HTMA Research

HTMA Research

There are many references supporting the use of hair tissue mineral analysis (HTMA)
in both clinical research and healthcare fields.

Several research programs for studying and establishing hair trace mineral concentrations have been implemented since 1965 by the International Atomic Energy Agency. These research programs have been coordinated under “Nuclear-based Methods for the Analysis of Pollutants in Human Hair.” Hair was chosen by the I.A.E.A. due to the concentration of minerals in the hair and its reflection of both external and internal contamination. The bulk of data on trace element concentrations has been reported from hair samples obtained from the scalp.

Ryabukhin, T.S.: International Coordinated Program on Activation Analysis of Trace Element Pollutants in Human Hair. Hair, Trace Elements, and Human Illness. Brown, A. C.; Crounse, R. G., ed. Praeger Publications, 1980.

“Bioassay of hair is attractive as it is an effective bio-concentrator, samples can be easily stored, the concentration reflects an integrated value, and, finally, the measurement of the (234)U/(238)U isotopic ratio in digested hair samples by MC-ICPMS is feasible and highly informative.”

Karpas Z, Lorber A, Sela H, Paz-Tal O, Hagag Y, Kurttio P, Salonen L., Measurement of the 234U/238U ratio by MC-ICPMS in drinking water, hair, nails, and urine as an indicator of uranium exposure source. Health Phys. 2005 Oct;89(4):315-21.

“Findings reported that individuals with normal serum testosterone levels had a significantly higher HTMA zinc level compared to a low testosterone group. Also, the study concluded that decreased testosterone was associated with a significant reduction of the zinc to copper ratio in hair samples.”

Hair Zinc and Copper Levels and Serum Testosterone Chang, CS, et al. Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue. Biol.Trac.Elem.Res. 144, 2011.

“Various mineral imbalances as revealed by hair analysis can indicate metabolic dysfunctions before any symptoms occur, and that hair analysis of minerals is used not only for diagnostic purpose but also to monitor the nutritional state of the patient until treatment benefits are achieved and the effects of the program have been stabilized.”

A Review of Hair Analysis for Minerals, Hormones and Drugs Ahmad, G. et al. A review Hair tissue Analysis: An analytical method for determining essential elements, toxic elements, hormones and drug use and abuse. Intl.Res.J.Appl.Basic Sci. 4, 2013.

“The value of exposure (kinetics and dose) of orthodontic patients to metal ions released from orthodontic appliances can be assessed by hair mineral analysis.”

Metal ions released from fixed orthodontic appliance affect hair mineral content. Mikulewicz M, Wołowiec P, Loster B, Chojnacka K. Biol Trace Elem Res. 2015 Feb;163(1-2):

“Human head hair is a recording filament that can reflect metabolic changes of many elements over long periods of time and thus furnish a print-out of post nutritional events.”

Strain, W. H.; Pories, W. J.; Flynn, A.; Hill, O. A.: Trace Element Nutriture and Metabolism Through Head Hair Analysis. Trace Substances in Environmental Health. Hemphill, D. D., ed. University of Missouri Press, Columbia, 1972.

It is well known that nutritional mineral deficiency can impair neurological development. Some transitional nutrients can cause later-life health disturbances when deficient in the diet, but in excess can be just as harmful and include iron, copper, manganese, zinc and others. Heavy metals such as lead, cadmium, mercury and arsenic are also neurotoxins and when present early in life can contribute to impaired neuro-development and detrimental health effects later in life and have been called the “fetal origins of disease.” Hair concentrations of cadmium compared to reference groups were found to be higher in children with mental retardation, learning disabilities, dyslexia and lower I.Q.

Metals and Neurotoxicology. Wright, RO, et al. J. Of Nutr. 138,12, 2007.

“Multivariate apportionment of trace elements in the blood, scalp hair and nails of the patients was also significantly different than that in the healthy donors.”

Comparative study of trace elements in blood, scalp hair and nails of prostate cancer patients in relation to healthy donors. Qayyum MA, Shah MH. Biol Trace Elem Res. 2014 Dec;162(1-3):46-57.

Hair, blood and urine minerals analyzed in diabetic patients compared to non-diabetic controls showed that the mean levels of zinc, manganese and chromium were significantly lower in the blood and scalp hair of patients diagnosed with diabetes. Higher levels of copper and iron were also found in the scalp hair of the diabetic group as well.

Copper, Chromium, Manganese, Iron, Nickel and Zinc Levels in Biological Samples of Diabetes Mellitus Patients. Kazi, TS, et al. Biol. Trace Elem. Res. 122,1, 2008.

“The consequence of trace elements deficiency has been associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) disease progression and mortality.”

Evaluation of chromium and manganese in biological samples (scalp hair, blood and urine) of tuberculosis and diarrhea male human immunodeficiency virus patients. Afridi HI, Kazi TG, Talpur FN, Arain S, Arain SS, Kazi N, Panhwar AH, Brahman KD. Clin Lab. 2014;60(8):1333-41.

“Statistical evaluation of these data by multivariant analysis (MANOVA) using a contrast matrix and by discriminant analysis showed that elemental hair anomalies can be used to diagnose correctly the above-mentioned pathologies, demonstrating the usefulness of hair analysis as a complementary tool for the detection of disturbances in calcium/bone metabolism.”

Miekeley, N., et al. Elemental Anomalies in Hair as Indicators of Endocrinologic Pathologies and Deficiencies in Calcium and Bone Metabolism., J. Trace Elem. Med. Biol. 15, 1, 2005

“The consensus of most workers in the field is that if hair samples are collected properly, cleaned and prepared for analysis correctly and analyzed by the best analytical methods, using standards and blanks as required, in a clean and reliable laboratory, by experienced personnel, the data are reliable.”

