In this live discussion between Dr. J and Evan Brand, they explore the topic of hair loss, mainly focusing on post-viral illness and acute stressors. They highlight the significant link between viral illness and hair shedding, explaining that nutrient deficiencies, gut inflammation, and malabsorption can exacerbate the issue. Furthermore, stress and cortisol also play a role in hair loss. Hair growth has three major phases: the anagen (growth) phase, the telogen (resting) phase, and the catagen (breakdown) phase. Therefore, hair loss can be classified into three types: telogen effluvium, which is more systemic across the scalp; androgenic alopecia, which affects the hairline and recedes; and alopecia areata, which is characterized by patchy hair loss.
To investigate hair loss, functional medicine testing, such as organic acid tests, can provide insight into B vitamins, amino acids, and other nutrients that may be deficient. For example, riboflavin, biotin, selenium, and NAC are essential nutrients for hair health. They also discuss strategies to help reverse hair loss, including modulating cortisol levels, improving blood flow, and supporting glutathione-dependent enzymes. Overall, understanding the root cause of hair loss and addressing underlying issues can help individuals work towards restoring their hair health.
Dr. Justin Marchegiani
In this episode, we cover:
01:47 – Article about Post Viral Hair Loss
06:00 – 3 Stages of Hair Growth
07:58 – Vitamins and Minerals
14:55 – Progesterone and Hair Loss
19:37 – Strategies to Reverse Hair Loss
25:12 – NAC
26:22 – Hair Transplant
Dr. Justin Marchegiani: And we are live! Dr. J here with Evan Brand! Really excited to chat about this wonderful topic. Again the topics that we bring you guys, they're from our clinical experience with our patients so we try to keep everything fresh and relevant. But I see lots of patients weekly with post-viral illness, and then they have hair loss after some kind of a viral infection, or just after an acute stressor. Both are kind of similar and we got patients that get these hair loss concerns, and we're going to talk about that today. Evan, how we doing man?
Evan Brand: Hey! Doing great! Nice to be back with you, and I experienced this myself. I had you know what, round two a couple of weeks ago, and I was looking at my couch pillow, and I thought am I shedding? Like, I'm like a cat or something, what the heck is going on? And so you and I were poking through the papers, but it matches what I saw personally. This is in the literature. This is well documented stuff, this is not just a clinical thing we’ll seeing. This is in the literature.
The medical journals are showing there's a massive link between viral illness and hair shedding. And also, you and I were talking about before we hit record, there's also the nutrient deficiency link that we need to hit today because we know that certain viruses hit the H2 receptor in the gut. So there's this gut inflammation, gut permeability, nutrient absorption, malabsorption problem that also happens. And I think it really just compounds what you already had pre-existing, meaning, if you have the stuff you and I chat about regularly, which is bacterial overgrowth, and candida, and parasites, and H. Pylori, and all these other issues, and then now you get this virus that activates all this inflammatory process in the gut. Well, you're at a much bigger risk of having something like a hair loss occurrence.
Dr. Justin Marchegiani: Yeah, so let's just kind of, I want to riff on that a little bit more. I think that's really, really good point. So here's one article right here, all right. And we're gonna just substitute some words as we chat. So we're talking about viral illness, right? Post-viral illness, gut microbiota disruption. And it's a possible role of probiotics in manipulating microflora and they're talking about different viruses, right?
Impacting the microbiome, creating inflammation, creating cytokine release, impacting the microbiome, right here, impact causing a cytokine storm, impacting coagulation, impacting blood flow, and then when you look a little bit deeper in here, it's really impacting the immune system because 80% of the immune systems in the gut, and then when your immune system is over-reactive in the gut.
Guess how that's going to impact your absorption of proteins? Fatty acids, minerals like silica, selenium, biotin, collagen peptides, right? It's going to impact it significantly and so we do know that there's a microbiome influence. And the microbiome especially the good bacteria like the bifidobacter and the lactobacillus play a major role in modulating inflammation and immune function in the gut. So this is really interesting.
