Every so often, I have decided to post a blog about an interesting clinical picture that I think may help our community out.  Today we are going to cover a clinical topic that came up a while back on Paleohacks about a young male patient about his recent hair loss.  I think this topic is timely because of the recent literature that is now coming out about the drugs that disturb the distal androgen pathways, and how they can wreck the Hypothalamic Pituitary axis on a permanent basis.  I have heard many doctors on public radio shows (Sirius Doctor Radio to be exact on their dermatology show recently) and in blogs say that these hair sparing drugs do not cause any long term problems with a males fecundity or libido.  In a nut shell, I am calling bullshit on that.  This statement can only be made in the context of not knowing anything about the brain and pituitary gland.  I have seen many men come to see me with back and neck problems get diagnosed with low free and total Testosterone  and signs of metabolic bone disease, loss of energy and inability to sustain an erection.  Then I see their medication lists, and see a bunch of hair loss meds.  These meds are used to solve a cosmetic issue by using a tomahawk missile to change their appearance.  If men knew what they were gambling with,  to get a head of hair,  this problem would vanish overnight.  The problem is few men are getting told the correct story.  Once you understand the biochemistry, you would never opt for these meds.  It makes absolutely no clinical sense to me really.  And I am hoping this blog will wake up some younger males and females with thin hair that there are better options than playing with your pituitary to fix thinning hair.  To prove it, I want to highlight a question that posted on back in March of 2011.  It was from a young male college student .  Here is his exact question,


“I’m 23 now, but since i started college (19) I noticed when I tug on my hair I can pull out up to like 10 strands. I literally can’t pull my hair without getting at least two. My hair also just falls out everywhere: the floor, the shower, a test in class. This may not seem like a big deal, but 4 years later, my hair is much thinner than it was. My forehead can’t be covered by my bangs now.


Also, my body hair can be pulled out VERY easily. When I started college, I went vegetarian, then vegan. This may or not have something to do with it. I also sometimes wait way too long to eat, even though I have mild hypoglycemia which makes me lightheaded if I don’t eat.


Basically, do any of you see anything out of whack that would affect my head hair and body hair?


A few years ago I was moderately low in vitamin D and Iron. My current tests came back as:


Vitamin D: 47 (normal 30-100 ng/ML)

Ferritin: 46 (normal 20-345 ng/Ml)

Iron Total: 108 (normal 45-175 mcg/dL)

B12: 439 (normal 200-1100 pg/mL


T3 Uptake: 36 H (normal 22-35%)

T4(THYROXINE),TOTAL: 10.9 (4.5-12.5 mcg/Dl)

Free T4 Index (T7): 3.9H (normal 1.4-3.8)

So, I appreciate the help. No doctors have given any real advice. Also, baldness doesn’t run in my family and it’s weird that my body hair does the same thing. So, I don’t think its MPB. (Male pattern baldness)


Edit: I realized I was gluten and soy sensitive or intolerant about a year ago and have stopped eating them. I have been about 90% paleo for about 2-3 weeks now and feel pretty great.


My response’s to him are chronicled in the thread over at  This case is instructive on several levels from the hair loss and the thyroid issues.  They tie directly back to my top ten paleo supplement post as well.


As soon as I read the history in this case, I knew what was wrong with him but I decided not to make the answer easy for him because I wanted him and everyone else who read this question to learn something more important about messing around with the HPA without a good reason.  If you read my responses to him, you can see him being a vegan and eating lots of grains were at the heart of his problem.  Alopecia Areata is almost always tied to gluten intolerance.  I am still amazed at how many hair specialists and dermatologists still are immune to the basic data.  If you have this condition, you should immediately do a grain elimination diet and stop being vegan of vegetarian because this is the cause in most cases.  Many women with PCOS also get thinning hair too.  PCOS is caused by insulin resistance and high levels of androgens that kill the hair follicles.  Again changing your diet should be de facto treatment number one,  not drugs that alter the androgen pathways.  For many doctors and hair loss experts they jump to drugs.  For them, it’s all about blocking the 5 alpha reductase pathway to stop making DHT (dihydrotestosterone)  and estradiol (E2) in men and women. Dutasteride and finasteride are the drugs names.  You know them as Avodart and Propecia.  These drugs carry major risks of hypothalamic pituitary shut down long or short term.  DHT is known to cause early apoptosis of hair follicles so that is why they use it.  Most cases of male pattern baldness is epigenetically caused.  So once the hair loss begins, not much can be done to stop it.  Waiting until it stops is best, and then one should consider a transplant without any of these drugs!  You might have trouble convincing a hair transplant surgeon to treat you this way, but if you’d rather go through life known as Mr. Softy the choice is yours.


This was chronicled in the March 2011 Journal of Sexual Health.  According to Dr. Abdulmaged M. Traish, a professor of biochemistry and urology at Boston University School of Medicine, almost all men taking these drugs experience side effects. Unfortunately, a study by Dr. Traish finds that some sexual side effects may be long-term or even irreversible. BPH medications may cause the inability to have or maintain an erection (erectile dysfunction), decreased sexual desire, and difficulty ejaculating or decreased volume of ejaculate.  In women, these can alter libido, performance, and ability to climax due to changes in blood flow to the clitoris.  After reading this, I would hope most men would rather have good stiffness over a head full of hair.  I don’t think ladies will like potentially giving up the ability to climax for some more hair.  Climax in women releases oxytocin which diminishes breast cancer risk by 50% in some studies.  Climaxing in women also extends their longevity by close to ten years as well.  It seems counter intuitive to me to gamble with both dutasteride and finasteride.  These meds belong to a class of medications known as 5-alpha reductase inhibitors.  I know women like men with hair, but what good is a full head of hair if the plumbing is not operational?  To me that is false advertising really and biologically not smart.  When our sex steroid pathways begin to fail as we age, it seems our biology seems to take us out.  This is why lower levels of testosterone in men and estrogen and progesterone in women are associated with higher heart disease risk and higher cancer rates.  The death rate also tend to correlate quite well with low sex steroid levels in humans.  When I was in medical school we were taught to believe that low testosterone was best to improve longevity from prostate cancer.  Now today new meta analysis data shows the exact opposite is true! It shows men with prostate cancer and the lowest testosterone levels have the most grim prognosis!  My urology pals Dr. Tom Landon and Gil Ezell led me to these studies last year when we spoke about men’s health issues in our surgeon’s lounge.  I think this information needs to get out to patients, because I don’t see many patients getting it from their own doctors.  Your life might depend upon it.


