Lab tests are critical to help rule out (or reveal) the chronic conditions that can precede hair shedding disorders. Remember: of the hair loss sufferers with whom I've worked, nearly 30% of men and almost 100% of women have tested positive for a condition linked to a hair shedding disorder — even when they thought they only had androgenic alopecia.

Here you'll find links to all lab test recommendations on this site. There are two ways you could've arrived here: (1) you read through an Ultimate Guide and suspect you might have an underlying chronic condition linked to your hair shedding, or (2) you just finished building your Custom Regrowth Plan, and are now following up with relevant lab tests.

Lab tests

These tests are provided by True Health Labs — a company that offers the lowest prices for at-home lab work without requiring a doctor's approval. You're more than welcome to shop around — though these are the best prices I've found.

Lab tests are organized by the chronic condition they help to identify. Try using “control + F” for your condition to avoid any redundant reading!

Polycystic Ovarian Syndrome (PCOS):

  1. SIBO breath test. As we’ve already learned, bacteria in our large intestine small intestine can migrate upward to our small intestine and begin competing to consume the nutrients from our food. In this case, we’ll often experience gut dysbiosis and low-grade nutrient deficiencies. To understand if these gut problems and deficiencies are related to the foods we’re eating versus a bacterial overgrowth, this test is critical.
  2. Stool analysis test. Again, long-term gut dysbiosis is a major driver of both insulin resistance and hormonal imbalances — both of which manifest into PCOS. As such, testing the bacterial composition of our gut is a must.
  3. Heavy metal toxicity test. Heavy metals — ranging from cadmium to lead — wreak havoc on our endocrine system. Unfortunately, they’re also rampant in our food supply and environments. Depending on our exposure and detoxification rates, heavy metal accumulation may be driving any insulin and hormonal problems precipitating PCOS.
  4. HPA-axis test. There’s evidence that 50-70% of women with PCOS show signs of adrenal dysregulation — and specifically, a developed “hypersensitivity” to cortisol. These sensitivities are linked to anything from sleep disorders to the consumption of stimulants — and identifying whether hypersensitivity exists can help target better treatments for the condition.
  5. Complete nutrient panel (include vitamin D, zinc, iron, and B12 biomarkers). In order to have a clearer picture of our nutritional status and whether certain inflammatory biomarkers — like c-reactive protein or homocysteine — are elevated and thus indicating the presence of systemic inflammation, we need to do a complete nutrient panel. This is really the only way to determine which nutritional supplements (if any) will help us.

For more information, see the PCOS Ultimate Guide.

Hypothyroidism

  1. A full thyroid panel. This is self-explanatory. These tests measure the amount of circulating thyroid hormones in our serum. Thus, they’re usually the first (and only) test general practitioners will order to determine if someone has a thyroid disorder.
  2. SIBO breath test. As we’ve already learned, bacteria in our large intestine small intestine can migrate upward to our small intestine and compete to consume the nutrients from our food. In this case, we’ll often experience gut dysbiosis and low-grade nutrient deficiencies. This is a driver of hypothyroidism, and as such, we need to test for it.
  3. Stool analysis test. Long-term gut dysbiosis can lead to both insulin resistance and hormonal imbalances — both of which can manifest as hypothyroidism. If we skip out on this test, we might attribute our insulin resistance or hormonal imbalances to false causes.
  4. Food sensitivities test. Identifying any food allergens is critical to determining what’s driving your hypothyroid symptoms and how to treat them. If we’re trying to treat gut dysbiosis while chronically (and unknowingly) consuming a food allergen, we’re going to be undermining our own efforts and likely exacerbating our hypothyroid symptoms.
  5. HPA-axis test. To rule out or identify pituitary dysfunction as a cause of our own hypothyroidism — completing an HPA-axis test is critical. Doing so will give us insights into our hormone metabolites and conversion rates. We’ll be able to identify any step-process dysfunctions in conversions, and get a clearer picture from where a hormonal imbalance might be coming.
  6. Complete nutrient panel (include vitamin D, zinc, iron, selenium, and B-12). In order to have a clearer picture of our nutritional status and whether certain inflammatory biomarkers — like c-reactive protein or homocysteine — are elevated and thus indicating the presence of systemic inflammation, we need to do a complete nutrient panel. With this information, we can begin to address any underlying nutrient deficiencies which might be contributing to our hypothyroidism.

