In addition to simple genetic predisposition, are several medical conditions that can trigger Androgenetic, or hormone driven hair loss. Chief among these are Poly Cystic Ovary Syndrome (PCOS), and Adrenal Hyperplasia , related to an 11 Hydroxylase deficiency. Classic correlates with these conditions are insulin resistance, adult acne, hirsutism (unwanted body hair growth), and hormonal patterned hairloss. Treating hairloss associated with these conditions is the same as treating hair loss triggered by standard MPB.

      Standard Medical/Pharmaceutical intervention for women afflicted with PCOS related hair loss typically entails Topical Minoxidil , and oral Spironolactone, finasteride, or birth control pills that have a mild anti-androgenic effect. Natural molecules shown to have a beneficial effect for reversing both hairloss, hirsutism and acne associated with these conditions are Aswagandha, high dose Inositol, and Spearmint (Peppermint) Tea.

      Spearmint tea has a potent anti-androgenic mechanism that may preclude its sustained use in men. Both Ashwaghanda and Inositol are insulin sensitizers that have properties that are similar to the anti-aging drug , Metformin.

Elevated 5AR activity and inflammation are associated with obesity and insulin resistance in both men and women. In women, increased 5AR activity is associated with polycystic ovary syndrome (PCOS) and hirsutism. In men, elevated 5AR activity is associated with benign prostatic hypertrophy (BPH) and male pattern baldness.

      Interestingly, Metformin,( the insulin sensitizing “anti-aging drug”) in limited studies done thus far, has been shown to effectively treat and reverse not only the insulin resistance, but the hairloss, hirsutism and acne associated with these conditions. We will discuss this emerging information regarding Metformin and its implications for treating MPB in a soon to be released update.

      Any treatments that are effective for PCOS induced hairloss, are equally as effective for standard MPB as well. Insulin resistance is established not only as a correlate of PCOS, but for Androgenetic Alopecia in men as well.

Metabolic syndrome in androgenic alopecia

      This case study, with excerpts, showed the complete reversal of long standing Androgenetic hairloss in an elderly woman with Ashwagandha, which is a mainstay adaptogenic herb from the traditional Ayurvedic medicinal system of India.

Case Rep Endocrinol.Epub 2017 Jun 20.
Treatment of Nonclassic 11-Hydroxylase Deficiency with Ashwagandha Root.
Powell D, Inoue T, Bahtiyar G, Fenteany G, Sacerdote A.


An elderly woman presented with acne and male pattern alopecia, which upon diagnostic evaluation was found to be due to nonclassic 11-hydroxylase deficiency. We previously reported that Ashwagandha root ameliorates nonclassic 3-β-ol dehydrogenase and aldosterone synthase deficiencies. This is the first report of its use being associated with amelioration of nonclassic 11-hydroxylase deficiency, where its apparent effects appear to be dose-related.

Excerpts from the Full Text
Our group has reported a number of interventions known to decrease insulin resistance or hyperinsulinemia, which ameliorate both classic and nonclassic CAH (Adrenal Hyperplasia) and include metformin, weight loss by way of lifestyle change or bariatric surgery, vitamin D replacement, and supplementation with Ashwagandha.

      “In our previous experience with Ashwagandha, we reported that it normalized elevated serum levels of cortisol and 17-hydroxypregnenolone and ameliorated acne and excessive scalp hairloss in patients”

      “On a gradually increasing dose of Ashwagandha root, her serum 11-deoxycortisol concentration had normalized (Figure 1). Biochemical improvement has been accompanied by resolution of acne and hairloss.”

      This and other emerging data clearly show that Insulin resistance is more than just a mere bystander, but an integral part of the pathogenesis of Androgenetic Alopecia, (MPB), implying a potential pathway for either primary or adjunctive treatment.

      What is particularly encouraging about this study is that an elderly person, (who generally have very limited responses to hairloss treatment) with long standing AGA, without using any other concurrent intervention, exhibited such a robust hair growth and acne reversal response to the simple usage of Ashwagandha, a low cost stress reducing, adaptogenic herb, aptly named “Indian Ginseng.” We have recommended Ashwagandha and Rhodiola for stress induced hairloss for several years. Aswagandha, also has well established uses for Anxiety, Deperession, and Cognitive Enhancement. In addition to Ashwagandha, Mega Green Tea Extract, Optimized Resveratrol, and Grape Seed Extract , amongst other mechanisms help to manage or reduce insulin resistance. Based on approximating the dosages of Ashwagandha used in this study, we recommend 4 capsules a day in two divided doses of Optimized Ashwagandha.

      In an upcoming feature we will delve into more detail about why Metformin, the insulin sensitizing “anti-aging drug”, may be highly useful for hairloss well.