Despite the name androgenetic alopecia, the exact role of hormones is uncertain. It is well known that androgens affect the growth of the scalp and body hair and even Hippocrates observed 2,400 years ago that eunuchs did not experience baldness (Yip et al., 2011). However, hyperandrogenism cannot be the only pathophysiologic mechanism for FPHL because the majority of women with FPHL neither have abnormal androgen levels nor do they demonstrate signs or symptoms of androgen excess (Atanaskova Mesinkovska and Bergfeld, 2013, Schmidt and Shinkai, 2015, Yip et al., 2011). Furthermore, cases have been reported in which FPHL developed in patients with complete androgen insensitivity syndrome or hypopituitarism with no detectable androgen levels (Cousen and Messenger, 2010, Orme et al., 1999).
Giorgos Tsetis: In the beginning, we left three factories because we didn't feel confident that they could do the job at our standard. These type of factories are sourcing the ingredients for you, but you have no clue where these ingredients are coming from. You don't know the efficacy, if they're clinically tested, and what about absorption? As a company, we decided to identify these root triggers that play a role in disrupting the hair growth cycle, then rigorously tested how we can target them and what specific ingredients solve for each trigger. Then, we developed individual partnerships with top suppliers all over the world that specialized in single ingredients that actually have that efficacy. We decided to source our own ingredients because we wanted to control the entire process. At least nine of the ten companies we consulted with said we couldn't do that, because the ingredients we chose to use were incredibly expensive. That's one main reason others can't do the work we do. For example, we purchase our primary ingredient for $600 per kilo, and you can buy the standard version of that ingredient in China for $30 per kilo. Same ingredients, but ours is clinically tested and proven to be effective. We only use patented ingredients, which made others think we're crazy, but creating the absolute best product is our top priority.
Everyone’s hair loss is different. Which is why, at Hair Club, we don’t provide a one-size-fits-all solution to restore your hair. Instead, we consult one-on-one with you to understand what’s needed to fit your taste and lifestyle. Only then will we custom tailor a solution that works best for you, so you can get the results you want. It’s what we’ve done for 600,000+ satisfied clients. It’s what we’ll proudly do for you. 

Giorgos Tsetis: Consumers are lost, and that's the sad part about it. You have a serious problem, you go on the internet and see thousands of products making similar claims, and you can't choose. Most likely, you're going to try the cheapest product with the most compelling claims, realize it doesn't work, and only add further stress. When an industry is not properly regulated, this is the result. Education is such a big component of what we do. Reverse engineering a solution requires a tremendous amount of time and research. What we did was connect all these dots reading hundreds of pages of scientific literature. Education, when it comes to this, is broken into education for the physicians and education for the consumers. It's always hard to educate, because what you're really doing is changing behavior. Slowly but surely, we're actively changing the mindset of physicians and consumers, evolving the way they view and treat hair loss. That is huge, and one of the key reasons Unilever invested in the company. What we did was raise the bar by introducing a new category in the medical channel that remained untapped. That's how we disrupted the market, where now you see hundreds of doctors using Nutrafol as a trusted alternative for men and women. We also have several writers in the company who imagine how we can make this world simple and digestible for people. We want consumers to make smart choices.

Hair loss may also occur due to dieting. Franchised diet programs which are designed or administered under the direction of a physician with prescribed meals, dietary supplements and vitamin ingestion have become popular. Sometimes the client is told that vitamins are a necessary part of the program to prevent hair loss associated with dieting. From a dermatologists’s standpoint, however, the vitamins cannot prevent hair loss associated with rapid, significant weight loss. Furthermore, many of these supplements are high in vitamin A which can magnify the hair loss.
A. Steroids are not for female pattern hair loss but are sometimes used for alopecia areata (spotty hair loss that is different than hair loss due to genetics and aging). Laser combs? There are some reports that low-level light therapy could stimulate hair growth in some people. It's something to try when people feel like they have no other good options. At $350, it's expensive and I'm not sure it's worth the money, but it is safe.
 Estrogen dominance is an extremely common imbalance and it can fuel thinning hair as well as an arms-length list of annoying symptoms, from bloating and PMS to irregular periods and infertility. Your first, best step in clearing excess estrogen from the body is doing a liver supportive detox. My 4-Day Hormone Detox has you eating fresh, nourishing foods for three meals a day, plus snacks. You won’t feel hungry or deprived and, most importantly, you will help kickstart hormonal healing. A hormone detox is one of the best first steps you can take to reverse thinning hair.
Alopecia is a common issue that can cause significant morbidity because even though scalp hair is not biologically essential, it can have great psychological and social significance. The results of a 1993 Glamour magazine survey showed that more than half of women said, “If my hair looks good, I look attractive no matter what I’m wearing or how I look otherwise,” and “If my hair isn’t right, nothing else can make me feel that I look good” (Cash, 2001). Add to this the fact that more than 21 million women in the United States alone experience female pattern hair loss (FPHL), and it is not surprising that hair loss in women can be a serious cause of psychological stress and morbidity (Pickard-Holley, 1995, van Zuuren et al., 2016). In one study, 55% of affected women displayed symptoms of depression (Camacho and Garcia-Hernandez, 2002). In that same group, 89% of women experienced an improvement of those symptoms after treatment for hair loss (Camacho and Garcia-Hernandez, 2002).
The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.

