Might biotin or zinc supplements prevent hair loss in men and women?
Supplements for Hair Growth
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Intro: We’re kicking off a three-video series on hair loss. What causes it? And what can drugs, supplements, and foods do to help prevent or reverse it? Watch the videos to find out. I know I’m going to.
“Studies show that by age 50, approximately half of men and women will experience hair loss.” No, it’s not caused by washing your hair too much, or brushing your hair too much––two of the many myths out there. The majority of hair loss with age is genetic for both women and men, in the case of this study. Based on twin studies, the heritability of baldness in men is 79 percent, meaning about 80 percent of the differences in hair loss between men is genetically determined. But that still leaves some wiggle room.
Even if you have identical twins––identical twin sisters in this case, with the same DNA––one can have more hair loss than the other, thanks to Increased stress, increased smoking, having more children, or having a history of high blood pressure or cancer. For example, check out these two identical twin brothers. Same genes, but the twin on the right reported more stress in his life. In this pair, the identical twin on the right was a smoker and drank more alcohol.
Smoking can contribute to the development of both male and female pattern baldness because the genotoxic compounds in cigarettes may damage the DNA in hair follicles, and cause microvascular poisoning in the base of the follicle. Other toxic agents associated with hair loss include mercury, because it seems to concentrate about 250-fold in growing scalp hair. In fact, maybe the reason Shakespeare started losing his hair was due to mercury poisoning from syphilis treatment. Thankfully, doctors don’t give people mercury anymore. These days, as the CDC points out, mercury mainly enters the body through seafood consumption.
“Women of reproductive age frequently seek treatment for what is thought to be hormone-related hair loss especially at menopause.” But, for example, this woman came in with hair loss, and blood tests indicated elevated mercury levels. And, no wonder, as she had a diet high in tuna. But the good news is that her mercury levels fell with elimination of dietary tuna. Within two months, her hair started to come back, and after seven months maintaining a fish-free diet, her hair completely regrew. So, doctors should consider screening for mercury toxicity when they see hair loss, since there’s something we can do about it. Instructing patients to reduce fish intake and repeat blood tests could offer relief of symptoms, and uncover dietary habits that may be a source of heavy metal-induced hair loss. Though admittedly, sometimes heavy metal can lead to too much hair.
What about nutrient deficiencies as a cause of hair loss? After bariatric surgery, the most frequent nutrient deficiency symptom is hair loss. But that’s because they’ve had their anatomy rearranged to cause malabsorption on purpose. In general, there is little evidence to suggest that vitamin and mineral supplementation benefits people, unless they are actually deficient.
For example, we’ve known for centuries that scurvy, severe vitamin C deficiency, can cause hair loss, but once you have enough vitamin C such that your gums aren’t bleeding, there’s no data correlating vitamin C levels and hair loss once you have a certain baseline sufficiency of vitamin C.
It’s also a myth that supplements containing zinc will increase hair growth––unless you have zinc deficiency, like if you’re an alcoholic or something. But if you have normal zinc levels in your blood, taking more zinc won’t help, and in fact can have negative side effects. It’s the same thing with taking iron supplements.
The most common ingredient in top-selling hair loss products is vitamin B7, also known as biotin. Yes, biotin deficiency causes hair loss, but there are no evidence-based data that supplementing biotin promotes hair growth. And severe biotin deficiency in healthy individuals eating a normal diet has never been reported. But if you eat raw egg whites, you can acquire a biotin deficiency, since there are these compounds that attach to biotin and prevent it from being absorbed. But other than rare deficiency syndromes, it’s a myth that biotin supplements increase hair growth.
But hey, why not just have the attitude, ‘‘Can’t hurt, might help?” Because of the lack of regulatory oversight of the supplement industry and, in the case of biotin, interference with lab tests. Many dietary supplements promoted for hair health contain biotin levels up to 650 times the recommended daily intake of biotin. And excess biotin in the blood can play haywire on a bunch of different blood tests, including thyroid function, other hormone tests (including pregnancy), and the test they do to see if you’ve had a heart attack––so it could potentially even be life or death.
And in terms of poor regulation, as I’ve done tons of videos about, there are all sorts of supplement manufacturer shenanigans. For example, this outbreak in which hundreds suffered selenium toxicity because they had an oopsie, and put 200 times the dose, and so it ended up causing hair loss. And the same thing can happen with getting too much vitamin A.
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- DiMarco G, McMichael A. Hair Loss Myths. J Drugs Dermatol. 2017;16(7):690-4.
- Rexbye H, Petersen I, Iachina M, et al. Hair loss among elderly men: etiology and impact on perceived age. J Gerontol A Biol Sci Med Sci. 2005;60(8):1077-82.
- Gatherwright J, Liu MT, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to female alopecia: a study of identical twins. Plast Reconstr Surg. 2012;130(6):1219-26.
