From the Guidelines
To evaluate hair loss in a female, common labs ordered include:
- Complete Blood Count (CBC) to rule out anemia or iron deficiency 1
- Comprehensive Metabolic Panel (CMP) to assess liver and kidney function 1
- Thyroid-stimulating hormone (TSH) to evaluate thyroid function 1
- Free thyroxine (FT4) and free triiodothyronine (FT3) if TSH is abnormal 1
- Iron panel, including serum iron, total iron-binding capacity (TIBC), and ferritin to assess iron stores 1
- Vitamin D level to evaluate for deficiency 1
- Androgen panel, including testosterone and dihydrotestosterone (DHT) to assess for androgenetic alopecia 1
- Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to evaluate for polycystic ovary syndrome (PCOS) or other hormonal imbalances 1
These laboratory tests can help identify underlying causes of hair loss, such as iron deficiency, thyroid disorders, vitamin D deficiency, and hormonal imbalances, and guide treatment decisions. It is essential to note that the specific tests ordered may vary depending on the individual patient's presentation and medical history.
From the Research
Laboratory Tests for Female Pattern Hair Loss
To evaluate female pattern hair loss (Androgenetic Alopecia), several laboratory tests can be ordered, including:
- Hemoglobin concentration to screen for iron deficiency 2
- Serum ferritin concentration to confirm iron deficiency 2, 3, 4
- Erythrocyte zinc protoporphyrin concentration, transferrin concentration, serum iron concentration, and transferrin saturation to further evaluate iron status 2
- Vitamin D levels, as low levels have been associated with hair loss in females with telogen effluvium and female pattern hair loss 3
- Thyroid function tests, as thyroid disorders can cause hair loss 5
- Blood tests to rule out other systemic causes of hair loss, such as infectious agents, autoimmune disorders, and nutritional deficiencies 5
Rationale for Laboratory Tests
The rationale for ordering these laboratory tests is to identify potential underlying causes of hair loss, such as iron deficiency, vitamin D deficiency, and thyroid disorders. Iron deficiency, in particular, has been linked to hair loss in women, and serum ferritin levels can be used to confirm iron deficiency 2, 3, 4. Vitamin D levels have also been shown to be lower in women with hair loss, and supplementing with vitamin D may be beneficial in the treatment of hair loss 3. A methodical approach to evaluating hair loss, including a thorough medical history, physical examination, and judicious use of laboratory tests, can help identify the underlying cause of hair loss and guide treatment 5.