by Laurie Lynch, ND

"Hair loss affects about 35 million men ... in the United States alone.  Approximately "40% of men have noticeable hair loss by age 35 and 65% by age 60" (.hairlosslearningcenter) . "However, the statistics with younger men losing their hair, and at a much quicker rate are high. Three in ten 30 year olds, and half of 50 year olds are quite bald. In its extreme form, some males start to thin at the age of sixteen and are almost entirely bald by the time they reach their early twenties" (london-centre-trichology) .

"Today more women than ever are experiencing hair loss -- and the causes may be quite different that what causes balding in men... According to the American Academy of Dermatology, it's a growing problem, affecting some 30 million women in the United States -- with some forms of loss occurring at earlier ages, (as young as 15 or 16) and being seen in increasing numbers" (Bouchez).                                                                                       

According to dermatologists, "it's normal for a person to shed about 50 to 100 hairs a day", But with about 100,000 hairs in the scalp, most people don't even notice. "As people age their rate of hair growth decreases. A hair disorder is evident when hair loss is out of proportion to the norm. 'The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place" (familydoctor.org). "The resting phase is called telogen. This phase typically lasts three to four months. At the end of the resting phase, the hair strand falls out and a new one begins to grow in its place. Once a hair is shed, the growth stage begins again.

"Hair loss may lead to baldness when the rate of shedding exceeds the rate of regrowth, when new hair is thinner than the hair shed or when hair comes out in patches" (Mayo Clinic).

As hair loss progresses, the hair gradually changes from long, thick, coarse, pigmented hair to fine, unpigmented vellus sprouts as the follicles shrink or die.  Most will shrink to the size they were at birth and produce weaker hairs. With a steadily shorter growing cycle, more hairs are shed, and the remaining hairs become thinner until they are too fine to survive daily wear and tear. 

Main Types Of Hair Loss       

•   Hereditary hair loss (known as Androgenetic Alopecia, or as female or male pattern baldness is the most common type of hair loss. Pattern hair loss affects an estimated 40 million men and 20 million women.  "Some estimates indicate that about 50 percent of all people over the age of 45 have androgenetic alopecia to some degree", according to Amy McMichael, M.D., assistant professor of dermatology at Wake Forest University School of Medicine in North Carolina.

Male and female pattern baldness differs in the pattern of hair loss.  Male pattern baldness usually begins in the early 20s.  Males are more strongly affected than females and often get completely bald. It starts in the front, crown and sides of the hairline.  The hair on the crown of the head begins to thin with a horse-shoe pattern of hair around the sides of the head. Any remaining hair in the balding areas becomes thinner and grows at a slower rate.

Female pattern baldness usually begins about age 30, becomes noticeable around age 40, and more noticeable after menopause, and affects the crown and front of the head, but the hairline does not recede.  Female hair loss is usually an overall thinning rather than a bald area on top of the head, though women may have a receding hairline, too.

In some people with a genetic predisposition to hair loss,  hormones called androgens interfere with this natural process. According to dermatologist Michael Reed, MD, "Androgen hormones include testosterone, androsteinedione, and dihydrotestosterone (DHT) -- all of which are made in men's bodies in large amounts, and in women's bodies in small amounts.  In those who are genetically susceptible, when testosterone comes in contact with enzymes residing in the hair cell, it is converted into the more potent androgen DHT, which then binds with receptors deep within the hair follicle. ...Over time, an excess build-up [of DHT] in the follicle causes it to begin shrinking, which in turn alters the natural resting and growth phases of the hair,"  Some of the follicles eventually die, while others are rendered incapable of producing or maintaining healthy hair growth. There is evidence that many other types of enzymes, as well as hormone receptors and blockers, may be at work in women (Bouchez).

•  Alopecia Areata is a sudden loss of hair in round irregular patches, where the scalp is not visibly inflamed. This type of hair loss occurs in individuals who have no obvious skin disorders or serious disease.. Alopecia areata may be confined to a few areas of the scalp and is often reversed in a few months. According to the National Alopecia Areata Foundation, an estimated four million men, women and children suffer from this type of hair loss.

•   Postpartum Alopecia is a temporary scattered hair loss at the end of pregnancy.

•   Telogen Effluvium is a premature shedding of hair in the resting or telogen phase.

•   Traction or Traumatic Alopecia refers to patchy or scattered hair loss. Excessive hairstyling or hairstyles that pull your hair too tightly cause traction alopecia. If the pulling is stopped before there's scarring of your scalp and permanent damage to the root, hair usually grows back normally" (Mayo Clinic).

