Common Screening Conditions Hair Growth Disorders ( loss & overgrowth )

WHAT IS

As hair growth disorders are considered:

• poor quality – loss of scalp
• male alopecia
• intense hair growth in hands, face, abdomen, legs in women – children

INDICATIONS – IMPORTANCE

Poor quality – Hair loss often comes from:

• Lack of trace elements (eating disorders – malabsorption – increased losses)
• Systemic diseases (autoimmune, chronic inflammation etc.)
• Thyroid disorders
• Genital factors
• Strong psychological issues

In male alopecia, the loss may come from:

• The common reasons of poor quality – loss as mentioned above
• Hormonal disorder

In women and children, unexpected intense hair growth, especially in places where hair is not expected, is a sign of hormonal disturbance.

LABORATORY TETS

A. Low quality hair (nail and skin) or loss 

Laboratory testing identifies potential chronic – systemic deseases, deficiencies in trace elements – vitamins, or thyroid disorders :

Basic Check Up

It is checked that there is no systemic disease that may be involved in low hair quality.

Iron (Fe) , and iron stores with ferritin (Ferr)

In cases of iron deficiency (dietary insufficiency, loss of appetite, loss) the hair thins, breaks, falls.

The vitamins  folic acid and B12 (Vit B12)

Possible vitamin deficiency, degrades the quality of hair.

Zinc (Zn)

Necessary trace element in healthy hair composition and hair maintenance.

freeT4 (free thyroxine) and TSH (thyroid hormone) ,

These are the basic tests for thyroid function and to rule out possible hyperthyroidism or hypothyroidism that potentially affect hair quality. 

Optional Check in case of loss   

If low levels of folic acid, vitamin B12, zinc are found, additional tests in vitamin A control, vitamin C and vitamin E could be useful in assessing dietary supplements that should be given to enhance hair growth.

B. In male alopecia

Additional tests of a possible hormonal disorder includes measurements of the androgens:

• Testosterone / Free Testosterone
• Dihydrotestosterone with DHT

C. Increased hair growth in children – women 

The hormonal profile is assessed with particular emphasis on the ratio of androgens to estrogens:

• LH (luteinizing hormone) / FSH (follicle stimulating hormone) 
• Testo (Testosterone) Main androgen
• DHEA-S (dehydroepiandroster  sulfate) Secondary androgen
• D4-Epiandrostenedione Secondary androgen
• SHBG Foesdesmethylic protein
• E2 (estradiol) Main estrogen
• PRL (prolactin)

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Information selected from :

•  MayoClinic.org
• Labtestsonline.org
• Interpretation of Diagnostic Tests – J.Wallach

The exact choice of tests required is under the responsibility of your treating physician

Editor: I. Gratsias  Lab Director / Clinical Biochemist

Last Update May 2019