A Wholistic Biochemical Approach To Understanding Unique Reasons for Hair Loss | Toronto/Richmond Hill Naturopathic Doctor
By: Dr. Nicole Roberts, Naturopathic Doctor
Hair loss has become a ubiquitous concern that I see across almost every age and gender population, appearing with frequency in as young as mid to late teens. This is definitely not a health concern reserved for middle age anymore. From diffuse hair loss across the head to receding hair lines or balding patches, hair loss is fast becoming a problem for many.
Losing hair, especially when the cause is unknown, is very distressing. Hair is personal! It may be a part of our appearance, we can cut and style it to suit our personality, and healthy hair is perhaps considered a sign of health and vibrance for some. When our physical self changes, it can be an emotionally draining process.
The difficulty in treating hair loss comes from 3 main factors:
- The cause of hair loss in an individual is usually multifactorial and unique to the person
- Hair can be quick to fall out and slow to regrow
- Healing hair loss often means healing the body as a whole
CAUSES OF HAIR LOSS; THE PERFECT STORM
*Note; this article is focusing on hair loss outside of conditions that cause lesions on the scalp. Evaluating scalp rashes and taking skin scraping to identify any fungal or other dermatologic causes is important if present.*
Common Causes of Hair Loss:
- Insulin & Blood sugar dysregulation
- Estrogen, Progesterone, Androgen ratios
- Thyroid Function; Hypo or Hyperthyroidism; an individual may have thyroid function that looks “normal” with blood work but is suboptimal function for them
- Iron Deficiency
- Stress: Telogen Effluvium
- Infectious Trigger: Viral infection
- Nutrient Deficiencies; Zinc, Selenium, B-Vitamins, Vitamin D, Silica, Sulfur-rich amino acids, etc
- Overburdened Liver Function
- Autoimmunity; triggers can be mold / mycotoxin exposure, viral infection, stress along with a genetic predisposition
- Side Effect of Medication
- Side Effect of Natural Health Products
Hair loss may occur when a number of the above factors come together and interact. The bodys’ systems all interlink and this deep connection means that most of the symptoms we experience are multifactorial in nature.
For example, iron deficiency, something very common in menstruating women, contributes to low conversion of active thyroid hormones. Poor insulin sensitivity and blood sugar regulation is something I commonly find in patients that had no idea they were in a pre-diabetic range. Insulin and the adrenal hormone cortisol, are intimately related to stress and inflammation. Healing estrogen, progesterone and testosterone, common reasons behind hair loss, is a result of healing adrenal function, stress levels, thyroid function, and nutrient levels. Stress, viral infections, gut health and vitamin D levels can be joint catalysts in autoimmune presentations.
The body works as a whole, and therefore must be healed the same way.
GETTING DEEP INTO THE BIOCHEMISTRY
When all the bases above are covered and hair loss still hasn’t been healed, we get to go deeper into what I call, “the fun stuff” aka the inner workings of your metabolism, to pinpoint exactly what how your body functions and where it might be getting “stuck”.
When we look at your metabolic input (your genes & genetic polymorphisms) and metabolic output (such as urinary metabolites) we can begin to understand a clearer picture of your unique metabolic function.
Methylation Pathway Function
Single nucleotide polymorphisms are a very common type of genetic variation that makes our our DNA unique.
These polymorphisms may be subject to epigenetic changes, that is - our environment can affect how our genes express themselves. Understanding your polymorphisms around methylation (the transfer of methyl groups between nutrients/metabolites) can determine how your body uses certain nutrients in biochemical processes, chiefly B vitamins and sulphur containing amino acids. A study looking at 266 patients reported a polymorphism of the MTHFR gene (a gene that creates the enzyme methylenetetrahydrofolate reductase that affects DNA methylation, folic acid utilization, etc) known as the C677T mutation, was correlated with a higher incidence of alopecia arreata, otherwise known as spot baldness where the immune system attacks hair follicles.(1) It is common in younger patients of either gender.
A study of European men found that specific SNPs could be used to further the prediction of whether a man would experience male pattern baldness.(2) Interestingly enough, a 2010 study found that men experiencing early male pattern baldness due to androgenetic alopecia had a higher risk of cardiovascular disease.(3) Cardiovascular disease risk markers have been explored in the research with regards to poor methylation status, which may show another link between hair loss and methylation.
Methylation pathways may explain why a person may notice hair loss accelerate after taking a natural health product in high doses or with a change in diet / lifestyle.
When you add a large dose of anything into your body, from a specific vitamin or mineral to stress, toxins, etc, the body is likely to respond to this added input with a shift in its biochemical reactions. This shift can draw on resource pools of nutrients, leaving unintentional deficiencies that throw metabolic pathways out of whack and have the potential to change gene expression! This is why high dose nutritional support of methylation pathways should be specific to the individual and monitored by a health care professional who understands their influence.
Mitochondrial & Cell Membrane Function
Poor mitochondrial health can be the missing link with tough to treat conditions like chronic fatigue and chronic hair loss. Studies in mice found that impairment of mitochondrial oxidative phosphorylation lead to significant delays in the regeneration of hair that had been plucked.(4) The presence of Super Oxide Dismutase (SOD2), is instrumental in preventing the damage of mitochondria from reactive oxygen species. (4) Overall, we see that mitochondrial health, which is supported by key components of nutrition, is necessary in healthy hair regrowth. In addition to nutrition, genetics, supplementation, inflammation levels and lifestyle all effect mitochondrial health.
Methylation and Mitochondrial function are only 2 of many biochemical pathways we may look at. Gut health & the microbiome, liver function and epigenetic factors including sleep health, stress levels, diet and exercise all play a macro role in the micro function of metabolism.
The health care professionals of the future (and present!) are fast becoming personal health detectives. To understand how to heal an individual and encourage optimal function of both body and mind in a society that keeps increasing stress after stress on the human condition, this is the new task at hand.
I hope this article provided some context (albeit limited compared to how intricate the body is) to hair loss in a variety of populations and explain why over the counter supplements and shampoos not used in conjunction with a clear diagnosis and treatment plan, are not sufficient treatment for many people with hair loss.
1. Kalkan G1, Yigit S, Karakuş N, Ateş O, Bozkurt N, Ozdemir A, Pancar GŞ. (2013) Methylenetetrahydrofolate reductase C677T mutation in patients with alopecia areata in Turkish population. Gene; 1;530(1):109-12. doi: 10.1016/j.gene.2013.08.016
2. Marcinska, M, et al. (2015) Evaluation of DNA Variants Associated with Androgenetic Alopecia and Their Potential to Predict Male Pattern Baldness. doi.org/10.1371/journal.pone.0127852
3. Arias-Santiago S, Gutierrez-Salmeron MT, Castellote-Caballero L, Buendia-Eisman A, Naranjo-Sintes R. (2010) Male androgenetic alopecia and cardiovascular risk factors: A case-control study. Actas Dermosifiliogr; 101(3):248-56.
4. Tang Y, Luo B, Deng Z, Wang B, Liu F, Li J, Shi W, Xie H, Hu X, Li J. (2016) Mitochondrial aerobic respiration is activated during hair follicle stem cell differentiation, and its dysfunction retards hair regeneration. PeerJ 4:e1821
About The Author
Dr. Nicole Roberts, ND is registered with the College of Naturopaths of Ontario and is a member of the Canadian Association of Naturopathic Doctors.
Dr. Roberts, ND sits on the YPC Board of the Women's Brain Initiative and is involved with Heal At Home drug addiction recovery programs
I want to help you get back to the best version of yourself so that you can get back to your life.