- Nutrition and hair loss
- Trace elements
- Polyunsaturated fatty acids
- Aging effects
- The 10 top foods that are the foundation of healthy hair diet.
- Patient education
Nutrition is a complex subject – the effects of incorrect nutrition are often slow to appear. Hair in particular is slow to respond to any stimulus. Healthy looking hair is in general a sign of good health and good hair-care practices. Most healthy individuals have adequate nutrients in their diet; however, some people do not have access to good nutrition, others have medical illnesses that predispose them to nutritional deficiency which influence scalp / body hair. Trials have indicated that correct nutrition is instrumental in healthy hair growth, and conversely many deficiencies correlate with hair loss.
NUTRITION AND HAIR LOSS Dr Tabassum Salim MB BS MTTS
Hair nutrition is therefore a vital part of any treatment regime. A systematic and rigorous approach must be taken when formulating a nutritional supplement for hair due the many factors that affect the eventual efficacy of the treatment.
Many states of malnutrition have important effects on hair growth. The most widespread is protein-calorie malnutrition, which is more prevalent in developing countries but is also seen in countries with high standards of living. The more specific dietary deficiencies, affecting hair growth are to some extent the product of sophisticated techniques of artificial feeding.
The speed of hair growth is based upon genetics, gender, age, hormones. It may be reduced by nutrient deficiency (i.e., anorexia, anaemia, zinc deficiency) and hormonal fluctuations (i.e., menopause, polycystic ovaries, thyroid disease). It is important to mention that many of the metabolic requirements of follicle cells (minerals and vitamins) must be satisfied for optimal hair growth.
Nutritionists confirm that people with certain nutritional deficiencies tend to have dry, stringy and dull hair, and sometimes experience hair loss. The latter may be restored once the deficiency is addressed. Crash diets cause temporary hair loss due to incumbent nutritional factors e.g. anorexia, bulimia and other medical conditions.
Diets should contain protein, fruits, vegetables, grains, and an appropriate amount of fat. Deficiency will typically show in the hair. A mild case of anemia can cause shedding of hair. B group vitamins are significantly important for healthy hair, especially biotin. When the body is under threat it reprioritizes its processes – the vital organs will be attended first hair follicles may not be considered a priority. While not all hair growth issues originate from malnutrition, it is a valuable symptom in diagnosis.
The essential omega-3 fatty acids, protein, vitamin B12, and iron, found in fish sources, prevent a dry scalp and dull hair color. Dark green vegetables contain high amounts of vitamins A and C, which help with production of sebum and provide a natural hair conditioner. Legumes provide protein to promote hair growth and also contain iron, zinc, and biotin. Biotin functions to activate certain enzymes that aid in metabolism of carbon dioxide as well as protein, fats, and carbohydrates. A deficiency in biotin intake can cause brittle hair and can lead to hair loss. In order to avoid a deficiency, individuals can find sources of biotin in cereal-grain products, liver, egg yolk, soy flour, and yeast. Nuts contain high sources of selenium and therefore are important for a healthy scalp. Alpha-linoleic acid and zinc are also found in some nuts and help condition the hair and prevent hair shedding that can be caused by a lack of zinc. Protein deficiencies or low-quality protein can produce weak and brittle hair, and can eventually result in loss of hair color. Low-fat dairy products are good sources of calcium, a key component for hair growth. A balanced diet is necessary for a healthy scalp and hair.
Nutritional deficiency may impact both hair structure and hair growth. Effects on hair growth include acute telogen effluvium (TE), a well-known effect of sudden weight loss or decreased protein intake, as well as the diffuse alopecia seen in niacin deficiency. Studies have also reported potential associations between nutritional deficiency and chronic TE, androgenetic alopecia (AGA), female pattern hair loss (FPHL), and alopecia areata.
PROTEIN-CALORIE MALNUTRITION (PCM): PCM is classified in four degrees of severity:
- Nutritional growth retardation
- Marasmus kwashiorkor
- Nutritional marasmus
Nutritional growth retardation and kwashiokar is due to deficiency of good quality proteins, while marasmus kwashiokar and nutritional marasmus may be due to protein and calorie deficiency. In PCM, hair becomes dry and lifeless in appearance. Partial loss of pigment from black hair gives patches which are reddish or pale in colour (Hennington et al. 1958). The hair roots show a prompt response to protein deficiency. The proportion of roots in telogen increases. Those roots in anagen show dystrophic changes with reduction in diameter of the hair-bulb and contour of the shaft (Bradfield 1968; Bradfield et al. 1969). Both internal and external root sheaths are markedly reduced. There is a gross reduction in the rate of the hair growth (Sims 1968).
Secondary protein deficiency has occurred after severe diarrhoea some years after a gastrectomy and in ulcerative colitis (Melnikoff 1957). In both patient’s black hair becomes reddish and sparse.
Marasmus is severe chronic malnutrition, in which the child adapts to the stress by failing to grow (Bradfield 1974). In marasmus the hair is also fine and dry but no anagen follicles remain, and if the marasmus state continues, the hair the hair becomes very sparse as the telogen hairs are shed. Follicles in telogen conserve nitrogen. In kwashiokar a relatively acute shortage of protein interrupts a period of more normal growth. Linear growth of hair may continue, but the calibre of the hair shaft is reduced, and some anagen follicles become dystrophic. Some intermediate stages are also seen.
