fbpx
Menu
Articles

Nutrafol Review: Half-Truths, Cherrypicked Data, & Misleading Study Results

First Published May 28 2020
Last Updated Oct 29 2024
Company Reviews
Ingredients
Natural Remedies
Researched & Written By:
Perfect Hair Health Team
Reviewed By:
Rob English, Medical Editor
Nutrafol Review: Half-Truths, Cherrypicked Data, & Misleading Study Results

Article Summary

Nutrafol is a hair loss supplement praised by media, endorsed by doctors, and supported by clinical studies. At first glance, it seems like the perfect option for anyone interesting in fighting hair loss naturally. Unfortunately, during our investigation, we found that (1) Nutrafol’s 2018 clinical study was done on a group of people that doesn’t represent the majority of hair loss sufferers in North America, (2) Nutrafol may have buried the results of their second clinical trial, and (3) the ingredients inside Nutrafol only support hair growth in very narrow contexts, and in certain cases, might be dangerous. Our full investigation can be found below.

Full Article

A Real Look Inside Nutrafol®

In the last two years, Nutrafol® has become one of the world’s most popular hair loss supplements. With an all-natural product line and a supplement that’s endorsed by doctors, praised by media, and supported by one clinical study… many consumers are turning to Nutrafol as a natural alternative to finasteride. In fact, Nutrafol’s own marketing team even writes that now, “You don’t have to choose between what’s natural and what works.

If I’d come across a company like Nutrafol 13 years ago – when I was first diagnosed with male pattern hair loss – I would’ve instantly become a customer. At the time, I wanted to stop my hair loss from getting worse, I wanted to do so without drugs, and I was naive enough to believe the majority of marketing claims I’d read on the internet. This was because I was young, desperate, and did not yet understand the extent to which marketers could legally misrepresent data to sway me into buying products that I probably didn’t need.

Today, I know better. I learned the hard way what did and didn’t work. In my first six years dealing with hair loss, I spent nearly $10,000 on products – none of which improved my hair, and many of which I later learned were well-marketed but scientifically baseless.

This experience is partly why I started this site, why I became a medical editor, and why I prioritize an education-first mentality for other hair loss sufferers – so that they can learn how to avoid my mistakes and, in doing so, save the time, money, and hair I’d lost while pursuing the wrong interventions.

One of best educational tools at our disposal is long-form, investigational product reviews.

I’m not talking about reading “testimonials” on Amazon. I’m talking about conducting full-fledged, unbiased investigations into a hair loss product. I’m talking about lining up marketing claims versus realities. I’m talking about sending products to a laboratory to test for impurities, heavy metals, and labeling accuracies.

I’m talking about revealing the half-truths, sleight-of-hands, and fictions a company conveys to hair loss sufferers… so that consumers are better informed, and can thereby make better product choices built around their needs, preferences, and unique hair loss case.

This is why we’ve spent the last month investigating Nutrafol’s Core product line. Now that our investigation is finished, we’re finally sharing the results – and our opinions on whether Nutrafol is worth its $88 monthly price tag.

Inside this Nutrafol review, we’ll uncover:

  • The biases in Nutrafol’s clinical trial: the participants in the study versus the consumers targeted in its ads
  • Nutrafol’s ingredients: what the company claims versus what the research says (note: just because an ingredient is “natural” does not mean it’s safe)
  • The results of nearly $1,000 worth of laboratory tests: does Nutrafol contain any impurities, heavy metals, pathogenic microbes, or labeling inaccuracies? We decided to find out.

…and so much more.

We hope this write-up illuminates the pros and cons shared amongst top-selling hair loss supplements – even those supported by clinical studies. We also hope this helps you make a more informed decision as to whether you’d like to try this product.

For what it’s worth, we aren’t affiliated with Nutrafol or any other company selling hair loss drugs, topicals, supplements, shampoos, or devices. We also don’t sell our own physical products. This puts us in a unique position to conduct reviews – as we neither compete with Nutrafol nor affiliate with any hair loss product lines.

If you have any questions, please feel free to reach out in the comments below.

Note: while our Nutrafol review is publicly available, our product reviews are typically only accessible inside our membership community. Each month, members submit (and vote on) a new supplement, topical, or device for review. When applicable, we send selected products to a third-party laboratory to test for impurities, pathogenic microbes, heavy metals, and labeling inaccuracies. The results have been fascinating, as we’ve discovered that many hair loss supplements contain too much (or none) of certain ingredients listed on their labels. If you’d like to learn more about our community, you can do so right here.

