What's the Problem, and How Do You Diagnose It?
Everyone loses some hair every day but through your younger life, that kind of hair loss is normally gradually
replaced by new hair. With aging, many men and some women may gradually lose hair in a traditional age-related type of
balding, and this hair may never be replaced. Neither of these processes are of concern, and despite wild claims there are
few therapies that are effective remedies for these natural processes. What is much more concerning is sudden, rapid, or
severe hair loss. If you suddenly begin to see clumps of hair on your pillow or collecting around your shower drain in
quantities much greater than in the past, this would be considered abnormal hair loss.
What are the Causes?
There are many drugs that can cause sudden disturbing hair loss, including cancer chemotherapies and some
arthritis drugs. Hair loss can also be caused by some HAART meds. The most common antiretroviral cause is the
nucleoside analogue 3TC (alone in Epivir®) and also in the combination drugs Combivir® and Trizivir®). Many 3TC
users have reported finding clumps of hair on their pillows in the morning. The protease inhibitor indinavir (Crixivan®)
has also been implicated in some instances of accelerated hair loss.
Another possible cause of hair loss is malnutrition, particularly low protein intake. This may occur in those with
appetite loss or diarrhea. For those with active AIDS wasting, it is not uncommon to see the hair become dull and begin to
thin. Deficiency of B vitamins and/or essential fatty acids, a common occurrence in HIV+ people, may also contribute to
For some people, hormone problems may contribute to hair loss. Thyroid problems are one possibility. People
with low thyroid hormones can experience hair loss.
In men, one of the normal causes of balding is a high level of testosterone. If supplemental testosterone is given in
too-high doses, this can cause the same problem, and the hair loss is often rapid. In general, transdermal (through the skin)
delivery (via gels or patches) of doses that simply return your body’s levels to normal are much less likely to cause this
problem. Injections, particularly of too-high doses, are much more likely to cause sudden hair loss, and should be avoided
for this and many other reasons.
What are the possible treatments?
For restoring lost hair, there are no miracle cures although there are some things that may help, or may at least
help prevent further loss. Helping to prevent hair loss with good nutrition and nutrient supplementation may work better
than trying to replace lost hair but even excellent nutrient programs may not be able to prevent the hair loss caused by
Drug discontinuation. If drugs appear to be the cause of your hair loss, there appears to be no perfect solution other than
switching or discontinuing the problematic drugs. Even then, the return of the lost hair may be slow and incomplete. This
type of hair loss does not usually resolve over time if you remain on the problematic drug so a wait-and-see approach is
not appropriate if the hair loss is a concern to you and you have other valid drug options.
Improving nutrition. If malnutrition is contributing to hair loss, ensuring that you take in a healthful level of nutrients
daily may help to restore hair growth and appearance. Particularly important are ensuring adequate protein daily, and a
sufficient intake of essential fatty acids and B vitamins. Supplementing with B complex (one pill with each meal daily of a
formula that includes biotin) and essential fatty acids (two flaxseed oil capsules, three times daily) may help. (For more
information on a healthy diet and obtaining sufficient protein, see NYBC’s Self-Care Guide; for more information on
nutrient nutraceuticals, see NYBC’s Basic Nutrient Protocols and Counteracting Inflammation in the Introduction.)
B-50 complex x 250
3/d (1B, 1L, 1D)
Essential Balance 100mg x 200
6/d (2B, 2L, 2D)
Avoiding inappropriate testosterone therapy. For those who need testosterone replacement therapy, it will be very
important to use only transdermal (through the skin) patches or gels, and use only the dose that is needed to restore normal
testosterone levels. Avoid injections or too-high dosing. Using Saw Palmetto Extract 320 to 480mg in divided doses may
slow or stop further loss from too high testosterone levels.
Scalp massage. Massaging the scalp in the shower while shampooing or any other time during the day that you could do a
three to five-minute scalp massage with your fingertips (not your fingernails to avoid scraping the scalp) may help by
stimulating circulation of blood to the scalp and, thus, encouraging hair growth..
Rogaine. For some people, minoxidil products (Rogaine) may help with some types of hair loss, but as with all
medications, check to make sure there are no possible interactions with your other drugs before taking such products.