An article in JAMA Dermatology, Evaluation of the Safety and Effectiveness of Nutritional Supplements for Treating Hair Loss, reviewed medical studies in an attempt to evaluate the effect of nutritional supplements on hair loss. Some of the supplements and micronutrients focused on stress-related hair loss (telogen effluvium): Omni-Three, NourkrinⓇ, vitamin D, and vitamin B1. Others like saw palmetto, pumpkin seed oil, Forti5, ViviscalⓇ, and NutrafolⓇ were focused on androgenic alopecia hair loss.
The study did not discuss the potential benefit of a daily multivitamin, particularly as many of the ingredients in standard multivitamin products overlap with nutritional supplements in more expensive supplements. For example, overlapping ingredients between Centrum Women multivitamin and NutrafolⓇ include Vitamin A, Vitamin C, Vitamin D, biotin, zinc, and selenium. The article also did not discuss the benefit of iron supplements, which are particularly beneficial for women with hair loss who have low iron stores. Finally, many of the studies were noted to be industry sponsored by the supplement manufacturer.
The take away message is that nutrition plays an important role in helping to reverse hair loss and that a well-balanced diet supplemented by a good multivitamin is likely as effective as more expensive supplements. Our recommendations are listed below.
1) Protein
Eat at least 45 grams of protein daily. Meat, poultry, nuts are all excellent sources for protein.
2) Zinc
Low levels of zinc can cause hair to shed. Zinc is important in many of the chemical reactions within our body. Walnuts, almonds, and cashews are excellent sources of zinc.
3) Omega-3 Fatty Acids
These are contained in cold-water fish, salmon, and sardines. Some studies have shown that omega-3 fatty acids help promote hair growth through the anagen activating pathways in the hair dermal papilla cells. They may also help to reduce inflammation associated with hair loss.
4) Vitamin D
Low levels of vitamin D have been associated with androgenic alopecia and telogen effluvium.
5) Iron
Low iron levels are commonly seen in females, frequently due to menstrual cycles. Iron supplements can be beneficial.
6) Vitamin C
Vitamin C supplements are recommended to facilitate iron absorption in patients with low iron levels.
At the present time there is insufficient data to recommend zinc, riboflavin, folic acid vitamin D supplementation, vitamin D, or biotin supplements. Biotin supplements can lead to inaccurate laboratory results for certain cardiac enzyme testing and for testing for thyroid function. Too much vitamin A and too much selenium can actually contribute to hair loss. Topical retinoids used in the treatment of acne can, in some cases, elevate vitamin A levels and result in hair loss and thinning. In contrast, premature graying may be improved by supplementing deficient micronutrients iron, vitamin D, folate, vitamin B12, and selenium.
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