Nutrafol® Review: Highlights

Key takeaways

  • Product: Supplement
  • Expectations: According to one clinical trial, hair count increases were observed after 3 months, with improvements continuing through 6 months.
  • Response rate (i.e., the percent of people who experience a slowing, stopping, or reversal in hair loss):
    • 80% for women with self-perceived hair thinning; unknown for others with hair loss
  • Regrowth rate (i.e., the percentage increase in hair counts):
    • 10-15% for women with self-perceived hair thinning; unknown for others with hair loss
  • Cost: $79/month for a subscription; $88/month for one-time purchases
  • Problems: Deceptive marketing tactics; data on second clinical trial never published; company markets its published clinical study to men with pattern hair loss, but the study was done on women with self-perceived hair thinning; subject selection in the published clinical trial seems focused on participants most likely to see hair growth from nutritional supplements; some of Nutrafol®’s ingredients can harm hair or pose a health risk in people who are already nutrient replete.

Pros

  • Clinical data. Nutrafol has at least one clinical trial supporting its efficacy. Moreover, the supplement features ingredients that have been shown to improve hair loss in humans.
  • Product quality. The company third-party tests their ingredients for purity and quality. Moreover, the product includes ingredients associated with benefits that extend beyond just hair health.
  • Lab test results. Our laboratory tests revealed little-to-no pollutants, heavy metals, or pathogenic microbes in its Core product for men. This confirms what Nutrafol® emphasizes in its marketing: that Nutrafol® is a product free of impurities.

Cons

  • “Buried” clinical trial results. According to clinicaltrials.gov, Nutrafol® has registered and completed two clinical studies on its Core product. Unfortunately, the company never published the results of its second study, and without explanation. When this happens, it’s almost always due to unfavorable findings. Nutrafol®’s failure to publish data from both of their registered clinical trials suggests that the company may be burying negative data and only showing consumers the “best” results.
  • Deceptive marketing practices. Nutrafol® markets its 2018 published trial to all hair loss sufferers. However, in their marketing copy, the company often fails to emphasize that this study was only conducted on women, mostly of reproductive age, with temporary, self-perceived hair thinning. Interestingly, this specific demographic is more likely to see hair regrowth from a nutritional supplement than others, and even more likely to see their hair loss resolve without nutritional interventions. Therefore, these study results cannot be applied to most hair loss sufferers. In all likelihood, the supplement isn’t nearly as usefulness for anyone who isn’t a woman with temporary self-perceived hair thinning due to stress, a poor diet, or menstruation.
  • Potentially dangerous ingredients. Some of the ingredients in Nutrafol® are largely unnecessary; they’re more so “buzzword” ingredients for hair loss consumers than they are ingredients that hair loss sufferers in the develop world lack. Examples include vitamin A, selenium, and iodine (to name a few) – many of which, ironically, are associated with hair loss if over-consumed via supplementation.
  • Only one proven ingredient for men with pattern hair loss. When it comes to male pattern hair loss, also known as androgenic alopecia (AGA), there’s really only one ingredient inside Nutrafol® Core that has been clinically demonstrated to improve hair growth: saw palmetto. This extract is available for a fraction of the cost as a standalone supplement. And since AGA is the most common form of hair loss in adult men, this implies that most men taking Nutrafol® are simply just overpaying for saw palmetto.

A deep dive into Nutrafol’s products, ingredients, pros, problems, and lab test results can all be found below.

What is Nutrafol®?

Nutrafol® is a nutritional hair loss supplement. With 25,000+ customers, a big social media presence, and a lot of “influencer” endorsements – it’s become an incredibly popular product in a relatively short period of time.

Moreover, Nutrafol’s praise among medical professionals makes it an attractive offering for those interested in hair loss solutions outside of the drug model. Needless to say that if you’re a millennial living in North America, you’re losing your hair, and you’re only interested in natural interventions – you’ve probably come across Nutrafol®.

Product offerings

Nutrafol® offers a wide range of hair loss supplements, all of which fall into two main categories:

  • Nutrafol Core. These supplements are Nutrafol’s most popular offerings. There are three Core products – two for women, one for men – which contain vitamins, minerals, and proprietary blends designed to multi-target hair loss from a variety of angles.
  • Targeted Boosters. These are optional supplements that act as complements to the Core product line. For instance, DHT reducers (for men with pattern hair loss), probiotics (for customers with compromised gut microflora), etc.

For the sake of this review, we’ll focus only on Nutrafol®’s Core products. This is because the Core products are the most popular, and are also the products tested in Nutrafol’s clinical trials.

