How to Regrow Hair | Podcast #243

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A large population in our community worries about hair loss. This type of problem is common. Some may think of the products that they use contributes to their hair fall, but Dr. Justin and Evan Brand thinks it’s more of a side effect, especially when you are unhealthy on the inside.

Listen and read this podcast as Dr. Justin Marchegiani and Evan Brand laid out information on how we can prevent hair loss on the functional medicine side.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

01:21 Medications contributing to Hair Loss

10:03 Healthy diet, organic foods

22:07 Nutrient supplements

30:13 Hair Supplements

39:53 Hair Transplants


Dr. Justin Marchegiani: And we are live. It's Dr. J here in the house. We have Evan Brand here as well. Today's going to be an exciting topic — we're going to be chatting about hair loss and how to naturally regrow your hair so, really excited about this topic. Evan how are you doing today.

Evan Brand: I'm doing pretty well we were just taken through some research before we jumped on here and it turns out there's a lot of stuff that people are doing that's contributing to their hair loss. And then people go to their doctor and the doctors don't know the stuff that we're about to tell you. Like all these different medications that we found that have been linked to hair loss and tons of people like the vast majority of Americans are on one or multiple of these different medications. So why don't we just start there– talking about drugs because people love drugs, Americans like the land of pharmaceuticals compared to other countries. So why don't we go down this list real quick of any medication that could be contributing to your hair thinning or hair loss.

Dr. Justin Marchegiani: Yeah that's definitely the low hanging fruit because if you're on a medication we already know the side effects are already documented. It's not really that controversial. It just may not be talked about so let's bring that to the forefront. Go ahead.

Evan Brand: All right. So I'm just gonna run through the list here and if you want to go further into these we can. But acne medications, antibiotics, antidepressants, antifungal medications, blood thinners, chemotherapy of course, cholesterol lowering medications ,epilepsy medications, high blood pressure medications, hormone replacement therapy, immunosuppressants, interference, mood stabilizers, insane oral contraceptives, Parkinson's disease medications, steroids thyroid medications. That's basically every drug that people use. I mean that's like all of them. So if you're on any of those and you have hair loss and you're complaining about your hair loss that's the first place to start.

Dr. Justin Marchegiani: 100 percent 100 percent. So let's kind of just dive in and just talk about a couple of simple mechanisms that could be at the root because we have foundational things that can be done and then we have more nuance thing. So it's like when you build a house you know you may not be worried about picking out the crown molding and the fancy tile that you're going to use in your master bedroom when we haven't even laid out the foundation yet. So let's start at the foundational principles. So first thing is going to be just generally inflammation. Why is inflammation. What's that. Why is inflammation important. So when we have excess inflammation that's gonna cause ourselves and our tissue to breakdown fashion than we build up. That's big. And the big vectors of inflammation are going to come from physical sources, chemical sources, and emotional sources, and all of these stressors interplay on our hormones, on our gut, on our immune system. And then of course if we're driving inflammation the nutritional means nutritional kind of fits into that chemical category. Chemical could be heavy metals mold it could be inflammatory foods like gluten and refined sugar, could be hormonal imbalances female thyroid, it could be autoimmune issues like he got gluten sensitivity so a lot of things kind of fit into that chemical stressor bucket. Of course the emotional stress is a big thing, a lot of people have had experiences with like maybe you know death of a loved one and you start losing hair and there's that or you're over exercising right you see it women they over exercise they may lose their period their hair starts thinning they start getting colder. So a lot of those symptoms are common on the emotional side, common on the physical side. We're gonna go into the more nuanced chemical stress, so of course if we're not getting enough nutrition to build our hair that's numero uno, so essential fatty acids right, healthy amino acids, these fat soluble vitamins– vitamin A, selenium zinc, magnesium, these are important biotin or B7 right. These are very important building block nutrients. So the first thing is if we're eating kind of a paleo template it's automatically going to be nutrient dense low and toxin and anti inflammatory. We may adjust the macronutrients protein fat and carbs according to what you need. But every bite of food is going to be anti inflammatory nutrient dense and low in toxins and low in toxins and being organic you're not getting pesticides, you're not getting roundup glyphosate, remember glyphosate is a chemical cue later so it'll pull out the zinc, it'll pull out important minerals selenium, that are important for hair growth, the catalysts enzyme is really important for hair growth and hair color and that's a glutathione based enzyme and we need selenium for glutathione and if you're eating your plants that are grown in depleted soils because of pesticides and roundup that can easily deplete some of these nutrients. So just highlighting the nutrients is going to be healthy proteins, healthy fats, vitamin A, fat soluble vitamins, your selenium, your zinc, very important for hair, and also skin and nails tend to connect with that and then the next thing I would say is OK great you're eating these things now we have to be able to digest them we have to have enough hydrochloric acid and enzymes and enough gut integrity to be able to break everything down so that's kind of foundation. I'll let you comment.

