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The overall problem I have with the herbal, nutritional products is that companies can make these products in any way they want, without any federal regulation governing them. So, “anything goes”, they are not regulated by the FDA or any government agency. As long as they watch their claims (even so they cross the line making outrageous claims), the FDA won’t come after them. I have found many of these products to vary in potency, purity, consistency from batch to batch so that you don’t know what you are getting, leading sometimes to real safety hazards, because they are considered as nutritional/herbal supplements and not thought to be harmful.
There have been cases where people get sick, and have bad side effects from taking these supplements bought at their local vitamin store or any other retailer. People also need to be aware of the drug interactions these products may have with any prescription drugs they are taking. Many herbal/nutritional agents are taken at high doses with multiple frequency thru the day, and they really haven’t been tested to their claims, not to mention, purity, concentration, consistency, any other additives from batch to batch.
I’m always asked about herbal and other nutritional supplements, and whether they help treat hair loss. The problem is that numerous herbal remedies make “hair” treatment claims and very few (or none) have undergone rigorous clinical trial testing. From a medical perspective, it is pretty well accepted that sudden weight loss, or crash dieting, loss of specific nutrients, such as B-vitamins, proteins, etc. from fad dieting, can initiate a telogen effluvium, or “hair shedding” process that can lasts months.
People don’t usually correlate the hair shedding to diet changes changes because it doesn’t start until a few months later. This is quite similar to postpartum effluvium (shedding) that women experience 2 to 3 months after giving birth. For most patients experiencing hair loss, it is best to do a thorough history of what happened 1 year ago, 6 months ago, or 3 months ago with regard to immunizations, exposure to any illnesses, fevers, diet/nutritional changes, etc. A lot of times, you can find a culprit in the basket that started the process.
For women, it is even tougher because their menstrual history is important. Women may notice their menstrual cycles are heavier, with greater blood loss, and sure enough, they can be anemic, which correlates with hair shedding and thinning. For many women, it can be a chronic hair shedding that never recovers. I would usually advise women to take a multi-vitamin of their choice and extra vitamin C with iron. It can’t hurt and might help alleviate any underlying anemia they may be experiencing. Why the vitamin C? It helps absorb the iron in the gut.
To me, that is about all the nutritional supplementation that you need.
Men would probably benefit from the multi-vitamin, vitamin C with iron, since our diets are “on the run” these days with nutritional content being varied so much from day to day. By and large, if you are a normal, healthy American on a “normal” diet, with no apparent nutritional problem, then taking high doses of extra vitamins, nutritional supplements, herbal agents may not be required.
There have been so many herbal supplements that have hit the marketplace, and for some people taking them who have hair loss, they swear they are seeing improvements. The problem is documentation. People want proof in the way of standardized photography taken by experts with controlled lighting, film exposure and film quality. Taking a snapshot, or quick digital photo just doesn’t cut the mustard.
For now, CAUTION is advised for any nutritional/herbal supplement you decide to take to treat your hair loss. For many, like biotin, they may not hurt you, but I doubt it will really help you.
Next issue will continue on herbal remedies and will discuss: Pygeum, Nettles, Green Tea, and Omega-3 Fish Oils.
Marty Sawaya MD, PhD
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