What supplements can help with hair loss?

Supplements for Hair Loss: Evidence-Based Recommendations

Vitamin D, zinc, and minoxidil are the most evidence-based interventions for hair loss, with vitamin D deficiency correction and zinc supplementation particularly beneficial for those with alopecia areata. 1

Primary Interventions Based on Hair Loss Type

For Androgenetic Alopecia (Male/Female Pattern Hair Loss):

• Topical 5% minoxidil is the first-line FDA-approved treatment
  • Apply 1mL directly to scalp twice daily 2
  • Results may appear at 2 months, but at least 4 months of consistent use is often needed 2
  • Continued use is necessary to maintain results 1

For Alopecia Areata:

• Vitamin D supplementation if deficient (check serum 25(OH)D levels)

  • Vitamin D plays an essential role in normal hair follicle function 1
  • Deficiency is strongly associated with alopecia areata 1

• Zinc supplementation

  • Multiple studies show lower serum zinc levels in alopecia areata patients 3
  • Severity of alopecia areata inversely correlates with serum zinc levels 3
  • Supplementation may be beneficial, especially in those with levels below 70 μg/dL 3

Secondary Supplements to Consider

Biotin:

• Despite widespread popularity, clinical evidence supporting biotin for hair growth is limited 4
• May be beneficial in cases of documented biotin deficiency 5
• One study found suboptimal biotin levels in male androgenetic alopecia patients 6
• Consider checking serum biotin levels before supplementing 5
• Biotin deficiency was found in 38% of women complaining of hair loss 5

Other Micronutrients:

• Iron: Check ferritin levels, as low iron stores can contribute to hair loss even without anemia 1
• Folate: Some evidence suggests associations between alopecia areata and low red cell folate levels 3
• Vitamin B12: Case reports link pernicious anemia with alopecia areata, but controlled studies show no significant differences in B12 levels 3

Emerging Options:

• Caffeine: Recent studies suggest topical caffeine preparations may help with hair loss 7
  • Works by stimulating cell growth and penetrating hair follicles
  • Clinical evidence is still developing but promising

Diagnostic Approach

Before supplementing, consider these evaluations:

• Thyroid function tests (TSH, free T4)
• Iron studies (ferritin)
• Vitamin D levels
• Zinc levels (preferably morning samples)
• Complete blood count

Important Caveats

1. Supplement only when deficient: Routine supplementation without documented deficiency is not recommended for most micronutrients 3, 1

2. Biotin popularity exceeds evidence: Despite widespread marketing, biotin's efficacy for hair growth remains largely unsubstantiated in scientific literature 4

3. Combination therapies: Some studies show benefit from combinations (e.g., zinc + biotin + topical steroids), but it's difficult to isolate the effect of individual components 3

4. Minoxidil is proven effective: Unlike many supplements, topical minoxidil has strong evidence supporting its efficacy 2

5. Temporary increased shedding: When starting minoxidil, hair loss may temporarily increase for up to 2 weeks as part of the normal process 2

The evidence most strongly supports vitamin D and zinc supplementation for those with documented deficiencies, particularly in alopecia areata, while topical minoxidil remains the most evidence-based treatment for androgenetic alopecia.