Q&A: How Diet, Medication and Illness Contribute to Hair Loss

Friday, September 19, 2014 1:17 PM comments (0)

Dr. Francis

Hair loss or hair thinning affects men and women, adults and children. Yet no matter the person and the cause, it is an incredibly sensitive issue for all.

Shani Francis, MD, Dermatologist at NorthShore, struggled with hair loss herself at a young age and thus brings a unique perspective based on her own personal experience. Recently, she shared her own story with us and sat down to answer questions on hair loss, from causes to treatment options:

Do hormones contribute to hair loss?
It really depends on which hormone you are specifically referring to, because some can help hair grow and others can contribute to thinning. 

It's important to mention that any hormonal shift in your body, is enough to cause a telogen effluvium, or massive hair shedding. This is typically seen after childbirth, but can also be seen when starting or discontinuing birth control, hormone replacement therapy or during thyroid hormone fluctuations. Hair loss can also be an effect of anabolic (muscle building) steroid use and glucocorticoid (e.g. Prednisone or Medrol) steroid use. 

DHEA is a supplement that is available over the counter without a prescription. This medication tends to be anabolic and can contribute to hair thinning as well. It is important if you are taking protein powder/muscle-building supplements to look for the DHEA in the ingredients to know whether or not you are consuming this product. By the way, anabolic steroids and DHEA can also cause acne. 

Would using birth control help/harm a woman with thinning hair? 
It’s well known that no two birth control pills are the same nor do they produce the same reactions in different people. Certain anti-androgen birth control pills, such as those the FDA approved for the treatment of acne, could be helpful in androgenic alopecia, or pattern hair loss.  FDA-approved acne medications include the following progestins: norgestimate, norethindrone, and/or drospirenone. Androgenic alopecia typically affects women (and men) early in life—late teens and early 20s—and is usually caused by a hypersensitivity to male or “androgen” hormones. Birth control pills, especially those formulations that are “anti-androgenic” could be helpful in minimizing this interaction in androgenic alopecia. While it may not give a complete cosmetic benefit, it certainly could be a good, inexpensive and relatively safe start.

Conversely, some birth control pills could worsen this condition, particularly if they are more androgenic. It’s important to discuss the androgenicity of your birth control medication as well as potential side effects with your prescriber.  As I mentioned earlier, it’s also important to note that any hormonal shift in your body is enough to cause a telogen effluvium, or massive hair shedding. This is typically seen after childbirth, but can also be seen with starting or discontinuing birth control. 

How do you prevent hair loss due to hypothyroidism? 
The best way to prevent hair loss due to hypothyroidism is to keep your thyroid levels normal. The thyroid really is in control of this process; however, regularly seeing the doctor managing your thyroid medication, and taking your medication as directed, is helpful. Natural thyroid replacement hormone is much less reliable and can contribute to increased hair loss as the amount of hormone frequently changes and is nearly impossible to regulate. 

When taking thyroid medication prescribed by a doctor, it’s also important to follow the doctor’s instructions very carefully. This medication is usually best absorbed on an empty stomach and without any other medications, vitamins or supplements because they can interfere with the proper absorption of a prescription thyroid medication.

Is there any connection between vitamin D and thinning hair?
There is growing evidence that vitamin D does play a role in hair growth. This exact role has yet to be clarified. What is known is that when comparing women with thinning hair to women without, the vitamin D levels were significantly lower in the women with thin hair. It is not clear if this is the cause of the thinning or a result of something else going on with the body that may also lead to hair loss. Additionally, it is not yet clear whether supplementation of vitamin D to normal levels would help with hair regrowth.  

How does diet affect hair loss or thinning? 
Diet can directly impact hair loss because hair loss can be the result of a nutritional deficiency. Hair needs iron, protein and the consumption of sufficient calories to grow.  Vegetarians, for instance, can still achieve adequate protein levels but they have to pay careful attention to their diets to ensure they are achieving those levels each day. A well-balanced diet with sufficient calories (1200+) and a healthy mix of whole grains, fruits, vegetables and protein is generally sufficient and supplementation is seldom required if this is followed. 

