Which remedies for baldness work?

WHICH REMEDY FOR BALDNESS WORKS?
With each remedy for baldness I have split up into two categories: "drugs" and "natural". Both remedies for baldness are said to work to a degree. The drugs (creams and pills) have had various clinical trials performed on them, but on the downside they are occasionally susceptible to unwanted side-effects. The natural remedies for baldness most often have had no clinical trials attached, merely word of mouth recommendations, but normally have fewer side-effects (at least less unwanted ones) reported. If you are unsure on which type to try, it is possible to try both (but please get advice from a physician before doing so).

ALLOPATHIC REMEDIES FOR BALDNESS
Before I start on any allopathic remedies for baldness, I have to explain the current thinking in science behind the causes of losing hair so that the mechanism and effectiveness of the drugs are easily understood.

Men convert excess testosterone into a more potent form called DHT by the enzyme 5a reductase. The DHT is highly active on the hair follicle receptors, readily latching to them and restricting blood flow to the hair. This causes the hair to become thin and miniturized creating the "peach fuzz" look. There is apparantly a greater quantity of this enzyme in the scalp of men who are susceptible to male pattern baldness.[1]

Women, however, have excess of the enzyme aromatase which converts their testosterone into a form of active estrogen called estradiol. The theory is that after women hit menopause, their levels of natural estrogen lowers letting the testosterone be converted into DHT which makes them more susceptible to losing hair post menopausal. However, that doesn't explain why post andropausal men lose hair when they become older and their testosterone levels die down.[1]

Well, that's the theory, so now lets look at each remedy for baldness in turn and determine its effectiveness and availability as of July 2006. Below is a list of each remedy for baldness:

Rogaine (Minoxidol)
Propecia (Finasteride)

ROGAINE
Mechanism - unclear. Seems to open potassium availabilty to the hair.
Effectiveness - average increase of hair per cm2 was 18.5% after 48 weeks. 1 to 3 months after stopping, hair condition returns to pre-treatment levels.
Side-effects - Dizziness has been reported. Local irritation, itching, dryness, and erythema may occur with use of topical minoxidil, most likely caused by the vehicle formulation of alcohol and propylene glycol.[2]
Availability - over the counter.
Cost - $10 to $15 per bottle (one month).

PROPECIA
Mechanism - inhibits the 5a reductase enzyme responsible for DHT production.
Effectiveness - A third study of 326 men with mild to moderate frontal hair loss found that after 1 year, finasteride treated men had statistically significantly higher hair counts on the frontal scalp. Approximately 50% of treatedmen and 30% of those who took placebo thought the appearance of their hair had improved. Hair regrowth was not reported in older men taking 5 mg finasteride.
Side-effects - A decreased libido, erectile dysfunction, or a decreased volume of ejaculate have been reported in less than 2% of patients, which in reality is between 0.5% to 1% when compared with placebo.[2]
Availability - was prescription only. Generic version now available.
Cost - $69.95 for 3 months

NATURAL REMEDIES FOR BALDNESS
Most natural remedies for baldness also work by blocking DHT, either by inhibiting the enzyme or blocking the hair follicle receptor, or providing the nutrient for the hair follicle receptor which DHT blocks. There is also an alternative interpretation of the "DHT alone causes hair loss " theory. Some believe that it is too much active estrogen-like substances as well as too much DHT that is to blame for prostate cancer and losing hair, and not enough free testosterone in the body.[3]

This sounds contradictory to the allopathic arguement, and concerning estrogen it is. Some naturopaths say that it is all about what blocks the hair follicle receptors. It is these protein receptors which attract nutrients to the hair. DHT and estrogen-like pollutants both block the receptor.[3] Apparently, certain bacteria which thrive on fat, produce estrogen-like substances[4], and there is excess of the aromatase enzyme (which turns testosterone into estrogen) present in fat cells of obese and balding men. Aging, a high fat diet and lack of exercise can create too much estrogen and too little testosterone. Even if testosterone is at normal levels, active estrogen levels can still be way too high.[3] Although this doesn't explain why women with high estrogen levels don't get male pattern baldness.

Here is a list of each remedy for baldness and nutrient:

Beta Sistosterol (from the herb: Saw Palmetol)
Chrysin (from the herb: Passionflower)
Vitamin D
Vitamin B12
Biotin (vitamin B7)
Iron and L-lysine (for women)
Folligen (copper peptide)
Soy
Rooibos tea

BETA SISTOSTEROL
Mechanism - blocks DHT from the androgen receptors sites found on the hair follicles.
Effectiveness - untested. Mixed reviews from people on health forums.
Side-effects - None, but side-effects of the herb Saw Palmetol can be male breast enlargement.[2]
Availability - over the counter.
Cost - 90 Capsules 400mg $7.95.

