A Comprehensive Guide to Hair Loss Solutions: BHRT and Minoxidil

This Podcast In Summary

In this podcast episode, Dr. Nayan Patel, Chief Scientific Officer at Thrivelab discusses hair loss solutions with Ashley Wheeler, a Nurse Practitioner at Thrivelab. They emphasize the importance of understanding the underlying causes of hair loss, considering factors such as hormones, nutrition, and genetics. Ashley highlights the significance of building a trusting relationship with patients to address sensitive issues related to hair loss. The discussion covers the use of minoxidil, its ease of use, and its effectiveness in both men and women. They also touch upon other treatments, including hormone replacement therapy, collagen, and biotin. The comprehensive approach at Thrivelab aims to address the root causes of hair loss, providing patients with confidence and transformative results. The conversation stresses the importance of patience in the process and encourages individuals to seek solutions for improved self-esteem and overall well-being.

Transcript

Dr. Nayan Patel (00:01)

Hello, welcome, this is Dr. Dr. Nayan Patel Patel with Thrivelab and today we'll be talking with an expert, Ashley Wheeler, who's a nurse practitioner at Thrivelab, about hair loss solutions. As you can imagine, I may not be the right person to talk about hair loss solutions, but here we are. As a pharmacist, I have dealt with hair loss solutions for a couple of decades and not a lot of things have changed, but what has is that we are able to combine a lot of different medications that has been successfully used in the past and now we can bring all those things together for us. And so the first and most important part is that- what's the importance of finding effective solutions? That's the key, right? How do you know that you have the right solution for your patient? Can you briefly tell us, Ashley, as to how do you work with your patients and how do you find the right solutions for your patients?

Ashley Wheeler (01:04)

So, you know, I think it really starts with that underlying patient relationship, you know, really getting to know your patient as a person and building that relationship from a base. So I always, you know, try to start with learning a little bit about their life and their lifestyle and some stressors in their life, their families, making that ultimate connection. And then from that point going on to talk about those really sensitive subjects, I think once you develop that trusting relationship with your patient, you can kind of get a little further into their insecurities and opening up about things that, you know, really are affecting them on a hormone base, on a medical base, on hair specifically, like we're gonna talk about today.

Dr. Nayan Patel (01:46.834)

And you're absolutely right. And now that we are seeing hair loss in such, the people that are getting younger and younger with hair loss issues too nowadays. So having a complete medical history makes it so much profound to find out what the underlying cause is. The cause can be completely different than what people think it is. So Ashley, what are some of the common causes of hair loss that you are seeing in your patients currently?

Ashley Wheeler (00:07.674)

So, you know, traditionally a lot of the patients that I see, especially, you know, women particularly, are entering that perimenopause, menopausal age. And during that stage in their life, their estrogen levels and progesterone levels start dropping. And typically, that's one of the first ways that we can identify hair loss. Aside from that, though, if we're outside of hormone as a whole, you know, things to look at are, you know, nutrient factors, what their diet's like. Genetics play a huge role as well. Also, as we're going through menopause, perimenopause, because the progesterone and estrogen are declining, then the androgens take over a little bit more, and that can also be a cause for hair loss with too much testosterone in women, those types of things.

Dr. Nayan Patel (00:54.766)

Absolutely. So what you're explaining to me is that the testosterone actually is not the hair loss issues, the conversion from testosterone to DHT, which is the androgenic alopecia in most of the males. But we see the same exact pattern even in the females. So I'm glad you brought that up. But the most important part, which I like what you said, was about the nutrition. Because we know the quality of the food we eat right now is not the best. We know that the nutrient dense food which was once available on this planet is very scarce at this point. And so even though you may be eating all the rights of fruits and vegetables and the meat sources but they're not densely packed with all the nutrients and even if they are, your body doesn't have the enzymes or the acids to actually break down these proteins and absorb the vitamins for what's necessary for your hair growth. And so I'm glad you're putting all these things out because as a pharmacist, I see this all the time. I say, I get a prescription for something to make. I said, wait a second, you know what? Your hair loss is because of nutrition deficiencies and what you're saying is right. In females, we fix the nutrition and the hair stops losing, right? Yeah. Don't get me wrong. I agree with you 100% that you will fix the hormones and the thyroid and all those things. But even by doing that if you don't have all the nutrients necessary, we're still gonna have some issues so I'm glad that you are- you're putting all those things out. So anyways, I understand that you prescribe some medications of the commercial size, especially the one that has been out there for so many years minoxidil, right?

Ashley Wheeler (02:47.501)

Absolutely.

Dr. Nayan Patel (02:48.022)

So, yeah, so how do you use minoxidil in your patients? And I can go over the pharmacokinetics of next after that.

