that the medicinal properties of the plant come from its brown-black berries.

Native Americans used saw palmetto to relieve urinary symptoms in older men who had difficulty urinating. Over the years, several studies have documented the effectiveness of saw palmetto in the treatment of benign prostate gland enlargement (BPH), and it’s used quite frequently in Europe.

Saw palmetto has also gained popularity as an herbal remedy for androgenic alopecia, or male pattern baldness, although there’s far less scientific evidence that it works to prevent hair loss.

Although the exact mechanism isn’t fully understood, several basic research studies have demonstrated that saw palmetto blocks the enzyme 5-alpha-reductase, which functions to convert testosterone to DHT, the male hormone responsible for male pattern baldness (see Chapter 4 for more about DHT).

Only one study examining saw palmetto to treat male pattern bald- ness has been published in the medical literature. In this small study, six out of ten subjects with androgenic alopecia who received saw palmetto benefited from the treatment. This is far too small a study to draw any conclusions on whether saw palmetto actually works to treat pattern hair loss.

Saw palmetto has several potential side effects. The most common are mild and include abdominal pain, diarrhea, nausea and vomiting, and constipation. Men taking saw palmetto have also reported erectile dysfunction, breast tenderness or enlargement, and loss of libido.

If you’re taking hormone medications for hair loss, such as Propecia, you shouldn’t take saw palmetto because combining these two may increase the way your body reacts to them. You also shouldn’t take saw palmetto without medical supervision if you’re on blood thinners, and the use of saw palmetto by pregnant or nursing women should be avoided as there has been no safety testing in this population.

Traditional Chinese medicine

Pattern baldness is relatively less common among the Asian population than among Caucasians; many believe this may be related to diet, although the Asian hair type and heredity may also play a part. Asians have a diet rich in vegetables and herbs, some of which may help fight hair loss.

Researchers have found that a series of amino acids found in legumes and vegetables inhibit the enzyme 5-alpha-reductase Type II, which converts testosterone to DHT, the male hormone responsible for male pattern baldness (see Chapter 4). Excess amounts of zinc taken in supplements can have the same effect. If these reports are accurate and reproducible, then the use of certain amino acids and zinc may slow down hair loss, much like the use of certain drugs such as finasteride and dutasteride.

Roasted sesame seeds are an herbal food used for hundreds of years in Chinese medicine. They’re believed to decrease hair loss and possibly stimulate hair regrowth.

The following sections take a close look at two Chinese herbal remedies with long histories.

He Shou Wu

Many believe that the Chinese herb He Shou Wu, also known as Polygoni multiflori or Fo Ti, stimulates hair growth and also converts fine vellus hair to thicker terminal hair. It may also delay natural graying. Practitioners of Chinese medicine use He Shou Wu for other conditions, such as strengthening weak bones, decreasing high blood pressure, and treating constipation. It’s also thought to have anti-aging properties.

To obtain a benefit from He Shou Wu, you have to ingest the root powder for several months. Known side effects include headaches and diarrhea.

Recently, the Medicines and Health Care Products Regulatory Agency (MHRA) in London released a warning about potential liver damage from the use of He Shou Wu. The MHRA advises that anyone with elevated liver enzymes or liver disease avoid this product until they discuss it with their doctor.

In 2002, a controlled clinical trial was conducted using a combination of oral tablets and lotion containing He Shou Wu. While the final groups were of very small sample size, results did favor the group who received the active herbal ingredients. However, you can’t draw any definitive conclusions from such a small study, and further research is needed to confirm the results.

Dabao

In 1991, researchers from the Netherlands studied the effective- ness of the Chinese herb extract Dabao for the treatment of male pattern baldness. In this study, 373 people with androgenic alopecia completed the full six-month trial. At the end of the study, the authors concluded that over a six-month period, Dabao has a (albeit modest) cosmetic effect superior to placebo.

Ayurvedic remedies

Ayurvedic medicine is an alternative medical practice based on the traditional medicine of India. The word Ayurveda is derived from a combination of two Sanskrit terms: ayu meaning “life,” and veda meaning “knowledge” or “science.” The practice of Ayurvedic medicine is believed to be over 5,000 years old in India, and it uses a number of herbs to help prevent hair loss, including

•  Bhringaraj (Eclipta alba), which is believed to promote new hair growth and also bring back natural hair color in people who are graying.
•  Gotu kola (Centella asiatica), very commonly used to treat hair loss as well as to stimulate brain cells, being believed to help with memory and longevity.
• Tridax procumbens, amalaki, sandalwood (Santalum), and licorice (Hlycyrrhiza glabra), all of which may stimulate hair growth.

In 2007 researchers in India tested the combination of extracts from three traditional Indian herbs to see what affects they would have on hair growth in rats. The topical formulation sped up hair growth on shaved rats, and analysis of the hair growth cycle after treatment revealed more hair follicles in the anagen phase, when hair cells grow rapidly, compared with controls.

