vitamin D Deficiency and Hair Loss

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Vitamin D deficiency has become a common problem these days. Many people suffer from vitamin D deficiency due to lack of exposure to sunlight or poor intake of foods rich in vitamin D. This can lead to hair loss and other health issues. What exactly is vitamin D deficiency and why does it affect our hair?

Vitamin D is a fat-soluble vitamin found naturally in animal food such as fish liver oil, egg yolk, milk, cheese, meat, butter, etc. The recommended daily allowance (RDA) of vitamin D is 600 IU per day.

Vitamin D helps regulate calcium metabolism and bone growth. It also plays an important role in maintaining normal immune system function. In addition, it helps prevent cancer, cardiovascular disease, diabetes, depression, arthritis, multiple sclerosis, and some types of dementia.
The most obvious symptom of vitamin D deficiency is dry skin and nails. Other symptoms include muscle weakness, fatigue, weight gain, brittle bones, and increased risk for infections.
There are many reasons that can lead to vitamin D deficiency. These include:

  1. Lack of sun exposure
  2. Poor diet
  3. Age
  4. Skin pigmentation
  5. Use of sunscreen
  6. Certain medications
  7. Liver or kidney disorders
  8. Malabsorption syndromes
  9. Chronic diseases like Crohn’s disease, celiac disease, inflammatory bowel disease, rheumatoid arthritis, lupus

With regards to Vitamin D deficiency and hair loss, Sharon Keene, MD, FISHRS and ISHRS Past President, presents a case report in an article published in ISHRS Hair Transplant Forum that suggests a correlation. The case is about a 41-year-old male patient who presented for a virtual consultation to see if he would be eligible for surgical treatment of his patterned hair loss. He had experienced hair thinning since the age of 22, and he had a family history of advanced pattern androgenetic alopecia (AGA), maternal uncle Class VI pattern). On review of the patient’s photos, he, too, was observed to have a Class V-VI pattern of hair thinning and hair loss. 

Figure 1: Thinning coverage (left) and top view class V pattern (right)
with early therapy of vitamin D deficiency. | Photo credit: Sharon Keene, MD, FISHRS

He had not tried either topical minoxidil or oral finasteride, and he stated his pattern had been stable for 2 years. His past medical history was remarkable for a diagnosis only 6 weeks earlier of severe vitamin D deficiency with a serum 25(OH) vitamin D value of 12ng/ml. He had nearly completed a 6-week course of weekly dosing of 50,000 IU vitamin D3, to be followed by 10,000 IU/week for 8 months.

Six months later follow-up photos were remarkable for significant regrowth of frontal hairs (Figure 2). Because he had agreed to begin medical therapy for AGA, it was assumed the regrowth was a response to the medications. Surprisingly, the patient reported that he had decided not to take either finasteride or topical minoxidil and that he had only continued with the vitamin D3 supplements.

Read the full report here which includes clinical practice guidelines from the The Endocrine Society and Harvard VITAL study.

Figure 2: Six months after starting vitamin D supplements treatment, front
and side views. | Photo credit: Sharon Keene, MD, FISHRS

He had satisfactory growth from hair transplantation to the vertex area, and one year later he maintained excellent frontal coverage based solely on correction of vitamin D deficiency and
has had no further androgenetic alopecia(AGA) progression to date. (Figure 3)

Figure 3: Regrowth at 1 year, front and side views. | Photo credit: Sharon Keene, MD, FISHRS

Additionally, Dr. Keene presents a review of the medical literature regarding hair loss associated with vitamin D deficiency that resolved with supplementation revealed two prior published case reports. In all three case reports, hair regrowth was associated with supplementation of vitamin D in the absence of other medical or surgical interventions.

Dr. Keene also examines the role of vitamin D receptor hair growth. Although comprehensive research on the direct link between vitamin D deficiency and hair loss in androgenetic alopecia remains incomplete, she discusses what is known so that you can consider supplementation as a potential medical treatment for hair loss in patients where vitamin D deficiency is identified. It is followed by a discussion of the relevant literature regarding the important role that vitamin D can play in hair health.

Other key points of the article include:

  • Multiple Non-Skeletal Functions of Vitamin D
  • Diagnosis & Treatment of Vitamin D Deficiency
  • Avoiding Hypervitaminosis D

In conclusion, Dr. Keene now routinely advises patients to check for and treat vitamin D deficiency along with any other recommended hair loss therapies she suggests after a hair loss evaluation. She states that the question remains to what degree vitamin D deficiency is a direct cause of hair loss or whether it has an impact in a myriad of other genetic regulatory influences.

Regardless of whether the impact of vitamin D deficiency is a direct or indirect contributing factor for hair loss, Dr. Keene states that the solution for most patients who are vitamin D deficient is simple enough: oral supplements with vitamin D3 to achieve and maintain a serum level of 25(OH) vitamin D between 40-100ng/ml (the lower limit reflecting the average serum levels in the VITAL treatment group after 1 year) with periodic blood sampling to assure against overzealous supplementation and hypervitaminosis D.

Article Reference:

Author: Sharon Keene, MD, FISHRS

Article: “Vitamin D Deficiency and Hair Loss: A Case Report and Review of the Literature for Diagnosis and Treatment”
Publication: Hair Transplant Forum International
Issue:  July/August 2022
Open access link:  https://www.ishrs-htforum.org/content/32/4/113

View Dr. Sharon Keene’s Bio: https://ishrs.org/doctor/37855/

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