← The Tamsen Show
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- [00:00]
A
foreign hi there ladies welcome back i am so glad you're here all right you may remember a little while back i did an episode on hair loss it was actually not a little episode it was enormous episode it blew my mind i had dm's i had comments i had emails you came flooding in with questions and stories and i just kept thinking we have got to go deeper on this so we thought we'd give it some time but the questions kept coming in so we we decided to bring in the expert and get questions answered and so that is exactly what we're gonna do in this episode today i brought in my own dermatologist who i adore and somebody i genuinely trust with my own hair and skin doctor dora stay she's a board certified dermatologist based right here in new york city she is a clinical professor of dermatology at nyu langone and has been named one of the top three cosmetic dermatologists in the entire country and she's been my doctor for years now so when i say i trust her i mean it personal not just professionally and with all those things going on the fact that she's here today to answer our questions i think is just speaks volumes about her a majority of the questions that came pouring in after that episode were about hair loss and here's the thing about hair loss and that i think we don't talk enough about it's not just a cosmetic issue for women especially losing your hair i truly have seen this it touches something deeper your identity confidence the way you show up in the world at work and this happens at every stage we're not just talking about menopause not just after having a baby it can happen at any point and feel really really isolating because most people aren't talking about it by the end of this episode i want to make sure your questions are answered and we also wanna make sure you have real tools so by the way doctor day brought in an entire toolkit of stuff to show us to show us how to manage going into this next chapter cause i want you to feel confident when you look your best you feel your best and i believe you deserve both so so before we get started one thing if you have a moment while you're listening please leave us a review it really helps more than you know it helps other women find the show and helps us bring in really incredible guests like doctor day and here's a little secret my team asked me to share we have been selecting random reviews and then sending a free copy of my book how to menopause because it is the one year like birthday of the book to people who are leaving a review so you never know leave a review and we might just reach out all right doctor doris day let's go ahead and get into it i'm ready today's podcast is sponsored by midi health so many women tell me the same thing they finally speak up about brain fog exhaustion or anxiety and they're brushed off or told it's just stress or age that kind of dismissal makes you question your own body midi changes that by offering expert insurance covered virtual care that actually understands midlife and treats women like they matter ready to feel your best and write your second act script visit joinmitty dot com tamsen today to book your personalized insurance covered virtual visit that's joinmitty dot com tamsen midi the care women deserve you know that thing where you get an amazing pair of shoes at a really great price and want to tell everyone about it yeah so do we here at designer shoe warehouse we'll give you something to brag about like the latest styles from brands you love or the trends everyone's obsessing over or shoes that make you feel like well you so go ahead show off a little buying shoes that get you at prices that get your budget head to your dsw store or dsw dot com today dsw let us surprise you i feel like you came in with this bag and i can't wait to dig into that but i have to ask you this first of all first thank you for coming here and answering these questions because i am not exaggerating when we you know we ask for questions and we wanna know what people are talking about this conversation ran so deep with so many different kind of questions so i appreciate you taking the time
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to be here oh it's absolutely my pleasure and this is a big conversation even in my office so i get why it matters to people why is
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this conversation so emotional when it comes to hair and hair loss we're hardwired
- [04:15]
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to care about hair it's actually inscribed into our dna when you have thick healthy hair it's a sign of youth fertility it help beauty so people don't choose to care about hair we instinctively care about it but the reality is it really is just hair and there's so many ways around it so what we have now is we have better treatments for hair loss than we did we have better ways of recognizing why hair loss happens and there's new treatments coming both that exist in the early stages and ones in the pipeline so there's a lot more we can do about hair today and that makes it a better conversation it's not just looking at someone and saying okay you have hair loss that's it now it's you have the beginning stage of hair loss these are all the things we can do about it only if you are fda approved most of it is off label but there's still pretty good data on a lot of these treatments and so much in the pipeline i feel
- [05:11]
A
like it's so reassuring to hear you say that there are options versus like good luck and you know not too many options available so is there a common type of hair loss well there's
- [05:21]
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a common type of what people perceive as hair loss which is really stress shedding that's called telogen effluvium telogen is part of the hair cycle and it's a stress shedding so a stress shedding can happen from anything but what people have to understand first is that you have hair cycles your hair has a growth base and on your head it's two to ten years that's how long your hair can grow then you have a transitional phase a resting phase and then it falls out and it regrows so you have anagen catagen telogen those are the phases anagen anage catagen is that transitionalagen telogen is that resting phase so the anagen phase is two to ten years and the catagen telogen is three to four months so when you have a physiologic stress it could be emotional it could be physical it could be chemo it could be childbirth it could be a divorce a wedding good things bad things all these things that stress you even change of season can be a physiologic stress on us and there's a three to four month lag so when you have that stress the hair that ninety percent of which is sitting in that antigen or growth phase all of a sudden should sh or does shift shouldn't but it does into that resting phase where it sits for three to four months then it transitions falls out so that is why when you have a stress if someone says oh i'm stressing my hair's falling that doesn't make sense when you stress your hair shifts from growing to resting and then it falls out months later so when someone says they have hair loss i go what happened three to four months ago did you give birth or go through a major life issue and then you'll see that lag but the problem is that you can have more than one cause so arresting so that stress shedding that telogen effluvium if it's chronic if you're undergoing chronic stress the hair does grow back but it sheds
