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Male Pattern Baldness
VDR expression was reduced meaning that excess retinoic acid was probably present.
Vitamin D and AA
Published data on AA suggest that vitamin D, due to its immunomodulatory effect, may be involved in AA [66, 67]. Lee et al. conducted a systematic review and meta-analysis of observational studies on the prevalence of vitamin D deficiency and/or serum vitamin D levels and AA [68]. These authors analyzed a total of 14 studies that involved 1255 patients with AA and 784 control patients without AA. The mean serum 25-hydroxyvitamin D [25(OH)D] level in patients with AA was significantly lower than that in the non-AA control group, by 8.52 ng/dL (95% confidence interval − 11.53 to − 5.50 ng/dL). Vitamin D deficiency was also highly prevalent in patients with AA, leading the authors to suggest that the vitamin D level has to be measured in patients with AA. These results also suggest that vitamin D supplements or topical vitamin D analogues should be considered for patients with AA and vitamin D deficiency. However, the meta-analysis did not find any clear correlations between extent of hair loss and serum 25-hydroxyvitamin D level [68].
Thompson et al. evaluated the association between AA and vitamin D in a prospective study. Survey data encompassing lifestyle and medical history from 55,929 women in the Nurses’ Health Study were investigated. The authors found that there was no significant association between dietary, supplemental, or total vitamin D intake and risk of developing AA [69].
More recently, a cross-sectional study conducted by Gade et al. sought to assess serum vitamin D levels in patients with AA as compared to healthy controls, and to further identify the association between vitamin D levels and disease severity in patients with AA. The study included 45 adult patients with AA and 45 control subjects. Serum vitamin D was estimated using enzyme-linked immunosorbent assay (ELISA) kits. The severity of AA was determined using the Severity of Alopecia Tool (SALT) score. The mean vitamin D level was found to be significantly lower in patients with AA (17.86 ± SD 5.83 ng/mL) than in the healthy controls (30.65 ± SD 6.21 ng/mL) (p = 0.0001). The level of vitamin D showed a significant inverse correlation with disease severity (p = 0.001) [70].
Dorach et al. conducted a prospective study to correlate serum vitamin D levels with the severity, pattern, and duration of AA and with the density of vitamin D receptor (VDR) expression over hair follicles in patients with AA. These authors evaluated 30 subjects with AA and 30 healthy controls with a mean age of 28.9 ± 9.96 and 31.17 ± 9.43 years, respectively. Of the 30 patients, 96.7% were vitamin D deficient (< 20 ng/mL), compared to 73.3% of the 30 healthy controls (p = 0.001). Serum vitamin D levels negatively correlated with the severity of the disease and duration of disease; however, vitamin D did not correlate with the pattern of AA and VDR expression in tissue samples. VDR expression was reduced in all patients and was normal in controls. There was an inverse correlation of VDR with the presence of inflammation, as assessed in histology studies (p = 0.02) [71].
Recent study from June.
Study of serum vitamin D levels in men with premature androgenetic alopecia
Abstract
Background
Vitamin D deficiency had been associated with various hair loss disorders, such as telogen effluvium, alopecia areata, and female pattern hair loss. However, previous studies have not found a correlation between serum vitamin D levels and the severity of androgenetic alopecia.
Methods
A case‐control study was conducted for a period of one year in a public tertiary care hospital. Fifty males clinically diagnosed with androgenetic alopecia and 50 age‐matched healthy controls were recruited. Serum vitamin D levels in both cases and controls were measured by radioimmunoassay technique, and the results were compared.
Results
A total of 50 cases and 50 controls were recruited and analyzed. The mean age of the cases was 23 years and that of controls was 24.2 years. The mean levels of serum vitamin D significantly decreased in cases, compared to controls (20.10 vs. 29.34 ng/mL; P ≤ 0.001). Eighty‐six percent of the cases had deficiency of vitamin D (<30 nmol/L), while 14% had insufficient vitamin D levels (31–50 nmol/L). There was a positive correlation between vitamin D deficiency and severity of androgenetic alopecia (AGA), which was statistically significant (P ≤ 0.5). However, there was no correlation between the duration of sun exposure and serum vitamin D levels (2.36 ± 1.2 in cases and 3.23 ± 1.6 in controls, P value = 0.98).
Conclusion
Our study showed a significant correlation between vitamin D deficiency and the severity of androgenetic alopecia. This suggests that vitamin D may play a role in the premature onset of androgenetic alopecia. However, further studies on a larger population and the effect of vitamin D supplementation on the progression of androgenetic alopecia are required to validate the above findings.
My hair is definitely increasing in number. It's very fine thin hair though as you would expect when recovering from Norwood scale 6-7 somewhere. It's 3.5 years into the Vit A reduction. Some quite long hairs at 3-4 inches growing in middle section. Some darker hairs growing which would be needed for cosmetic success ie not looking bald. When you look in sunlight there's definitely a lot of light hairs now. The scalp skin improved first. Brown patches (sun spots) got lighter too. I may try to estimate how many hairs there are. I do massage occipital points at back of head. I'm hoping this is the year where it will get thicker. It looks promising. Some light hairs on the crown. Less hopeful of losing bowling ball look at top.
@tim-2 yes, definitely on that middle strip where hair is last to go at Norwood 7. Slick bald there for 23 years. Also some isolated long hairs on the crown and elsewhere as well (slick bald for 33 years). 50% hopeful even the crown will eventually have fine thin hair.