•    Alopecia Universallis is loss of hair over the entire body. If it starts in childhood it has a poor reversal rate. If occurring in adulthood, it may reverse and reoccur.

•   Trichotillomania usually occurs in children and may correct itself.

•     Cicatricial (scarring) alopecia. This type of permanent hair loss occurs when inflammation damages and scars the hair follicle. This prevents new hair from growing " (Mayo Clinic).

What are the root causes of hair loss? - "It's vital ... to get at the "root" of ...hair loss (Bouchez).

•   Hormonal Imbalance is a cause of Androgenic Alopecia.   The Androgen hormones which play a role in hair loss (due to over or under expression) include: testosterone, androsteinedione, and dihydrotestosterone (DHT). Androgens are produced by the testicles and adrenals in men, and by the ovaries and adrenal glands in women. These hormones are important in both sexes, but occur in different concentrations, being much more predominant in males than in females.  "Dihydrotestosterone, a hormone formed by metabolism of the male hormone testosterone or from cholesterol, causes hair follicles to go into their resting phase" (Durk Pearson, p. 213) In time the hair follicles increase their production of an enzyme, 5-alpha reductase, produced in the prostate, adrenal glands, and the scalp, that transforms Testosterone into Dihydrotestosterone (DHT,  “the bad Testosterone”, which influences many aspects of manly behavior, from sex drive to aggression. DHT, which has also been implicated in prostate problems as well as hair loss, attacks the hair follicles at the base of the hair shaft, or at its roots.  There it creates a sticky wax-like substance around the roots and thus constricts their blood supply, preventing the absorption of nutrients, and resulting in withering and falling hair....To compound the problem, two sebaceous glands, one on each side of the hair follicle do not shrink as the follicle does.  These glands continue to pump out about the same amount of Sebum oils, causing the thinning hair to become oilier. When the hair is weakened by DHT, the sebum oils also accumulate and harden inside the follicles and further block normal growth.. (Many shampoos do not thoroughly cleanse the hair follicles of sebum oils or accumulated DHT.) Heredity is often thought to be the cause of male pattern baldness.  Men like to blame women for their baldness, claiming that there is a female gene responsible, that it is always inherited from the female side of the family.  "Genetically, hair loss can come from either parent’s side of the family" ().

  Female pattern baldness is also caused by hormonal imbalance. As the levels of the female hormone estrogen drop after childbirth, a woman's hair may begin to shed. Two or three months after a woman stops taking birth control pills, her hair may also shed, since birth control pills produce hormone changes that mimic pregnancy.  Excess estrogen can also contribute to hair loss because it interferes with zinc absorption which is a contributing factor in hair loss, according to Dr. Michael Biamonte. "Progesterone is a female hormone that is essential for proper thyroid function. As a result, a deficiency of progesterone can lead to or worsen a thyroid problem. A women suffering from hair loss should note if it worsens or only occurs at certain times of the menstrual cycle." (Dr. Michael Biamonte).  Hormonal changes and imbalances can cause temporary hair loss. This could be due to pregnancy, having a baby, discontinuing birth control pills, beginning menopause, or an overactive or underactive thyroid gland. The hair loss may be delayed by three months following a hormonal change, and it'll take another three months for new hair to grow back. During pregnancy, it's normal to have thicker, more luxuriant hair. It's also common to lose more hair than normal about three months after delivery. If a hormonal imbalance is associated with an overproduction of testosterone, there may be a thinning of hair over the crown of the scalp. Correcting hormonal imbalances may stop hair loss" (Mayo Clinic).  "Often these women are also suffering with polycystic ovary syndrome, [a common hormonal problem in women], and sometimes their hair loss is the only obvious sign," says Ricardo Azziz, MD, director of the Center for Androgen-Related Disorders at the Cedars Sinai Medical Center in Los Angeles"(Bouchez).
   

•   Environmental Toxins and Pollutants such as chlorine, inorganic minerals, rancid oils, polluted water, radon gas, benzene, formaldehyde, thallium compounds ( rat poisons), and other chemicals in pesticides, herbicides, fungicides, and cleaning products, and even some shampoos can cause sudden and severe hair loss. Chronic hair loss could be caused by a slow chronic toxicity. The toxins interfere with the nutrients and hormonal substances that help hair growth, and some toxins interfere with the glands or organs that govern these nutrients. They may also damage the hair follicle.  Dirt and sebum plugging the pores in the scalp can also contribute to hair loss.