Would losing or gaining weight have a positive/negative effect on hair?
There is no research that demonstrates an “ideal weight” in regard to your hair. However, if someone is far underweight or overweight, their overall health may be compromised. It’s important to mention that those who are greatly underweight and overweight are both nutrient poor. Well-balanced, normal caloric diets and healthy weights are important for maintaining overall health as well as hair health. Weight loss or gain for health must be done at safe speed as large shifts in body weight can instigate hair loss.

Does washing your hair every day have any effect on hair loss or thinning?
It’s important to think of the hair and scalp separately. Typically, what’s good for the scalp is not necessarily ideal for the hair and vice versa. The scalp loves to be clean. For oily scalp/hair types, daily cleansing is important to prevent excess oil build-up, which if left uncontrolled could lead to scalp inflammation (seborrheic dermatitis) and further hair loss. Curly hair or dry scalps may be able to get by with less-frequent washing. 

If you have dandruff, it’s a sign that you need to cleanse your scalp more frequently. Also, if your hair is massively shedding, dandruff typically makes this worse. So, although, it’s scary to see so much hair coming out when washing, washing your scalp less frequently can make the problem worse.

Are handheld laser lights like the HairMax Advanced Laser Comb effective tools for stimulating hair growth? 
The HairMax hair laser comb is low-level laser device that is approved by the FDA for androgenic alopecia, or pattern/hereditary hair loss. This device stimulates hair follicle energy cells to be more active through a process called photobiostimulation.  It also stimulates improved blood flow to the scalp and increased delivery of nutrients to the hair follicle. This device has significant research data that demonstrates that it works for androgenic alopecia; however, it does not work for everyone.  It may also work for other types of hair loss but this has not been proven yet. The best thing about this device is that it has a money-back guarantee, although it costs about $400-600. You also need to use this device for three times a week for 16 weeks before you determine results.  

How do Minoxidil and Rogaine work? Are they for both men and women?
Minoxidil, the generic for Rogaine™, is FDA approved for androgenic alopecia, which is pattern or hereditary hair loss. It’s available in men’s strength (5%) and women’s strength (2%). Research studies have found that the 5% strength foam is safe and effective for women, and only needs to be applied once daily. 

Minoxidil helps to reset the normal hair growth cycle. This is important for androgenic alopecia as well as many other hair loss disorders. Although it is only FDA approved for androgenic alopecia, it’s utilized in practice by dermatologists, especially hair loss specialists, for other forms of hair loss as well. 

It “wakes up” hair follicles that are in the resting phase of the hair cycle, and stimulates them to grow. Occasionally these follicles are just under the scalp, so it does appear as though new hair follicles are forming. It can also prevent further hair loss in androgenic alopecia.

It’s important to apply this product to the scalp and not the hair. It’s also important that the hair is dry before applying. Give it a chance to work! It may be only after four months of consistent use that you finally see improvement.  If you are using this medication consistently for longer than six months with no improvement or continued hair loss, you will need to consult with a medical professional or hair loss specialist as you may have other underlying medical issues or a scarring (potentially permanent) type of hair loss.

Do you have an opinion on Ovation Cell Therapy?  
I sure do. In my practice, I strive to recommend practiced, cost-effective solutions for hair loss. There are literally thousands of “miracle hair products” which offer much but deliver little. The Ovation product line utilizes many herbal ingredients that have limited data on efficacy, but likely do support healthy hair growth.  Saw palmetto (dried berry extract) is probably the most effective ingredient in the Ovation product line. This has been demonstrated to block DHT (dihydrotestosterone) in a very similar mechanism as finasteride, Propecia™, which will help with androgenic alopecia. Saw palmetto is sold over the counter as a supplement for “prostate health,” but you can find it much cheaper than the Ovations product line in topical and oral formulations. 


Fresh Recipe: Apple Muffins

Tuesday, September 16, 2014 1:40 PM comments (0)

appleFall has arrived! From pumpkin patches and apple orchards to grocery stores and food stands, delicious fall produce is everywhere. It’s just the right time to take advantage of all the new season has to offer. Let’s start with apples.