Evan Brand: Yeah, there was some crazy pictures that was, I don't know if it was in that particular paper or another paper like that, but man there's women literally going like almost bald post viral. I mean this is severe, there's some severe pictures in the literature there and I believe, and I don't know what you think about this, I believe it's mostly reversible. I don't know if you're going to get back to 100%. I don't even know if I fully got back to 100% because of this thing but I think you can get pretty damn close. What would you say?
Dr. Justin Marchegiani: Yeah, I think it just depends, right? The longer, the more, if your follicle goes 100% dormant, it's harder to bring it back. We'll talk about some strategies that we can do to help bring it back because I've seen things happen that, you know the literature says, it typically can't happen. They say like, “Hey, you have a shrinkage of certain hair follicles. Once it goes below 50%, you can't get it back.” But I've seen the opposite of that. I've seen people that had no hair in certain spots and get the hair back.
So we'll talk about different strategies, different nutrients, and in this one here, they're talking about right here, talking about the microbiome, right? Having invaded different gut bacteria, having different bacterial imbalances, and that's essentially being impacted by post-viral illness. I think because it impacts the immune system so it makes the bacteria you know, come through the house so to speak, without the guards being on patrol in the immune function.
Evan Brand: Yeah, well we know it activates the H2 receptors too, so that's not good and that could impact lungs and breathing, and and sleep, and stress, and there's a cortisol component to hair loss. We wanted to make sure we brought up cortisol. So think about well, I had a friend actually a guy that I would go hunting with, his name is Brian. And Brian used that-
Dr. Justin Marchegiani: And this is a New York Times article “What to Do if You're Experiencing Hair Loss after a viral infection” and it talks about the cortisol connection. And by the way this cortisol connection is very well known. There's a handful of really well-known hair products out there, and one of the main ingredients in that hair product is an adaptogen that's well known to help modulate cortisol function. So that's a real thing.
Evan Brand: That's cool, okay so, that's all right, so my friend Brian, he's around 50 years old. One year, brown thick hair, and then I knew that his marriage was on the rocks. Wife got a hysterectomy, she went crazy. So the next season that I saw him, completely gray, and his hair was very thin, I'm like “Oh my God”, and then the next season I see him, divorce is over. The storm is over, and guess what? His hair, I'm not kidding, it went from gray back to brown. Not fully, not fully, but it got more brown. I thought he was like totally gray, elderly looking. No it literally, he reversed and some of the thickness came back. So that just goes to show a major, major life stress. Whether it's a pregnancy for a female, menopausal change, a divorce, a big death. I mean these big cortisol moments can really affect the hair and that's what you have on this paper right here.
Dr. Justin Marchegiani: 100%. Totally. Now there's three major phases of hair growth, right? We have the antigen phase, where your hair is growing. We have the resting phase, which is Telogen, right? And that can happen for years. And then we have the Catagen phase where it breaks down, right? And so, the goal is, most hair loss issues when it comes to stress or post viral issues is known as telogen effluvium, and that's usually an acute stress that takes that resting phase and you lose that hair, and you have to essentially restart that cycle, right?
And about 20%, but they'll say right here about 10% of your hair can be actually in that resting phase at any given time, and so that's a real deal. There's three major kinds of hair loss, you're going to have telogen effluvium due to these acute stressors like we mentioned here. You have androgenic alopecia or male pattern baldness, mostly affects men. Some women can have it especially when they start to have high levels of insulin, and ovarian cysts, and that can drive up their testosterone and increase DHT. And then we have alopecia areata that's where you start to have like patches. It's autoimmune condition and you'll have just patch it here, like a big patch here, a big patch there.
