## 4 Complex Dietary Supplements for Hair Loss Treatment
_Study 1_: The study was conducted from November to February over a period of 56 days on 30 women aged 35-65 years with abnormal hair. However, the inclusion criteria \"abnormal hair\" was not further described by the authors. In this study, a complex blend, on the one hand, with green tea extract, vitamin C, natural beta caroten, zinc selenium, chromium borage seed oil (morning capsule) and, on the other hand, with grape extract, shark cartilage, vitamin B2, B5, B6, B8, copper, iron, and fish oil (evening capsule) INVERSION(r) Femme (Inversion Laboratoires, Hasselt, Belgium) reduced hair loss significantly compared to a pretreatment phase (28 days prior to supplementation). The weak points of this study are that it is not placebo-controlled, the period of testing of two months is extremely short, there is a lack of precise information on the inclusion criteria for hair loss, and brushed out hair for analysis was weighed [35]. A positive aspect is that there are extra capsules for morning and evening, so that the green tea extract in the morning capsule, for example, does not lead to problems falling asleep. _Study 2_: In this study, 120 female volunteers with stage I hair loss according to the Ludwig Scale between 18 and 65 years of age were included. Exclusion criteria were telogen effluvium (telogen rate >30%) or any confirmed or suspected condition or pathology that may induce hair disorder. It is a placebo-controlled, randomized study. Here, a nutritional supplement with omega 3 and 6 from fish and blackcurrant seed oils with antioxidants (lycopene, vitamin C, and vitamin E) led to a statistically significant increase of anagen hair from approximately 80% to 88% after six months of supplementation measured by Trichogram. In contrast, in the control group there was no difference in the anagen rate between before and after (81%) and thus a statistically significant difference in favor of verum over placebo is given. These data were supported by global photographs, self-assessment and trichometer for hair density. This study is well thought out and of high quality [36]. _Study 3_: Investigated were 120 volunteers between 18 and 60 years of age. The inclusion criteria were a telogen effluvium of more than 6 months and a telogen rate of more than 20% (determined by TrichoScale(r)). A period from September (protocol initiation) to September of the next year (end of study) was specified. In this study a food supplement was tested against a competing product. The product to be tested (Eximia Fortalize Kera D(r)), which consists of zinc, biotin, iron, vitamins A, C, E, and B complex, folic acid, magnesium, and amino acids of keratin and collagen was tested against the product Pantogar(r), which consists of calcium pantothenate cystine, thiamine nitrate, medicinal yeast, keratin, and aminobenzic acid. Hair density was significantly increased by approximately 11% after 180 days and by approximately 8% by the competitor product, measured by TrichoScale(r). In addition, an expert assessment of parameters such as hair loss and hair volume and a self-assessment by the volunteers was performed [37]. However, it is questionable why no more parameters of the TrichoScale were evaluated in such a complex study. _Study 4_: Included were 26 subjects in the verum group and 14 in the placebo group. The age of the women was between 21 and 65 years with Asian, Caucasian, or Hispanic ethnic background and self-perceived thinning hair. Exclusion criteria were hair loss disorders. Various phytocompounds were combined in a complex called Nutrafol(r) Women's Capsules. Nutrafol(r) contains a total of 21 ingredients, the most important of which are curcumin, ashwangandha, saw palmetto, locotrienol-rich-tocopherol complex, piperine, capsaicin, hydrolized marine collagen, hyaluronic acid, and organic kelp. This study resulted in a statistically significant increase in the number of terminal hairs, vellus hairs and total hair count in the verum group at 90 days and 180 days compared to the placebo group.