Gravity behind male pattern baldness?

November 4, 2013

Washington, Nov 4: The force of downward pull caused by the gravity on the scalp may be key contributor to the events leading to progressive hair loss in male pattern baldness, a new study claims.

The effects of gravity may explain the apparently paradoxical effects of testosterone in male pattern baldness, or androgenic alopecia (AGA), researchers said.

"The new theory's unparallelled ability to explain even the details of the hair loss process and the formation of the pattern in AGA is apparent," said Dr Emin Tuncay Ustuner, a plastic surgeon in Ankara, Turkey.

Ustuner's "Gravity Theory" seeks to reconcile some puzzling observations related to the development and progression of AGA.

Balding areas of the scalp show increases in a potent form of testosterone called dihydrotestosterone (DHT), while drugs that block conversion of testosterone to DHT can slow hair loss.

In the scalp, DHT seems to cause hair follicles to become thinner. But in other areas of the body, such as the underarms and genital area, DHT and other male sex hormones promote thickening of hair follicles.

Ustuner believes, in youth, the scalp has sufficient fat tissue under the skin, and it is "capable of keeping itself well-hydrated," buffering the pressure on hair follicles.

But with ageing, the skin and underlying (subcutaneous) fat become thinner, and the pressure on the hair follicles increases.

Testosterone contributes to thinning of the subcutaneous fat. In women, estrogen prevents thinning of these cushioning tissues, at least until menopause.

Ageing and testosterone-related changes create 'vicious circle' leading to hair loss as the cushion decreases, the hair follicle must strive against higher pressure, requiring more testosterone to achieve normal growth, researchers said.

This "local demand" leads to a buildup of DHT levels in the scalp, but not in the bloodstream. Rising DHT levels cause further erosion of the subcutaneous fat - creating a "vicious circle," according to Ustuner.

The hair growth cycle accelerates in response to DHT, but it's not enough to overcome the increased pressure. Over time, the hair follicle becomes smaller and smaller, resulting in progressively increasing hair loss.

If the pressure created by the weight of the scalp is the cause of balding, then hair loss should occur at the top of the head - "This is exactly what happens in AGA," Ustuner noted.

The study was published in the journal Plastic and Reconstructive Surgery.

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National Bone and Joint Day | Bone and joint problems in obese

Dr G K Sudhakar Reddy

August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip.

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology. Leptin is one of the hormones causing knee osteoarthritis.

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor.

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms.

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months.

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint. This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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'Diet drinks don't promise to aggravate weight loss'

Agencies

January 5,2020

Washington D.C., Jan 5: After a woman filed a lawsuit against a diet soda company, the California court has declared that the beverage does not promise to help buyers in losing weight.

The woman had gulped down the drink for over a decade but did not lose inches as a result.

The three-judge panel declared during the hearing: "The prevalent understanding of the term in (the marketplace) is that the 'diet' version of a soft drink has fewer calories than its 'regular' counterpart."

However, the members of the US 9th circuit court have felt that the consumers tend to make out something of their own that is unreasonable and eventually hamper the reputation of brands through a deceptive allegation, reports Fox News.

The response was due to a misleading case filed against Diet Dr Pepper by Shana Becerra from Santa Rosa, California. Shana claimed that she has been addictively purchasing the low-calorie beverage for the past 13 years hoping for losing some fat but failed to lose even a single inch.

The woman also stated that the attractive and fit models misled her into believing that drink will help her in perfecting her body like them.

However, the court's decision was that advertisements are for representational purposes only. "Cannot be reasonably understood to convey any specific meaning at all," as written by Judge Jay Bybee.

Shana had last week made such allegation against Diet coke as well where the court came to a similar verdict. She claimed that she had found various studies where it is evident that the artificial sweetener aspartame used in diet beverages actually boosts weight gain.

But the artificial sweetener is approved in by the concerned administrative department and thus is used in most American drinks.

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