Toxic Trace Metals in Mammalian Hair and Nails. United States Environmental Protection Agency Publication 1979; EPA-600/4: 79: 049

“The high exposure of toxic elements may be synergistic with risk factors associated with hypertension. These data present guidance to clinicians and other professionals who will be investigating the toxicity of heavy elements in biological samples (scalp hair and blood) of hypertensive patients.”

Distribution of arsenic, cadmium, lead, and nickel levels in biological samples of Pakistani hypertensive patients and control subjects. Afridi HI, Kazi TG, Talpur FN, Arain S, Arain SS, Kazi N, Panhwar AH. Clin Lab. 2014;60(8):1309-18

“Higher values of scalp hair mercury and lead content were observed in men and women with increased body mass index independently of their age.”

Hair toxic element content in adult men and women in relation to body mass index. Skalnaya MG, Tinkov AA, Demidov VA, Serebryansky EP, Nikonorov AA, Skalny AV. Biol Trace Elem Res. 2014 Oct;161(1):13-9.

A study of men over a period of thirteen years found that for each microgram of mercury found in the hair, the risk of acute coronary events increased by an average of eleven percent and cardiovascular disease death rate by ten percent.

Mercury as a Risk Factor for Cardiovascular Disease. J. Nutr. Biochem. 18, 2007.

An example of how mineral intake is reflected in the hair was demonstrated in a study of several thousand Iraqi peasants, whose diet contained grain heavily treated with fungicides. The fungicides contained organic mercury, which was reflected in higher concentrations in the hair when consumption was highest and decreased when consumption was lowest. Hair concentrations correlated directly with the extent of symptoms.

Al-Shahristani, H.; Al-Haddad, I. K.: Mercury Content of Hair From Normal and Poisoned Persons. J Radioanalytical Chem 1973; 15.

Al-Shahristani, H.; Shihab, K. M.: Variation of Biological Half-Life of Methylmercury in Man. Arch Environ Health 1974; 28.

Hair samples collected and analyzed from five countries with known arsenic sources, both high and low included the United States, Canada, and People’s Republic of China, Bangladesh and Nepal. Hair arsenic concentration in all hair samples correlated with the amount of arsenic in drinking water and revealed the low intake of selenium in areas of high arsenic concentrations. “The results demonstrate the viability of hair as a noninvasive biomonitor in assessing aspects of dietary Se and environmental As exposure.”

Spallholz JE, Boylan LM, Palace V, Chen J, Smith L, Rahman MM, Robertson JD., Arsenic and Selenium in Human Hair; A comparison of Five Countries With and Without Arsenicosis., Biol Trace Elem Res. 2005 Aug;106(2):133-44.

“The proliferation of trace element analysis as a tool for biological investigation of nutrition, growth and development, and disease processes has led to consideration of (hair) trace element analysis as a means not only of present evaluation and estimation, but also as a technique for the reconstruction of past biological events in an organism.”

Gilbert, R. I.: Trace Elements in Human Hair and Bone. Hair, Trace Elements and Human Illness Brown, A.C.; Crounse, R. G. ed. Praeger Publications, 1980.

“The findings indicate that hair samples are superior to urine samples. Even so, it can provide more valuable information for prevention, diagnostics, treatment and research of diabetes by simultaneously analyzing the hair and urine samples.”

The diagnostics of diabetes mellitus based on ensemble modeling and hair/urine element level analysis. Chen H, Tan C, Lin Z, Wu T. Comput Biol Med. 2014 Jul;50:70-5.

This study was performed to establish a relationship between elements in the serum, red cells and hair and included one hundred and seventy-four children. Tests measured the concentrations of the heavy metals, cadmium and lead, as well as calcium, magnesium, copper, zinc and iron. Serum and red blood cell concentrations of cadmium and lead were within normal allowable levels, but hair levels exceeded maximum levels. Supplementation of magnesium and vitamin B6 was begun in children with elevated hair heavy metals. Follow-up tests showed a marked reduction in the lead and cadmium concentration in the hair and erythrocytes.

Concentrations of Selected Bioelements and Toxic Metals and Their Influence on Health Status of Children and Youth Residing in Szczecin. Kedzierska, E. Ann. Acad. Med. Stetin. 49, 2003.

“Hence, assessing the levels of trace elements in hair of male pattern androgenetic alopecia patients may be more valuable compared to serum and urine for treatment planning.”

BMI and levels of zinc, copper in hair, serum and urine of Turkish male patients with androgenetic alopecia. Ozturk P, Kurutas E, Ataseven A, Dokur N, Gumusalan Y, Gorur A, Tamer L, Inaloz S. J Trace Elem Med Biol. 2014 Jul;28(3):266-70.

“Results showed that Mongolian subjects particularly those with Parkinsonism and arthritis had high accumulation of manganese, iron, lead, cadmium and aluminum in the hair compared to the controls. It was reported that the urinary 8OHdG also correlated with the hair mineral results.”

Excess Hair Mineral Accumulation, Oxidative Stress And Parkinsonism Komatsu,F, et. al. A High Accumulation of Hair Minerals in Mongolian People: 2(nd) Report; Influence of Manganese, Iron, Lead, Cadmium and Aluminum to Oxidative Stress, Parkinsonism and Arthritis. Curr. Aging Sci. 1, 2011.

“The significance of hair analysis as a biological indicator of abnormal intake of trace elements in man is confirmed. Geographical variations of hair trace element concentrations, on the whole, depend on geochemical conditions or nutritional factors.”

Batzevich VA., Hair trace element analysis in human ecology studies., Sci Total Environ. 1995 Mar 15;164(2):89-98.

“They found a significant correlation between the hair calcium to magnesium ratio with HOMAIR and insulin. Their findings concluded that insulin resistance was increased along with increased hair calcium to magnesium ratio and decreased concentrations of hair chromium.”

Hair Mineral Concentrations and Insulin Resistance Chung, JH, Yum, KS.Correlation of Hair Mineral Concentrations with InsulinResistance in Korean Males. Biol.Trace Elem.Res. 150, 12,2012.

