From the Guidelines
Laboratory tests for hair loss, muscle aches, joint pain, and fatigue should include blood testing to evaluate muscle inflammation, such as CK, transaminases (AST, ALT), lactate dehydrogenase (LDH), and aldolase, as well as inflammatory markers (ESR and CRP) and troponin to evaluate myocardial involvement, as recommended by the American Society of Clinical Oncology clinical practice guideline 1. When evaluating these symptoms, it is essential to consider a complete rheumatologic and neurologic history and examination, including muscle strength and examination of the skin for findings suggestive of dermatomyositis, as muscle weakness is more typical of myositis than pain 1. Some key points to consider when ordering lab tests include:
- Blood testing to evaluate muscle inflammation, including CK, transaminases (AST, ALT), lactate dehydrogenase (LDH), and aldolase
- Inflammatory markers (ESR and CRP)
- Troponin to evaluate myocardial involvement
- Consider electromyography (EMG), imaging (MRI), and/or biopsy on an individual basis when diagnosis is uncertain and overlap with neurologic syndromes, such as myasthenia gravis, is suspected
- Consider paraneoplastic autoantibody testing for myositis and neurologic conditions, such as myasthenia gravis These tests can help identify underlying causes of the symptoms, such as muscle inflammation, autoimmune disorders, or inflammatory conditions, and allow for targeted treatment of the underlying condition rather than just managing symptoms. While other guidelines, such as the British Association of Dermatologists' guidelines for the management of alopecia areata, may provide additional recommendations for specific conditions, the American Society of Clinical Oncology clinical practice guideline provides the most comprehensive and up-to-date recommendations for evaluating hair loss, muscle aches, joint pain, and fatigue in the context of immune-related adverse events 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Lab Tests for Hair Loss, Muscle Aches, Joint Pain, and Fatigue
- A complete blood cell count (CBC) is a common laboratory test that can help diagnose various conditions, including anemia, thrombocytopenia, and leukopenia 2.
- For hair loss, a CBC can be used to define inflammation levels, and parameters such as red cell distribution width (RDW), mean platelet volume (MPV), and C-reactive protein (CRP) can be studied 3.
- CRP values were found to be significantly higher in patients with alopecia areata, suggesting its use as a marker in diagnosing the condition 3.
- Vitamin D levels have also been associated with alopecia areata, with patients having significantly lower mean serum 25-hydroxyvitamin D levels compared to controls 4.
- Serum calcium levels were not found to be significantly lower in patients with alopecia areata compared to controls 4.
- Other lab tests that may be relevant for muscle aches, joint pain, and fatigue include: