Losing Your Hair? Nutritional Status Matters

September 10, 2018 | Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

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 Losing Your Hair? Nutritional Status Matters
Hair loss or baldness of any type is often a source of embarrassment, social anxiety, or stress. But, it can be much more than that. Hair loss or alopecia is often the first sign of a systemic illness. Something else is going on with health inside the body and the hair loss is an outward manifestation of the changes. Nutritional insufficiencies and increased oxidative stress are at the core. If you have noticed hair loss, the clumps of hair in your hand or hair brush is a key sign that you need to give your overall health some much needed attention.

Common Types of Hair Loss


Several types of hair loss concerns exist. Common disorders include female/male pattern hair loss/androgenetic alopecia, alopecia areata, and telogen effluvium.

• Female/Male pattern hair loss and androgenetic alopecia are related with a positive family history for hair loss, starts at puberty or older, and relates to androgen and testosterone hormone levels. It is thought to be caused by increased sensitivity to DHT/dihydrotestosterone of the scalp follicles. Hair loss occurs gradually over time.

• Alopecia areata onset occurs abruptly. There is a personal or family history of autoimmune disorders.

• Telogen effluvium also occurs abruptly. It is triggered by iron deficiency, thyroid dysfunction, medications, general anesthesia, and childbirth.

Nutritional Status and Oxidative Stress at the Core of Healthy Hair or Hair Loss


There are two main factors - nutritional status and oxidative stress that affect hair loss of all types. A recent small cross-sectional study from September 2017 identifies several nutritional deficiencies that were common regardless of the type of hair loss or alopecia that occurred. Researchers evaluated female/male pattern/androgenetic hair loss, alopecia areata, and telogen effluvium. Results show a marked deficiency in several amino acids and key minerals. When nutritional status was restored, hair loss improved.

Oxidative Stress


Oxidative stress is the other factor that plays a role in the onset and management of hair loss. Our bodies are equipped to handle a certain amount of metabolic stress in all tissues. It is a tight-rope balance between antioxidants, cellular function, daily wear and tear, and ongoing inflammation management. However, if there is more wear and tear, tissue stress, and lack of adequate nutrients like antioxidants, excessive stress or oxidative stress takes a toll on the tissues. This includes the hair follicle, shaft and scalp.

Research published December 2017 found a significant correlation with antioxidants and hair. A group of men between the ages of 18-30 with early-onset androgenetic hair loss were evaluated for oxidative stress, total oxidant levels and total antioxidant levels. Results were compared to healthy men. The results showed much higher levels of oxidative stress in the younger individuals who had the earliest onset of hair loss and with a positive family history for hair loss. The authors’ conclusion was that improving antioxidant status could provide promising support for androgenetic alopecia especially for younger patients.

In alopecia areata, research shows that there is increased SOD/super oxide dismutase activity in the affected tissue. Increased SOD activity reflects increased activity of antioxidant enzymes working to manage oxidative stress. SOD activity also relies on vitamin C and lutein as found in a diet rich in fruits and vegetables. When SOD is lacking in the skin, collagen levels suffer. Collagen provides amino acids essential for hair, skin, and connective tissue structure. Vitamin E may also help manage oxidative stress to the hair and scalp making it beneficial for healthy hair.*

So Why Is Hair Loss So Important to Understand and Healthfully Manage?


Hair loss is more than just the loss of hair, emotionally challenging cosmetic changes, and keeping the top of the head warm. The presence of increased oxidative stress and nutritional deficiencies described above reflect the local stress response to the head and hair. It also signals the presence of underlying systemic disease. These hair loss disorders may be related with metabolic syndrome, PCOS/polycystic ovarian syndrome, thyroid dysfunction, anorexia/bulimia, infection (syphilis), ovarian or adrenal disorders, iron deficiency anemia, excess androgens and other underlying endocrine disturbances.

It may be related with autoimmune connective tissue disorders like SLE/lupus, dermatomyositis, and scleroderma. Alopecia areata may be the only apparent sign of gluten intolerance and Celiac disease. It may be a side effect of gastric bypass or gastric sleeve surgery as these bariatric management surgeries lead to numerous nutritional challenges. Even medical endocrine therapy (aromatase inhibitors and tamoxifen) used with breast cancer patients may cause pattern hair loss/androgenetic alopecia.

Thyroid and Hair Loss


Thyroid dysfunction has many symptoms including loss of hair. Thyroid disorders are at epidemic levels and affect all ages, including children. A December 2017 JAMA Dermatology publication found that 20 percent of pediatric patients who had alopecia areata had thyroid problems. Thyroid disorders ranged from hypothyroidism caused most commonly by Hashimoto’s, Grave’s disease, and subclinical thyroid dysfunction, i.e. borderline hypothyroidism or mild thyroid failure. The authors recommended “restriction of routine thyroid function lab tests” to only those with Down’s syndrome, personal history of allergies, a family history of thyroid disease, or the presence of a goiter rather than further investigation to include those with hair loss. However, you may want to be more diligent about this for you or your child as thyroid health affects everything in the body

Gluten intolerance, thyroid disorders and hair loss are often seen together and may be related with poor methylation function in the body. Normal methylation requires several nutrients like B vitamins, choline, cysteine, glycine, zinc, sulfur and more.

Cardiovascular Disease, Metabolic Syndrome, and PCOS Linked with Hair Loss


Research published January 2018 compiled evidence and patterns of disorders that links metabolic syndrome and insulin resistance to hair loss, i.e. androgenetic alopecia. The imbalance of androgens, testosterone, and sex hormone-binding globulin as seen with skin changes like acne vulgaris and female pattern hair loss/androgenetic alopecia is associated with insulin resistance.

Androgenetic alopecia and increased insulin resistance lead to higher likelihood of diabetes and cardiovascular disease. A June 2017 meta-analysis review found that patients with androgenetic alopecia have significantly abnormal cholesterol levels. Total cholesterol, triglycerides, and LDL cholesterol levels were much higher and HDL levels were much lower in the patients with hair loss than those in the control group. These same patterns are often seen in girls and women with PCOS/polycystic ovarian syndromeOmega 3 fish oil DHA helps support natural cholesterol, blood sugar, and insulin management in the body. If your diet lacks daily intake of this essential fatty acid, then supplementation is essential.

Healthy hair follicles, hair shaft, and scalp require several nutrients like the amino acids histidine, leucine, valine, alanine, cysteine, B vitamins, vitamin D, and minerals like zinc, copper, and iron. These nutrients are required for building hair and dealing with daily wear and tear. They are also needed by other parts of the body for healthy metabolism.

At the core of hair loss is oxidative stress and lack of several amino acids and other nutrients. It is a sign of something not right and may be related with autoimmune concerns, poor thyroid function, heart disease, or insulin resistance. These concerns must be appropriately evaluated, supported, and not ignored. Start with some simple steps. How is my diet? Am I getting enough amino acids or protein? If not, consider adding collagen peptides or increasing protein intake. Am I running low in iron or zinc? If you are vegetarian, have gut stress, are an athlete, picky eater, or a teenager, then you may need more minerals. Am I diligent about consuming 5-13 servings of vegetables and fruits every day? If not, then your antioxidant reserves are likely running low. Do I have any methylation gene SNPs? Then focus on B vitamins, sulfur, and other methylation support. Do I suspect gluten intolerance or a thyroid concern? Don’t just dismiss hair loss as a sign of age or stress. Hair loss is a sign that the body’s structure is stressed. Deeper help is needed than just a prescription for minoxidil or Rogaine to stimulate hair growth.

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