- [07:06]
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so it's a net loss it's interesting i went through a divorce and then i never forget it i don't even know what was going on and i looked and i'm like my hair feels weird like thin i have very thick hair and i have coarse hair right and the ends were like straggly and i actually went back and looked at old pictures and i went wow like i'm assuming that's what caused it but it happened for a while it wasn't like in the months that i was you know signing the you know going through my actual physical divorce but you're right it was like maybe three to six months later i guess thinking back
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B
and it can take a year to cycle back but it can also accelerate a female pattern hair loss okay so you don't just have one cycle now when you have a stress shedding people will say i see hair everywhere because your hair is shedding when you go through a female pattern hair loss you don't necessarily see hair every because what happens is before the hair even falls out each strand becomes finer and it miniaturizes over time so what people will say is my ponytail is half as thick as it was they don't necessarily see hair everywhere they may have some shedding and they may be more attuned to hair shedding but it's really that the hair they have like you have coarse hair but hair naturally becomes finer with age for most people and then genetically it can be programmed to become finer and that's when you on top of that see the part widening so mal female patterned hair loss is very different men will have more receding temples then it can move back they lose the crown and then they go bald for women the part down the middle gets wider they notice temporal thinning as well but they have more diffuse shedding of the crown and they keep the frontal hairline so they're slightly different patterns but what we're learning is that in these both of these patterns there's some inflammation at the base of the hair follicle so the hair follicle is becoming a real focus for treating hair loss and we're finding that as great as it is to understand that there are stem cells there this is an active site of growth it's also really hard to reach it's immunologically protected so getting things to get to the hair follicle is not that easy and that's one of the challenges of treating hair loss so treating hair loss is problematic but we're looking at micro inflammation and we're looking at shampoos that can minimize inflammation and we're looking at even products that can do that now we're learning that hair follicles have olfactory like they have smell and taste receptors even though your hair follicles do your hair follicles do so even though they're in an environment that doesn't correlate with the brain for smell and taste things that have sensory like sandalwood can affect the follicle and promote hair growth and can affect bacteria that are part of the hair microbiome that can affect hair growth sandalwood like
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the oil yeah okay don't go throw that in your hair yet no don't
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throw it in your hair no and it's going to be an extract of it but the hair like people the hair has sensors even people who are losing hair will notice that their scalp hurts there are sensations that people have around hair loss that we can't fully scientifically explain now why they have those sensations but the more we're getting to study the follicles and proteins that are there even potentially glp one sensors that are there that can affect people who are doing glp one that actually might help hair growth not hurt it there's so many things we're learning about the hair follicles about proteins and peptides and sensors and how to actually reach that follicle to help the hair grow that goes beyond just minoxidil which seems to be working by improving blood supply to the area or what men take which is finasteride that affects enzymes and hormones that are there so we're expanding the treatments and the options and the approaches way beyond what's currently available it's such
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A
good news and i think it's reassuring to a lot of people who are listening all right i'm gonna go through some of the question if that's okay and i know we actually have a voicemail to listen to as well but let me start with this one i spent my twenties going to multiple doctors and dermatologists and they all told me it was stress and poor diet i recently saw another derm who said the same thing why do doctors keep dismissing this and what is actually going on
- [11:20]
B
hair is really hard to treat and even most dermatologists most doctors don't want to be bothered with it you have to see a hair specialist who will take the time to look at your scalp and see what's going on for you so she could be having chronic stress but we need to hear the whole story and there are things that we can control so it could be that she has early onset female pattern hair loss on top of a stress shedding and sometimes when you have hair loss and then you start stressing about the hair loss you create hair loss through the stress shedding it makes sense yeah it makes sense but even if somebody has chronic stress shedding there's things we can do for it so we can talk about even things like vagus nerve stimulation just through just box breathing where you breathe in for five seconds hold it for five seconds breathe out for five seconds hold that for five seconds do that for two minutes several times a day you lower your heart rate you lower inflammation and that is free you just do that at home it's good to do anyway meditation walking all those things are helpful getting enough protein is essential controlling your weight fluctuations is important worrying about your sleep patterns all of those things affect it so when somebody has something like hair loss if i don't see scarring in the scalp if i don't see a specific pattern that i can point to then we talk about lifestyle changes we can do we talk about prp which is where we take blood spin it down inject it back things that are gonna support the nutrients of the scalp to help hair growth but you never ever dismiss it and tell someone it's just
