A study investigating the role of vitamin D in female hair loss showed a direct correlation with the levels of vitamin D and hair loss. Whilst vitamin D deficiency is classed at a value below 25 nmol/L, the study revealed that all the participants that took part in the hair loss group had levels of vitamin D below 75 nmol/L. The blood vitamin D2 level in cases of thinning hair and excess shedding ranged from 11.5 to 74.4 nmol/l with an average of 28.8 nmol/l, while in female pattern hair loss cases, it ranged from 12.7 to 62 nmol/L with an average of 29.1 nmol/L .
A separate study found vitamin D levels were lower in women with alopecia areata. The concentrations of vitamin D were found to be below 50 nmol/L in 85% of patients with alopecia areata. There was no correlation with the levels of vitamin D and various clinical parameters, including extent of the hair loss patch, disease duration, number of patches, and nail involvement . Low levels of vitamin D also correlate to low levels of zinc. As zinc is a major indicator of haemoglobin, a complete CBC and zinc panel are recommended. Low vitamin D also correlates with high level of hepcidin (iron inhibitory hormone).
What to do: If your vitamin D levels are below 75 nmol/L, you can supplement with vitamin D, until it is within the desired range. Request a CBC and zinc panel from your doctor or trichologist.
Ferritin is a blood protein that binds iron, essentially holding this highly reactive ion in storage. A ferritin test evaluates how much iron you have in storage and high or low results may, or may not, be cause for concern. In normal circumstances, ferritin levels are a sensitive and accurate marker for iron status, but ferritin is an acute phase reactant that is elevated in response to inflammation, complicating the diagnosis.
In simpler terms, if there are other factors present, such as chronic inflammation, infections or autoimmune disorders, the ferritin test result will be unreliable and will not give an accurate reflection of iron stores. Even moderate exercise caused an increase in plasma ferritin concentration, with the increase being greater as the intensity and duration of exercise increased. This makes ferritin an unreliable biomarker for hair loss.
What to do: When investigating iron status, also look at serum iron and total iron binding capacity, and transferrin saturation.
When we’re stressed, or have irregular eating patterns or a lack of quality sleep, our adrenal glands produce a hormone called cortisol, and then the cortisone signals our hair follicles to shift from the growth phase, and into resting phase: meaning this hair will shed prematurely.
High levels of cortisol in the body can also be a reaction to uncontrolled inflammation within the body. To assess cortisol levels, often a saliva test or blood test is taken in the morning to assess whether cortisol is within the normal range: cortisol is always higher in the morning. What is vitally missing with this kind of test is a follow up throughout the day to check that cortisol levels drop as they are expected to.
What to do: Get a 12-hour cortisol test that lets you collect saliva samples throughout the day, giving you an accurate representation of your cortisol levels.
THE FINAL WORD
Blood tests are often offered to patients with hair loss and an overwhelming majority come back with inconclusive results. With little in the way of definitive serum ranges and an inconsistency in patient findings, it is clear that blood tests are not very sensitive in the diagnosing hair loss and offer little prognostic value.