A new multi-component hair growth supplement, has been shown to stimulate hair growth in those with Androgenetic Alopecia in a just published study. In evaluating the active ingredients of this formula, it contains only very modest doses of a few of our recommendations in our treatment protocol, and was still potent enough to induce hair growth. He active ingredients in this formulation Forti5, obtained in the full text of the study, are; Vitamin D (cholecalciferol)-200 iu, Beta Sitosterol -100mg, Soy Isoflavones 40% Extract- 300mg, Green Tea Extract 75% -250mg, Omega 3 and 6 -150mg, Melatonin-3mg. 

      Here is the just published abstract:

J Clin Aesthet Dermatol. 2017 Feb;10(2):52-56. Epub 2017 Feb 1.

An Open-Label Evaluator Blinded Study of the Efficacy and Safety of a New Nutritional Supplement in Androgenetic Alopecia: A Pilot Study.

Nichols AJ, Hughes OB, Canazza A, Zaiac MN.

Abstract

Objective: To evaluate the effectiveness of a novel oral supplement, Forti5, containing green tea extract, omega 3 and 6 fatty acids, cholecalciferol, melatonin, beta-sitosterol, and soy isoflavones, and in the management of subjects with androgenetic alopecia. Design: A prospective case series of 10 subjects. Setting: Open-label, evaluator-blinded, proof-of-concept study. Participants: Ten adult subjects with androgenetic alopecia completed the study. Subjects were not allowed to use oral or topical hair growth products in the 24 weeks preceding the study or during the study. The nutritional supplement was administered at a dosage of two tablets daily for 24 weeks. Measurements: Clinical evaluations were performed at baseline and at 24 weeks. Efficacy was evaluated using hair mass index measured by cross section trichometer, terminal hair count measured with dermoscopy and Investigator Global Photography Assessment. Results: Overall 80 percent of subjects (8/10) were rated as improved after 24 weeks of supplementation (mean change of +1.4 equivalent to slightly-to-moderately increased). Forty percent of subjects (4/10) were rated as moderately improved (2+), and 10 percent (1/10) were rated as greatly improved (3+). There was a significant improvement in terminal hair count (mean increase of 5.9% or 4.2 more terminal hairs in the area examined, p=0.014) and in Hair Mass Index (mean increase of 9.5% or 4.5 higher Hair Mass Index, p=0.003).Conclusion: These preliminary results indicate that Forti5 a novel nutritional supplement that contains cholecalciferol, omega 3 and 6 fatty acids, melatonin, antioxidants, and botanical 5-alpha reductase inhibitors, may be a useful in the treatment of androgenetic alopecia.

      Again, even the low doses used where enough to produce hair growth. Each of the active ingredients have identified mechanisms that support hair growth: 

Beta Sitosterol: Inhibits androgen binding Forti5 100mg, Our recommendation 150mg
      Phytosterols, both Beta Sitosterol and Saw Palmetto sterols, are potent 5-alpha reductase inhibitors, and have been shown in 3 published studies to exert hair growth effects 

      Functions as an androgen receptor blocker

40% Soy Isoflavones: Reduces DHT, Increases SHBG: Forti5 300mg, Our Recommendation 135mg, Super Absorbable Isoflavones

      Reduces DHT levels by 50%, even in modest doses 

      Confers an anti-oxidant effect, which helps quell inflammation seen in AGA and senescent hair loss. 

      Increases SHBG levels, which are significantly lower in those with hormonal hair loss. 

Green Tea Extract Anti-inflammation, increases SHBG: Forti 5 250mg, 40% Extract, Ours 725 mg, 95% Extract

      A potent antioxidant, which inhibits free radical induced sebaceous gland growth, increased 5 alpha reductase activity and the concurrent increase in localized DHT

      Anti-inflammation effects

      Elevates SHBG 

      Stimulates Hair Growth- several published studies

Omega 3 & Omega 6: Anti-inflammation Forti5 120 mg, Our recommendation: 2,000 mg

      Well established Anti-inflammation benefits

      Inflammatory messengers (cytokines) cause shedding and hasten the course of hormonal hair loss. 

Melatonin:stimulates pigmentation and hair growth, Forti5: 3mg, Our recommendation 3-10mg, only at night

      The hair follicle in the anagen phase locally produces melatonin to ameliorate apoptosis and for cyto-protection 

      Melatonin stops shedding (telogen) as it inhibits apoptosis in Hair Follicle keratinocytes

      Helps reduce stress-related hair loss. Melatonin shields follicles from endogenous stressors associated with elevated cortisol

      Melatonin is an especially effective antioxidant that can facilitate DNA repair mechanisms

      Melatonin down regulates androgen receptor activity

Vitamin D (Cholecalciferol) Forti5: 200 iu, Our Recommendation 5000 iu 

      Vitamin D3 regulates growth and differentiation of keratinocytes 

      Vitamin D knockout mice exhibit alopecia shortly after birth

      Vitamin D receptors facilitate transcription of follicle genes 

      Deficiencies in Vitamin D, which is endemic in Western Cultures accelerate the aging phenomena, including Hair Loss

      Vitamin D deficiency is correlated with hair loss

      Although we have yet to recommend Vitamin D and/or Melatonin as part of our treatment protocol, we feel their inclusion in any regime is warranted. Using Vitamin D at a much higher dose than a mere 200 iu would be indicated to get any ascertainable benefit on hair growth. 5000iu are recommended for most people to obtain any healthy response. 3 mg of Melatonin is OK, but you could go much higher, ie 10mg. Be sure to take Melatonin at night only. 

      In addition to the ingredients used in Forti5, there is much more you can do, both topically and systemically to more aggressively reverse the course of MPB (AGA). Here are some more useful recommendations along with their identified mechanisms and rationale: Our Updated Protocol