💈 Basic Hair Loss Panel

What this panel can settle, and by what logic

Four groups of tests for $225. What they settle is which of the reversible causes of shedding is present, and that is a narrower list than the panel's breadth suggests.

1. Ferritin is the highest-yield number here and the lab's range is the wrong one to judge it by. Shedding is associated with iron status well above the threshold for anemia, and iron-deficiency alopecia is described as a distinct clinical problem Lin 2023. A ferritin of 25 ng/mL sits comfortably inside most reference intervals and is a finding on a hair panel, not an all-clear — and no globally agreed ferritin cut-off for deficiency exists to appeal to Cancado 2025.
2. TSH (Thyroid-Stimulating Hormone) with Free T4 (Thyroxine) catches the thyroid in both directions. Under- and over-active thyroid both cause diffuse shedding, and autoimmune thyroid disease is the commonest route into it Klubo-Gwiezdzinska 2022.
3. The androgen tests answer a different question from the rest of the panel. Total Testosterone, SHBG (Sex Hormone-Binding Globulin) and Total & Free DHT speak to pattern hair loss, which is a different problem with different treatment from the diffuse shedding the iron and thyroid tests address Singh 2021.
4. The chemistry and Complete Blood Count (CBC) with Differential are the background check. Anemia, renal disease and a low albumin all cause diffuse hair loss, and all three are cheap to exclude.

What it cannot settle, and what would

It cannot diagnose pattern hair loss, which is the commonest reason anybody buys it. Androgenetic alopecia is diagnosed on distribution, trichoscopy and history — miniaturized hairs and diameter diversity at the vertex — not on a hormone concentration Singh 2021. Most men with pattern loss have entirely normal androgens; the sensitivity lives in the follicle, not the bloodstream.

It cannot see telogen effluvium, and telogen effluvium is what a lot of these buyers have. The trigger — an illness, a crash diet, childbirth, surgery, a drug — happens 2 to 3 months before the shedding starts, by which time the bloods have usually returned to normal Asghar 2020. A clean panel in that setting is the expected result, not a failure of the panel.

It cannot detect scarring alopecia, and that is the one you cannot afford to miss. Lichen planopilaris and frontal fibrosing alopecia destroy the follicle permanently and are diagnosed by examination and scalp biopsy Singh 2021. If there is redness, scale, itch or loss of follicular openings, the money belongs with a dermatologist, not a blood draw.

And it cannot tell you whether treatment will work. No marker here predicts response to minoxidil or to a 5-alpha-reductase inhibitor.

Draw conditions that decide whether the money is wasted

Three instructions, and the first is the one this specific panel gets wrong most often.

1. Stop biotin 72 hours before, which means stopping the hair supplement you bought for this problem. Hair, skin and nail products carry 5,000 to 10,000 mcg, and at that dose biotin interferes with streptavidin-based immunoassays and drives TSH (Thyroid-Stimulating Hormone) down while pushing Free T4 (Thyroxine) up Li 2020. The result reads as hyperthyroidism, which is a plausible cause of hair loss, which is how a wrong number becomes a wrong treatment.
2. Pair the Ferritin with a CRP and stay clear of recent illness. Inflammation inflates ferritin, so a genuine deficiency can hide behind a normal-looking 60 ng/mL Luo 2023. On a panel bought specifically to check iron, that is the failure that costs the money.
3. Stop oral iron for 5 to 7 days first. Serum iron and transferrin saturation on the Iron Panel (Iron, TIBC, Transferrin Saturation) track the last tablet rather than the store; ferritin is the slow number and the one you are paying for Cancado 2025.

How you would know it answered your question, and what each pattern means next

Four results, and the timescale each one runs on. All of them are governed by the same fact: the hair cycle, not the blood test, sets how long you wait.

• Ferritin under 50 ng/mL: treat and retest ferritin at 12 weeks Cancado 2025. Visible regrowth runs 6 to 9 months behind the correction because that is the length of the anagen re-entry, so judging iron treatment at 8 weeks judges it too early Lin 2023.
• TSH (Thyroid-Stimulating Hormone) outside range: repeat at 8 to 12 weeks with Thyroid Antibodies (TPO + TgAb) before treating Klubo-Gwiezdzinska 2022, having confirmed biotin was stopped Li 2020.
• Everything normal with diffuse shedding and a stressor 2 to 3 months back: telogen effluvium. It resolves without treatment and the useful measure is the shed count falling over 3 to 6 months, not another panel Asghar 2020.
• Everything normal with a receding temporal hairline or vertex thinning: pattern loss, and the next appointment is a dermatologist with a trichoscope rather than the $525 version of this panel Singh 2021.

Sources read for these sections

• Lin CS, et al. Diagnosis and treatment of female alopecia: Focusing on the iron deficiency-related alopecia. Tzu Chi Medical Journal 2023 · PMID 38035053
• Asghar F, et al. Telogen Effluvium: A Review of the Literature. Cureus 2020 · PMID 32607303
• Singh M, Acharya A. Overview and Algorithmic Approach to Management of Male and Female Pattern Hair Loss. Indian Journal of Plastic Surgery 2021 · PMID 34984079
• Cancado RD. Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity. Diagnostics (Basel) 2025 · PMID 39941219
• Luo H, et al. A Practical Guide to Adjust Micronutrient Biomarkers for Inflammation Using the BRINDA Method. Journal of Nutrition 2023 · PMID 36792034
• Li D, Ferguson A, Cervinski MA, Lynch KL, Kyle PB. AACC Guidance Document on Biotin Interference in Laboratory Tests. J Appl Lab Med 2020 · PMID 32445355
• Klubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment. Polish Archives of Internal Medicine 2022 · PMID 35243857