Omega 3 fatty acids: A potential adjuvant in hair loss treatment in women?

So what are omega 3 fatty acids?

Omega 3 fatty acids are called 'essential' fatty acids because we, as humans, can't synthesize them ourselves. We need to get them from our diet.   

While research in the role of these essential fatty acids in hair biology is still in it's early stages, and we don't really understand if they help or not, it is well known that these omega 3's have a variety of beneficial effects for human health. Evidence suggests that these omega 3's have benefits such as lowering triglycerides in the blood, decreasing inflammation, reducing the risk of heart attacks and strokes, possibly lowering blood pressure and improving brain function.  These fatty acids may also enhance the anti-inflammatory ability of certain drugs.

EPA, DHA and ALA

The 3 key omega 3 fatty acids are EPA, DHA (which are primarily found in fatty fish) and ALA (which is found in plant sources like walnuts), which stand for

• eicosapentaenoic acid (EPA)
• docosahexaenoic acid (DHA)
• alpha-linolenic acid (ALA)

How much: What dose of omega 3's do we need?

The exact amount of omega 3 fatty acids we need is not clear but 1000 mg (and maybe up to 3000 mg) seems reasonable and have been the numbers investigated in various studies. Doses more than 1000 mg should be used only in conjunction with a physician as they cause cause a variety of gastrointestinal side effects. While supplements are often recommended for standardized sources, many foods are rich in omega 3 fatty acids. These include oily fish like salmon, sardines, herring, mackerel, halibut, tuna. These are great ways to get EPA and DHA.  Many oils have ALA (canola oil, olive oil, flaxseed oil) but ALA in these have only a small benefit compared to the benefit of EPA and DHA.

Fish oils may not be right for everyone and I advise individuals to consider speaking with their physicians before starting. Omega 3's for example can theoretically reduce clotting and increase the propensity to bleed. While this may not be relevant on a day to day basis, it is relevant if someone is considering surgery. 

Omega 3s in genetic hair loss

The role of omega 3's in treating genetic hair loss (androgenetic alopecia) is still unknown. Two studies have prompted my research group to investigate whether omega 3's have a role in genetic hair loss. 

A study by Oner and colleagues from Turkey looked at hormonal changes in 45 women with polycystic ovary syndrome (PCOS) treated with 1500 mg of omega 3 fatty acids for 6 months.  Interestingly, body mass index, testosterone levels decreased and sex hormone binding globulin ( a protein which binds to and cancels testosterone) was increased.  Hair loss was not studied but these parameters certainly point to potential benefits. We've been studying omega 3's for a while now. 

A study by Nadjarzadeah and colleagues from Iran examined the effect of taking 3000 mg of omega 3's for 8 weeks in 78 women with PCOS. Interestingly, this study showed that omega 3's reduced testosterone levels; SHBG levels were not changed. 

Omega 3s in inflammatory hair diseases

The role of omega 3's in inflammatory hair diseases including autoimmune type scarring alopecias (lichen planopilaris, frontal fibrosing, folliculitis decalvans) and alopecia areata remains to be determined and is presently unknown. It's clear from a number of studies that consuming omega 3's lowers inflammatory markers in the blood (such as CRP, TNF-alpha). I've been closely following the role of omega 3's in the treatment of rheumatoid arthritis because some inflammatory hair diseases have similarities to the biological changes in rheumatoid arthritis. These studies suggest that omega 3's may have a modest benefit in the treatment of rheumatoid arthritis.  In another autoimmune condition lupus, studies suggest that EPA fish oils may help reduce symptoms. 

Conclusion

Overall, we don't yet know if omega 3's have any benefit in the treatment of hair loss. Studies are ongoing. Certainly, there is reason to believe that some benefit may occur. 

References

1. Oner et al. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gyncaecol 2013; 33(3) 289-91

2. Nadjarzadeh et al. The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iran J Reprod Med 2013; 11: 665-72.

3. Miles EA et al. "Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis.". The British journal of nutrition. 107: S171–84. 

4. Li K et al. Effect of marine derived n-3 polyunsaturated fatty acids on C-reactive protein, interleukin 6 and tumor necrosis factor alpha: a meta-analysis. PLOS ONE 9 (2) : e88103.