The Science of Healthy Hair, Hair Loss and How to Regrow Hair
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I'm enter huberman and am a professor, neurology, and opened ology at stanford school of medicine. Today, we are discussing here.

Here is a topic that occupies the minds of many people. There are people that are losing their hair and want to halt or reverse that loss of hair. And today we will talk about all the ways that science has taught us. We can slow or even reverse hair loss.

I confess that researching today's topic was a particular joy for me, not because i'm obsessed with hair mine, or the hair of others, but because hair turns out to be fascinating from the perspective of cellular biology and stem cells, which is a topic that i've long been interested in, and that for much of my career, i've focused on in the context of development. So when you are brain and your nervous system develop, IT develops from a small batch of cells that turns into many, many trillions of cells. And IT does that by cell replication, something that we call the cell cycle, and will talk a little bit about this.

And so called my toys is today, I promise not to get into too much detail. But what makes her so very interesting from a biological standpoint is that every hair, every single individual strands of hair, has its own little stem cell niche, meaning a little pocket down there in the follow, in which specific stem cells give rise to those hairs for different durations of time, depending on the hair where IT is on your body at set up. So for instance, the hairs is on your head will undergo ongoing growth for four to six or even eight years.

So we're you to not cut your hair. IT would continue to grow. One single hair would continue to grow. I guess we could say all the hairs will continue to grow for up to eight years.

That is very different from, for instance, your eyebrows, which have a much shorter period of hair growth lasting on the order of months. That's why you don't see people with eyebrows that extend down to their waste. But you can see people with hero on their head that extends down to the waste if they don't cut IT.

Now that describes illustrates for us just how incredible hair followers and the stem cells that resides within hairs are, and they're enormous potential to give rise to these things that we call hair, which are simply proteins of varying life. So today we are going to address what determines the length of a hair, or rather, what determines how long a hair continues to grow before ceases growing and eventually falls out. We're going to talk about what regulates those stem cells, what allows them to continue to produce hair or seized, producing hair.

And as we do that, you will learn all the biology in clear, simple terms, regardless of your background. That will really set the stage for understanding what will also talk about, which is how to slow hair loss or halt hair loss entirely, or even reverse hair loss. So we will talk about horton related hair loss in both men and women.

We will talk about some of the mechanical and stress related influences on her loss, and we will talk about the chemical and mechanical approaches to halting and reversing hair loss. Everything from min, oxy, dle to do tester's de to kito cons all to micro meddling to thyroid, estrogen, I G F one pathways, again, all made very clear, regardless of whether not you have a background in biology or not, I will also dispell some of the common myth about boarding and hair replacement. If you heard, for instance, that you inherit your patterns of boarding from your mother's father, that is not true, although IT is true, that you do inherit certain genes that influence whether not you have a previous position to bolding in particular parts of your head and believe or not, even in particular parts of your body.

But this is not the case that you can simply find a photo of your mother's father, say, age fifty or age sixty or seventy five, and determine whether not you'll have the exact same pattern of hair loss. So that's admit that i'd like to dispell right here now, and I will dispell some of the other miss about hair loss, hair replacement and her regrowth as well. Before we begin, i'd like to emphasize that this pot test is separate from my teaching and researchers at stanford.

IT is, however, part of my desired effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, i'd like to thank the sponsors of today's podcast. Our first sponsor is element.

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Today's episode also brought to us by waking up, waking up as a meditation APP that includes hundreds of meditation programs, mindfulness trainings, yoga eja sessions and nsd r non sleep depressed protocols. I started using the waking up up a few years ago because even though i've been doing regular meditation since my teens and I start doing yoga edra about a decade ago, my dad mentioned to me that he had found an APP, turned out to be the waking up APP, which could teach you meditations of different durations. And they had a lot of different types of meditations to place, to bring your body into different states.

And that he liked IT very much. So I gave the waking up up a try, and I too found IT to be extremely useful, because sometimes I only have a few minutes to meditate, other times I have longer to meditate. And indeed, I love the fact that I can explore different types of meditation to bring about different levels of understanding about consciousness, but also to place my brain and body into lots of different kinds of states, depending on which meditation I do.

I also love that the waking up up has lots of different types of yoga eda sessions, those you don't know. Yoga eza is a process of lying very still, but keeping an active mind is very different than most meditations. And there is excEllent scientific data to show that yogananda and something similar to IT called non sleep deep breath or nsd r, can greatly restore levels of cognitive physical energy even which is a short ten minute session.

If you'd like to try the waking up a APP, you can go to waking up dot com slash huberman and access a free thirty day trial again, that's waking up that com slash huberman to access a free thirty day trial. Okay, let's talk about hair. And in researching this episode, by talking to experts in the biology of hair and the stem cells that exist in all of us that give rise to our hair growth and the pigmentation in our hair, and in talking to experts who understand how to halt and even reverse hair loss, that there is a tremendously interesting biology surrounding hair.

But there's also an incredible psychology around here. In fact, most people who experience even marginal hair loss undergo pretty severe anxiety. Now, I confessed, is not something I can relate to. I am losing my hair in certain places. And forty seven years old, i've got a couple patches up front where there's very minimal hair.

I think that as well later learn in the episode reflects a higher density of dh d dhhs da tito stern receptors at that particular location is supposed elsewhere in my scale. But keeping my hair is not something that i've read IT about much of my life. And as I was researching this episode, I remembered an anecdote from my childhood where my father told me, and I think he was because I was stressing about something, because I was trying to get to sleep.

And he said, don't stress, calm down. And here's why. If you stress too much, I can actually make your hair ful out. In fact, I have a cousin who lay down one night, stressed and woke up the next morning and all of his hair was on his pillow and I i'll never forget that story. I think he was trying to get me to stress less.

I don't know if that story made me stress less or not um but in any event, I don't know that that story is true. I'm gonna chAllenge the authenticity of that story. I didn't have a chance to reach out to my my father and ask him to verify or not but as well soon learn IT is true that our psychological well being can impact both the coloration or lack the of and the growth rates of our hair.

That's a real thing. And the reverse is also true, which is that as hair starts to thin or fall out or change color, many people experience intense anxiety or even depression. This was not something I was really aware of.

Perhaps that's just because I always keep my hair pretty short. Anyway, I was assumed that if my hair started to really fall out out to shape my head, but that's me. And that's not most people out there.

I think most people um would low to lose their hair. And in fact, given the enormous number, probably up in the high billions of dollars and euros and other um currency, of course, that people invest in trying to halter, reverse their hair loss. It's clear that hair is very, very important to people.

What we know is that by age fifty, approximately twenty fifty percent of all men and women will have experienced significant enough hair loss that they start to notice IT. And a large percentage, up to eighty five percent of those people will experience some sort of anxiety that leads them to go out and try and either halt to reverse that hair loss. Now why the age fifty? Well, an important point arises from that, which is that the hair loss is not occurring between the forty nine thousand hundred and fifty at birthday.

Hair loss is ongoing from about age thirty to age fifty. It's only by age fifty, however, that about fifty percent of people out there. Start to notice that hair loss.

And this is typically because they're you'll be in a bathroom, we're looking in the mirror and the lighting will be bright enough that IT permitted the outer boundary of their hair. And they will notice that their hair is thinning in a particular location. That's usually how the sort of thing happens.

So again, our psychological states can impact our patterns of hair growth or loss in, of course, patterns of hair growth. But more typically, hair loss and her grain can really impact psychological state. So this is a subject that people take intense interest in. And today we're going to talk about how hair Normally grows, why IT grows at the rate and for the duration that IT happens to.

And then as we talk about ways to intervene with that, her loss, those bio ological mechanisms will come up because they really provide a nice framework for explaining why certain treatments work more or less well, or why certain treatments might have certain side effects or total lack of side effects. IT will also highlight a really key theme that will come up several times in today's podcast, which is that there are both mechanical and chemical approaches to slowing and reversing hair loss. Mechanical approaches would be things as simply as massaging the scalp, but mechanical changes to the scale can cause either hair loss or facilitate hair growth.

This is why things like micro needling are so prominent in the context of trying to reverse hair loss. But again, there are also chemical approaches to trying to halt a reverse hair loss. And this relates to the fact that the hair growth itself is strongly regulated by hormones such as estrogen fi royd hormones, insulin like growth factor, and that other hormones, in particular the android gans.

So things like testosterone, but mainly its derivative like the hydro testosterone, are very much involved in setting the stage for hair growth by controlling how big or small that pool of stem cells that gives rise to hair growth is. So if any of the terms I just use are confusing to you, don't worry, I will make all those very clear in a moment. It's actually all prety straight forward and simple.

And so i'd like to just start by talking about what here is, how IT grows, why IT stops growing and why hair Normally falls out. Let's talk about the biology of hair. And in doing so, I also want to talk about stem cells.

Keep in mind that when you hear the word stem cells, you, I would like most people, think about the sorts of cells that people are getting injected into their face to get rid of wrinkles or give them new skin, or to give them more hair. If it's injected the scale or into a joint to repair a joint to a muscle. Those stem cells are what we call exogenous stem cells, exogenous, meaning from outside the body.

The stem cells that we're going to talk about today are so called endogenous stem cells, cells that we all make that can give rise to other cells. And that's really the definition of a stem cell. Stem cells are present in all of us from the very beginning of life.

So in sperm at egg that sell what we think of as the egg starts to duplicate in, incorporates the D. N, A from the sperm. And the egg, of course, starts to duplicate. And then those cells give rise, and more cells and more cells, and the ability of all those cells to replicating create more cells are because those cells really are stem cells. Now, at some point, we are a completed body plan.

As the biologists say, we end up with a brain and a spinal court in limbs and fingers and livers and guts and all the things that we need in order to be a functioning human being. Even though we're a baby at that time, we haven't been grown up. We have all the bits that we're going to have for our entire life.

At that point, many of the stem cell populations disappear, for instance, past puberty and probably earlier. You don't get many more new brain cells. You get a few, but you don't get many more new brain cells because the brain doesn't have many stem cell populations where as other organs in your body maintained little pockets of stem cells, or in some cases, many, many stem cells that can give rise to more and more of that tissue across the lifespan.

And hair is one such tissue. So if we take a look at hair, what we find is that, indeed, there are these things we call hairs, but there are also stem cells. And those stem cells are actually what give rise to the hairs that we see on the head of our scale, or that we see on the surface of our body.

So write off the back. You should know that every single hair that you have is there because you have a stem cell population that is giving rise to that particular hair. So let's take a step back. Or rather, I should say, let's zoom in on one hair.

And the stem cell population that gives rise to that hair because in doing so, you're going to learn all the different components that you can tap into if your goal is to halt the loss of hairs or to replace hairs that have already been lost. And so if we were just women at the level of one hair, what you would find is that that hair has what typically called a hair route. So that's the portion below the skin.

And when we say below the skin, IT means that IT dives down into a narrow trench, which is in the so called epidural s, which is this outer layer of skin. IT also has a shaft. The shaft is the part that grows out above the skin.

So what you see on someone's head, or you see on the on their ARM, or when you see an eyebrow, you're seeing the shaft of the hair. The root, of course, goes below the skin. What most people don't realize, however, is that down at the base of the root, there's actually a little cave, a little pocket.

So if you were to look at this, that would look like a little ball below round area with a bunch of stuff in IT, right below the root. And within that low cave, there are stem cells. There are populations of cells that have the ability to divide, right? We call this my tosa, is a process by which cells can actually divide and take DNA with them and then give rise to other cells.