Evan Brand: Yeah, you may need to go more straight to a diet we may need to go more autoimmune paleo if this is like an alopecia type situation where you've had maybe a family history of immune system issues ,but when you have alopecia you know you could potentially lose everything. I mean you could literally be your eyebrows, your eyelashes. I mean every hair on your body could disappear. So if you're in that bad of shape and we've had those alopecia cases before, we got to go with an autoimmune paleo template. I'm so glad you brought up the point about glyphosate being a key later. I don't think many people discuss the fact that it's pulling minerals out. That's, that's huge because you could be on a paleo diet but if you're still getting exposed to a lot of chemical toxins like let's say, you do like some meal prep surface and they do sweet potatoes and strawberries and those are not organic but they're still quote paleo because they're real food. The average sweet potato has 20 plus pesticides, the average strawberry 22 pesticides and herbicides in it. And so you're actually doing more damage to yourself by doing those foods even though it's called real food if it's chemical it's just not worth it. So really really really focus on organic. This is key. I looked at the price difference. People complain, Oh you got to be rich eat organic at Whole Foods. I've seen a pound of strawberries for two ninety nine which is chemical conventional garbage. Organic was three ninety nine for the same size it was one dollar or more. And that extra dollar is going to provide you more nutrient density more trace minerals. You're not going to be getting genetically modified things and you're saving your gut because we know that glyphosate is damaging your gut bacteria too. So you and I are going to talk about that today. You're already giving us the preface talking about stomach acid levels. If you're damaging your gut bacteria by consuming pesticide foods. Now you have bacterial overgrowth and that bacterial overgrowth prevents you from digesting your food and then you don't have enough of those raw nutrients to build your hair. So the whole domino effect can fall apart just by you not doing enough organic, which sounds crazy but it's true.

Dr. Justin Marchegiani: One hundred percent and just get off the bat. I was a poor doctoral student for a long time being in school in San Francisco California which is obviously one of the most expensive places to live. I think I was living on like fifteen or sixteen thousand dollars a year for financial aid which anyone knows the poverty level. Francisco is like 80 grand a year. I was like living maybe six or seven times below the poverty level and I just had a really strict budget. So I had a budget. I would spend seventy five to eighty dollars a week on food and I would get a lot of my vegetables would be frozen organic. I would do some fresh spinach or fresh leafy greens that were organic. That you know five dollars you get a big thing and then a lot of my meats I would just do free range or grass. I was a little bit too expensive but I could do something at four or five dollars a pound. And because Amazon's bought whole foods, some of their grass fed meat is under that price now. So you're actually have better quality now. I would do a lot of chicken thighs which would be very helpful. I would do a lot of skipjack tuna which is pretty good because the sledding to Mercury ratio and that's really good. And then I would do more free range eggs. I wouldn't quite get organic so if you don't, if you're not all the way on the organic try to at least be hormone free antibiotic free, if you can't quite get the pasture fed grass fed. So there is an in-between. It's not an all or nothing. So do your best just to make sure the foods are nutrient dense and anti inflammatory and then try to see if we can at least get an in-between quality. Maybe you go organic on the frozen vegetables, you get some fresh vegetables that are organic. You do some fish. You try to get some wild Alaskan sockeye frozen maybe go to Costco to get some stuff there and then try to choose chicken thighs skin on over like a breast or any of the more expensive cuts you know stay away from the big steaks, ribeye filet, those things but you can at least do ground meat. You can at least do tuna fish, you can at least do a chicken thighs skin on those are really good starting points and I've done it. I did that for four or five years so I understand it and I hope it helps.

Evan Brand: And people go to Hardy's and they'll go get like a double cheeseburger with fries and a large coke and it's like seven ninety nine. So you take two people going to get a fast food meal that's six. That's 16 bucks. You could go to Whole Foods and you get an already cooked organic rotisserie chicken for eight or nine dollars and let's say you buy at the salad bar you get like a cup full of organic blueberries, that's maybe a buck or two and then maybe you buy a bag of like Seattle cassava chips for like four bucks, your total meals like sixteen dollars for two people and the food nutrient density was way better than the hardy seven ninety nine double cheeseburger with fries and a large Coke.

