The Causes of Hair Loss & Fatigue with Julie Olson, CFMP

Episode 95:

The Causes of Hair Loss & Fatigue with Julie Olson, CFMP and Evan H. Hirsch, MD

Evan H. Hirsch, MD  00:03

So if you have chronic fatigue, long COVID, or mast cell activation syndrome, and you're looking for help, check us out at energy MD method.com. We have a program for almost every single budget, and we're here to help. Hey, everybody, welcome back to the energy MD podcast where we help you resolve your chronic fatigue, long COVID and M casts. And we do that by finding and fixing all the real root causes that you have. So really excited about today's speaker, because we're going to be talking with my friend Julie Olson. And we're going to be talking about where fatigue and hair loss mixes are where they meet. And we're going to dive into that in just a minute. But let's learn a little bit about Julie first. So Julie has a number of different number letters after her name. She's a triple certified nutritionist and functional medicine expert. She is recognized as a top 20 expert in the health and wellness space by the Los Angeles Tribune magazine. She's the host of the healthy body healthy hair the truth about hair loss Summit, winner of Pub Pub Khan's book publishing contest, and creator of the healthy hair Fix program, which personalizes hair growth strategies by linking health, lab results and lifestyle to avoid long term medications, procedures and products. Julie's mission is to help women worldwide restore their health, hope and hair naturally. So they look and feel their absolute best. Julie, thanks so much for joining me today.

Julie Olson, CFMP  01:34

Oh, thank you for having me.

Evan H. Hirsch, MD  01:37

So hair loss can really be a big deal for the people that I work with. So let's talk a little bit about hair loss. And I guess, where's the best place to start here? I guess what is hair loss? I guess we can start there?

Julie Olson, CFMP  01:55

Well, there's different types of hair loss, there's the autoimmune hair loss, and that usually presents and coin size bald spots. But that's how it starts. And then then it just goes all over. And then there's diffuse hair loss. That's more, you know, pattern baldness, female male pattern baldness. And some, you know, some are auto immune, some are driven by hormonal, some are more genetic. But some of the new research which I really love, and I think we'll dive into today's there's a scalp hair follicle microbiome, they discovered and they accidentally, when they did some studies on the subjects that were losing hair, two of them had alopecia universalis, they lost hair over their entire body. And they were sick with some other issues. So they had a fecal microbial transplant. And they grew back their hair. Wow. So that is showing the value of gut health for hair health. That's some new research. And also the fact that our scalp hair follicles require an enormous amount of energy, not only from our nutrients, but from ATP or mitochondria. And unfortunately, since it's not a vital organ, when we're ill, or fatigue, or whatever have is going on, you know, our, our nutrients and, and that energy gets to our scout last, it's it's the last one to get the love. So it's tricky. And you know, when you're, you're fatigued, you're you're not going to get up and move like maybe you should, and that also is going to play a role because you need that that circulation and the nutrients get into your scalp. So you go ahead a lot of information right there.

Evan H. Hirsch, MD  04:15

No, that was great. I mean, it's it sounds it's really complex. And you know, that's what I see as well. It's like sometimes you can just give somebody thyroid and it really helps with their hair loss. But oftentimes, it's a lot more of these different components. And you talked about genetic, hormonal, there's the autoimmune component as well. Which one would you say is like the most common cause that you see for hair loss?

Julie Olson, CFMP  04:41

Okay, well, I'm going to break that down because there's over 50 causes. But I put them into four functional, more functional root causes that's inflammatory, hormonal stress induced and digested. And this is a bit of a matrix because your hormones are going to get off, if your digestion is off if you're not absorbing nutrients, and you might not be absorbing new nutrients because you're stressed. And if you're stressed, it prematurely puts you into the telogen resting phase of hair growth at your hair will grow, and it can damage hair follicles. And the end of they all work together and the inflammation just wreaks havoc on your scalp, it's really hard to grow your hair with chronic inflammation.