- [12:53]
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stress get over it every time i hear that and i feel like women hear it more than anybody else right in every stage of our lives thank you for that as a doctor thank you i'm forty seven and perimenopausal what is actually causing my hair loss right now is it horm or something else yes i was gonna say i'm not a doctor and i can answer that gosh those hormones man yeah it is
- [13:18]
B
hormones and it is something else it's hormones in that estrogen is important for hair growth testosterone is important for hair growth and i think it is a good idea and it is a sign that it's good to add some estradiol back unless you have a specific reason not to and too many women are dismissed because they have a family history of breast cancer or their doctor's just afraid to prescribe it or it's just too eas to tell them just to not bother and you'll be okay you'll get through this time which is ridiculous but i would definitely say it's a sign that you should consider menopause hormone therapy and then also add if you can oral or topical minoxidil which does help hair i used to be a little bit more hesitant about oral minoxidil because of some of the side effects which is potentially swelling of the lower legs fluid around the heart but i've spoken with enough cardiologists that i think at the doses that we're using the risk is low and it doesn't seem to be a great concern so i've gotten more comfortable with it both of those are prescription nope no the topical minoxidil is over the counter at the drugstore without a prescription even though it's a prescription drug it's available without a prescription at the drugstore the oral minoxidil is through your dermatologist and generally what i have women do is start with i give them a two and a half milligram pill which is cheap from a drugstore from a prescription and then they cut it in half and just take a half a pill a day and then after a few months if they don't grow hair on their face if they don't have side effects fast heart rate or other issues then they can go up to the two and a half milligram pill and then the biggest risk is really that you can grow hair where you don't want it and that's never fun so some people don't mind because they get the hair where they want it but a lot of women are really happy with that topical minoxidil is a little bit messy and the oral minoxidil around menopause seems to be more effective than the topical because your body metabolizes it and then it seems to have a different effect than just using the topical and there's a company now doing a study in creating a new drug that's a slow dose time release minoxidil that's oral that i think will be really exciting and that should be out in a year
- [15:26]
A
or two okay this is a voicemail i'm gonna play from suzanne out of the uk asking a question hi tamsen my name is susanna beni i am
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calling from the uk london just outside
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of london and a fan of the show and listen to your podcast i
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am forty seven years old and going through i think perimenopause i don't really have that many symptoms yet but one of the big things that hit me recently was hair loss hair shedding and i have a couple of questions about
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A
that why is that that we are
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being told at least in the uk that we are losing on average about fifty to one hundred or sometimes even some people say up to one hundred fifty hairs a day i sometimes ever feel that the reason why we are being told that because nobody really knows that what's the average and you know it depends on hair density and okay
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A
what are your thoughts about that again
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B
perimenopause so with perimenopause the estrogen cycle is going through a rollercoaster some months you have almost no estrogen some months it's really high estrogen that's a physiologic stress on the body so you can go through stress shedding and you're also having less estrogen overall and that can affect the hair quality of each strand she is right you do tend to lose one hundred to one hundred hairs a day that's been measured over time and that seems to be the norm but it's that the hair becomes finer the shedding can become more and this can cycle for a while so she may notice that she's stress shedding but the hair quality is also changing and the density is going to go down
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is that somebody you would recommend for minoxidil absolutely and then would there be anything else i know there's a lot of different hair growth you know there's supplements there's all sorts of things would you recommend those or would you go to minoxidil first i think they all
- [17:27]
B
work differently so it depends on how much it bothers someone so if somebody isn't that bothered i might just start with a supplement so we do things like vitamin d with k make sure they're getting enough magnesium making sure they're getting enough protein doing resistance training all these things that are good for you that you should really be aware of to start being better about around perimenopause because we want to age well overall then i'll add in a shampoo that has anti inflammatory benefits you can get that at the drugstore like an anti dandruff shampoo that has either selenium sulfide or zinc parathione any of those are helpful and then or ketoconazole that's also good so you wanna minimize inflammation sometimes the yeast overgrowth even if you don't have dandruff that can help and you just do it once a week or so then topical minoxidil i always think of that as anti aging because it improves the blood flow to the scalp and the follicles and that helps hair growth and in the studies that minoxidil did the brand they had almost eight hundred women and eighty percent regrew hair but the hair that regrew was up to fifty percent thicker so it doesn't just help the hair grow it helps the hair grow thicker and that's one of the benefits so i think of it as anti aging for the hair and if you don't mind using it you can use the topical if the topical is too messy or you don't like it or it's not helping then you can see your doctor and get a prescription for the oral and then i even like things like the supplements like neutrophil there's another one called extrasay that's really good neutrafol balance is geared towards women in perimenopause and it's a cocktail of supplements that has also ashwagandha curcumin i think of it as better than a multivitamin and it really covers hair loss so i i recommend that for a lot of women but the problem now is that people are taking so many different supplements that you have to be careful that you're not overdosing on any certain ingredient so if you're