Dr. Justin Marchegiani: Hundred percent. My goal when I was a poor doctoral student was always to get my meal below five dollars total if I could get it under five. Then I am doing better than going to a fast food restaurant right. That's kind of where I was at. Plus I'm getting a lot better nutrition. So just kind of people out there that are struggling with that just make it a priority. It's got to be a priority number one, you've got to see the value in at, number two junk foods artificially cheap because our government subsidizes soy and corn and wheat. So it's artificially cheap or you're not really paying the real cost of it. And then number three is we got to look at what we're eating as the quality components are really important. You can't just eat it and think it's good the quality has to be there too. So that's the food component. Next let's dive into hormones. So hormones are vitally important. So the first thing is if we consume too much carbs or too much refined sugar, insulin resistance is going to be a key key problem with hair issues. So one of the first things insulin is going to do is you're going to be depleting more minerals that run your energy cycle as your Krebs cycle, your mitochondria when your blood sugar is higher. Is that Krebs cycle then has to run and it requires amino acids magnesium minerals to help run it. So that's number one. So you're going to deplete a lot of those nutrients when you eat more sugar. So then it's like using a credit card. But you don't pay the bill so then your next month's bills higher because of the interest get to pay. It's kind of like that. And so when you have a high levels of insulin certain enzymes are going to be up regulated. As a guy you're going to regulate an enzyme called aromatase, that enzyme will cause problems with your testosterone having it convert downstream to estrogen and when estrogen goes downstream you start to up regulate enzymes called the Five Alpha Dihydrotestosterone, so the five Alpha reductase is the enzyme, and that the enzyme is important from testosterone going to the source around to die. Hydro testosterone so, dihydrotestosterone is the stronger testosterone. And that can is associated with causing hair loss. That's what a lot of these medications the finasteride. They block that enzyme five Alpha reductase and they block it. Now there are natural things that block it. Two really important ones are zinc and selenium also are natural five Alpha reductase inhibitors. So what happens is this here's the mechanism: we have high levels of insulin, too much carbs, too much sugar the high level of insulin starts to upregulate aromatase, aromatase causes testosterone to start going to estrogen, as testosterone goes to estrogen. Testosterone starts to drop and our body starts freaking out and it makes this stronger testosterone called Dihydrotestosterone DHT for short, DHT starts going up and the enzyme that goes from testosterone to DHT is the five Alpha reductase enzyme and as your diet becomes poor and nutrients drop the minerals that help regulate that enzyme selenium and zinc start going low which starts to increase a DHT more. So you can see low selenium, low zinc, more right more dihydrotestosterone as those minerals are the break that prevents that DHT or from going up and that DHT is associated with decreasing blood flow to the hair follicles. So insulin is a big big component with raising DHT, raising estrogen in men and lowering testosterone so that's one component there. You're also going to see it in women as well. You'll see it with testosterone you're actually gonna see different things. You'll see ovarian cysts start to form in women, and you'll start seeing more hair growth and you can start seeing hair loss on the head, when you start having excess cortisol surges especially in women and men you can start losing hair there as well. So you can see it with high cortisol. You can see it with high insulin, and then high insulin in women increases testosterone, high insulin in men decreases testosterone and increases DHT. So it's a little bit switch for men and women. So I know it's hard to kind of wrap your head around that. You may have to listen to it twice. So I'll say it one more time. Women– high levels of insulin, increase testosterone increase cortisol, hair loss from the high cortisol. Men increase insulin, you're going to have increase in aromatase, aromatase is going to decrease testosterone, increase estrogen and then DHT, the stronger testosterone starts to go up that pinches blood flow off to the hair follicles. Hair loss, that's one major mechanism.

Evan Brand: Well said that was very very clear. Crazy how you would think oh this high fructose corn syrup soda. You know this is bad because it's sugar but you don't think wow I could be messing up my hair by drinking a soda. And so when we talk about herbs we'll get into that soon. I do want to hit on the gut though are you ready to talk about the gut.

Dr. Justin Marchegiani: Let's do it. Let's hit it.

Evan Brand: OK. So I'll go on a little bit of a rant about the gut just because I've seen so many cool things happen with men and women that have had hair loss issues. You mentioned earlier it was connected to the skin into the nails too, which is huge because that was an indicator that my gut was messed up or my fingernails.

Dr. Justin Marchegiani: Correct.

Evan Brand: Oh you can look at your fingernails if you're seeing vertical ridges vertical lines. You've got real brittle nails the quality of your nails is not good. You've got skin issues then you probably have gut issues. And so obviously if you're working with us one on one we would be doing functional testing on you to look at your urine and look at your stool to investigate and find rule in or rule out various infections that are affecting digestion like H Pylori, which reduces stomach acid then your food doesn't digest then you can't get these nutrients adjusters talking about to fuel these pathways for optimal hair growth, then you got other bacterial overgrowth, you've got Candida, you've got parasites, you've got worms, all these issues in the gut can totally affect digestion which long story short affects the hair. So you've got to get the data and don't just guess. Don't just go and take like olive leaf because you read olive leaves good for candida or […]. Yeah those are cool but you want to know what you're up against for, so we really like you to get the data because you could go and take a probiotic and feel worse and don't know why you say, oh I heard probiotics are good for my gut. You said the gut is why I'm having hair loss. It's not that easy. You, you might find that probiotics make you worse you may get bloated or you may feel bad. So get your functional medicine testing done first and then you can make the order of operations. Well I've got these infections so first I need to work on getting rid of bad guys before I go into doing probiotic replenishment later. So that's really all I have to say about the gut is that it's huge. But you have to get the data because if you don't know what you're up against we literally can't just say, here's a supplement for your gut like aloe vera extract. Yeah. Maybe that reduces inflammation in the gut but it's not root cause.

