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


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


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


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


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


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


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