Some diagrams for Norwood scale. https://www.baldandbeards.com/norwood-scale/?utm_content=cmp-true
Recent studies suggested that dihydrotestosterone (DHT)-driven alteration in the autocrine and paracrine factors may be a key to androgen-potentiated balding. Also, we recently claimed that DHT-inducible dickkopf-1 (DKK-1) is one of the key factors involved in the androgen-potentiated balding. Here, we investigated whether I-ascorbic acid 2-phosphate (Asc 2-P), a derivative of I-ascorbic acid, could attenuate DHT-induced DKK-1 expression in dermal papilla cells (DPCs) from balding scalp. We observed that DHT-induced DKK-1 mRNA expression was attenuated in the presence of Asc 2-P as examined by RT-PCR analysis. In addition, we found that DHT-induced activation of luciferase reporter activity was significantly repressed when Asc 2-P was added together with DHT. Moreover, Asc 2-P repressed DHT-induced DKK-1 protein expression as examined by enzyme-linked immunosorbent assay (ELISA). Although there will be many hurdles to apply our finding to actual remedies, these results suggest that it would be worthy to evaluate Asc 2-P or its derivatives for the treatment and prevention of androgen-driven balding.
Vitamin C deficiency may be one way that Hypervitaminosis A causes MPB.
Hey has anyone tried lymphatic massage for this?
I've been doing some facial lymphatic massage and thinking that changes to my problem skin areas were seen almost right away. It makes me wonder if some part of our problem is that we need to get this bad stuff moving along to the elimination organs. Perhaps the pathways themselves are damaged and sluggish.
In the past, long before Grant, I found that lymphatic massage helped with spider veins.
I am far from an expert at this, but in general I think the skin is gently brushed in the direction of the heart. It isn't muscle massage, it is closer to the surface. You brush in the direction of lymph nodes and in the direction of the heart. It's quite easy to just towel off in this direction after a shower, without even changing much about your daily routine. I suppose since we are talking about scalp we could also comb or hair-brush in the correct direction and then follow up with massaging down the neck toward the heart.
I wonder if our friend @ourania knows some things she could tell us about this subject. I'll try to find a YouTube video.
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Here is a basic video but it centers on the face and not the scalp. Still, you can see what this is about.
Pattern Hair Loss appears to be multi-faceted, and it's very difficult to pin-point a singular cause.
Inflammation -> Fibrosis -> Calcification is one path (ever noticed the shine of bald men's scalps? That is hard calcified skin). Where this inflammation is coming from though ... hard to say.
Also reduced blood flow is a possibility -> a lawn without nutrients will not grow grass for very long.
Hormones are likely involved -> elevated cortisol, adrenalin, estrogen -> all are elevated under stressed states and poor metabolic health / poor liver health.
Thyroid function and general metabolism also likely play a role. I have been able to successfully recover hair on the front of my shins (that were balding) after c. 6 months on a thyroid supplement. Sadly, no head hair re-growth that I can notice (photo evidence below).
Interestingly, vA impacts almost all of the above in a negative way ... not necessarily the main cause, but it's an interesting thought.
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One thing I do find INCREDIBLY interesting and promising RE: hair loss, that most people don't discuss, is the idea of muscle tightness causing hair loss... BOTOX!!
The theory goes (with a few studies backing up), that chronic muscular tension in the muscles around the head - i.e. the frontalis, the temporalis, the occipitalis - causes a restriction in blood flow to the top of the scalp (the galea aponeurotica). This restriction in blood flow over a long period of time causes hypoxia in the follicles - when they eventually die, they do not grow back ... or at least, no where near as large or healthy as before.
Dr Brian Freund conducted a study YEARS ago, demonstrating that botox in the muscles around the scalp was able to significantly improve hair counts, and reduce hair fall, in c. 80% of men in the trial. I believe the 20% who did not respond were those who already had extremely calcified scalps - hair follicles literally could not regrow because the skin was so hard. IIRC, the average increase in hair density per given area was c. 21%. But that value is including EVERYONE, even those who did not respond. If we look at just the responders, it was c. 30%. And this was only over a 10 month period ... safe to say that things could have continued to progress after a few more treatments for say 2 years.
Unfortunately, the study is behind a paywall https://pubmed.ncbi.nlm.nih.gov/21042071/ . But some info here: https://www.hairguard.com/botox-injections-for-hair-growth/ and https://karger.com/sad/article/8/2/93/826745/Use-of-Botulinum-Toxin-for-Androgenic-Alopecia-A and an "excellent responder" attached in the photos below.
And here is the patent for the procedure: https://patents.google.com/patent/US6299893B1/en
I would still recommend HIGH caution. I personally do not trust botox and am skeptical. But the information was incredibly interesting. It at least goes to show that chronic muscular tension could be a factor.
What makes muscles chronically tight? Poor thyroid function (in hypothyroid people, muscles can take a very long time to relax after tightening, and tend to hold tight 24/7 , check this video on the ankle test https://www.youtube.com/watch?v=BAPlv62-ZZI ), as well as poor mineral balance (not enough magnesium and potassium, stress , poor sleep, chronic inflammation etc. etc.
Edit: the first two leg hair photos was January 2023 - pre-thyroid supplementation. The last one was August 2023 c. 6 months after starting thyroid supplementation (still haven't found an optimal level yet, and almost zero relief from any of my symptoms - but this was an interesting plus).
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