We call those cells that that divide and move out. We call those daughter cells. We call the cells that give rise and progenitor cells.

But they are effectively stem cells that give rise to these, what we call daughter cells. Those daughter cells then become the various types of cells that make up the hair. So when you see the hair, you're not seeing something that grows throughout the lifespan.

You're seeing something that's going to be born down there in that little cave then is going to grow. It's actually going to stack up on top of itself. That's because hares are made up of a protein called territon, the bunch of different kind carians, depending on what kind of here you're looking at.

But these are little proteins that stack up on top of one another, and they're structured in a way that makes them pretty darn durable. I mean, it's possible, of course, to pull a hair out. But if you ever tried to tear a hair, in particular, the care like one from the face or even one of the a top your head, it's actually a pretty tensile strong little thing.

And that's be caritas, stack up on top one another and bind one another with a really strong bond. So what you end up with is a bunch of protein stacked up on top of one another. And that's the actual hair.

Okay, so we've got the hair shaft, the hair route, and then we've got the stem cells down there in that pocket that give rise to very few cells that make up the actual hair. We also have down there in that little cave, which, by the way, is actually called the hair bulb. You really want to know the technical name because IT shaped like a bub.

We have not just stem cells, but we have cells that give rise to the pigment of the hair, that create what's called the melanin. Now some people have very blond hair, very light hair, some people have darker hair, but everybody, unless they have what's called the albano mutation, where the hairs are truly White, they lack all melon and is a pretty rare condition. Although IT does happen, most people have some degree of melanin in their hairs because there are little pockets of melanthon producing cells.

Melanin, just a protein that somebody gets injected into the curtain, into the hair and gives IT its darker color. Now there a couple of other components about the hair that you need to know about, especially if you're interested in reversing hair loss or reversing grain of hair. One of those components is a little gland, so next to every hair root within the dermal layer of the skin.

So this is below the epidemic. There is a gland called the subacid ious gland. And the severe ious land makes oil stuff, and the oilily stuff is called sea M. I know the names of evoke something kind of growth, but sebum is actually really cool and really important.

The sea bom gets injected or seats rather into the area right around the hair as the hair starts to approach the surface where IT goes from essentially route to shaft. And the sea bom does two things. First of all, IT forms a little bit of a seal right at the place where the hair exists, the skin.

And that seal is very important, actually, for waterproofing of your skin. So we don't often think of ourselves as waterproof because we are so customer to water just landing on our skin and and rolling off. But that's because of some of the oil properties of our skin.

And it's also true that our skin is pretty densely packed with cells. But in the absence of sebum, we would not be as waterproof as we are now. As I mentioned, sebum has two important properties.

The other important property of sebum is that IT actually is a strong anti bacteria and emptying microbial. Most people don't realize this. The oil of your skin provide a lot of immune boundary so that things don't get IT into the hair route or the region around IT and infect our skin.

So see, bum. Well, the name is sort of unattractive, to be honest, is actually performing some essential roles both for waterproofing and for our immune system function, protecting us from various kinds of infection. We're going to return to cbm later because IT turns out c bm is also very important as IT relates to surprise and as IT relates to some of the fungo components that can cause hair loss.

So just going to filed that away. There's another important component of the region around hairs, which is the erector peli muscle. Director pilling muscle is a muscle that lies diagonally between that bulb portion of the hero, a little bit above IT, and goes up to the surface of the skin.

The director polling muscle as a muscle that contracts when we get cold or when we get scared. So if you've ever had goose bombs, that's because the director pilling muscle contracts pulling the skin at the surface down around the little hair folkies, or at least where the hairs meet the the surface of the skin. And so those little bombs are actually where little microwave rs.

reside. And the dimples between them are the dimples that occur when this director ply muscle pulls down. Now why would this muscle exist? Has a couple of important functions.

One of the functions is that when IT pulls down, IT causes, as the name suggests, the hairs to stand up, maybe not perfectly vertical, but they, when you hear all I was so frighten, my hair stood up on end. And that's because the hair is become erect. They stand up.

Now, why would this happen when we get cold? IT happens because when the hair stand up, air can be trapped between those hairs and can actually warm our body. This is not so much the case. If you have very light hair on your skin, if you're a very Harry person, this is going to be a more robust aspect of your physiology. And yes, this is why dogs like huskies can go out in the snow and still remain warm.

When they get cold, their hairs actually stand up a bit on end, because the contraction of these director peeling muscles, trapping air in there, and then their body warms the hair trap and eath the hair. And is early theyve got a blanket on made by the interface between the hair, the air and their skin. So just to recap, all the components of hair and the different things around IT that are going to be relevant for understanding how to replace hair that's lost.

We have the hair itself, which has the shaft that sticks out over the skin, was a little bit into the skin, but basically sticks out over the skin. We have the root portion, which goes down into the skin. IT goes through the epidemic and into the domestic. And we have this bulb like region down at the bottom, down at the bottom, that bold. We have stem cells that actually give rise to the actual hair.

And we have pigmented cells that pigment that here, in addition, and this is very important, there are capable aries that go into that bulb region down at the bottom of the hair, and that can serve and support the stem cells, the melanie producing cells, which are called milano sites. So the melanie producing cells in the stem cells get a lot of blood flow that allows them to keep providing new hair, or the proteins that make up hair and the pigment that goes into those hairs. And those lucilla's deliver not just nutrient and things of that sort, but they also deliver oxygen.

IT turns out that the whole process of growing more hair is a very active process. now. Well, as soon as you hear oxygen and you hear that the growth is an active process, that will cue you to why so many of the stories around how to keep your hair and regrow hair involve statements like don't wear a hat, it'll make your hair fall out if you want your hair to grow back, you don't wear hat or massage scalp or increased blood flow.

Or are why some people will a suggest that people take peppering oil, for instance, or mental all type oils of different kinds and massage them into the scalp, things that make the scalp tingle. Or there will be light therapies design to what to increase blood flow to the scalp. The whole rationale is that you're trying to increase blood flow to the stem cell in the milano de populations that support the hairs and that actually create the hairs.

Now whether or not those approaches work, we'll touch on a little bit later. I'll just give you a little bit of a hinter right now, which is that, well, no single one of those approaches that I described is known to regrow hair in a very robust way because of the requirement for oxygen and nutrient, and because it's such an active process for the stem cells of milano sites to grow and dark in the hairs they grow out of your skin. IT is true that manipulations or treatments that increase blood flow to those regions can at least slow the loss of hair, or can even extend the donation over which he is continue to grow.

So if you heard things like don't wear a hat if you want to maintain your hair, or massage scale if you want your hair to grow faster, in some sense that's true. But none of those manipulations on their own is going to robustly enhance the rate of of your hair growth. Those things are designed to be done in conjunction with some other treatments that have been shown in many, many clinical studies to increase the rate and duration of hair growth.

So now you haven't mind a picture of what's happening at the level of individual hairs and you're anything like me. You're probably think, well, there's a lot going on down there just going to low the surface of the skin. And indeed, there is really the things to think about, or that stem cell population that actually give rise to the hair proteins so that actually create the hair, the melanoma sites that dark in that hair, that give IT pigment, that subacid ous gland and the oil sebum that provides some important antimicrobial and other properties to that general region.

And that a rector, pi muscle, that erector pilly muscle, as I mentioned earlier, is important for creating goose bumps, and it's important for keeping huskies warm and cold environments. But it's doing some other really important things as well. And we will talk about those as time goes on this episode right now, what I want to do is just talk for a moment about how hares actually grow and why they grow the way they do.

This is extremely important toward understanding hair replacement and slowing hair loss. There are three basic phases of growth of a hair. The first phase is the phase in which the stem cells down in that bulb givers to the cells that make up the protein to the hair.

So the actual growth of the hair, and keep in mind that the hair is actually growing from the bottom up. You might think, of course, it's grown from the bottom of everyone knows that a lot of people think that the hair starts growing right at the surface of the skin. That's not the way IT works.

The hair is actually growing from deep within the root and stacking up, and then eventually extends out across the top of the skin. That growth phase is called the energy en phase A N A G E N. And this, for some people, will ring about, because if you've ever been in interested in weight lifting, or even if you're an endurance runner, you'll hear about things that are anna olic that promote growth.

So anna of growth, or catabolic that promote breakdown. So the first phase of hair growth is called the energy en phase, and it's a period of ring duration, depending on which hair in the body were talking about. So the energy of the growth phase for hairs on the head, as I mentioned earlier, is anywhere from two to eight years.

For most people, it's going to be about six years. What this means is that if we were to just not cut our hair, just let our hair grow for two to eight years, that hair would eventually grow to a length that I was edit maximum and then would stop growing. So we can say that the energy en phase of hairs on the scale is two to eight years, the the duration of the growth face contrast that for instance, with the duration of the energy en phase for hairs of the, the hairs of the eyebrows grow about four point two millimeters per month.

Believe there are not. People have measure the sort thing. Now that's an average. So some people are going to have eyebrows. I'm grow much longer per month. Um i'm somebody who for instances, mostly the same length uh eyebrow hairs everyone's well I get when those I brow hairs like really seems to be heading off my head IT like really wants out of there. And so it's much longer than the rest.

What does that mean? Does that mean that IT grew faster? Maybe, but chances are the stem cell population in that particular I brow folko for that one eyebrow hair is longer than IT is for the others.

This is really important. I'm trying to illustrate two principles at once here. First principle is that different hairs on your body, including the hairs on your scalp, have a growth phase of different duration. This is why the hairs on your head to grow very, very long, because they have a very long energy or growth face, and the hairs is on your eyebrows will only grow for a few months before they actually fall out, and then have to undergo replication of the stem cells to give you new eyebrow hair to then grow.

What's important here is not just that there are differences in the duration of the growth phase, but rather that the rate of hair growth is not something that tends to differ within a given body region. right? You'll hear people say, oh, my hair goes really, really fast.

Other people will say, oh, my hair goes really, really slowly. That is probably not the case. Now there could be slight differences in the rate of growth, that is, the addition of more current to the actual hairs.

So creation of more hair more quickly. Almost certainly, what's happening is that the duration of the energy and phase in some people is just much longer than IT is in other people. And we don't realize this.

And we tend to think more in terms of how fast hair grows because if you were to just look at somebody dies here, you'd say, no, you know, they're all more or less the same way. Some people's banks are shorter than the back because they cut them. But if they were just grow their hair, you d say, oh, it's all more less the same length.

But if we were to sum in with a microscope, we would see that there are a lot of hairs down there in between the other hairs that are very, very short or even tiny, tiny, tiny. And those are coming in as the other ones are finishing their energy phase. okay? So that's the energy in or growth phase after the energy phase comes the cat tag en phase, again, this resembles the word catabolic or the breakdown phase.

During the cattle gen phase, the hair is actually receding, not from the top down to the skin surface and then into the root. But the other way is actually receding from that bulb region up toward the surface. And that cattle gen phase is going to also be a different duration depending on which the body in and IT will very.

A little bit, depending on who you are, meaning from person to person will talk about the influences on the energy and catering and phase in a moment. Why is IT important that IT actually received from the inside out? Well, that's important because as IT does that there's actually a change in that bulb region down below because Normally there's an interface, there's a conversation that's occurring between the stem cell population, the milano sides and the hair itself, and they support each other. And remember, there is blood vessels going into that area, rather capital aries that are feeding that area as well. After the cattle gen phase comes the tea gen phase, which means rest the telega phase is appear in which no new hair proteins are being added by those stem cells.

