From the Guidelines
For women with alopecia, I recommend a comprehensive laboratory workup including complete blood count (CBC), comprehensive metabolic panel, thyroid function tests (TSH, free T3, free T4), ferritin, vitamin D, zinc levels, and hormone panel (total and free testosterone, DHEAS, androstenedione, prolactin) to identify underlying causes of hair loss such as iron deficiency, thyroid disorders, or hormonal imbalances. These tests are crucial because many forms of alopecia in women stem from correctable metabolic, nutritional, or hormonal abnormalities. For example, low ferritin (below 40 ng/mL) can significantly impact hair growth even when hemoglobin appears normal, as noted in studies such as 1. Similarly, subclinical thyroid dysfunction can cause diffuse hair thinning before other symptoms become apparent.
Some key points to consider in the laboratory workup include:
- Iron status, as iron deficiency has been linked to hair loss in some studies, although the evidence is not conclusive, as discussed in 2.
- Vitamin D and zinc levels, as these micronutrients may play a role in hair growth, as suggested by 3.
- Hormone panel, as hormonal imbalances can contribute to hair loss, particularly in cases of androgenetic alopecia.
- Thyroid function tests, as thyroid disorders can cause hair loss, and early identification can lead to targeted treatment.
It's also important to consider the potential for autoimmune alopecia, in which case antinuclear antibody (ANA) testing may be valuable, as mentioned in general guidelines for managing alopecia areata 4, 5. However, the decision to test for specific conditions should be based on the individual patient's presentation and medical history.
Overall, a comprehensive laboratory workup is essential for identifying the underlying causes of alopecia in women and guiding targeted treatment to address the root cause of hair loss, rather than just managing symptoms.
From the Research
Alopecia Labs for Women
There are no research papers directly related to alopecia labs for women in the provided evidence. However, we can look at related studies on alopecia and thyroid function:
- The study 6 focuses on male patients with androgenetic alopecia and its association with iron deficiency and thyroid dysfunction. Although it does not directly relate to women, it provides insight into the potential link between thyroid function and alopecia.
- A review of thyroid function tests 7 discusses various tests used to diagnose thyroid dysfunction, which may be relevant to women with alopecia, as some studies suggest a link between thyroid diseases and alopecia.
- A systematic review and meta-analysis 8 investigates the association between alopecia areata and thyroid dysfunction, finding that patients with alopecia areata have higher odds of abnormal thyroid function test results and autoimmune thyroid diseases. This study may be relevant to women with alopecia areata, although it does not specifically focus on female patients.
Relevant Tests
Some tests that may be relevant to women with alopecia include:
- Thyroid function tests, such as serum total thyroxine (T4), serum total triiodothyronin (T3), free thyroxine (FT4), and free triiodothyronin (FT3) 7
- Thyroid-stimulating hormone (TSH) tests, as used in the study 6
- Autoantibody tests, such as antithyroglobulin antibodies (ATA) and antimicrosomal antibodies (AMA) 7