Dr. Nadav Pam - Israeli Dermatology Assosiation - 35th annual

Medical evidences of the therapeutic effect of edible gelatin on telogen effluvium and androgenetic alopecia in both men and women By Nadav Pam M.D. Research and Development Aripam Medical Center, Ashdod, Israel. Email: [email protected]

• Family: Married to Sara and father to Ori and Nadav. • 1978: Graduated from the School of Medicine at the Technion, Haifa, Israel. • 1979 – 1985: Medical doctor at I.D.F • 1985 – 1990: Resident in the department of dermatology in Rambam hospital, Haifa. • 1997: A member of the American Academy of Dermatology (AAD). • 1991- 2013: Chief executive officer of Aripam Medical Center, one of the largest dermatological clinics in southern Israel. Aripam Clinic is the leading clinic in Israel in Acne phototherapy & esthetic treatment. • 2001: He was the a co-author with Dr. Samuel Yorav of the book , titled: “Acne the real story” .

Gelatin and safety • In 1993 the FDA reiterated the “GRAS” (Generally Reconsidered As Safe) status of gelatin and stated that there was no objection to the use of gelatin from any source and any country provided that the hide from animals showing signs of neurological disease were excluded and also specified raw materials were excluded from the manufacturing process • In the year 2000 the European Union approved the use of gelatin • In the lecture of Infusion and transfusion therapy by Dr. Madách Krisztina, gelatin is used as an artificial colloid and is used as an I.V. plasma expander with estimated time of 90-120 min and it has the smallest influence on homeostasis among the artificial colloids such as: HES (hydroxyethyl starches) and Dextran (40 Rheomacrodex, 70 Macrodex)* *Dr. Madách Krisztina, Semmelweis University Department of Anesthesiology and Intensive Therapy, titled: "Volume resuscitations, pros and cons of crystalloids and colloids, indications and pitfalls of transfusion therapy", 2008 , slide 29/33.

The hypothesis of therapeutic effect of oral gelatin on hair loss in both men and women 1. Gelatin exhibited one of the highest specific dynamic effects of any food which is caused by increase peripheral blood flow. Increased blood flow had been shown to increase the growth rate of some tissues in both animals and men. 2. Gelatin causes vasodilation of peripheral blood vessels therefore improving the hair follicle blood circulation. 3. Gelatin is composed of 18 amino acids which are delivered via the blood stream to the hair follicle which are the building blocks for hair follicle growth. 4. The hair follicle stays longer time in the anagen stages due to increase availability of the amino acids provided by gelatin consumption. 5. Delaying the progression of the miniaturization of the hair follicle in androgenic alopecia by mechanisms mentions above (1, 2, 3, 4). 6. It is possible that there are changes of signals with the milieu of amino

acids in gelatin, through change of proteins produced and released within the hair follicle that promotes and stimulates hair growth in the anagen stage.

The specific dynamic action of gelatin* • As early as 1926, Rapport et al., discovered that gelatin exhibited one of the highest specific dynamic effects of any food • The increase in body temperature due to specific dynamic effect was thought to be cause by an increase in peripheral blood flow • This hypothesis is supported by an article in which finger blood volume was found to increase following gelatin ingestion • Moreover, increased blood flow had been shown to increase the growth rate of some tissues in both animals and men

* THE SPECIFIC DYNAMIC ACTION OF GELATIN HYDROLYSATES by DAVID RAPPORT, From the Department of Physiology, Western Reserve University Medical School, Cleveland. Received for publication, October 8, 1926. Published the American Society of Biological Chemists, Inc., Vol 71. p. 75-86 in English.

Food Derived Collagen Peptides in Human Blood after Ingestion of Gelatin* •

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Identification of several food derived collagen peptides in human blood after oral ingestion of gelatin. Healthy human volunteers ingested gelatin hydrolysates 9.4g - 23g from porcine skin, chicken feet and cartilage and after 12h of fasting. After oral ingestion the peptide form of hydroxyproline (Hyp) significantly increased and reached a maximum level of 2060 nmol/ml after 30-60 min and then decreased to half of the maximum level at 5h after ingestion. The ratio of the peptide form of Hyp to the free one was approximately 1:3. Major constituents of food derived collaged peptides in human serum and plasma were identified as Pro-Hyp. In addition, small but significant amount of Ala-Hyp, Ala-Hyp-Glu, Pro-Hyp-Gly, Leu-Hyp, IIe-Hyp and Phe-Hyp were contained.

*Koji Iwai, et al. article titled: “identification of food derived collagen peptides in human blood after oral ingestion of gelatin Hydrolysates. Department of Food Sciences and Nutritional Health, Kyoto Prefectural University, Japan. Published at the journal of agricultural and food chemistry. 2—5. 53, 6531-6536. DOI 10.1021/jf050206p. Published on American Chemical Society 2005.

Gelatin and hair growth study groups:

Morganti P., Randazzo S.D., Bruno C.,

M.P DE Padova., A. Tosti

Bruno Silvestrini

Hertel H, Gollnick H, Matthies C, Baumann I, Orfanos CE.

Morganti P., Fabrizl G., James B., Bruno c.,

Year of publication:

1982

1985

1985

1989

1998

Double blind

Subjects were controlled clinically every 2 weeks

Double blind

Pilot study fallowed by a double blind study

Randomized double blind for both diet and solution in combination and as stand alone

Description of volunteers

Total of 40 Italian volunteers from both sexes with confirmed telogen effluvium

Total of 60 patients (40 females, 20 males) effected by confirmed seborrheic alopecia.

40 health volunteers (20 males and 20 females). Division 2 homogenous groups according to age and body weight

Pilot study total of 36 patients. Double blind study with total of 47 patients. In both studies the patient had alopecia of the diffuse type.

Total of 48 volunteers (24 women and 24 men) affected by androgenetic alopecia type 3 and 4 according to Hamilton.

What was examined:

Hair samples of 1cm x 1cm between the rear vertex (VP) and the frontal vertex (VA) according to Moretti subdivision

Sebum level was determined by using the Sebumeter SM 410. Measurements at : 0,30,60,90 days.

Shaving of the median occipital region . Same region was shaved every month. Collection of 10 hairs from each volunteer and measuring them at 30, 60, 90 days. Measurement by millimeter.

The clinical efficacy was evaluated by standard methods, such as the preparation of trichograms and measurement of the hair density before and after treatment

Hair mass and the mean hair number were controlled according to price et al exclusion. Pre selected frontal/parietal scalp area 1 cm2 was hand clipped on day 0. and at week 10 and at week 50. Measurement according to Pirce and Menefee methodology.

20-40

Not mentioned

18-28

Not mentioned

21-38

Length of diet:

3 months (12 weeks)

3 months (12 weeks)

3 months (12 weeks)

Long term

50 weeks

Type of diet:

4 oral pills in total of 2 g gelatin + 0.8g cysteine per os/day

4 spherules of total of 2 g gelatin + 0.8g cysteine per os/day

First group: 8 grams of oral gelatin daily mixed in commercial yogurt.

Daily oral combination therapy of 7000 mg gelatin, 70 mg cystine and 18,000 IE retinol (Vitamin A).

Active diet (12 subjects): gelatin, soy oil, L-cystine, l-methionine, Cu, Zn., Active lotion: Serenoa Repens, Azeliac acid, ginkgo bilboa

Starch

N/A

Second group: 8 grams of starch mixed in commercial yogurt.

Placebo (starch?)

Diet (placebo): Starch and soy oil Lotion (placebo): water, ginkgo bilboa, and Azeliac acid.

50% Intense hair growth and leads to substantial increase in the diameter of fibers compared to placebo P