Vol. 2, # 48
December 10, 2005

Q: I am losing my hair (going bald). I have tried Minoxidil and Propecia with little success. Is there anything natural the will help stop my hair loss or grow back more hair? - Layperson

A: On average, there are 100,000 to 150,000 hairs on the human scalp. The hairs grow from hair roots, or follicles (saclike structures under the skin). Blood vessels at the base of each follicle provide the nourishment necessary for hair growth. Hair growth in each root occurs in a cycle independent of the other roots. At any time about 90 percent of the hairs on the scalp are in the growth phase, while the other 10 percent are in the resting phase. The growth phase lasts an average of four to five years, after which the follicle enters the resting phase, which lasts about two months to four months. At the end of the resting phase, the hair falls out naturally and is replaced by a new hair. Consequently, some hair loss is a normal part of the hair growth cycle. In fact, on a typical day, about 50 to 150 scalp hairs are lost. Baldness (or alopecia) results when hair loss occurs at an abnormally high rate; when hair replacement occurs at an abnormally slow rate; or when normal hairs are replaced by thinner, shorter ones.

There are many contributing factors to baldness, but all cause restricted blood flow and nourishment to the hair follicles, leading to dormancy and/or death of the hair follicles.

Certain diseases, such as diabetes, systemic lupus erythematosus and disorders of the thyroid gland can also cause baldness. Sudden hair loss may be an early warning sign for some diseases and should be reported to a doctor.

Hair loss has many other causes, including illness, poor nutrition, skin damage, some medications, and certain medical treatments such as anticancer chemotherapy and radiation therapy. Ringworm, a fungal infection, may sometimes be the cause of balding in children, but is generally not a problem in adults.

Alopecia, commonly known as baldness, is a set of disorders which involves the state of lacking hair where it would normally grow, especially on the head. The most common form of baldness is a progressive hair-thinning condition that occurs in adult humans and other primate species. Nonetheless, the severity and nature of condition can vary greatly; it ranges from male and female pattern alopecia (alopecia androgenetica), to alopecia areata, which involves the loss of some of the hair from the head, alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body. Treatment for alopecia has limited success. The more hair lost, the less successful the treatment will be. The psychological implications of alopecia include stress, anxiety and depression, and can in many cases involve issues relating to identity change, particularly when the eyebrows and eyelashes are also lost. Hair loss is sometimes the result of chemotherapy treatment for cancer sufferers.

Male pattern baldness is thought to occur in varying forms in about 66% of adult males at some point in their lives.[1] It is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline" or "receding brow." An additional bald patch may develop on top (vertex). The trigger for this type of baldness, which is also known as androgenic alopecia, is currently believed to be 5-alpha reductase, an enzyme that converts the hormone testosterone into dihydrotestosterone (DHT), which, in genetically-prone hairs on the scalp, inhibits hair growth. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern


The typical pattern of male baldness begins at the hairline. The hairline gradually recedes to form an "M" shape. The existing hair may become finer and shorter. The hair at the crown also begins to thin. Eventually the top of the hairline meets the thinned crown, leaving a horseshoe pattern of hair around the sides of the head.

Hair loss in patches, diffuse shedding of hair, breaking of hair shafts, or hair loss associated with redness, scaling, pain, or rapid progression could be caused by other conditions.

Signs and tests   

Classic male pattern baldness is usually diagnosed based on the appearance and pattern of the hair loss. Any atypical hair loss may be caused by other medical disorders. A skin biopsy or other procedures may be needed to diagnose other disorders that cause loss of hair.

Hair analysis is not accurate for diagnosing nutritional or similar causes of hair loss. However, it may reveal substances such as arsenic or lead.

Aside from male pattern baldness, some of the most common types of hair loss include:

  • Alopecia areata, which leads to patchy hair loss on the scalp. While the causes of alopecia areata are not completely understood, the hair loss is thought to be the result of the body's immune system attacking the hair follicle. Alopecia areata often resolves without treatment.

  • Traction alopecia, which results from long-term pulling on the hair. This type of hair loss can be caused by certain hairstyles, such as tight braids. The hair loss is usually reversible once the cause of this pulling is eliminated.  

  • toxic alopecia
    Toxic alopecia may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A, and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease, and after giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.

  • scarring alopecia
    Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury, or x-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.

  • trichotillomania (hair pulling)
    Hair pulling, a habit most common among children, may cause hair loss.

Female pattern baldness, in which the midline parting of the hair appears broadened, is less common. It is believed to result from a decrease in estrogen, a hormone that normally counteracts the balding effect of testosterone, which normally occurs in women's blood. Female pattern baldness is being classified on the Ludwig scale I-III.

There are several other kinds of baldness. Traction alopecia is most commonly found in people with ponytails or cornrows that pull on their hair with excessive force. Wearing a hat shouldn't generally cause this, though it is a good idea to let your scalp breathe for 7 hours a day.[2] Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium. Some mycotic infections can cause massive hair loss. Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis).