Bradfield advocated the microscopy of hair specimens for field surveys of the frequency, severity and chronicity of PCM in a population. Significant changes in hair shaft diameter and in anagen/telogen ratio were found between well-nourished and severely malnourished children, the different stages of PCM could not be reliably differentiated in a field survey by the examination of hair morphology. Such changes constitute an important physical sign in the individual child.
ESSENTIAL FATTY ACID DEFICIENCY:
Deficiency of essential fatty acids is liable to arise in patients who receive prolonged parenteral alimentation. Deficiency of the polyunsaturated essential fatty acids linoleic acid (an omega-6 fatty acid) and alpha-linolenic acid (an omega-3 fatty acid) can result from inappropriate parenteral nutrition and malabsorption disorders such as cystic fibrosis. Cutaneous changes caused by this deficiency have been reported in infants as well as adults. Unsaturated fatty acids may modulate androgen action by inhibition of 5α-reductase, similar to the drug finasteride. Additionally, arachidonic acid, an omega-6 fatty acid, may promote hair growth by enhancing follicle proliferation.
After 2-4 months of deficient alimentation the patient develops redness and scaling in the scalp and eyebrows. Hair changes include loss of scalp hair and eyebrows as well as lightening of hair. Most hair is shed and what remains is dry, unruly and lighter in colour. The suspected diagnosis can be confirmed by demonstrating a high serum level of fatty acid eicosatrianoic acid and a low concentration of arachidonic acid. The cutaneous changes can be reversed by the topical application of safflower oil, which contains 60-70% linoleic acid (Skolnik et al. 1977).
Zinc deficiency occurs as a result of an inborn defect of zinc absorption, or from dietary deficiency of this element, or as the result of long-continued parenteral alimentation. Zinc is an essential mineral required by hundreds of enzymes and multiple transcription factors that regulate gene expression. While the exact mechanism of action is unclear, one possibility centers on zinc’s role as an essential component of numerous metalloenzymes important in protein synthesis and cell division. Another possibility is zinc’s role in the Hedgehog signalling pathway, a critical component in the pathways that govern hair follicle morphogenesis. Zinc deficiency may be either inherited or acquired and may affect multiple organ systems. Patients may experience diarrhea, immunological effects, and delayed wound healing. Abnormalities in taste and smell may occur. Cutaneous effects include acral and periorificial dermatitis, while hair changes include TE and brittle hair.
This uncommon hereditary disorder of zinc metabolism is determined by an autosomal recessive gene (Moynahan 1974). The onset of symptoms often coincides with weaning. There are erythema and scaling plaques, partially covered with bullae and vesicles. These skin changes occur around the mouth and anus and on the extremeties. The hair may be sparse, dry and brittle or maybe completely shed. The child is listless and apathetic and growth is retarded. The symptoms respond rapidly to zinc sulphate 50 mg three times a day.
Acquired zinc deficiency may occur in malabsorption syndromes, such as inflammatory bowel diseases or following gastric bypass surgery. Other groups at risk include patients with malignancy, those with liver or renal dysfunction, pregnant women, and patients with alcoholism. Drugs that can affect zinc levels include valproic acid and certain antihypertensives.
Dietary risk factors include vegetarianism, as bioavailability of zinc is lower in vegetables than meat. Additionally, vegetarians typically consume more legumes and whole grains, which contain phytates that bind to zinc and inhibit absorption.
Environmental zinc deficiency:
In the absence of adequate zinc intake, such as occurs in some areas of Egypt and iran as a result of a diet of unleavened wholemeal wheat bread, high in phosphate, growth and sexual maturation are retarded in some prepubertal males (Ronaghy et al. 1974). Hair growth in such individuals has not been investigated, but there are no gross clinical signs. Serum zinc, the most commonly measured index of zinc status, may be impacted by several variables, and the functional effects of deficiency may be observed before serum levels decrease below normal. Screening in those with risk factors is indicated, as hair loss due to zinc deficiency can be reversed. A case series demonstrated reversal of hair loss following oral supplementation in five patients with TE and zinc deficiency.
Zinc deficiency after parenteral administration:
Acute zinc deficiency is characterized by a dermatitis resembling that of acrodermatitis enteropathica, and associated with diarrhoea, apathy and alopecia (Kay and Tasman-Jones 1975). Chronic zinc deficiency in patients receiving only parenteral feeding gave rise to skin changes after two months. redness and scaling developed in the naso-labial fold and the corner of the mouth. Red scaly patches appeared on the knees, bullae on the hands and feet, then perineal erosions and sparseness of the scalp hair and eyebrows. In another patient similar but less severe changes occurred after 16 months of hyperalimentation. The symptoms which suggest the possibility of zinc deficiency are peri-occipital redness and scaling, bullae and hair loss. the subject has been fully reviewed by Weismann (1980).
A study of 312 patients with AA, male pattern hair loss (MPHL), FPHL, or TE showed that all groups had statistically lower zinc concentrations as compared to 30 healthy controls. In patients with AA and low serum zinc levels, supplementation has been shown to have therapeutic effects. However, there is currently limited information on the effects of zinc supplementation on hair growth in those without documented deficiency. A major point when considering supplementation in the absence of known deficiency is that zinc toxicity can occur with excess supplementation. Acute adverse effects include pain, vomiting, and diarrhea, while chronic effects include interaction with iron and reduced immune function.
