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In 1942 Dr. Frederick Hoelzel’s “Ivory Dome” theory of baldness was published in the prestigious Journal of the American Medical Association. Hoelzel’s theory was based on observations he made in 1916-1917 while he served as a technician in gross anatomy at the College of Medicine of the University of Illinois. During that time he removed the brains of about 80 cadavers and noticed a seemingly obvious relation between the blood vessel supply to the scalp and the quantity of hair.

Baldness occurred in persons in whom calcification of the skull bones apparently had not only firmly knitted the cranial sutures but also closed or narrowed various small foramens through which blood vessels pass most prominently in persons with a luxuriant crop of hair.

? Dr. Frederick Hoezel

So if this observation is true, calcification will inhibit the passage of blood flow through the diploic veins that reach through the foramen that travel to scalp skin. Calcification of the diploic vein system will impair the blood supply to the scalp follicles resulting in hair loss and an “ivory dome” overtime

“It turns out menaquinones (K2) may influence hair growth. The explanation is a bit technical, just bear with me. A deficiency of Vitamin K2 results in the protein, osteocalcin being unable to bind calcium. Matrix Gla Protein (MGP), which is stimulated by vitamin K2 prevents the deposition of calcium in arterial walls. MGP is the most powerful antagonist of tissue calcification yet known to date.

Bone morphogenetic protein (BMP) signaling inhibits the anagen (growth) phase in hair follicle cycling. Matrix GLA protein (MGP) inhibits Bone Morphogenetic proteins (BMP)-2 and -4. It has been shown that Matrix Gla Protein is up regulated when the catagen (breakdown) phase is inhibited.

There is evidence that BMP-2 is responsible for vascular calcification and mineralization of the extracellular matrix, effectively calcifying soft tissue. In such a scenario, there is a loss of Matrix Gla Protein (MGP). This is where Vitamin K2 steps in and reverses this process.”

And of course, as Ray Peat and Chris Masterjohn have pointed out, carbon dioxide is an important cofactor for vitamin K.

This not only aligns with many of the themes discussed on this weblog (e.g., CO2, lactic acid, the benefits of fructose, aspirin, calcium/phosphate ratio, intracellular calcium, glycolysis vs. respiration, prolactin, parathyroid hormone, estrogen, serotonin, cortisol, vitamin K2, vitamin D, vitamin A, etc.), but also may explain why baldness is strongly associated with heart disease.