Like so many things, it seems that fashions change for no apparent reason. One year it’s one look, the following it may be completely different. It’s similar with hair styles, but it goes beyond styling as far as hair is concerned. Theories also change, and so-called ‘Hair Tests’ are beginning to find a certain amount of acceptance again when I thought they had gone forever, never to return.
About twenty years ago there was huge trend towards hair tests because it seemed an exciting and new method. Hair clippings were sent away to a ‘specialist’ laboratory to have them analyzed for vitamins and minerals. It was thought that the results would give definitive information on the state of your health and your hair. The laboratory would send back a mind boggling list, via a computer analysis, showing all your deficiencies or excesses of minerals and vitamins, and on that basis recommend the necessary supplements to put you back on track to a healthier you–and healthier and better hair.
It all sounded extraordinarily magical, but I’m sorry to say it was hokum, and the press eventually exposed the method. Hair from the same person was sent to three different laboratories and three different results were received. It wasn’t necessarily that the analysis was wrong, but because each batch of clippings were taken from different sites and were of various lengths, the trace elements deposited on the hair or absorbed into it had to be different. In addition, traces of shampoo, conditioner, styling products and pollution, which are inevitably present, changed the results of the readings.
This is a method no longer used by respected professionals in the ‘hair world’ as far as I’m aware, but it is often used by nutritionists to analyze a person’s ills. Many people also go to nutritionists for hair advice, thinking that their hair problem could be related to their diet, which may often be the case. As a result, they are given rather absurd advice based on the received readings via the laboratory they send hair clippings to. They are then advised to take multiple supplements, most of which are irrelevant to their hair, to correct the perceived problem.
I am not criticizing all nutritionists–there are some good ones, particularly those with medical degrees. Dealing with hair, however, is more complicated than simply addressing nutrition, even though it may be a factor and even if the analysis was valid in the first place. I urge you to think carefully before embarking on these expensive (and certainly irrelevant) tests.
The only hair tests that mean anything are trichograms, which test the status of hair growth and what your hair is doing or how it is responding to a particular form of therapy. A trichogram is used in scientific research to measure the hair’s status to give a reasonably accurate profile. It counts the number of hairs per square centimetre, their lengths cut or uncut and their phase of growth. There are two methods: the plucking technique, whereby a small area of the scalp has all the hairs plucked and measured microscopically; and the phototrichogram, whereby an area is shaved and photographed at regular intervals to determine growth factors via counting the hairs.
We know from the plucked hair trichogram that, on average, males have more hairs than females per square centimetre–312 to 279, which works out at approximately 10 per cent more than females and means that men not only have more hairs on their head, but that each hair is thinner in texture. This result is quite surprising, as one would have assumed the opposite. By microscopically examining the hair and its root, we are able to see, at intervals, the differences in growth phases and the degree of diameter changes. This has shown us that the thinner the hair’s diameter, the shorter it grows, which may partly account for the fact that Oriental women, who have the coarsest hair, can grow their hair longer than any other ethnic group. It has also shown that hairs less than 40 microns in diameter rarely grow longer than 80mm (3 1/2 inches), as discussed in Chapters 8 and 22 on ‘Hair Loss’. Another point illustrated is that the hairs at the back of the head, towards the base of the scalp, have a smaller diameter than the hairs at the front of the head. The problem with the plucked unit area trichogram, as it’s called, is the trauma of the plucking, which needs to be done at regular intervals. Similarly, the phototrichogram, although less traumatic because the area of scalp is shaved rather than pulled out, still results in a temporarily bald area. Either of these methods may be used in the research of new drug effects by pharmaceutical companies, but they are not really necessary in everyday practice.
All these characteristics can be seen by an experienced eye without expensive trichograms or tests. The changes seen also give us an indication of metabolic disturbances, as previously discussed. However, although hair can be an early warning signal of internal body changes, it doesn’t tell us the whole story. Blood tests are needed to verify the exact cause of hair volume changes, sometimes together with a sonogram (an ultrasonic scanning device that provides a two-dimensional image and can give an indication of an internal problem such as polycystic ovaries) and other procedures. Looking at the hair can reveal a great deal, but eventually other tests may be necessary. The most important being blood tests.
The amount of information these can give is often crucial in the treatment of falling, thinning hair. My consultants, as well as myself, have a number of ‘blood profiles’ that we recommend in relevant cases. The tests are administered by a doctor who sends the blood drawn to a laboratory for analysis according to the profile we recommend. Alternatively, we send the client direct to the laboratory for the profile. Within a week or so, the doctor’s laboratory sends a copy of the results for our own analysis as to how they can effect the hair. A typical profile, and one we use most, looks at all iron levels, including ferritin (iron stores), red and white blood cells, zinc, vitamin B12, folic acid and thyroids. Sometimes we ask also for hormonal levels and full blood chemistries. The problem with hormone tests, i.e. oestrogens (female hormones) and androgens (male hormones), is that they may be within the normal reference range but still affect the hair. I have already discussed this to some extent in Chapter 8 on ‘Hair Loss in Women’. So much depends on the susceptibility of the hair follicles. For example, androgens. You don’t need to have excessive androgens to have the hair affected adversely. It is known that much female and male pattern thinning is ‘androgen dependent’, i.e. it depends on the presence of androgens. But arguably you can have a high level and they have no effect on somebody who doesn’t have genetically susceptible hair follicles. On the other hand, normal or even low normal levels can effect those more genetically sensitive. Similarly, readings in the normal reference range of thyroid, iron, ferritin, B12, folic acid, etc. effect some people’s hair follicles more than others.
Then there is the question of how to read blood test results. In many instances all the results may be in the normal reference range, and if you have asked your doctor to arrange the tests, he may well say that everything is normal–and don’t worry! But you do (and should) worry, because your hair is thinning and there are normals and normals, so to speak. There can be low normal, mid-normal and high normal. The highs and the lows can certainly be a culprit. Ferritin, which I have so often mentioned, may have a reference range of, say, 10–130. The results show a reading of 20 and your doctor may say, ‘There you are–it’s normal.’ However, for hair, it’s not. Optimum ferritin for hair is about 70. Anything considerably less can be problematical. Haemoglobin, by which anaemia is measured, has a reference range of 11.5–16.5. A ‘normal’ reading of 11.5 or even 12 can also result in hair growth interference.
Thyroid is another example of how low or high normals can effect hair. The thyroid can be very complicated, and those with hypo (low) or hyper (high) who are on medication can fluctuate, and this often causes sporadic hair fall. I discuss some of these in Chapter 15 on ‘Your Health and Your Hair’. I am reiterating this because of its importance, and to stress that you may need to point out to your doctor (which can be difficult) that ‘normals’ are not always what they seem.
Biochemistries are sometimes required. These measure various liver and kidney functions, proteins, cholesterol, triglycerides, potassium, sodium, etc., all of which can have an effect on hair.
Blood tests are best taken after a fast of twelve hours, ideally in the morning before 11 a.m., without having breakfast. Subsequent tests should be taken at approximately the same time and circumstances for accurate comparison as the hair condition improves, so that any supplements or medication can be adjusted.