well hey guys I hope your week is going
well so as you can tell from the title
and thumbnail today's video it's going
to be one that has been so highly
requested for quite some time and that
is can I discuss the evidence for hair
skin and nail gummies or vitamins as
well as supplements for hair skin and
nail health are these good something
that we should be taking are they
helpful so today's video I'm going to
cover the data that we have to support
if any use of certain vitamins and
supplements albeit it is quite limited
but the first thing that I'll talk about
is biotin biotin is a water-soluble B
vitamin that is an essential cofactor
for many enzymes in the body frank
biotin deficiency however is incredibly
incredibly rare it only occurs in a very
few select number of conditions it can
happen in somebody who is in the
hospital and on what's called total
parenteral nutrition and they're getting
to feats and that nutrition perhaps is
not adequately supplemented with biotin
so they can become biotin deficient
there are certain rare diseases and
abnormalities in the GI tract and which
biotin is not absorbed and there are
some rare genetic diseases with
deficiencies in the enzymes that process
biotin so in those cases biotin
supplementation is essential for life
and then a very unusual condition that
can occur is in people who consume raw
egg whites can actually become biotin
deficient
raw egg whites have a protein called
avidin in it and the avidin can bind up
biotin and make it unavailable for for
what it's supposed to do in the human
body and therefore consumption of raw
egg whites can lead to that cooking the
egg whites denatures the avidin and
therefore eliminates that risk but if
anybody out there is drinking a ton of
raw egg whites be careful you can
develop biotin deficiency but otherwise
biotin deficiency really in
industrialized countries in particular
is it's non-existent that's why there's
no daily recommended biotin allowance
it's thought that the bacteria and our
gut make most advance and that we need
for our day-to-day function
you know we obtain it just from our food
so it's not recommended that we
supplement our diet with biotin outside
those conditions that I already
mentioned so where did this
recommendation come from for biotin and
biotin supplementation for hair skin and
nails they're really quite interesting
you know biotin has been something that
has been suggested for hair loss and
dermatology probably dating back to you
around the 80s I want to say not only in
dermatology but also in pediatrics
it was recommended that biotin be given
to any child presenting with hair loss
as well as some other symptoms of biotin
deficiency and the recommendation for
this perhaps was rooted in the fact that
biotin is fairly low risk and in
children presenting with those symptoms
supplementation of biotin should they
have something say like a genetic biotin
enzyme disease could help them so
perhaps that's where that recommendation
came from but as far as hair loss in
general you know in the 60s there was
actually a study of 46 females who took
on I don't knows unknown doses of biotin
supplementation just sort of variable
doses of not biotin and no effect was
observed on a hair in that study then in
the 80s there was a study in dogs it's
kind of unusual 119 dogs you had quote
dull coat I don't even know what that is
I'm not about it dull coat due to
unknown factors these dogs were given
five milligrams of by ten for ten
kilograms of weight for three to five
weeks and of those dogs 60% of them had
resolution of their dull hair 31% of
them had a partial resolute
if they're dull hair and 9% showed no
change so that kind of got people
interested I guess invites in for human
hair bear in mind that human hair
biology and the human hair cycle and dog
hair biology and dog hair cycle they're
entirely different their the the
physiology governing the hair cycle and
the the chemistry they're completely
different but that's probably kind of
where we started getting intrigued by
biotin for hair loss um however at the
molecular level we don't have any
support to suggest that biotin is
helpful for hair biology at the
molecular level it doesn't increase hair
keratin production and has no effect on
proliferation of the hair cells
themselves so really there is quite
limited if any evidence to support the
use of biotin for hair hair growth
outside of two conditions one is an
individual's taking the drug valproic
acid which is the seizure medication
that is given not only for seizure
disorders but also a variety of
neurological neurologic diseases and
psychiatric conditions mood disorders
those individuals as a result of the
eval prog acid drug can develop hair
loss related to the drug and it has been
shown that supplementation a biotin in
that condition can help improve their
hair and help improve that side effect
and it's thought that the valproic acid
interferes somehow in by two metabolism
and perhaps contributes you to that hair
loss to that hair shedding it's never
really been rigorously substantiated but
those individuals will will show
improvement when they take supplemental
bites and then another very rare and
unusual condition called pili triangle i
at canaliculi which this a genetic hair
shaft deficient disorder which the hair
the hair shaft itself has a little
triangular shape to it and a groove on
it it's called Uncle mobile hair
syndrome the presents in young children
or
an early adolescence as just hair that
is literally uncomfortable
it looks like spun glass it's brittle
and the hair doesn't grow properly in
those children it has been you know a an