And during that telega phase, that bulb down there at the bottom instead of nice in ovelar and um really having a lot of space in IT with all these different things like stem cells starts to pinch off from the from the little tube that comes down from the surface of the skin that Normally would have a hair in IT IT starts to pinch off and at some point many here focal pinch off that bulb region and IT receives and dies and when IT receives and dies, the stem cell population in the milano sides go with IT in other words, there is no longer a population of stem cells to give rise to more hair after that tea gin face and there's no longer milano sites to pigment the hair and in fact the harison there anymore so there's no hair even to pigment after that telega face unless it's a hair of a particular type such as the hair on your scalp which can then reenter the cell cycle and get back into an energy phase and regrow more hair from stem cells okay, so there are three critical stages of the life cycle of a hair that are relevant to today's conversation. There's the energy phase during which the hair grows. There's the cattle gen phase during which the hair actually starts to recede and die, the proteins actually disappearing from the bottom up.

And then we have the telephone phase, which is the phase in which the stem cell population is what's called the semi quiet and semi quiet, or completely quiescent, where is not active at all. Those three phases make up the life cycle of a hair, keeping in mind that for some hairs, they can reenter the life cycle and go back into the energy and face if there's stem cells there and if there is oxygen there and if there is sufficient blood support and and this is a very important and if there are the appropriate hormonal signals to support growth and there is a reduction or an absence in the hormonal signals that actually trigger that tile gen phase. I make this point now because much of the rest of today's discussion is going to focus on why particular hormones such as die hydro testosterone cause hair loss, and why inhibiting things like die hydro testosterone can support the preservation of hair that you have in the regrowth of hair.

And to make a long story very short, and then we'll get into some additional details that are relevant that I hope you stick around to listen to. Die hydro testosterone, which is a derivative of testosterone, causes changes in that bulb region where the stem cells reside. IT shortens or halts the energy en phase of hair growth, and IT extends and promotes the cattle gen and intelligent phase.

So when we hear that, oh, you know, dhada chest austro makes your hair fall out, or exogenous makes your hair grow, there are real chemical or wishes, a biochemical, legitimate reasons as to why that is. But IT all comes back to the three phases of hair growth, the energy growth phase, the cattle gen catabolic or hair loss phase, and the telega phase, which is a rest period in which the uhs can either come back if IT reenters the energy and phase, or maybe it's over for good hormones, or the accelerator and the break on each one of those phases. I'd like to take a quick break and acknowledge one of our sponsors, athletic Greens.

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Fact, there's capillary innovation delivering oxygen and blood flow to the stem cells that give rise to the hair. And that there are these three critical phases of hair growth, energy in catching intelligent. Now let's talk about the accelerators on hair growth and the breaks on hair growth.

There are many accelerators on hair growth, but the first one that I really want to underscore is blood flow itself, which equates to the delivery of nutrient and oxygen. This is very important. And IT explains a lot of the treatments for halting and reversing hair loss.

For instance, one of the longest standing treatments for halting and reversing hair loss is so called monoxide l. Monoxide dl, sometimes also referred to by the brand name. Rogaine was actually a drug that was developed to treat tension.

So this is a cardie rog, that lowering blood pressure and IT does that by causing vio dilatation. IT allows more blood flow not just to the hairs on your scale, but to hair everywhere on your body. And indeed, most people don't realize this, but oxide l want just slow the loss of hair from your scale.

IT is also effective at slowing the loss of hair elsewhere in your body. How does he do that? Well, you now know one of the major ways that does that. IT does that by extending the energy en phase. So IT basically makes that phase a bit longer and doesn't make IT much, much longer, which is why for most people who are losing their hair quickly or who have already lost their hair, minoxidil alone is not going to be a sufficient treatment. However, minoxidil has been shown to be effective at slowing rates of hair loss, and people that are starting to experience hair loss all get into dosages and things that sort a little bit later.

But right now, I just want to really on the logic of why people who have take this drug, which is lowering hypertension at all, as IT released to hair loss, right? That might seem like kind of crazy until you understand the anatomy and the growth of hairs which you now do. So that's what minoxidil is doing.

It's creating more blood flow to the hairs, which because monoxide le does have this positive effect, the most people would like to slow their rates of hair loss on their scalp. Anyway, IT tells you that blood flow and delivery of oxygen and other nutrient from the blood is pretty critical, if not very critical, for the support of the hair grow cycle itself. Now again, we haven't talked at all about the sort of chemicals or the signals within the boys, such as hormones that actually direct the growth of hair.

Here's we're just talking about a mechanical change, allow more blood flow to the region and thereby extending the energy phase, which is exactly what happens with minoxidil. Now monoxide does have other effects, and this is why dosing of monoxide becomes a little bit complicated and can be a little bit tRicky to troubleshoot. IT can greatly lower blood pressure, or lower blood pressure just a little bit, depending on how sensitive somebody is to that particular drug.

So often times, physicians will start people on minoxidil dosages that are very low. Ideally that would be the case, and then ratched IT up in order to figure out where the minimal effective those that the kind of critical threshold is beyond which they started experiencing some pretty uncomfortable side effects, such as swelling of the ankles or headaches or dizen ss. These things can happen with the use of rogaine a and oxide.

Now, monoxide has also been associated with increases in the hormones proactive prolactin, a hormone that's released from the petitti. IT is a hormones that acts, also is a bit of a neurotransmitter, like many hormones. And IT tends to be in tagish or an opposite to doping.

So dopamine is a neurochemical is actually a neural modulator, meaning IT modulates, the activity of a unch of neural circuits in the brain that also controls the release of various hormones in the body. Dopamine is is almost always associated with states of motivation, pursuit and drive. IT has a little bit of a feel good element to IT, which is why a lot of people think dopamine e is associated with reward and pleasure.

But it's really about energy, motivation and drive dopamine and proactive. Or as I mention before, tagish to another there in sort of a push pull. So people who take minoxidil, specially the very sensitive to, or they take dosages that are too high, will experience increases in proactive that in turn can cause things like reductions in label, reductions in overall feelings of well being, apathy.

And in some cases where the elevations in product are more extreme, they can experience, for instance, increase in mail, breast issue, gonna asia or even small bit of milk let down things of that sort in women who take my oxyde le, the side effects are much like the ones in experienced in men. So there can be swelling, edema of the tissues um because if you get too much dilation and to too much lowering of blood pressure, that's not good headaches, disease and so on. So dozing m in oxyde is really important if somebody's going to use monoxide l in order to try and slow or reverse hair loss.

And again, IT mainly is going to be used to slow rates of hair loss, not to actually reverse hair loss. The really key thing is to get that dosage right. So the ranges of monoxide l that you'll see suggested and that people use out there are vast.

And I should also mention that there are two major routes by which people get minoxidil to the airport ical. One is to take IT systemically as a pill, where IT goes into the general circulation. The other is to take IT topically as a cream.

There are prescription and non prescription forms of monoxide just to further complicate things. But the ranges of oral monoxide that you'll see out there and that people take range anywhere from zero point two five milligrams all the way up to five milligrams per day. So that's an enormous range as they get a twenty fold range.

The topical minoxidil is also found in various concentrations. The typical concentration is gonna, a five percent concentration that people will use once per day. Topical treatment with minoxidil at five percent concentration is thought to just stay at the scale.

But we now know that I can go systemically, you can get into the general blood stream. Why that that is should make complete sense to you. Because when you put something in your scale, i've already told you that there is little pits, these little tubes, that go down to those bulb regions below the skin, that have direct access to the blood supply.

So when you must ask something into your scale, IT not only has the opportunity to get into your general circulation, IT often does, especially if it's something that's very water soluble, and that way can into the capitalism, into the general bloodstream. Although topical treatments, of which we are going to discuss a number of them today, don't tend to get into the general circulation as robustly as taking something by way of pill or capsule. okay? So an ox works by way of increasing blood flow to the stem cell nih.

Below the hair. The dosage ranges of the oral monoxide are tremendous, point two five milligrams all the way up to five milligrams once per day. The dosage range of the topical solutions tends to be a little bit more confined, typically of five percent solution.

And it's recommended that people use IT one time daily, maybe twice daily. It's also important, by the way, if you're going to take this out that you actually leave that solution on the scale for three to five minutes. This is important and should make complete sense as well.

It's important you can just rub the stuff in your head and then wins IT off and expected to be absorb. That actually needs to sit down into those hair folles and access the niche. How do people arrive at the correct dosage for monoxide? Well, for Better, for worse, really, in some cases it's accomplished by finding out that you have an unwanted side effects like dizen ss or swelling of iran goals or ea ma.

Or I would hope this wouldn't be the case, but something that suggests there's hyper proactive. A you could get a blood test to measure protein, or you perhaps notice a drop in libido or some lethargy, these sorts of things that are common to reduce levels of dopamine and increase levels of proactive. I would hope that if people are working with a physician or if they're not in taking an oxide, that they would start with the lowest possible dose.

So for oral monoxide, that would be point to five milligrams and then increase IT as needed rather than jumping in write five milligrams. Because some of those side effects, in particularly the fluid retention in the hyper proxima, can be pretty uncomfortable and can disrupt a lot of aspects of life that most all of us considered desirable. okay.

So we're really focusing right now on treatments that relate to the critical requirement for hair stem cells to receive blood flow in order to receive oxygen and nutrient to get the hair to grow. And that's really what minoxidil is about. It's also what all of those anecdotes you hear are all about, like massaging the scalp or putting red light on the scale.

Now the red light might do some other things in general, heating or lighting at the scale or massage of the scale is really designed to increase blood flow to the scalp. Now the reason monoxide ks at all is because is going to increase blood flow around the clock. And that's because people are taking IT topically and it's seeing into the general circulation or at least things someone restricted to the hair cell niche or they're taking orally and IT makes IT to that hair cell niche below the follow when we massage our scale.

However, that's a transient thing. I can massage my scale right now, i'm no doubt um increasing blood flow to certain areas and probably decreasing blood flow to the areas and pushing down on, but it's all temporary. I don't know many people that can massage their scalp enough during the day or long enough during the day rather that I would sufficiently increased blood flow.

With that said, IT is clear that increasing blood flow to the scalp by way of reducing hypertension, which is effectively accomplished by broadening, by expanding the blood vessels in capital ies, is an effective way to at least hold on to the hair that you have. Is IT going to completely halt hair loss if you have a strong genetic bias towards hair loss? no.

Is he going to reverse hair loss? Very unlikely that IT will. But I can slow hair loss or even maintain the hair that you have. So if we were to take a step back and ask ourselves what other sorts of drug treatments are out there besides my oxy dl, that increased blood flow and that might increase the rates of hair growth or more likely, increased maintenance of hair that one already has by increasing blood flow to the niche.

And nowadays, there are more and more doctors who are familiar with this requirement for blood flow, understand the mechanisms by which monoxide works, and understand the vast desire out there for people to hold onto the hair they have. And we grow here, and they are proscribing things like low dose to dolphin. So two point five milligram to five milligram to the dolphin was initially discovered as a drug to treat prostate health. IT was a drug that we now know can increase blood flow to the prostate and thereby offsets some of the issues associated with aging prostate.

Higher doses of toda phu sometimes also refer to as the by its brand name, which is c Alice, are used to treat erectile this function, but at the dosages that are used to increase blood flow to the prostate, and that now a number of doctors are using to increase blood flow, not just to the prostate, but to all regions of the body, including the scale such as two point five to five milligrams to downa fill. So this is something that I think deserves attention, because IT falls under the umbrella of increasing blood flow to the hair dum sell in order to maintain hair IT is not something that most doctors are going to be familiar with as the way to reverse hair loss because IT won't do that. But the use of los to developed to slow rates of hair loss is very much, in a logical, mechanistic sense, exactly the same as the logic of using minoxidil to slow rates of hair loss is all about increasing blood flow to support the stem cell nh below the hair follow.

