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Good morning all, My last post (about a month ago) was about hair loss, a major stall, and some female issues. A month later, and nothing has changed, except maybe getting worse. The female issues are *hopefully* being addressed at an appointment next week, though I'm not sure what will happen. I'm still stuck at 181 and have been for almost two months. At one point, I got down to 178 for a few days, but I suddenly shot back up to 184 and have been bouncing between 180-183 forever now. It's SO depressing! My hair is falling out at a rapid pace. I know this is a common side effect, but I wasn't prepared for it to be this bad. I literally now have small, nearly bald patches and the texture of existing hair is like fine straw. 😞 Not only that, but it doesn't seem my hair is growing at all. I had it colored two weeks before Christmas, and no new growth is visible. My surgeon's staff keeps telling me I need to be better about getting my protein in, and I need to stick to three meals and no snacks meals. Well, that's difficult for me. Even a tiny meal takes me forever to eat...can't tell you the last time I finished a hot - or even warm - meal. And I feel like I get far less protein in. I find I do better eating small snacks throughout the day. Snacks include mini cucumbers, raw bell peppers, string cheese, cottage cheese, yogurt, a couple of slices of low-sodium lunchmeat, tuna pouches, V8 juice, Builders Bars, beef jerky, etc. I add Unjury Powder (yuck!) to just about everything. I've also tried to make sure everything is SF and low sodium. When possible, I eat lots of chicken & fish, but I'm getting super tired of those things. I've come to realize I no longer enjoy food, whatsoever. I don't miss junk food (not that I ever really ate much of that anyway), but I miss going to a restaurant and ordering a meal to enjoy with my family. I take a couple of bites and am done - such a waste. My husband is a great cook, and I miss the meals he makes...I can't finish even the smallest filet, can only have a few bites of salmon, etc. I feel terrible when he cooks a beautiful, healthy meal and I can only have a few small bites. Anyway, sorry for the long post...just having a mini pity party for myself today.

SAMMC Bariatric Clinic: Weight-loss Surgery, Nutrition and Hair Loss (whmcbariatric.blogspot.com Weight-loss Surgery, Nutrition and Hair Loss by Jacqueline Jacques, ND Original content: http://www.obesityaction.org/magazine/ywm22/wlsandhairloss.php Typically, about 90 percent of hairs are anagen (in a growth phase) and 10 percent are telogen (in a dormant or resting phase) at any given time, meaning you are usually losing a lot less hair than you are growing so you don't have noticeable hair loss. But sometimes this can change. A common fear and complaint of bariatric surgery patients is post-operative hair loss. While for most of us as people, our hair is an important part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like your brain and heart and away from your hair. Hair loss has many causes. The most common type of hair loss after weight-loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Growing and Losing Hair Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states; anagen, a growth phase, and telogen, a dormant or resting phase. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase which lasts for about 100 to 120 days. Following this, the hair will fall out. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include: High fever Severe infection Major surgery Acute physical trauma Chronic debilitating illness (such as cancer or end-stage liver disease) Hormonal disruption (such as pregnancy, childbirth or discontinuation of estrogen therapy) Acute weight-loss Crash dieting Anorexia Low protein intake Iron or zinc deficiency Heavy metal toxicity Some medications (such as beta-blockers, anticoagulants, retinoids and immunizations) Weight-loss Surgery and Hair Loss Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight-loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into the telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss rarely lasts for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight-loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One would be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if: Hair loss continued more than one year after surgery Hair loss started more than six months after surgery Patient has had difficulty eating and/or has not complied with supplementation Patient has demonstrated low values of ferritin, zinc or protein Patient has had more rapid than expected weight-loss Other symptoms of deficiency are present Nutrition Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40ug/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemia, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after bileopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high dose zinc supplementation as a therapeutic agent for related hair loss2 in patients with vertical banded gastroplasty. The study administered 200 mg of zinc sulfate (45mg elemental zinc) three times daily to post-operative patients with hair loss. This was in addition to the multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies, and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus we cannot say that zinc would prevent hair loss after weight-loss surgery, and further study would definitely be needed to make this connection. A further note: The Tolerable Upper Intake Level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60 mg/day. Information related to this study has made its way to many a support group and chat room – even to doctor's offices – with the message of "high dose zinc will prevent hair loss after weight-loss surgery." Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen or prealbumen. Limited studies suggest that patients with the most rapid or greatest amounts of weight-loss are at greatest risk.3 With surgical reduction of the stomach, hydrochloric acid,4 pepsinogen5 and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion, rather than malabsorption, is responsible for most cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2 grams of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Many individuals believe that supplementing with or topically applying the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include vitamin A, inositol, folate, B-6 and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS) and is influenced by genetics. Conclusion Hair loss can be distressing to bariatric surgery patients and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is mostly likely caused by surgery and rapid weight-loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. About the Author: Jacqueline Jacques, ND, is a Naturopathic Doctor with more than a decade of expertise in medical nutrition. She is the Chief Science Officer for Catalina Lifesciences LLC, a company dedicated to providing the best of nutritional care to weight-loss surgery patients. Her greatest love is empowering patients to better their own health. Dr. Jacques is a member of the OAC National Board of Directors.

