Hair loss can be distressing and significantly impact one’s self-esteem. As an expert trichology prescriber, I am here to help those suffering from hair loss or hair thinning. I also specialise in supporting patients who have undergone or are considering hair transplant surgery, ensuring their native hair stays as dense as their donor hair for as long as possible. Blood tests are an essential diagnostic tool for identifying the underlying health issues contributing to hair loss and devising an appropriate treatment plan. You can begin your journey to healthier hair by registering as a patient here.
Blood Tests Essential for Hair Loss Diagnosis
Here are the top twenty blood tests crucial for those experiencing hair loss, what the results mean, and the target ranges for optimal hair growth.
1. Complete Blood Count (CBC)
Why It's Important: A CBC measures different components of your blood, including red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. This test can help detect anemia, infections, and other medical conditions. Anemia, in particular, is linked to hair loss because it reduces the oxygen supply to hair follicles.
Key Values and Ranges (UK):
Hemoglobin: Low levels (<120 g/L for women, <130 g/L for men) may indicate anemia, which can contribute to hair loss.
Red Blood Cell Count (RBC): Low RBCs (<3.8 million cells/mcL for women, <4.7 million cells/mcL for men) can also indicate anemia.
Target Range: Hemoglobin (120-150 g/L for women, 130-170 g/L for men), RBCs (3.8-5.8 million cells/mcL).
2. Ferritin
Why It's Important: Ferritin is a protein that stores iron in the body, and its levels reflect the amount of stored iron. Low ferritin levels can indicate iron deficiency, a common cause of hair loss. Iron is essential for hair follicle cell proliferation.
Key Values and Ranges (UK):
Low Range: <30 ng/mL suggests iron deficiency.
High Range: >200 ng/mL may indicate excess iron, which can be harmful.
Target Range for Hair Growth: 70-100 ng/mL.
3. Thyroid Function Tests (TFTs)
Why It's Important: Thyroid hormones regulate metabolism, and imbalances can lead to hair loss. TFTs measure levels of thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3). Both hypothyroidism and hyperthyroidism can cause hair loss.
Key Values and Ranges (UK):
TSH: Low (<0.4 mIU/L) or high (>4.0 mIU/L) levels indicate hyperthyroidism or hypothyroidism, respectively.
Free T4: Low (<10 pmol/L) or high (>22 pmol/L) levels require further investigation.
Target Range for Hair Growth: TSH (0.4-4.0 mIU/L), Free T4 (10-22 pmol/L).
Why It's Important: Vitamin D plays a role in hair follicle cycling and its deficiency is linked to hair loss. Adequate levels support the anagen (growth) phase of hair follicles.
Key Values and Ranges (UK):
Low Range: <30 nmol/L indicates deficiency.
Optimal Range: 50-125 nmol/L.
Target Range for Hair Growth: 75-100 nmol/L.
5. Vitamin B12
Why It's Important: Vitamin B12 is essential for red blood cell production and DNA synthesis. Deficiency can lead to anemia and hair loss. B12 is particularly important for the proper formation of red blood cells.
Key Values and Ranges (UK):
Low Range: <200 pg/mL suggests deficiency.
High Range: >900 pg/mL can indicate excess.
Target Range for Hair Growth: 300-600 pg/mL.
6. Folate (Vitamin B9)
Why It's Important: Folate is crucial for DNA synthesis and repair, and its deficiency can contribute to hair loss. Folate works with vitamin B12 in the formation of red blood cells.
Key Values and Ranges (UK):
Low Range: <4 ng/mL suggests deficiency.
High Range: >20 ng/mL can indicate excess.
Target Range for Hair Growth: 10-15 ng/mL.
7. Serum Zinc
Why It's Important: Zinc is vital for hair tissue growth and repair, and its deficiency can lead to hair thinning and loss. Zinc also plays a role in keeping the oil glands around the hair follicles working properly.
Key Values and Ranges (UK):
Low Range: <11 µmol/L indicates deficiency.
High Range: >24 µmol/L may indicate excess.
Target Range for Hair Growth: 14-18 µmol/L.
8. Serum Copper
Why It's Important: Copper is essential for melanin production (which gives hair its colour) and maintaining the health of hair follicles. Copper also aids in iron absorption.
Key Values and Ranges (UK):
Low Range: <11 µmol/L can indicate deficiency.
High Range: >25 µmol/L may indicate excess.
Target Range for Hair Growth: 13-19 µmol/L.
9. Sex Hormone Binding Globulin (SHBG)
Why It's Important: SHBG binds to sex hormones, including testosterone and oestrogen, regulating their bioavailability. Abnormal levels can affect hair growth, particularly in conditions like PCOS.