Iron deficiency (ID) is the world’s most common nutritional deficiency and is a well-known cause of hair loss. While the mechanism of action by which iron impacts hair growth is not known, hair follicle matrix cells are some of the most rapidly dividing cells in the body, and it may contribute to hair loss via its role as a cofactor for ribonucleotide reductase, the rate-limiting enzyme for DNA synthesis. In addition, multiple genes have been identified in the human hair follicle, and some may be regulated by iron.
Certain populations are at higher risk for Iron Deficiency, and a medical and dietary history may reveal risk factors. Premenopausal women are at higher risk due to menstrual blood loss, while postmenopausal women and men may present due to gastrointestinal blood loss. Other risk factors include malabsorption disorders (such as celiac disease) as well as achlorhydria or the use of H2 blockers, as iron requires an acidic pH for absorption.
It is unknown if a deficiency of storage iron contributes to hair loss, as conflicting results have been noted. Some studies have found that low serum ferritin is more prevalent in patients with chronic TE, FPHL, AGA, and AA. Other studies have found no such link. Vegans and vegetarians are also at higher risk for ID, as their requirements for dietary iron are considered to be 1.8 times higher than for meat consumers. Non-heme iron, found in plants, has a lower bioavailability than heme iron, found in meat and fish.
Patients with more advanced ID develop iron deficiency anemia and require replacement. ID may also result in a reduction of storage iron, measured by serum ferritin. A normal ferritin level does not exclude ID, however, as it is an acute phase reactant. Patients must be approached on a case-by-case basis. In the aforementioned review articles, the researchers present their approach. Both groups test patients with iron studies, including serum ferritin. Both recommend treatment of ID, with or without anaemia, with dietary sources and oral iron supplementation when necessary, with a goal of ferritin levels above 50 μg/L or 70 μg/ml, respectively.
Patients are monitored to measure their response—an important point. Patients who take iron supplements without monitoring are at risk for potentially severe complications, as iron supplementation leading to iron overload can cause toxicity. This can occur even at low levels if taken over a long period.
Pellagra, due to a deficiency of niacin, results in the well-known triad of photosensitive dermatitis, diarrhea, and dementia. Alopecia is another frequent clinical finding. Pellagra became rare in many developed countries after niacin fortification of food was introduced. Alcoholism is now considered the most common cause of pellagra in developed countries. Other causes include malabsorption disorders or drug-induced cases, such as with isoniazid.
Biotin, or vitamin H, serves as a cofactor for carboxylation enzymes. Biotin is required for a number of enzymatic reactions within the body, and is necessary for the proper metabolism of protein, fat, and carbohydrates. Over time, poor metabolism of nutrients can contribute to undernourished hair follicle cells. Although rare, a biotin deficiency results in skin rashes and hair loss. A study conducted at Harvard University suggests that biotin is one of the most important nutrients for preserving hair strength, texture, and function.
Symptoms of deficiency include eczematous skin rash, alopecia, and conjunctivitis. One study of an infant fed with a formula lacking sufficient biotin content reported manifestations of periorificial dermatitis and patchy alopecia, both of which resolved with daily oral supplementation of biotin.
Biotin deficiency is rare, as intestinal bacteria are typically able to produce adequate levels of biotin. Deficiency is seen in cases of congenital or acquired biotinidase or carboxylase deficiency, antibiotic use disrupting the gastrointestinal flora, and antiepileptic use. Deficiency can occur from excessive ingestion of raw egg whites due to binding by avidin.
No clinical trials have shown efficacy in treating hair loss with biotin supplementation in the absence of deficiency. Despite this, biotin is found in multiple supplements marketed to consumers for hair loss. This marketing approach may have been chosen as biotin has shown positive effects in the treatment of brittle fingernails and onychoschizia. The recommended dosage of d-biotin is 500-1000 mcg per day.
Selenium is an essential trace element that plays a role in protection from oxidative damage as well as hair follicle morphogenesis. Rats deficient in selenium display sparse hair growth, while knockout mice lacking specific selenoproteins exhibit progressive hair loss after birth.
Risk factors for deficiency include living in areas with low selenium soil content (particularly in parts of China, Tibet, and Siberia), long-term hemodialysis, HIV, and malabsorption disorders. Given the lack of human research, it is surprising that some hair loss supplements are marketed as containing selenium. This is concerning, as selenium toxicity from nutritional supplementation is well documented. Toxicity can result in generalized hair loss, as well as blistering skin lesions, gastrointestinal symptoms, and memory difficulties.
Micronutrients such as vitamins and minerals play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with the development, prevention, and treatment of alopecia.
- Vitamin A: Consumption of vitamin A exceeding the recommended daily limit of approximately 10,000 IU a day can lead to vitamin A toxicity. As a general rule, consuming too much or over-supplementing vitamin A can cause hair loss. Typically, fat-soluble vitamin A is stored in the liver where its dispersal is tightly regulated by anabolic and catabolic reactions between the inactive and active metabolite. When levels of vitamin A are too high, the capacity of the transport system is exceeded and vitamin A spills over into the circulation. Maintaining homeostasis—and by extension the proper concentration of active metabolite—is important for healthy hair.