“Hair Mn concentrations were inversely associated with gestational age at sampling and positively associated with living within 50 m of a plantation and Mn concentrations in drinking water. Our findings suggest that pregnant women living near banana plantations aerially sprayed with mancozeb may be environmentally exposed to Mn.”

Blood and hair manganese concentrations in pregnant women from the infants’ environmental health study (ISA) in Costa Rica. Mora AM, van Wendel de Joode B, Mergler D, Córdoba L, Cano C, Quesada R, Smith DR, Menezes-Filho JA, Lundh T, Lindh CH, Bradman A, Eskenazi B. Environ Sci Technol. 2014 Mar 18;48(6):3467-76.

“The result of research studies indicate that hair mineral analysis can be useful as a diagnostic tool in the examination of trace metal exposure, including abnormal nutritional intake, and may assist in the study of certain mental states. They (hair mineral analysis) may suggest mineral imbalances present in the body that perhaps could be rectified by a mineral supplemented diet.”
“Hair metal testing is a fascinating new diagnostic tool and often gives unexpected clues to mineral imbalances in the body. The authors would support this statement from the results that they have accumulated to date.”

Barlow, P. J.; Kapel, M.: Metal and Sulfur Contents of Hair in Relation to Certain Mental States. Hair, Trace Elements, and Human Illness Brown, A.C.; Crounse, R. G., eds. Praeger Publications, 1980.

“By implementation of statistic pattern recognition methods, it has been found that the concentrations of TEs in hair can remarkably reflect different recovery phases of NPC patients.”

Leung PL, Huang HM., Following the recovery of naso-pharyngeal cancer patients by trace elements in hair using statistical pattern recognition methods., Biol Trace Elem Res. 1998 Jun;62(3):235-53.

“These data present guidance to clinicians and other professionals investigating deficiency of essential trace metals in biological samples (scalp hair and blood) of RA patients.”

Hair Mineral Levels in Rheumatoid Arthritis Patients Afridi, HI, et al. Evaluation of status of zinc, copper and iron levels in biological samples of normal and arthritis patients in age groups 46-60 and 61-75 years. Clin. Lab. 58, 2012.

“We suggest that the changed element status (Zn, Mg, and Cu) in hair may play an indicator role in the diagnosis of epileptic patients.”

Ilhan A, Uz E, Kali S, Var A, Akyol O., Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair?, Eur J Neurol. 1999 Nov;6(6):705-9.

Mercury, cadmium and other heavy metals have a high affinity for sulfhydryl groups, inactivating enzymatic reactions, amino acids, and sulfur-containing antioxidants. Cadmium concentrations in the kidney induce renal dysfunction and contribute to hypertension due to sodium retention, glucose intolerance, dyslipidemia and zinc deficiency. Heavy metal toxicity should be evaluated in any patient with hypertension, cardiovascular heart disease, or other vascular disease. Specific testing for acute and chronic toxicity and total body burden using hair, nail, urine and serum with baseline and provoked evaluation should be done.

The Role of Mercury and Cadmium Heavy Metals In Vascular Disease, Hypertension, Coronary Heart Disease and Myocardial Infarction. Houston, MC. Altern. Ther. Health Med. 13,2,2007.

Various changes in the content of trace elements in biological samples taken from patients with idiopathic scoliosis are not accidental. What might bring a shift in our knowledge is speciation of various forms of trace elements in the organism in relation to idiopathic scoliosis.

Changes of Selenium, Copper and Zinc Content in Hair and Serum of Patients with Idiopathic Scoliosis. Dastych, M, et al. 2008 Orthopedic Research Society. Wiley Periodicals, Inc. J. Orthop. Res.

The constituents of the hair is determined by the entry of substances from external sources and from substances which enter it from the blood stream.

Hopps, H. C.: The Biological Bases for Using Hair and Nail for Analysis of Trace Elements. Sci Tot Environ 1977; 7.

“The analysis of blood, excreted by-products, and human head hair represents method for determining body element levels.”

Pihl, R. O.; Drake, H.; Vrana, F. Department of Psychology, McGill University, Montreal, Quebec, Canada.: Hair Analysis in Learning and Behavior Problems. Hair, Trace Elements, and Human Illness. Brown, A. C.; Crounse, R. G., eds. Praeger Publications, 1980.

“Thus, it is observed that there exists some positive correlation between element levels in hair and nails and CHD, hypertension, and diabetes of these subjects.”

Sukumar A, Subramanian R., Elements in hair and nails of urban residents of New Delhi. CHD, hypertensive, and diabetic cases., Biol Trace Elem Res. 1992 Jul;34(1):89-97.

Hair chromium levels were analyzed in a healthy elderly population and an age-matched control group with type 2 diabetes. Lower hair chromium levels were observed in the diabetic group.

Longitudinal Hair Chromium Profiles of Elderly Subjects with Normal Glucose Tolerance and Type 2 Diabetes Mellitus. Stupar, J., et al. Metabolism. 56,1, 2007.

A hybrid algorithm was applied to the hair minerals from a group of healthy individuals compared to those with diabetes and was found to be a good symptom index that could recognize individuals with type 2 diabetes.

Hybrid Progressive Algorithm to Recognize Type II Diabetes Based on Hair Mineral Contents. Huang, H, et al. Conf. Proc. IEEE, Eng. Med. Biol. Soc. 5, 2005.

Lead and mercury levels were analyzed in eighty one hair and blood samples obtained at delivery of newborns. The results found that hair mercury and lead negatively correlated with calcium pump activity in maternal and cord blood erythrocytes.

Hair Mercury Negatively Correlates with Calcium Pump Activity in Maternal and Cord Blood Erythrocytes. Huel, G, et al. Environ. Hlth. Perspect. 116,2, 2008.

Higher serum magnesium was associated with lower bone mineral density at the spine, whereas high hair magnesium was associated with higher bone mineral density. The study concluded that magnesium in serum and hair was associated with bone mineral density in premenopausal women and the ratio of serum calcium to magnesium appears to be a significant indicator of bone density.