•   Heavy metal poisoning - lead, cadmium, mercury, iron, aluminum , copper, manganese, chromium, arsenic, and titanium accumulate in the body and contribute to hair loss. "Lithium and selenium toxicity have been well documented as causative agents in hair loss…Toxic metals usually do not appear in a blood test unless the person is suffering with extreme poisoning. However they will show in the hair or finger nails if the person is suffering with slow, long term exposure to the metals. This is the most common type of exposure" (Dr. Michael Biamonte).   These elemental minerals or heavy metals as they are called are toxic if derived from the ground or ocean, because we don't have the ability to absorb them in that form.  But if these minerals are processed by vegetation, such as kelp, they are then absorbable and essential for the proper functioning and health of the body.

•   Stress - Stress and Trauma can cause constriction of blood supply and poor nutrition to the hair and scalp. "During times of extreme stress, the body loses large amounts of vitamins, minerals and protein (in the form of nitrogen) in the urine." This sudden loss of nutrients could be a factor in hair loss. "During times of stress cortisol levels also increase. Cortisol is a hormone produce by the adrenal glands. It has many important functions. However, in excess, I believe that it can trigger hair loss as well as bone loss" (Dr. Michael Biamonte). This condition usually reverses once the trauma is stopped.

•   Diet and life style - Poor diet and nutrition, such as diets high in animal fat, too much animal protein and too little vegetable protein, too much fast food, or quick weight loss diets, as well as mineral deficiencies such as copper, zinc, iron, and according to Dr. David Watts, magnesium deficiency is also commonly found in hair loss.  Vitamin deficiencies such as B vitamins especially Biotin, and essential fatty acids deficiencies can be a contributing cause. According to Dr. Drake, some athletes such as runners are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia These deficiencies can result from many other sources such as coated intestinal tract, poor digestion, chemicals, and stress.  Japanese researchers note that Japanese hair was thick and healthy, with a small gland and little scalp oil, until they began consuming animal fat after World War II. This change has led to increased height and to hair loss.  Problems with greasy hair have often been noted six months to a year prior to when thinning hair becomes noticeable.  Japanese researchers reported a correlation between excessive sebum in the scalp and hair loss. Excessive sebum often accompanying thinning hair is attributed to an enlargement of the sebaceous gland. They believed excessive sebum causes high levels of 5-alpha reductase and pore clogging, which causes malnutrition of the hair root.

•   Sudden weight loss as with "crash diets".

•   Child birth

•   Surgery

•  Severe illness - Large amounts of hair may fall out one to three months after a severe illness. "Hair loss may occur as part of an underlying disease, such as lupus,( anemia), or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated" (familydoctor.org).

•  Skin diseases such as lupus erythematosus, psoriasis, or lichen planus

•  Injury, shock, or severe bleeding

•   Scarring  from trauma such as burns, injury, infections,  psoriasis, tumors, or x-rays, .

•   Excessive cold or heat - "Heating of the scalp from hot sun, hot air, high fever, hot curling irons, or hot combs, or cold air can weaken follicles, resulting in hair thinning and loss" (http://members.aol.com/hammo1/page3.htm).

•   Repetitive traction of the hair by pulling or twisting, over-styling and excessive brushing also can cause hair to fall out if the hair shaft becomes damaged.  "If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia. If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss" (familydoctor.org).

•   Infections - Various infections can cause thinning hair. The yeast living in the intestine is normal in small amounts, but "antibiotics, stress, high sugar diets and other factors can cause this yeast to overgrow out of control" (Dr. Michael Biamonte).  Fungal infections, ring worm, and parasites eat our nutrients, and prevent absorption of vitamins, minerals and proteins necessary for hair growth. 

•   Poor circulation

•   Radiation such as ionizing radiation, nuclear radiation, x-rays, microwave ovens, cell phones, and ultra violet light.

•   Malfunctioning glands and/or organs - A common cause of hair loss is a malfunctioning thyroid. "The thyroid gland produces hormones that help spark our metabolism and keep our body temperature normal. If our body temperature drops even slightly below what it should be, many chemical reactions in the body either stop or slow down. Among these chemical reactions are those involved with hair growth and health" (Dr. Michael Biamonte).  Malfunctioning of the adrenal glands and the pancreas, as in diabetes, can also contribute to hair loss.