There exists a proven association between male-pattern baldness and serious cardiovascular events, but the mechanism of action is unknown.

Now, a new study has shown a strikingly increased risk of insulin resistance, hyperinsulinemia, and insulin-resistance-associated disorders in men with early onset of male-pattern baldness (alopecia), supporting the theory that early male-pattern baldness could be a clinical marker of insulin resistance.

Different remedies work for different people.  The following have shown promising results:

Saw palmetto (Serenoa repens). This remains my top choice, although you might want to use a combination of approaches that includes an anti-baldness medication such as minoxidil (Rogaine) or finasteride (Proscar). Biochemistry supports saw palmetto. We know that DHT kills off the hair follicles, and taking this herb internally blocks the formation of DHT. If it turns out that saw palmetto helps prevent hair loss, it would be the herb for men, since studies have shown that it also helps prevent prostate enlargement.
Licorice (Glycyrrhiza glabra). Licorice contains one compound that prevents the conversion of testosterone to DHT. You could prepare a baldness-prevention shampoo by adding licorice to your favorite shampoo when you shower.
Rosemary (Rosmarinus officinalis). For centuries, if not millennia, both men and women have massaged their scalps with rosemary in jojoja oil to keep their hair lush and healthy. Is there anything to really recommend this practice, besides wishful thinking? Massaging the scalp certainly stimulates circulation and encourages hair growth, according to Wilma F. Bergfeld, M.D., of the Cleveland Clinic Foundation in Ohio. Naturopaths often suggest nightly scalp massage with one part rosemary oil and two parts almond oil.
Danshen (Salvia miltiorrhiza) and sage (Salvia officinalis). Danshen is actually Asian red sage. In folklore, both danshen and native sage have long-standing reputations as hair preservers. In this country, people frequently used sage extracts in hair rinses and shampoos. The herb allegedly had the ability to prevent hair loss and maintain hair color. This folk use of herbs is unlikely to cause any harm, so I suggest that you try adding a few teaspoons of sage tincture to your favorite shampoo.
Horsetail (Equisetum, various species). The minerals selenium and silicon both help promote circulation to the scalp, and as a result, they help maintain hair, according to naturopathic physicians. Both minerals abound in horsetail. I'd try adding a teaspoon or so of dried horsetail to herbal teas, but you should check with a holistic practitioner before using this herb.
Stinging Nettle (Urtica dioica). Tincture of nettle leaf can help prevent balding in those with thinning hair, according to Rudolf Fritz Weiss, M.D., the dean of German herbal physicians and author of Herbal Medicine. I don't know of any studies supporting this, but I respect Dr. Weiss. Perhaps his endorsement of nettle is a remnant of the Doctrine of Signatures, which was the idea that a plant's appearance announces its medicinal value. Nettle is a hairy plant, so the doctrine would endorse its use for hair problems. On the other hand, maybe there will be some other evidence to recommend this herb for balding. The more researchers look at nettle, the more uses they seem to find. Taking a teaspoon or two of tincture a day--or one or two cups of nettle tea--certainly shouldn't hurt.
Glutathion (amino acid). Glutathione help prevent the formation of pexozidized oil on the scalp, which left unchecked, can clog hair follicles.
Biotin (B-vitamins). Biotin is an essential hair growth nutrient.
Vitamin C and L-Cysteine (amino acid). Helps hair to become thicker, stronger with less hair breakage and hair loss

Other proven herbs include:

  • Aloe Vera - cleans, soothes, heals, and reduces chance of infection
  • Balm Mint - allows oxygen into the blood stream
  • Buckthorn - breaks toxins down into their harmless component parts
  • Burdock - acts as a blood cleanser and removes toxins
  • Cayenne - increases circulation
  • Chamomile - is a scalp conditioner and hair restorer
  • Comfrey - provides proper amounts of calcium and phosphorus for strong, healthy hair
  • Ginger - increases circulation
  • Hops - help alleviate nervous tension and relax the scalp
  • Horsetail - helps supply calcium for hair
  • Jojoba - aids in the removal of impregnated sebum and lowers the pH of the scalp to a healthier, more acidic condition.
  • Nettles - scalp stimulant (dilates the blood vessels)
  • Rosemary - stimulates the skin
  • Sage - invigorates and refreshes the scalp
  • Saw Palmetto - neutralizes the DHT (dihydrotestosterone) in the follicle and hair root
  • Thyme - increases circulation and has been used for centuries in the treatment of headaches
  • Yarrow - scalp conditioner and hair restorer
  • Yucca - helps to stimulate the scalp
In Chinese herbal medicine, Sheng Fa, an herbal mix, taken in capsule form, of Chinese Foxglove, Fo-Ti Root, Dong-Quai Root, Chinese Quinnce Fruit, Sichuan Lovage Root, Chinese Dodder Seeds, has been proven to renew hair growth. 
Recent research on the soybean, has shown promising results. According to a research team from Colorado State University and two other universities. Soy products, they say, may stave off baldness, prostate cancer and even improve troubled skin.

