Narrator: 0:18

Thank you so much for joining us. Make or break, even one day, where should you turn for informative, honest, science-based information? Kimberly Vaughn's goal for this podcast is to offer informative content with the help of subject matter experts, along with individuals just like you.

Kimberly Vaughn: 0:38

Welcome back to Restore Roots and Confidence, where we continue our deep dive into hormones and hair health with our special guest, dr Ashley Tapscott. If you haven't listened to part one yet, I highly recommend you going back and starting there, because there's some really important information. In this episode. We'll explore the seasonal nature of hair loss and the specific lab tests used to assess hormone levels. Dr Tabscott will also share valuable advice on advocating for your hair health. So let's just get started.

Kimberly Vaughn: 1:14

Yes, yes, so true, and I want to make one point and go back and ask you a question about. You know, when we started the discussion, you talked initially about those individuals who are on birth control, and you know, many times in all ages, right, depending upon the estrogen levels that a person or an individual's PCP or gynecologist or provider is recommending for them, the levels in the birth control don't always walk hand in hand with hair loss and hair growth. And so many times they will come back to us and say well, which pill is the best for hair growth? And exactly to your point, dr Tapscott, is that there is not a specific pill for you to grow hair. It's this specific pill, whether it is in oral contraceptive or vitamins or, you know, even oral suspension and medications. That is going to balance your optimal levels and your optimal health, to make sure that your hair is growing and not falling out and miniaturizing.

Dr. Ashley Tapscott: 2:27

Exactly and I think you know, going back to some of those medications, and we can certainly dive into that in terms of the minoxidils and things like that, if we want to address those specifically, because in my sexual dysfunction realm, finasteride, which is a alpha-reductase inhibitor, that's the class of medication we use that to decrease the size of the prostate in men who have enlarged prostate. It's one of the only medicines that really does that. We've used it in cancer treatment. We've used that in men who have some blood in their urine or prostate trouble. Before we had a lot of great interventional therapies for these patients, but I have seen some long-term orgasmic dysfunction for these patients. But I have seen some long-term, you know, orgasmic dysfunction and there are some documented instances of that of men who were just on it for hair loss and they, you know, maybe it helped them, maybe it didn't, but were they being optimized in other categories as well? Because I think all of these medicines can kind of help each other and certainly the hormonal balance. When we talk about hair loss, this goes so much further than just from the top of your head. It could go all the way down to the bottom of your toes, right, um, and so I think that, yes, I think it's important that we understand that optimization.

Dr. Ashley Tapscott: 3:33

And you know, I always tell patients. They say, well, um, I even treated a set of twin sisters at one point and they said well, how come, you know, susie's testosterone is this and she feels good and mine is this. And I said well, you know, you guys may be twin sisters but you don't have the same lives, you don't have the same external stressors, and it's almost like going to dinner. You have to understand there needs to be an expert designed, custom plan for you. You can take your neighbor's eyeglasses and read the menu at dinner, but you don't want to wear them every day because they're not fitted for you. Read the menu at dinner, but you don't want to wear them every day because they're not fitted for you.

Kimberly Vaughn: 4:06

Yes, yes, so well said, and and that is one of the issues that we run into so many times with you know new clients that are coming in that have tried either over the counter minoxidil or have gone with a telehealth quick solution and are being given a medication that is not at all the right medication because the rest of their whole body health has not been dove into and really looked at right.

Dr. Ashley Tapscott: 4:33

I agree. And that's you know again why I am so pleased that you were able to educate me, you know, prior to our discussion, because I think in our society we want quick fixes, we want things right away. We have really been used to things right at our fingertips. The invention of the smartphone, I think, is one of the greatest blessings, but also a little bit of a troublemaker. Sometimes we can get labs right to our phone but then, you know, patients are concerned because it's out of range or they have a concern. Am I normal? Am I not normal?

Dr. Ashley Tapscott: 5:06

So I think that you know, imploring some time to sit down and understand those processes. I'm not asking patients to read the life cycle of X, y, z or to understand this, but what I want them to understand is you know, give me the pebble in your shoe, tell me the top two to five things that are bothering you and let's look at everything in total and arrange it that way. You know, I think, obviously changing. You know I moved from a different climate. So you know, would that affect my hair? You know, humidity, moisture, season, change, all these different things I think you know humidity, moisture, season, change, all these different things I think you know, are really, really important that we can't forget. It's not just, you know, I always say I treat patients, not paper, although I use that as my guide and my lifeguard to kind of blow the whistle when I think things are sidestepping and aren't in appropriate ranges. But certainly we have to make sure that we have our goals aligned and really we have expectations discussed as well.