Dutasteride is a 5-alpha-reductase inhibitor that binds both types I and II enzymes. Compared with finasteride, its inhibition of type II enzymes is three times more potent; its inhibition of type I enzymes is 100 times more potent (Clark et al., 2004). Dutasteride is not approved for the treatment of FPHL by the FDA, and ongoing studies on the efficacy of the inhibitor are promising but largely focus on male patients (Gupta and Charrette, 2014, Olsen et al., 2006). A study of women after 3 years of therapy showed that dutasteride may be more effective than finasteride in women under 50 years of age as measured by hair thickness (not hair density) at the center and vertex scalp (Boersma et al., 2014). One case report of a 46-year-old female with FPHL showed some response after 6 months of treatment with a dose of 0.5-mg dutasteride daily despite a minimal response to treatment with finasteride and minoxidil (Olszewska and Rudnicka, 2005). Data with regard to the treatment side effects in women is extremely limited. Dutasteride is classified as pregnancy category X because of teratogenicity and should have the same theoretical risk of breast cancer as mentioned in relation to finasteride (Kelly et al., 2016).


Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working. 

Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.

According to the new study, British scientists say they found over 200 genetic markers linked to hair loss. More specifically, the study focuses on male pattern baldness. This type of baldness, also known as male alopecia, is the most common form of hair loss in men. Researchers believe this affects as many as 30 to 50% of men by the time they reach the age of 50.


That's why I've designed a system I call The Gottfried Protocol, a step-by-step, integrative approach to natural hormone healing that emphasizes lifestyle design first and foremost. It's based on decades of research, my education at Harvard Medical School, my own experiences with hormonal imbalances, my belief in peer-reviewed, well-performed randomized trials to support my recommendations, and what I've learned from patients over the past 20-plus years of practicing medicine. The Gottfried Protocol engages only the top hierarchy of scientific evidence and has been proven in scores of women in my practice.
Furthermore, Penn dermatopathologists developed an even more advanced method called the HoVert technique for diagnosing hair loss and other disorders from a scalp biopsy. The technique uses a unique horizontal and vertical testing approach that provides a greater amount of information to the referring dermatologist than standard industry longitudinal scalp biopsies.
In an article on menopause, the University of Maryland Medical Center states, “Estrogen loss can contribute to slackness and dryness in the skin and wrinkles. Many women experience thinning of their hair and some have temporary hair loss.” Meanwhile, this study reports, “It has long been known that estrogens also profoundly alter hair follicle growth … the time has come to pay estrogen-mediated signaling the full attention it deserves in future endocrinological therapy of common hair growth disorders.”

Giorgos Tsetis: In the beginning, we left three factories because we didn't feel confident that they could do the job at our standard. These type of factories are sourcing the ingredients for you, but you have no clue where these ingredients are coming from. You don't know the efficacy, if they're clinically tested, and what about absorption? As a company, we decided to identify these root triggers that play a role in disrupting the hair growth cycle, then rigorously tested how we can target them and what specific ingredients solve for each trigger. Then, we developed individual partnerships with top suppliers all over the world that specialized in single ingredients that actually have that efficacy. We decided to source our own ingredients because we wanted to control the entire process. At least nine of the ten companies we consulted with said we couldn't do that, because the ingredients we chose to use were incredibly expensive. That's one main reason others can't do the work we do. For example, we purchase our primary ingredient for $600 per kilo, and you can buy the standard version of that ingredient in China for $30 per kilo. Same ingredients, but ours is clinically tested and proven to be effective. We only use patented ingredients, which made others think we're crazy, but creating the absolute best product is our top priority.