The critical requirement for blood d flow, oxygen and nutrient to the stem cell niche is also why you hear a lot nowadays about the use of prp platte rich plasma for trying to offset hairy loss or even reverse hair loss. We're going to do an entire episode about prp. IT is pretty controversial in certain circles and well accepted in other circles.

A couple of key things understand about P, R P. First of all, IT is being used in multiple tissues for different purposes in different clinics. So for instance, board certified musicians in the united states, canada and europe are doing P, R P injections into over to try and expand the number of healthy followers and eggs so that people can conceive later in life, or even earlier in life if they don't have many followers.

People are getting P R P injections into their joints in order to try and support joint health. People are getting P R P injections into just about every tissue you can think of. However, P R P, despite what you may have heard, is not stem cells.

Somebody tells you they are injecting stem cells. They're either outside the U. S. Cano or northern europe, or they are injecting something else. So you want to a really look into that.

Are the safety issues there are the subject totally deserving of an entire episode? I'm not necessarily opposed to the future of stem cells as a treatment. Keep in mind that stem cells are the cells that can give rise to lots of other cell types, and there are cells that divide and replicate.

And there's a name for that when IT happens in the adult body, when you don't want that. And that's called cancer. Tumors are overproduction of cells from stem cells when those stem cells ordinary should be quiescent OK.

So keep in mind the difference between stem cells and P R P, P R P plate. Little rich plasma, again is legal in the U. S. And many other places because IT involves drawing somebody's blood, spinning IT down in a particular speed which separates out different components within the blood, then taking the plate lets and reinjecting those in a solution back into the person's body. So play lit rich plasma, or P R P, is play let enrichment asma from that person.

But the basis of P R P is really to encourage neutral delivery to a particular region in the body using somebody y's own platelets, because those planets are in rich for various nutrients. So people are getting P R P injections into their scalp. Those are not stemp sel injection.

So those are P R P injection into the scalp with some moderate success. These are very expensive treatments. They tend to be transients tly successful.

I'm sure there are people out there who are going to say P, R, P worked fabulously well for me. That might be the case. I'm not going to dispute that, and i'm happy for you.

Although there are not sufficient clinical data to suggest P R P as a treatment right now, especially given the cost many, thousands of dollars, many, many treatments, it's also the case that the P R P injections when they work, might work for reasons independent of the platelets. What do I mean by that? Well, soon we're gone to talk about a different type of treatment, which is a mechanical manipulation of the hair.

Follow typically on the scope because that's typically where people want to regrow hair. I don't know many people who are trying to maintain or accelerate or regrow their back hair, for instance. They might be out there, but I don't think there are a lot of them or their leg hair uh, for that matter, almost always it's going to be scale pair.

And one way that people are doing that is through mechanical stimulation of the hair forecast and the stem cell niche, using what's called the migrant needling. Micro needling, as the name suggests, is taking a bunch of little needles, either in a little stamp, so a little square or nowaday. Typically, it's a roll ler.

Looks like a paint roller. Accept it's got tons of little needles in rose all over that roller. Those needles range in length from half a millimeter to two point five million millimeters, okay, millimeters.

And one roles out over the scale. And if you're thinking, ouch, that probably hurts. Indeed, they can hurt a little bit or a lot, depending on the thickness and the length of those needles. mr.

Needling has been shown to do two things that has been shown to reactivate semi quiet ent populations of stem cells that are in that telegonus hase, putting them back in energy en phase and thereby stimulate more hair growth. IT is also, and this is, I think, the best use of micromanaging. IT has also been shown to be a very effective argument for some of the hormone based hair regrowth tools and pharmacology that we're going to talk about in a few minutes.

So micro needling in prop have something very critical in common, which is the needle, the actual injection into the skin. And for those of you that are hearing this and thinking, why would disrupting the skin with needles actually support hair growth or regrowth when that just damaged the follow? Well, this gets into some of the um I think interesting, if not fascinating aspects of our biology, which is that all of the cells in our body really can respond to both chemical and mechanical cues.

And when we hear needle injected in the skin, we think that must just be damaging everything, causing all sorts of inflation tion. But turns out that low levels of inflation tion caused by things like micro needling or P R P injection, even the introduction of any kind of fluid, like, for instance, sAiling fluid injected into a region, can cause changes in the cells in that region, causing, for instance, stem cell populations that we're wanting to reactivate, again, causing intelligent phase folk les that have melanin, a sides, and stem cells that are dying off, but not completely gone to reenter the cell cycle. So microhardness procedures, P R P injections, things like monoxide, they all kind of center around this same general theme of increasing blood flow, increasing oxygen delivery of nutrients, or in the case of microbial, increasing inflation tion, just enough at that local site that certain cascades of biological function that relate to proliferation, ation of stem cells or maintenance of stem cell populations are kicked off.

So I like reminding the sells in that area that they need to stay alive in order to replenish whatever is lost. So sometimes a wound can actually endo some healing, although I do want to point out that the micro o part of micrometers is absolutely key. And this should be obvious to you when you think about scars.

I don't know about you, but I ve never seen a scar with hair growing out of IT. If there was, there was rather like one hair. But if you've ever seen a scar, someone had the appendix out or someone had a brain surgery, you see that, god, because there is no hair growing out of IT.

So the mico portion of micro needling is extremely important. We are not talking about causing significant damage to a tissue in order to actually ate that stem sell population. We're talking about causing micro de damage and micro levels of information to stimulate growth.

For those of you that are interested in using micro needling or micrometer dle in combination with chemical treatments like monoxide lor, some of the other treatments will talk about in a little bit like and and caffeine, yes, believe or not, caffeine is being used to be grow hair very interesting. Get into that at the moment. But if you're interested in using microcredit ling alone or in combination with some of these other treatments, there's a wonderful review that was just publish this last year.

Wonderful because it's very comprehensive. Not so wonderful not to the fault of the authors because most of the studies out there on my grinling are not superb. There are ways of engaging the strength of a study mainly relate to their duration, whether other were control groups at sea.

But the review itself is excEllent. The title of the review is microhardness ling and its use in hair loss disorders, a systematic review. We will provide a link to this in the shoote captions, and this review did a very good job of highlighting both the strength and draw acts of the various studies.

Looking at micro needling, IT also explored the use of microhardness in both men and women and of various ages. And IT does appear to be the case. The microhardness shows some positive benefit in both men and women regardless of age, especially when used in combination with the various other treatments that we're talking about.

I was also able to clean from this review and some of the papers described within IT, that needle length of about one millimeter to two point five millimeters seem to be more effective then shorter needle lanes. So if you are scared of the needles and the needles es, keep in mind that, done properly, micrometers dle shouldn't be too painful. Some people experience a bit more pain than others, but it's not considered a very painful procedure.

IT is however, a procedure that can cause some bleeding of the scale and that bleating of the scale can be very apparent, especially if its in the front of the head as opposed to on the top of the head and hidden by some hair, or if you're already quite bold in a given region. So keep that in mind. I suppose one could wear head or a way or something in that sort if they were really self conscious about IT.

But the micro needling itself is causing a physical disruption to the scale, some degree of badding inflation tion. And again, all of that is part of the process by which micro elling can actually improve hair growth. And of course, there's healing that occurs of the bleeding in the damage the follow.

This is a transient thing, but understanding the cosmetic implications in the short term as well as in the long term is certainly worth knowing. One thing that's very clear that the combination of micro needling and monoxide al treatment together is far more effective than either of those treatments alone. In addition, the combination of micro o middling and monoxide has been shown to be effective in recovering what are called dead zones.

So these are regions of the scale that are either completely bored or mostly bored, for which there is essentially no stem cell population there. And the combination of monoxide plus micromanaging is somehow able to recover those stem ell populations and allow new hair to grow. The growth of that hair in those that zone regions can take a very long time, thirty to even fifty weeks.

Neither monoxide treatment alone nor mica needling alone has been shown to be effective in recovering these so called dead zones when those treatments are done IT separately. So this, I would say, a strong reason to consider combining micromanaging and monoxide l as supposed to just doing monoxide or just micro needling. I should also mention that minoxidil treatment, if you pursue IT IT, is likely something that you are going to have to do for the rest of your life.

If you want to hold onto the hair growth that you obtain with minoxidil, or if you want to maintain the hair that you are already maintaining with mod oxygen, some people have been successful in taking monoxide le, maintaining some hair growth or even stimulating some hair growth and then coming off in oxygen. But most everyone who goes on and oxygen has to stay on an oxyde. Because when they see taking monoxide le, even if they are doing other treatments, they lose the hair that they gained with monoxide le.

So that is an important consideration. The decision to go on an oxygen is likely a decision to beyond an oxygen for the rest of your life. So as you're probably starting to realize, is a relationship between mechanical stimulation of the follow and blood flow, both of which turned out to be critical for maintaining hair and for stimulating hair growth.

Not surprisingly then, an increasingly common treatment for hair loss is botox. Botox is the brand name for what is otherwise known as botching um neurotoxin. What is botching butcha? Neurotoxin, sometimes just called botching for short, is a toxin.

That's a bacteria toxin that serves to cut the protein that leads to snap vesicle release. What in the world did I just say? Well, when your nerve cells communicate with one another, they do that by way of electricity.

But the electricity within those nerve cells, those neurons, triggers the release of chemicals from neurons into the synapse. A little gap between neurons and the release of those chemicals allows the next neon to be chemically active, or in some cases, that will suppress the electrical activity of that next neuron. Bochum neurotoxin serves to cut a protein present in neurons so that neurons cannot release the chemicals that cause other neurons to be active.

So this actually is pretty serious. If you were to get box and neurotoxin injected into your muscle, you would be paralyzed because the nerves that control contraction of the muscles would not be able to control the release of that chemical onto the muscle, which makes IT contract bottle. And neurotoxin is commonly used in what's called the bow tox.

Botox is something most people are familiar with because people get injected in and around their wrinkles, because many wrinkles are triggered by not just loss of tensile strength in the skin, but rather the nerves around the skin and in the skin are hyper contracted, which causes wrinkles. So differences. I have close feet.

I like to think that because i've laughed a lot and smiled a lot, and it's probably also because i've squinted a lot in my lifetime, I have close feet because the nerves there have pinched the skin on either side of my eyes. And that's given me little cries there that are sometimes refer to as close feet. Botox injections can be applied to the scale in order to relieve tension of the scalp.

And in hearing that IT should be obvious why bo taxes being used try and offset her loss. It's decreasing the squinting, if you will, or the tensile nature of the scalp skin so that more blood flow can arrive at that stem. So follow area.

So botox treatment to the scalp is actually becoming pretty common. There are a couple of requirements with this photos tried. First of all, that has to be done by somebody who's really skilled.

There are numerous images online and websites online of so called botox fails, where people have ve gotten too much boat talks, or the injections have been done too deep or not at the correct locations on people's face or scale. And I can give them jumpy scale or jumpy eyes. All sorts of cosmetic nightmares can occur with boat tox.

The second thing understand is that boat tox does eventually wear off that box line of neurotoxic and doesn't stick around forever. And provided it's done correctly, tly at the correct dosage as IT doesn't actually kill in irons that caused that tension of the skin. So botox injections have to be done repeatedly. The advocacy of botox for offsetting her loss is not clear. There aren't a lot of large scale clinical studies on this just yet.

