HAIR LOSS & YOUR HORMONES

Hair thinning and/or hair loss is a familiar experience for many, especially as we age. It’s a topic close to home, as I’ve struggled with my own personal battle with hair loss. Until recently, the cause of male or female pattern baldness was not widely understood and thought to be primarily to be an inherited trait. But it turns out that a specific androgen – DHT – plays a significant role in hair loss. ​What is DHT? Dihydrotestosterone, or DHT, is an androgenic hormone derived from testosterone. We often think of testosterone as being mostly a male hormone, but it can also be found in smaller amounts in females and is essential for mood, energy, and reproduction. ​

In men, the androgen group of hormones, including DHT, play a significant role in the development of male sex characteristics such as deepened voice, body hair growth, increased muscle mass, growth of male reproductive organs, and how fat is stored in the body. While testosterone is the most abundant androgen found in men, playing the greatest role in controlling and maintaining many physiological and reproductive processes, DHT also helps influence these processes. In fact, DHT has been demonstrated to be 2.5x more biologically active than testosterone, however, it is found in significantly smaller amounts.

​ How does DHT impact Hair Loss It was once believed that genetics and testosterone were to blame for hair loss. However, evidence now suggests that it is less about the amounts of circulating testosterone, and more about the levels of DHT binding to the scalp follicle itself that are important in hormonal hair loss. About 10% of the body’s total testosterone converts to DHT each day for both men and women (1). The Type II 5-alpha reductase enzyme lives in the body’s hair follicle’s oil glands. Hair loss occurs when higher than-normal levels of DHT attach to the hair follicles and shrinks them, shortening the growth cycle of the hair follicle. This also leads to brittle hair, hair that falls out too easily, and resultant balding. Signs of elevated DHT in men will often present as: - baldness (male-patterned) - prostatic enlargement - acne - aggression - sleep apnea and in women as: - hair loss (diffuse thinning, may be predominant in the crown or anterior hairline) - increased body hair growth (chin, chest, nipples, abdomen) - acne - androgenic PCOS Genetics Are Still a Factor You can inherit baldness from either parent. Generally speaking, if one or both parents experienced male or female pattern balding, you will as well. Variations in the androgen receptor gene can make you more prone to the effects of DHT on hair. Additionally, the size and shape of your head can also affect how quickly DHT can shrink hair follicles. Reducing DHT There are several medications widely available that have proven to be effective in lowering DHT production and inhibiting receptor binding. But DHT blockers can have unwanted side effects, like erectile dysfunction, rash, vomiting, and congestive heart failure. Furthermore, they often provide short-term results, and lose their effect once discontinued. There are natural alternatives that have limited, yet promising, research as safe and effective treatment options in reducing DHT production:

• Caffeine: Your daily cup of coffee may be helping your hair grow. A 2014 study (2) found that caffeine can promote keratin production and extend the hair growth phase.

• Vitamins B-6 and B-12: Deficiencies in these essential vitamins can cause brittle hair or hair to fall out. Adding berries, vegetables, and almonds to your diet will increase your B-6 intake. B-12 is most commonly found in meats like tuna and beef, but can also be found in your cup of yogurt. Make sure to take a supplement if your diet is vegetarian or vegan.

• Pumpkin Seed Oil: Another 2014 (3) study found that men who took 400 milligrams of pumpkin seed oil every day saw an increase in scalp hair count.

• Saw Palmetto: limited research shows this herb may have promising effects due to its ability to block the 5-alpha reductase function. It’s used more predominantly for prostate enlargement but has potential benefits for androgenic hair loss due to its mechanism of action.

• Topical Melatonin: multiple studies site the use of topical melatonin to be an effective therapy for androgenic hair loss in women, showing a 2- to 3-fold reduction in hair loss volume after 3 months of use (4). This is a therapy I’ll often have compounded for patients who demonstrate findings of androgenic alopecia that is not responding to oral therapies.

• Collagen: With age, your body becomes less efficient at producing collagen and replenishing cells in the dermis. One eight-week study in 69 women aged 35–55 found that taking daily collagen supplements significantly improved skin elasticity compared to a placebo (5)

A NOTE on supplementing Biotin: May online blogs will site biotin as an effective therapy for hair loss. However, these results are not demonstrated in the research. Deficiencies in biotin can lead to hair loss, but supplementing with biotin when you are not deficient will likely have no added benefit. I tested this theory by taking biotin for 6 months at 5 g daily, with no benefits seen to my hair loss or regrowth. Lastly, it's important to note that androgenic alopecia is not the only cause of hair loss in women and men alike. Heavy metals, iron deficiencies, thyroid dysfunction, and Telogen Effluvium are amongst the other most common causes. Furthermore, the life cycle of a hair follicle is roughly around 100 days, so it may take that long before results are noted. This is why a full workup by your naturopath is important before trying these therapies at home. If you are worried about thinning hair, there is hope. If you are concerned that your hormonal health may be impacting hair loss, or wish to discuss treatment options, please contact your Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule your appointment today. References:

1. https://www.yourhormones.info/hormones/dihydrotestosterone.aspx

2. https://www.ncbi.nlm.nih.gov/pubmed/24836650

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017725/

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/