Associations of Calcium and Magnesium in Serum and Hair with Bone Mineral Density in Premenopausal Women. Song, CH, et al. Biol. Trace Elem. Res. 118, 1, 2007.

Hair levels of iron, zinc and selenium were found lower in the study group of fifty-two children diagnosed with anemia, compared to controls.

Serum and Hair Levels of Zinc, Selenium, Iron, and Copper in Children with Iron Deficiency Anemia. Gugoze, MK, et al. Biol. Trace Elem. Res. 111, 2006.

“The analysis of recently grown hair for zinc provides a biomarker of recent zinc status.”

Rush E, Li L, Chandu V, Whiting R., Hair zinc concentrations not subject to seasonal variation in adults in New Zealand., Biol Trace Elem Res. 2003 Dec;95(3):193-202.

“These data confirm that the analysis of Zn in hair represents an addition to conventional materials in the assessment of the nutritional status of groups of individuals.”

Contiero E, Folin M., Trace elements nutritional status. Use of hair as a diagnostic tool., Biol Trace Elem Res. 1994 Feb;40(2):151-60.

Dietary levels of some of the essential micro-elements have been reported to correspond to hair concentrations of the elements.

Reinhold, J. G.; Kfoury, G. A.; Ghalambor, M. A.; Jean, C.: Zinc and Copper Concentrations in Hair of Iranian Villagers. Am J Clin Nutr 1966; 18.
Strain, W. H.; Steadman, L. T.; Lankau, C. A.; Berliner, W. P.; Pories, W. J.: Analysis of Zinc Levels in Hair for the Diagnosis of Zinc Deficiency in Man. J Lab Clin Med 1966; 68.

Hair mineral analysis was performed on over three-hundred adult females with BMI’s ranging between low, normal and high. Significant differences were noted in zinc levels between women with a low BMI compared to those with a high BMI. The obese group had the lowest zinc levels as well as the lowest ratios of sodium/potassium, iron/copper and zinc/copper. “..we suggest that hair concentrations of Ca, Cu, Fe, Mg, K, Na and Zn may be correlated with adult female BMI, but further studies are needed.”

Wang, CT, et al., Concentrations of Calcium, Copper, Iron, Magnesium, Potassium, Sodium and Zinc in Adult Females hair with Different Body Mass Indexes in Taiwan., Clin. Chem. Lab. Med. 43, 4, 2005

Levels of lead, cadmium and nickel in scalp hair, blood and urine samples were significantly higher in groups of exposed workers compared to those of a control group. The determination of toxic metals in the biological samples of human beings is an important clinical screening procedure.

Evaluation of Toxic Metals in Biological Samples (Scalp Hair, Blood and Urine) of Steel Mill Workers by Electrothermal Atomic Adsorption Spectrometry. Afridi, HI, et al. Toxicol. Ind. Hlth. 9, 2006.

Mineral levels of one hundred and twenty male lung cancer patients were compared to one hundred-fifty controls. The study showed that the average cadmium concentration was high in the blood and scalp hair of lung cancer patients at different stages compared to controls.

Determination of Cadmium in Whole Blood and Scalp Hair Samples of Pakistani Male Lung Cancer Patients by Electrothermal Atomic Absorption Spectrometer. Kazi, TG, et al. Sci. Total Environ. 389,2, 2008.

Hair tissue mineral analysis was performed on one-hundred and twenty individuals. Supplementation of magnesium and vitamin B6 was implemented in the treatment groups and placebos in the control group. Repeat hair mineral analysis revealed a positive influence as a result of supplementation. Magnesium levels were increased in the hair along with a significant reduction of the heavy metals, lead and cadmium. “The above mentioned results indicate a positive influence of magnesium supplementation on the decrease of lead and cadmium hair content in the individuals studied.”

Kozielec T, Salacka A, Karakiewicz B., The influence of magnesium supplementation on concentrations of chosen bioelements and toxic metals in adult human hair. Magnesium and chosen bioelements in hair., Magnes Res. 2004 Sep;17(3):183-8.

“From the analyses, it was clear that hair concentrations of Ca, Fe, and Zn could reflect the effects of supplementation.”

Leung PL, Huang HM, Sun DZ, Zhu MG., Hair concentrations of calcium, iron, and zinc in pregnant women and effects of supplementation., Biol Trace Elem Res. 1999 Sep;69(3):269-82.

“One such procedure which has shown great potential, at least for the determination of micro-element nutriture…, is the use of hair as the biological sample. Perhaps an even more important advantage would be that hair, by the very nature of the sample, should reflect a rather long-term nutritional state rather than recent (i.e. previous meal or day) dietary intake.”

Sauberlich, H. E.; Scala, J. H. Department of Nutrition, Letterman Army Institute of Research, San Francisco, California.

Dowdy, R. P. Department of Human Nutrition, Foods, and Food Systems Management, University of Missouri, Columbia, Missouri

“Hair may provide a continuous record of nutritional status.”

Maugh, T. H. Hair: A Diagnostic Tool to Complement Blood Serum and Urine. Science1978; 202.

“The pathogenesis of liver cirrhosis/cancer has been associated with changes in the balance of certain essential trace and toxic elements. It was observed that the status of Se and Zn in addition to some biochemical parameters was improved in biological samples of both groups of patients after sixty days treatment with mineral supplementation.”

Investigation of essential trace and toxic elements in biological samples (blood, serum and scalp hair) of liver cirrhotic/cancer female patients before and after mineral supplementation. Kolachi NF, Kazi TG, Afridi HI, Kazi NG, Khan S. Clin Nutr. 2012 Dec;31(6):967-73. doi: 10.1016/j.clnu.2012.04.015. Epub 2012 May 17.

A positive correlation of selenium levels was found between samples of umbilical cord blood and the newborn’s hair. Correlation was also found between placenta and umbilical cord blood and between cord blood and maternal blood.

