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What Labs Should I Get Checked for Hair Loss?

I often see patients in the office for hair loss.  Mainly women, to be honest.  Is that because I’m a woman, or because men are more accepting of losing their hair?  Either way, more women tend to think about getting bloodwork checked for hair loss than men.  So, today I’ll start with general recommendations for men and women, then add a few for men. 

There are multiple different types of hair loss.  Telogen effluvium is the most common type seen in those with medical reasons for hair loss.  To learn more about Telogen effluvium, read our previous article that describes how hairs get “stuck” in the resting or telogen phase.   Telogen effluvium can be caused by stress, medical illness, medications, surgeries, and more.  For patients where there is not an obvious cause, I often order a series of labs to look for underlying medical problems that may be causing telogen effluvium.

Recommended labs for men and women that I often order for Hair Loss.

Complete Blood Count (CBC)- to look for Anemia primarily. If there is anemia then additional tests for Iron and Ferritin. 

Thyroid Stimulating Hormone (TSH) – to look for thyroid problems.

Chemistry Panel (Chem7)  – to look for Kidney Disease.

Liver Enzymes (AST/ALT) – to look for Liver Disease.

Antinuclear Antibody (ANA) -to look for rheumatologic disorders like lupus.

Vitamin D – to look for Vitamin D deficiency

Additional recommended labs for women with suspected hormonal imbalance.

Estrogen, Free Testosterone, DHEA and sometimes FSH and LH

I generally DO NOT wait for the labs to come back to make a recommendation for therapy.  Why? Because independent of the cause of the hair loss the treatment remains the same. Rogaine works to jumpstart hair growth independent of the cause of the telogen effluvium.

Some clinicians offer more tests, but this is the first line of what I order.  If additional hormonal disorders are still suspected in male pattern loss, androgenetic alopecia, in females, I sometimes refer to Endocrine or GYN for further workup.

Many patients have already had their lab checked prior to seeing me.  If the labs are recent, please bring a digital or paper copy of those to your visit to eliminate duplicating labs.

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