Nutrafol® Core

There are three Core products – Nutrafol® for Women, Nutrafol® Women’s Balance, and Nutrafol® for Men – all of which are similarly formulated to contain the following ingredients:

  • Vitamins, micronutrients, and trace elements. According to Nutrafol, these ingredients are chosen to help support healthy hair growth (and overall health).
  • Proprietary blends. This includes Nutrafol’s proprietary Synergen Complex® and Nutrafol Blend®, both of which contain herbal extracts, amino acids, and adaptogens. Nutrafol suggests these ingredients are featured to help reduce inflammation, reduce stress levels, and maybe even improve hair growth.
Nutrafol® for Women

Nutrafol® Women’s Balance

Nutrafol® for Men

Do these ingredients improve hair loss?

The short answer: yes and no. The long answer: it’s complicated.

When evaluating any ingredient’s impact on hair growth, we need to consider what’s known as the hierarchy of evidence. This is the level of scientific support for any substance; it’s how the scientific community reaches a consensus on whether something works.

If we were to oversimplify things, here’s what this hierarchy looks like for hair loss (from lowest to strongest).

  1. Does the substance improve hair cells in a petri dish (i.e., in vitro)?
  2. Does the substance improve hair loss in animal models (rats, mice, etc.)?
  3. Does the substance improve hair loss in humans?
  4. Does the substance improve hair loss in humans that are most likely to buy this substance / product?

Nutrafol’s ingredients do a really good job at meeting those first three qualifiers. For instance, many of its ingredients – such as selenium, iodine, biotin, and vitamin A – have been shown to support aspects of hair health in vitro, in animal models, and in some studies on humans.

However, it’s that fourth qualifier that matters most: do these substances improve hair loss in the people targeted by this product? And unfortunately, it’s that fourth qualifier where Nutrafol often falls short.

To illustrate why this is so important, we’ve spotlighted a few of the Nutrafol® Core ingredients: what Nutrafol says about these ingredients, what the research says, and the potential dangers associated with their ingestion.

Nutrafol® ingredients: marketing versus reality

Selenium

What it is: a mineral necessary for thyroid hormone production, glutathione activity, and oxidative stress regulation.

  • What Nutrafol says: “Selenium benefits hair health by supporting antioxidant enzymes that can defend against damage to cells, including those in hair. Another one of selenium’s benefits is that it helps to maintain proper thyroid activity, which benefits the endocrine and metabolic system and supports healthy hair growth.”
  • What the research says: What Nutrafol writes is true. However, context is key. For starters, current estimates suggest that only ~15% of people worldwide don’t ingest enough selenium – of which the majority of whom are not in the U.S. Moreover, in order for a selenium deficiency to actually cause hair loss, that deficiency has to be incredibly severe. This is only represented by a small fraction of the 15% of people who are deficient. In fact, hair loss from a selenium deficiency is generally only observed in rural pockets of Tibet, China, and Siberia – where the soil is almost completely devoid of the nutrient.
  • Potential dangers associated with its use: In one clinical trial, researchers found that selenium supplementation (200 mcg, the same dose included in the Nutrafol® supplements) increased the risk of high-grade prostate cancer by 91% in men with already sufficient levels of selenium. By comparison, finasteride – the gold-standard drug for pattern hair loss – has been found in some studies to increase the risk of high-grade prostate cancer by 68%. Ironically, this perceived risk is why many men avoid trying finasteride and, instead, opt for natural supplements (like Nutrafol)… all without realizing that they may face the same risk by over-consuming a trace element (selenium) included in those supplements.

Notably, our lab test results revealed that each serving of the Nutrafol® Core Men product that we tested contained much more selenium than listed on the bottle. (Note: nutritional lab test results vary depending on a supplement’s lot number, shipping location, testing methodologies, and more. Any lab test results featured here are only representative of the one Nutrafol bottle we tested, not all Nutrafol bottles.)

Ingredient

Per Serving (On Bottle)

Per Serving (Lab Test)

Selenium

200 mcg (364%)

274 mcg (499%)

So, if you’re thinking about supplementing with Nutrafol long-term, you may want to think about these risk factors, and at a minimum, reduce your intake of selenium elsewhere in the diet.

Iodine

What it is: a mineral necessary for thyroid hormone production and proper fetal brain development.

  • What Nutrafol says: “Iodine plays a key role in maintaining a healthy thyroid, which is important for supporting hair growth.”
  • What the research says: What Nutrafol writes is true. However, context is key. Iodine does play a role in supporting the thyroid, and poor thyroid function can lead to hypothyroid-driven hair loss (also known as telogen effluvium). At the same time, iodine deficiency is rare in the developed world. For the most part, individuals in developed countries like the U.S., Canada, United Kingdom, Denmark, and Belgium are actually iodine-sufficient due to salt iodization and the use of iodine in cattle operations. In fact, in countries with high iodine consumption, there’s evidence that iodine restriction can actually improve hypothyroid symptoms.
  • Potential dangers associated with its use: Over-consuming iodine via supplementation can actually harm the thyroid. As such, iodine should only ever be supplemented in high quantities (even from a natural source like kelp) in the presence of an iodine deficiency. If not, you risk triggering hypothyroidism (or hyperthyroidism), and maybe even exacerbating hypothyroid- or hyperthyroid-related hair shedding.

