Hair Mineral Test - Research

Iron and Hair Tissue Mineral Analysis

Iron deficiency anemia has been considered the major nutritional problem throughout the world. Anemia is a lack of the oxygen carrying red blood cells. Iron deficiency, however, can cause a host of other health problems since it is involved in many metabolic processes. In fact, iron deficiency without anemia is more prevalent than iron deficiency with anemia. Anemia accounts for only one-third of the problems caused by iron deficiency.

Infectious Anemia

During a bacterial infection, the body shifts iron from the blood into storage compartments such as bone, liver, spleen, and lymphatic tissues. This is a protective mechanism that makes the iron unavailable to the bacteria, which needs iron for its growth.

This action, however, prevents the body from incorporating iron into the red blood cells. If the infection becomes chronic, it can create a type of anemia called "infectious anemia". This type of anemia will not respond to iron therapy until the infection is brought under control, then the iron can be reutilised once more. Chronic infectious anemia can be spotted as an elevated iron to copper ratio on the hair tissue mineral analysis (HTMA) study. Many times the infection can be present for years. The most common type of infection of this nature is dental abscess.

Sequestering of iron into storage tissue also occurs in other conditions, such as rheumatoid arthritis, diabetes, and some types of malignancies. These conditions are known to cause anemia, even though tissue concentrations of iron are more than adequate. It has been found in patients with rheumatoid arthritis, iron can accumulate not only in soft tissues, but within joint as well. The pancreas can accumulate iron to the point that normal insulin activity becomes impaired, and diabetes ensues. People frequently develop this condition following a serious bacterial infection.

Iron deficiency is known to weaken the immune system, making the body more susceptible to infections. The decreased immunity is probably due to other accompanying nutritional deficiencies. It is found in individuals suffering from chronic candidiasis and recurring herpes viral infections.

Iron and Mental Function

Early studies have reported a correlation between haemoglobin levels and intellectual performance in teenagers. Other studies have confirmed these findings in adults as well as children. A lack of iron can lead to a shortened attention span, a reduction in cognitive functions, minimal brain dysfunction, and hyperactivity.

Flaws in the metabolic pathways that require iron can cause disturbances in mental function. Some of these defects are simply due to the effects of too little oxygen reaching the brain. Other disturbances can be due to DNA abnormalities. Since the synthesis of DNA requires iron. A deficiency of iron can impair neuronal development. Iron is also necessary for the activation of enzymes involved in brain neurotransmitters.

Our laboratory researches have revealed that individuals with increased tissue iron levels are intellectually oriented. Their intellectual aptitude indicates left brain dominance. Not surprisingly, EEG studies of iron deficient patients confirm increased left hemisphere activity. It has also been observed that too much tissue iron accumulated may lead to aggressive behaviour, as well as hostility and hyperactivity.

Symptoms Associated with Iron Deficiency

  • Anemia Hair Loss
  • Brittle Hair Inflammation of the Tissues of the Mouth
  • Difficulty Swallowing Nervousness
  • Digestive Disturbances Obesity
  • Dizziness Pallor
  • Fatigue Slowed mental Reactions

Symptoms Associated with Iron Overload

  • Cirrhosis Hypertension
  • Diabetes Hyperactivity
  • Rheumatoid Arthritis Hepatitis (Bacterial)
  • Allergies (histamine) Chronic Infections (Bacterial)
  • Migraines Emotional Disturbance

Dexter et al. reported their findings of autopsied brain tissue from individuals who died with Parkinson Disease and a control group who had no history of neurological disease before death. Their results revealed a 35% increase of iron in the substantia nigra of the parkinsonian brain as compared to the controls. The copper was reduced by 34%. They found that lipid peroxidation was increased in the parkinsonian nigral tissue, adversely affecting dopamine-containing cells. Since excess iron promotes lipid peroxidation and copper inhibits it, an imbalance of Fe/Cu may play a role not only in Parkinson Disease but other neurological diseases as well.

Iron Assessment: Blood or Tissue

Alpers et al. have indicated the inherent instability of serum iron, which fluctuates as much as 30% in the same person daily. Statland and Winkel reported a considerable variation of serum iron levels in blood samples taken from the same patient at the same time each day. Due to a normal diurnal variation, morning values can be as much as 30% higher than evening values. This rhythm is reversed in night workers. Sleep deprivation can produce as much as a 50% reduction in serum iron levels. Serum levels of iron are also known to fluctuate with the menstrual cycle and oral contraceptive (OCA) use. Iron levels decreases just prior to menstruation and elevated during OCA use.
Due to the normal and induced variation in serum iron concentrations, single iron determinations should be interpreted cautiously when assessing iron deficiency or iron overload.

HTMA has a unique advantage over serum in that it has the potential for detecting a tendency toward iron imbalance, either a deficiency or overload, before serum changes can be detected. HTMA studies are not subject to the normal diurnal variations found in serum. Since iron deficiency can exist without anemia (sideropenia) and has been reported to be 2 to 3 times more predominant than iron deficiency anemia, HTMA may serve as an appropriate screening tool for iron status.

HTMA iron levels should also be interpreted carefully. Sample variations and possible exogenous contamination should be considered when interpreting HTMA results. Our laboratory has established the ideal tissue iron level at 2.8mg%. However, tissue iron status should not be interpreted by the iron level alone, but more importantly in relationship with other minerals and, of course, in conjunction with serum test results and clinical findings.