- [19:15]
A
dealing with hair loss maybe you decide okay i'm just going to do the ones that are geared toward hair loss right now to at least not you know have that cabinet full of stuff that you wind up never taking or
- [19:25]
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that you're taking all of them and you're getting too much of some things which i think is even worse and then you want to also again manage your stress see a doctor about hormone therapy because these are signs and some people think of i don't have hot flashes i don't have symptoms of perimenopause i'm fine but there's so much more
- [19:41]
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- [21:02]
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- [21:32]
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A
okay next question is it common for hair to suddenly change texture mine has gone completely curly and i don't understand why and we pulled that out because i'd never heard of that before oh
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it absolutely changes texture i think people noticed it in their thirties and then
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doing what becoming curly all the time
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or if it's cur becomes wavy or frizzy but the hair texture changes and as it goes to gray it becomes wiry but the the hair does change texture with time that is normal that's just age and yeah that's normal so
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it could go anyway it could be frizzy it could be wavy it could be okay yeah all right well we're all in that boat together folks so yes this was the one that i you know that i i think we have actually have one can hair shed on a glp one and if you've lost hair from a glp one can you get it back and i guess i'd heard a little bit about hair shedding with glp one but i never know what's like you know really a thing or a couple people dealt with it and it's not you know i don't know what is it yeah i'm
- [22:40]
B
really really looking into this and studying this and trying to get all of the data like do we have glp one receptors in the hair follicle when you think about it glb one might be good for the hair because it's anti inflammatory and it's good for so many different organ systems and good for brain aging even and i've been reading things like it helps lower risk of breast cancer recurrence even so glp one seems to be more good than bad the problem i've been seeing with glp one and it's really distressing is i think it's causing in many people a pathologically induced anorexia where they get thin and they look amazing and then they keep going because they like that feeling of not being hungry and not eating and they don't realize i've seen so many people come in men and women who come in literally skin and bones and it's really scary to see but they don't realize it they like the feeling they don't necessarily like the look but they like the feeling of not being hungry and when they start to eat again and they start to get hungry it worries them that they're gonna gain all the weight back it's gonna
- [23:46]
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reverse or stop working or yeah i mean i think it's and they keep increasing the dose they keep increasing the dose and so then they've got that going on so they don't ever get hungry do you think there's gonna be a time where we have this like kind of balance we have a course correct right of everything we always see that what is that course correct is it helpful that we now have an oral or that doesn't really make a
- [24:04]
B
difference no i think people will just start to realize i see it in aesthetics all the time where when we first had botox we would freeze every movement and now we know it's about finessing and about redirecting movement not erasing it so i think there will be some course correction and people will understand that this is a tool and they'll start to get more in touch with how they feel and they'll dose it better but i think the first generation of people using it are really suffering and they're seeing the hair loss as a side effect of it because they're using it as an excuse to not eat but they're not getting nutrition so if i have someone who's going on a glp one in my office i don't prescribe it i refer them to people i very rarely prescribe it it's not never but very rarely but i will always review with them getting enough protein that before you start the glp one plan your meals because you're not gonna be hungry and you're not gonna have the distraction and the noise of like wanting to nosh on things that aren't good for you so or even alcohol so plan your meals because now you have the luxury of being able to feed yourself quality food that's really good for you getting high quality protein and not eating between meals and doing true intermittent fasting so people can do really well with this but you have to put a little bit of effort into it and you have to commit to resistance training so you don't lose muscle and then you have to commit to understanding that there's a limit to how much weight you should lose in a given week that's that's a big
- [25:26]
A
thing and i've not heard that conversation unless i'm just missing it i'm not in the circle because they're getting it online oh getting it getting it prescribed
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you mean yeah so no one's following or really telling them about the importance of that but if you're losing more than a pound and a half to two pounds a week depending on your weight you're not losing fat you're losing
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muscle so is it possible that hair loss with a glp one is due to a lack of protein or a lack of the right type of nutrients probably hair growth okay probably all right
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that's the thing is we have to we really have to study this to know we have to see that if it's just a stress shedding is it a nutrient issue is it a specific glp one issue and then if you look at people who do glp's right do we see better hair growth oh interesting yeah if you do it correctly and you lower inflammation and you use it as an opportunity to get healthier could you possibly have better hair growth it can help your skin barrier it can help with your skin so it probably could help with the hair as well but i think there's so much research that has to be done or data that has to be mined about what it's and what it could do for the hair follicles but people just want a quick fix and an easy answer and there isn't any such thing
