In addition to genetic predisposition to androgenic alopecia and poor circulatory health, stress may exacerbate the process. Acute stress causes hair loss in animals and humans. One investigation of serum cortisol levels and glucocorticoid receptor expression in patients with severe alopecia areata showed a lower expression of glucocorticoid receptors compared to controls1; researchers believe this contributes to pathological changes in the scalp that promote alopecia. Therefore, adaptogenic and nervine herbs might be included in formulas for patients with hair loss where stress and adrenal activation are suspected to play a role.Male-pattern baldness – referred to medically as androgenetic alopecia – involves a slow transformation of large, scalp hair follicles into shorter, thinner, vellus hairs. The major mechanisms that contribute to hair loss in genetically predisposed individuals include rapid shifts in hormone levels (such as in menopause and andropause), loss of extracellular matrix proteins in the follicular bed, poor circulation to the scalp, and localized microinflammation. The most active form of testosterone, 5α-dihydrotestosterone, aggravates genetically-programmed scalp hair follicles to stop producing “normal” head hair, and instead produce fine, miniaturized vellus hairs.