Friday, 11 January 2013

My Open Reply To The Response To "What Diet Is Optimal For Growing Longer Hair?"

Writing essays about hair ...
I received a nicely thought out comment last month in response to my post "What Diet Is Optimal For Growing Longer Hair."

I started to reply, but it turned into an essay, and the comments box is no place for essays!

I felt it deserved proper attention, so if you happen to like a bit of science, here is the original comment and my rather in-depth response:

Another very interesting post! For the most part I completely agree with you and am very happy to hear somebody finally extolling the rubbish behind all the supplements and suchlike out there. 

I think that first of all, it's important to reiterate that if your diet is well balanced but your hair doesn't reflect that, then it's worth going to see the doctor because it can be a sign of an underlying problem, like an underactive thyroid gland. 

Secondly, there are a few supplements or dietary changes that may have an impact on hair growth. Even if you are not clinically undernourished, it is still possible to see effects from subclinical deficiency. 

Blood tests always give an ideal range, but we are all different and have varying values of "normal" physiology, so one person's low-but-feeling-fine value might be another person's low-and-feeling-quite-ill. 

Iron is one such example. The principle behind iron and hair grown is actually much the same as that of minoxidil, except that the opposite occurs in anaemia: the scalp is less perfused with oxygen, so the follicles' output is reduced. 

Given that some 40% of women are, at varying points in a given month, anaemic from iron deficiency, then it's not hard to see why iron supplements can help hair growth. Vitamin B12 deficiency can also lead to poor hair growth and is hard to spot. 

It's common in vegetarians and vegans (especially those of us who don't like mushrooms!) - but then we return to your well-made point about a balanced diet. 

Lastly, I hope you don't mind if I make a really pedantic point ;-) Humans may not have hooves, as such, but we do have fingernails - which are exactly the same thing as hooves, but smaller! 

Hooves are simply very compact keratin and, if you go back through the evolutionary tree, you'll see that horses are actually walking on nothing but their middle fingernail! 

Apologies for the essay, but this is one of my pet topics and it really is wonderful to hear somebody talking sense at last! 


Dear Ells,

Nice to hear from you again!

Thank you so much for your comments. It's clear you are interested in this stuff, which is great, so I wanted to share with you and anyone else who doesn't mind going into the science some clinical research in recent years very specifically examining the relationship between hair and iron and B12 supplementation.

I also want to show - to be fair to all my regular readers - that the information I present on this blog isn't made up in my own head, nor am I just asserting a personal opinion on this topic.

I wholly agree with your point, which I think can be fairly summed up by saying hair loss can be a symptom of illness or malnutrition. And if you are concerned about thinning hair you should go see your doctor.

However - and I believe we're also in agreement on this point - if one simply wished she had thicker, longer hair that grew faster she, frankly, cannot take supplements to achieve that goal.

This blog is about hair, of course, not nutrition.

In particular this blog is about exploding a lot of the myths that infuriatingly crop up over and over in the popular press promising women "longer, stronger hair."

Now, more specifically your point about connecting anaemia to hair loss:

It is true that the information you mention in your comment has been the received medical view since at least 1963 with the research published in the Swedish journal Act Dermato-Venereologica by S. Hård, and repeated in a number of small studies conducted in the following 25 years.

In all dermatology textbooks, this is the research cited to support this view.

So it is not radical nor unusual.

However, I think you'll find the following studies fascinating.

Iron Deficiency And Female Pattern Hair Loss

Regarding iron deficiency, around 2008-2009 there was a call for more and larger controlled testing of the relationship between iron and female hair loss.

In 2010 a study at Duke University studied 457 women (both pre and post menopausal) and found that while iron deficiency is high in the sample studied, NO correlation between hair loss and iron deficiency was seen.

Indeed, iron deficiency was higher in some cases in the control group of women who had no symptoms nor history of hair loss.

This underlines an important assumption which I hear endlessly in women's groups and read in glossy magazines, which is a belief that if you increase the blood supply to the head, or somehow fortify the blood this will help grow hair.

Along these lines, I must correct your idea that the drug minoxidil and iron work in similar ways.

Iron is of course critical for the delivery of oxygen throughout the body, which is precisely what you said.

With Minoxidil, however, what is believed to occur is that the drug, used externally, somehow encourages the growth of the blood vessels specifically around every follicle site where the serum is applied.

Precisely how that happens with respect to Minoxidil is not entirely clear, however it is agreed that follicles lacking their own vascular network, or having one of an inadequate structure (too few, too small or too constricted) are not able to grow hair.

These follicles are either dormant or entirely dead.

If the hair loss is caused by a lack of follicular blood vessels specifically, increasing the oxygen content of the blood generally will not be sufficient to resolve the problem absent a vascular network in place at the follicle site.

Indeed, back in 2006, the recommendation published in the Journal of the American Academy of Dermatology concluded, "Currently, there is insufficient evidence to recommend universal screening for iron deficiency in patients with hair loss. In addition, there is insufficient evidence to recommend giving iron supplementation therapy to patients with hair loss and iron deficiency in the absence of iron deficiency anemia." (Emphasis mine.)

This repeats a similar conclusion found in a small study published in the British Journal of Dermatology, conducted at the University of Melbourne between 1997 and 1999, which found patients identified for treatment using iron supplementation alone showed neither cessation nor reversal of hair loss in any instance.

This study concluded that "no direct relationship between low serum ferritin and hair loss can be established.

The usefulness of serum ferritin in the routine investigation of women with chronic diffuse telogen hair loss is unclear, as is the role of iron supplementation therapy in the management of hair loss."

This isn't to say one shouldn't treat anaemia, obviously.

One's health and wellbeing is of course improved by resolving this deficiency.

But my point is that you are unlikely to grow more hair by supplementing with iron, whether you are deficient or not.

B12 Deficiency And Female Pattern Hair Loss

Regarding B12, the interest in this particular micronutrient again comes from the earlier belief in a possible connection between pernicious anaemia and hair loss or thinning in women.

If you generally feel well, you are unlikely to be deficient in B12.

Deficiency definitely leads one to feel unwell.

If you feel unwell, you need to speak to a doctor, not have a debate with me, The Hair Clip Lady, who's only interested in hair.

The point to hand is whether you can take supplements to grow your hair.

If you are healthy, the answer is still no.

The most recent clinical study in this area was in 2012, where a study at Ankara University in Turkey surveyed 129 women.

Again, NO correlation between B12 blood levels and hair loss was found.

This supports an earlier survey which looked at blood levels of several micronutrients, which also found NO correlation with regards to hair loss.

Nutritional Advice For The Vast Majority Of Women In The West Who Wish They Had More Hair

I'm not a doctor. I'm not going to tell you what to eat and what not to eat, or whether or not those vitamin supplements are doing you any good or not.

There are a thousand other blogs populating the internet who'll do that!

But if you are a woman in the West who wishes she had more hair, I have this advice for you:

Provided you are already eating a normal balanced diet and not taking any medication that messes with your hormones, properly structured research across large populations of women over the past decade are showing that you categorically cannot take vitamin supplements and grow longer hair faster.

Thanks Ells, for bringing all these points out for deeper discussion.

I alway appreciate it.

(Have fun reading the research!)


Having fun? Don't stop now!

More posts you'll enjoy:

Damaging Hair "Advice" From Around The Internet
Adding Volume To Your Ponytail Style
Hilary Clinton And The Hair Claw

All done reading? Visit Stone Bridge Hair Accessories for some super cute hair clips.

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