Katrina Herrejon, Registered Dietician and Certified Diabetes Educator, Adult Endocrinology Group, puts a healthy spin on breakfast and brunch with her recipe for apple muffins: 

Recipe makes 12 muffins
Serving Size 1 muffin

1.5 cups pink lady apples, grated
1/2 cup brown sugar
1/3 cup vegetable oil
1 teaspoon vanilla
2 eggs
1 cup whole wheat flour
1/2 cup all-purpose flour
1 teaspoon baking soda
1/2 teaspoon salt
1/2 teaspoon ground cinnamon
1/4 teaspoon ground cloves
1/4 teaspoon baking powder


  • Pre-heat oven to 350 degrees.
  • Prepare a standard muffin pan with cooking spray.
  • In a large mixing bowl, stir the apples, sugar, oil, vanilla, and eggs until well mixed.
  • Add the remaining dry ingredients to the bowl and mix well.
  • Divide the batter evenly among the 12 muffin cups.
  • Bake for 20-25 minutes.

Nutrition Information (per serving):
Calories: 166
Fat: 7
Carbohydrate: 23
Fiber: 2
Protein: 3

What is your favorite healthy fall recipe? 

In the News: What’s an Enterovirus?

Tuesday, September 09, 2014 2:37 PM comments (0)

enterovirusHundreds of children across the Midwest and some bordering states have been hospitalized for what appear to be severe summer colds that are caused by enterovirus. As one of many common summer viruses that cause colds, enteroviruses are not unusual this time of year but hospitalizations for enteroviruses are. The majority of patients presenting with symptoms of enterovirus up to this point have been children but adults can also contract the illness. Prevention of illness is important no matter your age. 

Typically with enterovirus infections, symptoms will be mild and treatment of these symptoms will be the only intervention necessary. It is believed that the enterovirus currently causing most of the hospitalizations across the Midwest is enterovirus D68, which can cause fever and severe respiratory symptoms. Children with asthma are at higher risk due to their increased chances of wheezing.

Lindsay Uzunlar, MD, Pediatrician at NorthShore, shares some important prevention measures and symptoms parents should watch for in their children:

The symptoms of enterovirus are the same as a bad cold. Similar to colds, there isn’t much that can be done except to treat symptoms and let the virus run its course. Most infections will be mild but some could eventually require hospitalization and intensive supportive therapy. If symptoms are especially severe including difficulty breathing, fevers lasting longer than 72 hours or if a child with asthma is wheezing, contact your child’s pediatrician or seek medical attention as soon as possible.

Here are some of the more common symptoms of colds, including those caused by enterovirus:

  • Fever
  • Body and muscle aches
  • Sneezing
  • Coughing
  • Rash

Wash hands often. There is no better way to prevent the spread of infection. Wash your hands with soap and water for 20 seconds, multiple times per day. This is especially important for school age children. Encourage your child’s teacher to schedule hand washing at various points throughout the day.

Model good hygiene. Make sure that your family practices proper coughing techniques such as coughing/sneezing into the elbow instead of the hand. If you do use a tissue or cough into your hands, make sure to wash them immediately afterwards.

Clean surfaces. Make sure you are cleaning surfaces that are touched frequently, including keyboards, doorknobs, phones, toys, countertops.

Stay home. If you or your children are feeling sick, think of others and stay home to prevent the spread of infection to co-workers and other children.  

Have questions about enterovirus or any other pediatric illness? NorthShore's new online community, The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans.  Click here to start now


Fact vs. Fiction: Concussion and Youth Athletes

Monday, September 08, 2014 2:28 PM comments (0)

concussionPlaying a sport, whether contact or not, puts your children at increased risk for injury. This includes many of the activities and sports kids and teens participate in during or after school. With any injury, especially head injuries, it’s important to know the difference between fact and fiction.   

