<\/p>\n\n\n\n
When I was about one year postpartum with my first baby, I was super fatigued. Not the kind of fatigue that comes with a baby nursing overnight\u2014that phase had thankfully ended months before. Instead, I felt depleted, tired, weak, and mentally cloudy. <\/p>\n\n\n\n
A quick Google search for these symptoms brought me to blogs and podcasts of popular wellness practitioners and influencers, touting how mainstream medical providers ignore these symptoms because they ignore the most insightful test: your mineral levels, as measured through a hair tissue mineral analysis (HTMA). If you just understood your mineral levels, they claimed, you could eat the right foods or take the right supplements to reset your body and get your health back on track.<\/p>\n\n\n\n
Coming from a position of skeptical curiosity, I dug in a little more. Can your hair really give you a window into your body\u2019s mineral status and any potentially associated symptoms? Could this explain my postpartum symptoms, and even more complicated cases like infertility? Let\u2019s take a look.<\/p>\n\n\n\n
Minerals are often referred to as the \u201csparkplugs\u201d of your body<\/a>. They are responsible for thousands of biochemical reactions that keep us alive. I\u2019m not a car mechanic, though, so sometimes this explanation goes over my head. This analogy is a bit more my speed: You can also think of minerals as the backstage crew at a concert\u2013there is no show without the crew, but they aren\u2019t the main performers on stage.<\/p>\n\n\n\n Both minerals and vitamins<\/a> are considered micronutrients, meaning that while they\u2019re essential, your body only needs them in very small amounts (in contrast to the macronutrients that provide your body with the energy needed to sustain life: protein, fat, and carbohydrates). Vitamins are organic compounds and dissolve in either water or fat. Minerals are inorganic compounds, meaning they don\u2019t break down when exposed to heat, air, or other elements like water or fat.<\/p>\n\n\n\n Some of the major mineral micronutrients needed by the body include calcium, magnesium, sodium, and potassium; we need these in larger amounts. The trace minerals include iron, zinc, iodine, and selenium; we need less of these minerals per day. <\/p>\n\n\n\n Infertility<\/a> is a hugely complex<\/a> reproductive issue that can have any number of causes, including endometriosis<\/a>, problems with fallopian tubes<\/a>, PCOS<\/a> or anovulation, uterine fibroids<\/a>, or hormone imbalances<\/a>. Could mineral deficiencies also be added to this extensive list?<\/p>\n\n\n\n Some minerals are known to contribute to the biological processes required for proper ovulation, fertilization, and implantation, which we\u2019ve written about previously at Natural Womanhood<\/a>. For example, zinc<\/a> contributes<\/a> to follicle maturation and release, insulin sensitivity, and thyroid health, all of which are important for fertility [1]. Iodine<\/a> is only needed in trace amounts, but is essential for thyroid hormones that regulate your metabolism and reproductive cycles [2]. Magnesium<\/a> supports<\/a> the endometrium, oocyte quality, and ovulation [3]. Iron deficiency<\/a> and anemia can affect ovulation and egg health.<\/p>\n\n\n\n While maintaining adequate mineral levels clearly matters, it\u2019s equally true that more is not always better. Excessive supplementation without testing can create new imbalances or even toxicity. <\/p>\n\n\n\n While maintaining adequate mineral levels clearly matters, it\u2019s equally true that more is not always better. Excessive supplementation without testing can create new imbalances or even toxicity. <\/p><\/blockquote><\/figure>\n\n\n\n Now that we know minerals are important, how can we test their levels in the body?<\/p>\n\n\n\n Hair tissue mineral analysis (HTMA) is a laboratory technique<\/a> that analyzes the mineral and heavy metal content of a small hair sample, typically cut close to the scalp (usually from the nape or back of the head). The rationale is that as hair grows, minerals from the bloodstream are deposited into the hair shaft and become \u201clocked in\u201d (i.e. keratinized), creating a longitudinal record of mineral and metal exposure over the preceding weeks or months. This is in contrast to a traditional blood (or urine) test that only samples the nutrient levels from that day (usually a 24-hour period).<\/p>\n\n\n\n When I began researching HTMA, I started trying to find reliable scientific or medical sources on the test and its analysis. Unfortunately, it was very<\/em> difficult to find any sources (let alone high quality ones) from anyone with a medical or dietitian license regarding HTMA use for detecting micronutrient deficiencies. <\/p>\n\n\n\n I did <\/em>find dozens of blog posts from various self-proclaimed nutritionists, which is unfortunately an unregulated term<\/a> (meaning that anyone with a knowledge of food and health could technically call themselves a nutritionist). On top of that, almost every single search result about HTMA was published by an individual or organization also selling <\/em>the test and an interpretation of the results. While that doesn\u2019t mean all the information is false, it does signal a big conflict of interest in reliable research.