5 CRUCIAL BLOOD TESTS THAT CAN COME BACK NORMAL WHEN ALL IS NOT WELL
(and what to do about it)
VITAMIN B12 | One of the eight B vitamins involved in the metabolism of absolutely every cell in your body. It used to be known as the “maturation factor” because all cells in the body require vitamin B12 to mature into fully functioning cells.
Early studies looking at the function of B12 showed that blood cells in the bone marrow that were initially deprived of vitamin B12 could mature within a few hours of exposure to B12. This explains why some patients feel rejuvenated within days of their first B12 injection .
B12 levels in the blood tend to fall late in deficiency, meaning the deficiency will be present for possibly months before it is reflected in the blood. In addition to this, new Chemiluminescence technologies measure total serum B12 although around 80% of B12 circulates in a biochemically inert form.
What to do: Testing for ‘active’ B12 rather than ‘total’ will give a clearer indication of available B12.
VITAMIN D | 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. 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 levels of hepcidin. Hepcidin inhibits uptake of iron contributing to anemia and iron deficiency.
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 | 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 levels will increase 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.
ZINC | An essential trace element derived from the diet, and one of the most studied minerals in relation to hair loss. Zinc is strictly regulated by the body and the concentration in the blood changes only slightly where there is insufficient zinc in the tissue in the body. Low zinc in the tissue causes changes to specific metabolic pathways that reduce the physiological need for zinc. The Triage theory predicts that essential proteins can resist low zinc for a longer period than non-essential proteins, like the proteins that make up the hair fibre.
Various studies show low zinc is a significant factor in alopecia areata via its role in immune regulation, androgenic alopecia via its role in reducing DHT, and in chronic telogen effluvium via its role in protein manufacture. Zinc levels fluctuate throughout the day, a fasting, morning blood test will give the most reliable result.
What to do: Get a blood test for zinc, if your zinc levels are lower than 85 µg/dl, it is likely that your zinc levels are contributing to your hair loss condition. Optimal blood zinc levels for hair growth are around 100 µg/dl.
CORTISOL | When we’re stressed, have irregular eating patterns or a lack of quality sleep, our adrenal glands produce a hormone called cortisol. Cortisol inhibits the action of growth signals on hair follicles causing a shift from growth phase into resting phase and premature shedding.
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.