Selenium Levels in Related Biological Samples: Human Placenta, Maternal and Umbilical Cord Blood, Hair and Nails. Lorenzo, A, et al. J. Trace Elem. Med. Biol. 19,1, 2005.

“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. The results suggest that quantification of hair iron may be useful to complement evaluations of the body iron status.”

Bisse E, Renner F, Sussmann S, Scholmerich J, Wieland H., Hair iron content: possible marker to complement monitoring therapy of iron deficiency in patients with chronic inflammatory bowel diseases?, Clin Chem. 1996 Aug;42(8 Pt 1):1270-4.

“Hair calcium concentration did reflect the risk of CHD on a population basis and was strongly influenced by both the hardness of the water supply and the annual sunshine hours which also independently affected the SMR for CHD.”

MacPherson A, Bacso J., Relationship of hair calcium concentration to incidence of coronary heart disease., Sci Total Environ. 2000 Jun 8;255(1-3):11-9.

“HTMA studies found that those affected with atopic dermatitis had significantly reduced zinc levels compared to controls.”

Hair Zinc Levels and Dermatitis Kim, JE, et al. Hair Zinc Levels and the Efficacy of Oral Zinc Supplementation in Children with Atopic Dermatitis. Acta Derm Venereol, 94, 2014.

“Thus, chromium and selenium levels in the hair of viscerally obese adults were inversely associated with insulin resistance, whereas copper levels in the hair were positively associated with insulin resistance. This suggests that the mineral status of viscerally obese adults might play a role in the development of insulin resistance.”

Concentrations of chromium, selenium, and copper in the hair of viscerally obese adults are associated with insulin resistance. Kim HN, Song SW. Biol Trace Elem Res. 2014 May;158(2):152-7. doi: 10.1007/s12011-014-9934-6. Epub 2014 Mar 19

“While the imbalance of certain trace elements leads to generation of more free radicals, the imbalance of some other trace elements causes changes in dopamine (neurotransmitter) activity. It is essential to monitor before and periodically during treatment the levels of essential trace elements for effective treatment of bipolar disorder.”

Trace elemental distribution in the scalp hair of bipolars using PIXE technique. Pradeep AS, Naga Raju GJ, Sattar SA, Sarita P, Prasada Rao AD, Ray DK, Reddy BS, Reddy SB. Med Hypotheses. 2014 Apr;82(4):470-7. doi: 10.1016/j.mehy.2014.01.028. Epub 2014 Feb 2.

“Conclusions. It seems safe to conclude that our results confirmed usefulness of hair element analysis in screening tests for the assessment of the biomarker of various cancer diseases in a female population.”

Screening of trace elements in hair of the female population with different types of cancers in wielkopolska region of poland. Czerny B, Krupka K, Ożarowski M, Seremak-Mrozikiewicz A. ScientificWorldJournal. 2014;2014:953181. doi: 10.1155/2014/953181. Epub 2014 Dec 15

“The study revealed that low level of trace elements (Se, Zn) and high level of heavy elements (As, Cd, and Ni) were associated with increased risk of cancer.”

Interaction between carcinogenic and anti-carcinogenic trace elements in the scalp hair samples of different types of Pakistani female cancer patients. Wadhwa SK, Kazi TG, Afridi HI, Talpur FN, Naeemullah. Clin Chim Acta. 2015 Jan 15;439:178-84. doi: 10.1016/j.cca.2014.10.007. Epub 2014 Oct 15

This study explored calcium and magnesium levels in patients diagnosed with fibromyalgia compared to matched controls. Findings revealed significantly higher hair levels of both calcium and magnesium in the affected group. “Wilcoxon rank sum tests showed that patients with fibromyalgia had significantly higher calcium and magnesium levels than the control subjects at alpha = .025 and .05, respectively.”

Ng SY., Hair calcium and magnesium levels in patients with fibromyalgia: a case center study., J Manipulative Physiol Ther. 1999 Nov-Dec;22(9):586-93.

Zinc and copper concentrations were measured in the hair and urine of patients who were hospitalized for myocardial infarction (MI). Mineral concentrations were also measured in descendants of the patients and compared to a control group. The study suggests that in MI patients, a genetic disorder of mineral imbalance at a younger age can be used in predicting susceptibility to heart disease in individuals prior to onset and diagnosis in asymptomatic patients.

Detection of Potentially Myocardial Infarction Susceptible Individuals in Indian Population: A Mathematical Model Based on Copper and Zinc Status. Taneja, SK, et al. Biol. Trace Elem. Res. 75, 2000.

It is concluded that hair metal analysis in samples close to the scalp is not seriously invalidated by sources of external contamination.

Cadmium, Copper, Lead and Zinc Concentration in Human Scalp and Pubic Hair. Wilhelm, M, et al. Instit, Toxicol. Univ. of Dussseldorf, W. Wermany. 199-206, Vol. 92, 1990.

Nickel- sensitive women had significantly higher levels of nickel in nails, hair and plasma than control subjects.

Nickel in Nails, Hair and Plasma from Nickel-Hypersensitive Women. Gammelgaard, et al. Acta. Derm. Venereol. 417, Vol. 70, 1990.

“High content of mercury in hair may be a risk factor for acute coronary events and CVD, CHD, and all-cause mortality in middle-aged eastern Finnish men.”

Virtanen JK, Voutilainen S, Rissanen TH, Mursu J, Tuomainen TP, Korhonen MJ, Valkonen VP, Seppanen K, Laukkanen JA, Salonen JT., Mercury, fish oils, and risk of acute coronary events and cardiovascular disease, coronary heart disease, and all-cause mortality in men in eastern Finland., Arterioscler Thromb Vasc Biol. 2005 Jan;25(1):228-33. Epub 2004 Nov 11.

“The elemental analysis of hair is becoming increasingly popular for the assessment of nutritional status.”