Evan H. Hirsch, MD  05:35

So you said telogen

Julie Olson, CFMP  05:39

intelligence. So there's a couple of phases of hair growth, the first one is antigen and that's the growing phase. And that lasts from anywhere from two to seven years. And then the catatan phase, which is more of the the short phase that lasts about 10 days, and that's where the hair follicle can shrink and detaches from the dermal, you know from the follicle and just regenerates. And then a lot of lot of a lot of charts just have the three phases, and then they skip to the telogen phase. But there's another fourth phase that the shedding phase, they call that exigent phase and that represents a period from from when a resting hair reaches its its like terminal position in the follicle when it finally detaches. And the rest of the hair is gradually loosen resulting in the shedding of the hair. So it's interesting because people don't realize, when they do like a detox program with your program with any practitioner, and they go, they're hurt, you know, they Herxheimer reaction they herx Or basically they get worse before they get better. Well, that's the same thing with hair loss, if if you did my program or someone else's program, you can often be losing a lot of hair because it's shutting out all those that have detached anyway, to make room for the new growth. And that's really tricky, because people get really frustrated in that face.

Evan H. Hirsch, MD  07:32

Yeah, so how can you tell them if that's like a healing response that's just going to be temporary, and that things are going to grow back? Or whether this is kind of like a runaway snowball?

Julie Olson, CFMP  07:46

Well, that's why it's really important before you start any program to determine what functional type of hair loss you have. Because that depends on their approach. And different types of hair loss. Different people need different approaches, and there's different outcomes for different types of hair

Evan H. Hirsch, MD  08:08

loss. Wow. individualizing treatment, how novel. That's awesome. So and when you say those different categories, you're talking about inflammatory stress induced hormonal and digestive. Did I get that right? Yes. Okay. And so then. So then, I guess, tell us about each of those, how does somebody know which one of those they have?

Julie Olson, CFMP  08:35

Well, they can, they can take a quiz on my website that will tell them but that's, that's kind of tricky. And again, there's even overlap with that. But at the end of the day, if, if, if you're experiencing any of those, you're gonna have hair loss. And if you don't fix it, if you don't fix them all, you're you're gonna continue to have hair loss. It's almost like that three legged stool. You talked about, you know, one can't stand without the other. And, you know, I mean, going back to nutrients and nutrition and digestion, I mean, a lot of these women that come to me, they're eating great, but they're not absorbing once you do some functional labs, they're not absorbing and you know, and some of it goes back to some stress they had they hadn't resolved and, or it can be something like Candida parasites, which are nutrient pirates. You know, of course, high DHT is more implicated in male hair loss, the hormonal but that often gets elevated because of lifestyle choices and low protein intake or maybe they're not absorbing their protein. And even a vegan and a vegetarian diet is really difficult to grow hair because you're not getting those branched chain and essential amino acids that are so necessary for hair growth. I mean, our hair is basically made out of protein, they call it keratin. So even people that go on those crash diets, they're, they're gonna have hair loss, it's rampid. Even those bodybuilders, you know, that, that starve themselves and dehydrate themselves before competitions and so forth, they, they struggle with hair loss, and, I mean, it's the gamut, you know, heavy metals, mast cell activation is a huge one, huge one. Viruses, you know, the COVID, the COVID, shed, Epstein Barr Virus, you know, a lot of, you know, just underlying infections that, that just wreak havoc on your system, certain medications, detoxification issues, maybe you're having methylation issues, you're having a fatty acid imbalance.

Evan H. Hirsch, MD  11:18

So this is

Julie Olson, CFMP  11:19

the list goes on.

Evan H. Hirsch, MD  11:22

That's it. So this is that list that you're talking about of like 50, different causes that you have to assess when somebody comes to see you, and they've got hair loss to figure out how to help them? Is that right?

Julie Olson, CFMP  11:33

Right. Right. And usually, it's more than one, one cause.

Evan H. Hirsch, MD  11:41

Yeah, that's, yeah, that. So then, in terms of the inflammatory stress, hormonal digestive, it sounds like, everybody has all of those, but it's just kind of like a component. If the question is, I guess, how much of each of those do they have? And then what are the underlying causes that end up triggering those? Is that correct? Right,

