Can Diet Influence Hair Pulling?
In order to effectively treat any condition we first need to understand the cause. With increasing awareness of body-focussed repetitive behaviours (BFRBs) such as trichotillomania, research in the field has also increased. One of the questions inevitably raised is whether there is a neurobiological cause for BFRBs that could be treated through diet or medication. One of the theories centres on the role of neurotransmitters in skin picking and hair pulling behaviours. It is believed that the amino acid glutamate acts as an excitatory neurotransmitter in the brain, which means it stimulates areas in the brain or other parts of the nervous system, and that an excess of glutamate contributes to problems in mood and anxiety. Glutamate occurs naturally in many foods such as wheat and dairy. The concern is that there is an over abundance of free glutamate (which is more rapidly absorbed than bound glutamate) in processed and packaged foods because of its flavour enhancing properties. Decreasing intake of processed and packaged foods may lower glutamate absorption, which can decrease the urge to pull.
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Trichotillomania has also been linked to food allergies and sensitivities, in particular Gluten. When your gut is not functioning properly then the brain cannot fully function due to malabsorption. One university professor, John Kender, who managed to keep his trichotillomania under control through dietary restrictions, developed what is known as the JK diet. Although the diet is not scientifically researched, the JK diet has received appreciation from many trich sufferers who have attributed a reduction in urges to the diet. One trichotillomania support website reports that in an unpublished study of 27 people with trichotillomania, 70% of those who complete daily diet and urge record sheets reduced the physical urges of trichotillomania through dietary restrictions.
According to the Natural Path Health Centre the over-consumption of sugar is one of the leading causes of neurotransmitter imbalance, which can lead to an increase in the urge to pull. Consuming too much sugar also over stimulates the body causing increased release and destruction of serotonin, dopamine and norepinephrine. These neurotransmitters are known for their mood stabilising properties, with deficiency in transmission being linked to mood disorders such as depression. Therefore excessive sugar intake can negatively impact mood and therefore aggravate underlying causes of hair pulling urges.
Process of Elimination
The only way to know if dietary changes will be effective for you, and which dietary restrictions to make, is by process of elimination. It is recommended that you eliminate one type of food from your diet at a time for a period of three months, before re-introducing it one day per week only for a further four weeks. Eliminating one food at a time will enable you to isolate which dietary change yields the most positive results. According to Trichotillomania Support, it is important to keep notes to observe patterns in order to get a clear picture of food-related urges. It is also imperative to consult a doctor or nutritionist before making drastic changes to your diet as this can be harmful.
A Holistic Approach
While many people with trichotillomania have had success with reducing hair pulling urges through diet, most would still advocate that diet be looked at in combination with other treatment options such as cognitive behaviour therapy (CBT). While there may very well be a neurobiological cause for the urge to pick, there is an undeniable psychological component to the behaviour that needs to be addressed too. As with all disorders, a holistic view of health and wellness is the key to ensuring sustainable management of the disorder.