I had my g.s on May 20th, 2020. As of 1 month ago I have started losing tons of hair, and notice very small bald patches. How long before my hair becomes thick again, and any tips to prevent loss?

So, I recently posted about hair loss. While I'm not happy that this is a side effect, it's comforting to know that some of you have gone thru this as well, and for most, your hair grew back. I'm taking all kinds of supplements in addition to the "regular" vitamins required post-op. I've added liquid iron, prenatal vitamins, biotin, and collagen. The first question is about stalling - again. I've been bouncing between 181-184 for over a month now. I'm not eating much due to the discomfort (I posted about this also). I'm desperately trying to get my protein in, but I simply can't eat enough to do that. I'm also taking the Unjury powder (which I can barely tolerate due to the taste even though I mix it into food/liquid), but still can't get anywhere near what I'm supposed to. I'm supposed to be getting in 60g-86g protein/day. Unjury only accounts for 22g/day. I can only eat enough to get about 40g-50g/day. My doctor is aware. How do I kickstart this weight loss again? Secondly (sorry to the men in the group), I'm 48 and suddenly started getting my period again. I'm on a medication that is supposed to stop it completely due to a previous medical issue, but obviously, something has changed so much with my body, that the medication, which has been effective for several years, is no longer working. I emailed my dr. and she started me on estrogen for 10 days but isn't sure why the previous medication stopped working. Have any of you ladies had this issue?

Hi all, I'm 3.5 months out and my hair started falling out about 2-3 weeks ago. In that very short amount of time, I've noticed it's become extremely thin and my hairline is receding bigtime. How long does this last? Is there something that works to stop it and restart growth? I've added prenatal vitamins and liquid iron to my vitamin regimen, but I know it will take a while for them to start working - if they work at all. I'm still having trouble getting all my protein in as I have almost no appetite and it's still a bit painful to eat (yes, I'm taking small bites, chewing A LOT, and eating slowly). I'm supposed to have 60g-86g of protein/day, but I'm probably only getting about 40g-50g. I simply can't eat more. I'm really freaking out as I knew this may be a possibility, but I was reassured by my doctor and his team that it was unlikely....and now it's happening. Ugh...

I had gastric sleeve May 28. Will have 6-month check up end of November. Just this week, I am shedding hair everywhere. But I have very fine hair but plenty of it. Don't see any bald spots. So not concerned and expected. My 3-month checkup blood work showed all vitamin levels and other tests perfect. I am just 9 lbs above clinic's goal weight with seven weeks until 6-month checkup. My post-op experience has been extremely smooth. No pain with eating. Always getting all my protein and water requirements without any issues. Eating normal food now with just one protein shake per day. Stats: 5'1", age 67, female. Highest weight: 245. BMI 41. Surgery Date: May 28, 2020. Weight at surgery: 211. VSG.

We all know that hair loss is likely due to WLS. I’ve accepted it, and am dealing with it. However, since WLS, my remaining hair is dry, frizzy, and brittle. I use good, moisturizing shampoo and conditioner (salon-recommended stuff), only wash my hair twice a week, and take biotin and all other recommended vitamins. Is this a new norm? Any thoughts on improving my crazy-lady hair?

So, I'm told that after my surgery, there's a good possibility that I could lose my hair...like a lot of it! Uggh! I've seen some videos where people started taking Biotin and other vitamins months before they had surgery. Is the hair loss really as big as people say? And if so, how much Biotin do I start off taking?

I am losing so much hair! My hair is so thin. i do take my 60g of protein a day I take biotin pills and use the multivitamin, iron, vitamin b patches. Is there anything else i can do about it. I Dont wash My hair everyday. Yesterday i bought Surface Awaken Therapeutic Treatment. the whole kit. I hope it works, or else Im going to start using lace fronts lol.