<\/p>\n\n\n\n When it comes to assessing mineral status, most physicians rely on blood tests, which show the minerals currently circulating in the bloodstream. However, as mentioned previously, these levels can shift quickly (after a meal, exercise, or stress) and don\u2019t always reflect what\u2019s stored in tissues. Proponents of HTMA argue that hair can offer a longer-term record of mineral accumulation, revealing patterns over weeks or months rather than moment-to-moment fluctuations. However, major medical organizations<\/a> still do not endorse HTMA for diagnosis.<\/p>\n\n\n\n Some of what I could piece together from this test boils down to the fact HTMA has not proven to be consistent or reliable for diagnosing particular medical conditions. Let\u2019s look at a few of the issues.<\/p>\n\n\n\n Critics of HTMA claim<\/a> the hair sample<\/a> isn\u2019t a good representative of other tissues in the body [4]. In other words, mineral levels measured in the hair don\u2019t necessarily give the full picture of the mineral status in your tissues and cells (where the biological functions are actually happening). Hair is also susceptible to contamination from coloring agents, shampoos, soaps, etc. <\/p>\n\n\n\n Critics also claim that the HTMA isn\u2019t a good diagnostic because there is no oversight regulation on HTMA laboratories, leading to vast differences in results across different labs [4]. For example, one study comparing six commercial HTMA laboratories showed dramatic variability in the results for 12 different minerals: the highest and lowest reported values differed by more than tenfold, and most minerals\u2019 reported levels fell into conflicting categories of \u201chigh,\u201d \u201cnormal,\u201d or \u201clow\u201d across the labs. The authors concluded<\/a> that HTMA results from these commercial labs were unreliable<\/em> and recommended that clinicians refrain from using them for diagnosing nutritional status or environmental exposures [5].<\/p>\n\n\n\n Critics also claim that the HTMA isn\u2019t a good diagnostic because there is no oversight regulation on HTMA laboratories, leading to vast differences in results across different labs. For example, one study comparing six commercial HTMA laboratories showed dramatic variability in the results for 12 different minerals: the highest and lowest reported values differed by more than tenfold, and most minerals\u2019 reported levels fell into conflicting categories of \u201chigh,\u201d \u201cnormal,\u201d or \u201clow\u201d across the labs.<\/p><\/blockquote><\/figure>\n\n\n\n Another issue with HTMA is the absence of standardized reference ranges (the \u201cnormal\u201d values labs use to decide whether a mineral level is high, low, or balanced) [4]. Each commercial laboratory sets its own internal benchmarks, often based on proprietary data from select populations. As a result, the same hair sample can yield very different interpretations depending on which lab analyzes it. <\/p>\n\n\n\n Finally, perhaps the kicker is that any good practitioner will admit the HTMA is very difficult to interpret and you shouldn\u2019t interpret it on your own. Instead, the practitioner sells the HTMA test with <\/em>a consultation, usually for a fee of several hundred dollars for their interpretation. There is no easy-to-find reference book or reliable website for you to learn how to interpret the HTMA, and your average physician has never heard of this test (because it currently lacks rigorous scientific evidence, and therefore, widespread credibility.)<\/p>\n\n\n\n While HTMA may offer some clues about element exposure over time, the current evidence suggests it is not sufficiently reliable to serve as a standalone diagnostic tool, especially for sensitive applications like fertility or endocrine evaluation.<\/p>\n\n\n\n While HTMA may offer some clues about element exposure over time, the current evidence suggests it is not sufficiently reliable to serve as a standalone diagnostic tool, especially for sensitive applications like fertility or endocrine evaluation.<\/p><\/blockquote><\/figure>\n\n\n\n I am not saying targeted nutrition isn\u2019t important for fertility\u2013it definitely is<\/a>! And, certain minerals are absolutely tied to optimal fertility<\/a>. Physicians who suspect a nutrient deficiency<\/a> can still order tests to check your levels [6]. Some of these might include your iron, magnesium, or zinc levels. They might also test your thyroid health using a full thyroid panel, and checking nutrient levels of selenium and iodine. However, most physicians will stick to blood tests for these nutrients, or sometimes urine tests (in the case of iodine).<\/p>\n\n\n\n If you\u2019re being seen for fertility concerns, a typical OB or midwife might order a few tests to get a baseline, like an iron panel and a thyroid panel. If there is something specific that you would like tested, you may need to advocate for yourself, or get connected to a physician specializing in a holistic approach to infertility<\/a>.