- Vitamin B: The vitamin B complex includes eight water-soluble vitamin substances—thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), vitamin B6, biotin (B7), folate, and vitamin B12—that aid in cell metabolism. Only riboflavin, biotin, folate, and vitamin B12 deficiencies have been associated with hair loss. Biotin deficiency can be genetic or acquired. Genetic causes of biotin deficiency can be either neonatal or infantile. The neonatal type is a life-threatening condition manifested during the first 6 weeks of life, and it is due to a holocarboxylase enzyme deficiency. It is usually manifested with severe dermatitis and alopecia, where there is loss of vellus and terminal hair on the scalp; eyebrows, eyelashes, and lanugo hair can also be absent. The infantile form of biotin deficiency occurs after 3 months of delivery and is due to a lack of the enzyme called biotinidase. In this form, hair of the scalp, eyebrows, and eyelashes is sparse or totally absent.
While signs of biotin deficiency include hair loss, skin rashes, and brittle nails, the efficacy of biotin in supplements for hair, skin, and nails as a means to remedy these conditions is not supported in large-scale studies. The role of folate and vitamin B12 in nucleic acid production suggest that they might play a role in the highly proliferative hair follicle. However, few studies to date have addressed the relationship between B vitamins and hair loss.
- Vitamin C: Although vitamin C deficiency is typically associated to body hair abnormalities, there are no data correlating vitamin C levels and hair loss. Vitamin C intake is crucial in patients with hair loss associated with iron deficiency as it plays an essential role in the intestinal absorption of iron due to its chelating and reducing effect, assisting iron mobilization and intestinal absorption. Therefore, vitamin C intake is important in patients with hair loss associated with iron deficiency.
- Vitamin D: Vitamin D is a fat-soluble vitamin synthesized in epidermal keratinocytes. Vitamin D obtained from the diet or synthesis in skin is inactive and needs to be activated enzymatically. Vitamin D modulates growth and differentiation of keratinocytes through binding to the nuclear vitamin D receptor (VDR). Murine hair follicle keratinocytes are immunoreactive for VDR, showing their highest activity in the anagen stage. The role of vitamin D in the hair follicle is evidenced by hair loss in patients with vitamin D-dependent rickets type II. These patients have mutations in the VDR gene, resulting in vitamin D resistance and sparse body hair, frequently involving the total scalp and body alopecia.
Vitamin D, due to its immunomodulatory effect, may be involved in AA. Vitamin D supplements or topical vitamin D analogues should be considered for patients with AA and vitamin D deficiency. However, the meta-analysis did not find any clear correlations between extent of hair loss and serum 25-hydroxyvitamin D level.
- Vitamin E: Vit.E is involved in the oxidant-antioxidant balance and helps to protect against free radical damage. Immune cells are extremely sensitive to oxidative damage. They also produce reactive oxygen species as part of the immune defense mechanism, which can induce a lipid peroxidation reaction. Antioxidant supplementation fundamentally reverses several age-associated immune deficiencies, leading to increased numbers of total lymphocytes and T-cell subsets, elevated levels of interleukin-2, increased natural killer cell activity, enhanced antibody response to antigen stimulation, improved mitogen responsiveness, decreased prostaglandin synthesis, and decreased lipid peroxidation.
Several clinical studies have implicated oxidant/antioxidant discrepancy in patients with AA, which is a disease dependent on autoimmunity, genetic predisposition, and emotional and environmental stress. Most results report increased levels of oxidative stress biomarkers and decreased levels of protective antioxidant enzymes in patients with AA.
Hair loss is considered to be a common problem in the dermatological community and has a profound negative psychological and emotional impact on patients. Micronutrients, such as vitamins and minerals, play an important, but not entirely clear role in normal hair follicle development and immune cell function. Deficiency of such micronutrients may represent a modifiable risk factor associated with the development, prevention, and treatment of alopecia.
Additional considerations by Melissa Bent
Nutrition is a complex subject – the effects of correct nutrition are indirect and often slow to appear. Hair in particular is slow to respond to any stimulus. Trials have indicated that correct nutrition is instrumental in healthy hair growth, and conversely many deficiencies correlate with hair loss.
Hair nutrition is therefore a vital part of any treatment regime. A truly systematic and rigorous approach must be taken when formulating a nutritional supplement for hair due the many factors that affect the eventual efficacy of the treatment.
Malnutrition, congenital heart disease, neuromuscular disease, chronic illnesses, malignancy, alcoholism, and advanced age can cause hair to change colour, be weakened, or lost.
Genetics and health are factors in hair wellbeing. Proper nutrition is important. The living part of hair is under the scalp skin where its root is housed within its follicle. It derives its nutrients from blood. Health concerns e.g. stress, trauma, medications, medical conditions, heavy metals, smoking etc. can affect the hair.
Hair is the fastest growing natural tissue in the human body: the average rate of growth is 0.5cm – 1.7cm per month depending on ethnicity. Optimal growth occurs from age 15 – 30 and reduces from age 40 – 50. although men find beard hair grows faster beyond the age of 50 years. Hair products (shampoos or vitamin supplements) have not been shown to noticeably change this rate. The cycles of growth of each follicle consist of creation followed by self destruction. During each new cycle the follicle is partially recreated.
The speed of hair growth is based upon genetics, gender, age, hormones. It may be reduced by nutrient deficiency (i.e., anorexia, anemia, zinc deficiency) and hormonal fluctuations (i.e., menopause, polycystic ovaries, thyroid disease).
It is important to mention that many of the metabolic requirements of follicle cells (minerals and vitamins) must be satisfied for optimal hair growth (not always derived from fast foods and punishing work schedules).