•   Poor digestion

•   Drugs and other man-made chemicals - According to dermatologist Dr. Lynn Drake, MD, there are more than 300 medications that can cause hair loss.  The following are some examples of drugs that are known to cause hair loss in some people:

    * Cholesterol-lowering drugs such as clofibrate (Atromis-S) and gemfibrozil (Lopid), ZOCOR
     * Parkinson Medications, :such as levodopa (Dopar, Larodopa)
     * Ulcer drugs,: such as cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid)
     * Anticoagulents, such as Coumarin and Heparin
     * Gout medications, such as Allopurinol (Loporin, Zyloprim).
     * Arthritis medications, such as penicillamine, auranofin (Ridaura), indomethacin (i\Indocin), naproxen (Naprosyn),  sulindac (Clinoril), and methotrexate (Folex)
     * Drugs derived from vitamin-A, such as :isotretinoin (Accutane) and etretinate (Tegison).
     * Excess synthetic Vitamin A  (100,000 IU or more daily over long periods).
     * Anesthesia
     * Anticonvulsants for epilepsy, such as trimethadione (Tridione).
     * Antidepressants:and bi-polar disorder drugs, such as tricyclics and lithium.
     * Diet medications that contain amphetamines.
     * Acne medication such as isotretinoin.
     * Heart medications and Beta blocker drugs for high blood pressure, :such as atenolol (Tenormin), metoprolol  (Lopressor), nadolol (Corgard), propranolol
       (Inderal) and timolol (Blocadren).
     * Birth control pills, or when they are discontinued.
     * Antithyroid agents, such as carbimazole, inorganic Iodine, thiocyanate, thiouracil.
     * Male hormones (anabolic steroids).
     *  Cancer drugs, chemotherapy, and radiation therapy.

 "Chemicals used for dying, tinting, bleaching, straightening or permanent waves can cause hair to become damaged and break off " (Mayo Clinic). Shampoos can also cause hair loss.

What are the medical treatments for hair loss, their effectiveness and their side effects?

•   Rogaine™ uses the drug Minoxidil in a topical solution, with alcohol and propylene glycol.  "Minoxidil was originally developed as a blood pressure medication to dilate blood vessels. If you're lucky, it might slightly treat the symptom of hair loss, however, a major cause, "the harmful DHT is still being produced in the body and is also still getting into the scalp and hair follicles and causing the hair in those susceptible hair follicles to become thinner and shorter throughout their growing cycles." (Hair Genisis).  According to clinical research, Minoxidil does not work effectively or at all on the receding hair line area in the front of the scalp where there is already noticeable hair loss, or on the back area of the scalp, where most men experience pattern hair loss.  The hair it grows is very fine and only on the top of the head, and the hair may fall out again soon after the drug is stopped.  It is a very expensive drug, ... Very little testing has been done on its long –term effects on women.... and may create female problems" (Burton Goldburg Group, p. 925).

  Minoxidil contains as much as 60% rubbing alcohol, a poison that is absorbed into the scalp, blood stream, and brain, and it dries the scalp, and actually weakens and damages the hair shafts themselves, making them dry and brittle, and inhibiting absorption into the hair follicles. The build up of sebum oils also blocks Minoxidil from getting into the follicles and penetrating past the sebum to the hair root where the hair growth begins. Since Minoxidil only dilates the blood vessels, whatever amount eventually does reach the roots does not remove the on-going problem of DHT build-up and the wax-like substance around the roots. 

  Harmful side effects of Rogaine include:
  *  Allergic reaction (allergic rhinitis, difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; and sensitivity, or hives).
  * Irritant or allergic contact dermatitis, eczema, erythema, scaling, pruritus, acne, burning of scalp, inflammation or soreness at root of hair, reddened skin,   itching or skin rash. Sunburn should be avoided while using minoxidil . 
  *  Hair growth in undesirable areas...
  *  Minoxidil can cross the placental barrier and is excreted into breast milk
  *  Headache
  *  Dizziness, faintness, lightheadedness
  *  Edema, salt and water retention
  *  Pericardial effusion
  *  Pericarditis
  *  Tamponade
  *  Cardiovascular problems, chest pain, irregular or very fast heartbeats (tachycardia), and angina  "Despite low levels of systemic absorption topical (2%) minoxidil has been associated with cardiac changes" (Altruis).
  *  Hypertrichosis (excessive hair growth)
  *  Diarrhea, nausea, and vomiting.
  *  Exacerbation of hair loss/alopecia - has been reported early in the treatment. "In some women, hair above the eyebrows and over the cheek bones may become more prominent. This usually disappears after one year even with continued use of minoxidil 2%. If the minoxidil is stopped the extra facial hair usually disappears in one to six months." (www.pharmacy.ca/htfhl.shtml)
  *  :Visual disturbances, including decreased visual acuity, have been reported." (Altruis).

