The Facts About Cold Capping



I was diagnosed with breast cancer in 2015, right around the same time the first FDA-approved cold cap came out. I’d heard about the potential hair-saving helmet on the news, and I crossed all my follicles that it could work for me as I prepared to start chemotherapy.

Unfortunately, I wasn’t a candidate for scalp cooling therapy. Back then, the cooling devices were only approved for early-stage breast cancer and less potent types of chemo. I was stage 3 and taking doxorubicin, also known as the “red devil.” So, yeah, pretty potent stuff.

Although I was disappointed that I couldn’t try cold capping to reduce hair loss during chemo, just knowing it was out there made me hopeful for advancements in cancer treatments. Hair loss may seem like a small thing when talking about disease, but it can be really devastating. One recent report cited up to 14% of women won’t consider chemotherapy because of hair loss.

Cold caps don’t work for everyone, and results vary from person to person depending on a lot of different factors. But new research shows using cold caps can help some people keep a good amount of hair during chemo — even people getting the red devil: In one study, 71.4% of people on doxorubicin saw successful hair retention. That’s a hair flip in the right direction.

If you or someone you know is interested in cold caps for chemo-induced hair loss, here’s what you need to know.

What is cold capping?

Cold capping involves wearing a helmet-like device to lower the temperature of the scalp during chemotherapy. The cold temperature decreases blood flow, which can reduce the amount of chemo that reaches the hair follicles and may reduce hair loss for some people.

What are the types of cold caps?

Scalp cooling therapy includes two types of devices:

  • Automated: The insulated cold cap is hooked up to a machine that circulates cooling liquid or gel inside the cap. Once the device is hooked up, the cooling system will keep the temperature where it needs to be. Automated cold caps are regulated by the FDA.
  • Manual: The frozen gel caps are stored in a freezer or with dry ice. Because the gel will start to warm once it’s on the scalp, a new frozen cap will have to be replaced about every 30 minutes. Manual cold caps are not regulated by the FDA.

How do cold caps work?

Both types of cold caps work by reducing the temperature of the scalp before, during and after chemo.

Typically, the person administering the chemo will help set up the automated cold cap machine and make sure the temperature is correct and that the cap is secured tightly around your head.

People using manual caps also need an outside pair of hands to help with the caps, although it doesn’t have to be a nurse — family or friends can help during treatment.

Who can use cold caps?

People with solid tumors (breast, colon, lung, gynecological) can use cold caps to help reduce hair loss during chemo.

Who shouldn’t use cold caps?

Cooling caps are relatively safe overall, but some people with certain health conditions shouldn’t use cold caps.

For example, people with blood cancers like leukemia or lymphoma shouldn’t use cold caps because the restricted blood flow may stop the chemo from getting to where it needs to go.

You also shouldn’t use cold caps if you:

  • Have central nervous system cancer
  • Are getting chemo for a bone marrow transplant
  • Had radiation to the head or will have radiation to the scalp

Cold capping is not recommended for people who have cold-agglutinin disease, cryoglobulinemia and post-traumatic cold dystrophy.

What are the side effects of cold caps?

Cold caps live up to the name, so if you’re sensitive to cold temperatures, you may feel uncomfortable during the sessions. Other side effects of cold capping can include:

  • Dry skin
  • Feelings of claustrophobia when wearing the cap
  • Headache attacks
  • Nausea
  • Cold thermal injury (burn) from manual caps

Do I need a prescription for scalp cooling therapy?

Whether you need a prescription depends on which type of cold cap you want to try. The automated systems require a prescription, and the manual systems do not. Always be sure to ask your healthcare provider before using any type of scalp cooling device.

Is cold capping covered by insurance?

Manual frozen caps are not covered by insurance, but automated cold caps are covered by Medicare and may be covered by other insurance plans.

If you need help paying for the cooling therapy, nonprofit organizations such as HairToStay and The Rapunzel Project may be able to help cover the cost of cold capping.

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Facts About Red Yeast Rice



Fact: Red yeast rice is the most colorful name in the supplement game. It certainly sounds cool as an acronym (#RYR vibes). But did you know red yeast rice is produced from a mold — not a yeast? We’re guessing “red mold rice” just doesn’t have the same ring to it.

