Something to Watch out for if You're Going Bald

Medically Reviewed by Gary D. Vogin, MD

Oct. 2, 2000 -- It's hard enough to grow bald in one's 20s and early 30s, for the obvious reasons -- but early baldness also is well-known within the medical profession to be a harbinger of some less obvious reasons, such as heart disease. And now, to add injury on top of injury, a team of Finnish clinicians reports that bald men are likely to have insulin resistance, which can lead to heart disease, hypertension, and, in about one out of 10 cases, diabetes type 2.

The baldness in question here is fairly severe loss of hair on the crown of the head, called vertex baldness. It is present in slightly more than one out of every 10 men, according to the Finnish team.

The good news is that the early warning from a shiny top gives men ample time to reduce their risks. And with insulin resistance, there are a fair amount of them. Insulin helps the tissues absorb glucose from the blood. Glucose, a type of sugar, is the body's fuel. Insulin resistance means that insulin has become less effective than normal at helping the tissues absorb glucose. The body compensates by producing more insulin. The resulting higher levels of insulin in the blood are believed to cause hypertension and cardiovascular damage.

The study, which was published as a letter in the Sept. 30 issue of the journal TheLancet, showed modestly higher insulin resistance among men who had gone markedly bald on the crown before age 35, as compared to men who were not bald. The bald men also were more likely than those with full heads of hair to suffer from obesity and high blood pressure, and to have abnormal levels of lipids (fats) in their blood or to be on lipid-lowering medication. The study included 154 men with early vertex baldness and 154 men without this condition.

Previous studies have shown that bald men are more likely to get heart disease, but investigators had been puzzled as to why this should be so. This study is "intriguing," says Robert Sherwin, MD, because insulin resistance in bald men would explain that link. But the study does not prove that vertex baldness indicates insulin resistance, says Sherwin, who is a past president of the American Diabetes Association and a professor at Yale University. The differences in insulin resistance between the bald men and those with full heads of hair were only "modest."

So what should a bald man do? "Find out what your fasting blood glucose level is," says Morris F. White, PhD, a researcher at the Joslin Diabetes Center and the Harvard Medical School in Boston. This is a simple, inexpensive test for insulin resistance and is usually performed during a routine checkup. Sherwin suggests that men with severe crown baldness might consider being screened for cardiovascular risk factors, such as high blood pressure and high cholesterol, especially since such men have been shown to have a high risk for heart disease.

Although baldness is only a suggested risk factor for insulin resistance, many of the preventive measures taken by people dealing with that condition also could be considered by men facing severe crown baldness at a young age. For instance, White says, people with insulin resistance should exercise because exercise improves the muscles' ability to absorb glucose, reducing the need for insulin.

Furthermore, people with insulin resistance usually gain weight, which aggravates their insulin resistance. This vicious circle can ultimately lead to diabetes, if the resistance grows so great that the pancreas can no longer produce enough insulin to control blood sugar. But exercise pares fat from the body, and that reduces insulin resistance, White says.

White says people with insulin resistance and diabetes probably gain weight because they eat too much. They do so because insulin resistance interferes with the mechanism that tells the brain when one has eaten enough food. "If you eat a candy bar, you don't feel hungry anymore," White says. "If you are insulin resistant, you may need to eat two candy bars to have that effect." This conclusion is based on research that White has just published in the journal Nature and other recent work, he says.

One can combat this effect to a small degree by drinking several glasses of water before eating, which stretches the stomach, adding to the sense of fullness, White says.