Genes & Hair Loss: Not So Simple Anymore

Read Time: 20 minutes

“You’re losing your hair? Well, it’s genetic.” This is what most men hear after asking a medical professional what causes hair loss. But it’s not entirely true.

While certain genes may predispose men and women to hair loss, not everyone with these genes will go bald. And even if you’re thinning and have hair loss-related genes, it doesn’t mean that baldness is your genetic destiny.

So why are so many doctors convinced that baldness is genetic, unavoidable, and only stoppable with potentially dangerous drugs?

This article uncovers why. After reading you will know:

  • Why genetic predisposition does NOT equal genetic destiny
  • My pattern hair loss medical diagnosis AND gene testing results
  • My hair loss ‘before’ and ‘after’ photos – no pills, drugs, shampoos, surgeries, or topicals
  • Other readers’ natural before-after hair growth photos
  • The basics of gene expression and DNA methylation
  • How to turn on or off your own genes (hint: it’s easier than it sounds)

Note: this article is an excerpt from the new book. Want to access the excerpt and all my hair loss before-after photos? Confirm your email. I’ll send you my photos and an entire chapter – absolutely free.

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Genetics & Hair Loss: Fact Or Fiction?

After my hair loss diagnosis, every medical practitioner I ever consulted told me I was losing my hair because of my genes. Even my physician said that while drugs like Rogaine or Propecia may slow or reverse some hair loss, there’s not much I can do (short of a hair transplant) to stop the process. In other words, it’s inevitable. It’s unstoppable. As my former barber explained to me, “You can’t fight genetics.”

But is the assumption that baldness is caused by your genes actually true?

Twenty years ago, the answer was yes. At that time, medical professionals agreed that your genes – or the DNA your parents pass on to you – determine all of biology (from how tall you are to how much hair you have). And since genes “run in the family”, if your father had a heart attack, you’re genetically predisposed to heart disease. If your father lost his hair, you’re genetically predisposed to baldness.

For instance, studies show a clear relationship between certain genes and hair loss. If we have this genotype, we’re twice as likely to go bald. If we’re really unlucky and have this genotype, we’re seven times more likely to bald. If we have both genes? We’re screwed. Or at least that was the assumption.

Today researchers are rewriting this assumption. New discoveries are dismantling the relationship between genes, disease states, chronic conditions… and even our hair.

It all began with The Human Genome Project.

Genetic Destiny: The Human Genome Project

In 1990, a series of international research teams began working on a multi-year, multi-billion dollar research collaboration: The Human Genome Project. The objective: to identify and quantify every single human gene. The rationale behind its funding: One major scientific assumption, and one major scientific promise.

The assumption: our genes are the root cause of our cancers, autoimmune disorders, and chronic conditions.

The promise: if we map every single human gene, we can identify the genes that trigger diseases like multiple sclerosis or Parkinson’s. If we know which genes cause disease, we can develop technologies to “delete” those genes and then prevent them from ever happening.

It’s no surprise that the US spearheaded this research project. Over 130 million Americans – or 45% of the entire US population – suffer from chronic diseases. Chronic conditions are responsible for seven out of ten American deaths. They account for over 80% of all US hospital admissions. And every 30 seconds, an American-based doctor amputates a limb as a consequence to one of the country’s most common ailments – diabetes.

Why wouldn’t a disease-ridden nation support a project with such potential? Why wouldn’t this nation want to be at the forefront of these discoveries?

The Human Genome Project’s expectations could not have been higher. Whereas mice have about 20,000 genes, scientists speculated that humans, due to their complexity, would have seven times that amount – 140,000 genes. Once all the genetic triggers of cancers, autoimmunity, and even autism were mapped, we’d begin creating technology to “turn off” those genes and paint a disease-free future.

Thirteen years later, the project was completed. What were the results?

The Human Genome Project’s Promises Fall Flat

The discoveries stemming from the Human Genome Project were puzzling at best, and disappointing at worst.

For one, scientists uncovered that humans don’t have nearly as many genes as we thought. In fact, humans have just about 20,500 genes. Shockingly, we have only 300 unique genes that distinguish us from a mouse.

But the most surprising discovery was that, despite mapping our entire human genome and identifying some genes linked to disease, nearly all gene variants posed a minimal risk for disease development. In other words, the root cause of most disease was not genetic.

Some genes are associated with disease, but most genes do not cause disease.