Another reason I wanted to blog about this now is the October 2011 issue of the Mens Journal (page 66-7) covers this very topic.  This magazine sits in my office and one of my patients yesterday came into the office for a spine bio-hack, and we found that his Testosterone was seriously low at 33 years old.  This article caught his attention and he happened to be bald too!  I told him this information about these meds and what they could do to him.  I also explained to him in detail what a low testosterone level means for men at his age.  We also talked about thyroid disease and labs as well and how they are associated with deficient androgen findings.  These are well chronicled in the paleohacks thread too I linked to as well.  Feel free to read it, because I think it makes a great case study for someone with alopecia areata from grains.  This is precisely what this person suffered from, and it appears he also likely sustained some Hashimoto’s from his vegan diet from the grains.



If your hair is thinning and you’re male, do not start hair loss meds.  First move is to eat a Epi-paleo diet loaded with iodine, and eliminate all grains.  Iodine helps limit excessive estrogen in both men and women that can alter your sex steroid hormones that cause you to lose hair.  If you’re vegan/vegetarian, adapt or accept mediocrity.  This statement is based upon evolutionary biology, not vegan dogma.  If this does not help you, then you likely have epigenetically altered androgen pathways.  Go get tested by a doctor.  You will likely find issues related to DHEA-s, Pregnenolone, testosterone, estrogen (E2), Progesterone, DHT, fasting serum insulin levels, complete thyroid panels to include TPO antibodies and Vitamin D levels.  I think optimizing minerals like Zinc, Selenium, Magnesium, Iron, and Iodine would also help.  If you find that your hair still falls out…then accept it and shave it all off because bald men get lots of women!  If you are  a woman, wigs are now pretty cool.  If those don’t float your boat, then get a hair transplant from one of the 100 board certified hair specialists in the USA, but tell them up front you wont take Avodart or Propecia.  If they balk, hand them a copy of this blog.  They clearly need some knowledge dropped upon them.


Progesterone and DHEA levels are tied to many things that can effect hair follicles.  So it is critical to know these levels too.  Anyone with high serum insulin levels also will lose hair in all body parts, but especially in the limbs.  Epigenetic signaling usually effects the hormone response and causes early apoptotic follicle loss.  The hormone response then can cause havoc in the gut where minerals are absorbed or not.  Remember our diet is not what we eat….it is the summation is what we absorb from our guts.  This ultimately can effect our biologic response in enzyme and protein production.






2.  Abdulmaged M. Traish PhD et al, “Adverse Side Effects of 5a-Reductase Inhibitors Therapy: Persistent Diminished Libido and Erectile Dysfunction and Depression in a Subset of Patients” Journal of Sexual Medicine, Volume 8, Issue 3 March 2011

3.  USA Today, 3/2011 (“Sexual Side Effects from Propecia, Avodart may be Irreversible”, by Steven Reinberg – HealthDay)

4.  Mens Journal October 2011 pages 66-67.


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  1. Resurgent October 14, 2011 at 8:40 am - Reply

    As usual, a great blog post..!

    Dr Kruse, if early hair loss is epigenetic due to diet/lifestyle, why doesn't a switch to the Paleo lifestyle, ultimately cause the genetic switches to reverse.?

    Some patients of Alzheimer disease have been known to grow new hair on bald patches as a side effect of some medications they take. So reversal is, apparently, a biological possibility.

    • Jack October 14, 2011 at 12:14 pm - Reply

      @ resurg. It is biologically possible but the number of hair follicles is also finite. So if they already underwent apoptotic failure then you wont. Interesltingly enough if you look at the leptin faqs post i mention in there that people who do the reset notice alot of skin hair and nail changes because they stop the apoptotic process. Diabetics lose hair on their extremities quickly but when they are reset they notice hair growth returning in my experience so i think it is possible

  2. Nicole October 14, 2011 at 11:44 am - Reply

    My hair started thinning several years ago, at about age 40. Since my mother's hair is thin and my father is bald, I assumed pure genetics. Also my sister had PCOS and I may well too, along with an excess cortisol problem. It is interesting to think that diet may have an influence. I stopped eating carbs 3 years ago and lost a huge amount of weight, although I can't seem to shift the last 20 pounds. I eat 2 meals a day of protein and fat, exercise and take proper supplements. I'm now 46.

    Does changing diet mean any chance that lost hair may come back, or am I stuck with having to bleach it for the rest of my life (so that my hair and scalp are approximately the same colour)? I asked about transplants, but the clinic wouldn't do it. I guess they didn't think it was bad enough yet, but I'm very sensitive about it. I do a lot of public speaking and TV interviews, and people are very cruel when it comes to appearance. Sadly they judge credibility by it.

    • Jack October 14, 2011 at 12:17 pm - Reply

      @nicole for women i think it has a bigger upside then men. You all dont convert a ton to dht and when you eat primal using the reset proceedure all women notice their hair improving. Sometimes i think they like this better than their new body honestly.

  3. Jack October 14, 2011 at 12:55 pm - Reply

    @Jodici. How do i decide who i will do a clinical paleo biohack on? Good question. When i see something posted on a website or on the net when a patient is struggling and i think it could help lots of people…..i go for it. It hits me like a bolt of lightening and i just start to write as soon as it hits me. Maybe that is why i have typo's. LOL.

  4. JC October 14, 2011 at 1:01 pm - Reply

    Dr. K,

    I would have avoided finasteride if I had any idea the damage the could and did cause. Do you have any suggestions for reversing the sexual side effects of finasteride?

    • Jack October 14, 2011 at 2:17 pm - Reply

      @JC The literature is being written now on how to treat these folks. In fact many of the haor transplant surgeons seem to be completely unaware of the article I mentioned in the Journal Of Sexual medicine. That is a shame. There are also forms on the internet where you can many young men with hypogonadism from these drugs and frustration because there a few docs who really know how to treat them. Many can be nursed back to help with diet changes, avoidance of the 5 alpha reductase drugs alone. Some need the help of physicians who understand how to restart the pituitary using some hormonal modulation. This is not dissimilar to the situation that exists for females who suffer from primary hypothalamic amenorrhea from overtraining.