But IT does seem to be at least one reasonably safe alternative to things like monoxide, although I think if one were to just want to increase blood flow to the scale, things like a low dose to deal film, which doesn't seem to Carry on the side effects that monoxide l can Carry, we talked about those side effects are earlier. That would probably be the Better alternative. Botox is a fairly invasive procedure, but some people up for botox treatment.

In fact, there is a syndrome called the cutis vertigo s giotto. Some of you you ve probably seen this. It's more typical in men. Although IT does occur in women IT literally means a lumping of the skin on the scalp or jy of the scalp um jy or ga pertains to the lattin word me so that means bump or me um and so any time you hear there were ga in neuroscience or in biology you're talking about a bump sometimes see people have ridges in the back or IT looks as if the skin was pushed together can like the a sharp dog. But on the scale, people with cutis verdicts, chara almost always experiences pattern hair loss.

Now part of the reason for that is cuticular fertik s charta is also associated with some androgen or testosterone related hormone issues that will talk about a little bit. But in addition to that, IT has been shown that relieving some of those, jada, by injections of botox to allow those folds to sit flattered a is effective. You can lead to less of those giant ride those bombs, and can improve hair growth in those regions, even if those people don't take on any additional treatments to address the hormone issues that really how people arrived at the understanding that botox might be a good treatment in general for reducing the kind of squinting of the scale of that can occur and the resulting hair loss in those regions.

I now like to turn our attention to the chemical variables that control the duration of the growth phase of hair, the duration of that cattle gen phase, which is when that hair essentially recedes from the inside out, and the quiet and semi asset intelligent phase. There are a couple of key chemical players here that we should all be aware of. First of all, the growth factor I G F one insuing growth factor one, which is produced by the liver, but that received stimulation from the brain and patuit tory to be released, is a strong regulator of hair growth.

And we can think of IT as the accelerator on hair growth. So IT does that by extending that energy en or growth phase for longer. IT doesn't necessarily speed up growth, but IT extends IT for a longer period of time. In addition, cyc amp, which is part of what's called a second messenger pathway, in fact, cyclic amp is a second messenger, is also a key player in stimulating growth of the hair focal. Now, cyclic amp does many different things in many different cell types in the body.

IT really acts, as the name suggests, as a messenger between signals that arrive at the surface of cells and transmitting or conveying those signals to things that happen deep within the cells, such as the turning on and off of various genes. So when you hear second messenger, don't let that confuse you or overwhelmed. Just understand that the whole process of getting signals from the outside of cells into the center of cells and controlling gene expression, for instance, causing a stem cell to continue to give off daughter cells, we're causing a hair cell to continue growing for longer.

That whole process is a bit like a bucket brigade of handing off water or a bucket from one component to the next or a long a chain. It's like an assembly line. I think that's probably the simplest st way to think about IT. So for sake of this discussion, I G F one is known to increase the growth of hair by extending that energy phase, as is cyclic amp. So those are going to be considered the accelerators, at least in this conversation.

The breaks on hair growth are going to be the things that either shorten the energy phase or that extend the cattle gen phase, or this quiescent phase, which is the diligence phase, and the two major breaks on hair growth that we want to think about, R P D E, which is a fossil dieterich, anytime you here ACE, it's likely to be an enzyme. And T G F beta two, right? So this is a particular growth factor that somewhat counter intuitively doesn't stimulate growth, that actually stimulates lack of growth or shortened growth.

So with all of that in mind, and please do also keep in mind that you don't need to remember all those specific terms, just understand that there are some factors like insulin growth factor, one that act as accelerators on growth, and there are factories that act as breaks on growth. We can start to think about why, for instance, half of all people by age fifty start to lose their hair. Well, they start to lose their hair because of something called androgen related alopecia, which translate english means testosterone.

And testosterone derivative induced her loss. This is true in men and women. So hearing that, you should probably be wondering the following thing. Young men have higher levels of testosterone than old men, right? Well, the answer is yes.

Although some older men in their forties, fifties, even eighties maintain testosterone levels similar to many men in their twenty years, but most don't. It's a downward slope starting at about age forty. How steep that downside slope is depends women too, have testosterone.

In fact, women have higher level of testosterone than they do estrogen. That's right. A healthy woman has higher levels of testosterone.

Then he does estrogen. However, women on average have a lower testosterone than most men. So they still have far more as rogen and far less test host the most men.

But the level of test test that they have within their body is higher than the level of estrogen they have andro gen such as testosterone and its derivatives such as die hydro testosterone, which will be much the topic of what we're getting into next. Inhibit I G F one and cyclic amp. Again, androgen, such as di hydro testosterone, inhibit, prevent the action of I G F one.

Encyclical mp, which you just learn a few moments ago, act to extend the energy or grow phase of hair. Which then raises the question, well, if Young people, both male and female, have higher levels of testosterone than they do when they're older, why would people lose their hair when they're older and not Younger? The answer lies in the conversion of testosterone to die hydro testosterone one.

Testosterone one most people have heard of. Die hydro testosterone, or D, H, T, is made from testosterone. There's an enzyme called five alpha duct.

They converted testosterone into dyne dr. Testosterone in both men and women. Die hydro testosterone binds to the androgen receptor at five times the affinity of testosterone. So IT is the most powerful androgen in humans. And IT is responsible for a number of things that we all really want and like, such as mental vigor, physical vigor, strength, healing capacity, drive libido and on and on. So D H D itself is not a bad.

So if we take a step back and we acknowledge to stop, levels are higher in males and females at Younger ages as about the older, but as they get older, there is more five alpha reductive activity, which is converting more of that testosterone to die hydro testosterone one. And die hydro testosterone inhibits hair growth by reducing I G F one and cyclic amp. Well, then we should all be aboard.

Why IT is that by age fifty, about fifty percent of people experience pattern hair loss. That is, androgen dependent. Aloha k, but translated to Normal english, is pattern hair loss.

And in a moment you'll understand why some people lose their hair from the crown region and in the back of the head or back on top of the head, whether other people lose their hair in the front of their head, in the flanks, right on either side of the midline or maybe in the midline in front altogether. And that's because different people, depending on their genetic linkage, have different patterns of android gen receptors on their scale. And the pattern of andero gen receptors that you inherit indeed does come from your mother's side.

So this is what gave rise to the the myth that if you want to know if you're going to go about or not, just look at your mother's father doesn't quite work that way. In fact, if you think about the logic, you should really look at your mother's mother if you want to know your pattern of android gen receptions on your scalp. However, most women don't lose as as much hair from their scalp, or they have ways of covering up the hair loss in their scalp because their hair is just generally longer, or they're using other approaches.

So you never really get a clear picture of what the androgen dependent hair loss was in your grandmother. okay. Now we don't want to go too far down the genetics rabbit hole because as you know, you can't select your parents anyway.

But if you want to know why, for instance, i'm losing a bit of hair on either side of the midline in the front IT almost certainly has to do with the fact that have a higher density of androgen receptors there, as supposed to say, on the crown of my head ware. For whatever reason, my heart seems to grow thickest. Other people lose hair on the crown, in the back and top, but not in the front, and some people lose IT all over.

Now you understand why hair loss occurs in certain regions of the body. You should also understand the androgen receptors on the face are also what a responsible for beard growth. And this is where I can get a little bit tRicky, but a lot of things will start to make sense if you can understand this and internalized this.

If you have a high density of android gm receptors on your face, will then as your dht levels go up with age, you will be able to grow a thicker and thicker beard. In fact, IT is rare to see someone who can grow a thick beard in their youth, but not so much as they get older. In fact, the reverse tends to be true.

So the pattern of androgen receptors defers between the scale and the face and the back OK. On your back you have androgen receptors and their h stimulates hair growth. So if you know someone who who has a very Harry bcr, if you have a very herry back, that means you have a high density of the android receptors on your back.

If you have a beard and that beard is thick, well, then you have a identity of android receptors on your face. However, hindenburg of android and receptors anywhere on your scalp is going to predispose those regions to android independent aleph a or hair loss in those particular regions, which is going to allow us to understand why all of the rest of the treatments for halting hair laws and for simulating hair growth. Almost all of those centre on inhibiting either D, H, T directly or five alf ducas the conversion of testosterone to D H T.

So now i'd like to discuss the ways that one can chemically adjust certain things within the hair growth pathway, things like I G F one, P D E, T G F, beta sea, in order to stimulate hair growth or halt hair loss. The first thing on this list is actually going to be pretty surprising to a number of you. And caffeine, we all think of cafe is a stimulant that we drink.

I certains drink coffee in your BMI dual energy drink things with that sort. Cafe does many things besides stimulate our central nervous system and make us feel less sleepy. However, one of the things that caffeine does is IT is a fairly poor P D.

E inhibitor, by being a pot P D inhibitor, IT indirectly stimulates I G F one. why? Well, because P D E can suppress I G F one. And by interesting caffy, or by applying topical caffe ine ointment or cream to the scalp, you can suppress P D E sufficiently enough to increase I G, F one and increase some hair growth, or at least maintain hair growth in that region. This might come as a shock.

IT might seem a little bit esoteric reading outside the margins of typical treatments, but head to head topical caffeine application can be as effective as monoxide application without actually lowering things like blood pressure and potentially increasing proactive. And some of the other negative, let's call them negative, because they are side effects of monoxide. So caffeine, ointments and caffeine present in various hair treatments and creams at sea is starting to become a more prominent female.

There, I will include a reference to caffeine and its uses for offsetting hair loss. Keep in mind that topical cafe announcements shouldn't necessarily be applied every single day. So this is the sort thing you might do three times week.

The concentration of cain in different intent variety tremendously. Most of the studies of cafe on the stem cell nisha that control hair growth and extension of the energy phase of hair growth have been performed in vitro in a dish. Although there are some clinical studies expLoring this, they are not nearly as extensive in number or duration as the studies of monoxide m, because this approach just hasn't been around quite as long.

However, when comparing side effects of minoxidil cost of monoxide le, comparing the because of caffeine and an oxide, I think caffeine as a topical treatment for offsetting hair loss stands as a pretty good choice if you're going to start expLoring this pathway. And there's no reason to think that if you were to try the cafe annointed ment and IT didn't work for you, you didn't like IT for some reason or you need to stop IT for some reason that you couldn't stop IT safely because IT doesn't Carry all the other in a blood pressure related effects and practice effects that an oxide does. So if you look out there into the hair maintenance and hair replacement literature, you look at the treatment that being.

So don't be surprised to see cafe in there and also don't be surprised when I tell you what i'm about to, you know, which is, no, you can't simply just drink more caffeine in order to accomplish the goal of offsetting hair loss. IT is true that when you and just caffeine, IT goes systemically. However, you have so many a denot's ine receptors throughout your body, those a dency recept tors and the parking of caffeine, and those a dense receptors is the main way in which caffeine exerts its stimulating effects, making you feel less sleepy.

So IT does that because then a dentist ine can't have its effects, which are to make you sleepy. Well, those identify receptor soaked up so much of the caffeine that you would ingest orally, that very, very little would make IT to the scale and to the hair followers at the concentrations that you would want. So that's why you have to rely on the application of these caffeine ointments about three times as a week.

Keep in mind that no one has really explored the dosages of caffeine and these ointments in a systematic way. We are still in the early stages of all this, but I do think it's important to mention caffeine because of the lower incidence of side effects, at least reported side effects and the general safety margins and the head head essentially comparable efficacy with minoxidil because monoxide has a bunch of other issues. Now keep in mind that both monoxide and caffeine are generally used as a preventative for reducing hair loss over time.