Biotin

What it is: a B-vitamin in the B complex that plays a role in energy (ATP) production, epigenetic DNA regulation, brain health, and immune function.

  • What Nutrafol says: “An essential water-soluble B-complex vitamin, biotin is one of the building blocks of healthy hair, needed to metabolize fatty acids and amino acids. Rich levels of biotin for hair health in Nutrafol help strengthen hair, as well as combat dryness, breakage, and shedding.”
  • What the research says: What Nutrafol writes is true. However, context is key. Similarly to selenium, only a small percentage of people in the U.S. have a biotin deficiency. Moreover, a biotin deficiency has to be incredibly severe to cause hair loss (which is unrealistic for most people in the first world). In fact, most of the research supporting biotin’s use for hair growth come from (1) disease-ridden children in the developing world, (2) people with rare genetic mutations, and (3) those who abuse antibiotics and/or alcohol – all of which aren’t target groups to which Nutrafol® markets. And while there isn’t any evidence that high doses of biotin harm our hair, there’s also no evidence that we need high doses of biotin to treat hair loss. In fact, researchers have rejected the common practice of high-dose biotin supplementation for the treatment of hair loss unless someone presents with a true (and lab-confirmed) deficiency.
  • Potential dangers associated with its use: Biotin can interfere with lab tests. Specifically, high-dose biotin supplementation can interfere with thyroid assays, causing the thyroid to appear higher-functioning than it really is, and troponin testing, a lab test used to diagnose a heart attack. There is at least one case of falsely low troponin levels leading to a misdiagnosed heart attack and death. And while the risk of this happening to you is incredibly small, so is the risk of having a biotin deficiency that’s bad enough to cause hair shedding.

Vitamin A (as beta-carotene)

What it is: antioxidant carotenoid that is converted to retinol, the active form of vitamin A. While beta-carotene plays a role in protecting the skin against free-radical damage, retinol is necessary for immune function, vitamin D activity, normal skin cell turnover, brain and eye health, and thyroid health.

  • What Nutrafol says: “Vitamin A is an essential component of hair growth and maintenance. It works with zinc to help reduce the drying and clogging of sebaceous glands in the scalp. The form of Vitamin A in Nutrafol is called beta carotene. Beta carotene is a precursor to Vitamin A and signaled for conversion when the body needs it for support.”
  • What the research says: What Nutrafol writes is true. However, context is key. For starters, vitamin A deficiencies are very rare in the first world. In some cases, severe vitamin A deficiencies have been linked to a condition called phrynoderma, a rare disorder that leads to skin bumps and, in rare circumstance, hair shedding. But aside from rare cases of a rare condition, vitamin A deficiencies have not been linked to human hair loss. In fact, in one mouse model, a low-vitamin A diet actually delayed hair loss onset. In the developed world, a normal diet provides more than enough vitamin A for the overwhelming majority of people, making supplementation more or less unnecessary, and in some cases, dangerous.
  • Potential dangers associated with its use: High dosages of active vitamin A (as retinol) can cause severe hair loss. Moreover, supplementing with vitamin A as retinyl palmitate or beta carotene has been associated with an increased risk of cancer and all-cause mortality, respectively. Nutrafol contains the beta carotene form of vitamin A.

Notably, our lab test results revealed that the Nutrafol® Core Men finished product contained 74% more beta carotene than what was listed on the label.

Ingredient

Per Serving (On Bottle)

Per Serving (Lab Test)

Vitamin A (Beta Carotene)

5,000 IU’s (174%)

8,142 IU’s (283%)

So, similar to selenium, you may want to evaluate if 200%+ of the RDA for vitamin A via each daily serving is really necessary, particularly given the low risk of vitamin A deficiency in the developed world (and the associative risk of long-term supplementation with beta carotene).

What about Nutrafols’ other ingredients?

We could continue this exercise for most of Nutrafol’s ingredients, and we’d generally keep seeing the same patterns and problems. For the most part, the studies supporting the inclusion of Nutrafol’s ingredients:

  1. Carry roughly the same relevance as promoting “water” for hair growth (i.e., water is necessary for survival, and if we’re dead, we technically can no longer grow hair), or…
  2. Were done on people who don’t represent buyers of Nutrafol (i.e., malnourished men in farmland Tibet), or…
  3. Don’t tell the full story (i.e., iodine and vitamin A may hurt our hair if over-consumed in supplemental form)

This practice is called cherrypicking. And unfortunately, cherrypicking is not unique to Nutrafol

Cherrypicking the practice of deliberately showing someone only part of the story… with the objective to get them to agree with something that isn’t totally true. It can happy deliberately or accidentally. In some cases, it’s accidental. But in cases where money is one-the-line, accidental cherrypicking becomes significantly less likely.