  5. Dan H October 14, 2011 at 1:20 pm - Reply

    So in other words, obese men are most likely to bald, what with the inflammation, cellular aging, insulin resistance, mineral depletion, high cortisol and low testosterone?

    • Jack October 14, 2011 at 2:13 pm - Reply

      @Dan H……not quite true. MPB due to genetics is actually due to high testosterone and shorter telomeres of the hair follicles. The high testosterone is biochemically broken down to DHT and E2. DHT is 5-7 times a more potent androgen to hair follicles. This causes them to mature and age much faster. People with leptin issues lose their hair earlier because of a combination of other hormonal factors like cortisol insulin and altered testosterone breakdown. Testing usually reveals which one it is.

  6. Pam S. October 14, 2011 at 1:49 pm - Reply

    Very interesting! I am female and my hair comes out in the shower, has been a problem for a long time. I suspect I have PCOS since I haven't been able to become pregnant, so this could be another symptom pointing to that. I've been eating paleo for 6 months and no improvement yet, am waiting patiently.

    • Jack October 14, 2011 at 2:09 pm - Reply

      @Pam PCOS women have lots of trouble with thin hair. This is usually due to higher testosterone levels in the face of higher basal insulin levels. Once you fix the leptin problem women really notice some tremendous changes over time.

  7. Kelly C October 14, 2011 at 1:50 pm - Reply

    Regarding bioidentical testosterone – I currently give my husband an injection every two weeks. What is your preferred method of taking this hormone? I've read somewhere that we should go to weekly injections…

    Also, interesting about PCOS & hair loss. My daughter's beautiful head of hair had been thinning for 18-24 months (prior to your leptin reset). She is on week 5 of the reset. It is now trending much better – thicker – healthier! This morning I noticed how much better her hair is looking. And she probably only gets 1-2T of CO/day. Working on getting that up – she just has a hard time with it!

    • Jack October 14, 2011 at 2:08 pm - Reply

      @kellyC interesting question. If supplemental Testosterone is needed for men I do favor the IM injection form over topical for many reasons. Moreover, the dosing of injections is based upon the response of the labs. Often men are placed on IM injections and have a great intial response and then their levels fall rather dramatically. The usual response of the clinician is to up the dose to very high levels and then recheck but a better way to do it is to change the frequency of the injections to bi weekly dosing. This gives the receptors a better steady state of free testosterone and the levels generally rise. One usually rechecks this in about 6 weeks to see how changing the dose frequency works. This is awfully common in men over 45 years old because their receptor affinity begins to change with aging. The young male makes a substantial amount of testosterone daily so changing frequency of dose and watching their LH response, DHT response, and E2 response is pretty easy for a clinician who knows how to do this.

  8. CB October 14, 2011 at 2:32 pm - Reply

    Dr. K,

    Loving the blog. You say you go for something when you see it on the net and can help a lot of people. I got one for ya: I don't know if you have ever heard about the lengthy (sometimes permanent) side effects people have suffered from quinolone abx (cipro, avelox, levaquin), but if you have, and have any thoughts, there are a few thousand people I know of that would be very grateful.

    Even if you don't post about it, keep this in your head somewhere because I will be calling to talk to you about it when you get your consulting program up and running. 🙂

  9. BR October 14, 2011 at 3:02 pm - Reply

    I am a 70 year old male who has been grain free for 20 + years and low carb for 2 years. I had a growth on my left testicle and my GP sent me to a Urologist, who determined that the growth was not a problem as long as it caused me no pain or discomfort. He also did a digital prostate exam and discovered a bump on my prostate (PSA=2.7). I had a prostate biopsy which was benign. The tests showed that my prostate was enlarged and my bladder was not emptying completely. He stated me on 2 medicines; Finasteride 5mg & Tamsulosin .4mg. From what I understand it is the Finasteride that can cause sexual problems. Am I correct in my understanding. I think I will stop Finasteridem but take the Tamsulosin. Any thoughts.

  10. JanSz October 14, 2011 at 5:00 pm - Reply

    You are suggesting keeping steroid hormones at good levels.

    I am 71yo male, started supplementation with testosterone in 2003.

    As years are progressing more different hormones are added to my protocol.

    Without supplementation, my natural DHEAs levels are DHEAs=25μg/dL

    I am supplementing now with sufficient amounts of DHEA & 7ketoDHEA.

    However that resulted in super high levels of

    (5αAndrostane-3α, 17β-Diol Glucuronide, Serum)=10501(340-2200)ng/dL

    Should I worry about it?

    10/14/2011 protocol= 750mg MLM pregnenolone, 200mg DHEA, 100mg 7keto-DHEA, 44mg-testosterone/EOD, 667iu-Ovidrel/EOD, Arimidex 1mg/week Monday

  11. Dexter October 14, 2011 at 5:59 pm - Reply

    @BR I also had an enlarged prostate which showed up for me in needing to urinate every couple of hours during the night. Digital exam said yes, enlarged, but not overly so.. I was told to live with it.

    About this time, I kept hearing a radio commercial about something called beta-sistosterol, which was being touted as an effective prostate shrinker. Sounded really expensive so I looked around the web and found the product is a plant sterol. I found a similiar product at Worked pretty well for me and my sleep was immensely improved.

    I have been Paleo eating about 3 years…but up until I found Dr K and am doing his Leptin Reset…in conjunction I have been drinking around 3 qts of green tea daily. A few weeks ago I started to notice my urinary frequency had diminished, yet the volume was greatly increased. And I had run out of the beta sistosterol. I Googled L-Theanine and prostate and by gosh, L-Theanine is a supplement purporting to help with prostitis and enlarged prostate gland.

    I am essentially eating the same primal diet as prior to the reset…just have changed the timing of meals.

    The only difference is the Green Tea. Coincidence, I don't think so…but I am happy.

    Perhaps copious amounts of green tea would do you some good to shrink your prostate.