attempted intervention is to supplement
with biotin basically because we've
never known what else to do to help and
biotin for the most part is fairly safe
so we've always thought why not give it
a try and in children with uncommon well
hair syndrome treated with supplemental
biotin they're uncomfortable hair their
uncle uncle noble hair improves in many
cases that being said a lot of cases of
uncommon well hair syndrome will improve
spontaneously as the child grows
regardless of what you do so whether or
not they improvement on biotin has
anything to do with biotin we don't know
but it's we continue to to recommend it
in that situation because it is so
unusual and you know I've seen a handful
of cases of it myself I think one of you
in the comments has this condition so
yes biotin is usually recommended for
that so that's really it for hair we
don't have any evidence that it helps
hair shedding related to you like
medical illness or crash dieting or
pregnancy or birth control pills we have
no evidence that it slows male pattern
hair loss or improves male pattern hair
loss or female hair loss
female balding we have no evidence for
that any any any hair condition outside
of what I've mentioned we do not have
rigorous evidence or randomized
controlled trials to support this
recommendation for biotin
supplementation for hairs really those
those are the only two conditions
there's no evidence to support the use
of biotin for skin health
none whatsoever as far as nails there is
a one condition in which it is
recommended to supplement with biotin
and that is brittle nails syndrome so
brittle nails syndrome
you know effects oftentimes women can be
related to you know age-related change
and we don't know how biotin
supplementation helps helps this
condition we just have observed that it
does it tends to observe it tends to
improve the condition of brittle nails
syndrome usually about two to three
months after the biotin has been
supplemented and the recommendation are
kind of how how it is is delivered if
you will is the individual with brittle
nails syndrome is followed if they
improve on the bunch and then you know
it is stopped if the brittle nails
Syndrome returns it is resumed if they
don't improve on the bunch and then the
biotin is stopped because there's no
sense in taking something that isn't
helping so that's kind of where biotin
comes into play often times for nails is
in the condition brutal male syndrome it
doesn't appear to be helpful just in
general for nail growth we don't have
any evidence to support that personally
a while ago I was taking buy it to
myself and I noted anecdotally an
improvement of mine in my nails I have
since stopped taking biotin and I
haven't noticed any change in my nails
so long story short I recommend it you
know to people in these in select
conditions and for the most part it
appears to be very safe so we've always
felt pretty comfortable being a little
cavalier with it what's almost common
commonly reported adverse effects are a
little bit of GI upset and many of you
report acne on this on when you take by
to in supplementation report flares of
your acne I've read that in the comments
over and over again I've had patients
tell me that I have spoken with other
other dermatologists you know my
colleagues and they too have had
patients come and say yeah I think my
acne is getting worse that's going on
this five cent supplement and then it
gets better when they stop we don't have
any studies showing that for sure but
that is something that people report but
the thing that you should be aware of is
that biotin supplementation we now have
have more evidence and found out can
actually interfere with the accuracy of
certain lab tests and that's important
specifically a lab test
for example thyroid function testing
bias and supplementation can't interfere
with the accuracy of thyroid thyroid
function test it can interfere with the
accuracy of certain tests used to detect
if you might be having a heart attack
and certain tests you detect if you
might be having a presentation of
congestive heart failure so that's kind
of scary you know if you are somebody
with a cardiac history you have chest
pain and you go to the emergency room
one day with with new chest pain the
bloodwork that they might take in in
order to evaluate your chest pain to
determine if you are having a heart
attack or or a congestive heart failure
or what have you
it could be falsely negative because a
biotin supplementation we now know that
and for me personally I've stopped
taking the biotin I've been taking it
probably in about a year but it is
something that we continue to recommend
particularly in the cases that in the
situations that I have mentioned for
which it seems to be helpful all right
and then the next ingredient that we
have a little bit of evidence for
something called saw palmetto saw
palmetto is derived from the American
dwarf pine and this is something that
can inhibit the enzyme 5 alpha reductase
as well as antagonize testosterone so
these are two components of things that
play a role in male pattern and female
pattern hair loss there is one
double-blinded placebo-controlled trial
that looked at a pill called hair
Genesis that had 200 mil it has 200
milligrams of salt palmetto plus 50
milligrams of beta C tosser all in
people taking that 60 percent
self-reported improvement in their hair
loss in comparison to the placebo group
only 10% reported improvement southbound
Mehta appears to be safe it does not
appear to interact with any medications
that we know of this common adverse side
