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Blood Tests to Have Done First for Diagnosing Hair Loss Causes

These are simple blood tests that you should have done if you think that your hair loss may be caused by a chemical deficiencyIt’s easy to get lost in the maze of tests and blood panels that your doctor should require to diagnose the cause of your hair loss. Here is a complete list of blood tests to talk to your physician or dermatologist about at the beginning of your hair loss journey, along with it’s corresponding recommended normal range/level.

Many dermatologists will recommend Rogaine (minoxidil) immediately without spending time reviewing bloodwork and ordering blood panels. It’s okay to remain assertive with your doctor and request a full series of blood tests to rule out any underlying conditions that could be causing your hair loss. Often times, a simple hormonal imbalance or vitamin deficiency can be discovered early with a blood test and you will be well on your way to restoring your hair.

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Vitamin Deficiency:

Simple blood tests to be ordered if you think your hair loss may be caused by a lack of nutrients in your diet.

CBC:
This test will show if you are anemic. Even mild anemia can often cause hair shedding. Look for lower than norm values for Red Cell Count, Hemoglobin.

RBC (Red Blood Count): normal levels: 4.2 to 5.4 mil cell/mcL
WBC (White Blood Count): normal levels: 4500 to 10000 cells/mcL
Hematocrit: normal levels: 36.1 to 44.3%
Hemoglobin: normal levels: 12.1 to 15.1 gm/dl
MCV: normal levels: 80 to 95 femtoliter
MCH: normal levels: 27 to 31 pg/cell
MCHC: normal levels: 32 to 36 gm/dL

Vitamin B12 and B6:
The lack of these vitamins can cause hairloss.
B6: optimum level: 2 to 26 ng/ml
B12: optimum level: 200 to 900 pg/ml

Zinc:
The lack of zinc is a known cause of hairloss. Be careful though, too much of zinc could cause hairloss as well. 😕

Iron:
Serum Iron: optimum level: 60 to 170 mcg/dl
Serum Ferritin: optimum level: 12 to 150 ng/ml
TIBC (Total Iron Binding Capacity): optimum level: 240 to 450 mcg/dl

A lot of hairloss specialists believe that one needs a level of ferritin higher than 40 in order to maintain hair and ferritin above 70 to regrow lost hair. There’s also a lot of opposing points of view, however in general it’s probably a good idea to get your ferritin stores at a proper level. One thing to notice is that TIBC above the norm (above 400) means the lack of iron in the iron stores. TIBC above 400 often corresponds to lower serum ferritin numbers. As ferritin increases, TIBC should drop.

ESR:
ESR: optimum level: >20mm/hr
There’s an article stating that if your ESR is less than 10 you need to considerably increase your serum ferritin level to stop/reverse hairloss.

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Electrolyte Panel:

Blood tests that you should have done prior to and during the administration of anti-androgenic medications such as spirolactone. These tests can also aid in diagnosing adrenal problems.

Sodium: normal levels: 15 to 250 mEq/L/day
Chloride: normal levels: 20 to 25 mEq/day
Potassium: normal levels: 25 to 120 mEq/L/day
CO2: normal levels: 20 to 29 mEq/L

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Thyroid Panel:

Rapid hair loss can be the worst symptom of a thyroid problem

Your thyroid gland is one of the largest endocrine glands in your body. [Image courtesy of SutterHealth.org]

Blood tests that are recommended to diagnose hyperthyroid, hypothyroid and other thyroid related problems.
TSH and T3/T4:
Thyroid conditions often cause hairloss as well. The best TSH value is between 1 and 2. Values above 3 are still considered normal by many labs (the upper level of normal is 5) however it usually indicates an overactive thyroid and should prompt for future evaluation.

TSH (Thyroid Stimulating Hormone): optimum level: .3 to 3.0 mlU/L
** if you are on thyroid medication already, your optimum level SHOULD be between .5 and 2.0 mlU/L
Total T3: optimum level: 100 to 200 ng/dL
Free T3: optimum level: 2.3 to 4.2
Total T4 (Total Thyroxin): optimum level: 4.5 to 12.5 mcg/dL
Free T4 (Free Thyroxin): optimum level: .7 to 2.0

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Auto Immune Testing:

These tests can also aid your physician in giving you a definitive answer as to what is causing your hair loss. They show the possibility of lupus, hashimoto’s, sjoren’s, alopecia areata and other autoimmune disorders.

ANA and Anti-DNA

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Adrenal Function Panel:

These are tests you should have done to rule out adrenal deficiencies which can cause hair loss as well as fatigue, joint and scalp pain.