 Signs and symptoms of too much medicine being absorbed into the body include: Blurred vision or other changes in vision, chest pain, decrease of sexual ability or desire, fast or irregular heartbeat, flushing, headache, lightheadedness, numbness or tingling of hands, feet, or face, swelling of face, hands, feet, or lower legs, and rapid weight gain. (keratin.com).

During clinical trials, several (eight) deaths occurred, but none of the deaths were attributed to use of the drug: (Keratin.com)

•   Finasteride (Propecia®) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working" (familydoctor.org).  Finasteride is not approved for use by women. In fact, it poses significant danger to women of childbearing age. If you're a pregnant woman, don't even handle crushed or broken finasteride tablets because absorption of the drug may cause serious birth defects in male fetuses. Harmful side effects could include fast heart rate, headaches, impotence and decreased libido, "bresst tenderness and enlargement, hypersensitivity reactions including rash, puritus, hives,  and swelling of the lips and face; and testicular pain." (PDR p. 2069) .

•  Corticosteroids. Injections of cortisone into the scalp and corticosteroid pills are sometimes prescribe for extensive hair loss due to alopecia areata.  Ointments and creams also can be used, but they may be less effective than injections.  "The administration of corticosteroids alters the metabolism of carbohydrates, proteins, and lipids, as well as affecting almost all other endocrine secretions, salt and water balance, and a large number of enzymatic
  reactions" (Becker).  Most frequent side effects and the most difficult to avoid or manage could include:
   *  Adrenal malfunction, Cushing's Syndrome (moon face)
  *  Weight gain with typical distribution, increased fat pads,
  *  Ruptured blood vessels, bruising
  *  Acne
  *  Excessive hair growth distributed abnormally
  *  hypertension
  *  Activation of peptic ulcers, occasionally with massive hemorrhage
  *  Diabetes
  *  Sodium and fluid, retention
  *  Osteoporosis, fractures
  *  Mental and emotional symptoms
  * Infections, such as fungal, tuberculosis
  *. Acute interstitial pancreatitis
  * Visual problems , such as cataracts, glaucoma, papilledema, keratitis, excessive dilation of the pupil, blurred vision, refractive change, lens opacities, drooping upper eyelid, mycotic abscess of the cornea (Becker).

•   Anthralin (Dritho-Scalp). Available as either a cream or an ointment, anthralin is a synthetic, tarry substance that you apply to your scalp and wash off daily. It's typically used to treat psoriasis, but doctors can prescribe it to treat other skin conditions. Anthralin may stimulate new hair growth for cases of alopecia areata. It may take up to 12 weeks for new hair to appear.  Harmful side effects could include allergic reactions and skin irritation, soreness, spreading of skin leisions (PDR p. 3162).

•   Surgery - Hair transplants and scalp reduction surgery are available to treat androgenetic alopecia when more conservative measures have failed. During transplantation a dermatologist or cosmetic surgeon takes tiny plugs of skin, each containing one to several hairs, from the back or side of your scalp. The plugs are then implanted into the bald sections. Several transplant sessions may be needed, as hereditary hair loss progresses with time.

  Scalp reduction, as the name implies, means decreasing the area of bald skin on your head. Your scalp and the top part of your head may seem to have a snug fit. But the skin can become flexible and stretched enough for some of it to be surgically removed. After hairless scalp is removed, the space is closed with hair-covered scalp. Doctors can also fold hair-bearing skin over an area of bald skin in a scalp reduction technique called a flap. Scalp reduction can be combined with hair transplantation to fashion a natural-looking hairline in those with more extensive hair loss.

  Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring. It will take six to eight months before the quality of the new hair can be properly evaluated. The anesthesia and antibiotics used in surgery can have serious side effects.

