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Hair Loss/Nutritional deficiency


QUESTION: Hi Dr Peter,

Dr Peter, Suppose if someone have male pattern baldness, but along with male pattern baldness he also has Nutritional deficiency so the nutritional deficiency would cause telogen effluvium? or nutritional deficiency would accelerate/increase his male pattern baldness ?

ANSWER: It is rare for nutritional deficiencies to cause TEs. When they do they can accelerate male pattern baldness a chronic illness can cause repeated TEs leading to early inherited pattern loss.

This is from my book "Hair Loss Answers"
Chapter 4: Other Hair Loss Causes
Nutritional Deficiencies

Nutritional deficiencies are rarely a cause of hair loss despite the marketing of a wide variety of nutritional supplements that claim to somehow enhance hair growth or hair health. Of the possible nutritional deficiencies that can cause thinning hair, iron deficiency anemia is most common, and when it occurs it is more frequently seen in women. Iron deficiency anemia is a result of a decreased amount of red blood cells in the blood because of inadequate iron reserves in the body.

There are several causes for this condition, including inadequate consumption of iron-containing foods, poor absorption of iron in foods or supplements, and loss of blood.

The main sources of iron in a typical western diet include meat, egg yolks, poultry, fish, legumes (lentils, dried peas and beans), whole grains, iron-fortified cereal products and iron-containing multivitamin tablets. Poor absorption of iron can result from disease conditions or from certain medications that interfere with iron absorption. Low red blood cell count from periodic blood loss can contribute to anemia because the body normally recycles the iron in worn out red blood cells. If the blood is lost, the iron in those cells is lost as well. Menstruation is the most common cause of blood loss-induced iron deficiency anemia; however; blood loss can also result from injury, frequent donation of blood, and internal bleeding from digestive system ulcers and various disease conditions.

The first step in determining if iron deficiency anemia as a cause of a hair loss condition is a blood test for ferritin levels. Ferritin is an iron-storing protein that circulates in the blood and reflects the body’s iron reserve level. Just taking an iron supplement is not likely to stop hair loss. If a serum ferritin blood test indicates a deficiency, the next step is to determine the cause of the iron deficiency, and to effectively treat the condition. Many doctors and laboratories assume the normal range of serum ferritin to be 10-230 grams per liter. But in the past few years it has been found that women with levels below seventy have an increased chance of hair loss. Inadequate dietary iron can be treated with iron supplement tablets however, iron absorption problems may require switching medications or injections of iron supplements, and blood loss treatments vary according to the cause. In addition to iron deficiency anemia, severe “crash” diets, and psychological disorders that result in extreme nutritional imbalances such as anorexia and bulimia, can also result in hair loss. Going without food for several days, or even several weeks, will not cause hair loss. But severe swings in nutrition and body weight from “crash” diets over several months time may begin to affect hair condition.

The American Journal of Clinical Nutrition published a study of two adult hospital patients who were unable to use their intestines to digest food. The patients were fed intravenously a diet that happened to be deficient in the B-complex vitamin biotin. Biotin deficiency is extremely rare because in addition to being present in many types of food, it is also manufactured by the friendly bacteria that live in normal intestines. Because these patients had inactive intestines, their intestinal bacteria did not produce adequate biotin, and they suffered hair loss as a result. When biotin was added to the intravenous diet, hair growth resumed.

With most nutritional deficiency-caused hair loss, hair growth resumes with adequate consumption of the missing nutrient.

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QUESTION: Dr Peter i mean to ask that I already have male pattern baldness, but if along with male pattern baldness If i do have Nutritional deficiency then It would have caused I would be having be having telogen effluvium along with male pattern baldness and my hair pull test would have been positive na?

ANSWER: That is correct. If you have a nutritional deficiency it may well cause TEs which should be easily noted with a positive hair pull. Shedding of hair is hard to miss. Chronic TEs will make your male patter baldness develop faster than the inherited pattern would normally have shown up.

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QUESTION: So sir if my hair pull test is negative, then does it mean that I do NOT have Acute/Chronic Telogen effluvium and ultimately does NOT have nutritional deficiencies and do not need to take multivitamins/supplements, and shall be just continuing finisteride for male pattern baldness. Correct?

Minoxidil I cannot use as I m allergic to it, therefore just taking finisteride.

It would seem reasonable to assume that if you are not losing more than 100 hairs per day and your hair pull test in negative then you are not having Telogen Effluvium problems. I do not know if you have nutritional deficiencies and need multivitamins. There are many malnourished starving people who have a full head of hair.
If you are allergic to minoxidil, do not use it.
Keep taking finasteride to prevent male pattern baldness or to keep it where it is now.

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Peter J. Panagotacos, <B>M.D.</B>


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website

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