    • Jack October 14, 2011 at 10:26 pm - Reply

      @DEx… is another reason to drink green tea with a large prostate…….its a natural aromatase inhibitor and that is really why green tea works to shrink a prostate. It is natures 5 alpha reductase drug of choice.

  12. BR October 14, 2011 at 8:19 pm - Reply

    @Dexter, Thank you, I drink 3 cups of hot green tea a day. Interestingly I some times take L-Theanine when I travel, as I think it help me sleep better. I read about L-Theanine & GABA on Dr Deans blog;… L-Theanine is made from the tea plant. I am going to try the Leptin Reset, but I do not need to lose or gain weight. Hopefully it will help with the prostate.

    • Jack October 14, 2011 at 10:27 pm - Reply

      @Bob……the green tea rec is a great one. I drink a boatload of green tea.

  13. JanSz October 14, 2011 at 5:18 pm - Reply

    You say:

    "but a better way to do it is to change the frequency of the injections to bi weekly dosing."


    For about 4 years, I use EOD EveryOtherDay testosterone & HCG injections

    Works real well. No complaints.

    I use (BD 31ga 5/16" long insulin syringe) for both injections.

    I use Testosterone Cypionate (Half Life 6 days)

    Healthy young men have daily testosterone levels variations like this:

    Max at 8AM

    Min at 8PM

    with rather large Δ(Max-Min)

    Weekly or even biweekly testosterone injections are nowere near in replicating young men profile,

    Testosterone Proprionate have 2 days half life.

    I am thinking of discussing with my doctor replacement to Proprionate.

    Same dose as currently would result in almost the same average testosterone,serum levels, but I may get closer to natural replication of daily variations.

    penny for your thoughts?


  14. Bill October 14, 2011 at 11:56 pm - Reply

    The hairloss thing is definitely interesting. Prominent VLC dude Fred Hahn says hes still loosing his despite being on a palep VLC diet for 10 years…I am guessing his issue is the thyroid.

  15. LisaAPB October 15, 2011 at 3:25 pm - Reply

    Fortunately, I have a head of very thick wavy/curly hair so hair loss is not noticed as easily. A few years ago, just before my hypothyroid diagnosis, I started noticing increased hair loss, and also my hair was getting even curlier than it already was. I was getting severe folliculitus on my scalp too, so my lymph nodes in my neck and armpits where always sore. I also noticed the hair on my arms and legs had practically disappeared. And the eyelashes on my right eye are practically gone but the ophthalmologist didn't see anything wrong with that? I've been mostly grain free for almost a year. I don't notice any more hair, but the hair on my head is softer and more wavy than curly now, like it used to be when I was younger and my scalp has not broken out once since giving up grains, what a relief!

  16. Erin October 16, 2011 at 1:10 am - Reply

    @Lisa- I have Hashimoto's and I find that the herb fo-ti/he shou wu is really helpful in halting thyroid related hair shedding. Shen Min is a good brand. My mom (who also has Hashi's) had major hair loss, as well as texture changes. Her texture has improved a lot since she's gone gluten-free.

    If you haven't read it already, I recommend Datis Kharrazian's thyroid book:

  17. Pam M. October 16, 2011 at 3:40 am - Reply

    A little off the subject but still on the subject of hair and that is hair color loss. My hair is way more gray than I would like it to be and it has been this way for several years. I am 51 years old and have my hair colored every 6 weeks, Is there a reason for this loss of hair color nutritionally?

    • Jack October 16, 2011 at 4:01 am - Reply

      @Pam M. Yes there is. The color of your hair is tied to the status of your telomeres of your melanocytes in your hair follicles. It actually is a fascinating part of biology that I have studied. The age at which you'll get your first gray hair (assuming your hair doesn't simply fall out) is largely determined by your epigenetics that you got from your ancestory. People get that first strand of gray around the same age your parents and grandparents started to go gray. However, the rate at which the graying progresses is somewhat under your own control. See your own lifestyle choice have a massive effect on your telomere length. Obesity and smoking are known to increase the rate of graying. Anemia, generally poor nutrition (think SAD), insufficient B vitamins (see why i suggest you take them), and untreated thyroid conditions can also speed the rate of graying because of the effect of shortening your telomeres. So what really causes your hair's color to change? That has to do with the process controlling the production of the pigment called melanin, the same pigment that tans your skin in response to sunlight.
      Every hair follicle contains pigmented cells called melanocytes. The melanocytes produce eumelanin, which is black or dark brown, and pheomelanin, which is reddish-yellow, and pass the melanin to the cells which produce keratin, the chief protein in hair. When the keratin-producing cells (keratinocytes) die, they retain the coloring from the melanin. When you first start to go gray, the melanocytes are still present, but they become less active in making the colored pigments. Less pigment is deposited into the hair so it appears lighter. As graying progresses, the melanocytes die off until there aren't any cells left to produce the color. This process is reversible. So if you change your lifestyle and yoru telomeres lengthen the color of your hair will also change. In fact, so will the quantity of your hair.

      While "greying" is a normal and unavoidable part of the aging process and is not of itself associated with disease, some autoimmune diseases can cause premature graying because they rapidly cause telomere shortening. However, some people start going gray in their 20s and are perfectly healthy. Extreme shock or stress (high cortisol) can also cause your hair to go gray very quickly as well.

  18. Dan H October 16, 2011 at 3:51 am - Reply

    I recently read RESVERATROL can act as an anti-oestrogen in the body. Esp for obese males (where aromatase is an issue), do you think resveratrol can have powerful effects on raising T levels? (which can expedite one's weight loss/recovery)

    ps. I'm getting constipation from drinking 2L of green tea per day LOL

    • Jack October 16, 2011 at 4:30 am - Reply

      @Dan H. Resveratrol has amazing effects on weight loss and on skin regeneration post weight loss. It also improves mitochondrial function and has amazing effects on mTOR via SIRT 1 activation.

      Dan the Green Tea is not doing it……I would suggest you up your Magnesium intake.

  19. Cú Chul October 16, 2011 at 6:14 am - Reply

    loss of testosterone in humans & animals result of birth-control pills diffusing estrogen in water supply

    Let us first recall the unusual biological phenomena scientifically recognized:

    – Decrease dramatic quality and sperm count (- 60% in fifty years),

    – Explosion of testicular cancer (multiplied by six in sixty years).

