Reduced Serum Vitamin B12 Levels During Oral Cyproterone Acetate and Ethinyl Estradiol Therapy in Women With Diffuse Androgen-Dependent Alopecia

    Ian Ramsay, D. H. Rushton
    TLDR Taking cyproterone acetate and ethinyl oestradiol for hair loss can lower vitamin B12 levels in women.
    In a study from 1990, healthy non-vegetarian women with diffuse androgen-dependent alopecia were treated with cyproterone acetate and ethinyl oestradiol. After 6 months of treatment, there was a significant decrease in serum vitamin B12 levels, haemoglobin, and haematocrit values, while serum folic acid, red-cell folate, and mean cell volume remained unchanged. The patients responded positively to vitamin B12 supplementation. The study suggests that for patients with baseline serum vitamin B12 levels below 350 ng/l, prophylactic cyanocobalamin should be administered alongside the alopecia therapy. The paper also indicates that for treatments longer than 3 months, vitamin B12 status may need to be evaluated, especially with different dosages or when cyproterone acetate is used alone.
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