For those veterans who experienced hair loss, when did yours stop? I started losing hair at about 3 1/2 months post surgery. I'm now exactly 8 months out and I am still losing a TON of hair. I honestly have no idea how I have any left on my head. I keep hoping it will stop soon.

Does any have experience with vitamin patches? Specifically the one for hair, nails and skin? I found this patch on the site site...

I am about 6 months post-surgery and have lost about 50 lbs. Unfortunately, a lot of that weight loss seems to be my hair!!! of course I'm being dramatic, but I am losing a SERIOUS amount of hair! Even my hair stylist (who saw me for the first time last week since my surgery) is astonished and upset by how my thick hair has now thinned so much! It is truly distressing. I am eating my protein and Biotin doesn't seem to be helping. I now hate to take showers because of the cascade of hair that is left behind. The hair that has managed to stay on my head is so brittle and delicate that all I need to do is look at it crooked and it splits and breaks! Ugh. Thinner, but bald. What a trade off. Any suggestions, solutions?

Hi I'm nearly 4 months post op for the bypass. Does anyone know if hair loss is a side effect of surgery? Mine is falling out by the handful which is causing me a lot of concern. I haven't had any post op checks or consultations to ask for advice due to covid so feel like I'm out on a limb. Thanks 👍

Hi there all, I was wondering about the extent of hair loss with the DS procedure as I have had a gastric bypass in the past that had to be reversed and with theBypass I lost a lot of hair although taking biotin and all vitamins. My assumption would be that since this is the surgery that seems to have the highest rate of malabsorption it will be worse.

Hi everyone my name is Paula and I'm 35 I had gastric bypass on 31 January this year. I am concerned about my hair loss I had thick long curly hair before surgery and now I am loosing so much of my hair that is more upsetting than loose skin. They become brittle and Matt. I am taking all my vitamins and I was taking them post op too. I dont know what else I can do to help my hair. Any advice?

I am 6 months post op. I am currently experiencing hair loss. Am taking all vitamins. Any suggestions? Sent from my SM-G960U using BariatricPal mobile app

Having a bypass, revision, on 5/27 - just spoke to my surgeon via teleconference... finally moving forward. I didn't have any hair loss with the original surgery - sleeve, back in 2015. I had thinning but was on Biotin. Is the revision, bypass, worse for thinning/losing hair?

Hi I'm a little over 6 months post op and my hair is shedding ALOT. My hair has never she'd so much and I fear I might go bald more than two handfuls of hair. I've heard this could be a side effect of surgery. Has anyone else experienced this? and does it ever stop?? Please help. Sent from my REVVLRY using BariatricPal mobile app

Hello all: I underwent a gastric sleeve on February 26, 2020. I was told that this type of surgery can cause hair loss. .... but we hear what we want to hear. I'm losing my hair at an alarming rate. Anyone else experiencing this? In addition to that problem, my weight loss is at a crawl. Since February 26 I've lost only 16 pounds.... so now I won't just be fat, - I'll be fat and bald. Any input would be much appreciated. Best, Grace

I'm almost 4 months post op and I am officially in the hair loss phase I was hoping I'd be one of the few lucky ones but after watching the amount of hair loss gradually increase over the last couple of weeks, I am accepting it. I have very fine hair, but lots of it so I'm hoping it won't become visible. I'm also taking the opportunity of working from home to not dye it or other things that generally increase loss. Keeping my fingers crossed. For those of you who also had loss, how long did the increase loss last?

Hi there. I am at 5 months post op and am experiencing hair loss and thinning. I take multi vitamin, B12 and Biotin every day. Had anyone tried a hair loss shampoo or product that helps through this phase ?

Hi there! I had gastric sleeve surgery on Dec. 4, 2019. I’m doing really well with my weight loss of 50 lbs already. My concern is that my hair has been falling out a lot. I’m eating enough protein as prescribed by the dietician but I’m losing big amount of hair. Has anyone had this problem? In need of advice.

Before surgery my hair was beautiful and long and thick. I knew hair loss was a side effect but so much falls out now at a time. I take biotin but I feel it’s not doing anything. The picture I posted is after brushing it out. Can somebody recommend a good vitamin or anything that will help me ? :(

So at the seven month mark and I have lost a fair bit of weight and while I never considered myself super hairy before as I shrink my back hair and body hair in general seems to be condensing. So not only do I have some gnarly excess skin but I look like Sasquatch. I am hesitant to wax given the excess skin has anyone got any advice? Anyone try laser hair removal?

More great advice from Dr. Duc C. Vuong regarding hair loss after weight loss surgery.