HAIR ANALYSIS CONTROVERSY

By Lawrence Wilson, MD

Revised © November 2010, The Center For Development

I have used hair tissue mineral analysis for more than 30 years and reviewed over 50,000 of these tests. I am somewhat familiar with all the major commercial testing laboratories in America, and a number of labs in other nations. I have also written a textbook and many articles about its use.

Controversy concerns the accuracy and reliability of the hair mineral test, as well as the interpretation of the readings. Also, some object to recommending diets and supplement programs based on tissue mineral testing. I would like to address these issues one at a time.

THE ACCURACY OF HAIR ANALYSIS

Mineral analysis by spectroscopy is a very standard laboratory procedure. The technology has been known for at least 75 years or more, and has improved greatly with the advent of computer-controlled mass spectrometers and induction-coupled plasma (ICP) instruments that are used today at all the hair testing laboratories in America, and probably around the world.

All commercial hair testing laboratories in the United States are licensed and inspected annually by the federal government, as part of the CLIA act. They are given blind samples to run. If they do not meet stringent criteria for accuracy, they are not allowed to operate.

The United States Environmental Protection Agency published a 300-page review of hair analysis in 1979 which they reviewed 400 studies of hair analysis.  Based on this review, they concluded that hair analysis is a "meaningful and representative tissue for biological monitoring for most of the toxic metals".  ("Toxic Trace Metals in Human and Mammalian Hair and Nails", EPA-600 4.79-049, August 1979, US Environmental Protection Agency, Research and Development.)

WASHING THE HAIR AT THE LABORATORY

A major controversy surrounding hair mineral analysis concerns the preparation of the hair samples for testing at the laboratory. Most of the laboratories wash the hair samples before performing the analysis.

Arguments in favor of washing the hair at the laboratory.

1. Hair is exposed to the elements and may be contaminated with dust, dirt, bacteria and other possible contaminants.

2. Hair may contain residues of hair products such as shampoo and other skin care products. Even the water that the patient bathes in could be contaminated with toxic metals or other minerals.

3. Any minerals that would be washed out due to washing the hair at the lab are “exogenous”, meaning they are not really part of the biopsy material and are thus not important.

4. Therefore, they contend, the advantages of washing the hair outweigh any possible negative consequences that might result.

Arguments against washing the hair at the laboratory.

1. Most people wash their hair frequently, and the lab requires that the hair be washed within about 24-48 hours of cutting the sample

2. Washing the hair with harsh chemical solvents and detergents can and does remove large amounts of the water-soluble elements, and perhaps others. This is reported in all of the studies of this subject.

3. Hair is about 10-15% porous, so the washing agents not only remove exogenous minerals, but affect the interior of the hair tissue as well.

I am aware of the following studies on this topic:

· Leroy, R. (J Ortho Med., 1986;1(2)).

· Seidel, et al. (JAMA, 2001, 285, #1). The authors compared hair test results from about six labs. The results of the two laboratories that do not wash the hair samples showed excellent correlation, whereas the results from the laboratories that wash the hair were not quite as consistent. One must obtain the actual test numbers or data to realize this, as the details are not mentioned in the body of the study.

· Assarian, GS and Oberleas, D., (Clin Chem., 1977;23(9):1771-1772).

Results of the studies. All of the above studies indicated that washing hair samples at the laboratory causes some degree of erratic and unpredictable removal of minerals from the hair sample. This is also my clinical experience, based on reviewing about 40,000 hair mineral analyses. A number of these were repeat tests done in close succession by different laboratories. In most cases, there were significant variations in the results when one of the labs washed the hair and the other did not. Results were very close, however, when both labs did not wash the hair.

Conclusions that I draw from these studies. These include:

1. Errors in the levels of particularly the water soluble minerals (sodium, potassium, and gto some degree zinc, copper, manganese, and magnesium) due to the erratic effects of washing are far worse than the possibility of contamination.  

2. Hair is a human tissue that is porous, and thus applying harsh chemicals to it is likely to penetrate inside the biopsy material and wash out some of the loosely-bound minerals.

3. Hair samples should not be washed at the lab, except if there is known contamination. In this case the sample can be rinsed quickly in alcohol so as not to remove the water soluble, loosely bound minerals.