- [26:36]
A
i think you're right i think it'll be interesting to see you know as we get used to something right like i do remember the botox time too where you're like make it all stop make nothing move and that has definitely changed right now less is more and so i'll be interesting to see it'll be interesting to see what happens as we get more information too and have more data but we're a society that
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that wants to go to the nth degree of everything and that's exciting but it's not healthy no i understand i
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do understand okay my hair is thin since starting bioidentical hormones is this common and what can i do so that's hormone therapy hormone replacement therapy menopausal hormone
- [27:16]
B
therapy that's such a great question and a great point i don't think that the hair has thinned because of the hormone therapy i think it's thinned in spite of the hormone therapy so one thing i've observed over the twenty years that i've been watching women and going through it myself is that hormone therapy done correctly does help against osteoporosis heart disease joint issues so many things but i don't think it helps as much for skin and hair at the doses that we're using so i'm looking at topical estrogen i'm doing a study now with a few other doctors and we're looking at topical estrogen and we're doing epigenetic testing so we'll have real data on whether or not it's doing anything and then i can tell you if it actually works for the skin for estrogen topically and just put it here
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first stop this is going to be
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your first stop to find out it's always my first stop i love talking to you but for the hair it seems that it's not perfect so if you have a genetic condition and you're programmed to lose hair it's not going to reverse that or stop it it might even be slowing it but you just don't know right but that's not
- [28:20]
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going to be your you know what i think was confusing i think a long time ago before the women's health initiative they used to do these ads like find your fountain of youth estrogen and i think that a lot of you know i think a lot of those things that weren't necessarily true we you know we still somewhere in the
- [28:37]
B
back of our heads have i mean listen i was hoping i was really hoping that doing hormone therapy would like stop my skin from aging and stop my hair from falling but it just doesn't do that you still age it's just slower it's healthier it's better but it does not stop it yeah i
- [28:51]
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know i'm with you what about testosterone treatment for menopausal women because i actually have been getting this question quite a bit some women have had thinning hair with hormone therapy is that a real
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risk from too much testosterone okay so
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too much testosterone yeah but the right
- [29:09]
B
amount does help hair so testosterone therapy if you need it is good and women i think it's helpful for women to do it and i think it's underutilized for women because there isn't any prescription testosterone for women that's fda approved so we're adapting from what's available for men and we're hoping that works we're getting it compounded but the reality is i think soon we will have testosterone approved for women and i think it is helpful for energy for hair for libido for so many things that are helpful but i stick to skin and hair and i think it's good for both but if you do too much you'll break out you'll lose hair so not a good thing but there's a way to know and your body will tell you so you don't even need labs necessarily although i believe in checking but if you are using too much back off it'll get better and then then you'll know the right dose and
- [29:59]
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a lot of times a doctor won't re prescribe it unless on that one anyone testosterone you have to get labs not necessarily with estrogen or progesterone past
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menopause although i think you should i've spoken with gyns who feel that once you pass once you're in menopause or you're menopausal you don't need to check labs anymore but i actually don't think that's true i think you still need to check labs you wanna know where your fsh is you wanna know if you're really getting good bone protection you wanna know if you're absorbing it and sometimes the symptoms don the numbers and you're going to wait till your bones fall apart like you i'm with you so i think it's good to check once in a while and then also monitor symptoms as well but for testosterone definitely monitor with labs i do it
- [30:42]
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i had gone from compounded to now like the men's which i just do a little small amount of it and
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you know and it's so much less
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expensive that's so much cheaper it's so
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much cheaper and it works and it
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A
works okay let's talk about red light therapy does red light therapy help with
- [30:57]
B
shift red light therapy is fda cleared as a wavelength for hair growth so that's fine but the companies will send you a whole bunch of different price points for their red light and they'll say we have this many diodes or we have low level laser and they'll make it so that you need their ten thousand dollars hat you don't so it doesn't have to be crazy expensive there are changes in diodes and the amount of energy delivered but the idea is to use something if you can and i like the ones that are hats or helmets because you just have hands free so the one by revion the one by care factor are my two favorite ones capillas has one there's a whole bunch of them out there some are super expensive i wouldn't go for those somebody sent me one that was like ten thousand dollars i'm like yeah i said that's exactly what i
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said before i got enough use out
