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QUESTION:

When I turned 49, I began to experience thinning of my hair.  It seems to have gotten worse with age.  I have read that hormones could be a factor in this, but I have been checked for any imbalances, etc. and everything is normal.  Do you have any suggestions such as supplements, etc. that could help me.  I had a maternal grandmother who lost most all her hair, but we always contributed it to her medications and diabetes.  Any suggestions for this problem would be greatly appreciated.
Hair?  What Hair?

ASK HEALTH & FITNESS' DR. ALEJANDRO ALDANA ANSWERS:

Dear Hair:

Diffuse hair thinning or hair loss can affect both sexes at any age. Triggers for hair loss may be physiologic or emotional stressors, nutritional deficiencies and endocrine imbalances. It is important to try to identify the possible cause or causes that may be contributing to this problem.

Related medical conditions include Hypo and hyperthyroidism. Hepatic and renal failure, inflammatory bowel disease, autoimmune disorders such as lupus erythematosus can also be causes. Chronic infections and inflammatory skin disorders could also be related.

Nutritional causes include Zinc, iron and Vitamin D deficiencies.  Chronic starvation and crash diets are also causes.

Evaluation should include: A complete blood count and serum ferritin level to look for anemia and iron deficiency. A comprehensive metabolic panel, thyroid profile, serum Zinc and Vitamin D levels should also be done. An androgen screen test may be needed if female androgenic alopecia is suspected.

Management depends on the different causes.  Adequate nutrition is important, and the patient may need to supplement Zinc and Biotin which can support hair growth. Anti androgens such as spironolactone (Aldactone) are used off label for female androgenic alopecia.  (Women of childbearing years should use adequate contraception).

Further readings can be found at the Cleveland Clinic Journal of Medicine web site. June 2009.

Harrison S, Bergfeld W. Diffuse hair loss: Its triggers and management. Clev Clin J Med 2009; 76:361-367.

Thank you for writing.
Alejandro Aldana, MD

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