Oral Supplements and Drugs for the Hair Loss and Hair Thinning Treatment 

Oral Supplements are the least expensive, least invasive, easiest to use option for the hair loss or thinning management and treatment. It is a good starting point for someone who is looking for a solution to hair thinning. 
The oral drug, Finasteride, is also easy to use, likely more effective, especially for the androgenetic alopecia and frontal fibrosing alopecia, though carries the risk of undesirable side effects. 

​Covered on this page -  ​
Full list of references

BASIC NUTRIENTS CRITICAL FOR THE HAIR GROWTH
hair nutrient basics
In some cases, hair loss reasons may be as basic as the lack of vital nutrients, particularly vitamins and minerals necessary for the hair growth. Among the critical ones for the hair growth are - 
  • Biotin, or Vitamin B7. Biotin participates in important metabolic pathways for energy production; daily intake - 30 to 100 mcg for adults. It is important for hair, skin, and nails;
  • Marine Omega-3, EPA and DHA. Deficiency in EPA and DHA may be implicated in decreased hair growth. Recommended daily intake is 1,250 - 2,500 mg combined EPA + DHA, preferably in a triglyceride form, from a manufacturer who tested the product for heavy metals and other toxins;
  • Zinc. This mineral benefits hair follicle health and participates in the collagen synthesis. 15 - 30 mg a day;
  • Vitamin C. It minimizes formation of dihydrotestosterone (DHT), a hormonal by-product of our metabolism that leads to hair loss. Vitamin C is also important for building collagen, and hence, hair growth; finally, it participates in the absorption of iron, which contributes to hair strength. 500 - 3,000 mg a day, preferably combined with rutin and bioflavonoids that are 'companions' of ascorbic acid (or its alternatives) in nature and support effectiveness of Vitamin C;
  • Iron. It carries oxygen to the roots of the hair. Recommended daily intake is 14 - 18 mg a day. 
  • ​Supplementing with collagen may also help hair growth.
All of those nutrients can be purchased and taken separately. Provided daily nutrient intake includes both food sources and supplements. For example, someone, whose diet includes 3 - 4 portions a week of wild-caught salmon, does not need supplementation with Omega-3. 

MULTI INGREDIENT HAIR GROWTH SUPPLEMENTS
All the supplements 
There are three multi-ingredient supplements with clinical studies behind them that show an improvement in hair thickness and hair regrowth. Two of them are Nutrafol and Viviscal available on the US market. The third one is a Chinese herbal supplement BeauTop.

​​Both Nutrafol and Viviscal contain marine collagen, biotin, and some amino acids. Apart from that, Nutrafol includes a range of vital nutrients, while Viviscal seems to be exerting its benefits primarily through the proprietory AminoMar Marine Complex. Overall, these two supplements target deficiency in vital nutrients described in the Hair Nutrients Basics section above and also add additional natural compounds intended to promote hair growth.
There are no studies that compare effectiveness of Nutrafol to that of Viviscal.

BeauTop's ingredients are very different, so potentially it can be taken together with Nutrafol or Viviscal for better results.
NUTRAFol and viviscal
With both products, it takes three to six months to start seeing results.
  • Viviscal - 75% of women reported a decrease in the hair loss and some improvement in hair volume and thickness.
  • Nutrafol - 81% of women saw an improvement in hair growth and hair thickness. 
The type of hair loss that those women were experiencing was not specified. 

Given that the majority of the male hair loss cases is caused by the androgenic alopecia (that is the effects of a testosterone metabolite DHT on the hair follicle), these two supplements are likely to be more effective for women than for men.
​However, web-sites of both manufacturers feature men success stories with before and after treatment pictures.
beautop
​The third supplement, BeauTop (Sun Ten Laboratories), is different from the above two in the type of ingredients and mechanisms of action. BeauTop is considered a Chinese herbal remedy and has six ingredients:  Ginseng Radix, Astragali Radix, Angelicae Sinensis Radix, Ligustri Fructus, Rehmannia glutinosa and Eclipta prostrata Linn.
In a rodent study, BeauTop was found to be effective in "enhancing growth factors that regulate hair follicle life cycles, and promoting hair follicle activity" (Lee C-Y, 2018).

Its effectiveness for the treatment of androgenetic alopecia in humans was evaluated on 32 participants during a 6-months trial, twice-a-day supplementation, with the following results  (Lee C-Y, 2017) - 
  • 47.1% saw no improvement,
  • 52.9% of participants had an improvement: minimally improved - 5.9% patients; moderately improved - 29.4% patients; and significantly improved - 17.6% patients.

The studies on BeauTop can be found in the National Center for Biotechnology Information (USA), however, search engines bring no results in English on where the supplement can be purchased. ​
supplement summary
Oral Supplements - 
Advantages - relatively inexpensive ($50 - $80 a month); non-invasive; the nutrients in the supplements are beneficial for the health overall, not just for the scalp hair; no side effects; may be a good option to start with while searching for a more drastic hair loss solution and then switch to other measures if the supplements do not work. 
Drawbacks - uncertainty whether the treatment will be effective and to what extent; unlikely to produce satisfactory results in cases with a major hair loss especially if the causes are genetic, hormonal, or auto-immune. 

FINASTERIDE - ORAL DRUG
about and dose
Finasteride, sold in the USA under the brand name Propecia, works by decreasing production of DHT (dihydrotestosterone). DHT is a by-product of testosterone metabolism and leads to minituarization of hair follicles and hair loss. 
Finasteride has been approved by FDA since 1997 for the treatment of scalp hair loss caused by androgentic alopecia in men. 
Finasteride is partially dose dependent. Studies were done on 0.01 mg, 0.2 mg, 1 mg, and 5 mg. (Roberts JL, 1999) - 
  • 0.01 mg is ineffective;
  • 1 mg and 5 mg are significantly more effective than 0.2 mg;
  • there is no major difference between 1mg and 5 mg .
​
Finasteride affects the entire body, not just the hair, and given the side effects from Finasteride, it is safer to use the lowest effective dose. That is why the typically prescribed dose for the androgenetic alopecia is 1 mg.
finasteride effectiveness 
Effectiveness for the androgenetic alopecia - 
  • 66% of men with androgenetic alopecia (male pattern hair loss) treated with 1 mg/d of Finasteride for two years experienced an average of 16% improvement in hair growth;
  • 17% more did not experience an improvement, but did not have any additional hair loss;
  • for the 17 remaining %, treatment with finasteride was not effective (Shapiro, 2003).
​
Effectiveness for the frontal fibrosing alopecia (FFA) - in the largest study of FFA treatment, over 100 patients were treated,-  The study also showed that 5-alpha-reductase inhibitors, which Finasteride is, are currently the most effective treatment for FFA. ​
side effects, pros and cons
Finasteride side effects are very rare, but may include impotence, loss of interest in sex, trouble having an orgasm, abnormal ejaculation; swelling in hands or feet; swelling or tenderness in breasts; dizziness, weakness, headache.

Advantages - over 60% likelihood of some effectiveness for androgenic alopecia, 47% effectiveness for frontal fibrosin alopecia; non-invasive, relatively inexpensive ($50 - $100 a month). 
Drawbacks - a minor risk of side-effects; unlikely to produce dramatic hair regrowth.