Intriguingly, researchers also discovered that our genes weren’t so “one dimensional.” Many genes actually serve multiple functions. They don’t have single-purpose relationships with specific processes – like cancer development or metabolism. If we delete a disease-linked gene, we might never develop that disease, but we might also impair our digestion, brain function, or even immunity. For example, the gene mutation that causes sickle cell disorder also protects people from malaria. Sickle cell disorder is more common in malaria-ridden regions, and many researchers believe this mutation actually helps sufferers survive to adulthood and reproduce, even if the disease shortens lifespan overall.

In short, the Human Genome Project failed to fulfill its promise, but it was still undeniably important. It forced researchers to revise one major scientific assumption…

Genetics do not determine all of biology. Our genes are not our destiny.

These Findings Rewrite Science, But Doctors Keep Repeating Outdated Dogma

By 2003, the conventional wisdom that genes are the root cause of our cancers, chronic conditions, and diseases was proven wrong. But doctors never stopped repeating the dogma. Most continued telling patients their ailments were genetically driven. Why?

The answer is threefold:

  1. Medical practitioners like to sound authoritative
  2. These findings created huge uncertainties and challenged what doctors told their patients for years
  3. Most patients aren’t scientifically literate. They do better with simple, blanket explanations.

Think about it. If you’re a cardiologist and your patient asks, “Why do I have heart disease?”, which answer sounds best?

  • “It’s in your genes,” or…
  • “We used to think it was your genes, but now we aren’t sure.” or…
  • “It’s complicated, and I don’t think you’d understand.”

Of course the first answer sounds the best. The layperson knows about “genes”, but very few people understand more than, “They’re passed down from your parents to you.” When an explanation feels beyond someone’s grasps, people often stop asking questions.

Don’t Blame Your Doctor For Not Wanting To Educate You

I don’t think doctors maliciously intend to withhold information from you. That’s conspiratorial and unproven. But when we look at the pressures doctors face, it’s no wonder they default to simple explanations.

Doctors work an average of 59.6 hours per week. Most family doctors manage a panel of 2,300 patients. A specialist’s waitlist is months-long and never-ending. On average, specialists spend just 20.8 minutes per patient. And for new doctors, face-to-face patient time lasts merely eight minutes. Keeping up with patient demand means longer hours, shorter patient interactions, and more daily appointments.

When a doctor tells a patient their condition is “genetic”, it’s the shortest answer possible. It yields the fewest patient inquiries. It’s an answer that gets a patient out of the chair faster. It’s an answer that gets physicians to their next appointment faster.

Unfortunately, it’s also an answer that’s mostly untrue. For the majority of diseases, the Human Genome Project took that “gene” argument off the table. In fact, new research speculates that 70-90% of disease risk isn’t genetic. It’s environmental.

So the next time a doctor tells you “It’s all in your genes,” ask for more information. And the next time a doctor says, “Hair loss is genetic,” ask the same question.

My DNA Test For Hair Loss: 23andMe

Early in this article we mentioned a few genes associated with hair loss. There are actually a lot more. I would know. I have almost all of them.

In 2015, I decided to discover more about my genes. So I went and got my entire human genome sequenced through a service called 23andMe.

This is how it works: 23andMe mails you a vial. You fill that vial with saliva and mail it back to their lab. 23andMe processes your vial, decodes your human DNA, and sends you back the raw data. The company also provides you with “fun” add-on services – like what percent of Neanderthal you are, where your mother and father come from, if you have any relatives in their database, or if you have any life-threatening genetic variants (that one’s not so fun).

I was more interested in finding out what my raw genetic data said about my potential to develop disease. Specifically, I wanted to know, based on my genes, how likely I was to go bald.

So I uploaded my 23andMe data into a company called Promethease. Promethease cross-references your DNA with all the published studies about your genotypes, then sends you an automated 100+ page report. The report tells you everything from how well you methylate B-vitamins to how quickly you detoxify drugs to your genetic predisposition for certain cancers.

So how did my raw DNA compare to all the studies on genotypes and male pattern baldness?

My Genes & Predisposition To Hair Loss

Here’s a readout of how my DNA stacked up versus all the genotypes linked to hair loss.

Let’s start with the good news. I have one genotype that says I have a reduced risk for baldness:

So far so good! (For anyone who’s curious, you can read the study about that genotype here.)

Now for the bad news.

I have ten other genotypes linked to hair loss. Each one of them increases my risk for balding.