  Some anesthetics can “cause increased cerebral-spinal pressure;… a skeletal-muscle hypermetabolic state leading to…malignant hyperthermia;…muscle rigidity, tachycardia, cyanosis, …unstable blood pressure,…hepatic dysfunction; cardiac arrest; hypotension; respiratory arrest; cardiac arrhythmias; hyperpyrexia; shivering; nausea; and emesis” (Physician’s Desk Reference, 1994).  Anesthesia has also been shown to be a cause of fungal infections, which are an underlying cause of most diseases, such as glandular malfunctions, allergies and chemical sensitivities, and cancers.

  Some antibiotics  used after surgery can cause “neurotoxic reactions,… optic nerve dysfunction, peripheral neuritis, arachnoiditis, and encephalopathy….irreversible vestibular damage is particularly high in patients treated with streptomycin., …ototoxicity: Both vestibular and auditory dysfunction can follow the administration of streptomycin… Vestibular damage is heralded by headache, nausea, vomiting, and disequilibrium… early discontinuance of the drug may permit recovery prior to irreversible damage to the sensorineural cells… may cause allergic type reactions including anaphylactic symptoms and life-threatening asthma… can cause fetal harm… The following reactions are common: vestibular ototoxicity (nausea, vomiting, and vertigo); paresthesia of face; rash; fever; urticaria (hives); angioneurotiv edema; and eosinophilia. . Less frequent: cochlear ototoxicity (deafness); exfoliative dermatitis; anaphylaxis; azotemia; leukopenia; thrombocytopenia; pancytopenia; hemolytic anemia; muscular weakness; and amblyopia” (Physician’s Desk Reference, 1994).  Antibiotics also are a cause of fungal infection which is a common cause of cancer.

Confirm the cause of your hair loss and review all treatment options, including nonsurgical ones, before proceeding with plans for surgery.

•   Wigs and hairpieces
  If you would like an alternative to medical treatment for your baldness or if you don't respond to treatment, you may want to consider wearing a wig or hairpiece. They can be used to cover either permanent or temporary hair loss. Quality, natural-looking wigs and hairpieces are available" (Mayo Clinic).

What are the alternative methods to reduce hair loss and restore hair?

•   EXERCISE, deep breathing, and lying on a slant board 15 minutes a day to get blood to the scalp. Massage scalp regularly.

•   A Wellness Consultation with Laurie Lynch, N.D. will provide information on how to eliminate your specific root causes of hail loss, and show you what foods, herbs, and nutritional supplements, shampoos, and rinses can help the body to regain health and regenerate new hair.  Call  Dr. Lynch at The Living Well Health & Education Center, (910) 426-515.

"Many times improvements can occur in just a few weeks, so there is hope!" (Dr. Michael Biamonte).

References:
*  The Burton Goldburg Group, Alternative Medicine, Future Medicine Publishing, Inc, Puyallup, Washington, 1994
*  American Academy of Family Physicians, 2000-2008,  http://familydoctor.org/online/famdocen/home/men/general/081.html
*  Physician’s Desk Reference, 1994
*  Durk Pearson and Sandy Shaw, Life Extension, Warner Books, New York, NY, 1982
•    James F. Balch, MD, Prescription for Nutritional Healing, Avery Publishing Group
*   Dr. Mary Sheen, Fighting Hair Loss, Clearbrook, Inc.
*   Hair Loss - Conditions and Causes, 2002, Sunset Marketing, Hair Vitamins.net 
*  http://www.mayoclinic.com/health/hair-loss/DS00278/DSECTION=causes
*   The Nemours Foundation, 2001, http://kidshealth.org/teen/diseases_conditions/skin/hair_loss_p6.html
*   (http://www.health-library.com/library/health/part7.htm)
*   (http://www.minoxidilshop.com/comdrugthatc.html)
*   Michael Biamonte, ND
*  Colette Bouchez, Women and Hair Loss: The Causes, WebMD, http://www.webmd.com/skin-problems-and-treatments/hair-loss/features/women-
hair-loss-causes
*  http://www.hairlosslearningcenter.org/content/cures/hairloss.asp
*  http://www.london-centre-trichology.co.uk/male-hair-loss.asp  
*  (Altruis Biomedical Network: http://www.e-minoxidil.com)
* (http://www.keratin.com/ac/baldnesstreatments/minoxidil/003minoxidilsideeffects.shtml
*  RXlist, http://www.rxlist.com/frame/display.cgi?drug=ROGAINE
*  New Hope Natural Media Online, http://www.newhope.com/news.cfm?news=1172
*  Bernard Becker, The Side Effects of Corticosteroids
 

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