So telogen effluvium is more going to be systemic across the whole scalp, okay? Androgenic alopecia is going to affect the Norwood Pattern. So it's going to start here typically at the hairline and recede back, and then here at the vertex. And so eventually, you look like a George Costanza with just that whole top part gone, right? And then you have the alopecia areata, that's the spots. So spots, alopecia areata, systemic telogen effluvium, that Norwood one through seven pattern, here at their hairline, here and in the crown, that's going to be your male pattern baldness androgenic alopecia.
Evan Brand: Yeah, okay, so let's talk about labs because we need to try to connect the dots here. What could we actually do from a functional medicine investigation perspective? What could we do to look into this? I would say organic acid would probably be my number one favorite because we're going to get a full work up on the B vitamins, amino acids, etc.
Dr. Justin Marchegiani: Yeah, we know, let me just pull it up here just so we have, we have it here. So this talks about the role of vitamins and minerals and hair loss. We'll put all these links here in the reference section below. But it talks about certain vitamins like A, B, C, D, E, your, you know, B6 and folate, and zinc, and B12 are really important for hair loss. Selenium especially with the gray stuff, with any of the grayer hairs, Selenium and NAC, super important because you have these oxidative stress that happens, and it creates hydrogen peroxide in the hair follicle, and the hydrogen peroxide literally really bleaches the melanin that gives the color of your hair follicle. It bleaches it out of it.
And so we can definitely help provide blood flow via lasers, via micro needling, but then also, we got to neutralize the hydrogen peroxide. How do we do it? We upregulate that enzyme catalase which is a glutathione dependent enzyme. So we get the NAC up, we get the different nutrients up to really help that.
Evan Brand: You know what's interesting in this paper on the vitamin B, section B for Bravo, they're talking about riboflavin in this and how important riboflavin is. But it says here riboflavin, while extremely rare in the USA, can cause hair loss. I would disagree with it being rare because when we do organic acids testing, I see low riboflavin all the time. You see it right there near the citation number 24, that next paragraph there, look at that, they're saying extremely rare. It's like I see it all the time.
Dr. Justin Marchegiani: Yeah, I mean I would say you can have functional deficiency because if you're eating a lot of processed food, right? You're going to deplete your B vitamins just because when you look at the Krebs cycle, for you to run that Krebs cycle around, it actually requires B vitamins to do it, and if you consume a whole bunch of processed sugar, it's like a, it's like using a credit card with a really expensive transaction fee, right? And then also, what if people have genetic defects and they're just getting crummy B vitamins that are fortified in their orange juice, at their grains, and they're not getting activated methylated Bs from a high quality supplement, or they're getting not getting grass-fed meat because they're vegan/vegetarian.
Yeah, we can have some problems. (Yeah) Right? Functionally for sure, meaning like, you may not get like Beri Beri, or like a severe deficiency on a blood test but it may be functionally low.
Evan Brand: Yes, yes, great, great distinction (You know?)
Dr. Justin Marchegiani: And then also, biotin or B7 is really important. You know, any hair or fingernail supplement that you'll see out there will typically have Biotin or B7 in there. And again most biotin is found in protein. So again, you know dietary protein must be broken down into free biotin. So let's say, you have H. Pylori or low stomach acid, it's possible that low stomach acid could impact you breaking down the protein and getting it into free biotin, so free biotin is important. And if we have this gut and balances, that can impact it for sure.
Evan Brand: Amazing, yeah, another part of that biotin there further in the paper, they're talking about researchers looked at serum biotinin 541, women complaining of hair shedding. Low biotin levels were found in 38% of these subjects. So, and then they're saying that some of that was linked to guess what? Antibiotic use, gastrointestinal diseases. (Yep!) So this is amazing! That no matter what topic you and I tease apart, it always ends up at the same foundational pieces.
Dr. Justin Marchegiani: You can also, biotin can impact your thyroid test. So if you go take a lot of biotin before a thyroid test, it can impact your TSH. So make sure you're not taking crazy amounts of biotin if you're testing your thyroid. And then also here look! Right? We need healthy levels of T3 to stimulate that follicle to grow and so, sometimes telogen effluvium can be caused by that acute viral stress, or that acute emotional stress, that can cause the cortisol to go up, right? We have the New York Times article here talking about the impacts of cortisol here. Let me just bring that up.
