Hair loss is often a health signal. Learn what blood tests and labs to ask for, from thyroid and hormone panels to nutrient and stress tests, to uncover the cause.
MMARA is a digital health platform created by three sisters to help you spot early signs of hair loss and take control with personalized care rooted in your daily habits.
Hair loss can be unsettling. You may notice more strands in your brush, thinner edges, or widening parts, and the first instinct is often to change shampoos or try a new growth oil. On average we shed roughly 50 - 100 hairs per day; so, some shedding is normal and should be expected. But consistent or excessive hair shedding is an indication that something in your body requires your attention. When shedding doesn’t stop, it’s time to look deeper.
We continue to beat the drum that hair loss is not just a cosmetic problem, but rather a window into your health. The truth is, hair loss is often your body’s way of communicating that something inside is off. From hormone shifts to nutrient gaps to chronic stress, there are dozens of biological factors that influence your hair growth cycle and follicles.
Lab testing can help uncover these hidden imbalances. When combined with symptom and lifestyle tracking through the MMARA app, it gives you and your provider a complete picture of what’s going on so you can move from worrying, to understanding, to taking control of your hair and scalp health.
Hair loss is complex. First, contrary to popular belief, hair loss is not just a sign of aging or genetics. It can be triggered by multiple overlapping causes, many of which can’t be seen on the surface. In fact, one study evaluated 1,360 scalp biopsies over a 16-month period and found that 12.5% of cases had a combination of diagnoses, meaning the cause of the hair loss was multifactorial (or caused by more than one thing).
While topical treatments and supplements may help, identifying the root cause through labs ensures you’re treating the right problem. For instance, iron deficiency hair loss requires a different intervention than stress-related shedding, but without testing, both feel and possibly look the same.
Early testing helps you:
Hormones control nearly every part of hair growth. Even subtle shifts in your hormones can shorten the growth phase (anagen), trigger shedding, or cause miniaturization of follicles.
Below are the key hormone-related labs to request from your provider:
Thyroid imbalance can significantly affect the body's metabolic processes, and one of the most noticeable side effects is its impact on hair health. Specifically, both an underactive thyroid (hypothyroidism) and an overactive thyroid (hyperthyroidism) can lead to changes in the hair growth cycle.
Diagnosis and Treatment:
If you are experiencing unexplained hair thinning or diffuse shedding, a comprehensive thyroid panel is essential. This panel should typically include:
Hormonal imbalances can have a profound and direct impact on the health of hair follicles, particularly by increasing their sensitivity to androgens (male hormones). The most well-known of these androgens is dihydrotestosterone (DHT), a potent derivative of testosterone.
When a woman experiences a hormonal imbalance such as elevated levels of androgens (a condition often associated with Polycystic Ovary Syndrome, or PCOS), or fluctuations during perimenopause or post-menopause, this can trigger a biological chain reaction in the scalp. Specifically, these imbalances can make the hair follicle receptors overly responsive to DHT.
In genetically susceptible women, this increased sensitivity allows DHT to bind more readily to the receptors in the hair follicles. This binding then initiates a process called follicular miniaturization. Miniaturization is the gradual shrinking of the hair follicle, which causes the growth (anagen) phase of the hair cycle to shorten and the resting (telogen) phase to lengthen.
The result is that each new hair that grows from the affected follicle is progressively thinner, weaker, and lighter in color than the last, eventually leading to diffuse thinning, reduced hair density, and, in some cases, a pattern of hair loss characteristic of female pattern hair loss (androgenetic alopecia). Therefore, addressing the underlying hormonal imbalance is a critical step in treating this type of hair loss.
Diagnosis and Treatment:
If you think you are experiencing hair loss related to an imbalance with your sex hormones, you can consider the following labs:
Let’s dive a little deeper on PCOS. It’s estimated that 6-13% of the world’s population of women of reproductive age suffer from PCOS and up to 70% of affected women remain undiagnosed according to the World Health Organization1. PCOS remains a condition that is not as well understood and so it may not be as effectively diagnosed as other conditions.
Why it matters: PCOS causes both hormonal and metabolic disruptions that can manifest as thinning at the crown or temples.
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that has far-reaching effects on a woman's body, often leading to a complex array of symptoms. Specifically, PCOS induces significant hormonal imbalances, such as elevated levels of androgens, which are the primary drivers of hair-related symptoms. Beyond the hormonal impact, PCOS also causes metabolic disruptions, often characterized by insulin resistance.
These underlying hormonal and metabolic changes frequently manifest as androgenic alopecia (female pattern hair loss). The classic presentation of this type of hair loss in women with PCOS typically involves progressive thinning at the crown of the head and/or recession and thinning at the temples. Unlike male pattern baldness, which often results in a receding hairline and a bald spot, female pattern hair loss usually spares the frontal hairline but results in a noticeable decrease in overall hair density, widening of the central part, and scalp visibility. The elevated androgen levels actively shorten the hair growth cycle and miniaturize the hair follicles, leading to finer, shorter, and less pigmented hairs over time, which contributes to the visible thinning.