Ideal Ratios

Ca/Fe = 15mg% to 1
Fe/Cu = 1.12 mg % to 1
Fe/Pb = >5.6 mg% to 1
Fe/Hg = >28 mg% to 1

* Significant changes in these ratios (elevated Ca/Fe, lowered Fe/Cu, Fe/Pb, and Fe/Hg) can indicate the tendency toward iron deficiency, since each metals is known to interfere with iron absorption or the metabolic processes that require iron. Using the tissue iron level in conjunction with copper and calcium (low Ca/Fe and elevated Fe/Cu) can also assess iron overload.

Other routine serum indications that may be used in conjunction with TMA studies include total iron-binding capacity (TIBC), percentage saturation of transferrin, hematocit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). These serum changes usually only manifest when iron storage is becoming depleted. They are also subject to a number of variations such as altitude, physiological status, age, and sex.

Case study:

An interesting case study related to iron was reported by one of our clients, Robert A. Rosen, M.D. An elderly patient blood test showed a pattern of iron overload suggested a possibility of hemochromatosis. However, the hair TMA pattern revealed a low tissue iron. Dr. Rosen stated, "it was not clear to me then how to reconcile these conflicting reports." The patient was diabetic and eventually began dialysis. At this time she had anemia and was started on erythopoietin. Her serum iron levels then fell as her hematocrit increased. She was then found to have a low iron and had to be given iron. Dr. Rosen then concluded, "it would appear that the hair analysis accurately reflected the backup in the blood. Not because of whole body overload, but because of inadequate tissue utilisation."

As we know, many minerals are maintained in circulation at the expense of tissue storage. Much more research in this area is needed, particularly related to iron status.

Hair Iron Content: a marker for other health conditions

Bisse et al., reported "Hair iron content: possible marker to complement monitoring therapy of iron deficiency in patients with chronic inflammatory bowel diseases." In this study, measurements of the concentrations of iron in hair from 10 patients with chronic inflammatory bowel diseases and from 10 healthy controls showed that the iron concentrations were significantly (p<0.05) lower in patients before iron intake than in controls. Three weeks after beginning iron treatment, the hair iron concentrations were found to be significantly correlated (r = 0.68; p <0.05) to reticulocyte counts.

Changes in the hair iron concentrations were accompanied by similar changes in the concentrations of the markers most commonly used to diagnose and monitor iron deficiency. Wang et al. has also reported that the hair iron concentration of patients with blackfoot disease decreased as the clinical stage processed. Both of their data suggest that hair iron concentration may provide short-term index as well as long term record of body iron status and may thus be useful for monitoring the course of the iron deficiency. In addition, because iron metabolism is regulated by the amount of iron absorbed rather than by the amount excreted, hair iron could be a useful complementary marker in the assessment of the body iron status.

FAQ : I heard that iron increases cancer risks. Should iron be given as a supplement?

It is true that excessive iron can contribute to certain forms of cancer. However, a deficiency may also contribute to susceptibility. The mechanism behind this effect might involve the iron-to-copper relationship. Excessive levels of iron will contribute to a deficiency of copper, which may result in decreased cellular respiration. Iron is also known to injure cells by contributing to lipid peroxide formation.

On the other hand, a deficiency of iron also result in decreased cellular respiration, thereby contributing to increased susceptibility toward malignancy as well. Over all, the majority of the population should not have to worry about getting too much iron. However, evaluation of individual iron requirements, as with any other mineral, would be recommended.

Red Wines and Migraine Headaches

Our laboratory research suggests that the mineral iron may be the migraine-provoking agent in red wines, as red or dark wines are a rich source of iron and alcohol is known to further enhance iron absorption. Excess iron accumulation increases lipid peroxidation, producing cell membrane damage and destruction of sulfhydryl groups (-SH). The -SH destruction results in an inhibition of the enzyme phenolsulphotransferase (PTS). Dexter and co-workers have reported the effects of increased iron/copper ratios causing lipid peroxidation in the brain.

Individuals who may be susceptible to iron-induced migraines are those with increased tissue iron accumulation or overload caused by an impaired re-utilisation of iron. This impairment is often found in individuals who have suffered from chronic or severe bacterial infections such as hepatitis, rheumatoid arthritis, and some malignancies. Copper Deficiency is frequently associated with these conditions as well.

Dr. David L. Watts, Director of Research


  1. Alpers DH, Clouse RE, Stenson WF: Manual of Nutritional Therapeutics. Little Brown and Co., Boston, 1983.
  2. Statland BE, Winkel P: Relational of Day-to-day Variation of Serum Iron Concentrations to Iron Binding Capacity in Healthy Young Women. Am. J. Clin. Pathol. 67, 1977.
  3. Watts DL: The Nutritional Relationships of Iron. Journal of Orthomolecular Medicine 3:3, 1988.
  4. Bisse E, Renner F, Submann S, Scholmerich J, Wieland H: Hair iron Content: Possible Marker to Complement Monitoring Therapy of Iron Deficiency in Patients with Chronic Inflammatory Bowel Diseases? Clinical Chemistry 42:8, 1996.
  5. Wang CT, Chang WT, Huang CW, Chou SS, Lin CT, Liau SJ, Wang RT: Studies on The Concentrations of Arsenic, Selenium, Copper, Zinc and Iron in the Hair of Blackfoot Disease Patients in Different Clinical Stages. Eur J Clin Chem Clin Biochem 32:107-11, 1994.
  6. Dexter DT, Wells FR, Agid Y, Less AJ, Jenner P, Marsen CD: Increased Nigral Iron Content in Post-mortem Parkinsonian Brain. Lancet ii, 1987.