Ksenia Kisimes , leading dermatologist, cosmetologist, BOGOMOLETS CLINIC, speaker, member of EADV, UHPS, Ukrainian Association of Dermatovenerologists and Cosmetologists

Let's consider the mechanism of action of vitamin D in autoimmune diseases.

Vitamin D is naturally present in only a very limited number of foods. In the human body, it is produced only under certain conditions, when ultraviolet rays of sunlight strike the skin. Biologically inert vitamin D, formed during exposure to the sun, obtained from food and in the form of food additives, must undergo two hydroxylation processes to be activated in the body. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D 25-OH, also known as calcidiol, a low-active (depot) form of vitamin D. The second hydroxylation occurs primarily in the kidneys and results in the synthesis of physiologically active 1,25-dihydroxyvitamin D 1,25-(OH), or calcitriol.

Dr. Robert Heaney recommends a daily vitamin D intake of 75 IU per kg body weight to achieve a serum level of 100 nmol/L (Can) or 40 ng/ml (US) (at 70 kg, 5250 IU per day).

But you can calculate it yourself: vitamin D: 1 mg 40 IU. Vitamin D level in the blood: 1 ng/ml 1 mg/l 2.5 nmol/l. Assessment: vitamin D3 deficiency 150 ng/ml (>375 nmol/l).

Polyunsaturated essential fatty acids (omega-3-eicosapentaenoic acid and docosahexaenoic acid) are classified as essential fatty acids. In both men and women, the combined use of omega PUFAs with zinc, taurine, and plant polyphenols can reduce pathological hair loss and improve their quality (study by Bouilly-Gauthier D, Jeannes C, Dupont N, Piccardi N, Manissier P, Heinrich U, Tronnier H. A new nutritional supplementation is effective against hair loss and improves hair quality. EADV 2008; Currently, eicosapentaenoic and docosahexaenoic acids are widely used in the treatment of chronic inflammatory skin diseases (psoriasis, atopic dermatitis, acne, etc.). PUFAs stimulate cell growth and division, ensure collagen synthesis, which helps fight wrinkles, atrophy and xerosis of the skin. In aesthetic medicine, PUFAs are recommended for the prevention of premature skin aging and protection against damage associated with insolation.

Biotin deficiency can develop in people who are on intravenous nutrition for a long time without the addition of biotin preparations. Other causes of deficiency: heredity (autosomal recessive biotinidase deficiency); the use of antibiotics and sulfa drugs (they kill healthy intestinal microflora, which synthesizes biotin), digestive disorders (malabsorption syndrome after resection of the small intestine); abuse of the sugar substitute saccharin, which negatively affects the synthesis and absorption of biotin; consumption of products containing sulfur compounds as preservatives (they destroy biotin); alcohol abuse, which interferes with the absorption of biotin; magnesium deficiency, which converts biotin into its active form. Symptoms of biotin deficiency are manifested by skin damage in the form of peeling, dryness, pallor, and perioral dermatitis. And later hair loss, ataxia, drowsiness, depression, muscle weakness and hypotonia, high cholesterol, anemia begin.

Copper and zinc are used to treat patients with different types of alopecia. There was a significant increase in hair density in a 50-week study, during which patients ingested a complex containing copper, zinc, as well as histidine and cysteine. Although copper and zinc supplements have been shown to be beneficial in assessing hair growth, correlations between serum copper and zinc levels and the degree of hair loss have not been proven in placebo-controlled studies. It has also been shown that copper, zinc and magnesium are required in combination for hair growth, and magnesium has a certain pathogenetic significance in certain types of diffuse alopecia in women. Copper and zinc preparations are traditionally used to treat patients with various types of alopecia.

What is the role of amino acids?

The sulfur-containing amino acids L-cysteine and L-methionine take part in the formation of disulfide bonds in the structure of keratin and improve hair growth in AGA (W. Gehring et al., Magazine for Skin Deseases). Taurine is synthesized on the basis of methionine and cysteine. Necessary for the synthesis of keratin, has an antifibrotic effect on hair follicles.

L-arginine is a precursor of nitric oxide, dilates blood vessels, supplies potassium inside cells, has an anabolic effect (Saini, R. & Zanwar, A.A. (2013) Arginine Derived Nitric Oxide: Key to Healthy Skin, Bioactive Dietary Factors and Plant Extracts in Dermatology ( pp. 73-82).

Glutamine is responsible for the transport of sulfur, regulates hair growth, and is a potential source of energy in the body. Supplements are used for stress-induced hair loss.

L-lysine is an essential amino acid that plays an important role in the synthesis of collagen and other proteins. The most important property of lysine is its ability, together with vitamin C, to form L-carnitine.

L-tyrosine is a precursor of melanin, thyroxine, and dopamine. It has a stress-protective, psychostimulating, antidepressant effect, improves intellectual functions. In trichology it is used for stress and autoimmune alopecia.

To summarize, we can say that almost any deficiency condition affects hair loss. We will talk about other deficiencies, for example, iron deficiency conditions or anemia in general, in the following articles.