And now for the worst of my genotypes… A 1.6x increased chance for baldness, followed by a 2x increased chance for baldness…

…followed by an increased risk to go completely bald before 40…

…followed by the worst genotype of them all… a 7x greater risk for baldness.

A seven times increased risk for balding! Remember those hair loss genes referenced earlier in the chapter? I have both. Based on my DNA, I’m screwed.

And then there’s the mounting physical evidence.

Most Men In My Family Are Slick Bald

My mother’s father is bald. My mother’s brother is bald. My father’s father was bald. My father’s brother is bald.

And then there’s my hair loss medical diagnosis…

My Hair Loss Medical Diagnosis

I started noticing hair thinning at age 16. A few months later, a doctor diagnosed me with male pattern hair loss. Here are his notes from our consultation:

Soon after the diagnosis I picked up a bottle of Rogaine and started an eight-week trial of low-level laser therapy (Luce therapy). While I never followed through with taking Propecia, I ended up taking Rogaine for seven years – even despite my continued thinning (see my photos).

My Hair Loss Photos

You can access hair loss photos inside the free chapter. Inside you’ll find:

  • My hair baseline photos (the mid 1990’s)
  • My hair photos one year before my hair loss medical diagnosis (2006)
  • My hair loss photos at year four and five of Rogaine (2011-2012)
  • My hair regrowth “after” photos (2014-present)
  • Other readers’ before-after hair regrowth photos (2015-present)

Access The Chapter + My Before-After Photos:

Get The Free Chapter

Enter your email for my hair loss diagnosis, regrowth photos, and a full free chapter.

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Now let’s review the facts:

  1. According to my DNA data, I have a genetic predisposition to pattern hair loss
  2. At 17 years old, a medical professional diagnosed me with male pattern hair loss
  3. My 2011 and 2012 photos show clear thinning at the vertex

All kidding aside – my DNA data, diagnosis, and hair loss ‘before’ photos all suggest that baldness will be my genetic destiny.

But my ‘after’ photos suggest otherwise. In fact, I was able to reverse my hair loss naturally – without pills, topicals, drugs, shampoos, or surgeries. The same is true for those other readers inside that sample chapter.

In fact, natural hair regrowth photos continue to arrive in my inbox to this day. Here’s a high-definition progress photo of a reader’s vertex from earlier last week.

Recent Regrowth Photos From A Reader

Massage Natural Hair Regrowth

So is baldness still a genetic destiny? I’d like to think, just like the Human Genome Project, that we can revise that assumption. And this “revision” can be done without drugs, shampoos, topicals, or surgeries.

Hair Loss And Genetic Destiny – Revised

What Causes Hair Loss? Genes Or Something Else?

If most genes are only associated with hair loss, but don’t necessarily cause it… Then what is the cause?

It turns out that while we can’t change our genes, we do have the power to turn genes “on” or “off”. Researchers now believe disease development has less to do with our genes, and more to do with which genes our body actives or deactivates. This is called gene expression – or when our cells turn combinations of genes on and off to perform certain functions.

Epigenetics – A Hair Loss Breakthrough

There’s an entire field of study exploring the factors that influence gene expression – Epigenetics. Epigenetics has revolutionized our understanding of disease prevention, pathology, treatment, and reversal. Epigenetics is what makes natural hair regrowth possible.

To understand the potential of epigenetics, let’s look at a few examples of just how easy it is to change gene expression, and just how transformative those changes can be.

We’ll start with agouti mice – a mouse breed once believed to be destined to a life of obesity due to their genes. Then one experiment changed everything.

Epigenetics Breakthrough: The Agouti Mice

Is it possible to stay 100% healthy even if your genes “relegate” you to a life of disease? In the early 2000’s, researchers set out to uncover the answer.

They set up an experiment with a certain type of mice called “agouti” mice. Agouti mice are genetically doomed. They have a mutation in what’s known as the “agouti” gene – a gene that determines fur color. Normal mice vary in color from brown to black. But this mutation makes agouti mice yellow.

But they’re not just yellow. One look at these photo and you’ll notice something else:

(source 1(source 2)

These agouti mice are also obese, ravenous, and far more likely to die prematurely from heart disease, cancer, and diabetes. It’s a mutation that, in extreme cases, is known as a “lethal allele” – a gene variant that causes early death in the animals that have it.

You can’t change your genes. So does this gene guarantee agouti mice to a life of disease?

Researchers decided the best way to answer this was to see if they could influence the agouti gene’s behavior.