Kimberly Vaughn: 5:59

Yes, most definitely, and you touched on such a great point, and then we'll move on after this. But yes, seasonal hair loss is is right here, right now, because March begins this seasonal hair loss season and we always we say this, you know, but it it comes in alignment, if you will, with spring break, and it's so, it's. You know, spring break shed, if you will, but that's when it happens, just because, if we notice, you know, at least in Tennessee, the last four weeks we have ranged from 20 degree temperatures to 80 degree temperatures. It's crazy, and so that really has a big effect on the body's immune system, it has effect on inflammation and so we see all of that affecting the hair follicle and it definitely can trigger a telogen effluvium shed or trigger any time type of acute hair loss at that particular season. So thank you for bringing that up. I appreciate that.

Kimberly Vaughn: 7:02

Well, so for the listener's sake, we talked about a lot of hormones and we talked about the importance of the estrogen and the testosterone. So now let's look at if someone is listening and they're unsure what is going on with their hormones. But for men or for women, they're starting to see this hair loss there and sometimes they're not even seeing loss. Right, we see miniaturization and someone says why is it that? You know I've been going to get my hair cut. They no longer cut the top race. For a male, they only cut the sides, and then for a female it's, why is my length not growing any longer? You know it's to my chin, but I needed it to my shoulders and it's just not going to get there. So, when we dive into those areas of understanding how the hormones can affect this hair growth and loss, what tests do you really focus on for your patients that help give a clearer vision for you when you're looking for different forms of imbalances?

Dr. Ashley Tapscott: 8:07

Of course. So I kind of I have a fairly straightforward panel. I either call it kind of my and again, in my practice I call it a male sexual dysfunction wellness or a female sexual dysfunction or wellness panel and they are fairly similar but they do differ in just a few little labs. So I think if we start kind of you know, at the top of the body, I would start with you know what we talk about is the hypothalamic pituitary axis. So these are the two generals up top that talk to the gonads down below. So that is our follicle stimulating hormone we call FSH, and our luteinizing hormone, LH. So in my mind, for guys and gals, this is the general. This is the command center that talks to the ovaries or the testicles, that tells the ovaries to ovulate, make eggs, or the eggs are there but to ovulate and to prepare the uterus for possible implantation or menses, the menstrual cycle that happens. And in men that tells the testicles to make sperm and to make testosterone. So FSH and LH. Then obviously guys and gals get a testosterone. I do like to look at free and total, but again, some labs don't use that SHBG and because we know SHBG is really more, has more of what we call an affinity or more of a likeness to take that free testosterone. I will calculate that on my own if it's not done for me with the lab. So I like to do that but and we can have equations for that, so I don't want patients to worry about that. So FSH, LH, testosterone, estradiol, SHBG, the sex hormone bonding globulin, so I can count the three.

Dr. Ashley Tapscott: 9:38

In women, I look at progesterone. Progesterone is important when we give women estrogen or testosterone in the postmenopausal phase because if they have a uterus, those hormones supplementing with those hormones or normalizing those hormones, optimizing those hormones can cause possibly some abnormal layering in the uterus and progesterone helps to counteract that if they have a uterus. Now, progesterone is also great for women for hot flashes and great for sleep at night, usually in a pill form. In a pill form is most superior. So certainly I check a progesterone. The P that I check in men is a PSA, a prostate specific antigen, because if I'm looking at hormone replacement in men, we need to have their prostate. Blood test helps us to measure the health of the prostate. So I have that If anyone has orgasm or other concerns.

Dr. Ashley Tapscott: 10:28

Again, looking at the brain, I check a prolactin. Prolactin you can have a benign hormone secreting tumor. Prolactin, kind of like the thyroid, can kind of throw things off. And one of the last labs in the brain that I look at uh, well, not the last, but part of the the family up there is a thyroid panel. So that's not just the thyroid stimulating hormone which tells the thyroid to do that, but also things like what we call a t3 and a t4. Uh, and I look at those things, so those are. And then obviously vitamin D. I do double check because I have a lot of fatigue complaints and I would never look at hormones without double checking vitamin D. So those are kind of some of my you know my biggest levels that we look at. You can get into DHEA, DHT, dihydrotestosterone. That's getting deep, kind of in the weeds a little bit. For my general panel I would say thyroid profile, FSH and LH, estradiol, testosterone, progesterone in women, PSA in men, vitamin D with those and from where you sit.

Kimberly Vaughn: 11:28

Let's just say that one of our listeners has gone to urologist because maybe, as a female, they're having some types of incontinence, they're having some type of cystitis, and so they come to you but say you know, I'm also noticing all of this hair loss, you know. So you know they're thinking, well, what is this related to, right? I mean, if, if I'm having cystitis, if I'm not feeling well, if I'm bloated, if I'm uncomfortable, how does all of that relate to now my hair is falling out of my hands, right? So how would you? What would you say to a client at that point in the patient of how do you think through that?