Many dermatologists believe that cortisol plays a role in the shedding process but guess what? Cortisol also impacts, right? It's going to impact reverse T3, and that reverse T3 could bind up the receptor sites that your free T3 binds into. So it can have a Metabolic Effect.
Evan Brand: For sure. Well, I remember when I'd first gotten exposed to mold and ticks in the same summer. My reverse T3 was like a 25, it was high.
Dr. Justin Marchegiani: Yep! It's very possible. Just the acute emotional stress, the acute inflammatory issues, that could also be increasing the cortisol, and that could also be impacting reverse T3, which could be functionally lowering your free T3 binding.
Evan Brand: Amazing! And then of course when you're stressed, maybe you're off the rails with your diet so you're not eating the proper proteins to get these amino acids, or if you're a vegetarian or vegan, how about we give a special shout out to vegan people complaining of hair loss? What do you have to say to them?
Dr. Justin Marchegiani: Well, like we talked about here, if you go back to this art, this one right here, all right and you look at it, let me see here where is it? Talks about biotin right here, biotin, normal diets. So it talks about biotin coming from protein. So we know protein is very important. Here you go. Biotin plays a major role, most dietary biotin is found in protein. So guess what? If you're not eating animal protein, that's where most of your biotin is going to be, and you're not breaking it down, and you don't have good hydrochloric acid levels, you may not get a lot of these nutrients to build up your hair. (Let’s look at this) And that could be problematic.
Evan Brand: Let's, let me, actually, I'll just put the link for you real quick and then you want to pull it up for me, I'll put it in the chat for you. Pull this up, this is from the National Institute of Health. They have an article on Biotin and they have a graph which I think is pretty cool or actually a chart rather, if you scroll down. Check that out, beef liver look at the amount of biotin you're getting.
Dr. Justin Marchegiani: Whoa! See look, see this hammers at home. So we go back to this article, right? We talk about most biotins in protein form, and then you have to be able to break it down, right? Dietary protein must be broken down, and then we go over to this article, and we look at how much biotin you're getting. Look at beef liver, holy smokes! Go ahead.
Evan Brand: Incredible! What would that mean? I need to take some more liver.
Dr. Justin Marchegiani: Eggs, salmon, pork chop, hamburger patties, then you have some seeds here. The problem with seeds, right? That looks nice, but it's still what 95% less than beef liver, but you have the bioavailability aspect because you have lectins and some anti-nutrients so, I guarantee you this is a little bit lower. Now if you soak them, I guarantee that goes up too. Sweet potatoes, almonds, tuna, spinach, broccoli, wow! Unbelievable! The first five to eight things are mostly animal products. That's good to know.
Evan Brand: So for folks listening, if they're not seeing the visual here, we're seeing here that according to the NIH, they're rating here a fresh cup of broccoli. You'd have to eat a half a cup, which is probably the most I would eat if I ever ate broccoli, you get 0.4 micrograms. So that's 0.4 micrograms per serving. If you do beef liver per serving 30. So I mean, (Wow!) I can't even do the math in my head, that's a lot different. That's huge, it's like 99% less in broccoli, in spinach it's 0.5. It's tiny.
Dr. Justin Marchegiani: Yeah, it's absolutely. And then, yeah, then you have the bioavailability aspect there, just because its there, doesn't mean you actually get it. And then, I think you're also going to see here, you see it a lot during menopause, women's estrogen and progesterone levels drop causing hair to grow more slowly and become thinner. And so, guess what? As you get stressed guess what happens to your progesterone?
Evan Brand: It's gonna crash.
Dr. Justin Marchegiani: It's gonna crash because it's going to make Cortisol! Progesterone and Cortisol, right? Let's go look at the hormone cascade here, this is a good one. Let's go pull this one up here.