The team believed that if they could give mega-doses of certain nutrients to an agouti mouse during its early development (ie: while it was still inside the womb), then maybe those early nutritional gains would help the mouse live longer. Agouti mouse would still be born yellow, but maybe they wouldn’t be so overweight or die so young.

So they split up their agouti female mice into two groups, fed them each two different diets, then impregnated them.

Two Mother Groups, Two Different Diets

One mother group was fed a standard lab rat diet. The other mother group was fed a diet rich in vitamin B-12, folic acid, betaine, and choline for two weeks before and during their pregnancy. The females were mated, and twenty days later, each group was ready to give birth.

This was a longevity study. It would take years for researchers to track each baby’s weight, length, development of cancers, and finally their age of death. In short, no one expected any surprises during the birthing stage. But that’s just what happened.

A Birth Of Surprise

When these agouti mothers gave birth, researchers discovered two things:

  1. In the group fed a lab rat diet, the babies were born yellow and fat (as expected).
  2. In the group fed a nutritionally rich diet, the majority of babies were born brown. And skinny.

(source)

These siblings are genetically identical. How can they look so different?

The Agouti Mice Defy Genetic “Destiny”

The group of agoutis fed mega-doses of nutrients defied genetic destiny. They were supposed to be born yellow and overweight. Instead, they were born brown and skinny – just like mice without the agouti gene mutation.

How is this possible? The agouti gene is unchangeable. It destines agouti mice to be yellow and fat. “You can’t fight genetics,” as my barber said.

Except you can. Here’s something doctors don’t mention about genes: they can become activated or inactivated. That’s what Epigenetics is – the study of gene expression. And this agouti mouse study was a breakthrough. Why? It proved we could control gene expression. We can turn off the gene that makes mice yellow and fat… using only better prenatal nutrition.

This is possible through a process called methylation.

Gene Expression & Methylation: Why Our Bodies Turn Genes On And Off

Before conducting the agouti mice study, researchers uncovered that the agouti gene – the gene responsible for agouti mice’s yellow coat and obesity – was “unmethylated”. What does that mean?

It means in the yellow mice, the agouti gene was always “turned on.” It was always activated inside the mouse’s cells.

Researchers also knew that methyl donors – compounds found in certain foods – could potentially “methylate” certain genes – or turn them off.

How Does Methylation Alter Genes Expression?

To put it simply, inside every cell is DNA, and inside DNA are genes. When we eat food, our cells break down that food for energy. If that food also contains methyl donors, those methyl donors will also enter our cells and leave behind small chemical tags on top of our DNA. These chemical tags tell the cell which genes it should turn on or off.

An unmethylated gene is active – or turned on (upregulated). A methylated gene is turned off – or inactivated (downregulated).

For a fascinating overview, see this flowchart.

These researchers thought that if they fed pregnant agouti mice enough methyl donors, maybe those methyl donors would “methylate” the agouti gene, and in doing so, dim the gene’s effects on the mother’s babies.

They did, and beyond all expectations.

The diets high in methyl donors not only methylated the agouti gene, they turned it off completely. What’s even more interesting, when those brown, healthy agouti offspring reproduced, they passed down their coat color! Their babies were also brown.

These results changed our understanding of genetics forever. Even before the Human Genome Project was complete, another research team had already rewritten its biggest assumption. You can control your gene expression. Genes might be your body’s blueprints, but genes do not determine your destiny.

The researchers published their study in 2007, and within the year, interest exploded in what is now known as Epigenetics – the study of the factors that influence our gene expression.

It turns out these factors extend far beyond the prenatal nutrition of agouti mice.

Gene Expression – Out Of The Womb, Into Your Control

At birth, identical twins’ genes are the same, and their gene expression (which genes are turned on and off) is nearly identical. But as twins age, their active and inactive genes begin to diverge. And by adulthood, their gene expression looks nothing alike. Some researchers believe these differences are why one identical twin can develop disease while the other twin remains unaffected.

Even more interestingly, new research suggests that epigenetic differences may explain why one twin balds faster than the other, and sometimes, not at all.

So what are the factors that influence gene expression and contribute to disease development… or disease prevention?

What Influences Gene Expression?

The short answer is everything. Let’s start with the bad:

The list goes on… But now for the good:

Here’s an infographic:

As we can see, the factors influencing our epigenome are extensive. Anything from the air we breathe to the foods we eat to the amount we sleep can change which genes our bodies upregulate and downregulate. Which brings us to an important question…

Can we influence our gene expression to arrest or even reverse pattern hair loss?