Kimberly Vaughn: 12:08

Because, you know, sometimes we have those who have a tendency to go in one direction and say, oh, you know, it must be because I'm going through the change of life, it must be because of my stress, it must be because of my divorce, who knows? Right, and I think you giving them some feedback and giving them a clearer vision of what they should be thinking of, instead of jumping off the train and saying, oh my gosh, you know, I'm really of jumping off the train and saying, oh my gosh, you know I'm, I'm really, really sick.

Dr. Ashley Tapscott: 12:43

Yeah, I think, when we talk and certainly you know, uh, uh, not to exclude you know, our male patients here, but when we talk about women, I think women typically, you know are, are the medical advocates of the family. We have that documented, uh, in in the medical caretakers of the family, uh, historically, and in some demographic breakdowns of studies that we've had. So I think the life gets lifey for everyone and I think that, yes, social situations, changes in jobs, changes in family dynamics, serving as a caregiver for your partner or being part of the sandwich generation, where you're still finishing raising some adult children but you're now taking care of your octogenarian or your older parents. I think, all of those things aside, that is, yes, stressful, but a simple blood test can maybe reveal a lot of different things. To make it easier, can I take away the social stressors or life stressors? No, but I think it's important, like we said, to optimize and understand where might you be struggling, that you don't have to. Um, like I said, if I go back to my own vitamin D story, why was I tired? Well, yes, I'm working X numbers of week. Yes, I'm doing all of these things, traveling, um, you know, operating all these things but my vitamin D was low and way less than half of what it should have been at a minimum.

Dr. Ashley Tapscott: 13:53

Uh, and so I think to tell them, you know, yes, I'm here to look at your bladder, I'm here to look at, you know, maybe you have some, you know, discomfort with intercourse. Well, obviously that's a local, possibly a local hormone issue with estrogen and sometimes the systemic. Well, I'm on a patch or I'm on pellets. Oftentimes it's a tissue issue and systemic estrogen or testosterone doesn't get to the estrogen dependent structures urologically, which is the urethra, the opening of the vaginal canal, and that can be uncomfortable for intercourse, no matter what kinds of lubricant or anything else that you're using. When we talk about that and there's also hair down there right, and so I think again, from the head to the toes, I'm able to kind of discuss that with patients, but I think, just saying let's talk about the pebbles in the shoe, let's identify our couple of concerns in addition to that, and really we can get a lot of information within just those few blood tests.

Kimberly Vaughn: 14:49

Well, and you know we talked earlier about, you know, the hormones and you shared, and you were so spot on that many times when we see clients and patients that are coming into our clinic, they're coming in first with hair loss.

Kimberly Vaughn: 15:06

But when we dive into a very deep consultative time and an appointment, we learn that that is not the only issue. And we have seen, oh, thousands of patients that have come to us and you know, once that labs have been drawn, we've sent them on to specialty providers and they find that they have autoimmune conditions, they find that their thyroid is very dysfunctional, that their hormones are way out of line right, and especially for men, you know, when we find that they're wanting to increase their testosterone levels, right. And so when they get to a certain age, how do they increase those testosterone levels without the side effects of losing their hair? And for women, not, it's really not far from the same. I mean, we have women that come in a lot that have been to sexual clinics, that have been misdiagnosed or given too much hormone on the testosterone side and they start having an acute shit. And so that is one of the things you know we love to talk about is which came first right? Is it the hair loss or is it the illness?

Dr. Ashley Tapscott: 16:24

Absolutely. And I think also you know, we know that as soon as age 40 in men testosterone can decrease at the rate of one to 2% per year. And then you know also, when we talk about stressors and things, let's also talk about, you know, toxins that we willingly put in our bodies, whether that is a cigarette smoking, tobacco chewing, vaping the data is nowhere near even remotely tap the surface on vaping, certainly for things like bladder cancer, I'm sure it somehow affects hair follicles, with nicotine, et cetera. Obviously marijuana use we know that has some impact on infertility and sperm count. And then alcohol, I think, because it is the legal substance of choice for a lot of people. I think it's pervasive in society, but I think we really don't realize how much of a toxin that can be to the system as well.

Kimberly Vaughn: 17:21

Oh, yes, for sure. And and that is you know again, you know, as we talk to our clients and our patients and helping them understand the effects of their environment and their external stressors, what is truly going on with their health and how the how that impacts right, the hair growth, the health. You know how you feel, your stress levels and all of those really do make a difference every single day. So, oh my gosh, you've given us so much detail and so much information. I know the listener, hopefully, is gonna come back and replay and replay and write all of these notes down, so we can't thank you enough for all of this.