Katz, S. A. Professor of Chemistry, Rutgers University.: The Use of Hair as a Biopsy Material for Trace Elements in the Body. Am Lab 1979; Feb.

“Regarding certain factors (age, sex, health, occupation, etc.), the influence causing the change in element levels is obvious, whereas the influence of other factors (structure of hair, height and weight of the subject, etc.) is obscure. It is very important to consider all the factors at the time of investigation for effective interpretation, validity, and application of results of hair analysis.”

Sukumar A., Factors influencing levels of trace elements in human hair., Rev Environ Contam Toxicol. 2002;175:47-78.

“In this study, we found that TAC, hair Zn, and hair Se levels were lower in children with RW than HC and negatively correlated with wheezing episodes in the last 6 months. Also body Zn and Se levels can be reliably measured in hair samples.”

Hair zinc and selenium levels in children with recurrent wheezing. Razi CH, Akelma AZ, Akin O, Kocak M, Ozdemir O, Celik A, Kislal FM. Pediatr Pulmonol. 2012 Dec;47(12):1185-91. doi: 10.1002/ppul.22628. Epub 2012 Sep 4

“Research literature supports the view that trace element content of the hair and nail reflect body intake…from which one can conclude that hair and nail are suitable samples for evaluating body stores.”

Hopps, H. C.: The Biological Bases for Using Hair and Nail for Analysis of Trace Elements. Trace Substances In Environmental Health VIII. Hemphill, D.D., ed. University of Missouri, Columbia. 1974.

“This reference range of trace elements in the mane hair of racing horses should be used to assess disease and the nutritional status in equine practice.”

Asano R, Suzuki K, Otsuka T, Otsuka M, Sakurai H., Concentrations of toxic metals and essential minerals in the mane hair of healthy racing horses and their relation to age., J Vet Med Sci. 2002 Jul;64(7):607-10.

“Hair concentrations may provide useful information on longer term nutrition.”

Casey, C. E.; Hambidge, K. M.: Trace Element Deficiencies in Man. Advances In Nutritional Research Vol.3. Draper, H. H., ed. Plenum Pub., 1980.

Hambidge, K. M.; Walravens, P.A.: Trace Elements in Nutrition. Prac Ped 1974, 1:1

“The patients were divided into three groups of ten; one group was studied two years after total hip replacement, one at four years, and one at six years. High levels of titanium and aluminum were found in the hair, especially in the group studied six years after implantation, while the levels of the three ions in the blood and urine were not significant.”

Trinchi V, Nobis M, Cecchele D., Emission spectrophotometric analysis of titanium, aluminum, and vanadium levels in the blood, urine, and hair of patients with total hip arthroplasties., Ital J Orthop Traumatol. 1992;18(3):331-9.

“The study holds promise that hair selenium may be used as a monitoring tool for low-level occupational exposure to selenium.”

Srivastava AK, Gupta BN, Bihari V, Gaur JS, Mathur N., Hair selenium as a monitoring tool for occupational exposures in relation to clinical profile., J Toxicol Environ Health. 1997 Aug 8;51(5):437-45.

“The results of the quality assurance program, which included 31 participants on four continents, are described. Of the participating laboratories, 92% consistently meet QA/QC performance limits for the determination of Hg in human hair.”

Gill US, Schwartz HM, Bigras L., Results of multiyear international interlaboratory comparison program for mercury in human hair., Arch Environ Contam Toxicol. 2002 Nov;43(4):466-72.

“The hair concentrations of Ca, Fe, Cu, and Zn in the three groups of gravida were lower or significantly lower than those in controls. In sera, the differences did not show statistical significance in most cases”

Huang HM, Leung PL, Sun DZ, Zhu MG., Hair and serum calcium, iron, copper, and zinc levels during normal pregnancy at three trimesters., Biol Trace Elem Res. 1999 Aug;69(2):111-20.

“There is now a considerable body of literature on the use of hair in forensic science, in the diagnosis of disease states, and in the assessment of nutritional status.”

Stevens, B. J.: Determination of Aluminum, Copper, and Zinc in Human Hair. Atomic Spectroscopy 1983; 4:45

“Data for Pb levels in scalp hair (≤120μgg(-1)) and blood (≥650μgdL(-1); WHO, 2004) for children that have lived within IDP camps in Mitrovica indicate significant Pb uptake has indeed taken place.”

Potentially harmful elements (PHEs) in scalp hair, soil and metallurgical wastes in Mitrovica, Kosovo: the role of oral bioaccessibility and mineralogy in human PHE exposure. Boisa N, Bird G, Brewer PA, Dean JR, Entwistle JA, Kemp SJ, Macklin MG. Environ Int. 2013 Oct;60:56-70. doi: 10.1016/j.envint.2013.07.014. Epub 2013 Sep 4

Results showed that hair copper concentrations could be correlated with the degree of severity, in that the higher the copper burdens, the more severe the autism. Levels of lead and mercury were also found higher in the affected group and increased with the degree of severity. Whereas, selenium and magnesium were significantly different in the low functioning group of children compared to others in the affected group as well as controls.

Priya, L, Geetha, A. Level of Trace Elements (Copper, Zinc, Magnesium and Selenium) and Toxic Elements (Lead and Mercury) in the Hair and Nail of Children with Autism. Biol.Trace Elem.Res. 2010.

HTMA is a good indicator of exposure to uranium and without these tests many individuals would unknowingly be exposed to not only heavy metals such as uranium and other metals, but radon gas as well.

Kehagia, K, et al. Hair Analysis as an Indicator of Exposure to Uranium. Radial.Prot. Dosimetry. Nov. 2010.

“This study demonstrated an independent association between chronic stress measures and hair mineral levels in young girls, indicating the importance of physiological stress-mineral pathways independently from individual or behavioural factors.”