Elizabeth Pieroth, PsyD, ABPP, the Associate Director of NorthShore University HealthSystem’s Sports Concussion Program, helps parents distinguish the facts from the fictions when it comes to concussion:

  • Fiction: You need to be “knocked out” to have a concussion.
    Fact: The majority of concussions do not cause unconsciousness. In fact, only about one in every 10 concussions result in loss of consciousness.  
  • Fiction: Men suffer from concussions more than women.
    Fact: Women are just as prone to concussion as men. Some of the highest rates of concussions occur in women who play soccer, basketball or do cheerleading.  
  • Fiction: If you’re feeling fine, you probably don’t have a concussion and can continue to play.
    Fact: If you suspect that you or someone on your team has suffered a concussion, it’s important to stop play immediately. Symptoms don’t always surface right away, and it’s best to get examined by a trainer or team/family physician before going back to the game.
  • Fiction: The use of helmets and mouth guards can prevent and reduce your risk of concussion.
    Fact: While wearing a helmet can protect the head from fracture, it doesn’t guarantee reduced instances of concussion. As for mouth guards, there isn’t sufficient evidence to support the claim that head injuries can be reduced. Safety equipment in any sport is important, even if it doesn’t always protect from concussions.
  • Fiction: If someone has a concussion, they must avoid any and all stimulation until they are symptom-free.
    Fact: Most newly concussed patients will feel better if they avoid loud noises, bright lights and busy environments. However, there is no scientific evidence to support prolonged avoidance of stimulation. In fact, it may be counterproductive. It is more important to examine what triggers a person’s symptoms to better manage their environment.  
  • Fiction: It takes months to recover from a concussion.
    Fact: Most people who suffer a concussion recover in 1-2 weeks, although some have symptoms that persist. There are, however, treatments to treat lingering symptoms.

Questions? Well let's chat! Join us on Twitter on September 15th from 11 to 12 p.m. @NorthShoreWeb and @DrEPieroth will answer all your questions on concussion and youth sports, from diagnosis to treatment and prevention. Tweet your questions using #nschats.  


A Caregiver's Love: Russ Bond Shares His and His Husband's Journey Through Prostate Cancer

Wednesday, September 03, 2014 5:12 PM comments (0)

russ bond

Patient Don Tabler was diagnosed with prostate cancer in 2000, with some charts giving him only six years to live. His husband Russ Bond cared for him throughout his 12-year journey with prostate cancer.

Here, Russ discusses the important role of a caregiver as well as the care his husband received at NorthShore Kellogg Cancer Center, including the cutting edge treatments and clincial trials that helped Don's doctor, Daniel Shevrin, MD, Medical Oncology and Palliative Medicine, improve and maintain his quality of live and extend his survival far beyond what was intially projected.


Ready to Hit the Books: Healthy Kids Make Happy, Successful Students [Infographic]

Tuesday, September 02, 2014 11:40 AM comments (0)

The kids are back in school and already busy with homework, classes and practice. Don't let hectic schedules put your children’s health in detention. Parents can do plenty to help their children stay healthy and succeed in school—from ensuring they get adequate sleep and regular exercise to serving up balanced meals and more. After all, children’s health has been shown to be directly linked to success in school. 

Our latest infographic explores the connection between children’s health and academic performance with health information and tips from the experts at NorthShore University HealthSystem. Click on the image below to see the full infographic. 


Join NorthShore's new online community, The Parent 'Hood, to connect with other new and expecting parents, as well as our expert physicians. Find support, ask questions and share your stories. Click The Parent 'Hood to start now! 


Fresh Recipe: Kale Salad with Homemade Honey Dressing

Friday, August 29, 2014 9:00 AM comments (0)

kale saladKale is all the rage. It's in grocery stores and on restaurant menus, but if it also happens to be in backyard garden, we’ve got the recipe for you. Packed with vitamins A, C and K, as well as plenty of antioxidants, there aren’t many leafy greens quite as healthy as kale.