For more information, see the Hypothyroidism Ultimate Guide.

Hyperparathyroidism

  1. Parathyroid test. Test your serum PTH levels. This is the baseline to determine how much parathyroid hormone is circulating in our blood.
  2. Calcium. Test serum calcium. Calcium levels above 10.2 are of concern. It doesn’t matter how high your calcium scores are beyond 10.2 — rather, it matters how long they’ve been elevated.
  3. Vitamin D. Test serum 25(OH)D levels. Low vitamin D levels in the presence of high calcium are often cause for concern, and will require insights from your PTH test to determine if you may have hyperparathyroidism.

For more information, see the Hyperparathyroid Ultimate Guide.

Small Intestinal Bacterial Overgrowth (SIBO)

  1. SIBO breath test. This is the actual test used to determine the presence of severity of bacteria within the small intestine — and will give us key insights into the types of bacteria present: hydrogen-producing versus methane-producing bacteria.
  2. Stool analysis test. SIBO infections often overlap with problems further down the digestive tract — like the large intestine. This means that SIBO often accompanies dysbiosis in the large intestine, and determining if this is present is critical toward developing an effective treatment plan.
  3. Complete nutrient panel (include vitamin D, zinc, and B12 biomarkers). Depending on the severity of the overgrowth, we may or may not be experiencing low-grade, widespread nutrient deficiencies. Testing may elucidate the extent of these issues, and help develop a more targeted treatment protocol.
  4. Full iron panel. This is critical for ruling out anemia as a secondary problem developing from SIBO, especially anemia of inflammation (where gut dysbiosis has progressed so that intestinal pathogens are now entering our bloodstream).

For more information, see the Small Intestinal Bacterial Overgrowth (SIBO) Ultimate Guide.

Nutrient Deficiencies

  1. Complete nutrient panel (include vitamin D, calcium, zinc, selenium, folate, and B-12). In order to have a clearer picture of our nutritional status and whether certain inflammatory biomarkers — like c-reactive protein or homocysteine — are elevated and thus indicating the presence of systemic inflammation, we need to do a complete blood panel.
  2. Full iron panel. This will help us rule out — if you’re iron deficient — whether supplementing / eating foods richer in iron will improve (or worsen) your symptoms.
  3. Tests relevant for other conditions (symptom-specific). If you have digestive distress or skin problems, this almost always means testing for SIBO alongside a stool analysis test. If you have lethargy, eyebrow hair loss, or imbalanced hormones — do a thyroid panel. In doing so, you’ll get a clearer picture of what’s going on.

For more information, see the Nutrient Deficiencies Ultimate Guide.

Nutrient Surpluses

  1. Complete nutrient panel (include vitamin A, vitamin B-12, vitamin D, calcium, zinc, selenium, and folate).
  2. Complete iron panel. If your iron is high, having a full iron panel will help delineate whether this is due to a sequestering problem or just seems symptomatic of iron overload from too much ingestion or hemochromatosis.

For more information, see the Nutrient Surpluses Ultimate Guide.

Trace Element / Heavy Metal Toxicities

  1. Heavy metal / trace element toxicity test. The problem with blood (serum) tests is that they only measure the amount of circulating heavy metals. Since heavy metals are quickly sequestered into hard tissues (like bone), serum tests really only give us a short-term idea of our exposure rates. A better approach is to test our hair. This will give a better idea of our longer-term exposure rates to heavy metals / trace elements (and what to target).
  2. Any other symptomatic conditions. If you have symptoms of hypothyroidism, do a thyroid panel. This condition often compounds with heavy metal toxicities, and as such, it’s a good idea to make sure it isn’t present. If it is, we need to treat both the heavy metal toxicity and hypothyroidism (or any other concomitant condition) simultaneously.

For more information, see the Trace Element / Heavy Metal Toxicities Ultimate Guide.

Other relevant tests

Some of these tests aren't specific to certain conditions, but they still bring a lot of insights in terms of metabolism, gluten sensitivities, cross-reactivity with gluten and other molecules, and a snapshot of your hormonal profile.

I usually don't initially recommend these tests – particularly because the costs of lab testing can add up quickly. In any case, I'm listing them below because doing many of these tests helped elucidate some pathways to my hypothyroid symptoms (as mentioned in the book).