Nutritionists confirm that people with certain nutritional deficiencies tend to have dry, stringy and dull hair, and sometimes experience hair loss. Fortunately the latter can be restored once the deficiency is addressed.
Crash diets cause temporary hair loss due to incumbent nutritional factors e.g. anorexia, bulimia and other medical conditions.
Diets should contain protein, fruits, vegetables, grains, and an appropriate amount of fat. Deficiency will typically show in the hair. A mild case of anemia can cause shedding of hair. B group vitamins are significantly important for healthy hair, especially biotin.
When the body is under threat it reprioritizes its processes – the vital organs will be attended first – hair follicles may not be considered a priority. While not all hair growth issues originate from malnutrition, it is a valuable symptom in diagnosis.
The essential omega-3 fatty acids, protein, vitamin B12, and iron, found in fish sources, prevent a dry scalp and dull hair color. Dark green vegetables contain high amounts of vitamins A and C, which help with production of sebum and provide a natural hair conditioner. Legumes provide protein to promote hair growth and also contain iron, zinc, and biotin. Biotin functions to activate certain enzymes that aid in metabolism of carbon dioxide as well as protein, fats, and carbohydrates. A deficiency in biotin intake can cause brittle hair and can lead to hair loss. In order to avoid a deficiency, individuals can find sources of biotin in cereal-grain products, liver, egg yolk, soy flour, and yeast. Nuts contain high sources of selenium and therefore are important for a healthy scalp. Alpha-linoleic acid and zinc are also found in some nuts and help condition the hair and prevent hair shedding that can be caused by a lack of zinc. Protein deficiencies or low-quality protein can produce weak and brittle hair, and can eventually result in loss of hair cooler. Low-fat dairy products are good sources of calcium, a key component for hair growth. A balanced diet is necessary for a healthy scalp and hair.
Healthy hair growth requires a complexity of nutrients and a ready supply of oxygen but comparatively few authoritive studies have trialled ingredients to maintain or promote hair growth. However a balanced, bioavailable formula to protect and maintain hair growth is vital. Dietary supplements marketed to thicken hair or make it grow faster may prove of nil value.
A good multivitamin can be a foundation of health and nutrition. Changes in skin and hair can provide clues to the presence of an underlying vitamin deficiency.
Hair ultimately reflects the overall condition of the body. In health problems or nutritional deficiencies hair may stop growing or become brittle. If a body is in good health, it is possible to maximize genetic growth cycle through taking the proper blend of amino acids and B-vitamins.
Certain vitamins, minerals and amino-acids are crucial to the metabolic pathways involved in keratin protein (hair) metabolism., leading to a potential loss of hair and substantial degradation of hair health. There is a rather adequate research basis to justify product effectiveness claims for a vitamin, mineral and amino-acid complex designed to supply the nutrients needed by healthy growing hair.
B5 (pantothenic acid) gives hair flexibility, strength and shine and helps prevent hair loss and greying.
Vitamin B6 helps prevent dandruff and can be found in cereals, egg yolk and liver.
Vitamin B12 helps prevent the loss of hair and can be found in fish, eggs, chicken and milk.
It is also important to include B6, biotin, inositol and folic acid in the supplemental program. It has been found that certain minerals including magnesium, sulfur, silica and zinc are also very important toward maintaining healthy hair.
Vitamins B1, B2, Niacin & Pantothenic acid
Reduced levels of thiamin (vitamin B1), riboflavin (vitamin B2), niacin, and pantothenic acid can contribute to the undernourishment of hair-follicle cells. A dosage range of 25-50 mg daily is recommended.
A decrease in folic acid may contribute to decreased hair-follicle cell division and growth. Folic acid is also essential for the maintenance of healthy methionine levels in the body. Signs of folic-acid deficiency include anemia, apathy, fatigue, and graying hair. A therapeutic dose of 400-800 mcg daily is recommended.
Biotin, part of the vitamin B complex, is another nutrient associated with hair loss. Biotin is required for a number of enzymatic reactions within the body, and is necessary for the proper metabolism of protein, fat, and carbohydrates. Over time, poor metabolism of nutrients can contribute to undernourished hair follicle cells. Although rare, a biotin deficiency results in skin rashes and hair loss. A study conducted at Harvard University suggests that biotin is one of the most important nutrients for preserving hair strength, texture, and function.
People who are eating adequate amount of protein should not have a problem with biotin deficiency, though vegans may be at risk. Good food sources of biotin are eggs, liver and soy.
It’s not known if biotin supplements, which are marketed to help with male- and female-pattern baldness, can help with hair loss, and there are not any research indicating that the biotin in biotin hair products, such as shampoos, can be absorbed through the hair or scalp. The recommended dosage of d-biotin is 500-1000 mcg per day.
One of vitamin C’s major functions is to help produce and maintain healthy collagen, the connective tissue type found within hair follicles. Vitamin C is also a strong antioxidant and protects both the cells found within follicles and cells in nearby blood vessels. A daily dose of 100-200 mg of vitamin C is recommended for hair and skin care. Vitamin C with bioflavonoids – one to two grams daily
Vitamin E helps to maintain the integrity of cell membranes of hair follicles. The vitamin provides physical stability to cell membranes and acts as an antioxidant while promoting healthy skin and hair. A daily dose of vitamin E should be within the therapeutic range of 50–400 IU. Vitamin E and selenium work together to prevent attacks on cell membranes by free radicals by reducing peroxide concentration in the cell. Vitamin E – 400 to 800 IU daily
Beta-carotene is also important to hair growth. This is so because beta-carotene is converted to vitamin A as the body needs it, helps maintain normal growth and bone development, protective sheathing around nerve fibers, as well as promoting healthy skin, hair and nails. Dosage for Beta-carotene is 10,000 to 15,000 IU daily.
