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Getting To The Root Cause Of Hair Loss

2/27/2017

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Women and Hair Loss

American doctors with various specialties are locked into their own little silos. Dermatologists just look at the skin. Endocrinologists may test only for Thyroid Stimulating Hormone (TSH) and base everything on too narrow a view.

As a Holistic Functional Medicine doctor, I explore a broad sweep of the body’s functions looking for the central, underlying problem. Just finding a treatment for the symptom is not enough — the difficulty with hair loss is that it can result from many different issues. Some are treatable and some (at this point in time) are still untreatable. I have to cast a wide net as I check the function of many glands, sugar metabolism, hormone levels, diet and family history.
 
Some of the issues I investigate:

Excessive Stress
A stressed brain and body is just trying to survive and excessive stress can contribute to hair loss — this is not a good time for growth or reproduction. The adrenal gland makes stress hormones and the pituitary (the master gland), sends strong signals to the adrenal to make more stress hormones. At the same time, stimulation of the thyroid and reproductive organs is dialed down.

Low Thyroid
Hypothyroidism (low thyroid levels) is a common cause of hair loss. Other symptoms are cold hands and feet, constipation, weight gain and loss of the sides of the eyebrows.

There can be problems with the thyroid itself. The most common cause of low thyroid is an autoimmune disease called Hashimoto's Thyroiditis. To rule this out, I check the three thyroid antibody tests available.

In general, if thyroid production is low, the pituitary tries to stimulate the thyroid even more to increase production. Many doctors only measure TSH to assess thyroid production and just measuring TSH alone can be misleading. Under stressful conditions, the pituitary dials down TSH production. The doctor can see a low TSH reading and assume thyroid production is high, when it is actually low. It is very important to measure the full set of thyroid tests at the same time to really understand what is happening with the patient. Low TSH usually indicates high thyroid levels and high TSH usually indicates low thyroid levels (but not always).

Anovulatin and PCOS
Women who are not producing eggs on a regular basis, either because of a hormone imbalance or due to age, can have irregular periods, rising levels of testosterone and other male hormones such as DHEA and androstenedione. Excess male hormones can cause loss of hair from the scalp while stimulating hair growth on the face and other body areas.

Low Estrogen
As women near menopause, estrogen levels can fall. Scalp hair growth and maintenance is supported by estrogen and if there is a loss or reduction in estrogen, hair loss can result.

The high estrogen levels of pregnancy enables individual hair follicles to live longer than usual. After having a baby, the placental estrogens disappear. In addition, breastfeeding suppresses estrogen production. The sudden loss of estrogen can result in a large die off of hair follicles and major hair loss in the months after childbirth.

High Testosterone and Other Male Hormones 
In some people, the hair follicles on the top of the head are sensitive to male hormones and stop growing hair in their presence. Those hair follicles can change the strong male hormone, testosterone, into the even stronger male hormone DHT (dihydrotestosterone).

There are several treatment approaches:
•    Spironolactone is a medication that was originally used to treat high blood pressure. It blocks testosterone from stimulating the hair follicles.
•    Finasteride stops the hair follicle from turning testosterone into DHT.
•    Birth control pills can stop the ovaries from producing too much testosterone.
•    Diet changes such as eating sugar and other carbohydrates can raise insulin levels. Insulin can stimulate the ovary to make more male hormones. A low carbohydrate diet can help reduce the hair loss.
•    Metformin reduces insulin production.

Genetic Male Pattern Baldness
Some people carry a gene that makes their scalp hair very sensitive to male hormones. Their hair follicles turn testosterone into DHT which inhibits hair growth. It is only hair located in certain areas that experience this issue -- thus the male pattern of baldness occurs. The gene is on the X chromosome. Men have only one X, which is inherited from the mother signifying male baldness comes from the maternal side. The mother’s brothers are also an indication. Women have two X’s, one from each parent. They can inherit hair loss from either side or both parents.

Estrogen-Testosterone Ratio
Many menopausal women still make normal female levels of testosterone from their adrenal glands. As estrogen levels fall, the normal testosterone becomes dominant. This can cause hair loss from the top of the head while still stimulating facial hair growth. Estrogen replacement therapy can solve the problem by restoring the normal estrogen-testosterone ratio.

Autoimmune Alopecia
Rarely, some individuals develop an immune condition where antibodies attack the hair follicles and kill them off. This can result in total baldness. There is no current FDA approved treatment that is known to be effective. There are a few individual reports of an intestinal parasite that can affect the immune system resulting with the hair growing back.

Other Causes
Some dietary deficiencies can contribute to hair loss (such as iron deficiency). Vitamin and mineral supplementation should also be considered.
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New Hope for Alzheimer's

2/7/2017

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New Hope for Alzheimer's

Most chronic diseases are not from a single source.
Strep throat, measles, mumps and other infectious diseases are caused by a single bacteria or virus. If we treat or prevent that singular cause, we can stop the disease. Most long-term chronic diseases such as coronary artery disease, type 2 diabetes, high blood pressure and osteoporosis are gradual problems that are caused by multiple things going a little wrong at the same time. This is also true for Alzheimer’s disease.
 
Dale Bredesen, MD, has been doing amazing work in this field. Using a multi-system approach, Dr. Bredesen has experienced significant results, especially with newly affected patients or folks just beginning to develop systems.


Here is the idea.
Patients have multiple issues that push the brain toward loss of function. The drugs that are currently used for Alzheimer’s each do one thing. You can’t fix multiple problems with a single therapy. You have to repair the problem from as many angles as possible. 
​

A brief description of Bredesen's approach:
Fix the diet. Stay on a low carbohydrate, low inflammatory diet with limited grains and lots of fresh (not processed) vegetables and fruits.

Healthy sleep. Take melatonin and magnesium before going to bed. If you stop eating four hours before bedtime and then sleep for eight hours, your body has gone twelve hours without food. The blood sugar levels fall, the melatonin levels rise, growth hormone rises and plaque is cleared from the nerve cells in the brain.

​Reduce stress. Personalize with yoga, meditation, soothing music, etc.

Regular exercise. Minimally 3 times a week, 30 to 60 minutes.

Brain stimulation. Learn a new language, play brain games.

Vitamin supplements. Take ideal levels for vitamin and mineral deficiencies (not just the minimum requirements).

Reduce inflammation. Take fish oil, stay on a low inflammatory diet and take curcumin (the most active ingredient in tumeric).

Hormone balance. Balance thyroid to ideal levels, utilize menopausal hormone replacement with appropriate dosage using bioidentical estrogen and progesterone. For men, balance DHEA, estrogen and testosterone.

Monitor blood sugar. Control with a proper low glycemic diet. Eliminate artificial sweeteners and keep sugar at a minimum.

Rule out sleep apnea. Treat if needed with C-PAP, surgery or appliances.

Dr. Bredesen measures many other parameters and treats the individual to attain a proper balance. It is a truly holistic approach. He does not rule out the use of drugs, but sees them as only one part of the program.
 

The take home message:
You can’t solve a complex problem (with many separate things going wrong simultaneously) with a single drug or therapy. It takes a holistic and a Functional Medicine approach to bring the patient back to balanced health.

Additional resources:
Below are two video’s of Dr. Bredesen speaking about reversing Alzheimer’s and a detailed paper written for the publication, Aging, a leading journal in the field. ​


Aging: Reversal of cognitive decline:
​A novel therapeutic program
dale_bredesen_paper.pdf
File Size: 813 kb
File Type: pdf
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    Robert P. Goldman, M.D.

    Dr. Robert P. Goldman provides guidance for female and male hormone balance, menopause management, holistic therapies and routine gynecological care.

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