Diagnosis and Treatment:
If you are experiencing symptoms consistent with PCOS, consider the following labs:
MMARA Insight: Track your menstrual cycles, mood changes, and shedding patterns in the MMARA app. Logging helps your provider time hormone tests correctly, usually on days 3–5 of your cycle for baseline accuracy.
Healthy hair depends on a steady supply of nutrients. When your body lacks key vitamins or minerals, it diverts resources toward vital organs, leaving your follicles undernourished.
Iron deficiency is widely recognized as one of the most common and pervasive causes of diffuse hair shedding, or telogen effluvium, in women. This type of hair loss is characterized by an overall thinning across the scalp, rather than distinct bald patches.
Iron is an essential mineral that plays a critical role in the body, primarily by producing hemoglobin, the protein in red blood cells that carries oxygen to cells throughout the body, including the hair follicles. A lack of iron can impede the optimal function of the hair matrix cells, which are responsible for healthy hair growth. When the body's iron stores (measured as ferritin) drop too low, the body redirects available iron to more vital functions, such as oxygen transport, essentially prioritizing survival over luxurious hair growth. This diversion forces a greater number of hair follicles prematurely into the resting (telogen) phase, leading to excessive shedding a few months later.
For women, the risk of iron deficiency is significantly higher due to regular blood loss through menstruation, inadequate dietary intake, or poor absorption. Therefore, when a woman presents with diffuse hair loss, a thorough evaluation of her iron status, specifically her serum ferritin levels, is a crucial first step in diagnosis and treatment. Restoring iron levels to an optimal range often helps to reverse the shedding process and promote eventual hair regrowth.
Diagnosis and Treatment:
If you think you’re suffering from low iron, consider the labs below:
Vitamin D, often referred to as the "sunshine vitamin," is far more than just a nutrient for bone health, it is a critical player in the complex biology of hair growth. Research has established that Vitamin D is essential for the healthy functioning of the hair follicle, the structure in the skin that produces hair.
Vitamin D plays a key role in regulating the hair follicle cycle. A deficiency in Vitamin D can severely disrupt this cycle. When levels are inadequate, the crucial signaling pathway needed to stimulate growth is inhibited, which can lead to:
This disruption is a significant contributing factor to various forms of non-scarring hair loss, particularly telogen effluvium (excessive shedding) and, in some cases, female-pattern hair loss (androgenetic alopecia). Therefore, maintaining optimal Vitamin D levels is a vital factor for promoting timely and robust hair regrowth.
Diagnosis and Treatment
The health and abundance of your hair are intrinsically linked to the efficient functioning of your body's circulatory and cellular systems. Specifically, B vitamins such as B12 (cobalamin) and B9 (folate), play a foundational role in this process.
These critical vitamins are essential co-factors in the synthesis of DNA and the formation of healthy red blood cells. Red blood cells are the primary carriers of oxygen and vital nutrients throughout the bloodstream. By supporting robust red blood cell production, these vitamins ensure optimal oxygen delivery to every tissue in the body, including the hair follicles.
Hair follicles are highly metabolic structures that require a steady, ample supply of oxygen and energy to undergo the rapid cell division necessary for hair growth. Inadequate levels of these B vitamins can lead to anemia, a condition characterized by a shortage of red blood cells. This can, in turn, starve the hair follicles, pushing them prematurely into the resting (telogen) phase and contributing significantly to hair thinning and noticeable hair loss. Ensuring sufficient intake of vitamins B12 and folate is a direct nutritional strategy to support the life cycle and health of the hair.
Diagnosis and Treatment
Zinc, an essential trace mineral, plays a vital and multifaceted role in several bodily functions, including protein synthesis, cell division, and immune function, all of which are critical for maintaining healthy hair growth. A deficiency in this mineral can have direct and noticeable effects on the scalp and hair cycle.
Zinc Deficiency and Hair Shedding
One of the most common and telling signs of a zinc deficiency is an increase in hair shedding, often manifesting as telogen effluvium, a temporary form of hair loss caused by a shock to the system. When zinc levels are inadequate, the hair growth cycle can be disrupted, prematurely pushing a higher number of hairs into the resting (telogen) phase, leading to excessive fallout. This increased shedding may be particularly noticeable when brushing, washing, or simply running fingers through the hair.
On the scalp, a deficiency can show up as slow wound healing. This might be observed as minor cuts or irritations (perhaps from scratching or styling) taking an unusually long time to resolve, or the skin being generally more prone to inflammation and persistent dryness. This weakened skin barrier can further exacerbate scalp conditions and hair loss.
Copper Imbalance and Hair Shedding
Copper, an essential trace mineral, plays a crucial role in maintaining healthy hair growth and structure. Its influence on the hair follicle is complex and multifaceted effecting things like hair pigmentation, collagen synthesis, providing antioxidant protection from free radicals and supporting iron metabolism.
When it comes to copper, balance is key. While copper is essential, both deficiency and excess can negatively impact hair health.