- Gatherwright J, Liu MT, Amirlak B, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to male alopecia: a study of identical twins. Plast Reconstr Surg. 2013;131(5):794e-801e.
- Lai CH, Chu NF, Chang CW, et al. Androgenic alopecia is associated with less dietary soy, lower [corrected] blood vanadium and rs1160312 1 polymorphism in Taiwanese communities [published correction appears in PLoS One. 2014;9(8):e105915]. PLoS One. 2013;8(12):e79789.
- Yu V, Juhász M, Chiang A, Atanaskova Mesinkovska N. Alopecia and Associated Toxic Agents: A Systematic Review. Skin Appendage Disord. 2018;4(4):245-60.
- Clarkson TW. The three modern faces of mercury. Environ Health Perspect. 2002;110 Suppl 1(Suppl 1):11-23.
- Ross JJ. Shakespeare's chancre: did the bard have syphilis?. Clin Infect Dis. 2005;40(3):399-404.
- Centers for Disease Control and Prevention. Fourth national report on human exposure to environmental chemicals: executive summary. US Department of Health and Human Services. 2009.
- Peters JB, Warren MP. Reversible alopecia associated with high blood mercury levels and early menopause: a report of two cases. Menopause. 2019;26(8):915-8.
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51-70.
- Ledoux S, Flamant M, Calabrese D, Bogard C, Sami O, Coupaye M. What Are the Micronutrient Deficiencies Responsible for the Most Common Nutritional Symptoms After Bariatric Surgery? Obes Surg. 2020;30(5):1891-7.
- Bater K, Rieder E. Over-the-Counter Hair Loss Treatments: Help or Hype?. J Drugs Dermatol. 2018;17(12):1317-21.
- Burns LJ, Senna MM. Supplement use among women experiencing hair loss. Int J Womens Dermatol. 2020;6(3):211.
- US Food and Drug Administration. The FDA warns that biotin may interfere with lab tests: FDA safety communication. US Department of Health and Human Services. November 28, 2017.
- MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Arch Intern Med. 2010;170(3):256-61.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Intro: We’re kicking off a three-video series on hair loss. What causes it? And what can drugs, supplements, and foods do to help prevent or reverse it? Watch the videos to find out. I know I’m going to.
“Studies show that by age 50, approximately half of men and women will experience hair loss.” No, it’s not caused by washing your hair too much, or brushing your hair too much––two of the many myths out there. The majority of hair loss with age is genetic for both women and men, in the case of this study. Based on twin studies, the heritability of baldness in men is 79 percent, meaning about 80 percent of the differences in hair loss between men is genetically determined. But that still leaves some wiggle room.
Even if you have identical twins––identical twin sisters in this case, with the same DNA––one can have more hair loss than the other, thanks to Increased stress, increased smoking, having more children, or having a history of high blood pressure or cancer. For example, check out these two identical twin brothers. Same genes, but the twin on the right reported more stress in his life. In this pair, the identical twin on the right was a smoker and drank more alcohol.
Smoking can contribute to the development of both male and female pattern baldness because the genotoxic compounds in cigarettes may damage the DNA in hair follicles, and cause microvascular poisoning in the base of the follicle. Other toxic agents associated with hair loss include mercury, because it seems to concentrate about 250-fold in growing scalp hair. In fact, maybe the reason Shakespeare started losing his hair was due to mercury poisoning from syphilis treatment. Thankfully, doctors don’t give people mercury anymore. These days, as the CDC points out, mercury mainly enters the body through seafood consumption.
“Women of reproductive age frequently seek treatment for what is thought to be hormone-related hair loss especially at menopause.” But, for example, this woman came in with hair loss, and blood tests indicated elevated mercury levels. And, no wonder, as she had a diet high in tuna. But the good news is that her mercury levels fell with elimination of dietary tuna. Within two months, her hair started to come back, and after seven months maintaining a fish-free diet, her hair completely regrew. So, doctors should consider screening for mercury toxicity when they see hair loss, since there’s something we can do about it. Instructing patients to reduce fish intake and repeat blood tests could offer relief of symptoms, and uncover dietary habits that may be a source of heavy metal-induced hair loss. Though admittedly, sometimes heavy metal can lead to too much hair.
What about nutrient deficiencies as a cause of hair loss? After bariatric surgery, the most frequent nutrient deficiency symptom is hair loss. But that’s because they’ve had their anatomy rearranged to cause malabsorption on purpose. In general, there is little evidence to suggest that vitamin and mineral supplementation benefits people, unless they are actually deficient.
For example, we’ve known for centuries that scurvy, severe vitamin C deficiency, can cause hair loss, but once you have enough vitamin C such that your gums aren’t bleeding, there’s no data correlating vitamin C levels and hair loss once you have a certain baseline sufficiency of vitamin C.
