Nutrition Factors Linked to Hair Loss

Photo by Emin Kuliyev

Premature baldness is not an accident. It is also not necessarily genetic. Certainly there are genetic factors, but research is increasingly showing that epigenetic factors – things we do now – often have a bigger influence.

More specifically, scientists have confirmed that baldness and premature hair loss are associated with a number of lifestyle choices, including drinking, smoking, caffeine use and others.

Identical twins and baldness

The researchers, including faculty from the Case Western Reserve University School of Medicine, studied 92 identical male twins between 2009 and 2011. They tested each of the twins and quantified their level of baldness, along with their testosterone levels using saliva analysis.

The baldness analysis utilized digital imagery that measured and segregated hair loss of the front above the forehead (frontal), above the temples (temporal) and around the crown of the head (vertex).

The researchers then conducted an extensive survey of each of the subjects’ lifestyle factors, including drinking, smoking, exercise, use of hats and many other factors. They then compared these results with levels of hair loss between the pairs.

By utilizing identical twins, the researchers effectively eliminated the factors related to genetics, since it is accepted that identical twins will carry the same set of genes.

The researchers found that frontal hair loss was significantly associated with having smoked for longer and the presence of dandruff.

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Temporal hair loss associated with alcohol consumption

They found that temporal hair loss – loss above the temples – was significantly associated with drinking more than four alcoholic drinks per week; using more hair products, and increased exercise duration (longer workouts).

Lower levels of hair loss on over the temples was associated with higher testosterone levels, wearing hats and having greater body weight.

Greater loss of hair at the vertex – the crown of the head – was also associated with increased alcohol use – more than four drinks a week.

Stress and smoking also associated with hair loss

It was also associated with smoking, longer workouts and increased levels of stress.

Hair thinning was associated with having more children, increased stress, thinness, more caffeine consumption and a history of skin disorders.

Some of the results of this study confirm research presented at the 2011 annual conference of the American Society of Plastic Surgeons. This research also examined twin sets – one study of 84 female identical twins and another study of 66 male identical twins.

In these studies, smoking and heavy alcohol consumption were both associated with greater hair loss. Dandruff was also associated with hair loss, along with hypertension and a lack of regular exercise.

Being divorced or widowed also was associated with increased hair loss, especially among women in this study. And men with elevated testosterone levels had increased hair loss among the men.

Hair loss types

There are several hair loss types, including andronogenic alopecia – male pattern baldness – and areata alopecia. Areata alopecia is often related to lifestyle and nutritional factors. Even genetically-oriented male pattern baldness can be related to nutritional deficiencies among ancestors. Research has traced ancestral baldness to zinc and copper deficiencies, for example.

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Because the hair follicle cells are frequently replaced, ones diet can greatly effect the health of the replacement follicle cells. Nutrients that can affect the health of hair follicle cells include essential fatty acids, minerals, amino acids and vitamins.

Dandruff is associated with an even faster skin cell turnover – from the typical 3-4 weeks to inside of a week. This hastened turnover of skin cells has been linked with chemical hair shampoos and hair products, as well as a type of skin fungus called Malassezia globosa. Malassezia globosa changes the fatty acid and amino acid composition among the skin cells to produce the dandruff.


Gatherwright J, Liu MT, Amirlak B, Gliniak C, Totonchi A, Guyuron B. The contribution of endogenous and exogenous factors to male alopecia: a study of identical twins. Plast Reconstr Surg. 2013 May;131(5):794e-801e.

James Gatherwright, Bardia Amirlak, David Rowe, Mengyuan Liu, Christy Gliniak, Ali Totonchi, Bahman Guyuron. “The Relative Contribution of Endogenous and Exogenous Factors to Male Alopecia: A Study of 66 Genetically Identical Males” and “The Relative Contribution of Endogenous and Exogenous Factors to Female Alopecia: A Study of 84 Genetically Identical Females.” Presented at the 2011 Annual Conf of the Assn of Plastic Surgeons. Sept 23-27, 2011.

Finner AM. Nutrition and hair: deficiencies and supplements. Dermatol Clin. 2013 Jan;31(1):167-72.

James AG, Abraham KH, Cox DS, Moore AE, Pople JE. Metabolic analysis of the cutaneous fungi Malassezia globosa and M. restricta for insights on scalp condition and dandruff. Int J Cosmet Sci. 2013 Apr;35(2):169-75.


  • Case Adams, Naturopath

    California Naturopath, Ph.D. in Natural Health Sciences, Doctorate in Integrative Health Sciences, Board Certified Alternative Medicine Practitioner. Diplomas in Blood Chemistry, Clinical Nutritional Counseling, Homeopathy, Aromatherapy, Colon Hydrotherapy, certificates in Pain Management and Case Management/Contact Tracing. Has authored more than 30 books and hundreds of periodical articles on natural medicine. Recreational activities include surfing, sailing, running, biking, swimming, SUPing, hiking. Contact: case(at)caseadams(dot)com. [email protected] Adams, Naturopath Case
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