Additional herbal remedies

•  Herbal tea: To treat hair loss, brew an herbal tea with a combination of nettle tea, sage, and rosemary. No time for a cup of tea? Apply the mixture directly to your scalp! (No, we’re not kidding.) No matter how you use it, herbal tea is thought to cause hair growth by improving blood flow to the scalp.
•  Procyanidin B-2: This extract from apples has been shown to promote hair growth in a laboratory study. Perhaps the old adage “An apple a day keeps the doctor away” may soon change to “An apple a day keeps the hair loss away!”
•  Procyanidolic oligomers (PCOs): Extracts from the French maritime pine bark and grape seeds belong to this family of antioxidant substances. One POC may have the effects of stimulating hair growth, but more studies are needed to confirm this.
•  Horsetail extract: This herb is a natural source of cysteine, selenium, and silica, which we discuss in the sections “Pumping up calories and proteins” and Table 10-1, earlier in this chapter.

Potions, Mixtures, and Other Dubious Products

We try to protect our patients from the unknown. When we don’t know something to be proven, we remind ourselves of how many undocumented side effects or enzyme defects occur that are

caused by natural herbs that could threaten a person’s health or life because they’re not researched or understood. For example, arsenic is a natural substance used historically to treat syphilis, but we wouldn’t recommend arsenic as an alternative to modern antibiotics, which are safe, well tested, FDA regulated, and accepted worldwide.

The supplements and substances listed in this section may not be covered in the FDA regulatory process that confirms dosages, purity, safety, and efficacy. The research and studies that show effi- cacy are often funded by the supplement manufacturers, which obviously may bias the reported results. Finally, the proper dosages for such products seem arbitrary and unproven. Just because the friendly neighborhood natural food outlet sales staff are dressed in white lab coats and attest to the efficacy of a homeopathic product doesn’t mean that these are safe and/or effective.

This exhausting — but not exhaustive — list of herbals, minerals, vegetables, and combinations of these substances may be pack- aged into products that make claims for hair regrowth:

•  Advecia: Herbal reported to be a hair loss vitamin.
•  Aloe vera: Plant extract with many uses reported in topical use. The leaf of the plant exudes a white, sticky substance that has been claimed to be a strong topical agent used for medicinal purposes.
•  Dehydroepiandrosterone (DHEA): Although suggested for hair growth, there are many reports that this hormone actu- ally causes hair loss, possibly working in a way similar to steroids.
•  Evening promise oil: Capsules contain gamma-linolenic acid, which is claimed to convert into hormone-like compounds that help regulate a number of bodily functions.
•  Fava beans: Fava is an herb widely used in Polynesia to treat anxiety. Though harmless, fava beans can cause death in very small quantities in people who carry a rare genetic defect.
•  L-Arginine: Homeopathic remedy thought to increase circulation to the scalp.
•  Lingzhi: Flat polypore mushroom used to treat hair loss, obesity, and liver disease in traditional Chinese medicine.
•  Methylsulfonylmethane (MSM): White, crystalline powder that’s odorless and nearly tasteless. It’s reported to be a sulphur-rich hair tonic in its cream form, but it’s also known to be quite smelly!
•  Nettle sting root: Reported effect on dihydrotestosterone (DHT) levels has also made it a treatment for hair loss.
•  Olive oil: Claims abound that it can grow hair, particularly when mixed with coconut oil and/or mayonnaise, heated, and rubbed into the scalp.
•  Soy extract: May arrest hair loss.
•  Tribulus terrestri and Ava Renewale: Reported natural Chinese herbs that seem to do everything and anything; they’re proposed as a cure for many conditions, including hair loss.
•  Wheatgrass: Young version of the common wheat plant that can be a source of vitamins A, B, C, and E; as well as calcium, magnesium, potassium, iron, natural enzymes, and chlorophyll.

The following items are manufactured products that may include the ingredients in the previous list:

•  Ervamatin: Hair lotion composed of herbs and plants from the Amazon rain forest.
•  Eucapil: Approved as a cosmetic hair care agent for topical use in the Czech and Slovak Republics.
•  Hairgenesis: Botanical that has claims of blocking DHT, a labeling violation under FDA labeling rules.
•  Himalaya Hair Loss Cream: An Ayurvedic preparation (refer to the earlier section “Ayurvedic remedies”).
•  Nutrifolica: Manufacturer claims this 100 percent pure herbal extract is designed to counteract hair loss causes such as poor scalp circulation, clogged hair follicles, and excessive sebaceous oil.
•  NutriSol-RM, or Scalp Med: Proprietary formulation packaged with essential amino acids and other agents. It claims to ensure optimal delivery of growth agents and nutrients to the matrix cells in the bulb of hair to revitalize the follicle, helping to grow hair.
•  Procerin: Invalid claim to be a vitamin for hair loss that’s specially formulated to block production of DHT, the primary cause of hair loss in men.
•  Provillis: Nutritional supplement claimed to contain all-natural herbal ingredients that aren’t specified.
•  Shen Min: Chinese medicinal line of natural dietary supplements designed to help reduce hair loss and enhance hair

growth in men and women. It’s a combination of “standardized” herbs such as He Shou Wu and horse chestnut extract with nutrients such as silica and biotin.

•  T Bomb 2: Product that claims to block estrogen and enhance testosterone and contains many and varied ingredients, making it potentially dangerous.