Julie Olson, CFMP  12:01

right. And that's where some functional labs come in. Really well. That's, that's what, that's what I call my whole new approach, because I'm doing these functional labs determined by the individual, I don't just have a set of labs, it depends on that individual. I mean, there's some I like better than others, but, and some of the same ones, you probably use the soil tested organic acids, test and neutral bow, heavy metals, I mean, you know, I mean, even Candida and fungal overgrowth, as you know, can wreak havoc, give you a lot of fatigue, but they also can cause hair loss and, and that can cause your hormones to get out of balance. And of course, we know, hypothyroidism, and even hyperthyroidism cause hair loss, Hashimotos graves, I mean, it's just at the end of the day, it's something that's out of balance in your system. And it can be a gift to do something about it. And that's how I got into it. I don't know if you know my story. I don't, yeah. And I'm so passionate because when, before I got into nutrition and functional medicine, I actually worked at Warner Brothers and I got the call that my mother had stage three breast cancer was going into emergency surgery. So I decided soon after that, to move back to my hometown to support her and in that transition, and working in the media there, and finally slowing down for once in my life, I was living a really fast lifestyle out there in Los Angeles. I realized I was putting blinders on my own health and I just got more interested in why my mother got so sick. And I just quit and I went back to school and studied all this and that's when my hair was coming out in clumps, clumps, and Evon I was a hot mess. I mean, I had everything I discovered h pylori, hypothyroidism, anemic. I was anemic. I it was, but just like other women, I would have probably just kept going, if my hair hadn't fallen out. So that's why I'm so passionate about this because it's a sign it's a symptom that you can actually finally wake up and go, Okay, I need to take care of my health.

Evan H. Hirsch, MD  14:44

Yeah, yeah. So then, yeah, cuz you can't avoid it. You know, there's a lot of things. You know, I had somebody on a call today who's in our programs, who's got chronic fatigue, and she's like, people keep asking me to join the fire department, because they don't know I look fine from the outside. You know, when you start to lose your hair that's different. And then vanity plays into that and you're like, Oh, I can't, I really got to do something about it. Right, I was just hiding at home.

Julie Olson, CFMP  15:11

Right. And, you know, there is an urgency here too, though, because it gets to the point of scarring of the hair follicles. It's, it's, it's virtually impossible to reverse. And, you know, with women, I mean, it's accepted for men. And men's hair loss is, you know, it's cool. You can shave your head and look cool. Yeah, like, Yeah, but women, they've been in the closet. And really that slap heard around the world. You know, the Academy Awards, people started asking what is alopecia? Uh huh. So people started paying attention, like, you know, there's something to this, whereas women can hide behind it, they can put on extensions, and fancy wigs you don't even know are not real. I mean, there's some really good ways out there nowadays. But that's all putting band aids on it, and so is taking all these medications. And that's why I was also so frustrated and decided to do something about it. Because everywhere I went, they're like, oh, you can't do anything, you know, get on these lifelong medications.

Evan H. Hirsch, MD  16:25

So, right. And that slap you're referring to was when Will Smith slapped Chris Rock because Chris Rock made a comment about Will Smith's wife,

Julie Olson, CFMP  16:36

Jada Smith, yeah. Jada Smith? Yeah, who has alopecia Arriaga?

Evan H. Hirsch, MD  16:42

So yeah, so let's, let's get into some of that. So is that the most common form of hair loss? No,

Julie Olson, CFMP  16:49

the most common form is androgenetic. For men, that's when basically that DHT gets to elevate it. And chronic telogen effluvium and female pattern hair loss for women? I mean, if you put technical names to it. Yeah.

Evan H. Hirsch, MD  17:13

And so, and let's kind of get a little bit granular here in terms of like, like, what is a follicle we keep on referring to like hair follicle? What is it? And how are these different things acting on the hair follicle that ends up causing either growth or lack of growth.