The hormone imbalance known as hypothyroidism is a common cause of abnormal eyebrow thinning, especially in women; roughly 27 million Americans suffer from thyroid disease, and about 80 percent of them are women. Thinning eyebrows appear as a symptom of both hypothyroidism (underactive thyroid production) and hyperthyroidism (overactive thyroid production), alongside issues such as excessive fatigue, difficulty losing weight and constantly feeling cold. If your brows appear particularly thin around the edges, visit your doctor for a thyroid screening, which should include thorough blood work. With prescription medication, your eyebrows should fill back in over the ensuing months.


Additionally, two other considerations are important for a patient who receives treatment for FPHL. First, there is a set of reasonable expectations in patients. Maintaining the current hair density can be considered a successful treatment because women tend to have further thinning as they age (Harfmann and Bechtel, 2015). Second, it is important to ensure that patients understand that progress is slow, and months or years can be required to see a significant improvement (Boersma et al., 2014, Yeon et al., 2011). In our practice, we wait at least 6 months to assess treatment efficacy.

Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks. 

Prostaglandins are modified forms of unsaturated fatty acids–those unsaturated or “essential” fatty acids (EFAs) that are also called Omega fatty acids. These EFAs cannot be produced by your body, but must be absorbed from our food. EFAs are naturally found in nut and seed oils in different compositions. EFAs have been shown to increase prostaglandin production in those with a deficiency (source, again).
Changing the shape, thickness and length of the eyebrow is a commonly practiced beauty technique. Some people even remove the eyebrow entirely only to replace it with a pencil-drawn mark (eyebrow pencil). As with any part of the body, repeated irritation can eventually lead to hair loss. Sometimes this is due to manual trauma, chemicals from cosmetics or even infections that arise when breaks in the skin occur. While eyebrow modification will not stop as a commonly practised beauty technique, it should at least be minimized.
Reduce stress. When you are stressed, your body starts shutting down processes that aren’t necessary for survival. This shutdown can occur with physical stressors, like surgery or an illness, and emotional stress, which often manifests as physical symptoms. Loss may occur up to three months after the stressful event and may take another three to grow again.[24]

Elizabeth Willett is the Senior Herbalist and Lead Educator at NaturalFertilityInfo.com. She holds a BS in Mass Communications (2000) from Minnesota State University, and a Master of Arts degree (MA, 2010) in Holistic Health Studies with a specialization is herbalism from St. Catherine University in St. Paul, MN. Liz has written over 200 articles on women’s fertility and brings a vast wealth of knowledge and expertise in holistic health and healing to Natural Fertility Info.com
Hair loss can occur either in acute or chronic hypervitaminosis A. Loss of eyebrows and eyelashes can occur in chronic hypervitaminosis A which can occur in a number of conditions, either due to enthusiastic overdosing or due to intentional prescription of high doses for diseases such as acne, retinal disorders with night blindness, and others.[116] The cutaneous manifestations include dry, rough, and scaly skin. Chronic hypervitaminosis A is also becoming increasingly common with use of retinoids for various skin disorders. Acitretin has been noted to cause a high incidence of diffuse hair loss.[117] Premature teloptosis may be a prime factor in hair loss induced by retinoids.[98]
Eyebrow thinning that manifests in irregular patches, especially accompanied by red and itchy skin, may indicate atopic dermatitis. This condition—commonly called eczema—can occur just about anywhere on the body and is usually hereditary. People with atopic dermatitis may be more sensitive to topical irritants, but eczema just from topical irritants is called allergic contact dermatitis or irritant contact dermatitis. While you wait on the appointment with your dermatologist, you can help ease eczema around the eyebrows by switching to mild soaps or a soap-free facial cleanser, and applying an intensive facial moisturizer within three minutes after bathing.
Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
It’s common for women to experience shedding hair after pregnancy. Usually, this is in response to estrogen levels returning to normal, shedding the extra hair grown during pregnancy. Usually, the hair will return to the same thickness it was before you got pregnant. New moms who are not breastfeeding should consider taking hair growth vitamins post-pregnancy too to balance out their hair growth cycle.

Unfortunately, there’s no magic solution, pill or product that will correct hair loss entirely. But if you think of your hormones as a cast of characters, knowing which ones are leading the show and which ones are only playing a supporting role can help you get to the bottom of the issue. If you haven’t already, take my free hormone quiz – it can help you determine what tests you may want to request from your doctor and which lifestyle or dietary changes may benefit you most. In the meantime, manage your stress levels and get enough sleep. This will help with general hormone balance and can protect your precious locks from any further damage.
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