## 4 Complex Dietary Supplements for Hair Loss Treatment
This was determined using a phototrichogram (via macro photographs). In addition, there was a positive trend in the Hair Mass Index (HMI) measured by HairCheck(tm), Divi International Co., compared to the placebo group. In this study, a survey by means of a self-assessment questionnaire, and a quality of life questionnaire was also conducted. The study was randomized and double-blind. There is no information available at what time of year the study was conducted, and the number of subjects was very small [38]. _Study 5_: This study was a double-blind, placebo-controlled study with 96 female subjects aged 21-55 years from Asian, Caucasian, and Hispanic ethnic background and self-perceived thinning hair over a period of six months. AminoMar(tmC marine complex composed of a proprietary blend of shark and mollusk powder with vitamin B7, vitamin C, and iron showed significantly reduced hair shedding after three but not six months compared to placebo, and vellus-like hairs were getting thicker after three and six months (being statistically significant after six months). A phototrichogram (via macro photographs) was performed to determine vellus and terminal hair, and shed hair during shampooing was collected and counted [39]. There are no differences in the total number of vellus and terminal hairs, and it is unfortunate that no group comparison was made for the other parameters. _Study 6_: This was a randomized double-blind placebo-controlled study with 60 male volunteers. Inclusion criteria were androgenic alopecia and a Norwood Scale scores of 2-3, and the measurements were performed by TrichoScan(r). Exclusion criteria were alopecia areata, scarring alopecia, and telogen effluvium. Analogous to the female study with AminoMar(tmC marine marine complex, a study with men was also conducted. This is the commercially available product Viviscal(r) Man (Lifes2 good, Inc.: Galway, Ireland). Each tablet contains vitamin C, zinc, AminoMar(r) complex horsetail stem extract, and flaxseed extract. Average hair count was shown to increase significantly from 162 to 175 hairs, average hair density increased significantly from 160 to 172 hairs, and terminal hair density increased significantly from 122 to 130 hairs after 180 days. The vellus hair density did not change. In addition, a survey by means of a quality of life questionnaire and a self-assessment questionnaire as well as an expert assessment were conducted. It was conspicuous that no group comparison was carried out as a statistical analysis, a period in which the study was conducted is also missing [40]. Finally, we come to the studies in which both men and women have been recruited. _Study 7_: Included in the study were 27 subjects--four men and 23 women aged between 19 and 76 years with telogen effluvium for at least three months. The patented product Omni-Three contains Boswellia Serrata, Curcuma longa and Vitis vinifera. Although not statistically significant, the vellus hair, terminal hair and hair density in general decreased. However, the hair thickness increased non-statistically. This study also has some weaknesses. Overall, the study only ran for three months and was not placebo controlled. For evaluation, the TrichoScan(r) was used, and an additional self-assessment was performed [41]. _Study 8_: In the following we would like to discuss two very interesting publications that build on each other. Included in the first study were 60 subjects, men and women, aged 18-60 years with telogen effluvium for at least three months. In a first step, the active substance was tested alone, in combination with other ingredients and against placebo. The active substance is spermidine. Spermidine is a biogenic polyamine and occurs in all living organisms and is closely related to cell growth. In addition, spermidine was administered together with the ingredients methionine, vitamin C, vitamin E, calcium pantonate, zinc, polyphenols from red grape peels, vitamin B6, copper, folic acid, and biotin as a complete food supplement. The trade name is Biogenina(r).