Week 11: Hair Loss

Another good week, further progress, and another milestone passed, 25Kg lost!

This week I have started a new feature to the blog, where I discuss a topic of interest to the WLS community, i.e. those topics which crop up again and again in the various WLS forums. This week the subject is hair loss.

Hair loss
I have followed with interest the various threads on the ThinnerTimes and WLSInfo forums concerning hair loss. It appears that many members of the ThinnerTimes forum believe that hair loss can be minimised or avoided with medications, supplements, or specialised shampoos. By comparison, many members of the WLSInfo forum have been told by their surgeons that hair loss is a fact of life for many (but not all) patients who have undergone Weight Loss Surgery (WLS), and no medications can prevent it.

The consensus is on both forums that the loss is temporary, that it typically occurs from 3-6 months post-op, and starts to return at about 9-12 months post-op.

It seemed to me at face value, before I did any research, that if hair loss could be prevented by medications/supplements, then all the surgeons in this field would be aware of it, and prescriptions for the 'cure' would be standard and that hair loss would not be a recurring issue (that it is) in the forums.

Looking back over my notes I got from my surgeon (in Germany) and researching various bariatric medical websites, it would appear that WLS patients have two major risks associated with hair loss, i.e major surgery and rapid weight loss. Rather than try to paraphrase the specifics, I will quote directly from one such website:

Hair loss has many causes. The most common type of hair loss after weight loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes.

Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states: anagen, a growth phase, and telogen, a dormant or resting stage. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase,which lasts for approximately 100 to 120 days. Following this, the hair will fall out. Typically, about 90 percent of hairs are anagen and 10 percent are telogen at any give time—meaning that we are usually losing a lot less hair than we are growing, so the hair loss is not noticeable. But sometimes this can change.

Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include the following: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end-stage liver disease), hormonal disruption (such as pregnancy, childbirth, or discontinuation of estrogen therapy), acute weight loss, crash dieting, anorexia, low protein intake, iron or zinc deficiency, heavy metal toxicity, and some medications (such as beta-blockers, anticoagulants, retinoids, and immunizations).

Nutritional issues aside, bariatric surgery patients already have two major risks, that of major surgery and rapid weight loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss will rarely last for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back.

 Nutritional reasons for hair loss are indicated in the following cases:

• Hair loss continued more than one year after surgery
• Hair loss started more than six months after surgery
• Patient has had difficulty eating and/or has not complied with supplementation
• Patient has demonstrated low values of ferritin, zinc, or protein
• Patient has had more rapid than expected weight loss
• Other symptoms of deficiency are present.

Your blood tests will show whether your protein and minerals are within the normal range, and if low you can increase your protein intake, and/or the specific minerals/foods associated with hair loss, i.e. (in order of importance): iron, zinc, protein, (and to a lesser extent - vitamin A, inositol, folate, B6, and essential fatty acids).

Myths
Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.

Please feel free to add your comments.

So, back to the weight. Today I weighed 100.5Kg (15st 11.6lb, or 221.6lb, that's a net loss of 25Kg (almost 4 stone, or 55lbs), and 1.2Kg loss over last week

Here are the progress photos:

100.5Kg BMI 33.19

Rock