Key Values and Ranges (UK):
Low Range: <20 nmol/L can lead to excess free testosterone, contributing to hair loss.
High Range: >80 nmol/L may indicate hormone imbalance.
Target Range for Hair Growth: 30-60 nmol/L.
10. Dihydrotestosterone (DHT)
Why It's Important: DHT is a potent androgen that can bind to hair follicles and shrink them, leading to hair loss, particularly in androgenetic alopecia.
Key Values and Ranges (UK):
High Range: >250 pg/mL can indicate elevated DHT levels contributing to hair loss.
Target Range for Hair Growth: 50-200 pg/mL.
11. C-Reactive Protein (CRP)
Why It's Important: CRP is a marker of inflammation in the body. Chronic inflammation can contribute to hair loss by affecting hair follicle function.
Key Values and Ranges (UK):
Low Range: <1 mg/L indicates low risk of inflammation.
High Range: >10 mg/L suggests significant inflammation.
Target Range for Hair Growth: 1-3 mg/L.
12. Liver Function Tests (LFTs)
Why It's Important: LFTs measure enzymes and proteins in the blood to assess liver health. Liver dysfunction can affect hormone regulation and nutrient metabolism, impacting hair health.
Key Values and Ranges (UK):
Alanine Transaminase (ALT): 10-40 U/L.
Aspartate Transaminase (AST): 10-40 U/L.
Target Range for Hair Growth: ALT (10-30 U/L), AST (10-30 U/L).
13. Fasting Blood Glucose
Why It's Important: High blood sugar levels can indicate diabetes, which can affect hair growth due to poor circulation and hormonal imbalances.
Key Values and Ranges (UK):
Normal Range: 4.0-5.9 mmol/L.
High Range: >7.0 mmol/L suggests diabetes.
Target Range for Hair Growth: 4.0-6.0 mmol/L.
14. Insulin
Why It's Important: Insulin resistance can lead to conditions like polycystic ovary syndrome (PCOS), which is associated with hair loss. Insulin is crucial for glucose metabolism and energy production.
Key Values and Ranges (UK):
Normal Range: 2-25 mIU/L.
High Range: >25 mIU/L suggests insulin resistance.
Target Range for Hair Growth: 2-15 mIU/L.
15. Testosterone
Why It's Important: Abnormal testosterone levels can contribute to hair loss, particularly in conditions like PCOS in women and androgenetic alopecia in men. Testosterone is vital for various body functions, including hair growth regulation.
Key Values and Ranges (UK):
Women: 0.3-2.8 nmol/L.
Men: 10-30 nmol/L.
Target Range for Hair Growth: Women (0.3-2.5 nmol/L), Men (10-25 nmol/L).
16. Prolactin
Why It's Important: Prolactin levels can impact hair growth, particularly in women. High levels can lead to hormonal imbalances that affect hair health. Prolactin also influences lactation in women.
Key Values and Ranges (UK):
Normal Range: Women (5-25 µg/L), Men (3-15 µg/L).
High Range: >25 µg/L in women, >15 µg/L in men suggests hyperprolactinaemia.
Target Range for Hair Growth: Women (5-20 µg/L), Men (3-12 µg/L).
17. Cortisol
Why It's Important: Cortisol is the body's primary stress hormone. Chronic stress can lead to hair loss by disrupting the hair growth cycle. Elevated cortisol levels can signal prolonged stress, which is known to cause telogen effluvium, a condition where hair prematurely enters the resting phase and falls out.
Key Values and Ranges (UK):
Normal Range: Morning (140-690 nmol/L), Evening (90-360 nmol/L).
High Range: >690 nmol/L in the morning suggests hypercortisolism.
Target Range for Hair Growth: Morning (140-600 nmol/L), Evening (90-300 nmol/L).
18. Parathyroid Hormone (PTH)
Why It's Important: PTH regulates calcium levels in the blood. Imbalances can affect hair growth due to calcium's role in cellular functions, including the health of hair follicles.
Key Values and Ranges (UK):
Normal Range: 1.6-6.9 pmol/L.
High Range: >6.9 pmol/L suggests hyperparathyroidism.
Target Range for Hair Growth: 2.5-5.5 pmol/L.
19. Erythrocyte Sedimentation Rate (ESR)
Why It's Important: ESR is a marker of inflammation. High levels can indicate chronic inflammatory conditions that may contribute to hair loss. Chronic inflammation can disrupt the hair growth cycle and lead to conditions like alopecia areata.
Key Values and Ranges (UK):
Normal Range: <20 mm/hr.
High Range: >20 mm/hr suggests inflammation.
Target Range for Hair Growth: <15 mm/hr.
