Zinc supplements lower serum ferritin in some patients
Patients who use zinc supplements need to be aware of the delicate balance that exists between how the body absorbs iron and zinc. Long term use of zinc supplements without measuring zinc and iron and copper levels is not advisable. This is because chronic zinc consumption has the potential to lower iron and copper levels. Zinc and iron complete with each other for intestinal absorption. In addition, increased zinc absorption has the potential to lead to increased exertion of copper. The net result is that chronic zinc use has the potential to lead to both low iron levels and low copper levels.
In 2002, Carmen Donangelo and colleagues published a nice study in the Journal of Nutrition. The authors studied the effect of 6 weeks of zinc supplementation compared to 6 weeks of iron supplementation in young women with low ferritin levels (less than 20). The women were divided in two groups - 11 took zinc supplements and 12 took iron supplements. In the iron-supplemented group, blood hemoglobin, plasma ferritin and the percentage of transferrin saturation increased but zinc indices did not change. In the zinc-supplemented group, plasma ferritin and the percentage of transferrin saturation decreased, whereas the plasma transferrin receptor and erythrocyte zinc protoprophyrin levels increased. The authors concluded that the use of iron supplements in women with low ferritin levels improves iron indices with no effect on zinc status but that the use of zinc supplement improves zinc indices, but has the potential to reduce worsen iron deficiency.
This was a very nice study and serves as a helpful reminder that supplements should always be used in a rationale manner. If zinc supplements are going to be used in an ongoing manner, one should consider periodically measuring zinc, iron (and copper) levels.
Reference
Donangelo C et al. Supplemental Zinc Lowers Measures of Iron Status in Young Women with Low Iron Reserves. The Journal of Nutrition, Volume 132, Issue 7, July 2002, Pages 1860–1864.
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
Biotin is a well-known and popular supplement for treating hair loss. Let's face it - the world loves biotin. However, true deficiencies in biotin are rare given the ability of bacteria in the gastrointestinal system to produce biotin. Nevertheless, many individuals and physicians turn to biotin in the search for treatment options.
Soleymani and colleagues from New York University School of Medicine set out to critically examine the evidence for biotin use for treating hair loss. Their findings point out that there are no randomized trials to support the use of biotin in treating hair loss and that the public’s interest in biotin over the past decades is not supported by medical evidence.
There is really no evidence to support routine biotin supplementation for individual’s with hair loss. Exceptions do exist, of course, and true biotin deficiency may be considered in individuals who are elderly, pregnant, using anticonvulsants or chronically using alcohol.
Reference
Soleymani T et al. J Drugs Dermatol. 2017 May 1;16(5):496-500
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
Coenzyme Q 10 is an interesting supplement with anti inflammatory and anti oxidant activity. I've been investigating whether it has any benefits in hair loss ... but the evidence is certainly not in yet.
Coenzyme Q 10 may have some benefits - under certain conditions. The best studies conditions include heart failure, various neurological problems (especially a condition known as multisystem atrophy) and in blood sugar control. It can lower inflammatory markers in the blood, including C reactive protein (CRP). Coenzyme Q 10 may have a variety of helpful effects on obesity too. Patients on cholesterol reducing medications (i.e. statins) may be at increased risk for coQ10 deficiency so that warrants further study.
In the autoimmune condition rheumatoid arthritis, a randomized study showed 100 mg per day of coQ10 reduced several inflammatory markers in the blood (such as tutor necrosis factor alpha). It's still too soon for those with various types of hair loss to start taking coQ10. But I am reminded of a 1995 study published in the Lancet that showed an improvement in hair loss in 2 patients who used coQ10 to treat hair loss caused by a blood thinner known as warfarin. The reference to this study is below.
Oxidative stress occurs from a variety of sources including normal cellular functions in the body but also from irritants, ultraviolet radiation, smoking, and microbes on the skin surface. Even bad dandruff and seborrheic dermatitis generate significant oxidative stress. The abnormal scalp lipids in some scarring alopecias are a particular source of potential oxidative stress and a key research interest of mine.
Overall more research is needed to better understand the uses and benefits of coenzyme Q 10.
Reference Nagao et al. Treatment of warfarin induced hair loss with ubidecarenone. Lancet. 1995; 21: 346:1104
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.