In my experience, yes.

Final Thoughts: Hair Loss And Epigenetics

Everything from the air we breathe to the foods we eat affects the genes we express. We might carry the gene for a rare cancer, but if we live in ways that never activate that gene, we don’t have to develop that cancer. The same is true for hair loss.

If we want to arrest pattern hair loss, we need to minimize our exposure to what can trigger it, and optimize our exposure to what promotes hair regrowth. And if we want to regrow lost hair, we need to reverse the two chronic conditions that cause hair loss in the first place. It starts with our scalp environment, diet, lifestyle, and even our microbiome.

Hair loss is chronic and progressive. There’s also a genetic component to it. But we don’t have to express the genes associated with hair loss. And even after we start losing our hair, we can even influence our own gene expression to activate the genes associated with hair growth and deactivate the genes associated with hair loss.

Gene expression – and our ability to change it – is the basis for what makes natural hair regrowth possible.

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Stop Googling "How To Regrow Hair" Until 3AM

Instead, just sign up for my 10-day course on natural hair recovery.

Inside, you'll get access to my before-after photos, the science behind the DHT paradox, hair treatment mistakes to avoid, reader-submitted photos, and more.

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33 Comments

  • Akeel Yaqub

    Reply Reply January 23, 2017

    hey rob i just wanted to ask, as i have acne will the diet changes in the program improve or worsen my acne?

    • Rob

      Reply Reply January 23, 2017

      On the contrary – I’ve seen significant skin improvements from the diet outlined in the book. But in general, improvement depends on the kind of acne. If it’s acne as a result of small intestinal bacterial overgrowth – then a diet void of heavy starch or carb meals will help significantly. To adopt this to the book’s diet, just eat fewer potatoes / rice but still keep total calories the same (avoid a deficit). If your acne is hormonally-driven, then the diet outlined in the book should help as-is.

  • Praz

    Reply Reply January 23, 2017

    Rob , Interesting article.

    According to Rei Ogawa mechanical stimulation changes Gene expression.

    are we talking about a matter of months before Gene expression changes? How often does this occur.

    And im seeing changes in Hair quality since doing the messages. Im three months in, and it looks feels more dense. No longer greasy and dead. However No re-growth( only three months) , but definite positive change in quality look. Wouldnt say complete thickness yet, but looks better than last month. Also skin is becoming much more elastic on vertex, frontal is also giving in. However ive lost ground on probably what was dead hair on the front.

    Il keep you up to date.

    Thanks.

    • Rob

      Reply Reply January 23, 2017

      Hey Praz – according to Rei Ogawa’s research, gene expression can change in a matter of hours. After 72 hours of continuous dermal papilla stretching, Ogawa and his team demonstrated thousands of genes expression changes. Obviously we can’t keep our scalps stretched all day long, but cumulatively the stretching exercises should help in the long-run.

      Great to hear about your progress. I’d consider easing up on any areas where you feel like you’re losing ground. There’s no need to regress so long as you ease into the regimen slowly. Everything else sounds like you’re on track.

  • Praz

    Reply Reply January 24, 2017

    Rob thats incredible.

    72 hours ?

    Allow me to play devils advocate. I know the answer might not be simple.

    So Gene expression has changed to a pro-growth status. Which would if my calculations are correct would take just over 4 months of the regimen (40 mins per day) . Funny enought this is where I read most people begin to see significant changes to quality if they have done the massage without missing a day. Most likely longer.

    But Scalp environment (Ie calfication reduction) would have to be in good shape and health in order for these newly expressed genes to allow re-growth process.

    Whats your opinion on Cupping therapy ? I read people halted Hair loss. And the biggest discovery was that they found clots of goo like blood in the scalp. Which sounds like fibrosis.

    Thanks

    • Rob

      Reply Reply January 25, 2017

      Hey Praz – cupping has long interested me, but I’ve never tried it and haven’t been able to speak personally with anyone who’s tried it for hair loss. My assumption, based off what we know about mechanical stimulation, is that the bruising/wounding effects are all pro-hair. The benefits are probably exponential if someone’s also already loosened their scalp or dialed in diet/lifestyle to minimize the conversion of free testosterone to tissue DHT during inflammatory processes. If you try it, please let me know! I’d love to hear about the experience.