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of it yeah you don't need to spend that much money but i think there are some out there that are good that do help in conjunction with other treatments you don't have to pick one thing you can do that with minoxidil with a supplement with prp i tend to try to have people do things at home before they do things in the office so i have a hair growth laser in the office that i combine with in office peptides or in office exosomes that are topical that i help drive into the skin of the scalp but that gets to the follicles but before i have them spend money in the office i tell them let's try these at home treatments so you don't have to be tethered to the office because the reality that whatever you do for hair now you have to keep doing to maintain the benefits even if you get a hair transplant you still need to do these other things because you don't want those transplanted hairs to be sitting there by themselves so everything you do you have to commit to doing consistently over time to maintain the benefits which i think is
- [32:43]
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why it's probably smart to like find one or find two instead of doing twenty different things and then you're gonna
- [32:48]
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just do nothing yep one topical one oral and a rest headlight that's a
- [32:53]
A
good combination you guys have these options i gotta tell you i mean i really think so is it true that once you stop using topical minoxidil all the hair you gain falls out yeah
- [33:04]
B
yeah it only works while you use it but it doesn't make more hair fall out it just lets you know where you would have been without it so i tell people whatever you do for hair you have to keep doing to maintain the benefits for now until we come up with something better but the good news is if you keep using it it keeps working i would tell people what don't you do forever you have to brush your teeth forever you have to eat forever you have to exercise forever you have to sleep forever you have to go to work forever you do everything forever that's one more thing you do forever but it does make your hair grow it makes your hair grow thicker and it doesn't stop working over time so as long as you keep using it it'll keep working and it doesn't stop working if you skip a day two or it takes three months to begin to see results it's not going to stop working if you miss a few days the issue that i have with people is that they feel like if they don't hit every spot when they get it they're afraid they're not going to get full coverage so how do you do
- [33:59]
A
that how much do you need topically
- [34:02]
B
just enough to cover i mean it's not as much usually as what's on the label but usually you put your hair into parts and then you just put it down the middle and then there's like a brush you can get that can can help let's see it's funny of all the things i brought that oh well this brush actually that you have oh good okay yeah this brush is good that you can then use this to gently massage it into the scalp but one of the things that i wanted to tell you is that when your hair is wet you wanna use a brush that's designed for wet hair and brush from the bottom going up because when your hair is wet the hair is a little bit looser in the follicles and it's easier for it to come out so you don't wanna pull the hair or do a lot of trauma on it when it's wet even when you're getting it blow dried you' good stylus will sort of dry the roots a little bit which does make the blow dry go faster but also helps the hair follicle settle better into the scalp and dry so it's not as loose in the follicle wow and then you don't want to burn the hair so if you're using a brush like a blow dry lesson i love that this is now
- [35:02]
A
a blow dry lesson okay i'm the
- [35:04]
B
last one to give a blow dry
- [35:05]
A
lesson okay it's okay just give me
- [35:06]
B
the right blow dry the rules i'm good at but the doing okay so this one can get really hot yes so if you're doing this with a blow dryer you want to be to not hold it too long cause you'll burn the hair and then when the hair is burned once the hair is off your scalp whatever you do to damage it the hair has to grow out you can't really fix that you can get a conditioner or something that's going to mask it and coat it but if you want healthy pretty hair as it gets longer don't burn it don't fry it over time so that's
- [35:38]
A
important i love all the different brushes you rock because i use that one
- [35:42]
B
i think that is yours oh it is okay now don't use a rubber band to tie your hair okay if it's in a pinch it's one thing but this is going to grab onto your hair and pull it out i've
- [35:52]
A
seen plenty of black hair of mine in those rubber bands yes terrible that's
- [35:56]
B
because you have so much hair that you can take it for granted use softer ones and then when i talked about minoxidil the thing that i said is that it improves blood flow to the follicle right when you put your hair into a ponytail especially a tighter ponytail or you get heavy extensions what you're doing is you're pulling on the hair and you're suffocating the follicle so you're lowering oxygen supply to the follicle which over time is going to make
- [36:25]
A
your hair fall wait what are you doing to it you're pulling it down
- [36:27]
B
you're pulling it tight which is putting traction and traction suffocates the follicle it reduces oxygen supply to the follicle which over time will cause the follicle to die and once the follicle is dead that's called scarring hair loss that hair was never going to grow back what
- [36:44]
A
do you do if you decide like okay i want extensions though do you have to treat those in a certain way in a certain amount of time
- [36:51]
B
the idea is not to make them too heavy or too tight which everybody does because the heavier you make it the thicker your hair feels and it feels good and the closer you make it to the scalp the tighter it is to the scalp the longer it takes to grow out so then you get more for your money that way and it looks better but it's not good for the hair so one thing to do is don't go too dense not too heavy you have to be realistic and two if you're wearing clip ins clip them in a little bit differently every time and then take them off when when you don't need it don't wear it and just do your best to i love play hair everybody's got play hair i mean everybody has play hair i brought some big play hair but also there's like little clip ins there's full on wigs like there's so much you can do to have
- [37:34]
A
fun okay what is this one this
- [37:36]
B
one i don't know this one is hairdo i can't this is from hairware but there's smaller ones but the whole point of having play hair is you can go long one day short one day if you're great you didn't get to the hair colorist you can just put in a clip in you can do a strip or a bigger piece or a little topper like a little cap with hair coming out but the mistake people make is they go too heavy too thick and it just doesn't look realistic so just do enough but have fun with it and who cares if people know like go blonde one day brunette one day curly straight i
- [38:12]
A
think that's the fun part of all
