Welcome to Nutrition Bites. The no nonsense podcast where you get the truth about food so you can eat what you want and be healthy. I’m your host Maggie and welcome to the series! A good head of hair holds a lot of societal and inner value, so it makes sense that we’ll try everything in our power to keep those locks luscious. On the menu today, hair supplements.
Avid podcast listeners and Instagram scrollers have a few things in common. One is a constant desire to distract from reality, and two is a disdain for advertisements. Sponsored posts weren’t always part of these mediums, but in today’s world there’s no escaping an ad for online-only mattresses, meal delivery kits, meditation apps, and of course, supplements. While we’ve covered a few of these pills and powders before, like Episodes 36 on collagen and 33 on Athletic Greens, one category that’s remained unexplored is hair supplements. Grounded in the adage “beauty starts from within”, these pills and gummies target a big insecurity of both men and women - having a head of thick, strong and full hair. One of the most famous supplements in this space is Sugarbear Hair gummies. In 2015 these Tiffany-blue bear-shaped vitamin gummies were widely promoted by celebrities. From Christmas movie darling Vanessa Hudgens, to iconic model Emily Ratajkowski and naturally, half of the Kardashians. This group collectively had an Instagram reach of over 300 million people. Needless to say - everyone knew about Sugarbear Hair gummies and their financial success reflected that. Now in 2022 other brands are vying for a piece of this lucrative hair health pie. But are all these supplements actually helping us, or are they merely preying on our vanity and wallets. Let’s find out.
Having a full head of hair is a societal expectation - at least that’s what the media tells us. Apart from George Costanze in Seinfeld, you don’t see many characters, actors, or singers with hair loss. And if it does happen, they’re almost always male who shave their head and become super buff like Jason Statham. But hair loss and thinning are clinical conditions that affect all genders, and over half of the global population will experience this. To understand more about why it happens, and whether or not supplements can help, let’s cover some hair basics.
The average adult has approximately 100,000 hair follicles on their head. Follicles are pore-like structures that surround the root of the hair, and amazingly, are a tissue that undergoes constant regeneration. Each hair follicle cycles between a stage of growth and rest. During the growth phase, hair follicle stem cells become activated and the hair lengthens. During the resting phase, the same stem cells are dormant, so the hair stops growing and is eventually shed. This constant cycling means on any given day you lose around 100 hairs. But as long as those stem cells re-enter their growth phase, you won’t notice any overall changes to your hair. Clinical hair loss occurs when those same stem cells remain dormant after shedding - meaning no new hair is regenerated, and thinning or balding begins.
Why and when those stem cells stop regenerating is down to a number of reasons.The most common is genetics. Male or female pattern baldness, think Prince William as prime example, is a hereditary trait. So all you can really do is curse your ancestors if this runs in your family. The second most common cause of hair loss is age. At some point our hair follicles just stop growing - yet another gift of an aging body. Now these two factors are responsible for the vast majority of permanent hair loss, but medications, hormonal imbalances, and autoimmune disorders can also lead to permanent or temporary hair shedding. Stress also has a really big influence on hair health. Childbirth, illness, infections like COVID, and physically or emotionally traumatic events, increases release of the stress hormone cortisol which can trigger hair follicles to go into their resting phase. Fortunately this is a temporary issue, and once stress is relieved, hair growth can resume. Another controllable influence on the cyclical state of our hair is nutrition.
In order to support the constant growth of our hair, our body has to be supplied with the right building blocks. Of course overall good nutrition is important, but a special focus is placed on four nutrients: protein, zinc, iron and biotin. Significant deficiencies in any of these is associated with hair loss. Protein is vital because hair is mostly made up of protein. Zinc is crucial because it’s used to help build protein. And iron is essential because it is necessary to keep our blood oxygenated, and a regenerating tissue like a hair follicle needs a constant supply of blood for cell growth. But despite their individual importance, none of these three nutrients are the focus of hair supplements. That role lies with biotin.
Biotin, also known as Vitamin B7, is an essential nutrient that plays a key role in metabolism, gene regulation, and cell growth. It’s the superstar nutrient of hair health and focus of most hair supplement marketing. And this is because severe deficiency affects all things skin - from rashes to brittle nails to hair loss. Interestingly, biotin doesn’t have an established recommended amount we should consume every day. Scientists have simply guesstimated a quantity they think is adequate, and it clocks in at a tiny 30 micrograms per day. But what if I told you that most supplements provide 330X this level. Now fortunately there is no known toxic amount of biotin, so these super high doses are safe, you simply pee out any excess. But does this mega boost mean you’ll suddenly sprout metre-long hair like Marge Simpson or Tarzan? Well, let’s evaluate some products to see just what they provide and promise.
Entering today’s comparison competition we have three contenders: Jamieson’s Gorgeous Hair Supplements, a relatively inexpensive over-the-counter pill, Sugarbear Hair Gummies, the influencer favourite chewable vitamin, and Nutrafol - a nutraceutical with a proprietary blend.
Let’s start with the simplest and most accessible of the three: Jamieson’s Gorgeous Hair supplements. This one-a-day pill combines a high dose of biotin with extra-virgin coconut oil. Now coconut oil is known for being a cult classic styling product, but ingesting it for hair health is not something I’ve seen before…so buyer beware. Anyways, this supplement allegedly promotes stronger and thicker hair while reducing breakage and split-ends. Each dose provides 10,000 mcg of biotin, and a month’s supply will cost around $24 Canadian, or $18 US.
