In 2017, Ben started exploring his treatment options. Not wanting to take drugs, he wanted to first to try an all-natural regimen. If that didn’t work, he’d reevaluate his options.

This is what led him to perfecthairhealth.com.

After reading the second edition of my book, Perfect Hair Health: Understanding, Stopping, & Reversing Hair Loss, Ben decided to start a regrowth regimen that he felt fit within his preferences and would also help his hair.

Specifically, he began implementing our standardized scalp massages.

In addition to the massages, Ben also implemented a few dietary and lifestyle changes to help improve the health of his scalp and reduce systemic inflammation.

If you’ve ever Googled, “The best diet for hair loss”, you’ve probably felt overwhelmed by the amount of conflicting advice online. Some hair loss sufferers swear they’ve seen improvements with veganism; others swear by paleo; others try to sell you a supplement.

The reality? Diet’s influence on hair health is often overstated, and it depends entirely on our hair loss type.

Yes, bad food choices can kickstart certain hair shedding disorders (i.e., telogen effluvium). But can a bad diet trigger the most common form of male hair loss – pattern hair loss (androgenic alopecia)?

The evidence so far suggests no. In fact, our 2019 massage study also found that different diets shouldn’t influence your ability to achieve results, provided that you…

1. Suffer exclusively from pattern hair loss
2. Are nutrient replete (i.e., you’re getting all of their nutrients)
3. Avoid a calorie deficit (i.e., you aren’t forcibly losing weight)
4. Avoid allergenic foods (this will vary person-to-person)

The bottom line: Ben was a long-time vegetarian. He didn’t want to start eating meat to improve his hair. And, in most cases, he shouldn’t have to… provided he meets all of the criteria above.

In any case, Ben made a few dietary / lifestyle tweaks that he hoped would help with his overall health. Specifically…

1. He cut back on shampooing to once per week (to help normalize sebum production)
2. He reduced his grain (and gluten) intake
3. He reduced his consumption of oxidized polyunsaturated fats from certain vegetable oils (i.e., canola oil)

At this stage, given Ben’s (1) year of massaging, (2) lacking results, and (3) his presentation of hair loss – it became increasingly likely that something else had to be going on. Here’s why.

In my five years working with readers, it’s become apparent that, in most cases, the massages work well for pattern hair loss (androgenic alopecia).

Again, androgenic alopecia is the most common form of hair loss in adult men. It’s so common that you often can’t walk a city block with spotting someone with the condition: hairline recession, a bald spot, or even general thinning across the top of the scalp.

Having said that, this isn’t the only type of hair loss from which men can suffer. There are also hair shedding disorders – conditions like telogen effluvium and chronic telogen effluvium – which can occur outside of pattern hair loss… or even compound it.

Some of the most common causes of hair shedding disorders? Problems like…

• Stress (emotional, physical, or stress following surgery)
• Medication use (birth control pills, NSAID’s, anti-depressants, etc.)
• Nutrient deficiencies (i.e., iron, zinc, vitamin B12, vitamin D, etc.)
• Nutrient surpluses (i.e., vitamin A, selenium)
• Hypothyroidism
• Hyperparathyroidism
• Small intestinal bacterial overgrowth (SIBO)
• Trace element / heavy metal toxicity (i.e., cadmium, aluminum, arsenic)

The bottom line: Ben was a long-time vegetarian. He didn’t want to start eating meat to improve his hair. And, in most cases, he shouldn’t have to… provided he meets all of the criteria above.

In any case, Ben made a few dietary / lifestyle tweaks that he hoped would help with his overall health. Specifically…

1. He cut back on shampooing to once per week (to help normalize sebum production)
2. He reduced his grain (and gluten) intake
3. He reduced his consumption of oxidized polyunsaturated fats from certain vegetable oils (i.e., canola oil)

When Ben got his results, he realized that his serum iron was just 29 mcg/dL and his iron saturation was just 11%.

Typical ranges for serum iron are 60-130 mcg/dL. Typical ranges for iron saturation are 25-35%.

In other words, Ben’s lab tests indicated he had an iron deficiency.

Not surprisingly, iron deficiencies are one of the most common causes of telogen effluvium (a hair shedding disorder). It looks like we were starting to put the pieces of the puzzle together.

After all, these lab tests suggested that Ben’s hair loss wasn’t completely androgenic in nature. They also provided an explanation for why Ben hadn’t yet seen results from massaging: he was applying a therapy for androgenic alopecia to hair loss that was likely androgenic alopecia + a hair shedding disorder.

In these cases, we often have to resolve the hair shedding disorder first, then tackle the androgenic alopecia second.

Knowing this, we had a clarity for next-steps.

1. Identify the cause of Ben’s iron deficiency. Yes, Ben was a long-term vegetarian (which predisposes him to a higher risk of anemia). But this doesn’t necessarily mean a vegetarian diet is the cause of his iron deficiency. In fact, iron deficiencies can arise not just from low iron intake… but also malabsorption issues, low folate levels, a blood infection, hypothyroidism, or even medication interferences. To be safe, more testing is often needed before someone starts supplementing with / consuming more iron to address their deficiency.
2. Resolve the iron deficiency. Once we have a better picture of what’s causing Ben’s iron deficiency, we can go about resolving its underlying contributors, rise his levels, and thereby start resolving his hair shedding disorder.
3. Reintroduce scalp massaging / other androgenic alopecia treatments. Once Ben’s iron levels are back to normal, he should begin to experience a better response to androgenic alopecia treatments (provided that’s the only contributor to his telogen effluvium).

So, I first recommend to Ben that he do a full iron panel (rather than the partial panel last ordered by his doctor). I figured this would be the safest and most cost-effect way to proceed.

After all, a full iron panel would give us better insights into whether Ben’s deficiency was due to low iron consumption or an underlying blood infection. If the latter, consuming or supplementing with iron might make his condition worse.

So I sent Ben the email. But three months later, I hadn’t heard back.

A few weeks later, I decided to check in with Ben again (this time, on an unrelated issue). This time, he got back to me with an (exciting) update.