- [38:13]
B
of this it's an accessory that's why
- [38:14]
A
it really is a part that's a fun part of all of it yeah
- [38:16]
B
and i love that so many celebrity women are starting to admit it kelly ripa was just at the oscars and she showed put putting in her clip ins i was so proud of her
- [38:25]
A
kelly's great she's wonderful and her hair
- [38:27]
B
looked great so pretty well i mean
- [38:30]
A
she's amazing i mean she's just beautiful period but it was amazing we are
- [38:33]
B
gushing we are that's okay are you
- [38:36]
A
over thirty five and confused about how to work out during perimenopause or menopause i remember feeling exactly that way my body was changing and i realized that the routines that once worked for me suddenly didn't make sense anymore i didn't to want to begin that's why conversations and real solutions around this stage of life matter so much to me i'm excited to share a new midlife program that i contributed to with megan roope over at the sculpt society a digital fitness platform created for women the midlife program was designed specifically for women in perimenopause and menopause it includes a structured movement program symptom based classes and an expert led guide to help you navigate this stage of life the goal is simple to help you feel strong and at home in your body again i had such a great time working out with megan the last time i was in los angeles she understands how women's bodies evolve and built this program to support the changes that happen in midlife the program includes workouts that help you build muscle support bone density improve mobility strengthen your pelvic floor activate your deep core and and more you can download the sculpt society app right now using code tamsen thirty that's tamsen thirty for your first month free and start the midlife program today i have to tell you about something i have been adding to my nighttime routine i kept hearing about magnesium breakthrough from bioptimizers from so many people i trust and everyone was saying the same thing tamsin this one's different most magnesium supplements use one or two forms forms this one combines seven forms plus co factors to help your body actually use it so i decided to try it for myself here's what i'll say i have been more intentional about how i wind down at night and this has become part of that rhythm it's simple it's consistent i'm paying attention to how i feel in the morning and that's what really matters so here's my challenge to you try it track your sleep notice your energy see how your body responds responds what i love is there's no pressure they offer a full three hundred and sixty five day money back guarantee so you can actually give it time go to buyoptimizers dot com tamsen and use my exclusive code tamsen to get fifteen percent off any order make twenty twenty six a year you finally start sleeping great again let's talk about expensive hair vitamins we talked a little bit about some supplements do you think they're worth it i
- [41:00]
B
do think neutrophil has really good data i do think that one is worth it my mom call it the miracle pill she's ninety three and the only thing she cannot run out of is neutral so she bugs me over that but it's not for everybody i have patients who can't tolerate it they get stomach upset and it does have a cost to it but i think that roland who helped develop it over i don't know ten years ago fifteen years ago put a lot of effort into sourcing the product studying what helps to grow hair and i think it set the standard of good supplements for hair i think they're working on the formula trying to upgrade but neutral balance seems to be a good one extra say is one i brought that with me as well so this is nutrafol balance for women and then extra se is one that's designed by a dermatologist okay so i think that's also a gummy and that has a bioactive blend some of the ingredients overlap i definitely wouldn't do both but for people who don't want to take four pills you can take a couple of gummies i know
- [41:59]
A
nutrafol has had a lot of data behind it and i think that that is reassuring we had somebody come on the show and i was so shocked by so much of the data which was really reassuring it was great it
- [42:10]
B
was really great to see that the sourcing is good and the amount of testing that they do is really prescription grade testing and then i love boldify i like the name powder and this one is as true to color as i've seen so if you feel like you have like a thin spot you can just you just put this powder on and what's nice about it is that it doesn't look like shoe polish some of the other ones as they got darker got more purple this this stays close to a brown and it just rubs off but it's a hair fiber expander so it makes your hair feel thicker it only goes from shampoo to shampoo so it's not like it's growing hair but i think this is a nice one and they have one in a pot that you can do to just cover the roots as well there's other brands as well there's topics there's color wow there's a couple of other ones i like all of them but boldify is my current favorite and
- [42:57]
A
that's a great solution for a temporary solution i love their bag of tricks
- [43:00]
B
this is the pot this is and then on the bottom it has the sponge so you can just do this and then you can kind of go along the roots and cover gray or
- [43:08]
A
just cover the scalp that's great yeah
- [43:10]
B
so this is kind of great for
- [43:11]
A
in between grays right this will buy
- [43:14]
B
you some time that will buy you some time and they're good color matches
- [43:17]
A
with this brand what shampoo brands actually help with hair loss are there any
- [43:20]
B
specific ones they really support hair growth one that i really like is by redken it's the acidic bonding concentrate so if you feel like your hair is thin it has citric acid in it which is a hair bonder and that will make your hair feel thicker you use that shampoo and conditioner for a few shampoos and your hair will feel three times thicker or five times thicker it's crazy i actually helped cerave with their shampoo line they have one for dandruff and one that's gentle they have citric acid in that as well but it's amazing how much the drugstore brands put into hair growth my favorite brand that's more on the medical grade is cara factor and that is a shampoo and a serum that has peptide and botanicals and that one mimics growth factors that your scalp needs and your hair needs for hair growth so that is i think probably the best one on the market for hair growth and i've had patients where we do so many things and when we add that they're like oh my god now i see the difference that makes me so happy
- [44:18]
A
yeah of course i think what's also great is the drugstores have it now and there's different you have different options so if you're not able to go to a dermatologist or you go to your dermatologist and they say go to the drugstore and get this it doesn't wind up being like crazy cost to be able to i don't know and