Ashley Wheeler (02:55.018)

Yeah, absolutely. So minoxidil has been a great resource for a lot of my patients. Traditionally, if I notice that there's hormone deficiencies, I'm very simplistic in nature in my care. So I try to start off with fixing the underlying cause and then slowly introduce the minoxidil if we need to. But it's been a great tool because it's very easy to use. It's a topical solution, as you know, applied to the scalp. Women like that because they don't have to worry about something more invasive like, you know, the PRP or hair transplants and even men, you know, same thing. But yeah, I found some really great success stories with this as a whole. But ultimately, you know, we want to look at the whole picture like I had said in the beginning. We look at the hormones, we look at the hair loss and we kind of- and the thyroid as well- and we kind of tackle the issue as a whole and get to the root cause but the minoxidil is a great starting point to give the patient some confidence even while we're waiting for the hormones to kind of correct themselves with the hormone replacement therapy.

Dr. Nayan Patel (04:03.274)

And I know that the FDA has already approved minoxidill as a hair loss treatment years, decades ago, right? The proper name, the brand name, it came out was Rogaine back in back, I don't know, 20 plus years ago. It was revolutionary when it comes to hair loss issues. I said, oh my goodness. And I'll tell you a little history about that because as a pharmacist, I'm very fascinated how the whole thing came about, right? They made a medication for reducing blood pressure and out came Sildenafil Viagra, which is a bit of a drug for impotence. Similar situation. There was another medication for blood pressure and what they started noticing was, hey, they were having hair growth issues. Right? I guess the best discoveries are made in surprise, or as a side effects of some of the medications. That's how minoxidil came first around. And now we can use the same medication topically to do that part. So I'm really fascinated about this compound. And so that we are able to provide this to our patients. After fixing every single thing that we do when it comes to fixing their nutrients and fixing the hormones and every single thing. So, I'm glad about that one.

Ashley Wheeler (05:23.106)

Sure, absolutely. And that's really fascinating. You're right, it does seem like the majority of medications, like not the majority, but a great deal of them, we figure out what they're used better for as we experiment. And it's kind of interesting to know that was originally a vasodilator. And here we are increasing hair growth. I mean, that's a great side effect, I'll take it.

Dr. Nayan Patel (05:42.102)

That's right. So how does minoxidil actually differ from the other hair loss treatments that we have?

Ashley Wheeler (05:49.434)

So I think my primary reason that I would prefer minoxidil compared to other options out there is because the ease of use. It's not going through the gastrointestinal system. We're not swallowing anything. Typically we use the topical minoxidil. People find it easy to use. It's not a major mess. It's convenient. Like I said, it's not invasive, which I really like, and that's usually why my patients turn to something like this, because it's not so invasive. And it really does give great results. It takes a little bit of patience, but it's been well known for years, as you said, too. So I think the name itself, patients feel confidence once you mention Rogaine, because they know that name. So I think that there's that confidence profile behind it as well, just because it's been around for some time. But yeah, overall, I think those are the primary reasons that I would suggest that medication compared to some of the others, as well as like I think the side effect profile is lower.

Dr. Nayan Patel (06:51.026)

It is, and it's over the counter, has been used for a long time with very minimal side effects. So it gives us some confidence that we can push the envelope a little bit more to get a little bit stronger dosages on the prescription strength and still be able to use by a lot of patients with less side effects and better outcomes. Because honestly, all our patients today, they don't have time to wait on for six months or one year to get the hair loss as a result. They want results much, much faster than that. So having a solution like this available along with the other treatments. Again, what are the other treatments besides minoxidil? I mean, still talking about HRT, hormones and thyroids and nutrition. And is there anything else that we missed?

Ashley Wheeler (07:53.89)

So, you know, I put a lot of focus on things like, you know, also I think some things that we didn't talk about is the collagen. A lot of my patients will do collagen, biotin, some of those. And honestly, a lot of the times I use those in conjunction with minoxidil just to kind of have that extra added bonus because it does go hand in hand with nutrition as well. There are medications out there, like Spironolactone is one of them that's used as actually a diuretic that's actually used for hair loss as well. I think one of the reasons that I tend to shy away from something like that is because it is a diuretic and there's more side effects. So like I talked about before, it makes me a little bit less-or more hesitant rather- to try that one than the minoxidil because of what the underlying treatment for that was made, what that was made for to begin with. And then of course there's all sorts of different treatments that are online that they advertise for conditioners and serums and things like that and that the studies just aren't there behind a lot of them. So I think, you know, with knowing that this medication has been around for a while and we have evidence that it's successful, that just makes me a lot more confident using that with my patients.

Dr. Nayan Patel (09:12.738)

Gotcha. And the thing is at Thrivelab, the best part about what we do at Thrivelab is that we take one medication that has been working great. We combine that with something else that's already available in the market. So we basically take two or three different types of ingredients to combine them with nutrition and vasodilators to improve the blood flow, give the proper nutrients to the hair follicle to grow stronger and then sustain so that it doesn't fall off very fast. So having a combination treatment is very, very instrumental in our health. And you combine that with hormones and it's like, it's like we say, there's no one approach for a massive problem like hair loss. And so having a comprehensive approach from addressing the nutrition, the hormones, the topical vasodilations, all those things gives extra help to make sure that other patients are actually getting the results they're looking for in a shorter amount of time. So I'm glad that we do that part. Can minoxidil be used in both men and women? Is there age restrictions, things like that?