Damaging the reputation of hair mineral analysis. A second, related problem with washing the hair at the lab is that most laboratories use 1) different washing chemicals and 2) different washing duration. The agents used to wash the hair include alcohol, detergents such as Triton-x, and solvents such as acetone. The duration of washing the hair samples varies from lab to lab, from three minutes to about ten minutes.

These differences result in some variation in the test results from laboratory to laboratory. It means that researchers and physicians will not receive the same results from two different labs that wash the hair. There have been efforts to standardize the laboratory procedures. So far, the laboratories that wash the hair have been unwilling to cooperate on hair washing standards, however.

For the best accuracy, I can only recommend using Analytical Research Labs or Trace Elements, Inc. because they do not wash the hair.

What about the effect of daily showering?   Research performed at Accutrace Laboratories indicates that showering is not the same as washing at the lab because:

* The hair is under the shower usually for only 15-60 seconds.

* While the hair is on the head, the oil and sweat glands of the scalp are able to reestablish the equilibrium concentrations of the washed out minerals rapidly after showering.  These concentrations probably depend upon many subtle factors, such as the electrostatic potential of the hair fibers. 

*      Shampoos are not nearly as powerful as the detergents and solvents used at hair analysis labs. 

Other common sources of hair contamination. Daily swimming in pools can increase sodium and copper readings. Selsun Blue Shampoo can increase selenium levels. Head and Shoulders Shampoo can increase zinc readings. Grecian Formula and Youth Hair hair dyes increase lead levels. Otherwise, in my experience, hair products have little effect upon the readings. None of these instances invalidates the hair test, in my experience. Practitioners can simply ask the patients which hair products they are using, and if they swim often in pools. Most laboratory tests, including blood tests, urine tests and others, have certain situations that tend to affect the test that must be considered when interpreting the test. Hair testing is no different from other tests in this regard.

Ask about washing procedures before submitting hair samples. Practitioners using hair mineral analysis should call and ask the lab about their washing procedure.  This will affect particularly the levels of magnesium, sodium, potassium, manganese, zinc, copper and perhaps a few others. The toxic metal readings are not too affected by washing, presumably because they are less water-soluble and/or they are more tightly bound to the hair tissue or perhaps less easily dislodged by the washing chemicals.

CONTROVERSY DUE TO TWO AMA JOURNAL STUDIES AND OTHER MEDICAL REVIEWS OF HAIR TISSUE MINERAL ANALYSIS

Two widely publicized articles published in the Journal of the AMA claimed hair analysis was inaccurate. Both were so poorly done that in my view they hardly deserve to be analyzed. However, in the interest of fairness, let us review them.

The first article appeared in 1985 (JAMA 254(8)1041-1045).  The author is a psychiatrist who admitted he had never used hair analysis in his medical practice and had no experience with it.  He is also a well-known medical “quackbuster” who controls some 30 websites dedicated to discrediting and debunking holistic therapies.

For this study, he cut long pieces of his teenage daughter's hair.  This is a direct violation of the protocol for hair sampling. One should never use long hair for hair analysis.  This is specified in the instructions from all commercial laboratories. Long hair unravels and mineral readings become unreliable. 

The author then washed his daughter’s hair samples in kitchen tap water.  This is another direct violation of hair sampling protocol. One should never wash hair that has been cut for sampling in any kind of water. Tap water, of course, generally contains a variety of random minerals.  This warning is also mentioned in hair sampling instructions supplied by hair testing laboratories, but was ignored.

Then he cut the hair into small pieces and mixed them by hand.  This is also unacceptable protocol.  Hair is quite electrostatic and sticks together.  It cannot be effectively mixed this way. The proper way to mix samples would have been to powder the hair and then mix it properly with a mixing machine.

The author then sent samples of the hair to 13 laboratories. Four of the laboratories showed excellent correlation between the results. Three others showed moderate correlation between the results, and six others did not correlate as well. Based on this, the author concluded that hair analysis is a fraud.

In the study conclusion, no mention was made of the fact that hair testing laboratories use different hair washing procedures that will yield differing results, and this fact was not taken into account in the discussion of the results of the testing.

Also, the references for the study were wholly inadequate and no mention was made, for example, of the US EPA review of 400 hair analysis studies that had been completed only 6 years before. This review concluded that hair testing was reliable and meaningful for testing the levels of the toxic metals, which is all the study addressed.

This JAMA study was widely circulated to the mainstream media and has influenced many physicians, even though it was so poorly done that it should never have been published in the first place.