Unfortunately, cherrypicking data to support the sale of a product is something that we’ve come across in every single hair loss supplement that we’ve ever evaluated. So, we can’t blame Nutrafol for following the herd. At the same time, just because a practice is widespread doesn’t mean it’s ethical.

So, this begs the question: with an $88/month price tag, what differentiates Nutrafol from competitive hair loss supplements?

Well, there are a few things that Nutrafol does really well. We’ll cover these first before diving into some of their bigger problems – particularly surrounding their clinical trials and marketing practices.

Nutrafol® Pros

#1: ingredients from high-quality sources

Nutrafol® makes every effort to source their ingredients from high-quality sources. This often includes avoiding ingredient suppliers in certain pockets of China and India (where heavy metal contamination is more likely), and instead, opting for ingredients from the U.S., Europe, and elsewhere that may cost more, but are of higher quality.

#2: Nutrafol® passed our purities tests for microbes, pollutants, and heavy metals

Supplements are an unregulated industry. The ramifications of this are that manufacturers can bring a product to market without extensive independent lab testing, meaning it can be a source of harmful contaminants like heavy metals and pesticides, which may actually negate the beneficial effects of some supplements.

This is why we spent roughly $1,000 buying Nutrafol® supplements, sending them to a third-party lab, and testing them for impurities: pollutants, pathogenic microbes, and heavy metals.

The good news: Nutrafol® passed all tests. There were little-to-no unwanted pollutants, pathogens, and heavy metals inside the supplements that we ordered.

Nutrafol: lab results for heavy metals, pesticides, E. coli, Listeria, pseudomonas, salmonella, and staph

Nutrafol also uses manufacturers who are Good Manufacturing Practices certified, meaning the FDA has inspected their facility to ensure the identity, strength, quality, and purity of the product being produced.

#3: The supplement is clinically tested

Nutrafol has a 2018 clinical trial to back up its use. This is almost unheard of for hair loss supplements. And at face-value, the results look promising:

  • 80% of subjects saw improved hair growth.
  • 80% saw improved hair thickness.
  • 73% saw improved hair growth rate.
  • Subjects saw an average terminal hair count increase of 10.3%, and a vellus hair increase of 16.2%.

Moreover, Nutrafol®’s study was a six-month, randomized, double-blind, placebo-controlled trial. This is the gold-standard of clinical trials. Their investigation team also used objective endpoints (i.e., hair counts) to evaluate its effectiveness, meaning that efficacy wasn’t determined on subjective markers like self- or investigator- assessments.

Knowing this, it’s no wonder why Nutrafol® references its published clinical study so frequently on its website and its advertisements.

In fact, ever since starting this article, I’ve received retargeting ads for Nutrafol – many of which claim that their product is clinically effective, or that their ingredients have been clinically proven to improve hair growth. On that last note, in my consultations with male customers of Nutrafol®, every single one of them has referenced the company’s clinical trial as the reason why they even decided to try the product.

Unfortunately, this is where Nutrafol’s marketing sleight-of-hand kicks in, again… and this one is a big problem.

Nutrafol® cons

#1: Nutrafol® markets its study to male and female pattern hair loss sufferers… but Nutrafol® isn’t clinically tested on men or women with pattern hair loss.

When we dive into the selection criteria for participants of the Nutrafol study, we see that all subjects were females between the ages of 21-65 with self-perceived hair thinning (as confirmed by the investigators).

At face-value, this seems fine. Plenty of women ages 21-65 feel that their hair is thinning. And it seems like the women in this study who took Nutrafol® saw increases to hair counts. So, why make a big deal about this subject criteria?

Because the subjects in the Nutrafol® study happen to overlap with the demographic of hair loss sufferers who are highly likely to have nutrient deficiency-related hair  loss, and thereby most likely to see hair regrowth from a nutritional supplement.

Let’s break this down further.

Females ages 21-65: what’s causing their hair loss?

It all depends on their type of hair loss. And, as we’ll soon see, the types of hair loss vary depending on someone’s age and gender.

For example, alopecia areata is a form of hair loss that leads to patches of missing hair in the scalp. It’s caused by autoimmunity, and it can affect anyone at any age. Contrast this to androgenic alopecia (AGA): a patterned form of hair loss whereby hair follicles slowly miniaturize. It’s caused by hormones, it’s mediated by genetics, and it generally affects people starting at puberty.

So, what are some of the most common types of hair loss for women between the ages of 21-65 in the U.S.?