A Comprehensive Metabolic Panel (CMP) is a vital blood test that provides a snapshot of your body's current chemical balance and metabolism. It evaluates key components that are essential for overall health, especially when investigating underlying causes of hair loss.
Key Components and Why They Matter:
MMARA Insight: Log dietary changes and supplement use in MMARA. Over time, you’ll see whether certain nutrients or dietary phases align with changes in hair growth or shedding.
When inflammation runs high, circulation to the scalp decreases and the immune system may start attacking follicles. These tests help identify systemic inflammation.
The CRP test is basically a check for widespread, low-level inflammation in your body. It's relevant to overall wellness and especially to figuring out what's up with your hair loss.
A high result suggests the presence of chronic inflammation. This sustained internal stress negatively impacts the hair growth cycle, often contributing to conditions such as Telogen Effluvium or certain autoimmune-related hair loss.
This panel of tests is crucial as it screens for underlying autoimmune disorders, which can often manifest with hair loss as a primary or early symptom. Specifically, it helps in the identification of conditions like systemic lupus erythematosus (lupus), a chronic autoimmune disease that can cause scarring alopecia (permanent hair loss), and autoimmune alopecia areata, an immune-mediated disorder characterized by non-scarring, patchy, or total hair loss. Early diagnosis of these conditions through these specific screens is essential for appropriate management and treatment, which can help mitigate hair loss and other systemic symptoms.
One of the most foundational and important blood tests when investigating hair loss is the Complete Blood Count (CBC). This test offers a broad look at the components of your blood, specifically focusing on red blood cells, white blood cells, and platelets.
MMARA Insight: If you log flare-ups, fatigue, scalp sensitivity, alongside shedding episodes, you can help your provider connect inflammatory symptoms to hair cycle changes.
Stress-related hair loss often manifests 2–3 months after a major event, but chronic low-grade stress can keep cortisol levels elevated for years. These tests help assess your metabolic resilience (or how well your body can cope with stress).
Disruptions in the normal, healthy rhythm of cortisol, often referred to as the body’s primary stress hormone, can have a profound and cascading negative effect on other critical endocrine systems. Specifically, abnormal cortisol rhythms interfere with the delicate balance of the thyroid hormones and the sex hormones (such as estrogen, progesterone, and testosterone), which can trigger cycles of shedding.
When the body is under chronic stress, the adrenal glands continuously produce cortisol, which can lead to a sustained state of high stress or an eventual exhaustion phase where cortisol levels become too low or erratic. Both of these abnormal patterns directly impact the hair growth cycle. Elevated or improperly regulated cortisol can hinder the body's ability to convert the inactive thyroid hormone (T4) into its active counterpart (T3). This interference can result in a state of functional hypothyroidism at the cellular level, which slows metabolism. This slowing of metabolism directly impacts the anagen (growth) phase of hair, pushing follicles prematurely into the telogen (resting) and subsequently the exogen (shedding) phases.
Diagnosis and Treatment
There are several ways to test cortisol levels including tests that evaluate your saliva, urine and blood. Since cortisol fluctuates throughout the day, the different tests give you different insights.
Elevated blood glucose and insulin levels in lab tests can be a crucial indicator of underlying metabolic issues that contribute to hair loss in women. Specifically, higher-than-normal results for tests like
Insulin is a crucial hormone that regulates the amount of sugar in your blood. Insulin resistance is a condition where the body's cells don't respond effectively to the hormone insulin, leading to the pancreas producing more and more insulin to try and maintain normal blood sugar levels. This constant overproduction of insulin (known as hyperinsulinemia) can be a significant driving factor behind several conditions linked to hair thinning, including Polycystic Ovary Syndrome (PCOS).
Diagnosis and Treatment
Fasting Glucose, Hemoglobin A1C (HbA1c), and Fasting Insulin often suggest a state of prediabetes or established insulin resistance. They may indicate an issue with blood sugar regulation and insulin resistance as a sole issue, or along with other symptoms demonstrate other medical conditions are at play.
Lipid panel results (cholesterol and triglycerides) are vital indicators of systemic issues, often reflecting endocrine or metabolic imbalance that can contribute to female hair loss.
Abnormal lipid levels are linked to:
A lipid panel is essential for investigating the metabolic and hormonal root causes of hair loss.
MMARA Insight: Use MMARA’s stress and sleep tracking features to visualize how cortisol and energy levels fluctuate over time. Many users notice shedding patterns align with high-stress or poor-sleep periods.
For persistent or unexplained hair loss, your provider may recommend deeper testing:
Hair loss often spans multiple systems, endocrine, dermatologic, nutritional, and psychological. That’s why the best outcomes come from collaboration between:
When you arrive prepared with tracking data and specific test requests, you transform the conversation from “I’m losing hair” to “Here’s what I’ve noticed and here’s what we can test.”
Hair loss can feel out of your control, but understanding your biology changes everything. By pairing lab data with daily tracking, you can see what your hair is trying to tell you, whether it’s stress, hormones, or nutrition speaking up. The first step to recovery isn’t a new serum. It’s information.
Start tracking with MMARA and discover the story behind your strands. Download the MMARA App →