Cortisol AM:
Cortisol is a stress hormone. Even though there’s no direct link to hairloss, a high cortisol value means the body is under a lot of stress and the adrenal gland is working overtime. This situation shows the ‘fight or flight’ reaction of the body as a result of which a lot of hormonal functions are interrupted. Stress significantly decreases the benefits of ALL the hormones. Moreover, high cortisol values can indicate a possibility of
adrenal tumor.

Cortisol: normal 8am levels: 6 to 23 mcg/dl

Serotonin:
Serotonin: normal levels: 101 to 283 ng/ml

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Hormone Panel:

Visit our online discussion forum to read more topics on hormone imbalances and how it affects hair loss in womenThese are ESSENTIAL blood tests to have done if you believe that you may be experiencing hair loss due to hormonal imbalances.

Estradiol:
For premenopausal woman the lowest estradiol value should be shown on the test taken on the 3rd day of her cycle (the week of her period). Values between 80-90 are preferable, values below 50 show estrogen deficiency. For the rest of the cycle the optimal range is 100-200 (closer to 200 the better). Younger women can produce significantly higher levels of this hormone.

Estradiol: normal levels:
**** Premenopause: 20 to 400 pg/ml
**** Postmenopause: 5 to 25 pg/ml

Total Testosterone:
If the value is above 50, it could potentially cause the situation of adrogen sensitivity, but the more important number is the one for free testosterone.

Total Testosterone: normal levels: 20 to 80 ng/dl

SHBG (Sex Hormone Binding Globulin):
Values around 90 are desirable. Values above 100 are considered too high. High values of SHBG decrease the availability of all the hormones in the body. Higher levels of estradiol are needed to raise SHBG.

Luteinizing Hormone (LH):
Luteininzing Hormone: normal levels: 5 to 20 IU/L

Prolactin:
Prolactin: normal levels: 0 to 20 ng/ml

Free Testosterone:
Values above 1-1.5 are considered on the higher end of normal range. Values closer to 0.5-0.6 are more desirable. Free Testosterone is the result of Total Testosterone divided by SHBG.

Progesterone:
Value above 5 means that woman is ovulating.

Progesterone: normal levels:
**** Pre-ovulation: >1 ng/ml
**** Midcycle: 5 to 20 ng/ml
**** Postmenopausal: >1 ng/ml

Follicle Stimulating Hormone (FSH):
Hormone that regulates production of female hormones. Levels above 15 indicate menopause. Levels of 3 and below usually indicate BCP use. Higher levels of FSH indicate decrease of estradiol production, while lower
levels indicate higher level of estradiol production.

FSH: normal levels:
**** Follicular: 3.5 to 12.5 IU/L
**** Midcycle: 4.7 to 21.5 IU/L
**** Postmenopausal: 25.8 to 134.8 IU/L

DHEA and DHEAS: Some doctors report finding that a high percentage of patients with autoimmune disorders are also deficient in DHEA, and should be tested.

DHEA: normal level for women by age:
18 to 29 years: 62 to 615 ug/dL
30 to 39 years: 52 to 400 ug/dL
40 to 49 years: 44 to 352 ug/dL
50 to 59 years: 39 to 183 ug/dL
60+ years: 11 to 150 ug/dL

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Illustration of glucose molecular structure

Diabetes is a common cause of hair loss due to the build-up of blood sugar in the body when it is not controlled.

Fasting Blood Glucose (also known as a Fasting Blood Sugar): Blood test done after fasting for 8 to 10 hours
Normal glucose tolerance: From 70 to 99 mg/dL (3.9 to 5.5 mmol/L)
Impaired fasting glucose (pre-diabetes): From 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
Diabetes: 126 mg/dL (7.0 mmol/L) and above on more than one testing occasion

Glucose Tolerance Test (OGTT or GTT): Blood test done two hours after a 75-gram glucose drink
[levels below are NOT for gestational diabetes GTT testing]
Normal glucose tolerance: Less than 140 mg/dL (7.8 mmol/L)
Impaired glucose tolerance (pre-diabetes): From 140 to 200 mg/dL (7.8 to 11.1 mmol/L)
Diabetes: Over 200 mg/dL (11.1 mmol/L) on more than one testing occasion

Fasting Insulin: normal levels: 5 to 20 mcU/mL

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Tests that your Dermatologist should do:

** Pull Test
** Scalp Biopsy

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“Personally, I think hair is overrated.”