There are two big ones.

  1. Androgenic alopecia (AGA), or female pattern hair loss. The prevalence of this type of hair loss increases with age, and it affects ~20% of caucasian women between the ages of 21-65. It’s chronic, progressive, and without treatment, it only worsens.
  2. Telogen effluvium. This type of hair loss is different from AGA. It’s a type of hair loss that generally presents as diffuse thinning throughout the entire scalp. It’s often temporary, and it’s often the result of excessive hair shedding. While the prevalence of telogen effluvium is unknown, it seems to impact women more than men, and its chronic form seems most prevalent in women ages 30-60. But the key difference between female pattern hair loss and telogen effluvium is that telogen effluvium is temporary. That means that once we identify and address its triggers, it can reverse entirely.

So, what are some of the biggest triggers of telogen effluvium?

Well, there are dozens – ranging from hypothyroidism to medications to stress. Some researchers (including me) also consider hair loss from a poor diet or a nutrient deficiency to also qualify as telogen effluvium… because nutrient-related hair loss interferes with the hair cycle and can be fully reversed after resolving those deficiencies.

Now, back to Nutrafol’s clinical study…

The company’s clinical trial showed great results: a 10% increase in terminal hair counts for women using Nutrafol Core. Knowing this, it’s no wonder why Nutrafol often references the words “clinically proven” on its website and in its ad copy.

But there’s something that nearly everyone misses about this study.

Nutrafol’s study excluded women with androgenic alopecia and telogen effluvium – the two most common forms of hair loss for women ages 21-65.

That’s right. A supplement company that advertises their clinical trial to females ages 21-65 also happened to exclude the types of hair loss most common in females ages 21-65 from their trial.

In fact, they essentially excluded anyone with any form of diagnosed hair loss at all. Here’s a quote from the trial submission at clinicaltrials.gov:

Inclusion Criteria:

  • Females with self-perceived thinning hair as determined on initial study assessment by the Investigator (This will not include patients with medically diagnosed telogen effluvium)…

Exclusion Criteria:

  • …Females suffering from other hair loss disorders, such as alopecia areata, scarring alopecia, androgenetic alopecia and telogen effluvium as determined on initial study assessment by the Investigator.

This is a huge problem. For starters, those four types of hair loss likely cover more than 95% of all hair loss cases in the developed world. That means that the women selected for this Nutrafol study don’t represent the majority of hair loss sufferers within that age- and gender- bracket: those with androgenic alopecia, telogen effluvium, or scarring alopecias.

And perhaps more importantly, this ambiguous selection criteria allows for investigators to (1) exclude female hair loss sufferers unlikely to respond favorably to a nutritional intervention, and (2) cherrypick women with nondescript, undiagnosed, non-androgenic hair thinning – the ones most likely to have telogen effluvium from a poor diet or minor nutrient deficiency, but not yet have had it “medically diagnosed”.

For females of reproductive age, these nutrient deficiencies are often the result of low iron, zinc, vitamin B12, vitamin D, and other nutrients depleted from stress and/or menstruation. And with the exception of iron, Nutrafol contains all of these ingredients.

Again, unlike female pattern hair loss, nutrient-related hair loss is often temporary. This is why studies have shown that a basic nutritional supplement can improve terminal hair counts in females with telogen effluvium by 10%… the same increase that Nutrafol reported in their six-month clinical study.

This is important! And if you’re not there already, here’s where we’re heading with this.

Summary (so far)

Nutrafol®’s 2018 clinical study picked participants who were females, mostly of reproductive age, with self-perceived hair thinning as confirmed by the investigators. But they also took measures to exclude the most common forms of hair loss in this demographic: androgenic alopecia and telogen effluvium.

This selection criteria creates a bias toward selecting females with hair loss due a nutrient deficiency (iron, zinc, B-12, etc.) – nutrients with can deplete due to stress, menstruation, and/or a poor diet.

Nutrafol® Core contains these vitamins, nutrients, and trace elements. And while it doesn’t include iron, it includes enhancers of iron absorption – like vitamin C, black pepper, and vitamin B12.

Nutrafol’s study showed a ~10% increase in hair count in the women taking their supplement. However, similar studies have shown nearly the same results for females with nutrient deficiency-related telogen effluvium – and all through taking a basic nutritional supplement consisting of iron, zinc, vitamins A, C, E, and an array of amino acids.

For a company that markets their clinical results to all men and women with hair loss, Nutrafol’s study selection criteria ironically excluded all of the most common forms of hair loss for women. Therefore, we can only surmise that study wasn’t designed to truly evaluate the effectiveness of the supplement on a group of hair loss sufferers representative of their target consumer; it was just designed to reap positive results to showcase to all consumers.