Vitamins A, C and E are antioxidants that enhance skin cell turnover and collagen synthesis. When applied topically these vitamins protect against premature skin aging from the damaging effects of ultraviolet light and environmental pollutants.
Vitamin C helps reduce the damage caused by free radicals and UV exposure. Over time, free radicals can damage collagen and elastin, the fibers that support skin structure.
Vitamin E also helps reduce the skin effects of free radicals and UV exposure.
Selenium is necessary for iodine metabolism. Case studies have indicated that selenium deficiency can lead to cancer, heart disease, and poor hair growth. Supplementation of 25-50 mcg of selenium per day is the recommended dosage.
Calcium – a fraction of the body’s calcium stimulates cell mediators that act on cell-membrane phospholipids in hair-follicle cells. Most Americans fail to meet the recommended daily intake for calcium. Patients have to be advised to take magnesium with supplemental calcium to maintain healthy calcium levels in the body. Without extra magnesium to balance it, large doses of calcium may be harmful. The recommended dosage is 100-200 mg of calcium per day.
Zinc is essential for DNA and RNA production, which, in turn, leads to normal follicle-cell division. Zinc is also responsible for helping to stabilize cell-membrane structures and assists in the breakdown and removal of superoxide radicals. Zinc intake is generally low. Topical applications of zinc have been shown to reduce the hair loss activity of 5-AR type II. The recommended dosage is 15 mg of zinc (in the form of zinc amino acid chelate) per day.
Zinc deficiencies, and any associated hair health, may associate with low-calorie diets, especially young women. Zinc is found in meat, eggs and seafood.
Iron deficiency causes microcytic and hypochromic anemia. Moreover, most other organs including the skin and pilo sebaceous follicles are affected.
Iodine – Suboptimal thyroid functioning can lead to abnormal hair growth. Because iodine supports proper thyroid functioning, 112-225 mcg of iodine (in the form of kelp) per day is the recommended dosage.
L-Methionine, one of four sulfur-containing amino acids, supports hair strength by providing adequate amounts of sulfur to hair cells. Sulfur is required for healthy connective tissue formation. Hair requires sulfur for normal growth and appearance.
L-Cystein – supports hair strength by the provision of sulphur. Skin, nails and hair are high in L-Cysteine. There is evidence that defficiency may be a factor in hairloss. Supplementing the diet accordingly may be helpful.
L-Lysine – It is interesting to note that male pattern baldness is less common in Asians than Americans. Is this in part due to he Asian diet being rich in L-Lysine -an enzyme inhibiting amino acid in vegetables and herbs affecting 5-alpha-reductase in some way.
Polyunsaturated fatty acids (PUFAs)
play an important role in cell structure, barrier function, lipid synthesis, inflammation and immunity. PUFAs help reduce dry, scaly skin. Most popular sources are walnuts, fish oil, flaxseed oil etc.
People on low-fat and non-fat diets are at risk for nutrition-related hair loss because hair needs essential fatty acids. Essential fatty acid deficiency causes a drying-up of the scalp and skin. These are vital nutrients that support follicular health. When the follicle is not healthy, hair loss or thinning occurs.
there is no solution for this. Even with outstanding nutrition, genetic blueprint is eventually going to take control and hair may change in colour, structure and density.
Contol of biological aging may be influenced by superfoods e.g. supergreen mixes, chlorella, spirulina, micro-algae extracts such as astaxanthin, broccoli sprouts fresh vegetables blueberries, raspberries, strawberries, blackberries etc also garlic, ginger and other culinary and medicinal herbs.
Water – is important in general bodily health and potentially good hair health. Water quenches thirst and aids food digestion.
Many common vitamins and all amino acids exist as multiple isomers; however it is rare that these are equally available to human metabolism. The chirality of amino acids is well established, as is the dramatic difference between left and right enantiomers in the human body. On the whole, humans can only metabolise left or L enantiomers, such as L-Cysteine. R-Cysteine is not taken up or commonly metabolised, therefore commonly used racemic mixtures of the two forms are only half comprised of useful amino acids.
Vitamins, such as vitamin B6 also have several forms, pyridoxine is the form of vitamin B6 most commonly used in nutritional supplements, however it is not the bio-active form. Instead it must be phosphorylated to become pyridoxal-5-phosphate, which is active as an enzyme cofactor for many reactions, and is important for uptake of other nutrients as well. The phosphorylation reaction to activate pyridoxine takes energy and a certain set of conditions, and therefore not all the pyridoxine taken in a supplement is used. A more efficient alternative is to use pyridoxal-5-phosphate in the supplement, so the bio-active form is immediately available, requiring no energy, and minimal wastage.
Bioavailability is not just controlled by isomeric forms. Nutrient uptake is complex, and there are many surprising instances where one nutrient is dramatically affected – either negatively or positively, by a completely different nutrient in the formula.