Evan Brand: I love it, I love it! Teach us about the steal.
Dr. Justin Marchegiani: What's happening here? So check this one out. All right, so look what's happening, here's our cholesterol. You see it? (Yep) Cholesterol converts to Pregnenolone, Pregnenolone can go downstream to (hopefully) Progesterone. Progesterone can go, right? So we have the steal here. This is just part of the stress response. Think about it. Why does the body do this, right? Because is the body prioritizing survival in the moment versus your health, productivity, hair, fertility. It's about surviving now, and so it makes sense that the body is going to have hormonal cascades that are going to allocate resources, so you can stay alive and deal with whatever that stress is.
Remember, this stress to your amygdala, or to your brain stem, could be you running from a tiger, or you having to pay your mortgage not having enough money. Your brains in aceta is the same thing. So even you're like well, it's not make or break it, it's not like I'm running from a tiger. Your brain's not differentiating the two.
Evan Brand: Yeah this is, this is modern, the modern world for you. Man, you know how many people I'm seeing now just in social media. Guys in their 20s losing their hair and they're posting all these little videos of them putting cream, and I don't remember the the drugs. What are the drugs that they're using? The Minoxidil?
Dr. Justin Marchegiani: Yeah well there’s, yeah you have, you have your Minoxidil or your Rogaine. You have your Finasteride. (Finasteride, yeah) Those kind of things, yep. And again those are a little different, right? We're talking about telogen effluvium which is mainly driven by stress, the male androgenic alopecia. That's more from DHT issues. And then that shrinks the follicle and decreases the blood supply. So this is a little bit different of a mechanism here. One's more genetic but still, you know, if you have even male pattern baldness but you have deficiencies in some of the nutrients, that can definitely accelerate the hair loss.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Yeah, that's true. Anything else you wanted to highlight with that?
Evan Brand: Well, people need to be really, really diligent. I mean, and I'm talking to myself as I say this. People need to be diligent about learning how to de-stress. Like you actively have to pursue de-stressing. I mean you were telling me about your vacation and how you prioritize fun, but you also prioritize relaxation. And I think, I think so many of us with kids, we feel this constant need to go, go, go, go, go, go, and we don't downshift. (Exactly) That's a problem if we're not downshifting.
Dr. Justin Marchegiani: I 100% agree, And so we got it, we got to make it a priority. So what are we going to do here, right? That's the big thing. So I think out of the gate, on the functional medicine side, we can get the gut looked at. We can get the adrenals and the stress handling system looked at. We can look at the dopamine, the adrenaline, the neurotransmitters, that's helpful. Depending on what comes back there's different patterns, okay?
We can use adaptogens to modulate the Cortisol. We can use Rhodiola, we can use Ashwagandha, we can do extra Magnesium, we can do extra Thinine and Gaba. We can make sure we're getting to bed on time. Those are good things nutritionally. Anything else you want to hammer there?
Evan Brand: I love that you brought up Gaba. I mean, that's what I'll do. I'll do a chewable Gaba at night. That'll really settle down. Passion flower, mother wart, I mean anything you can do to really settle the nervous system. I will tell you, if I do you ever just feel like your kids are driving you crazy, I literally can feel my hair, almost like I'm electrified. You know in Ayurvedic medicine, they say that the excess heat leaves the body through the head.
So in Ayurvedic medicine, the idea is that, the reason people are having thinner hair, balding, is because the excess heat in a way, is leaving through the head. And I felt that. I mean, if you're in an intense situation, you can almost feel like your head is buzzing in a way. So, I would just say that, you, you really got to try to snap yourself out of fight or flight. It's so easy in the modern world to get triggered.