effect from saw palmetto it is a little
bit of GI upset
does it appear to also renew any
as well and you interfere with any blood
work so it seems to be fairly safe but
how effective it is for hair loss that's
really the only the only data that we
have to be honest then there is this
supplement on think by online that
people ask me a fair amount about a
Bacoor this is a this is a three-part
system of course it's like two hundred
and fifty dollars for our shampoo some
sort of topical solution in a supplement
the supplement has inko bilberry saw
palmetto which i've already mentioned in
horsetail so the saw palmetto you know I
told you the evidence for that the other
three things we don't have any evidence
for in hair loss but that's what's in
there
their website summarizes these clinical
these you know this clinical study in
which people saw improvement in their
hair loss but that clinical study is not
actually published it's not actually in
a peer-reviewed journal and the only way
you can obtain it is if you buy the body
of a car so I can't really say too much
about the efficacy of a car I don't
recommend it to anyone
I'm just clinically and so buyer beware
on that then the other supplement is
marine extracts marine extract is what
is in supplement the dis cow which is
sold to promote hair growth again not
something I recommend or that has
rigorous evidence to support
recommending this supplement but there
have been some there has been one report
of visual at least people reporting
visual improvement in male and female
pattern hair loss and it seems to be
well tolerated so you know there haven't
been any reports of adverse outcomes on
it but whether or not it's worth it I
can't say I don't recommend it there's
really not any evidence to so I don't
tell people to go out and take bringing
extracts for any type of hair loss
there's simply not not the data for it
then the other thing is oral zinc
supplementation oral zinc supplement
station really has only been shown to be
helpful in cases of hair loss and
children who are deficient in zinc due
to very very rare conditions zinc
deficiency is very very rare so there's
really not any evidence to go suggesting
supplementing with oral zinc for hair
skin or nail health there is a little
bit of evidence for zinc for acne but
the reports on its success are
conflicting and it can cause some GI
upset so not not recommended not enough
evidence to to recommend it then last up
the only other ingredient that I
definitely think bears mentioning
because I get asked about it a ton is
collagen supplements and you know when I
first heard my channel two years ago
there really was only laboratory data at
that time to suggest you know perhaps
taking a collagen supplement could be
helpful for skin and I wasn't too
impressed with that since that time you
know in June of this year there have
been some more studies and actual people
and with that appear to be promising
again preliminary early stuff from
limitations of being small and
underpowered but promising okay for
collagen supplements specifically taking
low molecular weight collagen peptides
at a thousand milligrams for 12 weeks in
64 women ages 40 to 60 who had a
diagnosis of photo damaged skin all
right so you had to you had to have
photo damaged skin at baseline those
women after 12 weeks showed improvement
in skin hydration wrinkling and
elasticity then there is another small
study looking at OVA derm which is
derived from ground-up eggshells and
that showed improved hydration in the
skin and some improved elasticity as
well then the other studies are largely
in
largely in skin models and in laboratory
laboratory conditions so the collagen
supplementation is potentially promising
but not not enough data definitely to
make it a routine recommendation or any
kind of standard of care recommendation
or says to suggest that it's helpful and
it really hasn't been pursued by people
for that long to have a good sense of
how safe it is and if it might interfere
with with you know medications and
things like that really don't know but
seems to be fairly well tolerated and is
very popular on the Internet so there's
that but you know it's not vegan so
personally I don't eat I don't consume
it and I don't recommend people take it
because there's not enough evidence to
recommend it at this point so yes that
is really all I can say about what
evidence we have in terms of different
nutraceuticals different supplements
those are kind of the main ones out
there and really what there is as far as
actual literature to support the use but
big picture wise as far as supplements
what I want to communicate to you is the
supplement industry is like the cosmetic
industry it's not regulated the claims
that supplement manufacturers make are
not regulated at all they can say
whatever they want
the FDA has no oversight into
supplements whatsoever they don't
regulate them these supplements are not
required to demonstrate safety efficacy
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purity anything like that and you know
there have been cases in the past of
supplements that are contaminated
there's no there's no oversight as far
as purity like you would get from a
prescription drug so they come with some
risks not only are they not regulated
they're not really monitor it the same
way that prescription drugs are so we
can't really get a sense of how much
people are using
purity of it how it interferes with lab
things and how it might interact with
medications it's really really hard to
to track those things when you have
something that is unregulated and there
are so many so many different