The 2001 JAMA “Study”. The second study appeared in JAMA #285 (1), Jan. 3, 2001.  For this study, six hair samples were cut from one woman's head. The hair sampling procedure was correct, and the hair samples were sent to six different hair testing laboratories to compare the results.

The odd thing about this study was that one of laboratories chosen to test the hair was operating illegally, as it had performed badly on tests and had lost its operating licence.  The authors could have chosen many other labs for their study.

When the results came back, the worst performing lab was the illegal one. Based on this fact alone, the authors concluded that hair mineral analysis is inaccurate and probably a fraud.

The flaws in this study are obvious:

1. Why anyone would use an illegally-operating laboratory to study a scientific procedure makes very little sense unless the goal was to discredit hair mineral testing. It is like testing a new operation, but having someone who is not qualified do the operation.

2. Another flaw in this study is that only one person was involved. I learned in medical school that this is nothing but anecdotal evidence, rather than a study, and one should not draw any conclusions from it.

3. The references were horribly inadequate. As with the first JAMA study, no mention was made of the hundreds, if not thousands of previous studies of hair mineral testing that show it is a valid, accurate, reliable testing method.

4. To their credit, the authors mentioned that washing procedures vary among laboratories and this will influence results.  However, they ignored their own statement in their conclusion, where they did not attempt to separate out the results by which labs washed the hair.

5. In fact, the two laboratories that do not wash the hair showed superb correlation of the readings.  This finding was completely ignored by the authors. 

The 'Nightline' expose on hair analysis. In this report from the late 1980s, hair from a dog was sent to a commercial hair analysis laboratory.  The Nightline personnel led the laboratory to believe it was a human hair sample. They did not tell the laboratory it was from a dog. Identifying the species from which hair is sampled is the standard and an obvious procedure.

When results came back, they were very odd because the normal mineral values for a dog are very different than for humans.  The television host claimed that this was a healthy dog and that such odd results proved that hair analysis is a fraud. 

Of course, if one sent a dog's blood to a blood laboratory and did not tell the laboratory it belonged to a dog, the exact same thing would happen. This, of course, was not pointed out in the Nightline piece.

The June 12-13, 2001 Centers For Disease Control Report On Hair Analysis. The CDC review of hair analysis was actually just a meeting of a panel of "experts". The panel reviewed 10 studies of hair analysis. Among the 10 were the two poor studies published in JAMA mentioned above.   (Recall that the EPA reviewed 400 studies of hair analysis in 1979.) 

No independent research was done by the CDC.  After a short meeting, the panel concluded hair analysis is not reliable.  I was quite disappointed in the CDC review and wrote a letter to a CDC officer with my observations and comments. I never received a response.

EVERY MINERAL LEVEL AFFECTS EVERY OTHER LEVEL

Another area of controversy concerns the interpretation of the hair mineral analysis.  Often, hair analysis is viewed like a SMAC 24 or other test, in which each mineral value is regarded as a separate test. While this will yield some information, others suggest that the test must be interpreted as a whole system, not as 20 or more separate tests.

Dr. William Albrecht, PhD first described the 'mineral system' of the body, which are the way the minerals in the body relate to one another. He designed the “mineral wheel “to indicate some of the interactions that exist between minerals.  Since then, much more work has been done to identify mineral relationships.

By analyzing the mineral ratios and relationships, information can be derived about organ and gland function, mental and emotional tendencies, how the body is responding to stress and how to support the body nutritionally.  Many disease 'trends' can also be identified, making hair analysis an excellent and cost‑effective preventive and predictive tool. 

DOES HAIR ANALYSIS INTERPRETATION INVOLVE METABOLIC TYPING AND THE STRESS THEORY OF DISEASE?

Dr. Paul Eck and a few other researchers interpret hair analysis by identifying the stage of stress a person is in, and the oxidation type and rate. However, this idea is quite controversial. Those who do not believe this are content to interpret the test much like one would interpret a blood or urine test for minerals, and not bother with metabolic typing and stress theory.

I cannot prove that Dr. Eck is correct, except that from a clinical perspective his approach has proven extremely accurate in its ability to predict a client’s symptoms, and the ability of this theory to suggest a correct diet and proper supplementation to balance body chemistry. The use of stress theory and metabolic typing also simplifies the interpretation and makes it much easier to understand and learn.