  • Kuba

    Reply Reply January 27, 2017

    Rob I need your advice. About tho months ago my doctor who is actually both doctor in chinesse medicine and west medicine instructed me to using something like Zhangguang 101. This person came from china by the way and claims that this product have very good results. I am using this product with massage since 2 month. It’s too short time to see any result but do you have any knowledge about this products ? Remember that I am talking about Zhangguag, not Fabao, fabao is a scam.

    • Rob

      Reply Reply January 27, 2017

      Kuba – I checked out their site but could only find minimal information about each product’s ingredients. It looks like most ingredients are catered toward 5-AR inhibition and increasing blood flow. I don’t think using this product will hurt, but I’ve also never advocated for or endorsed any supplements or topicals, ever. But if you’re going to spend money on hair regrowth supplements or topicals, you might want to also consider attacking DHT from a different angle: rather than blocking DHT, increasing the speed of its metabolism. Check out the research on sulforaphane, or just start eating foods rich in it (like broccoli sprouts).

      • Paz

        Reply Reply January 29, 2017

        Rob

        I’ve just read some information on sulfarphane.

        Seems promising. But would a supplement be enough ? And should this be categorized like a DHT blocker IE saw palmetto ect

  • Ankur

    Reply Reply January 27, 2017

    Hey Rob..A brilliant article regarding gene expression nd balding.
    Can you please advice regarding one thing. Regarding microbiome, nutrition, gut flora & gene expression can all these years of eating inflamotory food could have diminished the good gut microbial counts? And in this regard will a good probiotic and/or fermented foods/veg be beneficial for restabilising the proper gut biome..

    • Rob

      Reply Reply January 28, 2017

      Great points. It’s been shown that different diets encourage different populations of gut flora, with stark differences observed in vegans versus standard american diets versus paleolithic diets versus fasting-related diets. A probiotic / fermented foods can help mitigate or even restore damaged or missing flora due to years of poor dieting. But unfortunately 99% of probiotics on the market are scams. They’re over-priced, don’t have a high enough bacteria count, and sometimes the bacteria are often dead-on-arrival due to poor shipping regulations and heat exposure.

      The best probiotic I’ve ever tried has been VSL#3. And it’s hard to come by. But it’s one of the few that have been clinically studied and shown to improve gut health in those with compromised immune systems.

  • Mert

    Reply Reply January 28, 2017

    Hey guys I have a question. I’m a bodybuilder, (especially I like powerlifting) not like a gym rat but I go for 1 hour of workout once in 2 days. As I realize more and more balding bodybuilder I become getting anxious 😀 Do you think that there is a relation between balding and hair loss, or is it balding guys tend to develop their body more because of losing confidince caused by hair loss?

    • Rob

      Reply Reply January 28, 2017

      Hey Mert – great question and very tough to answer. We know that hair loss and an imbalance between testosterone:estrogen exists in men. But interestingly, bodybuilding’s effects on testosterone levels is debatable, with testosterone increasing shortly after burst-related workouts (sprints, powerlifting, etc.) but with those upticks never sustained over days or weeks.

      With the limited evidence available, I think if bodybuilding has any negative impact on hair, it probably comes from its potential to increase baseline cortisol levels – with increases sustained for those working out too hard, too long, and too often. Couple this with dietary choices that can exacerbate cortisol release (caffeine, etc.) and you can end up with increased hair shedding as a bodybuilder. Check out this article for more information:

      https://perfecthairhealth.com/part-2-of-3-the-exercise-and-hair-loss-connection/

      As far as the relationship between balding guys and bodybuilding – this could be due to any number of things:

      1) A slight uptick in free testosterone right after heavy lifting, and resultantly (in susceptible individuals), an increase in the conversion of free testosterone to tissue DHT in the scalp (though this is a bit of a stretch).

      2) Chronically increased cortisol (more likely)

      3) Steroid use

      But I don’t assume that just because someone lifts, they are more likely to lose their hair. If you’re smart about your workouts, have nutrition dialed in, and are working within the parameters of your body, you can get solid gains without the hair loss.

      • Mert

        Reply Reply January 29, 2017

        Another short question too then Rob 😀

        I think I’m a stressed guy generally, I have overthinking problem 😀 I examine people, things, events around me too much and think about them. I assume that I probably have chronically increased cortisol levels. (Also, all my hair loss cascade started during a very very high stress period. I had ocd, thoughts that always stress me immensely, and also I had to study hard for university. I lost very much hair in that 9 month period, people could easily say I was losing hair. It’s mostly recovered now after that, but I still have hair loss.)