Everyone is like, I don't know, if you, if where you live, you notice that, but it seems like everyone is on a hairline trigger. Like you could cut somebody off and they're super pissed. Or something like you don't go with the green light, beep! It's like everyone's on edge. I don't remember it being like this even, you know 15 years ago, my wife and I first got together. The intensity of society has increased and what I'm telling, you what I'm getting at, is you need to build things into your daily life – Supplements.
You mentioned before we hit record, like cold bath, cold shower. Whatever you can do to de-trigger yourself. And I think it's going to be more important as we head into the technological age.
Dr. Justin Marchegiani: 100% I agree. Now, what are some strategies that we can do so you mentioned a lot of things from a health standpoint? A stress reduction standpoint? What else can we do to attack the hair? I think topically, we can do some things to help. We can use laser lights. LED laser lights can be super helpful to drive down the inflammation and to help stimulate blood flow. Again this isn't going to matter if you're not doing the other diet and lifestyle and nutritional things. So we kind of have our hierarchy, right?
So everything you already said and we already said is foundational. Now we add things to it. We can make sure we have collagen peptides. We can make sure we supplement biotin. We can use some laser lights that are very helpful. LED laser. There's different grades that are out there. I'll put a link to the one that I'm recommending and using now that I think works really well, that can be super helpful. And six to ten minutes a day, it's going to stimulate the mitochondria, stimulate blood flow. Reduce inflammation at the follicle.
One of the other things I love is using a micro needling device. I'll put one down below that I like and I use I do it once a week. And I hit those areas I'll hit along my front hairline, down the side, the vertex. And that's wonderful because that's going to increase blood flow it's going to stimulate stem cell production. there's a lot of data on this. Typically, you're going to hit it at the scalp level at 1 to 1.5 millimeters depth. And that's going to help enough to really stimulate. Once a week is going to be great with that, very helpful.
Evan Brand: I am seeing a lot of people, once again, this is another like social media thing. I've seen not only these guys in their 20s, rubbing all these you know drug creams on. But also, a bunch of people getting hair transplants. Now that's obviously a more extreme intervention but what I would say is it's not root cause. Now I don't know enough about that. I'm speaking a little bit out of my expertise here, I don't know enough about hair transplants but what I'll say is, I mean number one, it's probably got to be pretty bad to get to that level.
Probably more expensive, but then what about the underlying biochemistry that's wrong. The nutrient deficiencies, the gut infections, whatever that led to that. I wonder does the hair transplant still last? Is it just such a magical remedy that it counteracts all of your issues and deficiencies, and toxicities? Or does even a hair transplant fail after five years? Do you know anything about it?
Dr. Justin Marchegiani: Yeah, so there's different, there's different things here, right? So Telogen Effluvium, most of this hair loss will come back in three to six months on its own. I think Telogen Effluvium is not going to be impacted by androgens. Androgens are going to typically impact the Norwood one, which starts here through seven, which is all the way in the back. Let me just give people a reference of what the Norwood Scale looks like. Just so when I use the word, people know what I'm talking about here.
Here's the Norwood Scale, right? So when you start to look at people, you can kind of size them up, okay? So here we go. So Norwood one is typically just a little bit right here and then Norwood two it comes back a little bit further, right here. and then it comes back a little bit further in three, and then in four you start to see the vertex, the crown starts showing up. And then it gets bigger bigger and bigger until this whole area is like George Costanza in case anyone, and you know has a Seinfeld as a reference, right? So this whole top part.
So like someone, like you Evan you're probably like a two. I'm probably like a two-ish as well. Obviously, people start once they start going with two to a three they're, like all right, let's just start, you know working on these areas right in here. let's start working on the crown with the micro needling once a week. It can't hurt right and that, you keep a lot of the results.
Now depending on what happens next, if it's influenced by DHT, then you got to look at what else do you want to put on there? Do you want to put on some saw palmetto to reduce the DHT? Do you want to do some copper peptides which have shown to be helpful? If you want to start adding a little bit of Rogaine and Minoxidil without the propylene glycol. That's shown to be held helpful. Again, you know,you'll get some golden handcuffs with some of these, meaning you'll have to keep it up, but the micro needling, you know, is going to keep no matter what.