    – Increase exponentially genital malformations of the little boy at birth (undescended testes and micropenis).

    – More singular still, statistically perineal length (distance of the testicles to the anus) in newborn male has fallen. [1]

    – In wildlife, for 30 years there has been a decline in male fertility combined with an extraordinary animal feminization of many species of wildlife (alligators, frogs, fish, birds …) It was found that in lakes and estuaries where wastewater is discharged, wildlife is feminized: male polar bears copulate, the male gulls incubate their eggs, etc..

    This devirilization warming is the result of the massive taken oral contraceptives. Huge amounts of hormones of birth control pills are daily discharged into the sanitary sewage and untreated sewage treatment plants for ages.

  20. Erin October 16, 2011 at 4:52 pm - Reply

    @Pam- the herb I mentioned for hair loss (fo-ti/he shou wu) can also help to somewhat reverse graying. Its name literally translates to "black-haired Mr. He" and it's been traditionally used in China to help reverse graying and as a major antiaging tonic.

    I've seen work for a number of people, including an 80-something woman. After a few months, her hair had begun to grow in darker. It has also darkened and thickened the hair of my martial arts teacher (he's 65).

    BTW, that herb is in the same botanical family (polygonum) as the giant knotweed resveratrol is extracted from, which probably explains its use as an antiaging tonic. Those Chinese are ahead of the game!

  21. Jack October 16, 2011 at 5:30 pm - Reply

    pretty cool link about the lack of baldness in Hunter Gatherers.

  22. ViaSwiss October 16, 2011 at 8:32 pm - Reply

    There are thousands of men at who have optimized all of their endocrine hormones from thyroid, adrenal, androgens, progestins, prolactin, estrogens, etc, etc…

    and still have no change in their sexual symptoms (ED and complete lack of libido). It is almost as if Finasteride has caused them to become asexual. Any ideas as to how this medication could affect them in other areas to cause this i.e. nuerological, epigenetically, etc ??

  23. Dan H October 17, 2011 at 7:58 am - Reply

    wow so Dr. Oz was actually right about something for once? I rmb years ago him saying that RESVERATROL triggers Sirtuin.

  24. Cú Chul October 17, 2011 at 6:31 pm - Reply

    Dr. Kruse, you pointed me towards the GAPS diet and the possible link between birth control pills and autism in babies. Would you be so kind as to blog about what prospective parents, especially mothers, should do to optimize the health of their babies, especially when giving birth later in life?

    I gather pregnancies past 26 or so are considered geriatric…

  25. moreporkplease October 17, 2011 at 7:46 pm - Reply

    Based on this study: Wood, J. M., Decker, H., Hartmann, H., Chavan, B., Rokos, H., Spencer, J. D., Hasse, S., Thornton, M. J., Shalbaf, M., Paus, R., Schallreuter, K. U. (2009) Senile hair graying: H2O2-mediated oxidative stress affects human hair color by blunting methioninesulfoxide repair. FASEB Journal online.

    Some has started applying Methionine Sulfoxide Reductase (MSR). It might work if you haven't been gray very long.

    And based on this study:

    Keratinocyte growth factor is required for hair development but not for wound healing. Guo, Lifei; Degenstein, Linda; Fuchs, Elaine. Genes & Development (1996), 10(2), 165-75 Stimulation of human hair growth by the recombinant human keratinocyte growth factor-2 ( KGF -2). Jang Jun-Hyeog Biotechnology letters (2005), 27(11), 749-52. Hair growth regulation by growth factors. Tsuboi, Ryoji Nippon Koshohin Kagakkaishi (1997), 21(3), 218-222. Keratinocyte growth factor increases hair follicle survival following cytotoxic insult. Booth, Catherine; Potten, Christopher S.. Journal of Investigative Dermatology (2000), 114(4), 667-673. Growth factors and hair growth. Tsuboi, Ryoji Fragrance Journal (1997), 25(5), 19-26.

    others have started applying Keratinocyte Growth Factor (KGF), which may work again, if you start early, and your genes are in your favor.

  26. Cú Chul October 17, 2011 at 9:05 pm - Reply

    Doc tells me I need to have surgery to rebuild my ACL with allograft tissue from a cadaver and repair meniscus in my knee.

    Need to get my quads as strong as possible for this.

    Any suggestions for preparation and recovery from this?

    • Jack October 18, 2011 at 12:15 am - Reply

      @Cu look into having your ACL done using a Cayenne Medical ACL repair. Not all orthpedists do it but if I had to have one done this is the repair I want done. You will need to build your quad up post up. I generally want all my patients "tuned up" prior to surgery and post op. I would make sure you are taking a multi vitamin, some Magnesium for the impending stress, drink lots of green tea for the calming L theanine, I would also take a B complex three times a day and consider supplementing with Krill Oil post op. Your surgeon may not want you on Krill pre op because it can increase your risk of bleeding but bleeding is minimal in ACL repairs and he may allow it. I would suggest you ask him. I also would take fairly large doses of Vitamin C pre op because this helps with the stress response of surgery (like Mg does) and you should I would up my dose of Vitamin D3 ten days before the surgery and for a month after it because of the studies done on post op knee replacement surgery and crashing vitamin D levels.

      With muscle issues I also recommend to my patients PQQ one week pre op and Arginine and Ornathine (2000 mgs a day) because it helps increase GH release and increase muscle mass. I would suggest you get your free and total testosterone checked pre op too because if they are low it will reduce your ability to increase your quad post op. You can supplement this too with IM injections to improve your recovery. I often do this for all my spine patients.

      Talk to your surgeon about these.

  27. Dexter October 17, 2011 at 9:23 pm - Reply

    @Cú Chulainn

    I know that Dr K would want your Vit D3 level to be between 70ng/ml-100ng/ml for the healing properties.

    And you should read his personal story about repairing his miniscus contained in this posting;

  28. Cú Chul October 17, 2011 at 11:46 pm - Reply

    thanks Dexter, now I am wondering if I need to delay surgery…

  29. Dexter October 18, 2011 at 12:13 am - Reply

    @Cú Chulainn

    There was this posted by on the Vit D blog by Jonathan

    70.Jonathan Says:

    October 12th, 2011 at 8:48 pm

    In April of this year my labs for D3 were 17. In October they were 85.

