My hair is still falling out....

I am about 3.5 months out from surgery - it started at the end of the first month and it continues. I eat about 80-95 grams of protein a day so the doc says I am getting enough. She thinks it is rapid weight loss and told me to take biotin. I take about 5000 mg of powdered biotin everyday - and to no avail. And now it is starting to really show... I am distressed..... can someone provide some comforting feedback on this? My weight loss has been pretty rapid I guess, I am loosing right now about 3 lbs per week - and I guess I would take skinny over my hair - but I am freaking out....

I was told that what happens is when your body is stressed it can loose hair also. So besides the surgery which was a huge stress on your body, has there been any other stresses in your life? If not I am at loss.

My hair is still falling out....

I am about 3.5 months out from surgery - it started at the end of the first month and it continues. I eat about 80-95 grams of Protein a day so the doc says I am getting enough. She thinks it is rapid weight loss and told me to take Biotin. I take about 5000 mg of powdered biotin everyday - and to no avail. And now it is starting to really show... I am distressed..... can someone provide some comforting feedback on this? My weight loss has been pretty rapid I guess, I am loosing right now about 3 lbs per week - and I guess I would take skinny over my hair - but I am freaking out....

Are you also taking a GOOD multi-Vitamin? Children's chewables may not be enough IF you are having hair loss.

Look at this list of vitamin deficiencies and what they effect.

Bariatric fusion | Nutritional Deficiency and Its Symptoms

I went to my PCP and had him run bloodwork to check for all of these deficiencies, plus thyroid plus vit D levels (D was just 2 be sure as long as they were taking blood). Nothing came up as off scale.. so he sent me to a Dermatologist. I was put on Rogaine. Derm said mine was mainly post menopausal.

In a bit I'll post a real long article about Telogen Effluvium.. which is what is USUALLY going on with post WLS hair loss.

The Latest on Nutrition and hair Loss in the Bariatric Patient

by Jacqueline Jacques, ND

Nutrition and Hair Loss

A common fear and complaint of bariatric surgery patients is postoperative hair loss. While for most of us as people, our hair is important as 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 the brain and heart and away from 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.

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

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

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

Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One should be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if any of the following occurred:

1. Hair loss continued more than one year after surgery

2. Hair loss started more than six months after surgery

3. Patient has had difficulty eating and/or has not complied with supplementation

4. Patient has demonstrated low values of ferritin, zinc, or protein

5. Patient has had more rapid than expected weight loss

6. Other symptoms of deficiency are present.

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 40mg/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 anemic, 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 biliopancreatic 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 who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative 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 definitively 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 60mg/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 that “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.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, 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 many 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 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1

Biotin

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, B6, 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.

Conclusions

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 most 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.

References

1. Rushton DH. Clin Exp Dermatol. 2002;27(5):396–404.

2. Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65.

3. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc. 1981;78(2):135–140.

4. Segal A, Kinoshita Kussunoki D, Larino MA. Postsurgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg. 2004;14(3):353–360.

5. Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity.Dig Dis Sci. 1994;39(2):315–20.

6. Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–28.

7. Mock DM. Biotin. In: Shils M, Olson JA, Shike M, Ross AC, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:459–466.

I lost a lot of hair starting around 3.5 months.....I also average 3lbs. weight loss/week. I'm now in month 7 and my weight loss has slowed down (I lost 70 lbs in the first 4-5 months)....my hair is finally growing back. I have 1" strands popping up all over the place....if I pull it back into a ponytail it looks like fuzz all over my head.

So thankfully, it's coming back. I do believe it's the rapid loss and that it does come back. It looks kind of funny now but I look & feel great!!!!!

Hang in there....I'm sure it will come back. Best of luck to you!!

Sorry to hear that Molly :frown:

In the booklet from my Nutritionist, it says; "If Protein intake is meeting the minimum recommended guidelines and hair loss continues to be bothersome, you can try supplements with ZINC (no more than 50 mg per day). Ongoing hair loss can also be a sign of iron-deficiency anemia. Please consult your surgeon."

i didn't start losing my hair until i was about 3 months post-op. i thought i had gotten past that possible side effect but i was wrong.

it IS scary seeing how much hair comes out after a washing. my hair stylist commented on it too so THAT really worried me.

my hair loss lasted about 3 months but did end up stopping. stay strong... this is one of the easier hurdles to overcome!