They are not expected and they do not, as far as we know, create new hair growth to any sufficient degree. If any of you have used caffeine, ointment or monoxide and observe new hair growth that was robust, please put that in the comment section. I be curious about those experiences, but as far as I know in from the clinical literature that I read, there is no examples of that.

One other point about caffeine IT does appear that caffeine can not only indirectly stimulate I G F one in the energy phase of hasso growth, by way reducing P D and T G F beta, but IT also seems to reduce appetiser, which is naturally occurring cell death of that stem cell niche. We've been talking lot about the energy or growth phase of hair. We also talked about the cat gen, where the recession of that hair from the inside out.

But remember that third phase, the tEllies en phase, where that whole bulb down at the bomb, the bulges it's called, that gets pinch off and the whole thing dies and takes the stem cells off the grave. With IT IT appears that caffeine can offset the death of that niche and potentially maintain the stem cell population longer, making caffeine a really good choice to think about in conjunction with the various chemical treatments aimed at directly attacking the day chea pathway that will talk about next. So there's one very direct way to increase hair growth and maintain the hair that you have on your head.

And that's to increase I G, F, one that can be accomplished through prescription drugs such as growth hormone, and things that stimulate the release of growth hormone. And I G F one. Keep in mind growth hormones released from the anterior patuit tory during the first hours of sleep, especially when you haven't eaten anything for the two hours prior to sleep, and especially when you get regular bedtimes.

Yes, this is a real thing. If you are going to sleep at variable bedtimes, especially if you go to sleep much later than you're usual habitual bedtime, you will miss that growth hormone pulse that Normally occurs in the first two to three hours of sleep. This does not mean that you need to be erotic about getting asleep at the exact same time every night.

There's probably plus or minutes thirty minute window and IT doesn't mean that you can't stay out late or have a bad night, sleep every once in a while or get woken up. Your hair isn't gona fall out, my dead story not was standing. Your hair is isn't gona fall out because of that.

But you do want to try and get that natural growth alone release each night. And as I mentioned, there are prescription approaches and those are growth ormon itself. And things like sir morran, which is a pepped tie.

The increases growth hormones is actually a secreted gog. IT causes the secretion of growth ormond, and thereby increases in I G F one. This is well documented, both growth hormone and I G F one, as I mention, are available by prescription.

They are not without their side effects, so they do cause growth of all tissues. They do increase height and children. They increase bone mass and density.

They can increase mainly fat laws, not so much muscle size, but they can increase leaning ss, and they increase hair growth. They can increase turn over of skin. They can make skin look more useful.

Only things sound wonderful. And yet they also have problems because they can increase growth of small tumors that Normally might be eliminated. So there is an increased cancer risk with growth ormon treatments in I G F one, or anything that increases I G F one, such as server alan I moran, any of the peptides that you hear about nowadays.

That said, a number of people are using thermo Ellen as an indirect way to increase I G F one, and thereby to increase hair growth. IT does seem to be fairly effective in doing that, especially when done in conjunction with other treatments that will talk about. But keep in mind, these are prescription drugs, and they do Carry their own risks.

The other thing about stimulating the natural production of I G F one is that, as its name suggests, insulin growth factor one IT is insulin dependent in many ways, if not for its secretion, then for its action at the hair follow and stem cell. So one of the things you really want to pay attention to is to avoid being insulin resistant, or rather, you want to try to be insulin ent sensitive. So if you're Carrying a lot of excess body fat to your obese, or if you have type two diabetes mean your insulin resistant, you're going to want to deal with that.

There are number prescription treatments to deal with that. nowaday. People are very excited about all the G L P.

One agonies, but addition to that regular cardio ashlar exercise and resistance exercise, making sure that your body fat percentage is not in excess of where IT needs to be. And everyone has a slightly different idea where IT needs to be, both cosmetically and for health. So that's a conversation betwen.

You and your doctor and you and you, Frankly. But you want to avoid being insulin resistant, because being insulin resistant and being obese can indeed lead to her loss. And there are many people out there who are not obese who nonetheless are experiencing hair thinning and hair loss because they are instant resistant by way of reduced I G F one activity.

There are a few supplements that these are over the counter, supplements such as mile and ospital, taking a dosages of about nine hundred milligrams before sleep, which, by the way, can also assist in sleep. Or things like burberry or met forming, which are known to improve insulin sensitivity. Each and every one of these has its own profile of positive and negative effects.

The lowest number of side effects is associated with one hundred milligram mile in hospital taking about thirty minutes before sleep, most because I can make people low bit drowsy. And IT does aide sleep in some really great ways. But really, exercise and maintaining a healthy nutritional program are also going to be key.

You just can't discard those. Burberry, which is a substance made from tree bark, is sometimes called the poor man's met forman met form being the equally effective prescription version of burberry. Or put differently, burberry is the non prescription but equally effective version.

Of met form men. Keep in mind that both burberry and met formin dramatically reduced blood sugar levels. And so if you're not going to take them with carbon hydrates, IT can lead to some feelings of discomfort.

That's why i'm not a fan of them. But if your goal is to really improve incident and tivy, they are considered very poor tools on the list of things that can do that. The other thing that's really important for maintaining proper hair growth, this energy phase, is that you need sufficient iron.

This is because iron and theron play a key role in the cell growth pathways that from the stem cells to the stimulation of heroin within the hair itself don't have time to go into this pathway in a lot of detail. But you can have your blood levels of iron measured turns out to be pretty important because you don't just want to start popping iron supplements because too much iron can be toxic. Too little means you're nemec.

For women, the levels of iron that you want are somewhere between twenty five and one hundred, and for men, somewhere between thirty and one hundred and fifty. Fortunately, the tests or the blood tests for iron are usually a very inexpensive add to your current blood panel. So if you're going in for a blood panel for ldl, hdl and typical things, or if you doing the more elaborate hormone testing, which I do recommend people do if they can afford IT or if the insurance covers IT, do ask for an iron test as well.

If your iron is low, you may need to supplement your iron. If your iron is too high, that's not good either. But iron plays a key role in the energy en phase of hair growth.

So you want to make sure you at least have sufficient iron. And if you don't, you want to make sure that you're getting IT from nutrition and supplementation. okay.

So earlier we were talking about die hydro testosterone di hydro testoon, just to jog your memory, is a form of testosterone that combine the androgen receptor at five times the affinity of regular test. Both men and women have a lot of testosterone relative to estrogen is just so happens that men tend to have more testosterone than women do overall. But both men and women, as they age, convert more of the testosterone.

They have to die hydrogel astre one and die hydrotreater rone does two things that are bad for hair maintenance and hair growth. First of all, IT shortens the energy en phase that growth face. So whatever here is going to grow is going to occur over a shorter period of time. Second of all, because of the presence of androgen receptors on the stem cell niche area and around IT IT, actually miniature zed, the follow and the stem cell niche. In other words, that makes the population of cells that give rise a more hair protein smaller and can eliminate IT all together.

And that is why anything that reduces five out for reductions is going to reduce the ht, is going to maintain or extend the growth, face the energy en phase of hair growth, and is going to offset or prevent some of the tiller en phase, the pinching off and the removal of that stem cell niche. Now, one substance that we know can inhibit five out for a doctors, although IT does IT pretty weakly, is sol pal metal, which is an extract of the soul paleo. Barry, to be honest, I don't know how this was initially discovered.

If anyone knows, please put IT in the showing te captions. When I looked online, I found a bunch of conflicting stories about who was the first person to start extracting me, extra act of the sol pal， metal berries. So I have no idea which one of those is true.

Maybe somebody can tell me. The good thing about sapp edw treatment is that is known to have very few, if any, side effects. There might be some side effects in about one percent of people, but it's not associated with a lot of side effects. It's also known that when taken at about three hundred milligrams per day, and here IT doesn't have to be that strict. Most of the studies that are explored involve taking anywhere from two hundred to five hundred milligrams of sol paleo, but most of them focused on about three hundred milligrams of sol parameter per day, divided into two or three days, as why, well, I has a relatively short half life, meaning it's going to get cleared from the blood streaming. More importantly, its biology gc action is gonna very short lived.

So if you can get a hold of fifty or one hundred milligram capsules or tablets, ts of soul paleo and divide those up, take them in the morning, afternoon and evening, or even just in the morning and evening to achieve a total of about three hundred milligrams per day, that's going to very likely help you hold onto some of the hair that you would have otherwise lost, maybe even grow some new hair. And I say, maybe give you some new hair growth, because so tomato is not known to be a particularly robust treatment for the reversal of her loss, is known to have some effect, but it's generally taken in conjunction with a bunch of other things. And so it's really hard to teeth out just what amount of hair growth or prevention of hair loss is due to sell paleo specifically.

But I mentioned in here because the mechanism of the action is logical and fairly well known, which is this weak effect in reducing five alpha reductio and thereby reducing D. H. T.

So again, because IT has relatively low side effects, even though it's not super effective in because it's fairly low cost and is available over the counter, I felt IT was important to include. Now as soon as people hear things like saw paleo barry, they probably also thinking, oboe, here you're come, all the urbes. Now keep in mind that there are some urban compounds that have pretty robust biological effects.

Talk before in our optimizing to toaster one episodes about things like toner, ali and fidgety gressier taken in correct dosages and in the correct way can be pretty potent, increasing luntz, zing, horon and free test test one. They are going to have huge effects, not like taking exogenous and exteriors, but they can have real effects. And so urban compounds can be potent.

However, I do acknowledge that there is a vast market out there of urban compounds and plant based compounds that people are arguing. Mostly the people who sell them are arguing can increase hair growth. And there are some decent studies of these things.

The hard part about study these urban compounds and these plane arrive compounds for increasing hair growth is that they are often taken in combination with one another. In fact, most of the hair growth supplements that involve these urban compounds and plant compounds include five or ten, sometimes even more things altogether. So tee zing out which ones are effective, in which dosages are effective, is merely impossible.

There are just too many variables. So you will hear, for instance, that Green tea extract, racy mushroom, pumpkin oil sink curium, that all of these things can increase hair growth. Perhaps the only thing on that list that makes logical sense with respect of biochemistry is that curcumin is known to, in some people, be a potent inhibitor of five other doctors in the H.

D. So much so that I can personally say, for me, I want to took cucumber. Tumeric is also called in hy dosage.

This is about a gram to two gram capture. And I felt absolutely terrible. I mean, just dreadful.

I don't care if IT allowed me to keep my hair forever. I'd rather lose all my hair three times over. Well, I guess that mean that I would have grown back.

I'd rather lose all my hair. Let's just put IT that way. Then ever take curcumin tur can hide dosages again. And in saying that I know that many people take tumeric kirk mine and really like its entire and filming properties and don't experience any side effects, I just happened to be particularly sensitive to cucumber by way of this dht pathway. And I know this by way of blood works, so i'm never going you're that stuff again.

That said, a lot of these urban compounds and cocktails probably will have some minor marginal infant assembly small somewhere in that range. Effect on maintaining her growth or in stimulating new hair growth is just that they're really aren't clinical studies to support any one of them. And that's why I singled out sapo.

Eto is one of the few for which the biochemical pathway of inhibiting fa reduct and the low intense subside effects and the fact that many people have used IT with some degree of success makes IT a stand alone. I won't say recommendation, but a consideration. Another commonly discussed and use commercial compound for offsetting hair loss and stimulating ir growth is kito conall.