Katrina Herrejon, Registered Dietitian, Certified Diabetes Educator, shares a recipe for kale salad that is sure to have the entire family asking for more:

Recipe makes 5 servings


For dressing:

  • 1/4 cup hazelnut oil*
  • 1/4 cup honey 
  • 1/4 cup apple cider vinegar
  • 1 clove of garlic, finely minced
  • Salt and pepper to taste 

For salad:

  • 2 bunches of kale (should yield 5-6 cups chopped kale)
  • 1 large head of broccoli (should yield 2 cups of chopped broccoli florets)
  • 1 1/2 cup fresh strawberries, sliced
  • 2 medium golden beets, cooked and sliced 
  • 1/2 cup of toasted hazelnuts


  1. Whisk all dressing ingredients together in a small bowl and set aside.
  2. Remove the inner rib from the kale and finely chop the leaves.
  3. Remove the stem from the broccoli and finely chop the florets.  
  4. Remove the stems from the strawberries and thinly slice.
  5. Cook the beets until tender, peel the skin, and remove the stems. Slice each beet into 8 segments.  
  6. Combine the kale, broccoli, strawberries, beets and hazelnuts in a large bowl. 
  7. Add the dressing and toss to coat.

Nutrition Information (per serving):
Calories:  292
Fat: 16g  
Carb: 31
Fiber: 4
Protein: 6

*Canola or olive oil can be substituted if hazelnut oil is not available.


Four Essential Nutrients for a Healthier Lunch Box

Wednesday, August 27, 2014 4:06 PM comments (0)

lunch boxHot dogs, pizza, tater tots, chicken nuggets, ketchup and bagged chips – these high-fat, high-sodium and low-fiber foods are made available every day in some schools across the country. With over one-third of American children overweight or obese, it’s little wonder First Lady Michelle Obama has made improving standards for school lunches a focus. And improvements are happening, but packed lunches are still a great way to help your children keep calories and fat under control, as well provide the essential nutrients they need to grow and thrive. 

Kimberly Hammon, Dietitian at NorthShore, shares some healthy lunch tips for how to include essential nutrients – vitamin D, calcium, fiber and potassium – into your kid’s packed lunch:  

Vitamin D: Vitamin D deficiency has been linked to various cancers, including colon and breast, heart disease and depression. Vitamin D is needed to absorb calcium to maximize bone growth and strength. 

What to pack?

  • Most milk products have vitamin D.
  • If your child isn’t a milk drinker, pack vitamin D-fortified orange juice instead.
  • Up vitamin D intake in the morning with yogurt, oatmeal or cereals.

Calcium: Calcium is an essential nutrient that helps build strong bones, but it also can help with heart rhythm, blood clotting and muscle function.

What to pack?

  • Milk or flavored milk is a healthy addition to every meal.
  • Orange juice with added calcium is a non-dairy option.
  • Add cheese to sandwiches or include cubes or sticks. Low-fat mozzarella and Swiss have the highest amount of calcium.
  • Trail mix with raw almonds is a healthy dessert or snack. Almonds are high in protein, fiber and calcium, and promote heart health and, when consumed in moderation, can help prevent weight gain. 

Fiber: Fiber can help prevent type 2 diabetes and high cholesterol. It also helps tummies feel fuller longer. 

What to pack?

  • A sandwich with whole grain bread. Whole grains not only have lots of fiber, but protein, B vitamins and antioxidants.
  • While fiber from whole grains and fruits and veggies is still the best option, cereal bars can be a complaint-free way to get a little more fiber into your child’s diet. Make sure you check labels! Some brands don’t have enough fiber to justify the added sugar.
  • Apples have lots of fiber. Tip: to keep apple slices from going brown, sprinkle with lemon juice. Other high-fiber fruits include bananas, berries and dried fruits. 
  • High in fiber and heart-healthy fat, avocados can add flavor, creaminess and nutrients to sandwiches and wraps. 

Potassium: Potassium-rich diets promote heart and muscle function, maintain fluid balance, energize and help build strong bones. 

What to pack?

  • Dried fruit, especially dried apricots, have lots of potassium, as do bananas, nectarines and oranges.
  • Try to sneak some vegetables into sandwiches or wraps, especially spinach, which is high in potassium. 

What do you pack to provide a healthy lunch for your kids?


