While botanically-derived substances may certainly play a positive role in ameliorating the
onset and progression of pattern hair loss, 'good nutrition' has not, per se, been
demonstrated to have a like beneficial effect. The two notions may sound similar at first
blush, but we will now explore how they differ.
A simple proof-of-principle is instructive. One may observe numerous unfortunate souls who
are homeless, poorly nourished, and even starving. Often, these people lack the most basic
access to health care, clean water and good food. Yet, no higher degree of pattern hair loss
is found in homeless shelter populations. If good nutrition was a prerequisite to good hair
than many if not most homeless people should be balding. But this is simply the case.
Accordingly, poor nutrition does not necessarily lead to baldness just as 'good nutrition'
does not necessarily equate to 'good hair'. So if nutrition doesn't play a critical role in hair
loss, something a bit more esoteric must be at work. But what?
First of all, it is helpful to consider the steroid hormone driven biochemical, genetic and
epigenetic context under which pattern hair loss occurs. To begin, it has been conclusively
shown that the conversion of the precursor androgen hormone testosterone (T) to its more
pathological metabolite dihydrotestosterone (DHT) via the enzyme 5-alpha reductase sets
pattern hair loss in motion, as a match lights a fuse to ignite a stick of dynamite. Strikingly,
this hormonal pathway is widely understood to trigger several disorders including benign
prostatic hyperplasia (BPH) and common pattern hair loss, also known as androgenetic
Immediately, one comprehends that a useful therapeutic target would be the blockade of
one or more steps associated with DHT metabolism. In fact, a number of drugs, including
finasteride and dutasteride, have been designed with this goal in mind. And in fact, due to
their ability to down-regulate DHT metabolism, both finasteride and dutasteride have
demonstrated benefit in AGA as well as BPH. Because both drugs are linked to negative side
effect, safer alternatives have been sought.
Saw palmetto extract represents one such possibility. A number of well-controlled European
clinical trials show that saw palmetto extract exhibits some benefit in ameliorating the
clinical signs and symptoms of BPH. Basic science studies show that key fatty acids and
sterols in saw palmetto block 5-alpha reductase.
These findings are certainly interesting, but where does that leave us in regard to our
original question pertaining to diet and hair loss? Here, intriguing anecdotal evidence
suggests that a diet steeped in androgen-rich steroid hormones could indeed play a role in
pattern hair loss. Some authors report that prior to World War Two, AGA was almost
unknown in Japan. A recent study undertaken on hair loss in Thailand proffers a similar
conclusion. In both cases, the evidence tends to suggest that the conversion from a
typically Asian diet rich in fish, rice and vegetables, to a Western diet filled with red meat
and mammalian animal fat seemed to coincide with a statistically-relevant uptick in the
occurrence of pattern hair loss in Asia. Recent studies support this hypothesis and point to
targeted supplementation as a means to blunt the onset and progression of AGA.
In 2002 a modest clinical trial in which the author of this article participated showed, for the
first time, benefit for a naturally-derived composition containing saw palmetto and its
glycoside betasitosterol in the treatment of AGA. So substances like saw palmetto constitute
a useful beginning, but they are not the complete answer. Here's why. Pattern hair loss is
described in the literature as a 'complex trait disorder' -- meaning that numerous genetic,
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