Your dermatologist has just diagnosed you with Telogen Effluvium, or the “excess shedding of resting hairs”. What can I do about this? Do I need blood tests? Is there something I can take as a supplement? I heard about biotin, does it work?
The first part is to identify what may have caused the hair loss, and if there is a specific reason, such as weight loss, childbirth, major illness or surgery, or major traumatic life event, that the hair shedding should resolve without requiring any specific intervention. If a cause cannot be identified, some laboratory studies should be considered, particularly for iron deficiency, vitamin D deficiency, and thyroid disease. The laboratory studies to be considered are: ferritin, vitamin D, and TSH.
Iron deficiency is the most common nutritional deficiency in the world. Ferritin is a measure of the body’s iron stores. Iron is essential in many of the body’s metabolic functions, and as the body’s iron stores are depleted, these processes are affected negatively. Studies have shown that women with hair loss are often iron deficient. If you are determined to be low in iron, you should also have vitamin C supplementation, as it is essential for iron absorption in the intestine.
Vitamin D is important in immune function, and low vitamin D levels are common. Although studies have not shown low vitamin D levels to be significantly associated with telogen effluvium type hair loss, supplementation is recommended.
Thyroid disease is associated with different forms of hair loss, and since thyroid hormone is the major metabolic stimulator in the body, it is important to check to make sure the thyroid is working properly. If TSH, or thyroid stimulating hormone, is too high or too low, then the thyroid gland is not working properly and additional tests are needed.
As for all the other vitamins and supplements that have been recommended for hair loss, there is little to no data to suggest that any of them can improve hair growth or slow hair loss. Yes, this includes biotin, which has been the subject of controlled studies. Furthermore, taking large doses of biotin can affect the results of other blood tests. However, pregnancy, alcoholism, and malabsorption can cause acquired biotin deficiency, as can a diet that is very low in protein intake, as dietary protein is the main source of biotin, and in these circumstances biotin supplementation may be beneficial.
Zinc is found in fish and meat. Like biotin, low protein diets, as well as pregnancy, alcoholism, and malabsorption can cause acquired zinc deficiency, and supplementation may be beneficial.
Selenium is available in many foods, so supplementation should generally be avoided, as excess selenium may be toxic, and side effects can include hair loss.
Vitamin A supplementation for treatment of hair loss should be avoided, as it has been associated with hair loss.
In closing, a balanced diet which includes adequate protein, is extremely important in all patients with hair loss. Proteins are broken down into the essential building blocks for our body, and without proper nutrition, the body will conserve its energy and these essential nutrients to maintain its most important functions to survive.