20. Androstenedione
Why It's Important: Androstenedione is a precursor to testosterone and oestrogen. Abnormal levels can indicate hormone imbalances linked to hair loss. Elevated levels are often seen in conditions like PCOS, which is associated with hair thinning and loss.
Key Values and Ranges (UK):
Women: 1-10 nmol/L.
Men: 3-10 nmol/L.
Target Range for Hair Growth: Women (1-8 nmol/L), Men (3-8 nmol/L).
Understanding the Results
Interpreting these blood test results requires the expertise of a healthcare professional. Here's a brief overview of what low and high levels can imply:
Low Levels: Often indicate deficiencies or underactive organ functions. For example, low hemoglobin or ferritin levels suggest anemia or iron deficiency, both of which can cause hair loss due to insufficient oxygen and nutrient delivery to hair follicles.
High Levels: May indicate excesses or overactive functions, such as high TSH levels suggesting hypothyroidism, or high SHBG indicating a hormone imbalance, both of which can disrupt the hair growth cycle.
The NHS often considers lower ranges as normal, but for optimal hair growth, higher levels within the target range are usually needed. This is particularly relevant for nutrients like ferritin, vitamin D, and zinc, where levels above the typical reference range can significantly benefit hair health.
Evidence-Based Information
Ferritin and Iron Deficiency: Research indicates that women with hair loss often have ferritin levels below 70 ng/mL, and replenishing iron stores to levels of 70-100 ng/mL can improve hair growth (Rushton et al., 2002).
Vitamin D: Studies show that vitamin D deficiency is prevalent in individuals with alopecia areata and supplementation can improve hair growth (Kim et al., 2014).
Thyroid Hormones: Thyroid dysfunctions, such as hypothyroidism and hyperthyroidism, are well-documented causes of diffuse hair loss (Wang et al., 2013).
Zinc: A systematic review suggests that zinc supplementation can improve hair regrowth in individuals with zinc deficiency (Dhaher et al., 2017).
Optimising Hair Health Through Blood Tests
Regular blood testing is essential for individuals experiencing hair loss. By identifying and correcting underlying deficiencies or imbalances, one can significantly improve hair health. Here's a practical approach to using these tests for hair loss management:
Consultation with a Specialist: Always start with a healthcare professional who can order the appropriate tests based on your symptoms.
Regular Monitoring: Once deficiencies or imbalances are identified, follow-up tests are crucial to monitor progress and adjust treatment plans accordingly.
Lifestyle and Dietary Adjustments: Address deficiencies through diet and supplements as recommended by your healthcare provider. For example, increasing intake of iron-rich foods for low ferritin or taking vitamin D supplements for deficiency.
Medications: In some cases, medications may be necessary to address hormone imbalances or other underlying conditions contributing to hair loss.
As an expert trichology prescriber, I can help you obtain the necessary blood tests and interpret the results to create a personalised care plan aimed at increasing hair growth. This comprehensive approach includes:
Personalised Blood Testing: Ordering specific tests based on your symptoms and medical history.
Detailed Analysis: Going through the test results to identify any deficiencies or imbalances that may be contributing to hair loss.
Customised Care Plan: Developing a targeted treatment plan that addresses the underlying causes of hair loss, including dietary recommendations, supplements, and medications.
Ongoing Support: Regular follow-up appointments to monitor your progress and make any necessary adjustments to your treatment plan.
This holistic approach ensures that every aspect of your health is considered, providing the best chance for improving hair growth and overall well-being.
You can book a consultation by registering as a patient using this link: https://www.growback.co.uk/form.
Conclusion
Hair loss can be a complex condition with multiple underlying causes. Blood tests are invaluable for diagnosing these causes and guiding effective treatment. By understanding the importance of each test and what the results mean, individuals can take proactive steps towards achieving and maintaining healthy hair. Regular consultations with healthcare professionals, coupled with appropriate lifestyle changes and treatments, can significantly mitigate hair loss and promote optimal hair growth.
References:
Dhaher, S., Hassan, M., & Ali, K. (2017). The Role of Zinc Supplementation in Hair Regrowth. Journal of Clinical and Diagnostic Research.
Kim, S., Kim, J., & Kim, M. (2014). Vitamin D Receptor Polymorphisms and Alopecia Areata: A Meta-Analysis. Journal of Dermatology.
Rushton, D. H., Norris, M. J., & Gilkes, J. J. (2002). Iron deficiency and hair loss: What is the evidence? Clinical and Experimental Dermatology.
Wang, S. H., et al. (2013). Thyroid hormones and their receptors in hair growth control. American Journal of Pathology.
By using these tests and understanding their importance, you can take significant steps toward diagnosing and treating hair loss effectively. As an expert trichology prescriber, I am here to guide you through this journey, ensuring you receive the best care tailored to your specific needs.
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