To the Editor.—
The recent letters of Drs Goette and Odom (235:476, 1976; Arch Dermatol 111:930, 1975) regarding hair loss during rapid weight loss deserves comment.Over the past four years, we have been investigating the metabolism of modified fasting. We1 and others2 have observed the increased telogen hair counts, but only in patients in whom weight loss was associated with the loss of body cell mass (eg, a significant negative nitrogen balance). With an increase in protein intake during fasting to preserve nitrogen balance, hair loss has been almost completely eliminated.We would conclude that when mobilized body protein plus dietary protein are insufficient to meet requirements, the low priority of hair growth for available protein accounts for the telogen effluvium, and not the rapidity of weight loss per se. These data are derived from more than 200 patients in whom weight loss approached a half pound
Blackburn GL, Bistrian BR, Hoag C. Hair Loss With Rapid Weight Loss. JAMA. 1976;236(3):252. doi:10.1001/jama.1976.03270030012010
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