HTMA References


Following is a limited sampling of references supporting the use of hair tissue mineral analysis in the research and healthcare fields.

Ryabukhin, T.S.: International Coordinated Program on Activation Analysis of Trace Element Pollutants in Human Hair. Hair, Trace Elements, and Human Illness. Brown, A. C.; Crounse, R. G., ed. Praeger Publications, 1980.

Several research programs for studying and establishing hair trace mineral concentrations have been implemented since 1965 by the International Atomic Energy Agency. These research programs have been coordinated under “Nuclear-based Methods for the Analysis of Pollutants in Human Hair.” Hair was chosen by the I.A.E.A. due to the concentration of minerals in the hair and its reflection of both external and internal contamination. The bulk of data on trace element concentrations has been reported from hair samples obtained from the scalp.

Karpas Z, Lorber A, Sela H, Paz-Tal O, Hagag Y, Kurttio P, Salonen L., Measurement of the 234U/238U ratio by MC-ICPMS in drinking water, hair, nails, and urine as an indicator of uranium exposure source. Health Phys. 2005 Oct;89(4):315-21.

Bioassay of hair is attractive as it is an effective bio-concentrator, samples can be easily stored, the concentration reflects an integrated value, and, finally, the measurement of the (234)U/(238)U isotopic ratio in digested hair samples by MC-ICPMS is feasible and highly informative.

Park, B, High Calcium­Magnesium Ratio in Hair is Associated with Coronary Artery Calcification in Middle Aged and Elderly Individuals. Biol.Trace Elem.Res. 179,1, 2017

Coronary calcification scores were strongly associated with a higher calcium­to­magnesium ratio in the hair than lower calcium to magnesium ratios found.

TH Ha, J Lee, YJ Kim. Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth. Pediatr. Gastroenterol. Hepatol, Nutr. 19, 4, 2016.

Hair samples were sent to Trace Elements, Inc, (TEI), via TEI­Korea. Zinc deficiency was found in the hair of eighty­eight percent of the study group. Serum zinc was found low in fifty­five percent of the affected group. Zinc therapy resulted in improvement in clinical signs and symptoms in most of the children including increase in body weight, appetite and growth.

Hair Zinc and Copper Levels and Serum Testosterone Chang, CS, et al. Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue. Biol.Trac.Elem.Res. 144, 2011.

Findings reported that individuals with normal serum testosterone levels had a significantly higher HTMA zinc level compared to a low testosterone group. Also, the study concluded that decreased testosterone was associated with a significant reduction of the zinc to copper ratio in hair samples.

A Review of Hair Analysis for Minerals, Hormones and Drugs Ahmad, G. et al. A review Hair tissue Analysis: An analytical method for determining essential elements, toxic elements, hormones and drug use and abuse. Intl.Res.J.Appl.Basic Sci. 4, 2013.

Various mineral imbalances as revealed by hair analysis can indicate metabolic dysfunctions before any symptoms occur, and that hair analysis of minerals is used not only for diagnostic purpose but also to monitor the nutritional state of the patient until treatment benefits are achieved and the effects of the program have been stabilized.

Metal ions released from fixed orthodontic appliance affect hair mineral content. Mikulewicz M, Wołowiec P, Loster B, Chojnacka K. Biol Trace Elem Res. 2015 Feb;163(1-2):

The value of exposure (kinetics and dose) of orthodontic patients to metal ions released from orthodontic appliances can be assessed by hair mineral analysis.

Strain, W. H.; Pories, W. J.; Flynn, A.; Hill, O. A.: Trace Element Nutriture and Metabolism Through Head Hair Analysis. Trace Substances in Environmental Health. Hemphill, D. D., ed. University of Missouri Press, Columbia, 1972.

Human head hair is a recording filament that can reflect metabolic changes of many elements over long periods of time and thus furnish a print-out of post nutritional events.

Metals and Neurotoxicology. Wright, RO, et al. J. Of Nutr. 138,12, 2007.

It is well known that nutritional mineral deficiency can impair neurological development. Some transitional nutrients can cause later-life health disturbances when deficient in the diet, but in excess can be just as harmful and include iron, copper, manganese, zinc and others. Heavy metals such as lead, cadmium, mercury and arsenic are also neurotoxins and when present early in life can contribute to impaired neuro-development and detrimental health effects later in life and have been called the “fetal origins of disease.” Hair concentrations of cadmium compared to reference groups were found to be higher in children with mental retardation, learning disabilities, dyslexia and lower I.Q.