Sometimes this is known as nicer all where niseron is the brand name of a shampoo kito consoles and anti fungo that was initially developed to treat dandruff and severe serious is so IT connel has been shown to be effective in increasing hair number. It's also been shown to be effective in increasing hair diameter, which is somewhat surprising because one of the common side effects of kito console is drawing, shining and brittle hair. So what's going on there is a little unclear.

We'll return to that in a moment. The mechanism of action for key tag, as is pretty interesting. Remember earlier we were talking about the subacute gan and the production of sea bom, that oilily stuff whose very name seems to evoke, discussed in certain people. Well, you can is all can disrupt some of the fungo growth that, Frankly, we all have on our scale all the time.

I know this is a surprise to many of you, but you are constantly bombarded with viruses, bacteria and fungus all the time, but we mention battle, those of our immune system, either by physical barrier, such as an oil barrier, like to see bum, or through into microbial action. So chemical approaches, our immune system, the sea bat, ta kito, is all access and anti fungo that in some way seems to reinforce the properties of cbm, keeping out other fungal infections. And the net effect, at least as far as we know, is a mild reduction in dht.

Now exactly how this happens isn't really clear. What is clear is that the use of key icon as all shampoos two to four times per week with a scalp contact time of about three to five minutes, has been shown to give about an eighty percent response rate of maintaining hair that would otherwise be lost. So that's pretty dramatic, eighty percent.

What is less clear is whether not key to connal shampoo can actually stimulate new hair growth. But as you're probably starting to realize, this is always a bit of a tough thing to disentangle maintenance of hair that you would have lost versus new hair growth. Certainly, that's an easy thing to dividual.

If you have a patch of scalp, whether is absolutely no hair, these so called dead zones that you can react in a certain treatment. But what about areas of your scale where hair is thinning? So for instance, on the top, your head. Is where many women will first experience um pattern hair loss alopecia is um right at their midline.

If especially if they have a part right there, they'll start to notice that under very bright light for accent lights in particular, they'll notice that thinking of their hair there or in the forehead region, they'll start using key to okon is all shampoo again, the typical recommendation is two to four times per week, with a scope contact time of three to five minutes and really rubbing in and then rinsing IT out. You don't need to be super vigorous, but you wanted make sure that he gets down into the follow and around the folks, not just sitting on top of hair, which is going to be especially important for people have long here to really mash IT in. Well, they will experience a growth of hair in that particular region that almost certainly we're due to miniaturization of the hair follow and reduction of the total population of stem cells in that follow as supposed to complete loss of the stem sol population.

The reason we say this is that there's no reason to think that ketchin is all can actually stimulate igf one or activate growth itself. It's probably offsetting some of the reductions in the energy in phase and some of the exasperation of the telegdy phase. Now if you decide to to use kito consol as an approach to offsetting hair loss is very important that you get a hold of a shampoos that at least two percent concentration of kito.

This is important because a lot of the ones that are available out there, especially online, we're going to be one percent or lower. So you want to try to obtain A C O L shampoo of two percent or higher concentration of kito console, because as other things in IT, of course I should mention that there are occasional side effects, key to console the rates of side effects from the metal analysis and reviews that I read, or somewhere between one and eight percent of people will experience some side effects. But those side effects tend to be pretty mild.

Things like irritation of the scalp, things like thinning and bitterness of the hair, that sometimes can be offset by using shampoos that contain things like biot. I know many people are probably curious about biot, which is a protein that can be incorporated into the curtain um whether or not different biot in rich shampoos can really enhance the total amount of biot that gets incorporated into the hair isn't clear but IT is clear that having sufficient biotin around is important so if you get a bit extra from your shampoo, can imagine how that would tap off the amount of biot in that hair. And there are people out there saying that bitten in rich shampoo have done wonders for them.

Who knows? I'm not going to dispute their experience. So if you're going to use kito console, keep in mind that the more typical brand names that are out there, you know which ones they are often times don't have two percent. Or if they do have two percent, they can be very drawing and lead to brittle hair. There are newer and now, fortunately, a greater variety of cuttin's shampoos.

We is a podcast and I don't have any ation to any of these, but I will provide a links to a couple of the more prominent ones that are known to have two percent concentration of key to, as well as some other things in them known to offset some of that danaus in brittleness y okon, as all shampoos can trigger. So by now, I think that will be abundantly clear why inhibiting five alpha reduction and thereby reducing the ht should increase hair growth because of the negative impact that dht has on the hair. Follow the major player in this whole story around inhibiting five alpha reductions in reducing the H.

T. To maintain or increase hair growth is going to be fine. Steroid and its close cousin due asteroid fancy ID is effective in reducing the ht because of its actions in reducing the type to ISO enzyme, or ice form of five out for reductio IT.

Turns out there's three different ice forms, or what are sometimes called I S O N times of five out for a ductile. This is getting prety far down in the weeds. But I think most of you just need to know is that fancy ID reduces D H D.

That's the net product of financial. And in doing so, you can increase hair count by as much as twenty percent. Pretty remarkable if you think about IT. In addition, fanatic I treatment done properly, which will define in a moment, can reduce hair loss in ninety percent of all people that take IT. That is, I mean, near stagger ing.

I think many pharmaceuticals out there that have that kind of efficacy really dramatic, and in addition, is known to increase hair thickness by about twenty to thirty percent overall. So not just create new growth of hairs and thicker hairs, but whatever here you do happen to have on your head, IT can further or thick in those. So the financial story is one, I think, of general success.

I mean, IT really seems to improve hair growth and help you hold on to the hair that you have. The issue with an asteria is too fold. First of all, IT is known to have some pretty significant side effects if it's not dozed properly, and in particular, populations of people.

And this is because there is a wide variation in the amount of the different iole enzymes that people make. This is why I brought up the ISO enzymes earlier. Some people make more of ISO enzyme.

Me, one and three, some people make more of ISO. Enzi, two and three, and every variation there are. So when people take phanatic ID, some people are very strong responders, and they achieve really effective hair regrowth and maintenance of hair.

Other people less effective, although still pretty impressed, but the catalogue size effects that people experiences at a given those varies widely. So there's a lot of trial era that has to take place also should point out that fanatic I comes in two major forms. There's an oral form and there's a topical form.

So this is not unlike our discussion of an oxygen earlier topical phanatic ode is typically taken in one percent solution or ointment and rubb into the head. Sometimes it's now also incorporated into shampoos, but typically it's put into a solution that people rubb into their head. And IT is thought that the one percent solutions are equivalent to one milligram of systemic phanatic.

Roy, now we need to take a step back and ask, why was fantasy developed in the first place while fanatic I, as a barely poin five alfa ducket, inhibited its great at lower dht? IT was developed for treatment of prostate and largest and various issues of the prostate that are associated with eleven dht that occurs with age. The topical fancy ze were designed with the hope that phanatic ID would make IT into the hair follow and would inhibit dht there and allow for more growth of the hair, which apparently IT does, but not make IT into the systemic circulation, or at least not at concentration, sufficient enough to cause as many side effects as with the oral dosing.

Now the problem is IT does make IT into systemic circulation. The issue is also that topical application of phanatic rode is harder to dose than oral. Phanatic rode not saying you should be taking oral rather than topical finance ride, but keep in mind that the dosages of an asteroid that have been shown to be effective for reducing hair growth cover an enormous range, so as low as point zero one milligrams per day and as high as five milligrams per day, which is a just staggering range.

Now, when trying to simplify the problem of how much finance I to take, either by way of world tablet or by way of topical solution, we can get a bit of leverage on this by thinking about how much dht reduction occurs as a unction of those. And there fancy shows this really interesting what's called logistic mic distribution. What that means is that for a dosage of point zero one milligrams of phanatic rode, you're going to achieve approximately fifty percent reduction in the hd and that systemic dht.

So this is a blood drop measuring your dht than taking point zero one milligrams of fanatic. I again, point zero one very low dose of fraser appear a couple weeks, measure people's D, H, T in their blood. Again, you see that it's reduced by fifty percent. However, at increasing dosages of point two milligrams, one milligrams, five milligrams of oral franco ID per day over the same period of time, the increase or I should say the reduction in dyed testosterone doesn't increase linearly.

It's not that you go from fifty percent to sixty percent to seventy five percent to one hundred percent with each increasing dose IT tapers off IT kind of flats out IT tends to increase a little bit, but it's sort of a gradual slope increasing as you head from point two milligrams out to five milligrams. So what this means is that given that reducing the ht can cause very side effects, sexual side effects, reductions in either sexual function or sexual drive, as well as overall drive and motivation, sometimes even some depressive symptoms, that everything points to taking the lowest effective dose of an asteroid and starting with a very low dose of phanatic roy, because lotus is a fanatic oed. Even at that point, zero one milligrams, taken orally daily, are already leading to a fifty percent reduction in di hydro testosterone, and thereby taken for a long enough period of time, should offset her loss and stimulate hair growth.

One of the problems, however, is that people will start taking financial at a low dose, you know, point one milgram, or point two milligrams, maybe even point zero one seven grams. And there will be a reduction in their dht. But because of the long duration of that energon phase, they don't see a lot of change in hair growth in the first month, even two months.

And so what they end up doing is increasing their dosage and then they start to see her growth, but then they start to experience more side effects. Now the side effects of oral an asteroid are serious enough and common enough in people that take an asteroid that the topical solutions were developed. But there are two.

One needs to exercise caution, because if we are going to translate between topical phanatic ID and oral phanatic rode with the understanding that topical finance trade can actually make IT into the systemic circulation, we need to look at what's been shown in clinical studies, which is that, for instance, taking one million leader, a point two, five percent finance, I apply to the scalp. This is very typical recommendation, translates to the same thing that would be achieved with two point five milli grams of oral phanatic ID. And when I say translates to the same thing, what I mean is that leads to the same concentrations in the blood.

Now consider that point two, milgram. Point two, milgram, fanatical in the blood, is known to be effective in generating new hair growth and maintaining hair that one already has when they start the treatment. So if you think that the topical and asteroids are actually creating lower overall systemic concentrations of phanatic ode, that is not necessarily the case.

Again, one million leader of topical fanatic, rated point two five percent, leads to a two point five milligram concentration in the blood. When the effective dose within the blood stream by taking IT early as a pill is point two milligrams. That might not seem like a big deal to you.

Although IT is a big deal, I was trying two point five milligrams versus point to, but IT is a huge deal when you consider that the side effects of an asteria increase as you increase the concentration of an aside in the bloodstream. So where does this leave us? Should people who are interested in taking financial take the oral form at low dose or take the topical form and simply trying apply less often, or guess at what their systemic concentration of financial is? Well, it's going to vary from person to person.

Some people are very sensitive to financial and not in the good sense. The side effects just really shop quickly, and they tend to be dramatic. Other people, not so much.

The dosage recommendations that I was able to arrive at based on the clinical studies and Frankly, in discussion with some doctors who prescribed an asteroid where the following point five milligrams to one milligram of an asteroid as a tablet per day seems to be effective in pretty safe starting place for most people. Now some people will find that even that point, five milgram dosage is just going to call side effects that are not going to work for them. And they're going to either have to reduce their dosage of anthropoid or move to the topical or maybe sees taking phanatic royd altogether.

But for many people out there, that's going to be pretty well tolerated. The key thing here is that one is going to have to wait some period of time to see whether not any her growth occurs. IT is a nine even, Frankly, a foolish approach based on what we know about the duration of that energy and phase of the hair.

