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My mother had esophageal band surgery a couple of years ago due to her excessive weight problem. Following this she has noted progressive hair loss and a change in her personality. I’ve read that band surgery and stomach stapling can cause hair loss. Is this true?
Bariatric (Weight Loss) Surgery: Metabolic, nutritional, psychological and physiological Consequences Bariatric or weight loss surgeries have become commonplace in the USA and in other countries, in part due to an ever increasing incidence of obesity in the context of a societal standard of beauty that emphasizes a thin, shapely physique. Lobbying by various organizations, as well as medical studies detailing the present and future consequences of untreated obesity, has led to insurance coverage for these surgeries, which were previously deemed “cosmetic”. This article will detail some of the physical and mental aspects of the often rapid weight loss which occurs after bariatric surgery.
The bariatric surgery community utilizes a number of procedures to promote rapid and hopefully permanent weight loss. Some of the earlier methods have been abandoned or modified due to unacceptable morbidity in the post-operative period, both immediate and long-term. Currently used techniques most often decrease absorption of calories or promote early satiety (feeling of fullness), or some combination of the two.
Unfortunately, the decreased absorption of calories is accompanied by decreased absorption of macro- and micro-nutrients. This often leads to nutritional deficiencies of varying degrees of severity. Sometimes these deficiencies may go undetected for some time, until they have had a profound effect on the patient. Many of these deficiencies can be very difficult to treat (refractory) once established. They may cause significant derangement in the patient’s physical, mental and emotional health.
Nutritional deficiencies associated with bariatric surgery:
Multiple vitamin deficiencies: D, A, B12, B1
Multiple mineral deficiencies: iron, magnesium, calcium, zinc
Macronutrient deficiencies: protein, fatty acid, caloric
The endocrine system may also be deranged; hyperparathyroidism may occur, secondary to vitamin deficiencies, and this condition may cause multiple physical and mental/emotional disorders. This may lead to new micro nutrient disorders, or exacerbate those which have already resulted form the surgery. All of these factors together may set the stage for multiple, interrelated metabolic conditions that may have an overwhelming effect on the patient after bariatric surgery.
In addition to the physiological issues detailed above, mental and emotional distress or overt illness may also occur subsequent to these procedures. This may range from mild depression to full-blown psychosis. The etiology of these symptoms is only partially clear. Some may be due to radical, sudden changes in body image. Others manifestations may be due to metabolic derangements such as magnesium deficiency, hyperparathyroidism, and/or various B vitamin deficiencies. Unfortunately, authorities say that the psychological effects of bariatric surgery have yet to be as fully elucidated at the physiological ones have been.
Another major issue in the post-operative period has to do with the cause of the obesity itself. It is widely believed that many overeaters use food for “self-soothing”, in other words, it calms their anxieties, cures boredom, temporarily alleviates depression (but worsens it in the long run), may act as a substitute for caring relationships and love interests, and generally supports the individual emotionally. When the ability to eat is radically curtailed, this whole quasi-“relationship” the person has with foods is interrupted, sometimes with disastrous consequences. This is one of the many reasons that bariatric surgeons must screen the population of patients so strictly, and this is also one of the reasons that psychotherapy before and after such procedures is seen as mandatory. It is of interest that current studies reveal a substantial percentage of these patients eventually regain much or all of the weight they initially lost, despite the “permanent” nature of the surgery.
Hair loss is another very common consequence of bariatric surgery, and of course can exacerbate the psychological problems the patient may develop. The germinal cells found in the bulb at the base of the hair follicle are among the most rapidly dividing cells in the body. This is one reason that hair is so sensitive to any stressors experienced by the human organism.
It is well known that people may experience an effluvium, or shedding, under the influence of myriad stressors. These can be physiological or psychological, and the hair loss may be permanent or temporary. Bariatric surgery may be an overwhelming stressor, and even in the most optimal cases, it is a major perturbation to the body as well as the mind.
I am a 22 year old female and 6 months ago I moved into a house that is on well water. My hair has thinned a ton, and I’ve been to the doctor to test my iron levels, thyroid levels, and hormones (including testosterone). All the levels are normal. The dermatologist said I might have mild alopecia. I KNOW that is not the case. I had a beautiful head of hair up until I moved into this house. When I pull my hair back I can see through to my scalp. Should I get a Reverse Osmosis water filter? The doctors said that well water wouldn’t cause hair loss, but I have found so much evidence that says otherwise. Please help me, the thought of loosing my hair is consuming my life.
The main thing to do is to first identify the cause of your hair loss.