A final and often overlooked factor is the circulation of oxygen and nutrients to the hair. Even a perfectly balanced supplement would be ineffective without adequate blood flow to the hair. Hair loss may conceivably be caused or exacerbated by a deficient blood suppl,. therefore it may be beneficial to increase the circulation. This can be achieved through topical treatments that stimulate nitric oxide production or angiogenesis.
The stimulatory effects of caffeine and taurine on nutrient uptake and metabolism may also be beneficial. An added consideration is the possible effect of caffeine upon dihydrotestosterone and hair loss. Caffeine has been shown by several studies to reduce hair loss caused by dihydrotestosterone, the in vivo studies were successful topically, but the effects of oral caffeine have not been tested at this time. Taurine has also been shown by in vitro testing to protect the hair from TGFβ-1 induced apoptosis.
In spite of the paucity of clinical data in the area, it is possible through careful formulation to develop a potent, bioavailable, and balanced formula with combinations of ingredients that are likely to have good clinical outcomes. This is particularly true if supplements are used to support wider treatment regimes – even surgery.
The 10 top foods that are the foundation of healthy hair diet
The question often asked: what food I really have to eat to have good hair?
Healthy Hair Food No. 1: Salmon
Salmon and Mackerel provide omega-3 fatty acids, protein, vitamin B-12 and iron.
Essential omega-3 fatty acids support scalp health. Deficiency can result in a dry scalp and dull hair.
Vegetarians may source plant-based omega-3 fats from ground flaxseed macadamia nuts and walnuts.
Healthy Hair Food No. 2: Dark Green Vegetables
Spinach, broccoli and Swiss chard, provide vitamins A and C used in sebum production (secreted by hair follicles)
Dark green vegetables provide iron and calcium.
Healthy Hair Food N. 3: Beans
Legumes (kidney beans and lentils) provide protein, iron, zinc, and biotin. Biotin deficiencies can result in brittle hair.
Healthy Hair Food No. 4: Nuts
Brazil nuts are a natural source of selenium. Walnuts contain zinc and alpha-linolenic acid, an omega-3 fatty acid that may help hair condition. Pecans, cashews and almonds also contain zinc. Zinc deficiency can lead to hair shedding
Healthy Hair Food No. 5: Poultry
Poultry provides the high-quality protein and iron with a high degree of bioavailability.
Weak brittle hair may derive from protein defficiency.
Healthy Hair Food No. 6: Eggs
Eggs are sources of protein, biotin and vitamin B-12 – important beauty nutrients.
Healthy Hair Food No. 7: Whole Grains
Fortified whole-grain breakfast cereals, containing zinc, iron, and B vitamins are important.
Healthy Hair Food No. 8: Oysters
Provide zinc — a powerful antioxidant.
In addition to other sources e.g. whole grain, nuts, beef and lamb.
Healthy Hair Food No. 9: Low-Fat Dairy Products
Calcium, Whey and Casein are important minerals for hair growth sourced from skimmed milk and yogurt.
Healthy Hair Food No. 10: Carrots
Carrots are an excellent source of vitamin A.
A balanced diet of lean proteins, fruits, and vegetables, whole grains, legumes, and fatty fish (salmon) and low-fat dairy products are potential aides to hair.
Crash diets with rapid weight loss can affect the normal hair cycle causing increased shedding within 6-12 weeks. This temporary problem should recover with dietry improvements.
People experiencing hair loss should take appropriate advice from a physician, registered trichologist and registered dietician to determine the cause and any appropriate treatment.
Whereas nutritional solutions may not currently cure hair loss, they may slowly assist its condition.
- Blume-Peytavi, U. at all. Hair Growth and Disorders. Springer-Verlag Berlin Heidelberg. 2008.
- Goldberg, L.J. at all. Nutrition and hair. Clin Dermatol. 2010 Jul-Aug; 28(4):412-9.
Nutrition and Hair Health
by Melissa Bent
Nutrition can impact on the health of hair, Good nutrition can show in hair growth, strength, lustre. Deficient nutrition can correlate with, hair thinning, dull, dry or brittle hair.
Nutrient Deficiency may occur by crash dieting, eating disorders, medical conditions such as anaemia and thyroid anomalies.
The following vitamins are important for hair health;
Beta-carotene is converted to vitamin A as the body needs it. Vitamin A acts as a natural antioxidant and important to bone development and hair growth and forms a protective sheathing around nerve fibers, promotes healthy nails and skin. If taken as supplement, the recommended daily dosage of Beta-carotene is 10,000 to 15,000 IU.
Is one of the most important nutrients for hair strength, texture and function. It is found naturally in a high protein diet such as Liver, eggs and soy. If taken as a supplement, the recommended daily dosage of d-biotin is 500 – 1000 mcg.
- Vitamins B1, B2, Niacin & Pantothenic acid
A Reduced levels of vitamin B1 (thiamin) , vitamin B2 (riboflavin), niacin and pantothenic acid lack of these vitamins can leave the hair follicles under nourished.
- Vitamin B5 (pantothenic acid)
Contributes to hair strength, hair flexibility and lustre. This vitamin helps to prevent hair loss and contributes to the retention of melanin which stops hair from turning grey.
- Vitamin B6
This vitamin can naturally be found in egg yolks, liver and cereals and helps to prevent seborrheic dermatitis (dandruff).
- Vitamin B12
This vitamin can naturally be found in chicken, fish, milk and eggs and helps to prevent hair loss.
- Vitamin D
Low vitamin D can affect the severity of patients with Alopecia Areata a non-scarring alopecia.