Not to beat a dead horse, but again, the subjects inside Nutrafol’s study all had nondescript, undiagnosed forms of hair loss. That means they didn’t have androgenic alopecia, telogen effluvium, scarring alopecias, or autoimmune-based alopecias – which, when these types of hair loss are combined, account for more than 95% of all hair loss cases in the U.S.

Yet ironically, Nutrafol® advertises their clinical study to all male and female hair loss sufferers.

I would know; I’m a male with androgenic alopecia, yet I’ve been receiving retargeting ads on Facebook about Nutrafol ever since beginning this article. Here’s an example of an ad that showed up on my newsfeed this last week:

Nutrafol retargeting ad (to a male)

Again, Nutrafol’s study is only relevant to a very, very small portion of the hair loss population – women with nondescript, temporary, self-perceived hair thinning due to stress, a poor diet, and/or menstruation. That’s not me. And it’s for these reasons that Nutrafol has received Truth In Advertising complaints.

For what it’s worth, of the people with whom I’ve worked who are/were taking Nutrafol, 100% had no idea the study was done on a population group that didn’t represent them. That’s a problem.

Con #2: Nutrafol® conducted multiple clinical trials, but not all results have been published

During our research on Nutrafol’s clinical trials in 2020, we came across two registered completed trials on their Core product. One was completed by the Ablon Skin Institute (the one we referenced above); one was completed by the Sadick Research Group.

Nutrafol’s registered clinical trials on clinicaltrials.gov

The Sadick Research Group’s trial was completed in 2017. As of today, their results have not been published.

We can only speculate as to why. But in general, companies tend to bury less-favorable results and showcase more-favorable ones. It’s also common practice for well-funded companies to run multiple trials on the same product and only publish results for the best-performing ones.

However, based on our above analysis, we think it’s more likely that the Sadick Research Group found a neutral or negative outcome for Nutrafol’s supplement. Why? Because their subject selection criteria was different from the Ablon Skin Institute.

In fact, the Sadick Research Group actually included females with “adult female subjects with mild to moderate hair loss”… and women with pattern hair loss. To quote from their criteria:

Inclusion Criteria:

  • …Clinically confirmed to have hair loss or thinning by the investigator via physical exam, including subjects with female pattern hair loss with Savin Classification score of I2-II1 as determined by the investigator (through medical history, physical exam and /or strong family history of hair loss as defined by 2 or more relatives known to have a similar Savin pattern of loss without diagnosed disease)

It’s this slightly different inclusion criteria that probably excluded more women with nutrient deficiency-related hair loss, which would’ve likely led to poorer results.

Again, we don’t know with certainty why these results weren’t published. All that we know is that the subject criteria across studies were different, only one study was published, and that we don’t have the full story.

Con #3: For male pattern hair loss sufferers, the only clinically-proven ingredient inside Nutrafol® Core For Men is saw palmetto.

Again, there are different types of hair loss. Each type has a different set of causes, and therefore a different set of treatments.

Pattern hair loss and telogen effluvium account for the majority of adult hair loss cases. But for men specifically, pattern hair loss is far more cosmetically noticed. It’s caused by male hormones (DHT), mediated by genetics, and affects up to 80% of men throughout a lifetime (if they live long enough).

Nutrafol® markets to men with pattern hair loss, and even references the term “clinically effective” in their materials to men. While many men with pattern hair loss will presume this phrase is in reference to Nutrafol’s study, it’s actually just relevant to one single ingredient inside Nutrafol: saw palmetto.

That’s right. When it comes to male pattern hair loss, there’s only one ingredient clinically demonstrated to improve hair loss outcomes in men… saw palmetto. And while saw palmetto isn’t as effective as finasteride, it can help lower DHT levels enough to slow, stop, and even partially reverse hair thinning in men.

…But you can buy saw palmetto separately for just a fraction of the price. In fact, high-quality saw palmetto that is (1) manufactured in accordance with the methodologies outlined in clinical studies, and (2) third-party tested for purity, pollutants, and heavy metals – can be found for just $12 (or less) inside CVS, Walgreens, Walmart, and other drug or big box stores.

This means that for males with pattern hair loss, buying Nutrafol® is probably just as clinically helpful as buying high-quality saw palmetto. And this brings us to our final issue with Nutrafol®…

Con #4: It’s overpriced.

If you have a good idea of what’s driving your hair loss, you don’t need to spend $79 per month (or more) on a supplement that broadly targets many hair loss types. Rather, all you need to do is take the time (1) identify your causes of hair loss, and then (2) address each one of them systematically.