    What I did to correct that was MASSIVE doses of D3. I took 2,500,000 iu in the first week. for the next three weeks I took 100,000 iu daily. I am now on 50,000 iu daily.

    It is critical to remember that while you are not optimal your body is stealing the D3 for other things that it would not normally use it for. Additionally we store 2 million or so IU for emergencies. I suspect I ran out decades ago.

    Also remember that if your reserves are gone you CANNOT make D3 from sunlight, that pathway is the first to go.

    If you look at the effects of too much versus too little you find that too much is a far better state of heath than too little.

    And I do know that Dr. K approved the posting by Jonathan and Dr. K shows it to other Docs and they are amazed.

    If I was facing surgery immediately, I would do what Jonathan did…conventional wisdom be damned….Toxicity has been reported at Vit D Council by Dr John Cannell three times…all three were either patient error or compounding pharmacy error in dosage or in instructions. And all three of the patients did not suffer any ill effects either during the toxicity except feeling a little off..but all returned to normal levels.

  30. Cú Chul October 18, 2011 at 6:49 pm - Reply

    thanks very much, Dr. Kruse

    my doctor is using the Smith & Nephew Endobutton fixation for the ACL reconstruction, and considers it an excellent product–should I insist on the Cayenne product?

    • Jack October 18, 2011 at 9:42 pm - Reply

      @cu. Your doc may like that method but as i said if i had to have an ACL done i would want my surgeon to be someone who repairs them for professional athletes. Most athletes get the cayenne ACL. Dr. montgomery of the ny jets does them, Dr. Uribe in miami does them, and so does Dr. Andrews in birmingham. Ultimately this is your choice not the Surgeon. I have had people request certain surgeries as well.

  31. Cú Chul October 19, 2011 at 12:41 am - Reply

    my doc is the knee expert in Sports Medicine of a Big Ten university, he does the operation for the football team and other athletic teams; thanks again for the references

  32. Franco October 19, 2011 at 5:28 am - Reply

    Jack, on the grey hair:

    I'm 43 y.o. and have full hair (maybe a tiny bit receding hairline over the last 10 years but hardly visible), mostly brown but interspersed with a few initially red hairs. A few more red ones in eyebrows and a lot in facial hairs. Those turned white completely now over the last 3-4 years. Why is that?

  33. Franco October 19, 2011 at 5:30 am - Reply

    Just to be clear: the brown hair is still brown like it always was.

  34. Grizz October 23, 2011 at 9:10 pm - Reply

    Dr. Kruse FYI


    Your article is confirmed by a class action lawsuit against Propecia:….

    PS) This was difficult to find in a Google Search. Most search hits resulted in these problems being hidden.


  35. Moreporkplease October 29, 2011 at 5:00 pm - Reply


    Just looked into the fo-ti but I read it's packed with lectins! Is this a problem?


  36. Isa Kornman November 13, 2011 at 10:19 am - Reply

    I'm only good at easy. But I will have to start learning medium. Hard and Expert are insane.

  37. Les November 28, 2011 at 11:39 am - Reply

    interesting–my husband developed alopepcia universalis 4 years ago with no regrowth since. Then in January of this year my 10 year old daughter started to develop alopecia areata. I had started the paleo diet after Chrstmas for my own hypothyroid and weigth issues, once my daughter started her hairloss the family started eating my paleo diet. Her hair on her head has grown back and seems to be holding. We also hit her with the dematologist regimine of rogaine, topical steroid ointment and I threw in acupuncture just to cover all the bases. The hair on her arms has come back somewhat. Her legs continue to be mostly bald- not that is it important to have but shows the extent of recovery-

    You are right when you say that the dermatologists won't mention gluten free as with both my husband and my daughter that was never brought up. We did have them tested for gluten allergy because of my reading and they were both neg but I am not convinced gluten is not an issue. Especially with our family history of autoimmune stuff I am conviced that gluten free is necessary for my families health. My question is– Are there supplements I should be giving my daughter/husband or labs we should be tracking to stay on top of this more?

    • Jack November 28, 2011 at 6:49 pm - Reply

      @Les no…….I would make the dietary changes and I bet in 12 months you will see major changes all related to your hormones rebalancing.

  38. Les December 15, 2011 at 11:12 am - Reply

    Dr Kruse– I emailed earlier see message 49. Just this morning I went to do my daughters hair and the initial spot of hair loss is bare again. We are still eating paleo at home. Any other suggestions to help. I am desperate to not have her go completely bare like my husband. It is interesting that it is happening at the same time of year that it did last year.

  39. Jack December 15, 2011 at 11:27 am - Reply

    @LES the fact it has come back make me think she might have a serious gut issue tied to her vitamin D levels. The fact that it has occurred again this year in Vitamin D winter also is very interesting and needs to be worked up. she may have a leaky gut as the root cause of this from her diet or an impending autoimmune process. You may want to read my blog posts on leaky and the ones that tie autoimmunity to this. I think you will struggle finding a pediatric dermatologist who will know a lick about this issue. You my need to get her into a naturopathic doc to get at the root cause. My bet it is her gut with that history you gave. Keep us in the loop on how she does.

  40. Les December 15, 2011 at 12:07 pm - Reply

    Thanks– anybody have the name of a naturopath in the Denver area??

  41. Deidre March 10, 2012 at 9:41 am - Reply

    Hi Dr.Kruse.

    I have severe alopecia areata (started 9/2011. It continues to fall out and I am now wearing a wig. I am gluten free, paleo and grain free. My HDL is 115 (no gut issue?). I am currently doing acupuncture. I have sleep issues (nothing works), and I can’t lose weight despite HIIT and Paleo. I have low thyroid and AF. Any thoughts that you would have. Could this be from mercury in my mouth or a heavy metal detox. Getting all mercury out next month? Loving cold baths!!! Thank you!

    • Jack March 10, 2012 at 9:43 am - Reply

      @Deidre Yes, I would be very worried about a toxin issue……get tested. The Cold will help you for sure.