Dr. Justin Marchegiani: One hundred percent. All of the important nutrients that we talked about from a dietary perspective and how the nutrient density and also the food quality affects the nutrient density, that is important but above and beyond we have to be able to digest that. So if we're not breaking it down digesting assimilating absorbing and utilizing then that just everything goes well from there. So one hundred percent. We talked about the hormone issues now in women. If we start going more into menopause late 40s early 50s estrogen and progesterone start dropping that can definitely influence hair as well. We start to see more skin dryness, hair quality. Those type of like connective tissue things start to decrease as women go into menopause. We see more wrinkles increase. We see more libido issues. And then of course the hair is going to be part of that connective tissue cascade. So we have to make sure if we're going into menopause we're supporting the adrenals and we're supporting those hormone pathways to to a place of balance. So that's going to be different for every person. So if you're a female and that you know, late 40s early 50s and that's happening to you or even if you're postmenopausal in your 50s 60s or 70s, you really want to find a good functional medicine doctor that can work on your hormone balance. But it's really important that you'll look at the adrenals, because as those ovaries start to drop those follicles start getting depleted, your adrenal is are going to be utilized a lot more to fill in the gap where those hormones from the ovaries are not. So that's really important is the adrenal is the second thing and this affects men and women equally. But women five times more is going to be thyroid issues. So low thyroid or hypothyroid or Hashimoto's which is an autoimmune attack on the thyroid that causes Lothar what function is important cause we know thyroid hormone is really important for follicle growth and if you don't have enough thyroid hormone, we're not going to have that that milieu you to cause healthy follicles to grow. And that can cause hair loss too. You may also see eyebrow thinning which is a patented low thyroid symptom so outer third of the eyebrow thinning you may also see cold hands, cold feet, constipation, mood issues, depression anxiety. So typically there's not just hair as being an isolated symptom you're going to have hair issues and a whole bunch of other cascade of symptoms as well. So thyroid is really important. Now it may be as simple as getting on a bioidentical thyroid support and that can fix it. Most thyroid issues are autoimmune so typically you're going to have to fix the autoimmune attack and we may use certain herbs and nutrients and diet changes like an autoimmune template, we may use natural anti inflammatory compounds to help modulate the immune system like curcumin or glutathione, the enzymes that are really important for hair growth and hair color are catalysts enzymes, and these enzymes are strongly connected to glutathione. And it's interesting because selenium is a really powerful glutathione building block but solarium is also really important for hair color and hair growth but it's also really important for thyroid conversion and it's also really important for helping to decrease thyroid inflammation when this autoimmunity. So it's amazing how so many of these things kind of dovetail and a lot of people are taking synthetic thyroid medications which Even mentioned have side effects of hair loss. So the first thing is look at those medications. Number two, if you're on a conventional thyroid medication, you really want to look at the full hormone cascade,TSH T4 T4 free, T3 free, reverse T3 TPL thyroid glob an antibiotic you may even want to throw in T4 total and T 3 total as well, because you may not be converting T 4 to T3. You still may have very high amount of antibodies you may have high amount of reverse T 3 which tells me there's adrenal stress. So there could be other things in this whole cascade and you really want to zoom out and get a complete picture and we may need to have a natural thyroid support that actually has T3 in it that can help.

Evan Brand: I mean I've seen that where women have switched over from like a centroid over to sometimes just a Cytomel, just a straight T3 and sometimes that's enough or we get them over to like essella that can NP thyroid nature throid. There's a couple that you and I've used like thyroid gold which is a desiccated thyroid and I've heard massive massive improvements on that just based on that. Also anemia you know that's kind of a low hanging fruit that we haven't mentioned. Why don't we talk about anemia real quick just because a lot of women that have come to us have had different issues with their menstrual cycle, maybe they're heavy bleeders or they're having long cycles and if these women are now postmenopausal, they don't have a cycle anymore all the terrible hormone issues they had, they didn't just magically disappear just because they don't have a cycle those lasting effects of anemia is could still be a big factor.

Dr. Justin Marchegiani: One hundred percent. So when we talk about various things or nutrients I don't want you to just think of the nutrient and say just take it. I want you to go upstream and think about the mechanism because the nutrient being helpful or not that's downstream. Right. The root cause and the mechanism is upstream. So iron is really important why. Because iron binds the hemoglobin to help you carry oxygen. Why is oxygen important. Well because oxygen helps with a robust metabolism. And part of the reason why let's say DHT is harmful for men is because DHT can decrease blood flow to the hair follicles. What happens when there's decreased blood flow, decreased oxygen, so you can see how some of these mechanisms when you look at Iron, low iron especially in women, why women. Because women can menstruate, guys don't, when they menstruate they had their periods they lose blood there. So if your estrogen dominant and you're losing a lot of blood there's another hormonal mechanism, you lose a lot of blood. You have low iron low iron. Not enough healthy oxygen carrying capacity, not enough healthy oxygen capacity going to the hair follicle, not that's important for healthy hair generation. Right you choke out the hair. You don't give it enough blood flow and oxygen. It's going to die. Right. So there's that mechanism, two is we could be vegan or vegetarian and not getting enough high quality heme based iron. Right. We can't just base it off of spinach. We actually even though spend it behind our and we need actual animal products to get good quality iron in there, and the number three there could be a lot of malabsorption. So I see a lot of patients who have a lot of gut inflammation. It could be autoimmune where there's irritable bowel disease like Crohn's or all sort of colitis. It could be something in between where there's a gluten sensitivity issue, or some kind of an IBS or some kind of just low grade gastritis or gut inflammation and they're not breaking down the nutrition is adequate and then they're not getting enough of their animal products broken down. So those are the three big mechanism when it comes to iron. Yes. So when we do blood work, we would want to look at a marker called ferritin. It's an iron storage protein. When women start to get down to like a 20 or 30 with ferritin, number one there's going to be a lot of hair loss. But number two these women may complain that they can't catch their breath like they'll go up a flight of stairs and they're just like, oh I can't breathe like I can't catch their breath. And that's exactly what you talked about. There's just it's it's a starvation you're starving from not enough oxygen. So when we really want to get to optimal hair growth levels, the ferritin usually going to be somewhere like 90 and I believe it's like in G nanograms over deciliter NG over DL. I believe that's the normal reference range either way regardless of whether you're in U.S. or somewhere else and uses a different reference range you want to be on the upper end of the reference range for ferritin and you don't want to be just at the low end and the doctor is going to miss that they may look at ferritin, 30 is fine but 30 is not optimal.