CHRYSIN
Mechanism - increases free testosterone by inhibiting the conversion to estrodiol.
Effectiveness - shown to be effective at stopping aromatase in the petridish, but not in the body. Not known if it helps with losing hair.[5] Not a proven remedy for baldness.
Side-effects - none.
Availability - over the counter.
Cost - MRM, Chrysin 500, 30 Caps. $14.99.

VITAMIN D
Mechanism - binds to the many vitamin D receptors in the scalp and hair follicle.
Effectiveness - shown to dramatically stimulate hair follicle growth in "nude" mice.[6]
Side-effects - none, unless taken over 50 micrograms per day.
Availability - over the counter.
Cost - 400iu (10 micrograms) 60 capsules $4.99.

VITAMIN B12
Mechanism - deficiency causes hair loss.[7]
Effectiveness - 40% of Americans are deficient. Not proven to remedy hair loss if taken.[8]
Side-effects - None, unless taken over 100 mcg daily.
Availability - over the counter.
Cost - 1000 mcg, Tablets $7.99.

BIOTIN (VITAMIN B7)
Mechanism - increases blood flow to the hair follicle.[9]
Effectiveness - it can promote hair growth in high doses, although not a proven remedy for baldness.
Side-effects - none.
Availability - over the counter.
Cost - 300mcg tablets $2.99.

IRON AND L-LYSINE (for women)
Mechanism - deficiencies in both these nutrients have been associated with losing hair in women.[10] Interacts with zinc and copper.[11]
Effectiveness - proven effective remedy for baldness for women with losing hair.[10]
Side-effects - none unless taken over 250 mg daily (iron).
Availability - over the counter.
Cost - 100 Tablets $7.29

FOLLIGEN (copper peptide)
Mechanism - most effective blocker of the production of both types of 5a reductase enzyme.[12]
Effectiveness - low copper and zinc enzyme levels caused hair loss in mice.[13] A topical copper peptide solution created near perfect hair rejuvenation in 6 months in a woman with 10% of her hair at the start.[14] No studies on the remedy for baldness Folligen itself, but some reports of success by women on forums.
Side-effects - none.
Availability - over the counter.
Cost - 2 oz tube, $21.95. 2 months.

SOY
Mechanism - promotes the production of the good inactive estrogen. Blocks the receptor sites for active estrogen and inhibits 5a reductase.[3]
Effectiveness - proven to inhibit the enzyme 5a reductase.[15]
Side-effects - none.
Availability - over the counter. A food substance, not a remedy for baldness.
Cost - ?

ROOIBOS TEA
Mechanism - unclear.
Effectiveness - in a 10% lotion called herbasol, 89% had increased speed of hair growth. 45% saw an increase in hair growth. 78% reported no further hair loss.[2]
Side-effects - none.
Availability - over the counter. A food substance, not a remedy for baldness except as above.
Cost - ?

I would personally recommend trying Beta Sistosterol with a powerful multi-vitamin and mineral supplement coupled with the Folligen solution as a good remedy for baldness.

[1] Have Scientists Accidentally Discovered the Answer to hair loss?
http://www.emaxhealth.com/65/6131.html

[2] Treatments for hair loss.
http://www.hairlosstalk.com/download/sawaya1.pdf

[3] Grow Young and Slim
http://www.growyoungandslim.com/articles/MensHealth102a.pdf

[4] Health Loss Education
http://www.stuff4beauty.com/page/hairlosseducation.htm

[5] Chrysin: Is It An Effective Aromatase Inhibitor?
http://www.vrp.com/art/1208.asp

[6] Vitamin D3 analogs stimulate hair growth in nude mice.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&listuids=12399436&queryhl=41

[7] Diet and Nutrition - vitamin B12.
http://www.internethealthlibrary.com/DietandNutrition/VitaminB12.htm

[8] Do You Need B-12?
http://thyroid.about.com/cs/newsinfo/l/blb12anemia.htm?terms=vitamin+B12+and+Tufts+

[9] Biotin and Hair Growth
http://www.add-hair.com/Biotin-hair-loss.htm

[10] Nutritional factors and hair loss.
http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2230.2002.01076.x/abs/

[11] Interaction of iron, zinc and copper in the body of animals and humans
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2700243&dopt=Abstract

[12] Folligen
http://www.folligen.com/

[13] Age-related cochlear hair cell loss is enhanced in mice lacking copper/zinc superoxide dismutase
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10466888&dopt=Abstract

[14] Have Scientists Accidentally Discovered the Answer to hair loss?
http://www.emaxhealth.com/65/6131.html

[15] Regulation of Male Sex Hormone Levels by Soy Isoflavones in Rats
http://www.leaonline.com/doi/abs/10.1207/S15327914NC422_9;jsessionid=nFFp1FovOhX-OhcS3V?cookieSet=1&journalCode=nc