<\/p>\n\n\n\n In my deep dive into whether to put my faith in HTMA for this article, I came across a Substack post<\/a> by Christy Harrison, MPH, RD who said the following when asked whether HTMA was worth the time and money:<\/p>\n\n\n\n \u201cMy short answer is: I\u2019d recommend continuing to save your money, because these tests aren\u2019t based on solid evidence. They\u2019re unlikely to tell you anything helpful, and they can provide misleading results that cause harm by convincing you to try unnecessary treatments or forgo evidence-based medicine.<\/em>\u201d [emphasis mine]\n\n\n\n To put it simply, it\u2019s not that minerals and their levels in your body aren’t important for fertility and overall female health, but HTMA is probably not the most reliable way to understand them for the average woman. You could <\/em>get an HTMA done, for several hundred dollars, but you risk faulty interpretation of the results and potentially delaying real answers. (In fact, it reminds us of another expensive test without enough data to support its use in an infertility workup: The DUTCH test.<\/a>) Note that while there is little data to support the reliability of HTMA in the detection of subtle micronutrient deficiencies, there may be more data to support HTMA for the detection of toxic levels of heavy metals, chemicals, drugs, and other toxins<\/a>, and it has therefore been utilized for these purposes in the fields of toxicology, pharmacology, and forensics [7].<\/p>\n\n\n\n To put it simply, it\u2019s not that minerals and their levels in your body aren’t important for fertility and overall female health, but HTMA is probably not the most reliable way to understand them for the average woman.<\/p><\/blockquote><\/figure>\n\n\n\n If you are struggling with something as complex as infertility, or a serious nutritional deficiency, you\u2019d be better served by putting your time and energy into finding a compassionate physician<\/a> who understands women\u2019s hormone health. Practicing a fertility awareness-based method can give you initial insight into your hormone health, and a NaProTechnology or other restorative reproductive medicine (RRM) practitioner<\/a> can recommend helpful testing that has proven to be reliable.<\/p>\n\n\n\nMinerals and their connection to infertility<\/span><\/h2>\n\n\n\n
What is hair tissue mineral analysis (HTMA)?<\/span><\/h2>\n\n\n\n
Is HTMA evidence-based?<\/span><\/h2>\n\n\n\n
Issues with HTMA reliability <\/span><\/h2>\n\n\n\n
Reliability of the hair sample<\/span><\/h3>\n\n\n\n
Inconsistency between labs<\/span><\/h3>\n\n\n\n
Vastly different reference ranges<\/span><\/h3>\n\n\n\n
Difficult to interpret the results<\/span><\/h3>\n\n\n\n
What are<\/em> some recommended tests?<\/span><\/h2>\n\n\n\n
Yay or nay on HTMA for infertility?<\/span><\/h2>\n\n\n\n
References<\/span><\/h4>\n\n\n\n[1] Nasiadek M, Stragierowicz J, Klimczak M, Kilanowicz A. The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients. 2020 Aug 16;12(8):2464. doi: 10.3390\/nu12082464. PMID: 32824334; PMCID: PMC7468694.<\/p>\n\n\n\n[2] Kapper C, Oppelt P, Ganh\u00f6r C, Gyunesh AA, Arbeithuber B, Stelzl P, Rezk-F\u00fcreder M. Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health. Nutrients. 2024 Mar 29;16(7):1008. doi: 10.3390\/nu16071008. PMID: 38613041; PMCID: PMC11013220.<\/p>\n\n\n\n[3] Kapper C, Oppelt P, Ganh\u00f6r C, Gyunesh AA, Arbeithuber B, Stelzl P, Rezk-F\u00fcreder M. Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health. Nutrients. 2024 Mar 29;16(7):1008. doi: 10.3390\/nu16071008. PMID: 38613041; PMCID: PMC11013220.<\/p>\n\n\n\n[4] Jones SL, Campbell B, Hart T. Laboratory tests commonly used in complementary and alternative medicine: a review of the evidence. Ann Clin Biochem. 2019 May;56(3):310-325. doi: 10.1177\/0004563218824622. Epub 2019 Feb 27. PMID: 30813740.<\/p>\n\n\n\n[5] Seidel S, Kreutzer R, Smith D, McNeel S, Gilliss D. Assessment of commercial laboratories performing hair mineral analysis. JAMA. 2001 Jan 3;285(1):67-72. doi: 10.1001\/jama.285.1.67. PMID: 11150111.<\/p>\n\n\n\n[6 ]Deepak Kumar K, Huntriss R, Green E, Bora S, Pettitt C. Development of a nutrition screening tool to identify need for dietetic intervention in female infertility. J Hum Nutr Diet. 2023 Feb;36(1):154-168. doi: 10.1111\/jhn.13055. Epub 2022 Jul 24. PMID: 35762584; PMCID: PMC10087620.<\/p>\n\n\n\n[7] Venetia A. Florou, Auraya Manaprasertsak, Maria Slyusarenko, Sarah R. Amend, Julhash U. Kazi, Emma U. Hammarlund, Kenneth J. Pienta. Human hair as a diagnostic tool in medicine. Biochemistry and Biophysics Reports<\/em>. Volume 43, 2025. 102129. SSN 2405-5808. https:\/\/doi.org\/10.1016\/j.bbrep.2025.102129.<\/p>\n","protected":false},"excerpt":{"rendered":"\u0418 \u043c\u043e\u0433\u0443\u0442 \u043b\u0438 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u044b \u043f\u043e\u043c\u043e\u0447\u044c \u0432\u0430\u043c \u0432 \u0431\u043e\u0440\u044c\u0431\u0435 \u0441 \u0431\u0435\u0441\u043f\u043b\u043e\u0434\u0438\u0435\u043c?","protected":false},"author":120,"featured_media":23709,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5368,5316],"tags":[6524,59],"class_list":{"0":"post-23708","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-infertility","8":"category-trying-to-conceive","9":"tag-hair-tissue-mineral-analysis","10":"tag-infertility","11":"cs-entry","12":"cs-video-wrap"},"acf":[],"yoast_head":"\n