Dr. Justin Marchegiani: Yeah at least 30 ideally above 40. You may want to look at Iron served to make sure it's more mid reference range. We also want to look at Iron saturation make sure it's at least twenty five. We can also look at TIBC and UIBC binding proteins those actually go high when iron goes low. So somewhat in the middle high doesn't mean necessarily good when it comes to those binding proteins because they're kind of on the reverse side. So that's really important. But again we want to look at the root cause and vegans and vegetarians definitely are going to have a harder time with that. If it's really important that you be vegan and vegetarian. Well I would I would advise having some level of protein in there or protein at least maybe the liver capsules if you could if you can wrap your head around doing liver capsules there are some vegan vegetarian iron sources that are decent ones called Flora vital or Floradix. It's a German herbal product that's been around for about 100 years. Flora vital is the gluten free source of that. So if that's really important that you maintain a vegan status or vegetarians that if that's at least one good option I always try to at least push for at least deliver capsules. Hey you're not tasting it maybe you can wrap your head around it. That's a good source right there off the bat.

Evan Brand: Good idea. Good idea. I'm glad you're putting solutions because I like to make fun of vegans and say hey what you're doing is not sustainable quit doing it. But I like that you put in a sustainable idea.

Dr. Justin Marchegiani: Yeah. I mean hey it's like I'm real it like my first goal was getting you a result. That's number one. So if you're fully onboard with what I'm saying or you still want to be on board is there a middle kind of road. Right. So that's the least the middle of the road thing. The second thing we already highlighted in some of these things there's gonna be tips here that people listening can just do on their own. That's great. And there's gonna be some tips that you're going to really need a good skill a practitioner like looking at the gut. Making sure there's no infections like Candida or H Pylori that could be affecting absorption. Also looking at gut permeability you're looking at parasitic infections that could be creating more gut stress. Right. Making sure these nutrients are being absorbed we may run nutrient panels whether it's an iron panel or a neutral eval or spectrocell. We may see some of these intracellular nutrients are very low. We may want to support them as well. Right. But we're going to support them in conjunction with, Hey why are we low to begin with. Is this just a poor diet thing is it a hormone thing is it a good thing. So we may use palliative support with the focus still being on the upstream root cause.

Evan Brand: Make sense and there's different multivitamins like for the hair skin nails that we can use, we could throw in collagen peptides, we could throw in like sol palmetto which helps to block DHT, you could throw in like pumpkin seeds. I've read pumpkin seeds can help with the DHT by blocking the binding sites. Fish oil could be a good and antiinflammatory adaptogenic herb supporting adrenal is like we talked about, aloe for reducing inflammation in your gut. Zinc you mentioned that selenium so there are supplements you can throw in but I just want to point out that this whole way of thinking which hopefully you all are adopting this by listening to Justin and I over and over and over again, which is the fact that you're going to find a symptom or a complaint like hair loss. OK so you'll come to us and you'll say, oh my my I want to lose weight and I'm losing too much hair, like very I'm not going to say they're vain but I'm going to say they're very like vanity based. Like OK you really care about your hair and you care about your weight. But then after we do all the diagnostics and we pull all these labs out and put them in front of you, we're actually showing you, hey look really what you should care about is look at your mitochondrial function, it's not good. Look at your gut inflammation it's really high. Look at your nutrient absorption, we're assuming it's low based on how low you are in these amino acids, look at your neurotransmitters, your brain chemistry is burned out. Are you sure that you're not eating a chocolate bar every day. Oh yeah I am I craved chocolate at all the time. OK so your endorphins are burned out and your adrenal hormones look like this and your vitamin D too low and you've got anemia and you've got high insulin and your A1 sea levels too high and you've got this parasite and you've got this bacterial overgrowth. Now you have some candida too, and oh look you're deficient all these trace minerals and you've got some thyroid antibodies. So when we really pull all that other stuff out it's like OK here's what you should really care about, and you have to fix all this to work to fix that one goal of, Hey I'm losing too much hair and I want to lose 10 pounds. So I just it's, it's a whole ‘nother way of thinking but it is like the best way to approach these issues.

