ASK Dr. BAUMAN
Q: I wanted to ask you if taking the herb Tribulus Terrestris is safe or will it "boost testosterone" and contribute to hair loss?
A: Although we don't know the specific action or effectiveness of many of these "testosterone boosting" herbs and supplements, the use of Tribulus Terrestris may in fact be risky for those with hair loss. But, as of now, there's no definitive answer. Though the herb T. Terrestris (Tribulus Terrestris) was popularized by a 1970’s bodybuilder to increase the body’s natural testosterone, human studies have failed to prove that it increases testosterone or strength. Animal studies in rats, rabbits and primates have demonstrated ambiguous results or results that were not statistically significant. Only one single animal study showed that it altered sexual behavior in castrated rats by theoretically stimulating androgen receptors in the rats' brains. Another animal study found that administration of Tribulus terrestris extract produced statistically significant increases in levels of testosterone, dihydrotestosterone and dehydroepiandrosterone, and produces effects suggestive of aphrodisiac activity. This is where things get risky for hair loss patients.
The most important thing for your readers/viewers to understand is that if they are genetically predisposed to hereditary hair loss (male pattern hair loss), ANYTHING they do which increases the body’s testosterone level naturally or unnaturally poses a risk to the hair follicles because testosterone becomes dihydrotestosterone (DHT) in the body. Dihydrotestosterone is the primary trigger for male pattern baldness. For example, testosterone replacement can significantly accelerate the hair follicle miniaturization associated with male pattern baldness, unless they are on a medical hair loss management regimen.
If someone is not sure if they are at risk for hereditary hair loss and wants to check, there's a simple cheek-swab genetic DNA test for that called HairDX as well as other non-invasive evaluations that can be performed using HairCam dermoscopy and HairCheck cross-sectional bundle measurement comparisons. These are evaluations we commonly perform during an initial hair loss evaluation at Bauman Medical Group.
Bodybuilders, pro athletes, hormone replacement patients and many others often seem to have trouble maintaining good quality hair growth. However, there are many effective medical hair loss treatments to help stop and reverse the effects of the DHT: finasteride, minoxidil, laser therapy, nutraceuticals, cell therapy (PRP), etc. and there are ways to scientifically evaluate and measure what is going on at the level of the scalp before, during and after anything that may boost DHT so we know what is working. Advanced treatments like compounded finasteride FinPlus, compounded minoxidil Formula 82M, the powerful/portable/discreet LaserCap, nutritionals, Platelet Rich Plasma with ECMs like BioD are all at the leading edge of treatment.
On a separate note, we've seen supplements like Creatine--commonly found in post-workout recovery shakes--now proven in humans to increase DHT dihydrotestosterone, confirming the hair loss risks we predicted years ago after we saw hair loss in those patients using it. (Therefore, supplements can sometimes cause trouble for hair loss patients!)
When it comes to hair regrowth, which can be subtle at first, self-monitoring rarely works so encourage your viewers to seek out a board-certified hair restoration physician that can perform seasonal HairCheck cross sectional bundle measurements, diagnostic genetic testing (if needed), prescribe an effective medical regimen and track the progress. Good luck!
Dr. Alan J. Bauman, M.D. - Diplomate, American Board of Hair Restoration Surgery - Medical Director, Bauman Medical Group
Do you have a hair loss question? Ask Dr. Bauman!