evad99 asked
I am looking into different options for supplemental hair regrowth products. I currently take the following prescription medications: Metoprolol, Atorvastatin, Fluoxetine, and Buspirone, and Klonopin as needed. I take the following OTC medications: Fish Oil, Saw Palmetto, Align, and use Minoxidil. I also use a laser therapy device. I have the following health conditions: alopecia, high blood pressure, high cholesterol, high triglycerides, major depressive disorder, dysthymia, generalized anxiety disorder, SIBO, mild diverticulosis, and am a little overweight. I used Biotin in the past. I have also used Finasteride, but became concerned about the long-term effects of use. The Finasteride seemed to help, however, after I stopped use, I noticed a difference. I'm trying to find if there is something out there in addition to what I now use that could help further. I have heard of products like BioSil, Vivascal, NuHair, and wasn't sure how any of those would interact with what I'm currently taking. Also, if you have any other suggestions, I would greatly appreciate it. Thank you for your time.
Answer
Although chemotherapy is the most common medical treatment associated with hair loss, multiple prescription drugs are known to cause it as well. If hair loss does occur due to prescription medication, you typically will see this occur within two to three months upon initiation of treatment. In the vast majority of situations, hair loss due to prescription drugs is reversible upon discontinuation of the offending agent, but it takes time. It can commonly take up to 6 months to stop losing hair and an additional 2-3 months for it to start to grow back. Below is a list of drugs that are associated with hair loss:
Ace Inhibitors (e.g. Lisinopril, Ramipril, Benazepril, Quinapril
Studies show between 1% and 5% of patients will experience hair loss on ACE Inhibitors. The hair loss is typically reversible upon drug discontinuation.
Beta Blockers (e.g. Metoprolol, Atenolol)
The overall incidence of hair loss is unknown, but was a commonly listed adverse reaction during trials. The hair loss is typically reversible upon drug discontinuation.
Selective Serotonin Reuptake Inhibitors (e.g. Sertraline, Fluoxetine)
There is a low reported incidence of hair loss on these drugs but if it does occur, it typically happens 3-4 months after initiation of therapy. The hair loss is reversible upon drug discontinuation.
Anti-Anxiety Drugs (e.g. Benzodiazepines, Buspirone)
There is an unknown incidence of hair loss with these drugs but it has been reported nonetheless. The hair loss is typically reversible upon drug discontinuation.
Anticoagulants (e.g. Warfain)
Anticoagulants represent the class of medication that is very much associated with hair loss. Higher doses greatly increase the incidence. Preliminary studies show that Co-Enzyme Q10 may be helpful to prevent it.
Anti-Fungals (e.g. Fluconazole,Terbinafine)
There is a relatively high incidence of hair loss on antifungals, over 5%. The hair loss is typically reversible upon drug discontinuation.
Anti-Virals (e.g. Acyclovir, Valacyclovir)
There is a relatively high incidence of hair loss on anti-virals, about 1%-5%. The hair loss is typically reversible upon drug discontinuation.
HMG-COA Reductase Inhibitors/"Statin" Drugs (e.g. Lovastatin, Atorvastatin, Pravastatin)
There is a low reported incidence of hair loss on these drugs but if it does occur, it typically happens 3-4 months after initiation of therapy. The hair loss is typically reversible upon drug discontinuation.
The above is just a sampling of the medications that cause hair loss as there are many more. Looking at the list that you provided in your question, you are on some medications that are known to cause hair loss. Since discontinuation of many of your drugs most likely isn't an option, let's talk about some potential treatments.
With the exception of Rogaine (Minoxidil), the over the counter supplements you mentioned in your question may or may not work... it's difficult to tell as there aren't many high quality studies that evaluated them. They should mostly be free of adverse reactions or drug interactions based on the data available, but I urge you to speak to your doctor of pharmacist regarding possibly supplementing with them since they have your full medical history.
Below are some additional therapies you can speak with your doctor about that have some positive data associated with them to stop hair loss:
- Proscar (Finasteride): You mentioned you did take this at one point and it is a effective medication for hair loss in men. You are correct that there could be some negative side effects such as decreased libido and sexual dysfunction.
- Rogaine (Minoxidil): You said you tried this as well and it does have a lot of good data for effectiveness. Be aware that hair shedding may increase when you first begin for about two to six weeks but hair re-growth should start after that.
- Biotin: Biotin is a B vitamin that has been used as a nutritional supplement for thinning hair and brittle nails. It does have some data to support its use and it is relatively free of side effects. The only concern would be that it can affect thyroid function tests.
- Essential Oils: Believe it or not, topical application of essential oils have been shown in studies to have fairly good evidence for hair re-growth. One such study can be found here. The essential oils used in the study were thyme, rosemary and cedarwood.
- Ketoconazole Shampoo: Over the counter ketoconazole shampoo has some good evidence for hair loss in men only. Several small studies show some benefit when used alone or with finasteride in men.
- Saw Palmetto: Saw palmetto is commonly used in men as an over the counter supplement for enlarged prostate. There are some studies that have shown a benefit in reducing hair loss when taking this supplement.
- Zinc: There is very limited data with zinc but some studies have shown that zinc, when combined with biotin, may help reduce hair loss.
We hope this information gives you some guidance in regards to treating your hair loss. Please speak with your doctor regarding some possible therapies you can use!