Cross-sectional relationship between chronic stress and mineral concentrations in hair of elementary school girls. Vanaelst B, Michels N, Huybrechts I, Clays E, Flórez MR, Balcaen L, Resano M, Aramendia M, Vanhaecke F, Rivet N, Raul JS, Lanfer A, De Henauw S. Biol Trace Elem Res. 2013 Jun;153(1-3):41-9. doi: 10.1007/s12011-013-9647-2. Epub 2013 Apr 2

“Although human hair can be a useful tool for biomonitoring temporal changes in metal concentrations, levels are not correlated with those found in urine except for total mercury, thus providing additional information.”

Biomonitoring of arsenic, cadmium, lead, manganese and mercury in urine and hair of children living near mining and industrial areas. Molina-Villalba I, Lacasaña M, Rodríguez-Barranco M, Hernández AF, Gonzalez-Alzaga B, Aguilar-Garduño C, Gil F. Chemosphere. 2015 Apr;124:83-91. doi: 10.1016/j.chemosphere.2014.11.016. Epub 2014 Nov 27

“Both deficiency and excess of trace elements was shown to be of pathogenetic value in the development of thyroid disease.”

Hair Trace Elements in Patients with Goiter. Farkhutdinova, LM, et al. Klin Lab Diagn. Aug. (8) 2006.

Imbalances in the optimum levels of trace elements may adversely affect the biological process and are associated with many disease processes.

Rahman, A. et al. Zinc, Manganese, Calcium, Copper and Cadmium Level in Scalp Hair Samples of Schizophrenic Patients. Biol.Trace Elem. Res. 127,2, 2009.

“As part of the metabolic syndrome, the optimal calcium and magnesium concentrations in hair tissue may reflect decreased risk of metabolic syndrome.”

Hair Tissue Mineral Analysis and Metabolic Syndrome. Park, SB, et al. Biol.Trace Elem.Res. 130,3, 2009.

“The levels of iron and zinc were significantly lower in the whole blood of children with growth retardation compared to the control group.”

Hair Minerals and Growth Ozmen, H, et al. The Levels of Calcium and Magnesium, and Of Selected Trace Elements,in Whole Blood and Scalp Hair of Children with Growth Retardation. Iran, J.Ped. 23,2, 2013.

Their research findings suggested that some minerals such as arsenic, selenium and probably iodine, zinc, sodium and vanadium contribute to the regulation of cancer and that a metallomics study using multiple logistic regression analysis is a useful tool for estimating cancer risks.

Metallomics Study Using Hair Mineral Analysis and Multiple Logistic Regression Analysis: Relationship Between Cancer and Minerals. Yasuda, H, et al. Environ. Health Prev.Med. 24,5, 2009.

Heavy metals are being increasingly recognized as mediators or factors in the development and progression of cardiovascular disease and that a deficiency, lack of homeostatic control or excess intake of some metals may lead to cardiovascular mortality.

Afridi, HI., et al. Evaluation of Toxic Elements in Scalp Hair Samples of Myocardial Infarction Patients at Different Stages as Related to Controls. Biol. Trace Elem. Res.134, 1, 2010.

“Analysis of t test showed a significant difference between NASH (P < 0.001) patients in hair selenium concentrations when compared with controls.”

Hair selenium levels in hepatic steatosis patients. Pan D, Huang H. Biol Trace Elem Res. 2013 Jun;152(3):305-9. doi: 10.1007/s12011-013-9624-9. Epub 2013 Feb 15

“Hair analysis used to determine mineral content in the body may be an auxiliary tool in identifying the links between factors leading to the development of hypertension.”

Blood pressure and levels of Fe, Ca, Mg, Zn, Cu, Na and K in the hair of young Bantu men from Tanzania. Rębacz-Maron E, Baranowska-Bosiacka I, Gutowska I, Chlubek D. Biol Trace Elem Res. 2013 Mar;151(3):350-9. doi: 10.1007/s12011-012-9578-3. Epub 2013 Jan 3

“Hair lead levels have been found to correlate well with body lead contamination.”

Black AP, Knight R, Batty J, Haswell SJ, Lindow SW., An analysis of maternal and fetal hair lead levels., BJOG. 2002 Nov;109(11):1295-7.