It all rests with something called equol, a bold but enigmatic molecule created in the intestine when soy is digested.

The equol molecule chemically binds itself to dihydrotestosterone (DHT), the male hormone that causes male-pattern baldness, acne and excess body hair and that stimulates prostate growth — hazardous for men already suffering prostate cancer or an enlarged prostate.

"This molecule is remarkable," said Kenneth Setchell, a biochemist with Cincinnati Children's Hospital, which was part of the research team, along with Brigham Young University.
The news could make edamame (green soybeans), tempeh (fermented soybean patty) and miso (soup made from soybean paste) part of the male snacking vocabulary.

Researchers are excited because equol has no side effects, unlike powerful drugs that prevent DHT from being made in the body. The equol molecules function as "handcuffs," they say, not altering the hormone level in the body but simply blocking its effects.

The research team made its determination after injecting male rats with an equol solution and measuring its effects on their DHT function.

Ironically, women of a certain age have been urged to eat more soy products in recent years to alleviate annoying symptoms of menopause. Soy contains phytoestrogens, which some doctors believe can supplement dwindling natural estrogen and alleviate hot flashes, dry skin and fuzzy memory, among other things.

Equol itself is defined as a "nonsteroidal estrogen of the isoflavone class," according to research that Mr. Setchell conducted two years ago, which found that some people were more prone to create the molecule from soy than others. Some proved to be "equol producers," some were "non-equol producers."

Though Mr. Setchell and his team did not address this issue in their current study, soy consumption does not cause feminization in men or affect sexual function, according to the American Dietetic Association.

"The novelty of equol is that it inhibits androgen hormone and influences estrogen hormone action," said Edwin Lephart, a biologist with Brigham Young University who was part of the research team.

"We don't know of any other molecule that possesses these important biochemical properties," he said.

Biochemists led by Elaine Fuchs of have isolated stem cells that may someday grow new hair on a bald head. This is more than a vanity project for the Rogaine set: The work could also lead to custom-grown skin grafts and a better understanding of how the body regenerates itself.

The skin’s ability to grow back after a wound led scientists to assume that it must contain stem cells, immature cells that can rapidly differentiate into many different types of tissue. Until now, however, nobody knew where such cells were located in the skin or how many kinds there might be.

Using fluorescent markers, Fuchs and her colleagues isolated two distinct populations of stem cells from mouse skin. The researchers then extracted the cells and grafted them onto genetically engineered hairless mice. Both cell populations caused the mice to develop thick patches of fur, along with all the other components of skin, including sweat and sebaceous glands.

These stem cells are different from the controversial ones extracted from embryos. “Embryonic stem cells are pluripotent, meaning they have the ability to become any type of tissue,” Fuchs says. “We know these stem cells are multipotent—they can become any epidermis-derived tissue—but beyond that, we don’t know.”

Fuchs is now working on isolating equivalent cells in humans. “To really treat baldness, you’d have to understand all the chemical pathways cells use to tell each other when to grow,” she says. “That could take a while.”    

Kevin McElwee, a biologist and immunologist,completed his unique PhD in the immunological mechanisms involved in alopecia areata, an inflammatory hair loss disease that can affect men, women and children and cause full body hair loss. The cause of the disease is not fully understood but it is believed that an individual's own immune system prevents hair follicles from producing hair fibre.

This month, McElwee will travel to the International Meeting of Hair Research Societies in Berlin to present his findings on the cells believed to be the primary culprits in causing the disease.

By separating cells in lymph nodes, McElwee has determined which cells are capable of inducing the disease. He found two types of cells caused balding problems: CD8, which produce patchy baldness and CD4, which produce systemic balding.

"This research is the first evidence that CD4 cells are our primary target in fighting alopecia areata," he says. "This new data will help us develop interventions and treatments to ease or stop this condition which can be psychologically devastating for patients."

Coenzyme Q10 and /or the essential fatty acids have been shown to increase hair growth.
Correcting certain medical conditions (hormonal imbalances of the pancreas and thyroid), and/or nutriional imbalances of  amino acids, carbohydrates, electrolytes, fats, minerals, protein, vitamins, and so on can increase hair growth. 
Edgar Cayce, America's sleeping prophet recommended the external use of Pennsylvania Crude oil for hair loss conditions.
If one method doesn't work, try another or combination of others.

For those persons on anticoagulants, blood pressure medications, cardiovascular medications, or are pregnant, consult the appropriate health care professional.

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DISCLAIMER:  The information in this column, is NOT intended to diagnose and/or treat any health related issues and is provided solely for informational purposes only. Consult the appropriate healthcare professional before making any changes to your healthcare regime. Even what may seem like simple changes in the diet for example, can interact with, and alter, the efficiency of medications and/or the body's response to the medications. Many herbs and supplements exert powerful medicinal effects. Neither the author, nor the website designers, assume any responsibility for the reader's use or misuse of this information.

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