Story from a woman who has alopecia universalis:

I’m 40 years old and have had alopecia for more than 20 years. Up until the last year, my hair would grow in spots. I decided last year I was tired of the wigs and showed the world my bald head with a little peach fuzz. I have since lost even the peach fuzz with no hair in sight. I hope they come up with a treatment that works, but if not, I have come to grips with the fact that I may never have a full head of hair again. Personally, I think hair is overrated.

Thank you for sharing your story!

Information on Telogen Effluvium & Tips on How to Deal with Hair Loss

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with telogen effluvium and other forms of hair lossTelogen effluvium (TE) is the second most common form of hair loss most dermatologists see. When a woman is actively shedding hair during an effluvium (meaning ‘outflow’), it can be exasperating, depressing, and scary.

Sometimes a TE shed, as our forum members frequently call their thinning hair loss, can last for months or even years. Occasionally, it will appear as if the shedding occurs along with your menstrual cycle (cyclical shedding). Women with TE never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. Whatever form of hair loss your telogen effluvium takes, it is fully reversible.

Things that can help minimize a telogen effluvium shed (or hair thinning):

  • Sometimes skipping a shampoo for a day will make it seem as though more hair comes out the next time you wash. Many of our forum members say it helps to shampoo your hair every day.
  • Use an apple cider vinegar hair rinse once per week.
  • Blot your hair dry with a towel instead of vigorously rubbing your hair.
  • Apply a light conditioning cream to your hair after towel drying to protect it from unnecessary breakage.

Things that can help boost volume and give the illusion of thick hair:

  • Visit a professional hair salon professional in your area and request a cut that will give your hair more bounce and move lightly (generally just below the chin and lightly touching the shoulders). Highlights and lowlights using foil can also give the illusion of thicker, fuller hair.
  • Use a gentle hair care product that has thickening properties. Some of our forum members’ favorites include: Tigi Bedhead Superstar Sulfate Free Thickening Line, WEN Lavender Conditioning Cleanser, WEN Sweet Almond Conditioning Cleanser, Aquage Sulfate Free Shampoos and Conditioners, and Aquage Thickening Style Gel.
  • Loosely piling your hair up on top of your head and then piecing random pieces of hair with a good hair texturizer makes thinning hair look healthy and thick.

Supplements
Supplements can be a controversial topic in matters of hair loss. Many women who have recovered from telogen effluvium agree that you should steer clear of unnecessary supplements unless you have had blood tests to diagnose any vitamin deficiencies that can contribute to your hair loss. For example, if you are iron deficient or anemic, you should take a doctor recommended amount of iron supplements. Iron deficiency is known to cause or aggravate hair loss.

It’s important to remember that one supplement that worked for one woman may not work for you. Our bodies are unique and unnecessary supplements and medicines may do more harm than good.

Video of Cosmetic Application on female alopecian

A female alopecian named Chrissy has her eyelashes and eyebrows done by a professional makeup artist.

Lists of Medication That Cause, Can Exacerbate, or Can Possibly Cause Hair Loss in Women

I’ve compiled a new listing of medications that are either known to cause hair loss OR attribute to the immature (anagen or telogen) loss of hair… the list is EXTENSIVE so I made it into a .pdf file for easier reading/printing. I was (once again) surprised by a few of the new additions.

I did NOT include BCPs or HRT on this listing because I’m actively working on a separate listing for these. I’m also planning on putting together another listing of ADs that are hair or “non”hair friendly since that comes up often as well…

Hope this helps!!
melanie

 

Click the image to view the full PDF file.

Click the image to view the full PDF file.

Ludwig Scale of Hair Loss for Women

courtesy of www.dermalogix.net

courtesy of www.dermalogix.net

Photo of AGA in younger woman

Photo image of young woman with diagnosis of androgenetic alopecia (female pattern baldness) courtesy of www.trichologists.org.uk

Photo image of young woman with diagnosis of androgenetic alopecia (female pattern baldness) courtesy of www.trichologists.org.uk

Photo image of middle aged woman with AGA

Photo image of middle aged woman with female pattern baldness.  Courtesy of www.trichologists.org.uk

Photo image of middle aged woman with female pattern baldness. Courtesy of www.trichologists.org.uk

Sharon Blynn: Beautiful Things {commercial}

Sharon Blynn of www.baldisbeautiful.org is a survivor of ovarian cancer. In this commercial for Bristol-Myers Squibb, she talks beautiful things. Sharon, you are beautiful!

melanie