I also lost a bunch of hair, luckily my hair was thick to begin with but it really scared me. I am eight months out now and I too am noticing hair growth again and not as much hair coming out so just like everyone else said, "hang in there"! It was worth it to me!

Thank you to you all.... I feel calmer now reading all of this - plus that great article. I think I will get my blood work done and change my multivitamin (just in case) - but the whole thing about the different phases of hair growth makes complete sense to me. And, as I said, I would rather be skinny :eek:

Molly, I am glad you brought up this problem. My hair

Has been falling out like mad! I am just over 2

Months post op and my stylist had a fit when he sae

How much has come out. Thanks everyone for the advice!

My gosh, thank you all for posting this info. I've been silently terrified, losing my hair. I have always had very thick hair and a lot of it until recently. I'm feeling absolutely devastated because I've worked for so long to get my hair this length - it's about 4 inches lower than the bottom of my bra. My hair has fuzzies all over and some areas it's starting to become noticeable for me. I could usually only wrap a coated rubber band around a ponytail twice and now I can wrap it 3 times. I am feeling quite overwhelmed by this - I can deal with sliming and PBs and saggy skin and all that nonsense, but my hair? Please God, no. I'd not heard of this as a side effect until recently when I actually started looking for answers. I've tried oil treatments, hair masques, wearing it up, wearing it down, only washing it every 3-4 days, buying new brushes and wide-toothed combs - everything and I feel like I'm shedding more than our dogs. I'm embarrassed and feeling like I'll never have normal hair again - what may have resolved for someone else doesn't mean it will resolve for me. I'm 5 months out from surgery - June 29th was banded - and I've lost about 55 lbs. Weight loss is going well, fills have gone well, save one (he put in double on accident and I had to be unfilled and given fluids in the ER). Yes, life is stressful right now but I don't see that changing for a while.

Sorry for the rant, just feeling overwhelmed and hair loss is the last thing I needed right now.

I take a Multivitamin - Vitafusion Gummy Vites - I try to take 4 a day now (2 servings) - 1 in the am, 1 in the pm. I probably don't get enough Protein, but I'm working on that. I don't take any Iron or zinc or anything extra. Does anyone have any recommendations for not terrible tasting, reasonably priced supplements? I am surprised no one has come out with a widely available chewable just for bariatrics pts - like prenatals.

Thanks to all...

One more thing - I try to take Fiber daily - sometimes a supplement, sometimes Fiber One products, because since surgery being "regular" has been a real issue. The fiber gives me so much gas which is painful that I end up skipping it sometimes.

I would recommend using Nioxin. If you go on their website and answer their questions it will direct you to exactly which system you should use. I think there are like 9 different sets. In addition I have been using Nexxus Emergencee. I was told by a hair dresser to also wear a silk cap at night and brush from the ends and not from the scalp.

My hair loss is actually from a bad straightener but hair loss is hair loss. I totally feel your pain. Good luck.

I take Biotin everyday along with Fish Oil. It seems to help me out.

PHEW..... I'm not the only one. My hair is falling out in clumps. I absolutely dread showering every day because what ends up at the bottom of the shower is devastating! I just went and had 9 inches chopped off my hair so that it doesn't look like so much is falling out, I figured I'll more than likely be bald in a few months anyways, may as well go shorter to slowly get used to it. lol

Regarding Biotin... Do you all swallow them or break open the capsules? I'm terrified to swallow anything in fear of getting stuck. Protein is high enough, I take multi Vitamins but maybe I need to up those as I'm just taking kids chewables.

I to have had some pretty quick weightloss. Just over 4 months out and I hit 70 pounds lost today.

Search Burdock Tea for hair loss. Many years ago I had hair loss on Atkins. Someone suggested buying Burdock Root Tea. I can't remember the all details - you make the tea and let it sit overnight, then strain it and put it in an application bottle. You apply it directly to your roots and leave it in. I was skeptical, but I reasearched it and people swore by it! I tried it and after only 3 weeks I had the thickest hair of my life! I plan to start it again. I bought it at a local herb shop.

Regarding Biotin... Do you all swallow them or break open the capsules? I'm terrified to swallow anything in fear of getting stuck. Protein is high enough, I take multi Vitamins but maybe I need to up those as I'm just taking kids chewables.<br /><br />I to have had some pretty quick weightloss. Just over 4 months out and I hit 70 pounds lost today.<br />

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I don't have the capsules but a small pill form from CVS. Now I shallow the fish oil capsule.