IDEAL HAIR MINERAL LEVELS AND RATIOS VERSUS REFERENCE RANGES

This is a very critical area of controversy having to do with the interpretation of hair mineral analyses. Almost all mineral testing laboratories use reference ranges. These are usually calculated mathematically to be one, two or three standard deviations from a mean or average value of a large population of those tested at the laboratory.

In contrast, Dr. Paul Eck, and the laboratory he founded, Analytical Research Laboratories, ignores reference ranges and instead focuses upon ideal mineral levels and ratios in their graphs, their information and their interpretations of hair mineral analyses. This difference causes confusion and controversy among doctors, patients and laboratories.

Dr. Eck’s reasoning for using ideals was that we are aiming for optimum health and wellness, not some average level of functioning. Also, most people tested at mineral and other laboratories are ill. Therefore, using their average or mean values as a basis to judge others is faulty reasoning.

Dr. Eck viewed the human being more like a performance automobile that should be in perfect tune or alignment for optimum performance and health. Therefore, he reasoned that optimum or ideal values would be of more usefulness to assess people’s health and guide their healing programs. In this assertion, I concur. In fact, many of the most exciting hair mineral patterns that have been discovered depend wholly upon the use of ideal mineral levels and ratios. Without this concept, the patterns cannot be seen or appreciated nearly as well.

For more on this important subject, read the article on this site entitled Ideal Mineral Levels Versus Reference Ranges.

CAN ONE RECOMMEND A DIET AND NUTRITIONAL SUPPLEMENTS FROM A HAIR ANALYSIS?

Some say this is not possible, as the test only reads mineral levels. However, those who use hair analysis clinically find that it is possible to suggest food and nutrient therapies from the test for several reasons:

· Some foods and nutrients assist the body when it is in a particular stage of stress or metabolic type. Dr. Geroge Watson found that slow oxidizers need more B-complex vitamins, for example, and less fat in their diets.

· Some foods and nutrients are more helpful to correct certain mineral deficiencies. For example, cooked vegetables are rich in many minerals such as manganese, iron, chromium and selenium.

· Certain foods and nutrients can assist the body to remove toxic metals. For example, vitamin C can chelate and lower copper, while calcium-containing foods or supplements can help reduce the level of lead and cadmium.

The textbook I wrote, Nutritional Balancing and Hair Mineral Analysis, covers this subject in much more detail.

WHY ARE HAIR TEST RESULTS SOMETIMES DIFFERENT FROM BLOOD AND URINE TEST RESULTS?

Their meaning is not different at all, in my experience. However, one must be able to interpret the hair and the blood tests correctly to understand how they relate to each other. Few doctors understand both types of tests well enough to do this. A few of the major differences between hair testing and other common tests include:

· The hair measures a different body compartment than the blood or urine. Each has its own metabolism.

· The blood is maintained at the expense of tissues such as the hair. This means the hair will change first, often years before the blood. The blood is far more buffered. It has to be because it touches every cell. Large variations in mineral levels here would be fatal. This is not the case with the hair.

· The hair is a storage organ and, to some degree, an excretory tissue. The blood is a transport medium.

· Blood, urine and saliva provide short-term or even instantaneous readings, whereas a hair test provides a 3-month average or a longer-term reading.

· Homeostatic mechanisms at work in the blood such as buffering of pH and osmotic balance are extremely different from homeostatic mechanisms at work in the tissues and at the cellular level in the hair.

IF HAIR TESTING IS SO HELPFUL, WHY IS IT NOT USED MORE?

I believe it is a combination of factors that include:

· Ignorance of the importance of trace mineral nutrition, toxicology and the critical importance of toxic metal poisoning in the causation of all the major killer diseases.

· Opposition from allopathic medical boards, and mainstream journals such as JAMA that have published phony studies to discredit hair testing.

· Misuse of the test just to measure toxic metals. This does not work well.

· Misuse of the hair test to do replacement therapy. This does not work well, either. Replacement therapy is when the doctor prescribes the minerals that read low on the test, and tells the patient to avoid the minerals that read too high. This way of using hair tests completely ignores important principles such as the bioavailability of a mineral, mineral defenders, mineral displacement and others. The failure of replacement therapy unfortunately causes most doctors to abandon hair mineral testing. My teacher and mentor in hair analysis, Dr. Eck, found the same thing. For this reason, he changed course and used the test was to measure and correct the stress response, a far more sophisticated and elegant use of this test.

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