Dr. Justin Marchegiani: Exactly. I want people to walk away from our podcast not with just random factoids but with a new perspective on how to think if I can get people to think better when they come to a conclusion or an understanding of something they're going to be able to understand how they got there what the mechanism is when you understand the mechanism. You don't ever you know, you don't forget it's locked. Right. You understand a concept versus memorizing a fact the concept sticks forever. So that's really important. So let's go look at one. There's a common sentiment out there. It's called Nutrafol. I want to break people kind of mindset down so they can understand why that product may work.

Evan Brand: What is it how do you spell this.

Dr. Justin Marchegiani: N U T R A F O L Now I've seen it help some patients I've seen it not. We use a lot of these ingredients even in our supplements already. So if you're a patient working with me we typically use a lot of these nutrients anyway in different formulas that we have. But here's just one product. Let me walk you to the thinking. So the first ingredient is tocotrienols. What's that. That's Vitamin E right. Where does Vitamin E fit in, vitamin D a fat soluble vitamin. So we already talked about how fat soluble vitamins actually vitamin A D E and K which you're gonna get in healthy animal products is gonna be very helpful. We may supplement it as well it's in my multi support packets. We have a full spectrum to cover all complex in there. So vitamin E is important. Next one, ashwagandha. Why is that important. Well if you remember the hormonal mechanism we talked about earlier cortisol in stress is really important. Ashwagandha has various glycoloids which help with the HP axis the pituitary adrenal feedback loop to the adrenal. And it can help kind of curtail high amounts of cortisol. It can help curtail stress perception the less you perceive stress, the less stress hormone you make the more you feel relaxed etc. It's a self-defeating cycle. So ashwagandha can help break that up. Third is curcumin. Why Curcumin. We talked about curcumin is a natural anti inflammatory. Earlier we mentioned how inflammation does what it decreases blood flow. So when we decreases inflammation we can help improve blood flow and we can help improve oxygenation. Next sol palmetto. Why sol palmetto important? Remember earlier we talked about blood sugar and we talked about high amounts of insulin upregulate aromatase, aromatase in men. It's going to decrease testosterone increase estrogen and then it increases this hormone called DHT Di hydro testosterone that inhibitor that enzyme that goes from testosterone the DHT that's five Alpha reductase that enzyme is going to be downregulated with sol palmetto. So sol palmetto is a five Alpha reductase inhibitor. It's a little bit more gentle than like a lot of the finasterides, right finasterides can decrease that enzyme as well but there's also a lot of symptoms associated with that. So like Rogaine minoxidil, flowmax a lot of these are like finasterides and they can decrease that enzyme. But there's also you can just google post finasteride syndrome. So there is some of those medications we got to be careful of. All right. Next is gonna be Marine Collagen and me back up. So Sacramento's a five Alpha reductase inhibitor. Great. So is zinc so with selenium. Right. So there's other nutrients that can be used outside of supplements to down regulate that enzyme. Fifth is collagen and I use collagen and all the time college is really important. I have a product called true collagen and why do I like it. We don't get enough connective tissue amino acids in our diet active tissues are bone broth right. Most people aren't making foods where they're putting the all the bones everything in there. And when you do an eye soup you can extract a lot of those amino acids people that aren't drinking bone broth may not get enough good collagen amino acids these collagen amino acids are more connective tissue base and they're going to have a lot of building blocks for good quality hair integrity. So just kind of walking people through my thinking. Most people see this supplement and they're just like OK great. Now you understand the deeper thinking so I think these are some good things that can be used. I would also add bites into that. I would also add things like horse tail I would add in zinc I would add selenium I would add more vitamin A as well. These are other things that I would utilize in conjunction with that to help it be even better.

Evan Brand: It sounds like they've got a really good marketing though, you promote this product for hair, hair wellness from within. Eighty eight bucks a bottle. I mean they're making a lot of cash on that. Eighty eight bucks.

Dr. Justin Marchegiani: Yep it's definitely expensive you can do these things when we put them into our program they're going to be cheaper because we're we're doing them. It's not by itself it's going to be part of an adrenal support. A lot of time we'll have some of those products in it. We may be using things like curcumin for inflammation regulation we may be doing sol palmetto in a natural 5 alpha reductase enzyme formula which will have more things that will have lycopene in a pumpkin seed it will have more things than just that. So for sure it is.

Evan Brand: It's funny though isn't it the world of supplement marketing you know you could market something for hair loss but like you mentioned you and I are already basically implementing this entire protocol of these different nutrients just as part of our functional medicine philosophy of supporting hormones, restoring gut balance, giving collagen, reducing inflammation but we don't market it as a hair loss protocol. We just make it a protocol to get you really healthy and as a side effect of you getting really healthy your hair grows.

Dr. Justin Marchegiani: Yep MSM is also great as well. That's a sulfur based kind of amino acid compound that's really really good. We already talked about sol palmetto, fully and B12 are also going to be really important. We already mentioning Millennium and biotech being helpful. Go ahead.