Next up is Sugarbear Hair gummies. These two-a-day gummies are formulated with 9 nutrients, including zinc, and the daily dose provides 10,000 mcg of biotin. True to their name, Sugarbear Hair gummies pack a sweet punch. With 2 grams of added sugar per gummy bear, your two-a-day dose makes up 20% of your recommended added sugar intake. But it’s easy to be distracted from this with labels like “vegan and cruelty free vitamins”, that promise you will “feel good about your hair and the planet”. Coming in per month at $47 USD, or about $60 Canadian, these are some costly supplements. But then again, you gotta pay a premium for a Kardashian sponsored pill.
Finally we have Nutrafol - a physician-formulated, medical-grade daily hair growth supplement. Supposedly Nutrafol targets the root causes of hair thinning to promote faster-growing, thicker, fuller and stronger hair. At 4 pills per day, Nutrafol provides 3000 mcg of biotin, which is significantly less than the other two supplements. But that said, it also has over 20 other ingredients including a bunch of vitamins and minerals, a “synergen complex” full of fruit and root extracts, and a proprietary blend of amino acids. Apart from the vitamin and mineral levels, and similar to other mega-mix supplements, I’m looking at you Athletic Greens, Nutrafol doesn’t state the actual amounts of any of their ingredients, so you really don’t know how much you are consuming. But with an abundance of science-scripted claims and multiple before and after photos of people’s hair, it’s easy to overlook. Coming in at $88 US, or $115 Canadian, per monthly bottle, Nutrafol is by far the most expensive supplement in this comparison. But they’re also the only ones who have clinical evidence to support their claims. Or so they say.
Back in 2008 a clinical trial investigated Nutrafol’s synergen complex on forty women with self-perceived thinning hair. Over the course of 6 months these women either took a pill with this complex, or a placebo, and at the end of the trial their overall hair growth, volume and quality were evaluated. Results showed that those who took the supplement saw statistically significant improvements, and equally as important - no one reported any side effects or adverse events. Now this is some really promising evidence, and naturally, Nutrafol widely promotes these results online. But of course, it wouldn’t be an episode of Nutrition Bites if I didn’t try and tear down a clinical trial. Right off the bat, the sample size used here is tiny. Of the 40 people in the trial only 26 actually received the synergen complex. Not only that, but the participants were predominantly white women, which makes extrapolating these results to men or those with darker skin tones difficult. Also, the Nutrafol supplement available today may contain different types and quantities of ingredients than what was studied. And lastly, one of the authors of this study worked at Nutrafol, which means bias was likely at play when conducting or interpreting the research.
Now don’t get me wrong, the fact that this supplement has any sort of clinical evidence is impressive. But without repeatable, larger, more diverse studies, we can’t really conclude that the Nutrafol supplement works. And unfortunately, the same can be said of the Sugarbear Hair Gummies, Jamieson Gorgeous Hair pills, and pretty much any other hair supplement on the market. There is an overwhelming lack of evidence that supplementing with any micronutrient improves hair loss conditions, unless you have a real deficiency. And despite the focus and mega-dose of biotin in these pills, it is so incredibly rare to actually have a biotin deficiency. The U.S. National Institute of Health has even stated that severe biotin deficiency has never been reported in healthy individuals who eat a normal diet. And that’s because biotin is kind of a “set it and forget it” micronutrient. It’s in a decent range of food, so if you eat a varied diet, you’re probably getting enough. In a 2018 review of biotin research in particular, scientists concluded that for healthy individuals supplementing with biotin to improve hair health is pretty much useless.
Which begs the question - how can these companies get away with all of their braggadocious statements without much evidence to show for it. Well, as I explained in the episode on Athletic Greens, the supplement space is genuinely wild. Worldwide there are pretty much no regulations which means companies have free rein to say what they want so long as there is an element of truth. And because biotin deficiency is linked with hair loss, that’s enough to make a claim.
Although all signs point to these supplements not being effective, the reality is that losing hair is an incredibly emotional experience, and people are willing to try anything to stop or reverse it. Speaking as someone who’s hair makes up a big part of their personality, even my skeptical and logical self could be convinced to try a supplement that could possibly help with hair loss. And I will say this. Despite their lack of efficacy, hair supplements, and specifically biotin supplements, seem to be relatively safe. With no max intake level of biotin, you’re not really putting yourself in harm's way by taking such large doses. The only documented negative effect is that biotin supplements can interfere with the results of some blood tests. In particular, it may falsely cause high or low levels of biomarkers related to thyroid and heart health. And some people have even been misdiagnosed with thyroid disease because of this! So just make sure you disclose any type of supplement with your healthcare team before undergoing medical testing or treatment. And this is especially true for pills, like Nutraful, with proprietary blends, as some of these ingredients may interact with medications. But for the most part, the only real damage these hair supplements are likely to cause is monetary. Most companies recommend taking a daily dose for 6 months to see results, which could mean spending upwards of $500 USD, or nearly $700 CAD, on these types of pills.
Maintaining full, luscious, hair is a beauty focus for us all, especially as we age. And if you’re desperate for a non-pharmaceutical solution to hair loss, a few hundred dollars and a dash of patience may be a good investment. But before dropping cash on a yet-to-be-proven pill, remember that nutrition is just one of many underlying causes. Eating a well-balanced diet, keeping your stress in check, minimizing the use of hot hair tools like straighteners and blow dryers, and avoiding damaging products like bleach, are all proven ways to protect your hair. And if hair loss persists, seeing a dermatologist is the best way to figure out the root cause (pun intended) and start a tailored treatment plan. But also recognize that you can’t cheat genetics, or age, no matter how much the biohackers try to convince you otherwise. So perhaps it’s time to embrace our inner Mr. Clean and Wakanda warriors, and realize bald and balding, can be beautiful.
That’s been the bite for today. Stay hungry.