Julie Olson, CFMP  17:32

Um, well, an active your cells in the bowl, the hair follicle, right. And they divide and differentiate to produce new hair. And again, that's, that's the active phase, that's the antigen phase. And that's where you, you need to be in that. That's for two to seven years, because that's where about 85 to 90% of your hair growth takes place. Whereas the Catagen phase that lasts only about 10 days is when the hair follicle shrinks, right, and that's the lower part is actually destroyed and the hair stops growing, but it does not shed. And that only lasts for about one to 2% of the time. And then the third main phase is the telogen. And that's the resting phase that lasts about three months. And that is the hair is at rest and eventually sheds and the new hair begins to form in the follicle and that's about 10 to 15% of the time. But again, with with the chronic stress and diseases worldwide, especially the last couple of years, what's happening is people are popping prematurely into that telogen phase. And that's what they're calling the COVID shed the COVID hair loss. They're calling it chronic telogen effluvium. The good news is that type of hair loss should only last about three to six months and there's a good chance it will come it will grow back. Whereas other types of hair loss like different types of allergies, autoimmune alopecia, if they have scarring of the hair follicles, it's it's nearly impossible. I mean, that was an anomaly. Those studies and their PubMed studies that I mentioned at the beginning of this conversation of these people growing back their hair after taking a fecal microbial transplant. But even that, you know, if you you know, you probably know the science behind that and then when people take that and then they still go back to their normal lifestyle. They're gonna revert back in is the same with hair loss. And also with hair loss. It comes to the point where it gets miniaturized, they call it miniaturization. And your hair still growing, but your follicles shrinks so much that's more in the Catagen phase, but that can often just last too long. And that can also cause scarring and use don't most women,

Evan H. Hirsch, MD  20:27

and so the scarring is scarring is coming from the immune system acting on or attacking the hair follicle as an autoimmune process. Is that correct?

Julie Olson, CFMP  20:37

Yes. And then it's, that's part of it. But for instance, in the in the COVID. And with viruses and, you know, probably a lot of conditions you you deal with, it's the interferons. What happens is what happens exactly is it's like this cytokine storm, right? And, and then, whereas our defense mechanisms, the interferons are critical for fighting infections, their presence starts the onset of hair loss. And but what really triggers it is not only these interferons, but the cumulative effect of inflammation and immune activation that disturbs the hair follicles. That makes sense. Yes. And

Evan H. Hirsch, MD  21:38

so then, so then with with COVID, and this long, COVID picture that we're seeing with the chronic tele flu Veeam. Moving, then the COVID is causing this inflammatory reaction that ends up having this effect on the follicles, the follicles end up falling out. But you said that lasts for about three to six months, and then oftentimes, it can grow back, what percent of the time does it go back? Um, you know, approximate,

Julie Olson, CFMP  22:16

I would say, I would say about? Gosh, that's a really good question. I haven't come across, I think I haven't come across studies saying that it doesn't grow back. Um, so I think probably, like 80% or so grow back. I don't know, I'm just pulling numbers out of the hat. But I haven't come across a lot of studies saying that it doesn't grow back, I've come across a lot more saying that it will grow back as long as you get your health in, in line.

Evan H. Hirsch, MD  22:56

So it seems like so the so the people that you're working with who have COVID, and they ended up losing their hair, it sounds like you I mean, you're gonna go through your process, and you're gonna figure out what's going on and fix it. And they'll probably get their hair back faster than if they did nothing. Right, right. And

Julie Olson, CFMP  23:15

also, we discover other underlying imbalances that, as I'm, as far as I'm concerned, was why they got COVID so bad in the first place. I mean, I'm not a doctor. But I mean, it makes sense to me. But also, I mean, it this the same narrative is also what happens with the Epstein Barr Virus, which causes fatigue and other viruses and infections that are associated with hair loss is the inflammatory response and immune activation that disturbs those hair follicles. And that was part of my problem, too. I, I had really bad Epstein Barr Virus. I don't even know it. You know, I just worked through it. Back when I was losing chunks of hair. So you know, I like to hide. I like to test for that the act of Epstein Barr Virus when I work with these women. But anyway, as a side note, I'm kind of getting off track here. Sorry.

Evan H. Hirsch, MD  24:22

No, this is great. And just so that people know, like what a fecal transplant is, or if you grill that you that you mentioned before, can you expand on that a little bit and kind of how the mechanism is, is affecting the hair growth in that particular study?

Julie Olson, CFMP  24:39

Sure, sure. And I have a Polish abstract on it. So what a fecal microbial transplant is feces poop, from a healthy individual that they give to an unhealthy individual. And they do it in a You know, you have to, there's only certain facilities that do it is it's more common in Europe than it is here. But you take on the healthy microbiome of that Beagle transplant donor. And as we know, if your microbiome is out of bounds, if you have dysbiosis, you have, you know, more bad bacteria than good bacteria you have, there's so many things I keep discovering new strains every day. And it's just, it's really interesting. And you know, ours, it's attached to our brain through our vagus nerve and the gut, brain axis and all the so so. So once you do that, and these subjects are it's actually more than two, there are four of them. They're there, their health, just just got great. And but they've also done studies where people's health was resolved after taking it. Mostly it was done initially for C diff. And then that was resolved. But if they went back to their regular lifestyle that was a trigger for them getting C Diff or what have you in the first place, then it'll revert back. So still making healthy lifestyle choices is very important.