  42. Deidre March 10, 2012 at 9:45 am - Reply

    One more question. I have two root canals. They went bad and I had apioectomies (sp) in both. Holistic dentist in Pittsburgh said that they are still bad, and wants me to go to a root canal specialist and have ozone therapy on them. I would love to have them pulled, but they are my two bottom front teeth and I am not sure how to replace them. Thoughts on the ozone treatment? Thanks again for all you do. If you are doing one on one consulting, I would love to use you. I have been to so many naturopaths and integrative medicine doctors, and I don’t seem to progress.

  43. Deidre March 10, 2012 at 9:51 am - Reply

    What kind of toxin test? Thanks!

    • Jack March 10, 2012 at 10:04 am - Reply

      @Deidre you would need a work up and a history and physical with your doctor to assess that.

  44. Deidre March 10, 2012 at 10:07 am - Reply

    The problem seems to be that there are no good doctors. I have been told that alopecia areata is an autoimmune disorder and that I am perfectly healthy otherwise.

    • Jack March 10, 2012 at 10:08 am - Reply

      @Deidre never accept that as a stopping point. Head to a functional medicine practitioner if the allopathic doctors let you down. Never settle and take no for an answer. Become unstoppable………

  45. Pat March 29, 2012 at 10:05 am - Reply

    I have BPH. My docs are recommending Alpha-blockers. Is this the way to go? Do the herbals (saw palmetto, pygeum, etc.) work?

    • Jack March 29, 2012 at 10:09 am - Reply

      @Pat it depends upon how bad you BPH is. The best way to solve it in my opinion is to really eat a strict paleo diet and use the meds your docs give you for a short period until your symptoms get better.

  46. Pat March 29, 2012 at 11:27 am - Reply

    Thanks. It’s interesting but I have no symptoms. None of the usual ones. I had a kidney scan that showed “marked bladder distension with residual urine post void.” The radiologist commented “please correlate for obstructive uropathy.” I went to a urologist and he said I have BPH. Meds or laser surgery were his suggestions.

  47. JedEye May 24, 2012 at 11:21 pm - Reply

    I have been on finasteride for hair loss and androgel for 3+ years. Went off both the meds cold turkey two months ago. Free T is still low (237), fatigue, low libido and attention issues. Without the T I have carb cravings and gained about 10 lbs. No functional docs take my insurance. Hard to find someone.

    Besides aramatase inhibitors, clomiphene, paleo diet, green tea and HCG are there any other options I can ask my doctor to explore?

    • Jack May 25, 2012 at 6:45 am - Reply

      @Jedeye I hate topical testosterone replacement for men because our skin is loaded with aromatase enzyme so it tends to driver our E2 through the roof and never give your the free T dose needed. Finasteride is nasty drug for Testosterone and many many have had primary testicular and pituitary failure after taking it. If you do not respond you likely will need clomid or HCG to jumpstart your machinery again. If that fails you will need Testosterone cypionate to replace it. If you want to try natural ways you need to eat a lot of red meat with very heavy lifting as you do deep CT……..these are the only way to stimulate the pituitary once again with out drugs.

  48. JedEye May 25, 2012 at 8:33 am - Reply

    Thank you so much!

  49. JedEye May 25, 2012 at 3:36 pm - Reply

    My endo wouldn’t do HCG or clomid unless I was trying to have children. He said that my T will go back down after taking I stop taking them. And recommended the gel or T shots after I get my morning T tested 3 more times. I don’t want to be on any lifelong drugs unless absolutely necessary plus folks like Thierry Hertoghe which you mentioned on a podcast, don’t recommend single hormone replacement.

    • Jack May 25, 2012 at 3:47 pm - Reply

      @Jedeye this is a tough problem…..the best way is to use clomid and HCG…….you may never recover the ability. There are scores of young men who this has happened to…….some can recover in years but they will be miserable while waiting.

  50. SCRN2007 July 7, 2012 at 9:19 pm - Reply

    Thanks for this blog! I think it is wonderful that there is an MD out there who is revealing the whole body consequences of pharmaceuticals–I am sick of trying to piece it all together on my own. I am a 34 y/o PCOSer who has used 100 mg spironolactone BID for acne and hirsutism for 4 of the past 6 years. I went off of it while TTC, pregnant, and nursing, but have been back on it for about a year now. After reading this post, I decided that it is not worth the potential harm to my HPA, given that the mode of action of spironolactone’s effect on hirsutism is suspected to be blocking of the 5 alpha reductase pathway–just as with the meds you named. I have weaned off over 2 weeks’ time (trying to avoid the horrible 10-pound edema that I experienced when going off cold-turkey before TTC). I was good up until I went from three days of 50 mg q day to none. I gained 7 lbs of edema in one day! I suspect that I am suffering from an adult version of “stupid kidneys,” and that this may resolve with time (last time I got pregnant before it had resolved, so I do not know for sure). Is there a way to hasten the resolution aside from caffeinated green tea, which I suspect will stress my adrenals more? I look like someone blew me up with a bicycle pump, and my eyelids, nose, and face are so swollen in the morning that they hurt (I think I probably do have adrenal fatigue too, am doing the leptin reset, and easing into CT). I am at a healthy weight (5’6″ and 124 lbs before edema), so the edema is very noticeable to others. I use a bit of Himalayan Sea Salt and Celtic Sea Salt on my food. In the recent past using these salts has actually helped me to not retain water, but should I eliminate them now? I crave salt lately for the firt time in my life (adrenal fatigue, I am guessing), but can stop using it if need be. I have eaten ketogenic for the past 4 weeks (prior to that I was on GAPS for 6 months with an eye toward keeping lower-carb). I have eaten “lower carb” since my PCOS diagnosis in 2006. I am on bio-identical HRT, but am doubtful that my levels are optimal, since my OB believes in symptomatic replacement rather than labs. I am taking 500 mg of metformin BID (I cut down from 2500 mg q day when I went ketogenic, because I was having hypoglycemia Ss). I have thinning hair at the temples, but this is improving since I have gone ketogenic (as you say it should above). Any breadcrumbs would be much appreciated. My doctor’s answer to this question in the past was, “It’s your PCOS.” I find your answers much more insightful!