Comparative study of trace elements in blood, scalp hair and nails of prostate cancer patients in relation to healthy donors. Qayyum MA, Shah MH. Biol Trace Elem Res. 2014 Dec;162(1-3):46-57.

Multivariate apportionment of trace elements in the blood, scalp hair and nails of the patients was also significantly different than that in the healthy donors.

Copper, Chromium, Manganese, Iron, Nickel and Zinc Levels in Biological Samples of Diabetes Mellitus Patients. Kazi, TS, et al. Biol. Trace Elem. Res. 122,1, 2008.

Hair, blood and urine minerals analyzed in diabetic patients compared to non-diabetic controls showed that the mean levels of zinc, manganese and chromium were significantly lower in the blood and scalp hair of patients diagnosed with diabetes. Higher levels of copper and iron were also found in the scalp hair of the diabetic group as well.

Evaluation of chromium and manganese in biological samples (scalp hair, blood and urine) of tuberculosis and diarrhea male human immunodeficiency virus patients. Afridi HI, Kazi TG, Talpur FN, Arain S, Arain SS, Kazi N, Panhwar AH, Brahman KD. Clin Lab. 2014;60(8):1333-41.

The consequence of trace elements deficiency has been associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) disease progression and mortality.

Miekeley, N., et al. Elemental Anomalies in Hair as Indicators of Endocrinologic Pathologies and Deficiencies in Calcium and Bone Metabolism., J. Trace Elem. Med. Biol. 15, 1, 2005

Statistical evaluation of these data by multivariant analysis (MANOVA) using a contrast matrix and by discriminant analysis showed that elemental hair anomalies can be used to diagnose correctly the above-mentioned pathologies, demonstrating the usefulness of hair analysis as a complementary tool for the detection of disturbances in calcium/bone metabolism.

Toxic Trace Metals in Mammalian Hair and Nails. United States Environmental Protection Agency Publication 1979; EPA-600/4: 79: 049

The consensus of most workers in the field is that if hair samples are collected properly, cleaned and prepared for analysis correctly and analyzed by the best analytical methods, using standards and blanks as required, in a clean and reliable laboratory, by experienced personnel, the data are reliable.

Distribution of arsenic, cadmium, lead, and nickel levels in biological samples of Pakistani hypertensive patients and control subjects. Afridi HI, Kazi TG, Talpur FN, Arain S, Arain SS, Kazi N, Panhwar AH. Clin Lab. 2014;60(8):1309-18

The high exposure of toxic elements may be synergistic with risk factors associated with hypertension. These data present guidance to clinicians and other professionals who will be investigating the toxicity of heavy elements in biological samples (scalp hair and blood) of hypertensive patients.

Hair toxic element content in adult men and women in relation to body mass index. Skalnaya MG, Tinkov AA, Demidov VA, Serebryansky EP, Nikonorov AA, Skalny AV. Biol Trace Elem Res. 2014 Oct;161(1):13-9.

Higher values of scalp hair mercury and lead content were observed in men and women with increased body mass index independently of their age.

Talpur, S., et al. Interaction of Lead, with Calcium, Iron and Zinc in Biological Samples of Malnourished Children. Biol. Trace Elem. Res. Aug. 2017

Results showed twice the level of lead in the malnourished group compared to the control group and half the levels of calcium, iron and zinc.

Skalny, AV, et al. Whole Blood and Hair Trace Elements and Minerals in Children Living in Metal­Polluted Area Near Copper Smelter in Karabash, Chelyabinsk Region, Russia.. Environ. Sci. Pollut. Res. Int. 2016.

Their findings show that adverse health effects of individuals living near or in a polluted environment is not only associated with heavy metals exposure, but altered mineral homeostasis as well.

Lee, SH, et al. Coronary Calcification is Reversely Related with Bone and Hair Calcium: The Relationship Among Different Calcium Pools in Body. J. Bone Metabol. 23, 4, 2016

Hair samples were analyzed in fifty women along with their coronary calcium scores, bone mineral density. They found that coronary calcium scores were negatively correlated with bone mineral density and hair calcium levels.