Ashley Wheeler (10:25.678)

Yeah, absolutely. So it can be used in both men and women. Really, age is not a huge factor in this. It works better sometimes in younger patients under the age of 40, but not all the time. I have some great, great success stories in menopausal women as well. So I find that both genders can benefit from this greatly. And really, there's no crazy age limit on this, no.

Dr. Nayan Patel (10:52.786)

Oh good, because you know, as I said earlier, we have so many young kids nowadays with hair loss issues that would love to get them some solutions early on. I would love to fix their diet, but you know, it's really hard to get these kids to change their diet. And so maybe if I don't fix the hair, they might change the dye, but it's a hard thing to do for these people. So anyway, having a solution like this available is very helpful for these young folks that are actually struggling to figure out how to help the hair loss go away. So.

Ashley Wheeler (11:27.05)

Yeah, that's actually a really good point. I'm glad that you brought that up too. I didn't even think about, you know, that population because I'm typically seeing older population, you know, 18 and up. But yeah, that is true that this is an option for the younger population as well. So good point there.

Dr. Nayan Patel (11:59.258)

I'm sure there are people that are still hesitant to use this medication. Do you have any words of encouragement for these people?

Ashley Wheeler (12:33.526)

Yeah, so I think honestly, I can't speak highly enough of Thrivelab as a whole in developing, even outside of Thrivelab, developing a relationship with a trusting practitioner who can sit there and listen to the whole story and take everything into account. If that time is spent and that relationship of trust is built and the whole picture is looked at, I think that makes a world of difference in the patient's ability to try new things, attempt to see if the minoxidil can work for them, as well as be open-minded to any other changes in hormones and diet and vitamins and things like that. So I think just putting that big emphasis on overall health care and letting them know that even though we're gonna try this for hair loss, we wanna look at the underlying cause and we want to get to that as well. And hopefully it wouldn't have to be something that they have to use forever, but more so kind of an aid until we get to the base of the problem.

Dr. Nayan Patel (13:54.59)

Oh, absolutely. Thank you for sharing that part because I always thought that, you know what, if I have a solution for the hair loss, I wish it was a one step approach, but as you gently put it down, that individual treatments are probably the best option, having, making sure that we fix the underlying cause, we address the hormone issues, we address the nutrition issues, give them something extra support. And we hope it's a short-term treatment. If it's a short-term treatment, then it's better. But from what I hear, minoxidil, once you stop using it, if the underlying causes are not fixed, within six months, you can still get the hair loss back and get started.

Ashley Wheeler (14:40.258)

Yeah, absolutely. Yeah, so it's kind of one of those things that we may need to continue until we can get to the root of that, and if we can get to the root of that. But.

Dr. Nayan Patel (14:50.186)

That's right. And so I'm glad that we have a comprehensive approach for the hair loss solution so that if you do decide to stop the minoxidil, which in normal cases, within six months your hair loss will start kicking up again, with addressing the root cause of nutrition along with the minoxidil, you have a lasting chance of having a permanent hair loss solution. Even after you stop the medications, that is i.e. once that's helping you with the hair growth. So I'm glad we have that approach available to us. Do you have any closing remarks for our audience?

Ashley Wheeler (15:23.594)

Honestly, I think that just the big takeaway point here is finding that trusting provider, giving all the information, laying out all the information on the table, working together as a team to go through all of the information behind what may be causing this, and patience. Patience is a virtue when it comes to hair, hormones, all of the above, so patience, patience, patience, but you know. We'll get you there. And it's such a life-changing event when you finally start to see the changes in patients who have been suffering from hair loss. It really affects self-esteem. It affects everyday life. And I've seen myself countless times, just such amazing transformations in patients' life and their confidence levels and what they can do and what they want to do now that they feel better about themselves. So, patience is a virtue, but getting to that end point is the goal and that's what we're here to help with at the Thrivelab.

Dr. Nayan Patel (16:29.114)

Oh, thank you very much. I, you know, for me, it's the male versus the female, right? A male can always shave their head and they may look decent, not like me, but may look decent enough. They can pull it off. But for females, hair loss is a big deal. And I'm glad you pointed out because improve the self-esteem and just overall their own, how do they feel within their own skin? It's just so much important. And having a solution available for both men and women, especially women that have this hair loss issues which are nonspecific, may not be androgenic, could be nutrition related, could be hormone related, and having addressing all those issues and putting a solution temporarily to get the hair loss back under control. I think it's the best thing that we can do for our patients. And I'm glad to be part of this organization to have the solutions for customers. Because at Thrivelab, we really try to be a solution-oriented company, rather than trying to get you some medications that may or may not be the right option for you. But we are really looking to provide solutions for you. So thank you very much.

Ashley Wheeler (17:49.062)

Absolutely. Thank you. I really enjoyed this talk today and learning a little bit more about the pharmacologics behind this as well.

Dr. Nayan Patel (17:58.25)

Yeah, thank you.