Kimberly Vaughn: 18:05

If you could give the listener a takeaway, what would you say that for women that are starting to see this hair loss, whether it is aggressive or whether it is of, you know, just a slow, gradual, chronic nature? You know we try to get people into our trichology clinic as often as possible. However, sadly, there are not trichology clinics all over the United States, and that's one of the reasons that we have telehealth as well, because we're just able to help more people. But what could someone really dive into and request that their PCP or their general practitioner provider could help them, either by diving deeper into labs or looking at different functional medicine experts to help them try to get to the you know, as we call it, our root cause of the problem.

Dr. Ashley Tapscott: 18:57

Yeah, I think that you know, and even I'm taking inventory of myself. Like I said, I've moved. You know I will have to establish a great you know primary care internist here in Nashville myself. So I think you know this is a good time. We're doing this podcast today in March, near the first day of spring in Nashville it's, I think it's almost one of those 80 degree days that you stated.

Dr. Ashley Tapscott: 19:24

So maybe just look at your, your body and your life and let's do a spring cleaning and let's do an inventory of things that need dusting off, of concerns that you've kind of pushed to the back burner. We don't have to conquer them all at the same time. But why don't you make a list? Because I would more than bet that about 80% of the concerns on your list may all be driven by the same thing, from hair loss to fatigue, sexual dysfunction, gut health you know any of those things Muscle mass. You know hormones are so important for our bone health as well, and that's kind of the long game, right. And I think that hair care is also the long game. It's something that you see kind of and you take notice of, maybe immediately, but likely. There are processes that built up to that over time.

Dr. Ashley Tapscott: 20:06

So I would just have an honest and open discussion with you know, your main medical provider, and just you know, I understand. You know we are all stressed in medicine kind of under the gun for time and space and time on schedules and it is okay to say, hey, you know Dr So-and-so or provider so-and-so, um, it's okay that you know you don't have to treat me for this, but this is important to me and so you know I encourage everyone in the national medical community and beyond find a great physician or provider, advocate and champion for these patients. I don't expect everyone to be able to spend, you know, 15 to 30 minutes on on female sexual dysfunction discussion or, you know, in your clinic and your in your practice on hair loss, but certainly find that advocate that can do that Because you know they will always come back to that provider. It's an absolute honor when people send me a referral. I know it's a reflection of them and their practice. I know they take that responsibility very seriously and so I would say you know, find a physician champion, find an advocate.

Dr. Ashley Tapscott: 21:08

There are several societies in terms of sexual medicine and I'm sure you have some societies that you work with as well. So Sexual Medicine Society in North America. I work with the International Society for the Study of Women's Health, ishwish. They have physician finders for people for these conditions that are vetted, that are board certified and recognized with their dedication to the society and patient care efforts.

Kimberly Vaughn: 21:30

And those societies are fantastic because, you know, we have listeners all over the world and so within those associations, it does make a huge difference, because we work very much with the American Hair Research Society, we work with NAF, which is the National Alopecia Foundation, as well as the Scarring Alopecia Foundation, and so they are so important and that's a great tip, dr Tapscott, thank you.

Dr. Ashley Tapscott: 22:00

Yes, and I think that also. You know, social media is really fun and really great, but I think social media, you know, with a little, a little word of caution, there's a lot of stuff that gets out there quickly and a lot of people influencers, as they call them that are on social media. I'd love to be on social media more I'm working on that but if I'm not on social media it's because I'm in the office, you know, counseling and taking care of patients, and so just make sure that those patients and clients have a healthy, balanced understanding of who to go to and make sure that, again, you know they've got some society backing and they've done some good work under their belt.

Kimberly Vaughn: 22:36

Yes, yes, so true, Dr Tapscott, thank you so much for your time today. We welcome you to Nashville. We can't wait to start getting more patients over to Pozona MD and we're excited for all that you have to share with women's health and men's health alike. So you make it a great spring. Make sure that you don't fall into our spring shed. Just fall into spring cleaning. Make sure that you don't fall into, you know, our spring shed. Just fall into spring cleaning and we will see you soon. Well, we can't wait to have you back. You take care. Thank you so much. It was a pleasure. Take care everybody.

Narrator: 23:16

Thank you for tuning into this week's episode. We hope you've gained valuable insights into the world of hair care and restoration. Thank you at hpihairpartnerscom, and make sure you never miss an episode by hitting that subscribe button. Tune in every week for fresh and enlightening updates. Until then, here's to healthier hair and boosted confidence.