Shishniashvili, TE, et al. Primary Teeth and Hair as Indicators of Environmental Pollution.J. Clin. Pediatr. Dent. 40,2, 2016.

Hair and dental tests showed higher levels of lead, mercury and tin in tissues obtained from groups living in polluted areas. Therefore, hair and dental material can be used as indicators of environmental pollution.

Ozden, TA, et al. Copper, Zinc and Iron Levels in Infants and Their Mothers During the First Year of Life: A prospective Study. BMC Pediatr. 15,157, 2015

Hair zinc levels and serum iron levels decreased significantly toward the end of the first year. The maternal hair copper and serum iron also decreased. The study concluded that infants appear to require an increase in zinc intake after six months of age.

Krol, E, et al. The Relationship between Dietary, Serum and Hair Levels of Minerals (Fe, Zn,Cu) and Glucose Metabolism Indices in Obese Type 2 Diabetic Patients. Biol. Trace Elem. Res. Aug. 8, 2018.

Both hair and serum minerals were analyzed as well as serum insulin, HbA1c, glucose, and cholesterol. The patients with diabetes had higher hair iron and lower serum zinc than controls. Insulin levels were positively associated with the hair copper / zinc ratio.

Hotta, Y, et al. Essential and Non-essential Elements in Scalp Hair of Diabetics: Correlations with Glycated Hemoglobin (HbA1c). Biol. Pharm. Bull. 41,7, 2018.

Findings included lower tissue levels of zinc, copper and chromium in the diabetic group and these levels were significantly lower with higher HbA1c levels.

Lee, SH, et al. Low hair copper concentration is related to a high risk of nonalcoholic fatty liver disease in adults. J. Trace Elem Med Biol. 50, 2018.

Lower hair copper was correlated with higher body mass index, waist circumference, blood pressure, and low HDL. Individuals with NAFLD had significantly lower hair copper levels.

Grabeklis, AR, et al. Hair Mineral and Trace Element Content in Children with Down’s Syndrome. Biol. Trace Elem. Res. Sept. 12, 2018.

Findings concluded that 1 to 2 year old children with Down’s syndrome are characterized by significant alterations of mineral and trace elements status.

Jamshidi, S, et al. Evaluation of scalp hair nickel and chromium level changes in patients with fixed orthodontic appliance: a one-year follow-up study. Acta Odontol Scand. 76,1 2018.

Hair samples were analyzed in a group of individuals with orthodontic appliances after one year since placed. Elevated levels of both nickel and chromium were found in the treatment group compared to controls.

Mercury as a Risk Factor for Cardiovascular Disease. J. Nutr. Biochem. 18, 2007.

A study of men over a period of thirteen years found that for each microgram of mercury found in the hair, the risk of acute coronary events increased by an average of eleven percent and cardiovascular disease death rate by ten percent.

Al-Shahristani, H.; Al-Haddad, I. K.: Mercury Content of Hair From Normal and Poisoned Persons. J Radioanalytical Chem 1973; 15.
Al-Shahristani, H.; Shihab, K. M.: Variation of Biological Half-Life of Methylmercury in Man. Arch Environ Health 1974; 28.

An example of how mineral intake is reflected in the hair was demonstrated in a study of several thousand Iraqi peasants, whose diet contained grain heavily treated with fungicides. The fungicides contained organic mercury, which was reflected in higher concentrations in the hair when consumption was highest and decreased when consumption was lowest. Hair concentrations correlated directly with the extent of symptoms.

Spallholz JE, Boylan LM, Palace V, Chen J, Smith L, Rahman MM, Robertson JD., Arsenic and Selenium in Human Hair; A comparison of Five Countries With and Without Arsenicosis., Biol Trace Elem Res. 2005 Aug;106(2):133-44.

Hair samples collected and analyzed from five countries with known arsenic sources, both high and low included the United States, Canada, and People’s Republic of China, Bangladesh and Nepal. Hair arsenic concentration in all hair samples correlated with the amount of arsenic in drinking water and revealed the low intake of selenium in areas of high arsenic concentrations. The results demonstrate the viability of hair as a noninvasive biomonitor in assessing aspects of dietary Se and environmental As exposure.