It’s also a myth that supplements containing zinc will increase hair growth––unless you have zinc deficiency, like if you’re an alcoholic or something. But if you have normal zinc levels in your blood, taking more zinc won’t help, and in fact can have negative side effects. It’s the same thing with taking iron supplements.
The most common ingredient in top-selling hair loss products is vitamin B7, also known as biotin. Yes, biotin deficiency causes hair loss, but there are no evidence-based data that supplementing biotin promotes hair growth. And severe biotin deficiency in healthy individuals eating a normal diet has never been reported. But if you eat raw egg whites, you can acquire a biotin deficiency, since there are these compounds that attach to biotin and prevent it from being absorbed. But other than rare deficiency syndromes, it’s a myth that biotin supplements increase hair growth.
But hey, why not just have the attitude, ‘‘Can’t hurt, might help?” Because of the lack of regulatory oversight of the supplement industry and, in the case of biotin, interference with lab tests. Many dietary supplements promoted for hair health contain biotin levels up to 650 times the recommended daily intake of biotin. And excess biotin in the blood can play haywire on a bunch of different blood tests, including thyroid function, other hormone tests (including pregnancy), and the test they do to see if you’ve had a heart attack––so it could potentially even be life or death.
And in terms of poor regulation, as I’ve done tons of videos about, there are all sorts of supplement manufacturer shenanigans. For example, this outbreak in which hundreds suffered selenium toxicity because they had an oopsie, and put 200 times the dose, and so it ended up causing hair loss. And the same thing can happen with getting too much vitamin A.
Please consider volunteering to help out on the site.
- DiMarco G, McMichael A. Hair Loss Myths. J Drugs Dermatol. 2017;16(7):690-4.
- Rexbye H, Petersen I, Iachina M, et al. Hair loss among elderly men: etiology and impact on perceived age. J Gerontol A Biol Sci Med Sci. 2005;60(8):1077-82.
- Gatherwright J, Liu MT, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to female alopecia: a study of identical twins. Plast Reconstr Surg. 2012;130(6):1219-26.
- Gatherwright J, Liu MT, Amirlak B, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to male alopecia: a study of identical twins. Plast Reconstr Surg. 2013;131(5):794e-801e.
- Lai CH, Chu NF, Chang CW, et al. Androgenic alopecia is associated with less dietary soy, lower [corrected] blood vanadium and rs1160312 1 polymorphism in Taiwanese communities [published correction appears in PLoS One. 2014;9(8):e105915]. PLoS One. 2013;8(12):e79789.
- Yu V, Juhász M, Chiang A, Atanaskova Mesinkovska N. Alopecia and Associated Toxic Agents: A Systematic Review. Skin Appendage Disord. 2018;4(4):245-60.
- Clarkson TW. The three modern faces of mercury. Environ Health Perspect. 2002;110 Suppl 1(Suppl 1):11-23.
- Ross JJ. Shakespeare's chancre: did the bard have syphilis?. Clin Infect Dis. 2005;40(3):399-404.
- Centers for Disease Control and Prevention. Fourth national report on human exposure to environmental chemicals: executive summary. US Department of Health and Human Services. 2009.
- Peters JB, Warren MP. Reversible alopecia associated with high blood mercury levels and early menopause: a report of two cases. Menopause. 2019;26(8):915-8.
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51-70.
- Ledoux S, Flamant M, Calabrese D, Bogard C, Sami O, Coupaye M. What Are the Micronutrient Deficiencies Responsible for the Most Common Nutritional Symptoms After Bariatric Surgery? Obes Surg. 2020;30(5):1891-7.
- Bater K, Rieder E. Over-the-Counter Hair Loss Treatments: Help or Hype?. J Drugs Dermatol. 2018;17(12):1317-21.
- Burns LJ, Senna MM. Supplement use among women experiencing hair loss. Int J Womens Dermatol. 2020;6(3):211.
- US Food and Drug Administration. The FDA warns that biotin may interfere with lab tests: FDA safety communication. US Department of Health and Human Services. November 28, 2017.
- MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Arch Intern Med. 2010;170(3):256-61.
Motion graphics by Avo Media
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Supplements for Hair Growth
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Content URLDoctor's Note
This is the first in a three-part series on hair loss and growth. Stay tuned for Pills for Hair Growth and Food for Hair Growth.
For more on what you can do about mercury exposure, see How to Lower Heavy Metal Levels with Diet.
I mentioned having a lot of videos on the sketchy supplement industry. Here are some of them:
- Dietary Supplement Snake Oil
- Some Dietary Supplements May Be More Than a Waste of Money
- Are Calcium Supplements Safe?
- Are Calcium Supplements Effective?
- Black Raspberry Supplements Put to the Test
- Dangers of Dietary Supplement Deregulation
2023 Update: You may also be interested in my newer video, Caffeine Shampoo and Rosemary Oil for Hair Growth.
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