There are many medical illnesses that can cause hair loss in women. The lab tests you have done are helpful, but usually they are all normal. One should evaluate you for chronic inflammatory diseases such as Lupus, as well. Have your DHEA level checked if this has not been done, but it is usually normal. As you mentioned, iron deficiency anemia can cause hair loss so you should check your ferritin level if you have anemia. You need to do more than look at your iron level if you have a microcytic hypochromic anemia. One should also check for Syphilis, but this is unlikely.
The next step is to have two 4 mm scalp biopsies done. They should be done in the area where you are loosing your hair and they should include intact hair follicles. One biopsy should be for vertical sectioning and the other should be for a lateral sectioning. These should be read by someone experienced in reading scalp hair biopsies such as David Whiting at Baylor.
This will probably give you the diagnosis.
You mention well water. The thing to look for here is heavy metals. These can cause hair loss, but usually this is not present.
Female pattern hair loss is the most common cause and the two biopsies will confirm or rule out this diagnosis. If this is what you have, you should then consider treatment options to include Rogaine for women.
I am now 29 and have been using propecia for around 6 years and my hair sitution has now got worse.
I was wondering With your expertise and vast knowledge if you would recommend me trying avodart to help my situation alongside propecia or take it by itself?
The studies that have been performed show that Avodart does work better than Propecia. The only problem is that we don’t know the long term consequences of taking it. You are blocking both forms of 5 alpha reductase. We don’t know if this will produce problems later on such as depression.
The other problem is we don’t know the proper dose because it has not been studied. People take it once a day or as little as once a week because it has a long half life. There are many patients on it because it works better than Propecia, but I’ve heard a few say that the Propecia worked better than the Avodart.
Shedding probably means it is working for you because hair shedding occurs when resting hairs return to the growing phase and push the old resting hair out. This means that the drug is stimulating growth or Anagen. Of course it could take up to one year before you see a noticable improvement. I think it will always work best when you have some existing hair. If your hair line is bald, don’t expect much benefit. If the hair line still has hair, then the Avodart could stimulate new growth. The main thing all these products do is prolong the life of hair. It is actually rare to see a significant improvement in coverage, but when it occurs, it can be amazing.
I am recovering from trichtilomania and the hairs that are gone that place stopped growing hair all together and you can see the scalp, I was wondering if there is a miracle to help me regrow or start regrowing my hair…my currant shampoo is nioxin and nizorel…
Patients who’ve suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible.
Hair transplants will restore the hair, but it is very common for those with trichotillomania to resume pulling out the hair after the transplants begin to grow.
First strp will be to address the trichotillomania from a medical/psychiatric medication or therapy approach and solve the underlying problem. Once the patient knows that the cause of the trichotillomania has been fully addressed (fo a long period of time, then the reward can be a hair transplant to put their hair back.
I am a 36 year old American Indian female with very long black hair. I have noticed that i have been losing my hair on top by my center part. I have bi-polar disorder, i have been on the same prescription for two years. I have always had extremely thick hair and now it feels so thin. What do you think could be causing this and what can i do to get my hair back to it’s normal fullness? I do not get periods anymore, i had a uterin embolisation three yrs ago. I am very vain about my waist length hair. Please help me.
There are many medications that can cause hair loss. It would be helpful to know what medications you are on.
With women hair loss can begin in your 30s, 40s, or 50s due to normal female pattern hair loss. The cause of this form of hair loss is not as well understood as male pattern hair loss. It will generally leave an intact frontal hair line with loss beginning just behind this. Over time it continues into the top and the very back of the top scalp. It can also involve the sides and back of the scalp in some women. All women with hair loss should rule out hormonal diseases including hyperthyroidism, hypothyroidism, and an elevated level of male hormones. You should also be checked for iron deficiency anemia that can come from heavy periods though this does not seem possible in your case. Laboratory testing includes a T4, TSH, FSH, LH, DHEA, CBC, Ferritin level. Some connective tissue diseases such as lupus can cause hair loss so you might check a WESR and an ANA. If you are having joint problems such as arthritis, this might point to a connective tissue disease.
If all these tests are normal, consider two 4mm biopsies of the affected area that should be read by someone who is a dermatopathologist experienced in reading hair biopsies. It is important to obtain intact hair follicles when taking these biopsies and they must be taken from where you are having hair loss. These can often identify the cause also tell us if you have a more difficult form of hair loss to treat such as a scarring alopecia such as lichen planopilaris.
Someone experienced in evaluating hair loss might be able to help evaluate possible cause of your condition by performing an examination of the hair shaft diameters and a hair pull test.