Hair Mineral Analysis: What It Can and Cannot Show

Urgent first

If you think someone has been poisoned by a metal, medicine or product, do not wait for a hair test. In the US call Poison Help at 1-800-222-1222, or 911 for collapse, seizure or trouble breathing. See poisoning: what to do first. This page is information only and does not replace medical care.

What it is

Hair mineral analysis (also called hair tissue mineral analysis) sends a snippet of hair to a laboratory, which reports levels of minerals and sometimes toxic metals. It is offered by some naturopathic, integrative and nutrition practices and by direct-to-consumer companies. It is marketed to show nutrient status, "mineral imbalances" or toxic exposure, and results are often followed by supplement advice. The question here is the test, not the profession of the person selling it.

What the best-known comparison found

A study in JAMA took a split hair sample from one healthy volunteer and sent it to six commercial US laboratories, which the authors said analyze 90% of samples submitted for mineral analysis in the United States. [1]

The authors concluded that hair mineral analysis from these laboratories was unreliable and recommended that practitioners refrain from using it to assess individual nutritional status or suspected environmental exposures. [1] They also called for attention to the regulation and certification of these laboratories. [1]

Limits of this evidence. It is a 2001 study using one volunteer, so it speaks to agreement between laboratories, not to every possible use of hair testing. We searched for a newer comparison of commercial hair mineral laboratories and did not find one we could read, so we cannot say whether laboratories have changed since. We also did not find a readable guideline from a medical society either endorsing or rejecting hair mineral analysis for health assessment. Summary label for the marketed uses (nutrition status, toxic exposure): no good evidence of benefit, based on this study.

Why this matters for decisions

A report that calls a mineral "low" or "high" may lead to supplements, a restricted diet or further tests. Since the labs disagreed on both numbers and normal ranges, the same hair could be described as normal or abnormal depending on the lab. [1] Please do not start or stop a supplement or medicine on the strength of a hair report. For supplement safety see Natural remedy safety.

What doctors use instead

• Suspected nutrient shortage: a clinician decides which blood test fits your symptoms and history. Symptoms such as unexplained weight loss or ongoing fatigue need a medical visit.
• Suspected metal poisoning: the history of exposure matters first. For lead, MedlinePlus says a blood lead test can help identify whether a problem exists, and that chelation can remove high levels of lead. [2]
• Urine "challenge" tests: a medicine is given before the urine is collected. An article quoting the American College of Medical Toxicology says these tests have not been validated, have no demonstrated benefit and may be harmful. [3] See provoked urine tests.

Questions to ask before paying

• What exactly is this test validated to detect, and where is that published?
• What would a high or low result change in my care?
• Do you sell the supplements the report recommends?
• Will my own doctor see the result?

Children, pregnant people, people with kidney or liver disease and those on several medicines should check with a clinician before acting on any report. If a test is used to justify a "detox" or chelation program, read detox programs and chelation claims.

Related reading

The overview is tests sold in integrative practice. The Biohacking page is hair mineral analysis. To check any test claim, use home and direct-to-consumer health tests: what to check.