        Shortly, my question is do you have any recommendation to people who have chronically increased cortisol, and are we sure it causes hair loss?

        • Rob

          Reply Reply January 31, 2017

          Elevated cortisol is associated with increased shedding, and while there’s a debate between whether excess shedding is the same as pattern hair loss (I consider the two different), in general we want to keep cortisol in check. Here are just a few things that can contribute to chronically high cortisol levels:

          1) Lack of sleep
          2) Lack of sunlight
          3) Caffeine
          4) Alcohol
          5) Stress

          Dial those in! The triggers of high cortisol vary for each individual. But when it comes to common causes, those are top-of-mind.

  • dante

    Reply Reply February 9, 2017

    Hi rob,
    i was talking about DHT metabolites involved in baldness. Well, there are two prominent ones -> 3-alpha-diol and 3-beta diol.
    http://meridianvalleylab.com/testosteron-metabolite-3b-adiol
    I thought since it is anti-prostate cancer , may be there might be less breakdown of DHT in 3-beta-diol in balding scalps. Turns out i was wrong.
    https://www.ncbi.nlm.nih.gov/pubmed/2091154
    https://www.ncbi.nlm.nih.gov/pubmed/8104354
    Or may be it’s higher quantity is present as a response to some other thing in the balding scalp.(Frankly i don’t know)
    however, on its own , 3-beta-diol has very anti-stress, anti-anxiety effects when taken/inhaled at physiological doses(Source: wikipedia + people who have taken it).
    I know people who have taken pure DHT yet didn’t get any hair loss. Some clinical trails which used DHT haven’t reported hair loss as a side-effect. May be downstream metabolites are the key here

    • Rob

      Reply Reply February 15, 2017

      Hey Dante – thank you. I’m looking into this more and will report back if I find anything worth sharing. Unfortunately, I don’t know if enough research has been done on metabolites to say with certainty that they’re a causative factor in balding. It’s certainly possible. If I find something, I’ll send you an email right away.

  • paola

    Reply Reply February 14, 2017

    Hi Rob,
    I have a question regarding the technique because there is an article that talks about the inversion method which is when you give yourself a massage for one week of the month. Only one week because she states that if you do it everyday, your scalp gets accustomed and will eventually slow the hair growth. What are your thoughts on this?

    • Rob

      Reply Reply February 15, 2017

      Hi Paola – I’ve never seen anything in the scientific literature suggesting that hair growth slows due to massaging (or any mechanical stimulation). It certainly hasn’t been the case with me. Best, Rob

  • Kuba

    Reply Reply February 27, 2017

    Rob I am doing your regimen and I have a lot of dandruff or something like this caused by massage of course.
    The problem is , because of dandruff ( or something like this) my skin mainly on my temples is dry…
    Should I use maybe any oil on this places or leave it ? Is it any problem ? I mean dry skin. I don’t use any shampoo, only water, often is a cold water.

    • Rob

      Reply Reply March 2, 2017

      Hey Kuba – try decreasing your intensity or taking a day off. Conversely, you can also try an oil (emu, coconut) and even apple cider vinegar to see if that helps alleviate some of the dryness.

  • Wyatt

    Reply Reply March 5, 2017

    Hey Rob, I was just wondering why you don’t recommend bottled water in your book. And also what’s your opinion on like tuna in a can as opposed to like sardines or oysters. Thanks!

    • Rob

      Reply Reply March 6, 2017

      Hey Wyatt – thanks for reading. When I was an undergraduate student, my friend did a research project on the phthalate concentrations of water from major bottled water brands. Companies like Poland Springs had recently transitioned to a more “eco-friendly” packaging – meaning thinner, flimsier plastic to save on materials, and we’d yet to know how this would affect the rates of plastic leeching. Her study’s results: all major tested water bottles had phthalate concentrations far beyond what was projected… especially for national/international brands that were shipped far distances in hot trucks (the heat likely increased the leeching). Bottom line: bottled water might sound better than tap, but it’s got its own problems worth avoiding. I use tap water + an activated carbon filter.

      RE: canned tuna / oysters / sardines — my advice is to always opt for fresh. If you can’t get it, then just be sure the manufacturer from whom you buy your canned goods isn’t lining their tins with BPA, etc.

  • Ivan

    Reply Reply March 17, 2017

    Hello Rob.

    I was reading one of your articles recently about stopping the use of shampoos and conditioners.