Additional References Regarding HTMA Research and Hair Testing

  • The influence of physical activity on hair toxic and essential trace element content in male and female students. Zaitseva IP, Skalny AA, Tinkov AA, Berezkina ES, Grabeklis AR, Skalny AV. Biol Trace Elem Res. 2015 Feb;163(1-2):58-66.
  • Comparison of zn, cu, and fe content in hair and serum in alopecia areata patients with normal group. Dastgheib L, Mostafavi-Pour Z, Abdorazagh AA, Khoshdel Z, Sadati MS, Ahrari I, Ahrari S, Ghavipisheh M. Dermatol Res Pract. 2014;2014:784863.
  • Efficacy of hair analysis for monitoring exposure to uranium: a mini-review. Joksić AŠ, Katz SA. J Environ Sci Health A Tox Hazard Subst Environ Eng. 2014;49(13):1578-87.
  • Reference values” of trace elements in the hair of a sample group of Spanish children (aged 6-9 years) – are urban topsoils a source of contamination? Peña-Fernández A, González-Muñoz MJ, Lobo-Bedmar MC. Environ Toxicol Pharmacol. 2014 Jul;38(1):141-52. doi:
  • Meta-analysis of Zn, Cu and Fe in the hair of Chinese children with recurrent respiratory tract infection. Mao S, Zhang A, Huang S. Scand J Clin Lab Invest. 2014 Oct;74(7):561-7
  • Determination of 33 elements in scalp hair samples from inhabitants of a mountain village of Tonglu city, China. Luo R, Zhuo X, Ma D. Ecotoxicol Environ Saf. 2014 Jun;104:215-9. doi: 10.1016/j.ecoenv.2014.03.006. Epub 2014 Apr 14
  • Hair Uranium an Indication of Exposure Zunic, ZS, et al. 2012. Radiat.Prot.Dosimetry. 152. Distribution of Uranium and Some Selected Trace Metals in Human Scalp Hair from Balkans.
  • Metals and metalloids in hair samples of children living near the abandoned mine sites of Sulcis-Inglesiente (Sardinia, Italy). Varrica D, Tamburo E, Milia N, Vallascas E, Cortimiglia V, De Giudici G, Dongarrà G, Sanna E, Monna F, Losno R. Environ Res. 2014 Oct;134:366-74. doi: 10.1016/j.envres.2014.08.013. Epub 2014 Sep 14
  • Hair calcium concentration is associated with calcium intake and bone mineral density. Park SJ, Lee SH, Cho DY, Kim KM, Lee DJ, Kim BT. Int J Vitam Nutr Res. 2013;83(3):154-61
  • Two cases of long-term home parenteral nutrition in which increased doses of intravenous selenium were administered and the serum and hair selenium concentration was measured]. Washizawa N, Kozono K, Naganuma H, Kimura Y, Sato Y, Sakai M, Chino K, Shimoda M, Suzuki T, Oshima Y, Kaneko H. Gan To Kagaku Ryoho. 2013 Dec;40 Suppl 2:227-9.
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  • Comparing the metal concentration in the hair of cancer patients and healthy people living in the malwa region of punjab, India. Blaurock-Busch E, Busch YM, Friedle A, Buerner H, Parkash C, Kaur A. Clin Med Insights Oncol. 2014 Jan 9;8:1-13. doi: 10.4137/CMO.S13410. eCollection 2014 Jan 9
  • Association of hair iron levels with creativity and psychological variables related to creativity. Takeuchi H, Taki Y, Sekiguchi A, Nouchi R, Kotozaki Y, Nakagawa S, Miyauchi CM, Iizuka K, Yokoyama R, Shinada T, Yamamoto Y, Hanawa S, Araki T, Hashizume H, Kunitoki K, Sassa Y, Kawashima R. Front Hum Neurosci. 2013 Dec 18;7:875.
  • Maternal hair selenium levels as a possible long-term nutritional indicator of recurrent pregnancy loss. Thomas VV, Knight R, Haswell SJ, Lindow SW, van der Spuy ZM. BMC Womens Health. 2013 Oct 22;13:40. doi: 10.1186/1472-6874-13-40
  • A preliminary study of a Peruvian diet using dietary analysis and hair mineral content as indicators. Tueller DJ, Eggett DL, Parker TL. Biol Trace Elem Res. 2013 Nov;155(2):161-8. doi: 10.1007/s12011-013-9774-9. Epub 2013 Aug 7
  • Rare earth elements in human hair from a mining area of China. Wei B, Li Y, Li H, Yu J, Ye B, Liang T. Ecotoxicol Environ Saf. 2013 Oct;96:118-23. doi: 10.1016/j.ecoenv.2013.05.031. Epub 2013 Jul 3.
  • Hair minerals and metabolic health in Belgian elementary school girls. Vanaelst B, Huybrechts I, Michels N, Flórez MR, Aramendía M, Balcaen L, Resano M, Vanhaecke F, Bammann K, Bel-Serrat S, De Henauw S. Biol Trace Elem Res. 2013 Mar;151(3):335-43. doi: 10.1007/s12011-012-9573-8. Epub 2012 Dec 20
  • Association between trace element and heavy metal levels in hair and nail with prostate cancer. Karimi G, Shahar S, Homayouni N, Rajikan R, Abu Bakar NF, Othman MS. Asian Pac J Cancer Prev. 2012;13(9):4249-53
  • Cohort study for prevention of atopic dermatitis using hair mineral contents. Yamada T, Saunders T, Kuroda S, Sera K, Nakamura T, Takatsuji T; Fukuoka College of Obstetricians and Gynecologists, Pediatric Association of Fukuoka District, Hara T, Nose Y. J Trace Elem Med Biol. 2013 Apr;27(2):126-31. doi: 10.1016/j.jtemb.2012.08.003. Epub 2012 Oct 24.
  • Decreased bioelements content in the hair of patients with Fahr’s disease (idiopathic bilateral calcification in the brain). Takagi M, Ozawa K, Yasuda H, Douke M, Hashimoto K, Hayashi Y, Inuzuka T, Hozumi I. Biol Trace Elem Res. 2013 Jan;151(1):9-13. doi: 10.1007/s12011-012-9529-z. Epub 2012 Oct 24.
  • Mineral concentrations in hair of Belgian elementary school girls: reference values and relationship with food consumption frequencies. Vanaelst B, Huybrechts I, Michels N, Vyncke K, Sioen I, De Vriendt T, Flórez MR, Aramendía M, Balcaen L, Resano M, Vanhaecke F, De Henauw S. Biol Trace Elem Res. 2012 Dec;150(1-3):56-67. doi: 10.1007/s12011-012-9495-5. Epub 2012 Aug 22.
  • Levels of Cd, Pb, As, Hg, and Se in hair of residents living in villages around Fenghuang polymetallic mine, southwestern China. Li Y, Zhang X, Yang L, Li H. Bull Environ Contam Toxicol. 2012 Jul;89(1):125-8. doi: 10.1007/s00128-012-0650-7. Epub 2012 Apr 22
  • Blood pressure of omnivorous and semi-vegetarian postmenopausal women and their relationship with dietary and hair concentrations of essential and toxic metals. Rodenas S, Sánchez-Muniz FJ, Bastida S, Sevillano MI, Larrea Marín T, González-Muñoz MJ. Nutr Hosp. 2011 Jul-Aug;26(4):874-83. doi: 10.1590/S0212-16112011000400030
  • A comparison of levels of select minerals in scalp hair samples with estimated dietary intakes of these minerals in women of reproductive age. Suliburska J. Biol Trace Elem Res. 2011 Dec;144(1-3):77-85. doi: 10.1007/s12011-011-9034-9. Epub 2011 Mar 29
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