Evan H. Hirsch, MD  26:31

Yeah, and I think, yeah, I think one of the things that people don't realize is that what they eat, really has a direct translation into the bugs that they have in their gut. And that this, then that the bugs in the gut end up talking to the immune system, of which 80% is in the gut itself. And so then the good bugs in the gut can now talk to the immune system and say, Hey, don't be so inflammatory, don't be auto immune. And then they can kind of shut that down, relax that and then stop attacking the hair follicles in this particular case. So, yeah, very important point. So then, in terms of the, so that's, like, kind of like gut hair connection, right.

Julie Olson, CFMP  27:19

And it's also evidence that, you know, if their gut is so out of balance, it's gonna have a really difficult time absorbing nutrients. Right? Yeah. And then, and then anything they do absorb is gonna go to their vital organs, their hair's gonna be neglected and

Evan H. Hirsch, MD  27:40

right, it's like a second class citizen,

Julie Olson, CFMP  27:42

right?

Evan H. Hirsch, MD  27:45

The poor hair follicles? So then do you find that if somebody got their hair loss from COVID, that addressing COVID directly is the fastest way to get their hair back? Or what do you what do you find is like the fastest way back?

Julie Olson, CFMP  28:03

I, in my experience, is getting them into balance, doing functional labs, figuring out what is out of balance.

Evan H. Hirsch, MD  28:15

So you don't always have to address the COVID It sounds like just by optimizing their lifestyle habits, and then looking at some of these functional labs and addressing those I mean, is it usually like, is there an infection in the gut that you find makes the biggest that's the biggest needle mover or is it a dressing the hormones? Or what do you find is like the biggest thing not just with like, COVID hair loss, but like hair loss in general, when you're like, Oh, I know when I do this with somebody that they're going to have a significant improvement.

Julie Olson, CFMP  28:45

Yeah, I find a lot of food sensitivities I find most of these people have a sensitivity to gluten, dairy, you know, some of the the calm eggs, taking some of those, those common food sensitivities out of their diet and I you know, the nightshade. So my I put them on a 12 week food plan that is anti inflammatory modulates inflammation. And it's, it's, it's really, I mean, yeah, it could move the needle just with that. But balancing out everything else and depending on what I find in those labs depends on what what supplements they need to be on or not what needs to be removed first, you know, you'll first need to remove the parasites and then get the gut optimized, get rid of the Candida and then remove the toxins if they have those, you know, do it systematically. But you know, because at the beginning, they're not going to absorb those those supplements anyway, until they get to bat or bow at least that's my experience.

Evan H. Hirsch, MD  29:59

You Yeah. And so it sounds like, it sounds like it's different for everybody. It's not like you do. I mean, you talked about diet and doing like a food elimination diet, and that helps to quiet down the immune system and then you have less autoimmunity, less inflammation, it sounds like that's helpful. But then it sounds like everybody's got a different combination of causes. So it's not like, Oh, when I go after yeast, I noticed that that's like the biggest needle mover, as opposed to like going after parasites.

Julie Olson, CFMP  30:29

Well, I'll go after both, if they have both. Yeah, even mast cell activation, I'm finding on the stool past a couple of markers that are also associated with mast cell activation, I'm finding that in a ton of these of these women.

Evan H. Hirsch, MD  30:46

So that's indicating histamine activity. So these are all different components of the immune system that are inflammatory. So it's telling us yes, there's inflammation happening in the body. And inflammation is associated with hair loss. Not always, but in this particular case, with the people that you see, when they have hair loss, you know, they have inflammation, you know, that their hormones are probably off, you know, that they've got all these different underlying causes, which are causing the immune system to be dysfunctional. Is that fair to say? Yes,

Julie Olson, CFMP  31:17

yes. Okay.