There’s no better example of this than one of our members – Jenna – a 31-year old female with self-perceived hair thinning. Jenna has been diagnosed with female pattern hair loss, high testosterone, borderline insulin resistance, and an iron deficiency. We’ve been working together for the last 9+ months. In that time, here’s how Jenna’s been systematically tackling the causes of her hair loss:

  1. Address female pattern hair loss with a regimen she’s comfortable trying (for her, that’s massaging)
  2. Address her iron deficiency with iron pills
  3. Address her insulin levels with Metformin.

Her results speak for themselves. Here are the progress photos Jenna has shared inside our membership forum.

Jenna’s results: six months without Nutrafol or other hair loss supplements

Again, this regrowth was achieved naturally (if you don’t count Metformin, which isn’t used directly to treat hair loss anyway). Moreover, these results were achieved for just a fraction of the costs compared to Nutrafol®… a supplement that would’ve too broadly targeted causes of hair loss that didn’t relate to Jenna’s case.

The bottom line: if you take the time to better understand your own drivers of hair loss, you can often arrive to much more economical (and potentially effective) interventions – ones that can still fit with your needs and preferences.

Nutrafol®: best and worst candidates

Generally, the best candidate for Nutrafol® will likely be someone who matches their subject selection criteria: a female between the ages of 21-65 with temporary self-perceived hair thinning as a consequence of stress, a poor diet, and/or menstruation.

But, based on the clinical evidence supporting each of its ingredients, we can drill this down even further.

Nutrafol® might be right for you if…

You are…

  • A female with self-perceived hair thinning
  • Aged 21-65
  • Interested in natural hair loss interventions
  • Don’t have the time to investigate what’s causing your hair loss
  • Have low-grade deficiencies in iron, iodine, selenium, zinc, vitamin B-12, and/or vitamin D

If this is you, you’ll likely see some sort of benefit from supplementing with Nutrafol®. But, keep in mind you may also get the benefits of Nutrafol® without the costs by supplementing with a high-quality (and less expensive) multivitamin.

Nutrafol® might not be a good fit for you if…

You are…

  • A male or female with androgenic alopecia (AGA)
  • Financially constrained to an approach that costs less than $79/month

In this case, you’re better off just buying the one clinically-proven ingredient inside Nutrafol® for AGA: saw palmetto. It’ll likely be similarly as effective, and you’ll also likely save yourself a lot of money.

The bottom line

Nutrafol’s allure resides mostly in its branding, not benefits, to consumers. Peeling back the curtain, we found that:

  • Most of Nutrafol’s ingredients only support hair growth within vary narrow contexts, most of which don’t apply to hair loss sufferers in developed world, and thereby their potential customers. In fact, there’s also evidence that some of these “natural” ingredients might be dangerous when taken long-term.
  • Nutrafol’s 2018 published study – which is marketed on its website and in advertising to people with all types of hair loss sufferers – was actually conducted on women with temporary, self-perceived hair thinning as a result of stress, poor diet, and/or menstruation. This participant group is (1) far more likely to see hair growth from a nutritional supplement than most others, (2) only represents a tiny fraction of hair loss sufferers, and (3) is in no way representative of the average person dealing with hair loss in North America. During interviews of people with whom I work who were taking Nutrafol, none of them knew this.
  • Nutrafol may have buried the results of their second clinical trial, which was never published. Ironically, this unpublished trial included participants with common hair loss disorders, like androgenic alopecia. This means, compared to the published trial, that the unpublished trial’s results probably better matched how Nutrafol would perform for the average hair loss consumers (who usually has androgenic alopecia and/or telogen effluvium).
  • When it comes to the most common form of hair loss in adult men – male pattern hair loss – the only clinically effective ingredient featured in Nutrafol Core for Men is saw palmetto. This can be purchased as a standalone extract for $~15 per month.

There are a lot of ways to spend $79 per month (or more) fighting hair loss naturally. Nutrafol might be an option for women ages 21-65 with nondescript, self-perceived, temporary hair thinning stemming from stress, nutrient deficiencies, and/or menstruation. But these women may see the same degree of benefits by simply taking the time to catalogue the drivers of their hair loss and then systemically fixing them.

For men and women with androgen-driven pattern hair loss – it’s likely that a saw palmetto supplement will likely reap a similar degree of effectiveness, and for a fraction of the price.

Perfect Hair Health Team

Perfect Hair Health Team

"... Can’t thank @Rob (PHH) and @sanderson17 enough for allowing me to understand a bit what was going on with me and why all these [things were] happening ... "
photo photo
— RDB, 35, New York, U.S.A.
"... There is a lot improvement that I am seeing and my scalp feel alive nowadays... Thanks everyone. "
photo photo
— Aayush, 20’s, Boston, MA
"... I can say that my hair volume/thickness is about 30% more than it was when I first started."
photo photo
— Douglas, 50’s, Montréal, Canada