And with some of these too, with the Rogaine for instance, there's a lot of data that you're going to get a 400% increase with micro needling and Rogaine, than just Rogaine by itself. So you get four times the benefit partly because you create little channels into the scalp area, and it's going to stimulate and work on that scalp tissue to grow better. With Rogaine, that works on the sodium-potassium pumps at the hair follicle level, and it's a, originally was a blood pressure medication in the 70s and 80s, so there's some sodium-potassium pumping that's opening and vasodilating and allowing better blood flow and nutrition to get to the scalp. And so if you can use some nutrients as well, and really have your diet dialed, then you'll get better results.
Evan Brand: That's interesting. Okay.
Dr. Justin Marchegiani: And then, if you're gonna do some Fina- again this is, we're talking male pattern baldness here, right? That's different than telogen effluvium. So women listening, if you're like, “I just got COVID, I'm shedding.” Totally different, totally different for you. But you can still do the micro needling, I think that's helpful. You can still do the laser. A good laser cap that’s high quality, that has actual lasers not LED lights. Because that's going to stimulate the blood flow, and that's going to reduce the inflammation from all the cytokines. So I think that's still going to help you. Just you know we got to differentiate people having male pattern stuff and and this post-viral stuff at the same time.
Evan Brand: Sure, sure yeah. And in the vitamin-mineral paper, I mean, there's a discussion about vitamin C, vitamin E, basically just other antioxidants, right? So, I really think that's where like a good Professional Multi is going to hopefully cover your bases. Now digestive enzymes in a roundabout way, that may be helping. Because now you're increasing the breakdown of your food, fixing the gut bugs, so I still think a stool test would be warranted if you have this issue. Why not? Take a look see what's there. See what infection may be robbing you of your, of your hair, of your nails, your skin, right? I mean there's a reason these hair, skin, nail issues all happen generally at the same time.
Dr. Justin Marchegiani: Yeah now, what I personally like, is I like using NAC for hair loss as well, right? NAC, there's studies on it showing it up against Rogaine and Minoxidil, and it's done better! And also guess what NAC also does? It has a benefit of lowering viral load. And guess what? NAC also builds up that catalase enzyme, that's glutathione dependent, and can help with the graying from the hair follicle, from the hydrogen peroxide. So I like adding in 2 grams of NAC a day.
Some of the studies show 1800 milligrams, so I like putting the NAC in there. Combine it with some micro needling, you know make sure you have good Biotin, and a good collagen peptides, and then you know, from telogen effluvium standpoint, work on the stress reduction. Maybe add in some Rishi mushroom to help with the immune system and the trigraphines in there, actually lower the viral load. Add the NAC that helps with the viral load. Make sure your vitamin D is good. Make sure you're you know getting the microneedling or do a laser cap as well. I'll recommend some of the brands down in the description down the road here. Questions on that, anything you want to highlight there?
Evan Brand: I think it's good and if people need help, we can walk you through this. Now, no I can't do a hair transplant, Dr J don't do hair transplants-
Dr. Justin Marchegiani: But! One thing, one thing please. With hair transplant, right? Telogen effluvium, it's gonna grow back, don't worry about that. It's is going to come back. The people that need to worry about hair transplants will be the guys with the androgenic alopecia.Here's the deal, guys you don't want to get hair transplants in your 20s. You need to save that hair, right? You know, you'll probably need 1500 to 2000 hair follicles per transplant.
So ideally, you may only get two to three in your life. So you want to save this as far as you can go. Some people are genetically programmed to have hair loss sooner than others. So you really have to be on top of it with the stress, with the nutrients, but the first line thing you should be adding in is microneedling. That should be the first thing you add in. And then you can start topically adding things in to help with. If DHT is a problem, start with saw palmetto topical. Or if you need get a topical low-dose finasteride, if you need. Most finasteride side effects happen due to systemic levels. If you go locally, at a very low dose, you can start to starve that. So again, you want to push those hair transplants into the 30s and 40s not in the 20s ideally.
