Reversing hair loss over the counter sounds like a perfect fix: A daily supplement, with nutrients your body may need anyway, that can help regrow thinning hair. It would certainly be nice if this alternative to prescription medications and hair implants actually worked. However, the proof for Nutrafol and other hair-growth supplements just isn’t there—and these products may not always be harmless or safe.
What’s in the bottle?
Nutrafol is a dietary supplement that came on the market in 2016 and has grown in popularity ever since. It’s available in five different formulas: Women (for ages 18–44), Women’s Vegan (for those 18–44 who don’t consume animal products), Women’s Balance (for women ages 45 and up), Postpartum (for women in the first year after childbirth), and Men (no subcategories here, apparently). The cost is approximately $88 for a monthly supply, and the manufacturers say you’ll see visible results in three to six months. Of course, they also recommend that you continue taking the supplement after you’ve achieved your desired results.
The formulas vary in ingredients, but some are common to several of them. Among the ingredients in its “Synergen Complex” is sensoril ashwagandha, a proprietary plant extract that is purported to “balance stress hormones to support a healthy hair growth cycle.” Marine collagen peptides (absent in the Women’s Vegan formula) are made from fish scales and reportedly provide hair’s building blocks and increase moisture in the scalp. Tocotrienol complex, a concentrated form of vitamin E, is intended to improve hair density by minimizing the effects of environmental stress. Curcumin, one of the active ingredients in turmeric, is meant to address “multiple root causes of hair thinning.” Saw palmetto is intended to help reduce levels of dihydrotestosterone (DHT), a hormone that is thought to shrink the hair follicles and contribute to thinning hair.
The various formulas also include lists of other ingredients, such as kelp minerals, resveratrol, horsetail, keratin, L-Lysine, zinc, selenium, hyaluronic acid, black pepper, and vitamins A, C, and D. Like the “Synergen Complex” mentioned above, none of these ingredients have been proven to help regrow hair.
The biotin problem
Most of the formulas (with the exception of Women’s Vegan) also include biotin. Biotin (sometimes called vitamin B7 or vitamin H) is a water-soluble vitamin that, because of its availability and low cost, has become a go-to ingredient for consumer products promising healthier hair and nails. However, there is little research proving that biotin can help treat thinning hair or brittle nails. Although biotin deficiency (rare in the U.S.) can cause hair loss, “there are no evidence-based data that supplementing biotin promotes hair growth,” according to a review in Dermatology and Therapy.
Moreover, biotin can interfere with laboratory tests, which has led the U.S. Food and Drug Administration (FDA) to issue several warnings. For instance, when taken in high doses—at the levels contained in some hair and nail supplements—biotin can interfere with lab tests for heart attacks and thyroid function.
“My opinion on patients taking biotin supplements has changed since the FDA issued a warning in 2017, and then again in 2019,” says Shari Lipner, MD, PhD, associate professor of clinical dermatology at Weill Cornell Medicine in New York, who published a commentary on biotin supplements in 2018. “For example, if a patient is taking biotin, has chest pain, and troponins [proteins found in heart muscle] are drawn, they could be falsely lowered, and a heart attack would be missed. Unfortunately, this is not only a hypothetical situation. There are people taking biotin who have died due to test results that were false.”
If patients stop taking biotin in advance of having labs drawn, these issues could potentially be avoided. However, testing for a heart attack is not something you can plan for ahead of time. The makers of Nutrafol say that their products do not contain the levels of biotin that the FDA warns against, but they still recommend that anyone undergoing blood testing stop the supplements 24 hours beforehand, so that biotin can fully clear from the body.
What does the research say?
Studies have generally found that dietary supplements likely have no benefit but no harm, either—although this is not the case with Nutrafol, according to Dr. Lipner. “The data showing that supplements can help with hair loss are tenuous at best,” she says. “In the Nutrafol studies, participants also reported nausea, bloating, and diarrhea.”
Like many supplement manufacturers, the makers of Nutrafol (Nutraceutical Wellness) use somewhat misleading language to describe their products. According to the company, Nutrafol is “clinically tested”—tested, not proven. The website refers to 20 clinical studies, including randomized placebo-controlled trials, but doesn’t link to each study; instead, there are footnotes referencing “Data on file” or several irrelevant studies, some that date back to 1975, before the supplement even existed. And the studies that they do point to may be biased because they are funded and researched by the company itself, including these two:
A 2022 study in the Journal of Clinical and Aesthetic Dermatology found that after 24 weeks of taking Nutrafol, all participants reported significant improvement in their hair growth, coverage, density, and volume. The researchers also found significant improvements in 84 percent of male participants and 80 percent of female participants. However, the fine print notes that the study was very small (47 men and 51 women) and the participants had not actually been diagnosed with thinning hair—their hair loss is referred to as “self-perceived.” Not to mention that four of the five researchers were company employees, and the study was funded by Nutraceutical Wellness. The study was also not double-blinded, and there was no placebo group.
A 2018 study in the Journal of Drugs in Dermatology lasted six months and used a double-blind, placebo-controlled design to evaluate the Women’s formula. As in the study cited above, the women were not diagnosed with hair loss—instead, they had “self-perceived thinning.” The researchers did use hair counts in the affected area and quantitative assessments to observe significant improvements in hair growth and quality. Women in the supplement group also reported a significant improvement in self-perceived hair growth as compared to women in the placebo group. However, the study was small (26 women received the supplement, while 14 received the placebo). Again, one of the two researchers was a Nutraceutical Wellness employee, and the company provided funding for the study. In addition, participants both diagnosed their own hair loss and assessed their own hair regrowth—not exactly a gold-standard design.
Here’s Dr. Lipner’s take on the research: “Rigorously controlled trials are needed to assess whether a given supplement or medication is effective for hair growth,” she says. “Studies on Nutrafol and other supplements have not been rigorously designed. Issues with the Nutrafol studies are that the participants judged themselves as having hair loss—it was not assessed by a physician. In addition, nutritional status of the participants was not assessed, and funding came from the manufacturer, which creates bias.”
Still, some users may be convinced that Nutrafol works because the company claims its products are the ones commonly recommended by dermatologists—a difficult claim to prove. Celebrity endorsements can also make people believe the product is more effective than it is.
BOTTOM LINE: If you have a true vitamin deficiency—something that should be diagnosed by your doctor—then supplementing with that vitamin could help promote hair growth. But at this time, there is no magic supplement that can stop or reverse thinning hair. Nutrafol and other supplements like it seem more likely to drain your bank account and potentially obscure important lab findings than to fix any hair issues.
Talk with your primary care doctor or your dermatologist if you have any concerns about hair loss. He or she may be able to recommend a prescription medication or other treatment that may be more helpful, as well as get to the root cause of your specific problem.