Evan Brand: The last thing I wanted to mention was we did look into the research on the low. They call it LLLT low level laser or light therapy. And it does work. So you've seen I've seen some of these ads on Facebook and other places where they'll promote these men or women wearing this crazy contraption looking like Dr. Emmett Brown from Back to the future and he's got a bunch of like laser beams beaming his head to regrow hair. They do work. There are studies on this and it does appear within. I think it was a 16 week trial that I found it was like a six hundred and fifty five nanometres laser. Let's see here. So this was a six month study. A six month study, 55% increase in women who did this.74% increase in men who did this. There was another double blind trial on a different type of laser for hair. Twenty six week trial and they didn't give us a percentage they just said significant hair density improvements we're seeing. So the lasers do work but I don't want people to still eat McDonald's and just do a laser on their hair and most people do that.

Dr. Justin MarchegianiYeah. I think the major mechanism that lasers are going to work is number one, lasers tend to have stimulatory effects in the mitochondria. So that's going to be helpful and they're going to help reduce inflammation. So anytime you reduce inflammation you increase blood flow and that's going to provide better nutrition. And then in and of itself they're naturally going to stimulate blood flow as well. So if you get better blood flow less inflammation, less inflammation helps blood flow you stimulate the mitochondria. Right. You provide stimulation to the cell and then as long as the nutrition and all the other building blocks are there and you reduce all the other internal stressors like pesticides and all the junk in the diet, it could be more helpful from a root cause perspective but it will definitely be palliative but at least that's palliative without all the side effects of maybe an Astra medication.

Evan Brand: True. We just don't want your average person who's eating a Standard American Diet go into Chick Fil A drive through on a Saturday morning and shoving their breakfast sandwich with MSG. By the way, Chick fil A. They promote themselves as like higher quality fast food. There's MSG in all their products just look them up look up their sausage biscuits got MSG. The eggs are fake. The chicken nuggets have MSG and other garbage even dairies and a lot of their products. So you go oh I'm going to go get my morning Starbucks then I'm going to Chick fil A and I'm gonna get my morning drive through you know sausage egg and cheese biscuit and then I'm gonna go get my laser therapy. No that's not you're not thinking about it the right way. You gotta do the other stuff and I don't even know how much a laser cost. So ditch the garbage fast food get real food in your price save more money and not even need a laser.

Dr. Justin MarchegianiHundred percent and there's also other things as well like a PRP injection which is a platelet platelet rich plasma and also various stem cell injections that can be used in the scalp as well. Again these are gonna have really good important building blocks and growth factors that will help stimulate the hair to grow which I think is beneficial but still it's going to be palliative. It will not fix the root cause mechanisms of your guy and you're like, Hey I really want to get my hair turned around. These are other options that I would look at but make sure you have the foundation already dial them because these procedures are expensive. So if you are gonna go into it you want to give it the highest chance of it working. Therefore you want to get the cortisone check, selenium all the minerals all the nutrients, make sure your hormones are good, make sure your guts good make sure your blood sugars are good and that's gonna give you the first best step. And I understand. Like if you're a guy and you're losing hair you know and you're trying a lot of these things you know some of these topical Rogaine or Minoxidil they can be helpful. So if you're a guy coming in there maybe a tiny amount of these things topically on on that area versus taking it systemically like you would with kind of a flomax med maybe more beneficial. It's kind of like if someone had a skin infection. Well I think it'd be better to use an antibiotic cream than taking a whole systemic antibiotic in itself right orally. So you kind of have to figure out that and again if you're on the prescription side of the fence make sure you talk to your prescribing doctor about that to adjust it. So it's more specific and more localized versus doing a kind of systemic thing.

Evan Brand: Yeah. Well said that's great advice.

Dr. Justin Marchegiani: And then of course the last but not least thing is going to be a hair transplant. And again the hair transplants have done you know they're much better today there's less scarring they're more exact and how they do it. And a lot of times they'll combine it with PRP or stem cells to help the hair grow even better. Big thing is though if you're gonna do it's definitely definitely definitely definitely do it with all the other conjunctions. In fact I mean it's a lot of celebrities you can see that have definitely had hair loss and then their hair. You can see it's grown back a ton. I mean for instance Ellen Moss just look at his pictures in the late 90s. He was basically bald and look at his hair. So it's a beautiful set of hair. Same with Matthew McConaughey late 90s. Look at his mug shot online right. Basically balding. Look at him today. Beautiful head of hair. So some of these procedures do work combine them with all the other things that we're talking about. And then you got a winning team.

Evan Brand: Yep. Amen.

Dr. Justin Marchegiani: Yeah that's got to be on the extreme side say most people, especially women, they're going to have a better chance because a lot of it's hormonal and gut based. There are some genes that will skip generations the gene is a big one that can encode for androgen receptor protein and these are the ones that are going to be really affected when free testosterone drops and that can have a significant effect on hair loss. And again that's typically going to be on the mother's side. Usually skips generation and it's on the mother's side. So that's the big genetic component there.

Evan Brand: So you're saying look at your grandma and if she balding then you might bald.

Dr. Justin Marchegiani: I think it's gonna be your grandmother's Dad.

Evan Brand: Oh yeah.