From Survivor to Supporter: Debbie Hulick Helps Raise Funds for Ovarian Cancer Research

Friday, August 22, 2014 11:28 AM comments (0)

Debbie Hulick

Debbie Hulick is not only the co-chair of the 2014 American Craft Exposition and an active board member of the Auxiliary of NorthShore University HealthSystem, she’s also an ovarian cancer survivor. She was diagnosed with stage three ovarian cancer in June 2007. With three daughters of her own, raising awareness and raising funds for ovarian cancer research has become a passion. The American Craft Exposition (ACE), which provides funding to the research efforts of her own physician, Dr. Gustavo Rodriguez, was a natural next step after she completed treatment at NorthShore. 

Debbie tells us what led her to ACE and why research into this “silent” killer is so important:  

What is your role with the American Craft Exposition (ACE)?
I am co-chair of the 2014 American Craft Exposition and an active board member of the Auxiliary of NorthShore University HealthSystem.

How did you learn about ACE? Why did you want to become involved?
After my treatment for stage three ovarian cancer at NorthShore was completed, I found out that ACE was funding the ovarian cancer research efforts of my physician, Gustavo Rodriguez, MD, for at-risk women. Having three daughters, it was very important for me to become involved and help support this very significant cause. Today the funds raised at ACE are being applied to help better the lives of women in our community and I could not be more proud to have a hand in these efforts. 

How does ACE help women with ovarian cancer?
Funds raised at ACE support pioneering research being conducted at NorthShore that is already showing promising results in preventing ovarian cancer in at-risk women. Ovarian cancer is called the “silent” killer because symptoms are easy to dismiss and the disease is often diagnosed too late for effective treatment. More than 100 researchers are engaged in breast and ovarian cancer studies at NorthShore encompassing an array of multi-disciplinary programs addressing better methods for prevention, detection and treatment.

What excites you most about this year’s exhibition? What will visitors see?
I am very excited that we have over 30 new artists exhibiting at ACE for the first time this year, including artist Thomas Marrinson. His brightly colored ceramic bowls create a stunning display and are sure to “wow” attendees! Besides Marrinson’s work, visitors will have the opportunity to peruse and purchase stunning pieces from over 160 of the country’s finest craft artists. We also are bringing back our Craft in Action stage this year where visitors can watch both ceramic and wood demonstrations. 

The American Craft Exposition is open to the public starting Friday, August 22nd. Visit americancraftexpo.org for all of the details.


Summer Cold or a Sinus Infection?

Wednesday, August 20, 2014 11:07 AM comments (0)

Cold-SinusAt one time or another—and maybe even multiple times each year—we’ve all had the symptoms of a cold. But there's no worse time to suffer the symptoms of a cold than in the summer. The familiar prolonged running nose and sniffling, and the sinus pressure that comes along with it. How do you know if it’s just a common cold or a sinus infection?

Ilana Seligman, MD, Pediatric Otolaryngologist at NorthShore, breaks down the differences between a cold and a sinus infection, and tells us the right time to make an appointment with a doctor: 

Common Cold
There are not perfect steps to follow for cold prevention; instead, it’s best to wash your hands frequently, and avoid sharing cups and toothbrushes. If you already have a cold, there isn’t much a doctor can do because prescribing antibiotics is not recommended. You can, however, treat the symptoms. Most colds typically last 7-10 days, and common symptoms include:

  • Nasal congestion
  • Fever
  • Sore throat or cough
  • Clear or colored nasal discharge

Treating the Symptoms

  • For a stuffy nose, nasal decongestants can help you breathe easier. If you want to go the more natural route, try a saline nasal sprays or even a Neti Pot. 
  • For cough, warm liquids, like tea with honey, can be enough to provide relief. The honey also pulls double duty by soothing sore, scratchy throats. 
  • Sleep! Rest is the key to bouncing back fast.  

Sinus Infection
A sinus infection is an infection or inflammation of the lining of the sinus cavities. Very few colds—only 5-10%—will turn into sinus infections. Common signs your cold is a sinus infection include:

  • Continued nasal congestion after 10 days
  • Significant headaches, teeth or facial pain
  • High fever or persistent drainage

If you experience these symptoms it may be a sinus infection, which means it's time to consult your physician. Common treatment often includes prescribing antibiotics.

Do you know when you have a cold versus a sinus infection? What home remedies to you defer to when you have a cold?

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