Hair today… gone tomorrow

Did you know that out of 1000 women surveyed, 33% reported to suffer from noticeable hair loss, that’s around one in three. We tend to take hair for granted but when it starts falling out who do you turn to for help?

It’s interesting how we can be unaware that our hair can be saying a lot about us simply by how we choose to style it. Hair is often a good predictor of our self-image and chosen lifestyle. Hair that is cut short and carefully styled may reflect a hidden artistic personality while hair that required regular cuts, colouring and maintenance suggests that the person cared deeply about their appearance which in turn could signify inner insecurities. More radical hair styles and colours also indicate an artistic aspect to the persons personality combined with more adventurous, rebellious tendencies sometimes spiced with a desire to taunt authority figures such as parents or employers. Hair has always been an important statement of health and status so when we start loosing our hair deep set worries besiege us; will I go bald, will it ever grow back, how can I go our in public, will my partner still love me? These are all very real anxieties and worries that those suffering hair loss face and often deal with for a long time before seeking advice.

Hair basics

Humans are all very individual and the same can be said about our hair. So many things influence hair growth ranging from ethnic differences and genetics through to less well-understood influences like stress and even seasonal changes.  When we look at the effects of ethnic differences its becomes clear that the three major geographical origins (Asian, Caucasian and African) all reflect variations in hair type, growth and character. For example, African hair is known to be more fragile than Asian or Caucasian, probably because of the thin ribbon-like cross sectional structure of the follicle that underlies the more tightly curled appearance of this hair type. African hair typically needs careful maintenance to avoid unnecessary damage and premature loss.

As in so many aspects of our life and health genetics plays a powerful controlling part. A BBC news story in December 2009 highlighted this following the reports that scientists have been studying the genes that underlying hair greying in twin sisters. The results of the study confirm that genes do significantly influence hair greying in identical twins who share the same genes compared to non-identical twins where there are differences in the genetic code. The twins studied were aged between 59 and 81. The effects of genes on hair colour were also seen to be independent to levels or stress and type diet.

When it comes to stress the research is shakier as to the exact cause and mechanism but the reality is clear to see. Stress and hair loss go hand in hand! We know that the hair follicle is surrounded by a dense network of nerves – just try and pull one hair out and see how sensitive it is! All nerves, no matter how small, connect up with the spinal cord and all roads lead to Rome; the brain. Stress, anxiety and depression are brain centred issues that ultimately effect the nervous system in general. One known effect of stress affects the oil producing glands of the scalp known as the sebaceous glands. Hair becomes oiler when a person is stressed. Continued stress causes the hair follicle to age quicker and forces it into a ‘resting’ phase during which no more growth occurs. This may be seen as hair loss when infect its more likely to reflect a reduction in growth than an actual loss. The good news is that once the stress passes the hair follicle wakes up and starts growing again. In health, around 10% of our hair follicles are always in the ‘resting’ phase that lasts around 3 months after which new hair starts growing and the old ‘rested’ hair shaft falls out. The hair cycle, as it is known, is carefully controlled by the nerve networks at the base of the follicle along with a delicate orchestration of hormonal influences any one of which could alter the growth cycle.

The dreaded hormone effect…

It has been said that we are slaves to our hormones and this is very true in the case of hair growth. Even though the fundamental biology of men and women are characterised by testosterone and oestrogen respectively both sexes have biologically significant amounts of the other genders hormones to make things difficult for the hair if the levels go out of balance. This can be seen in men who need oestrogen hormone therapy for prostate cancer. In this case hair growth is boosted. In men and women however, an excessive amount of testosterone can cause problems.

Biologically active testosterone, known as dihydrotestosterone, or DHT for short, is produced by the action of a key enzyme called 5-alpha-reductase that is found in the hair follicle. The conversion of testosterone to DHT is a toxic reaction to the hair follicle which shrivels up over extended exposure to DHT and dies causing hair thinning and eventually hair loss. However, help could be at hand in the form of a herbal remedy known as saw palmetto. The way it works is simple, saw palmetto lowers levels of DHT in the body by blocking the key enzyme that fules the conversion of testosterone to DHT; 5-alpa-reductase. The other effect of saw palmetto is more direct, it appears to blocks the effects of DHT on the various DHT sensitive cells of the body. Saw palmetto has not been studies as a remedy for testosterone related hair loss but one could assume that there is compelling evidence for trying it!

