Question
We are still having the issue with hair loss. I understand that it can be a side effect for patients who are on the program for 90 days or so. Our patients are experiencing this side effect sooner. We reassure our patients that it has already started growing back, but I have several patients who have completed the program and have been on maintenance for 2 to 3 months and their hair is continuously falling out in large amounts. To the point one patient said if it keeps going she will have to buy a wig. We are just little concerned and wondering if anyone else is having this problem and any suggestions.
Answer
I have not seen any change in the incidence of this, and feel the incidence remains low. These patients seem to be at the extreme, and I would reassure them of likely full re-growth but would suggest consultations with their PCP and perhaps an endocrinologist or dermatologist to look for other causes. If the patient's alternative is bariatric surgery, then this (bariatric surgery) is likely to have a much higher incidence of hair loss and clearly issues with short and long term vitamin and mineral metabolism. —Christopher Case, MD
If the patient remains adherent to good nutrition, then it should eventually stabilize. 2-3 months is still early. Telogen effluvium is very common. In the years I have been caring for patients, I have never had to have a patient wear a wig. That said, the patient is in maintenance and perhaps is not maintaining adequate nutrition. —John Hernried, MD, FACP