- [44:34]
B
vichy durcos is another one vichy the drco is good yeah vichy that shampoo that's maybe twenty dollars the cerave one is ten dollars there's so many great ones the cara factor is a little bit more expensive but what i usually recommend is doing a double shampoo so you'll use one you can do one with one of the anti dandruff shampoos and then the second one with more of a peptide based shampoo that's going to support the follicle and this way you're not doing a double shampoo with the more expensive one i heard i
- [45:03]
A
hear this all the time you're not supposed to towel dry your hair when it's wet is that true cause you showed us how to brush but you can't towel dry your hair when it's
- [45:12]
B
wet you can towel dry it's the same idea of not pulling you don't want to shear the hair and you don't want to pull the hair so if you gently pat it dry that's fine and there are towels that you can just wrap your hair in that absorb the moisture and that's fine yeah that's what i do you definitely just don't want to pull your hair or shear it like if you take a ribbon and you rub scissors across you know how it makes the ribbon curl your hair will do the same thing if you shear your hair when it's wet you're going to fray the hair and it's going to make it coarse or wavy or frizzy or actually break
- [45:43]
A
wait when you shear it what does that mean when you shear it so
- [45:45]
B
if you take a harsh brush or a harsh towel and you rub your hair really dry and your hair's already dry and somewhat damaged you're going to shear the hair you're going to abrade it and that's going to make split ends it's going to make the hair more damaged and ultimately look frizzy and dull and break more easily okay last thing to do one just be gentle
- [46:06]
A
just be gentle all right final question what are some of the ways i can help with hair loss that don't require me to take medication you could
- [46:14]
B
do topical minoxidil you can use an antifungal shampoo like ketoconazole shampoo you can take the supplements and then yeah and then just make sure you have a good diet get enough protein in your diet just look at all the things in your life that could be driving your hair loss if you have just general aging of the scalp a lot of times people will come in and they think they have a hair problem but they they don't it's just hair naturally aging or it's something in their life if you actually have a scarring hair problem you need to see a dermatologist because that requires in office treatment so scarring is when the follicle is lost and around perimenopause and menopause women get something unfortunately called frontal fibrosing alopecia and it happens in all ethnicities but it's when you start seeing loss of hair at the follicle at the frontal hairline and you can see redness around the follicles or just the front hair receding and the skin looks waxy smooth or it looks like you have plugs of hair there so we use injectable cortisone for that just very low concentration monthly to try to slow that down and turn it off and a lot of times we can really protect that hair loss so it's not it's not a female pattern problem but that's a scarring pattern that you should see your doctor for so if you don't want to take medications there's so many things we've talked about so many of them but see your dermatologist somebody who cares about hair who will hear what you have to say and see what the best things are and sometimes it is about medications it is about hormone therapy and we can work around it but that would be the shortest cut and the safest one because your hair is sometimes telling you about your body and you don't want to just mask the problem and treat the hair with without reading what else can be going on and then you suffer later with osteoporosis or frozen shoulder or dementia or heart disease when we could have looked and asked you more questions and help you get to the right doctors to make sure your whole body gets taken care
- [48:12]
A
of i love that you make women feel so powerful and i remember you saying sometimes i know that a woman is in perimenopause or menopause before she's even gone to the obgyn just from looking at skin or i guess even hair probably right absolutely absolutely doctor day thank you for being so incredible and thank you for your bag of tricks i love it all all right to all you ladies listening i hope this episode got questions answered for you and i hope you feel more confident going into this next chapter knowing you have some options you have tools and you're definitely not alone if you are listening you can actually see this over on youtube and see some of the products that doctor day brought in we'll also put them in the show notes for you and if you have any more questions about any topic call or text us at nine one seven three
- [49:01]
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i
- [49:01]
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would love to hear your beautiful voices if you love this episode tell me what you learned by leaving a review it genuinely means the world to me and helps so many more women find the show thanks so much for being here and we will talk next week today's podcast is sponsored by midi health so many of you know this but i was dismissed over and over again when i was struggling with perimenopause symptoms i didn't even know i was in perimenopause it is so important you're getting care from someone that's specializes in women in midlife and that they're willing to have the hormone therapy conversation with you i get questions from you every single day about where to go for support and i'm always suggesting midi health it's covered by insurance and you don't even have to leave your house ready to feel your best and write your second act script visit join midi dot com tamsen today to book your personalized insurance covered virtual visit that's join midi dot com midi the care women deserve this is a monday dot com ad the same monday dot com designed for every team the same monday dot com with built in ai scaling your work from day one the same monday dot com with an easy and intuitive setup go to monday dot com and try it
- [50:10]
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for free ryan reynolds here from mint mobile with a message for everyone paying big wireless way too much please for the love of everything good in this world stop with mint you can get premium wireless for just fifteen dollars a month of course if you enjoy overpaying no judgments but that's weird okay one judgment anyway give it a try at mintmobile dot com switch upfront payment of
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A
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