The other key player in the hormonal effects on hair is the thyroid hormone known as thyroxin. As a major regulator of metabolism thyroxin deficiency slows our ‘tick-over’ and slows hair growth by forcing the follicle into an extended resting phase. Only when this hormone deficiency been corrected will the follicle wake up again. Border-line low thyroid function could be addressed with the use of certain nutrients that are known to help support the glands function before thyroid hormone replacement is needed. We covered the issue of border-line thyroid deficiency in a previous blog post entitled; The Missing Link in Low Energy.  In essence, the thyroid needs an adequate supply of iodine, magnesium, copper, zinc, manganese and molybdenum along with vitamin B12 and amino-acids. These are all found in a food supplement called Thyroid and Tyrosine Complex, Metabolic Advantage. It is true that a good diet should deliver all these nutrients but sometimes even the best diet can benefit from a boost up for a few months.

Feeding your hair

Just like any other tissue in the body your hair is active and the follicle is living and needs plenty of high quality nutrients for optimal health. Ill health, fad diet’s and generally poor eating habits will take it’s tole on hair health. The food supplement MaxiHair was developed to support the general nutritional requirements of hair. It’s formula boasts a range of ingredients including vitamin B6, B12, folic acid along with the trace minerals copper, manganese and selenium. However, one key nutrient that can be over looked is iron. While it is true that iron can be highly toxic it is also true that a low level of iron can have equally devastating effects of health. Iron deficient anaemia is the common association we have when talking about low levels of iron. A simple blood test soon detects this and a course of iron restores the blood so long as nothing else is underlying the problem. However, it’s important to remember that our tissues also need iron but in a different form. This form is stored iron known as ferritin. It is possible to have adequate blood iron (haemoglobin) but only at the expense of drawing on our iron stores (ferritin) to re-dress the bloods deficiency. By topping up the blood levels we tend to deplete the iron store to the point where other tissue that depend on stored iron for health and growth suffer; the hair follicle. This situation can hit women between the ages of 18-50 when their follicles are especially sensitive to ferritin deficiency. Unless a blood test is performed specifically to measure ferritin levels regular blood profiles will only measure haemoglobin. As explained above, this may be well balanced but only at the expense of a depleted ferritin store. There is nom link between low haemoglobin and hair loss unless the low haemoglobin is accompanied by a low farritin as well. In general a low ferritin level usually result from the loss of blood during menstruation, which is just enough to cause a gradual depletion of iron stores in the body. Additionally eating a diet containing little or no red meat is likely to give rise to a lower amount of available iron since the iron in vegetables is often difficult to absorb.

If you obtain a serum ferritin blood test it’s always good to do so along with a general profile covering red and white cells and hemoglobin known as a basic hematology profile. At the same time requesting a serum vitamin B12 levels is a good idea. According to a key study published in the journal Dermatologic Clinics optimal hair growth your results should look something like this; serum B12 between 300 & 1000 ng/L, hemoglobin level of 13.0g/dL or over and a serum ferritin of 70ng/mL or greater. If your ferritin needs a lift and you do not want to increase your red meat intake consider a 6-9 month course of Florisene. This supplement has been formulated specifically for ferritin deficient hair loss. It contains vitamin C, B12, iron (as ferrous glycine sulphate) and the amino acid L-lysine. Because of the dose and type of iron used Florisene is unlikely to cause gut upset.

In general, hair loss can be managed naturally and safely but there can be some underlying medical causes not discussed in this review. Professional advice is always recommended in the first instance to help you follow the right pathway and exclude other more complex causes.

Treatment link

Trichology service at Hadley Wood Healthcare

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