If you have high cholesterol, you may have heard of red yeast rice as a possible alternative to prescription cholesterol-lowering medication. The ruby-red food and dietary supplement has also been thought to have anti-cancer properties.

But is it too good to be true?

Here’s what you need to know about the potential benefits and the red flags to consider before taking red yeast rice.

What is red yeast rice?

Red yeast rice has been around for centuries and is known as a “natural statin” in traditional Chinese medicine. It’s produced by fermenting rice with a type of mold called Monascus purpureus.

Depending on the strain and the conditions of fermentation, the fungus enhances the rice with compounds called monacolins, which can lower cholesterol levels in the body. One of those monacolins — monacolin K — has the same makeup as the medicine lovastatin, a prescription cholesterol-lowering medication.

Read: Cholesterol-Lowering Drugs 101 >>

What are the potential red yeast rice benefits?

The most celebrated benefit of red yeast rice is its ability to lower cholesterol thanks to monacolin K. Some studies have shown that taking red yeast rice on a daily basis for six to eight weeks can lower total cholesterol and LDL (“bad”) cholesterol levels.

Red yeast rice may also have anti-cancer benefits. One study found that red yeast rice stopped the growth of cancer cells in the colon. And a different study found that red yeast rice extracts stopped breast cancer cells from growing. But more research needs to be done regarding any anti-cancer benefits to taking the supplement.

Read: I Was “Too Young” to Have Colon Cancer >>

How much red yeast rice do you need to lower cholesterol levels?

Lower cholesterol levels are directly linked to the amount of monacolin K in red yeast rice supplements. Research shows taking up to 10 mg of monacolin K on a daily basis is associated with lower cholesterol levels.

What does the FDA say about red yeast rice?

This is where things get a little complicated. The FDA approved lovastatin — which is basically monacolin K — as a drug before it was marketed as a supplement. So, any product that lists lovastatin or enough monacolin K to work like a statin, is illegal to sell in the U.S. as a dietary supplement. Over the years, the FDA has issued warnings against companies who market added or enhanced supplements with lovastatin and monacolin K.

As a result, the red yeast rice products you see online and in the grocery store typically won’t list the amount of monacolin K on the product label. The product may not contain any monacolin K — although most will have some level of the cholesterol-lowering ingredient — but you won’t know for sure the actual amount.

What are the red yeast rice side effects?

Because red yeast rice can act like a statin, the same side effects may apply. These can include:

  • Liver damage
  • Kidney damage
  • Muscle disorders

Some people experience other side effects. These can include:

  • Heartburn
  • Dizziness
  • Abdominal pain
  • Headache attacks

Red yeast rice products may contain citrinin, which can cause kidney damage.

Who shouldn’t take red yeast rice?

Red yeast rice may not be an option for everyone. You shouldn’t take it if you’re on cholesterol-lowering medications like a statin because it can increase the risk of serious side effects.

Also, people taking certain substrate drugs (CYP450 3A4 or P-glycoprotein), including some antibiotics and antifungals, shouldn’t take red yeast rice as it can affect how the body metabolizes medication. If you are taking any medication and you don’t know if it’s a substrate drug, be sure to ask your healthcare provider.

Is there anything specific women and people assigned female at birth should know about red yeast rice?

Red yeast rice isn’t recommended for people who are pregnant or lactating because there are no clinical studies — good or bad — that show the effect of taking the supplement while pregnant.

Is red yeast rice safe?

Overall, red yeast rice is considered safe and has few side effects. However, because the amount of monacolin K usually isn’t listed on supplement labels, you never know what you’re going to get. For example, one brand online says their red yeast rice supplement has “appropriate levels of naturally occurring monacolin compounds, especially monacolin K.”

If you’re thinking about red yeast rice for cholesterol, the supplement may not contain enough monacolin K to make a difference or have any benefits. High cholesterol can lead to serious health problems such as heart disease — the number one killer of women in the U.S.

Just like with any supplement, it’s a good idea to talk to your healthcare provider before you give red yeast rice the green light.

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