March 1, 2018 at 12:39 pm #822Nathalie GudgeonParticipant
Would welcome feedback on this case please, many thanks;
15 year old boy started to experience hair loss age 13 after a not easy transition to high school. He was very active up until this point, lots of tennis and exercise. Now obsessed with X box (have addressed link with stress here and how to find a balance)
Past history of ear infections and antibiotic use.
Genetic history of AI disease (MS and RA on mother’s side). Mother also experienced some hair loss as a teenager but did not develop into Alopecia. Mother very anxious and does not sleep. Father very strict and boy a little afraid of him (could understand why). Lives with mum.
The boy’s hair did grow back for 3 months at age 14 but hair loss started again and is now quite significant. The family have started steroid injections.
He also suffers from bloating , tummy pains and nausea. Would like to rule out H Pylori.
Serum Ferritin levels are low – he has been advised by Tricologist to take 200mg of ferrous sulphate twice daily to increase levels to 80-100 (advises for hair growth). They are currently at 43 (10-322 ug/L). Talked to the family about gut health here and need to do stool test.
Vitamin D is low 71 nmol
TSH is 4 (borderline high)
Free T4 was 16.7 and his serum thyroid peroxidase antibody was negative
Serum C Reactive Protein was negative
Tissue transglutaminase IgA level was negative
I have suggested an elimination diet and we are in the process of ordering a GI Map with zonulin. I’ve also asked for a full thyroid panel.
Mum and Dad would like specific references to Alopecia and Gut Permeability (aware of a lot of research connecting AI).
I’ve added in Vitamin D complete 1 x day
Arthred collagen 1 scoop x day
S Boulardi 1 x day
B complex 2 x day
Pro Omega 1000mg 1 x day
Probiotic 1 x day
Also suggested good protein powder and good green stuff (nuzest)
I would be interested to hear any additional thoughts for this boy – especially relevant to addressing iron deficiency.
posted by Nathalie Gudgeon 1.3.2018
March 5, 2019 at 12:41 pm #823Christine BaileyModerator
Many thanks for your question about your client who is suffering with hair loss at a young age. You have already identified a lot of key links and I agree with you that a stool test would be recommended. I would also suggest looking at the Cyrex testing – arrays 3 and 4 as these are particularly helpful when autoimmune conditions are evident. However, these would not be possible if the client is taking steroids as these will interfere with the results.
Alopecia areata, an autoimmune condition in which the immune system attacks hair follicles, can affect children and adults of both genders. It causes round patches of balding, mostly on the scalp and beard region. This can be aggravated by hormone changes and this may explain why it is now noticeable as the boy goes through puberty.
In patients who opt for treatment, corticosteroids that suppress the underlying autoimmune process can be applied to affected areas either as cream or injections, and oral corticosteroids are used in some cases of extensive hair loss.
Qi J, Garza LA. An overview of alopecias. Cold Spring Harbor perspectives in medicine. Mar 2014;4(3). https://tinyurl.com/y8buxy5x
Various B vitamins can be helpful for hair growth. Forty-six women with diffuse alopecia received 200 mg per day of oral vitamin B5 plus daily intramuscular injections of vitamin B6 for 20–30 days. The treatment was repeated after six months and resulted in improved hair condition and reduced hair loss.
Brzezinska-Wcislo L. [Evaluation of vitamin B6 and calcium pantothenate effectiveness on hair growth from clinical and trichographic aspects for treatment of diffuse alopecia in women]. Wiadomosci lekarskie (Warsaw, Poland: 1960). 2001;54(1-2):11-18. https://tinyurl.com/y72t56ly
Some preliminary evidence suggests that biotin supplementation may help treat alopecia caused by the medication valproic acid.
Famenini S, Goh C. Evidence for supplemental treatments in androgenetic alopecia. J Drugs Dermatol. Jul 2014;13(7):809-812. https://tinyurl.com/yb95lu74
A growing body of evidence shows that vitamin D participates in regulation of the hair cycle (Amor 2010; Low serum vitamin D levels are associated with autoimmune disorders including alopecia areata.
Mahamid M, Abu-Elhija O, Samamra M, Mahamid A, Nseir W. Association between vitamin D levels and alopecia areata. The Israel Medical Association journal: IMAJ. Jun 2014;16(6):367-370. https://tinyurl.com/yaobme6w
Protein deficiency is a well-established cause of hair loss, and one protein, keratin, is the main component and primary structural element of hair so protein is important in the diet and yes, the collagen could be helpful.
Silicon, a trace element present in the body in small quantities, is thought to function as a structural component of hair.
Martin KR. Silicon: the health benefits of a metalloid. Metal ions in life sciences. 2013;13:451-473. https://tinyurl.com/y9regxxl
Lower zinc levels in patients with alopecia areata have been correlated with increased severity, longer duration, and higher likelihood of treatment resistance.
Bhat YJ, Manzoor S, Khan AR, Qayoom S. Trace element levels in alopecia areata. Indian journal of dermatology, venereology and leprology. Jan-Feb 2009;75(1):29-31. https://tinyurl.com/ybc9m5n5
Emerging evidence suggest tocotrienols may help promote healthy hair. In a study involving 38 women and men with various types and degrees of hair loss, those receiving supplements with 23 IU alpha-tocopherol plus 50 mg mixed tocotrienols experienced > 34% increase in hair numbers over eight months, while those receiving placebo experienced a slight decrease in hair numbers.
Beoy LA, Woei WJ, Hay YK. Effects of tocotrienol supplementation on hair growth in human volunteers. Tropical life sciences research. Dec 2010;21(2):91-99. https://tinyurl.com/yanntohp
Selenium intake is important for healthy hair follicle function, and selenium deficiency may play a role in hair loss.
Yes, iron is important – one study found lowest ferritin levels were associated with most severe hair loss. Assessment of iron status, and iron supplementation if necessary, can be considered in women with hair loss. like the spa tone product which is easy on the digestive tract. You could also add in lactoferrin as well to aid absorption and improve iron levels.
Rasheed H, Mahgoub D, Hegazy R, El-Komy M, Abdel Hay R, Hamid MA, Hamdy E. Serum ferritin and vitamin d in female hair loss: do they play a role? Skin Pharmacol Physiol. 2013;26(2):101-107. https://tinyurl.com/yd3el73q
This is a good paper on the condition and autoimmunity – it highlights the key link with thyroid autoimmune conditions.
Abi et al. Alopecia areats & autoimmunity: a clinical study. Indian J Dermatol. 2008; 53(2): 70–74. https://tinyurl.com/yaq2q57b
This paper includes comments on gut health as being important.
Skogberg et al. Mechanisms of tolerance and potential therapeutic interventions in Alopecia Areata. Pharmacol Ther. 2017 Nov;179:102-110. doi: 10.1016/j.pharmthera.2017.05.008. https://tinyurl.com/yd46ybjy
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Vitamin D3 Complete (ARG) – take 1 daily – https://tinyurl.com/jqx3ttt
Bio-3B-G (Special B Complex) (BRC) – take 2 twice daily
Zn-Zyme (BRC) – take 1 daily – https://tinyurl.com/lnlffjd
Arthred Collagen powder (ARG) – take 1tbsp twice daily – https://tinyurl.com/j2arfe4
Whey Protein Concentrate (BRC) – take 1 serving daily – https://tinyurl.com/j39tt95
Laktoferrin with Colostrum (ARG) – take 2 daily – https://tinyurl.com/jsq55kx
Tocomin SupraBio Tocotrienols (ARG) – take 1 daily – http://tinyurl.com/jv9pntj
I hope this helps answer your question
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