    • Jack July 7, 2012 at 10:40 pm - Reply

      @SCRN yes….you should ask your doc about metformin, bromocriptine, and high dose vitamin K2 to reverse your IR. That is the real issue here. You also need to consider reading my Vitamin D and K2 blogs.

  51. SCRN2007 July 10, 2012 at 2:31 pm - Reply

    Thanks Dr. Kruse! I take 5000 I.U. of vitamin D3 daily and my docs have promised they will order a 25 OH level for me soon since I seem to have symptoms of MS and will be getting the work-up. The K2 post was eye-opening for me. I have taken 90 mcg of K2 per day since starting Dr. Sinatra’s protocol for NS VTACH several months ago, but supect I am one of those that needs to be taking mg doses, as I am the poster child for gut dysbiosis. Especially since you say that a lack of K2 can disrupt sex hormones and cause IR down the line, and I ended up with PCOS and IR after years of dysbiosis and near vegetarian eating. My HDL was 106 when last tested and my last HS CRP was only 0.3, even though I was having an active flare of a pericardial and pleural effusion (I was surprised that my HS CRP was so low). I developed the Post Cardiotomy Inflammatory Disorder after RF ablation for PSVT I have had since my todler years and NS V-TACH I developed post-partum. The ablation did not fix the NS V-TACH, which is why I started taking the Sinatra protocol supplements and using Earthing devices. The preceding worked to stop it! I was put on Celebrex for the effusions. It helped, but it undermined much of the progress I had made with my gut on GAPS. After months of Celebrex, I went to a ketogenic and AI version of paleo to try and get at the root cause of the inflammation I obviously have in my body despite the low HS CRP. A few weeks in, I ditched Celebrex, started meal timing according to your reset, CT, Curcumin, Ginger, and Resveratrol in addition to the Sinatra Protocol supplements. I am thus far not experiencing any of the effusion relapse symptoms I had in the past when stopping the Celebrex, so I must be doing something right. I intend to read ALL of your posts, but am very grateful that you directed me to the K2 and Vitamin D posts right away. Thanks again!

  52. Jeff November 13, 2015 at 4:23 am - Reply

    Since rice is gluten free, should it also be avoidef? it Is the only grain i eat

    • Jack Kruse November 13, 2015 at 10:42 am - Reply

      Jeff depends upon the UV exposure via the eye. I eat in Spring and Summer but I live in strong UV latitude.

  53. William March 10, 2016 at 4:58 am - Reply

    Another unfortunate finasteride sufferer here. I’ve read through all your posts on this Jack and was wondering if you had any new advice on this particular problem?

    Main symptoms are low test, low cortisol, bad brain fog/disconnectedness, cold extremities, prostate inflammation but a relatively unaffected libido.

    I’ve just travelled abroad to Asia for 3 months to focus on improving my health, starting with a low carb diet after a 1 week detox, with weightlifting every other day along with daily meditation, plenty of sun and daily massages. I also take chinese herbs as recommended by a practitioner out here in Asia and weekly acupuncture.

    I’d really appreciate any help you could give here.

    • Jack Kruse March 10, 2016 at 12:14 pm - Reply

      You have to improve your mitochondria in your follicles and then feed them fat after you complete step one. Mitochondrial swelling is defined as an “increase in the volume of mitochondria due to an influx of fluid”. Swelling of mitochondria is also on a scale that is built around geometry of the inside of mitochondria. This changes the physics of the environment.

      Early phase of mitochondrial swelling involves movement of water from the intercristal spaces into the matrix. Matrix swelling thus results in collapse of intermembrane space in cristae affecting the respiratory proteins distances without increasing the total surface area of inner boundary membrane and change in external shape of mitochondria. The change in the respiratory proteins is what Wallace and Lane have found is a big deal. These changes act as phase transition for energy transformation that involves fission and tubularization of cristae to allow additional matrix expansion. Every thing is quantum with respect to hair.

      • William March 10, 2016 at 10:48 pm - Reply

        Your depth of insight is astounding, thanks for responding to my message.

  54. Barry Kingsley April 21, 2016 at 11:38 am - Reply

    I was with you until you stated it was best to load up on iodine. Iodine is anti-thyroid in large doses, and not something that should be messed with since we get PLENTY of it in our diet.

    Calcium is the anti-dote for estrogen which is why humans (men especially) can drink large amounts of cows milk (which contains estrogen) and not develop breasts. Men who drink large amounts of beer or soy milk tend to develop the dreaded “man-boobs” because these beverages do not contain much calcium.

    With so many xenoestrogens present in our environment a diet high in dairy can help prevent estrogen dominance, people should also make sure they’re getting adequate k2 and d3.

    I don’t think I’ve ever really suffered from hair loss, but since increasing dairy intake and supplementing d3, magnesium, and k2 I’ve noticed healthier hair and skin and a reduction of tonsil stones.

    • Jack Kruse April 21, 2016 at 3:13 pm - Reply

      Barry that may be your belief about iodine but it is not backed up by the facts collected by several people. Cunnane and Crawford have written extensively about the deficiency. The easiest way to supplement iodine is to eat Epi-paleo. I do not recommend supplementation for most things.

  55. Mike Jones June 1, 2016 at 1:36 pm - Reply

    My dad is bald, and my sister suffers from pcos. I’m at a nw5 currently, thin all over including the sides. I have a horrible diet, and eat whatever is in front of me. I’ve been told that I suffer from dupa, which is a different form of mpb. Should I get my text levels checked, along with other tests? Perhaps, I can narrow down the root of the cause. If I go bald, I atleast want some closure. I am 25 by the way.

    • Jack Kruse June 7, 2016 at 3:53 pm - Reply

      Think autoimmunity and alter circadian cycles and looking red light therapy for your hair loss

  56. Ed August 8, 2016 at 2:40 pm - Reply

    I have genetically thinning hair and it it looks 10x healthier when I go raw vegan. Sorry you don’t like veganism or vegetarianism but I look and feel great on that diet.

    Sugar, caffeine and gluten are the real enemies.

    • Jack Kruse August 8, 2016 at 8:17 pm - Reply

      I have no issues with vegans. But they need sunlight more than an omnovore to make up their ATP deficits.

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