Gilbert, R. I.: Trace Elements in Human Hair and Bone. Hair, Trace Elements and Human Illness Brown, A.C.; Crounse, R. G. ed. Praeger Publications, 1980.

The proliferation of trace element analysis as a tool for biological investigation of nutrition, growth and development, and disease processes has led to consideration of (hair) trace element analysis as a means not only of present evaluation and estimation, but also as a technique for the reconstruction of past biological events in an organism.

The diagnostics of diabetes mellitus based on ensemble modeling and hair/urine element level analysis. Chen H, Tan C, Lin Z, Wu T. Comput Biol Med. 2014 Jul;50:70-5.

The findings indicate that hair samples are superior to urine samples. Even so, it can provide more valuable information for prevention, diagnostics, treatment and research of diabetes by simultaneously analyzing the hair and urine samples.

Skalny, AV et al. The impact of lifestyle factors on age-related differences in hair trace element content in pregnant women in the third trimester. Acta Sci Pol Techn Aliment. 17, 1, 2018.

Older pregnant women had lower hair zinc, vanadium and cadmium content and higher boron compared to younger women. Their data indicates that lifestyle factors has an influence on age-related changes in hair trace elements during pregnancy that may impact the outcome of pregnancy.

Akainy, AV, et al. Toxicological and nutritional status of trace elements in hair of women with in vitro fertilization (IVF) pregnancy and their 9-months-old children. Reprod. Toxicol. 11,81, 2018.

The children of the IVF group had low hair levels of chromium, iron, magnesium and higher mercury and molybdenum compared to the control group. Hair mineral levels were associated with infertility and pregnancy complications. The authors conclude that the results suggest the need for preconception monitoring and correction of essential elements as well as toxic metals in order to improve the course of pregnancy and child development.

Tippairote, T, et al. Hair Zinc and Severity of Symptoms Are increased in Children with Attention Deficit and Hyperactivity Disorder: a Hair Multi-element Profile Study. Biol. Trace Elem Res. 179,2, 2017.

Copper to zinc and phosphorus to zinc ratios were found to be significantly lower in affected children than controls. Apparently elevated higher hair zinc levels were correlated with more symptoms of inattention, hyperactivity and total ADHD symptoms.

Wang, B, et al. Alkaline-earth elements of scalp hair and presence of hypertension in housewives: A perspective of chronic effect. Chemosphere, 181, 2017.

Lower levels of these elements was associated an increase presence of hypertension and reflected the different dietary intake between the two groups tested.

Dhaher SA, et al. Estimation of Zinc and Iron in the Serum and Hair of Women with Androgenetic Alopecia: Case-Control Study. Indian J Dermatol. 63,5, 2018.

Serum and hair zinc and iron levels were markedly lower in women experiencing hair loss compared to the control group.

Afridi, HI, et al. Assessment of selenium and mercury in biological samples of normal and night blindness children of age groups (3-7) and (8-12). Environ. Monit. Assess. 187,3, 2015.

The concentrations of selenium were lower in scalp hair and blood samples of male and female children with night blindness. Mercury was higher in hair, blood and urine compared to controls. The authors concluded that the data obtained from this study can provide guidance to clinicians and other professionals investigating deficiency of essential trace elements and excess toxic elements in children with night blindness.

Janabai, G, et al. Investigation of Trace Elements in the Hair and Nail of Patients with Stomach Cancer. Indian j Clin Biochem. 33,4 2018.

Magnesium and strontium levels were markedly lower in the cancer group and iron levels were found to be significantly higher. The mean levels of iron, selenium and phosphorus increased with advanced cancer stages in nail samples. Their results show that the increase in trace elements could a potential diagnostic marker to help predict cancer progression and its etiology.

Ozgen, IT, et al. Hair Selenium status in children with leukemia and lymphoma. J. Pediatr Hematol Oncol. 29,8, 2007.

The hair selenium levels were found to be significantly lower in the cancer group. In conclusion, it was found that the hair selenium levels of children with leukemia and lymphoma, particularly in those that were malnourished were low compared to the healthy group.

Skalny, AV, et al. Whole blood and hair trace elements and minerals in children living in metal-polluted are near copper smelter in Karabash Chelyabinsk region, Russia. Environ Sci Pollut Res Int. 25,3, 2018.