supplements out there with such a little
oversight so buyer beware you know these
things are not necessarily safe and not
necessarily you know there's really
little data to support using them so you
kind of have to ask yourself is it worth
putting myself potentially at risk for
something that frankly at the end of the
day not a whole lot of research to
support its use on my channel I get
requests all the time to review certain
hair and nail gummies that there's a lot
of passion for in YouTube I think what
was it maybe six months ago there were
some very specific hair nail gummies
that I was asked to review on a daily
daily basis and I have no intention of
going into every single hair nail
supplement out there my hope is that
this video will provide you with with
the evidence-based knowledge to kind of
make an informed decision for yourself
as to if you want to pursue any
particular hair skin and nail gummy but
at this point you know I don't recommend
them outside of the cases that I
mentioned to patients generally and I
don't take them myself I don't have you
know an valproic acid I don't have uncle
mobile hair syndrome so I don't really
take any of these I don't have brittle
nails syndrome so for me personally I
don't don't have any of these conditions
and enough evidence for me to recommend
them clinically to anyone that I see so
you know it it doesn't make sense for me
to go reviewing all of these I have no
way of objectively giving you that
furthermore I would just caution you as
well to you know tongue-in-cheek a
little bit any anybody's enthusiasm for
a particular hair and nails supplement
it's not to say that that individual did
not improve all taking a supplement or
things didn't get better for them as far
as their skin hair and nails but big
picture wise is the dermatologist I can
hopefully impart this on you the complex
biology of the hair cycle of nail growth
is regulated and controlled and and
modified and influenced by so many
factors out there that somebody's saying
hey I've started taking these gummies
and you know my hair is great whether or
not that has anything to do with the
gummy or just the fact that a lot of
hair and nail things eventually with
time albeit slowly it can't improve and
you as the viewer or friend or whatever
you have no way really of knowing
completely the full picture of what's
going on for that individual have they
have they been sick in the past year
that led to a hair loss later on that
improved on its down as it would
otherwise
and maybe that improvement coincided
with them taking this vitamin who knows
are they have they been on other
medications in the past do they do they
start and stop birth control pills
have they been pregnant at all during
this time did they have some fibroid
issues at one point that I have been
addressed now and slowly their hair loss
is recovering those are all potential
reasons have they been on any have they
don't any kind of marathons or new
exercise routines in the past year and
you kind of crash diets these are all
part of their medical history now you're
not gonna know are taken that influenced
how that person's hair and nails and
skin may be responding nothing to do
with the supplement so you really can't
yet you really can't get an unbiased
objective review of a hair skin and nail
vitamin it's really difficult you need
you need studies for that you need a
randomized control trial to really give
you objective information otherwise you
know it's just picking your favorite
your favorite gummy like because it's
cute or this one happens to be vegan or
you know I like this person and they're
promoting it and that's up to you you
know you can make that decision yourself
those are those are just objective
components that go into picking that
objectively though I can't give you any
information on I'm really any hair skin
and nail supplement but at the end of
the day there's very little research
very little evidence to support to
support their use not saying can't be
helpful not saying you might not see
improvement just can't guarantee it
can't predict it can't tell you which
where why how etc but if you are
electing to take a supplement a few tips
you can look for certification on the
supplement that it has been
independently tested to at least affirm
that the dosages of the active
ingredients that they're saying are in
there or in there at the amount they're
saying and that the supplement is not
contaminated there are a variety of
things like the USP organization I'll
list some of the names of these
independent testers down below you can
can look for that certification on on
your supplements to give you a little
bit of extra in assurance that the
product is is at least not contaminated
and at least contains the dosage that
the manufacturer is claiming and then
lastly I will link down below the link
to the FDA's MedWatch site for which if
if you are someone you love is taking a
supplement and you believe you develop
an adverse I'll come to it like a bad
rash or a bad reaction some you report
acne with certain supplements you know
report that to the FDA that's important
you know I can help people down the road
the FDA it can go in and
potentially if they get enough reports
of that maybe they'll investigate it
whether or not they do I don't know but
it's definitely it's definitely worth
reporting you know it could potentially
could potentially help people down the
road so I hope this video was helpful to
you guys if you liked it give it a
thumbs up share with your friends and as
always don't forget sunscreen and
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