To do one of these treatments, wait a week or two and then decide to up your dose. Now, IT is not foolish to reduce your dose if you're experiencing bad side effects, but to simply increase your dose because you're not getting results quickly enough, that's not going to be the best approach. I really encourage people who are going to explore the fanatic aid route to think of this as a long term project and really ratchet up slowly, if at all, starting initially with a low dose taken for a long period of time, maybe even as long as twenty five weeks before considering going up any further.

Certainly, as I mentioned before, if you need to go down further, that's not going to be a problem, at least not in terms of reducing side effects of you not going to get an additional hair growth, but you're certainly not going to increase your side effects if you reduce your dose. However, I will talk a little bit later about post finance ride syndrome, which is something that's getting increasing attention nowaday, that something that occurs after people take in fanatic I for an extended period of time. Now some of you have perhaps heard, and i'll just tell you right here, that the topical forms of an asteroid are associated with far less side effects.

Now that might come a surprising given that topical application of financial, I can lead a systemic distribution of phanatic roy. But the numbers that are out there right now is that topical fancies associated with thirty to fifty percent fewer side effects, or thirty to fifty percent less severe side effects than oil phanatic y now there are several things probably responsible for that. One is that people tend to ratchet up their dose of oral phanatic RAID pretty quickly, but keeps in mind that the effective dose of an asteroid in the blood is point two milligrams.

And earlier I said the typical, typical for astral solutions are point two five percent people taking one mile IT that equate to two point five milligrams. And so IT seems like a massive overdosing. Uh, but here's the discrepancy and here's what we can arrive at some reasonable recommendations.

If you decide if an asteroid is right for you, you get a prescription. I would hope that you're monitoring your dht levels and other hormonal levels that would be ideal. And working with the doctor, please point five milligrams to one milligram per day of oral phanatic.

Rode seems to be the best starting place for topical phanatic ID. It's going to be that one million leader, a point two five per cent that we talk about earlier, but that's taken only one time per week. And you can fully expect that right after the application, you will have higher levels of finance riding your bloodstream and therefore lower levels of D, H, T.

And that, that will alter across the week. Most people are not going to be able to measure their dht on a day by day or even weekly basis is just too expensive and labor intensive. But I think those dosing regiments ought to get people into more less the same category of optimizing hair maintenance and hair growth.

While mini zing plan aside side effects, one point about phanatic oi taken either alone or in combination is that in recent years, really in the last five or so years, there's been increasing discussion about so called post fanatic I syndrome. Now post phone asty ized syndrome is indeed a new phenomenon in the sense that financial has been prescribed ed for a very long period of time for treatment of the prostate, ate at dosages of about five milligrams per day, right? That's a very high dose, sometimes lower, but as high as five milligrams per day.

And for many years there was no discussion about this post franco ID sync. What is post financial drop? Post phanatic roy's synergy is when typically its males, this is where it's been described, will take phanatic erode at any range of dosages from one milligrams to five milligrams per day.

They're either doing this for prostate or more likely, they're doing IT to offset their laws and increase her growth and then they stop taking for asteria, for whatever reason, financial or wasn't working for them where the side effects were not they're liking. And they start to experience some very severe, what can only be called syndrome effects, such as very reduced libido, very reduced erectile function, very reduced mood to the point of depression, even suicidal depression. So this is pretty scary stuff, especially since it's occurring at an age when most of these things are not typically occurring in males.

They can occur, but they're not typical of Younger males in their twenty years and thirties and early forties. So we have to ask ourselves what's going on here. After all, people have taken phanatic ID for the prostate and fairly hy dosages without this post phantasy synthetic when they're stopped.

Now these Young males are taking phanatic y, they are coming off an asty, and they're getting this very severe, very debilitating postpone asteroid syndrome. This has become a kind of hot topic, and not so that medical doctors who have been prescribing for anatole for a very long time have been forced to address this. I think at first they were perplexed and thought, I don't know this might be psychosomatic, whatever that means.

I mean, as a neuroscientist who works on mind body connection, we know that nothing is truly psychosis tic, every of the mind and body. But the point is that enough medical attention has been placed on postpone asterias ndr me and trying to unravel exactly what that is, where there are now a few general conclusions about what might be going on. First of all, IT seems that Younger males taking fine aside in particularly high dosages to improve hair growth or offset hair loss seems to be one of the key variables.

We're not seeing this post on asteria syndrome as much in older males. In fact, IT seems to occur more in males in their twenty and thirties and males in their forties and older. So that's one thing in that may relate to the ways in which die hydra astern, we know, has a very key role in early embro ic development.

It's actually what's responsible for the male genitalia, also responsible for certain things in female development, but mainly in utero. It's responsible for male development and development, the penis in particular. And then around the time of poverty, die hyda testosterone acts again in what's called its activating effect.

Two further increased growth of the genetic aria, increased the musculars bond growth at sea and increased libido. One in a number of other things it's probably also involved in. The activation of puberty is certainly not the only hormone involved in the activation of male puberty, but it's certainly one of the key players.

So that add to stone has these known early roles in embracing development and in puberty. But what post financial sync, me seems to indicate is that dyah dri st. Ostrom is likely having further effects on male urine, in particular maturation of the hypothalamus and areas of the brain that continue well into one's twenty years and maybe even one's thirties.

And here, I just want everyone to keep in mind that we tend to think about development as childhood, teenagers, Young adulthood, adult. But really, development never stops. Development is something that starts at conception and birth, of course, and then extends all the way out until the point when we die. So even if we live to be in our late nineties or achieve a one hundred years of age, helped has occurring that entire time. And these different hormones, such as the hydroid to saw, are having different impact for across the lifespan, and in different ways across the lifespan.

So there isn't a clear conclusion about what post phanatic royd syndrome is really all about, but IT points to the fact that dhc is likely to be involved in development of the brain and the brain to genital access because I mention that because so many the side effects that are associated with this post finance s generation seem to center on sexual side effects, although they're also the depressive side effects. Of course, those can be related to one another in either direction. So while I do understand that loss of one's hair or potential loss of one's s hair can be particularly troubling, and anxiety provoking even caused depression.

In some cases, as I am sensitive to that, you also want to be sensitive to the fact that some of these treatments, such as phanatic rode, can Carry very serious side effects, even if you come off them A K, A post phone astride syn rome. As long as we're talking about fanatic I and this general pathway of five other duck takes innovation and their idea SHE univision and on on topics and themes and no monitor you are now very familiar with, we have to talk about due asteroid, due taste. IDE is yet another molecule similar to finance rode.

But remember those three ice forms of the five of reductive enzi, well, IT inhibits all three, mainly type one and type two, but also type three. And IT does IT very potent tly. So as a consequence, the typical dosage of world to taste get this. Point five milligrams to two point five milligrams, taken early, works two to five times faster, then typical phanatic ride at inducing here regrowth and reduces D H T by get this ninety five percent. So we just near flat lines.

D H, T, and that can occur at concentrations as low as point five milligrams, although you will see prescriptions and people taking do tax ride anywhere from point five milligrams all the way to two point five milligrams or now, not surprisingly, due tax rate is associated with a lot of side effects related to the dht pathway. So things like reduction in sex drive, reduction in overall drive IT also tends to impact other hormone on pathways. So increases in egan proactive, that's why going to come assia.

Male growth of male breast issue sometimes occurs when people take to tasty. And so you're probably asking why would take to taster iid, why not just take fanatic urie and wait for that hair growth? Well, the answer is that people are often very impatient.

And IT turns out that due tasty ied works about two to five times faster than finasteride. So some people don't want to wait a full thirty weeks or forty weeks or fifty weeks or more in order to grow hair back. And they are very concerned about the hair loss that's occurring. So they will take what I hope would be a very low dose of due tasty. I realized that there are always to take to tax ride that can be safer, offset some of these side effects.

But by my read of the literature, if one is going to try to mildly inhibit the d hg pathway, things like saw paleo, things like topical caffeine, which has some effect on the energy gen pathway, but as we talked about earlier, ticals other pathways, things like kito console, mild reduction in energy, ine recept pathways in the follow. And very direct because it's supplied directly, the scout things like that are going to be that's out for mild reductions in dht as an attempt to maintain hair or grow hair, where as if one really wants a potent stimulus for increasing hair growth, that's very likely going to be fan asteroid. And hopefully long enough dosages of an aside and hopefully a patient enough patient person that they are willing to wait the duration time required for that hair growth to come back because they understand that energy and phase take some time.

Now the holy grail of all this hair stuff is an understanding that no one specific treatment is magic. And in fact, there are now a number of good meta analysis comparing the various treatments we talked about today alone or in combination. And we can summize that pretty easily by saying that combination treatments that involve a mechanical stimulus and a chemical stimulus are always going to be Better than either one alone.

And within the mechanical category, the stimulus that seems to work best is microhardness. So the combination of mr. Needling and fanatic rode can lead to some pretty robust and impressive hairy growth, so much so that people that were, we only describe them as pretty bold or bold can regrow significant amounts of hair.

I've never seen examples of people who were completely bowled, meaning lacking all scale hair to grow back a full head of hair. But the combination of microhardness and fanatic roy is probably the most effective way to go. And if you're going to do that, there's no reason why you could not also use co, ocp, oo, could also use saw, palm, eto.

There's no reason to think that these things collide with one another. Although anytime you're inhibiting at the ht pathway, whether not you're increasing or decreasing any hormone pathway for that matter, you want to be careful about layer in too many different treatments because you don't want your dht level to go too low. I mean, let's keep in mind that even if you take a very low dose of aside and reduce your dht and don't have side effects, maybe just the mire addition of sol paleo, which leads to a slight reduction in dht combined with some caffeine ointment, would be sufficient enough to start reducing some of the low D H T associated side effects.

So you really have to see for you. And that's one of the major issues in this whole field of hair growth than regrowth is that people are highly individual in their response in in their side effect profile to these various treatments. But there's an enormous range they are.

Unfortunately, there is no way to know a priority before doing these treatments what your response is going to be in terms of side effects. So you're simply going to have to explore. And I would hope that you would explore starting with minimal possible effective dosages and to do that incorporation with a medical professional so you could really evaluate these things at the level of blood and cosmetic changes.

And in fact, that's a pretty good motivator for thinking about the different treatments that we talked about today, everything from mechanical treatments as simple as massage, which we have all heard about, but for which they're really aren't a lot of data for supporting her growth. But certainly things like microhardness, which is a mechanical stimulus for which there are pretty good data that I can improve hair growth, also things things like sol pal, metal, a weak D H T and tag nist, also things like kiopo's or shampoo, which again is a weak D H T N tag and Operates through some other pathways as as well to stimulate hair growth. My suggestion is that anyone, Young, old, male, female, who's thinking about embarking on various treatments for offsetting hair loss and stimulating her growth, consider both mechanical approaches and the approaches that attack the chemical pathways that can stimulate hair growth and can inhibit the inhibitors of hair growth.

In fact, that's the reason why we spend so much time on the biology of hair growth and what shuts down hair growth early on in today's episode, and then systematically went through each of the various treatments that relies on, and in some cases hinges entirely on, either mechanical stimulus or a chemical stimulus in order to exert its effects. My goal today was not to overwhelm you with a ton of biology about hair, although we did cover a lot of biology of hair and stem cells and hair growth. My goal in describing all that was really for you to be able to hear about various treatments.

But they're not its lasers or P R P or financial due tasty or whatever is coming next that we're sure to hear about soon online. In from the medical community and to be able to place those into bins related to their known or potential mechanisms and then to be able to step back and evaluate which, if any, of those treatments might be right for you. If you're learning from and or enjoying this podcast, please subscribe our youtube channel.

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