Evan Brand: It's become trendy though, that's the weird thing. Guys like, think it's cool or I don't know, it's desperation. I mean, I don't know what's driving it, but I'm seeing a lot of videos of young dudes doing it.
Dr. Justin Marchegiani: Hopefully in the next 10 years, they're going to have the 3D printing technology out, where they'll just take a hair. They're gonna clone a couple thousand of it and then you can do your hair transplant from the clone hair that. That'll be the ideal because you know, they're just pulling hair from your non-DHT hair. So they're pulling it here and a good hair surgeon will pull out. But you know, you don't want more than 2000 at a time or so because you're gonna see it. You're going to see the patches on the side of your hair. You only have about maybe three, max four probably transplants in your life. And so if you start at 20, in the time you're 60 or ish, you're kind of screwed. So yeah-
Evan Brand: That's amazing, so so you're saying when they pull from the back of the head, it's gone. As in when you yank that thing out of there, you're taking all the parts with it, and it cannot regrow back there? Is that what you're saying?
Dr. Justin Marchegiani: Correct! I mean, you know, the benefit of these hairs, it's when these hairs, they lay down on each other, so you get coverage. It's harder to see, right? Where the hair, your top kind of parts here, this kind of, you know, goes over it. So, you just got to be careful. You want to make sure you get to the root. If you have to do a topical medication, just make sure you're doing everything else as well, and then you add in the microneedling, and then you do some of these topical things at lower doses, especially with the finasteride. With the Rogaine, you know, five percent for guys. Just you know, I recommend just get one that's going to be a propylene-glycol free.
Evan Brand: Wow! it's amazing stuff.
Dr. Justin Marchegiani: But like myself, I don't use any Rogaine or anything like that. I'll do it maybe a little bit of topical saw palmetto. I'll do microneedling. I'll do laser light. I'll do all the nutrients and so I just try to do some of that. But I wouldn't, you know, if I'm doing everything I'm doing, and that starts to become a problem, I would add in a low-dose pharmaceutical if needed. Just because there's genetics that you're running up against. Oh also, copper peptides, I'll use some of that as well along with the C60, which is a powerful, fatty acid. That's an antioxidant scavenger. It looks like a soccer ball, it's 60 Carbon. So those are some great things I'll throw in there as well.
Evan Brand: Cool. Well if people want to reach out if they need help, if it is regarding hair loss, or chronic fatigue long-term, mood issues, hormonal issues, digestive issues. Whether it's resulting from viral issues or if it's just other issues outside of that. Feel free to reach out. We work worldwide virtually. It's incredible because we have distributors set up, we have professional labs. We work with professional supplement companies. So it's amazing what we're able to do worldwide.
So if you need to to get some help reach out to Dr J, that's Justin Marchegiani and that is at justinhealth.com. justinhealth.com or myself, evanbrand.com. We help people worldwide, we love what we do. We've seen incredible success from fertility to skin, to mood, to gut, to the hair. There's some cool stuff so we'd be happy to help you. Do a real work up where we're looking at things that you've never looked at before.
Dr. Justin Marchegiani: 100% and guys that's normal to lose about 100, 150 hairs a day. So if you're losing some that's normal. Don't freak out. But you know, keep an eye on your scalp. They take some pictures with the same angle, hair dry, same lighting, right? You know just being out in a really bright light it can make your hair look thin, so have a consistent regular lighting to to monitor your pictures so you can see where you're at.
Evan Brand: Cool, cool, we'll catch up soon.
Dr. Justin Marchegiani: Excellent Evan! Good chatting with you. Have a good one y'all! Take care!
Evan Brand: Take care now.
Dr. Justin Marchegiani: Bye.
Evan Brand: Bye.