    As someone with medium-long hair at the moment I’m interested in keeping it for as long as possible and this definitely caught my attention.

    Right now, I’m shampooing/conditioning twice a week. I used to shampoo/condition once a week but found my hair to get sort of limp and heavy by the end of the week so I decided to increase the frequency of my washings. On the days that I don’t wash my hair, I use coconut or argan oil to control frizz.

    My questions are:

    1). Do you think washing twice a week will increase the likelihood of thinning/balding? I like my current routine very much and I believe I’ve found my personal balance when it comes to the frequency of washing/not washing.

    2). Do you think shampoo/conditioner quality makes a difference? I’ve done my boatload’s share of research into what brands are good what brands are bad (mostly asking around on forums) and what ingredients to look/avoid. I would like to think I’m using some fairly high quality products but I don’t know if this makes any sort of difference.

    3). Do you think the use of oils has any effect on any of this? Like would coconut oil make the hair more brittle or clog the pores and cause thinning, etc. I would like to note that I do not apply the coconut/argan oil to my scalp but rather to the mid-shaft and ends of my hair.

    Thank you very much, I will be buying your book in the next few days and I look forward to making changes in my diet and lifestyle so that I may have a higher chance of keeping flowy hair into later life.

    Regards, Ivan.

    • Rob

      Reply Reply March 17, 2017

      Thanks for reaching out Ivan. To answer your questions–

      1) It depends on each individual. The main concern with frequent shampooing / conditioning is that you’re constantly stripping your hair of its natural oils (sebum), and thereby likely increasing the production of sebum, which over time, will make your hair look greasier faster and increase your dependency on shampooing / conditioning. There’s some evidence that excess sebum is associated with increased hair thinning – suspected to be the result of certain microbial colonies that feed off sebum and in turn create inflammation. So in my experience, it’s best to keep sebum production within normal ranges – and for myself and others, that means we need to stop the sebum overproduction cycle by quitting shampoos / conditioners.

      2) Quality does make a difference. But in general, most major brands skirt quality control and use misleading wording to make someone assume a shampoo is devoid of problematic ingredients when it isn’t. For instance, after sodium laurel/laureth sulfate started getting some negative attention, many brands stopped including it and instead advertised “no sodium laurel sulfate!” Their replacement ingredient? Coco laurel sulfate. It’s essentially the same molecular compound, only derived from coconuts. It’s less studied than SLS, but likely produces the same effects.

      3) Coconut hair might make the scalp and hair feel greasier, but it shouldn’t hurt hair quality or make your hair more brittle. On the contrary, most people report the opposite when they consistently use fat-based oils on their scalps (either as a leave-in nightly topical or even more sparingly – like application 20-30 minutes before showering).

      Best,
      Rob

      • Ivan

        Reply Reply March 17, 2017

        Thanks for taking the time to answer.

        If you don’t mind me asking, what’s your opinion on the theory floating around hair loss forums that excess body hair indicates how fast someone will lose their hair or if they will lose their hair at all?

        I live in the UK currently and probably 70% of all men around me that I see with MPB barely have any hair on their body let alone an excess of it. I have also seen some that fit the “hairy body, hairless scalp” type but I haven’t really observed any pattern.

        Do you think they’re related?

        • Rob

          Reply Reply March 17, 2017

          It’s an interesting theory! But the body hair-baldness connection seems to be more associative than causative. We know this from looking at the extremes: while relatively uncommon, there are men with lots of body hair and most (if not all) of their scalp hair – even late into life (for instance, Alec Baldwin).

          I wrote about a few of the leading theories and their shortcomings here:

          https://perfecthairhealth.com/the-leading-theories-of-pattern-hair-loss/

          • Ivan

            March 18, 2017

            Thanks man, just bought your book gonna start reading now and start applying the knowledge within.

  • Ivan

    Reply Reply March 20, 2017

    Is the massage meant as a treatment option for those who already are experiencing thinning, or is it also a preventative measure if you have a full head of hair?

    • Rob

      Reply Reply March 21, 2017

      Based on the evidence, it should be preventive too. I wish I’d started them long before my hair started thinning… It probably would’ve saved me a lot of time and energy!

      • Ivan

        Reply Reply March 21, 2017

        Ok, that makes sense.

        Regarding iron levels, I recently had a blood test but I couldn’t see any iron levels on my results.

        I had a red blood cell count, haemoglobin and haematocrit levels.

        Would those be enough to find out my iron levels or would I need an additional test just for iron?

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