Evan H. Hirsch, MD  31:21

And so then, so we've kind of talked about a number of these different causes. What is what is happening? You know, there's been times where I am working with somebody, and I start to give them either adrenal support, or sex hormone support, and all of a sudden, they start losing their hair. And it makes me think, well, it's probably because, you know, we've got that, that stool of like the adrenals, the thyroid and the sex hormones. And by replacing these other things, it's putting more stress on the thyroid, and then they're having more hair loss. What do you think is happening in situations like that?

Julie Olson, CFMP  32:04

That That makes a lot of sense. You know, the other two, leis got more love than the one that they didn't, and so they can't support each other if they don't have all of them.

Evan H. Hirsch, MD  32:20

Yeah, yeah. So do you find that if you are going to replace hormones that you have to do them in a certain order in order to avoid additional hair loss?

Julie Olson, CFMP  32:33

Um, that's a great question I, I find it depends on the situation. And, and the person, I go for the gut first, I try, you know, try to get the gut bounce out as, as best first because the hormones are created in the gut anyway. And then, and then I'll look closer at the hormones. I mean, you know, initially, I'll do a whole, you know, for hormone panel and a thyroid panel and iron, but you know, I'll look at everything, but I had to do it systematically.

Evan H. Hirsch, MD  33:18

Excellent. And do you find that, you know, a lot of the people that I see, they've been working on, you know, healing their gut for years, you know, they've done food elimination diets and taken different digestive enzymes and HCl and this then the other thing, and I find that part of the reason why they're not better. And this is kind of heresies, you know, if I tell people you know, it's not in the gut, but oftentimes, if you have heavy metals, chemicals, molds, infections and trauma that haven't been addressed yet, you can keep replacing and working on the gut till the cows come home, but you're not going to be successful. Are you with

Julie Olson, CFMP  33:53

you? I totally agree with you. And I feel bad, but even when I get these women, in fact, I just got one recently. She had eight mercury fillings, and I'm like, I can't start working with you until you get those out. Because I can't detox her properly. Right. I mean, I feel bad, but it's all my form and everything. It's just, you know, and they don't get it, a lot of them that they just don't understand how that has anything to do with their hair loss and their health. But it does and the mold and you know, a lot of people are exposed to mold every day, and they have no idea but that plays havoc on your hair and health.

Evan H. Hirsch, MD  34:47

Right? Yeah, it's it's this combination of all these things that are in our body that aren't supposed to be there that end up triggering the immune system to do all sorts of wacky things that it's not supposed to be doing. Yeah, Brilliant. Well, where can people go to learn more about you? Well, we're going to drop the links that that you provided us. So Julie olson.com, and fortitude, functional nutrition, are those the best links? Sure. And then you have a free gift for our audience, which we'll drop a link down below, which is the roadmap to healthy hair.

Julie Olson, CFMP  35:21

Right. And in that, in that roadmap, there's a link to some free recipes and some other goodies too.

Evan H. Hirsch, MD  35:27

Nice. Yeah. Yeah, that's awesome. Well, wonderful. Um, last question is, what is one practical thing that people can take away from this right now and do to take care of their hair loss or take a step towards resolving their hair loss?

Julie Olson, CFMP  35:49

There's hope. There's hope and you can do it. Don't let someone tell you that you need to take medication for the rest of your life for it, or that you can't grow it back. And what Evan and I do can make a difference.

Evan H. Hirsch, MD  36:08

Awesome. Julie, thank you so much for joining me today.

Julie Olson, CFMP  36:12

Thank you.

Evan H. Hirsch, MD  36:16

So if you have chronic fatigue, long COVID, or mast cell activation syndrome, and you're looking for help, check us out at energy MD method.com. We have a program for almost every single budget, and we're here to help. I hope you learned something on today's podcast. If you did, please share it with your friends and family and leave us a five star review on iTunes. It's really helpful for getting this information out to more people who desperately need it. Sharing all the experts I know in love, and the powerful tips I have is one of my absolute favorite things to do. Thanks for being part of my community. Just a reminder, this podcast is for educational purposes only, and is not a substitute for professional care by a doctor or other qualified medical professional. It is provided with the understanding that it does not constitute medical or other professional advice or services. Thanks for listening, and have an amazing day.