Dr. Justin Marchegiani: And that's the ARG. But I've had some people where you know that didn't quite ring true and then some people it may just be a genetic predisposition and let's say they did other things to combat that and maybe they were able to starve it off longer or have less. So you know it's not going to be you know something that happens right away. It's not a guarantee but it's definitely a strong strong predisposition. And let's just say there's a more. Let's just say sensitive environmental factors if they're in a play. Yeah you're going to lose your hair but you may be able to starve it off by doing all the things we talked about today and that may give you the best possible chance of keeping your hair and then that's where you'd want to look at something that a more natural surgical type of things while doing all the foundational things to.

Evan Brand: Make sense. I have had so many women that reported on their follow up so I went to my hairdresser and they said I'm growing so much more new hair. I was not intending to do that. I'm just fixing what I see. I'm working on the gut the adrenal is like we talked about. So you and I really we've become able to speak on this topic because from clinical experience it's not like we took a course on how to regrow hair naturally. No we just we just help people improve their health and as a side effect the hair grows so now we feel that we have enough information to share on this. But you know when we're working with someone we don't say hey, my goal is to help you grow more hair. I always tell him straight out my goal is to fix your gut and all these other issues I see. And you're probably going to grow more hair as a side effect of getting healthy.

Dr. Justin Marchegiani: A lot of these superficial types of goals or symptoms which they're still important they're all downstream. Right yeah. The guy gets better and all these root cause upstream things happen. Right. It's always top down inside out. Right you work inside out top down and a lot of these things are in the downward kind of manifestation. So if we go inside out top down we're going to fix a lot of these things downstream so I think it's really important. And if people are listening to this now. All right. Dr. J. They haven't just listed out a whole bunch of like mechanisms and a lot of science like I'm overwhelmed like what the heck do I do. All right. Let me break it down. So number one if your issues are severe and hair loss is just one thing out of many. You really got to find a good functional medicine doctor were available., number one. Number two what can you take action on right away. Cut grains out of your diet right. Cut you go on a paleo or at least autoimmune paleo template no to get adequate amount of selenium and zinc. What does that look like at least two hundred micrograms supplement it through selenium and 30 milligrams so automated through zinc. So two hundred micrograms of selenium, 30 milligrams of zinc different metrics there will not be doubt you know make sure the recall that get enough collagen in your diet. What does that look like. That could be about 30 grams a day maybe 40 or 50 if we have hair loss issues. That's to give you extra building blocks and then we could also use extra vitamin an extra fish oil extra Vitamin E. These are good low hanging fruit to kind of start off with one, nutrient based, two you already need them anyway. And if we don't get enough there at least low hanging fruits to bumpy in that right direction and then everything else find a good functional medicine doc if that's not getting you where you want to be to figure out the next steps.

Evan Brand: Well said. you mentioned the websites but I'll mention them again. Justin and I work with people around the world. So if you do want to reach out we can send lab tests to your door except for blood. We send you to a local lab for that but still you're in a lot of the functional testing we do. Urine, saliva, Hormone Testing, et cetera. That's all done at your house. So pretty awesome, pretty easy and very effective. Far better than the standard care you get done from your once a year blood work with your doctor, you're once a year hormone check with your endocrinologist, this is far and above that we're not saying, Ditch those people we're saying we're just going to go beyond what they're doing. So if you want to reach out to Justin, or me We love to help people were super blessed, we've got really really cool jobs because we send people back into the world feeling better. And if you want to change the world the best way in my opinion is to help multiply ourselves. So I feel like we're pretty awesome. We put out good stuff to the world. So if we can help other people get their energy better, get their sleep better help the relationships with their kids because now they have enough energy to play with their kids and now they've got enough energy to do the dishes. So the wife's not complaining the dishes are piling up, and then their marriage gets better because they're both sleeping better, so they're not grumpy, and we doubt in their diet. So they're not hungry and having blood sugar crashes like all the stuff we're doing is making people better people. And then those people are hopefully nicer and better to their people and then it just kind of spreads like a healthy virus. That's our goal.

Dr. Justin Marchegiani: One hundred percent and if you guys love this then and you enjoy it. Give us a thumbs up. Share it with a friend or family member that's dealing with this problem and then also if you really enjoy it too. Right below there'll be a link to go write us a review so if you go to and I imagine Evan probably has a similar link, that will show right up to our review pages and feel free to write us a great review and if you want to give us the same review and just cut copy and paste it to make it easier and just change the names. That's cool too. We know you guys are busy. We appreciate the review, we appreciate the feedback, and if you're a little bit overwhelmed which is normal. We're still here for you as well and we'll put the contact info below. Hey Evan today was a phenomenal podcast. Anything else you want to leave the listeners with?

Evan Brand: This was fun. I would just say pick a step and start there. And don't give up. This is a fixable problem.

Dr. Justin Marchegiani: Absolutely also. I'm having my second son this Friday so really excited. His name is gonna be Hudson. So we're really really excited about that. Putting the name out there early so keep your fingers crossed and probably won't be here next Monday but the following Monday I'll be back in the saddle. Right now I'll be on terrorism late nights but I got my adrenal support I'll be all right.

Evan Brand: Oh Man I'm excited for you. Congratulations. I hope everything goes well.

Dr. Justin Marchegiani: Hey Evan thanks so much man. It was great chatting. You have a great day.

Evan Brand: You too. Take care.

Dr. Justin Marchegiani: Bye.


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