- Vitamin E
This vitamin acts as a natural antioxidant to promote healthy hair and skin. It provides physical stability to cell membranes by maintaining their integrity to hair follicles and teaming up with selenium to prevent attacks from radical cells by reducing the amount of peroxide present in the cell to maintain the cell membrane. If taken as a supplement, the recommended daily dosage of Vitamin E is 400 – 800 IU.
This vitamin acts as a natural antioxidant and plays an important role in iodine metabolism which is mostly located in the thyroid gland. A deficiency in selenium can lead to poor hair growth, cancer or heart disease.
If taken as a supplement, the recommended daily dosage of selenium is 25 – 50mcg.
- Folic acid (Folate)
Folic acid is essential for the maintenance of methionine levels within the body. A lack of folic acid will result in a decrease in hair follicle cell division and growth. Other symptoms of low folic acid are fatigue, premature hair greying, apathy and anemia.
If taken as a supplement, the recommended daily dosage of folic acid is 400 – 800 mcg.Trace elements essential for hair health;
Cell mediators that act on cell membrane phospholipids in hair follicles are stimulated by a portion of the bodies calcium supply.
Zinc plays an important role in DNA and RNA production. stabilizes cell membrane structures and helps to break down and remove and superoxide radicals. Generally zinc intake is low, it can be found naturally in seafood, meat and eggs.
If taken as a supplement, the recommended daily dosage of Zinc in the form of zinc amino acid chelate is 15 mg.
Topical zinc applications have proven to be effective in the reduction of hair loss activity for 5 alpha reductase type 2 (5-AR type II), enzymes involved in steroid metabolism.
- Low calorie diets are usually an indicating factor in young females that zinc levels maybe low.
Iron deficiency causes anaemia, which affects the most organs and pilosebaceous follicles. Hair loss caused by a deficiency of iron, appears in the form of male or female pattern baldness, however, hair loss due to iron deficiency is not permanent.
Ferritin (protein) levels which helps the body retain iron. its presence can be supplemented.
this supports thyroid hormone production, any disruption may cause slower hair growth.
- L-Methonine is one of four amino acids that contain sulfur. Sulphur is needed by the hair cells to support hair strength and growth. it promotes healthy connective tissue formation.
- L – Cystein is one of the four amino acids that contains Sulphur. High levels of this amino acid play a vital role in hair, nails and skin. Should a deficiency occur, hair loss may be an indicating factor.
- L Lysine is one of the four amino acids that contributes to males pattern baldness should a deficiency occur. A typical Asian diet is rich in L – Lysine therefore affecting the 5 – alpha-reductase enzyme levels which reduces the effects of male pattern baldness.
- L-Taurine is one of four amino acids, this is regarded as one of the most important for hair health. It is a building block for proteins such as keratin which is what hair fiber is made of. L – Taurine can be found naturally in fish and meat. A deficiency in L -Taurine can causes hair to lose its colour, keratin strength and even result in hair loss.
- Polyunsaturated fatty acids (PUFAs)
Fatty acids are vital nutrients essential for hair growth, thus finding low or non fat diets can result in hair loss as the lack of fat causes the skin and scalp to dry up. Bad fats can also encourage the production of DHT. DHT derives from testosterone, in large quantities it can attack the hair follicles, causing it to narrow and shrink which causes hair loss and or hair thinning. PUFA’S can be naturally found in walnuts, flax seed or fish oil, they play an important role in cell structure, barrier function, lipid synthesis, inflammation and immunity.
Complex carbohydrates play a major role in converting protein into hair cells. They provide the energy needed as hair is the bodies second fastest growing cell structure. The body gives low priority to hair presence and a prolonged lack of carbohydrates may result in the body converting stored proteins such as muscle into energy, which can also result in hair loss.
Complex carbohydrates can be found naturally in; baked beans, whole grain cereal , peas, parsnips, jacket potatoes, barley, oatmeal, brown rice, pasta, legumes, fresh fruit.
Once consumed energy to hair cells drops 4 hrs after eating, regular snacking on complex carbohydrates in between meals will sustain energy levels.
Ageing is an inevitable process in which bodily functions start to retard. Hair may become under-nourished. and may undergo colour, structure and density changes `Some foods may be effective in the control of biological ageing. Items such as blueberries, broccoli, sprouts, garlic, ginger, super green mixes or medicinal herbs are beneficial to health.
Water – is important in general bodily health and potentially good hair health. Water quenches thirst and aids food digestion.
Treatment and Prognosis
A blood test combined with a clinical hair examination and questioning will ascertain which nutrients are deficient. It is a case of replacing those deficient to the levels in which they will function correctly. Once the optimal levels have been reached, the hair loss will cease, hair growth restored to normal functioning, hair will gain back it’s lutre, thicken and regain its strength. Should these levels relapse the hair loss, hair thinning, dull, dry or weakend hair will reoccur.
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Standring, Susan (2008) Gray’s Anatomy: The Anatomical Basis of Clinical Practice. London: Elsevier
Dawber, R.P.R. (1997) Diseases Of The Hair And Scalp. Oxford: Blackwell Science Ltd
Dawber, Rodney Pr. Neste, Dominique V (2004) Hair And Scalp Disorders. Oxford: Martin Dunitz
Blume-Peytavi, Ulrike et al (2008) Hair Growth And Disorders. Germany: Springer
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