💇 Hair Panel — Comprehensive

What this panel can settle, and by what logic

Everything the basic panel settles, plus four additions. Two of them change what you do; two mostly change how much you paid.

1. Thyroid Antibodies (TPO + TgAb) is the addition that earns its place. Autoimmune thyroid disease causes shedding at a stage when TSH is still inside range, so antibodies find the case a two-marker thyroid check misses, and they predict who will need monitoring rather than treatment Klubo-Gwiezdzinska 2022.
2. Total & Free DHT is the second, and it is a drug-monitoring test more than a diagnostic one. On finasteride or dutasteride a low DHT means the drug is working as designed, which is the intended effect of a 5-alpha-reductase inhibitor in androgenetic alopecia and not an adverse finding Landells 2025. Off treatment, a DHT concentration does not diagnose pattern loss.
3. Reading Ferritin against hs-CRP (High-Sensitivity C-Reactive Protein) is the point of adding inflammation to a hair panel. Inflammation raises ferritin independently of iron stores Luo 2023, so on this panel a ferritin of 70 ng/mL with a CRP of 6 mg/L is a different fact from 70 ng/mL with a CRP of 0.5 — and the first one can still be deficiency Lin 2023.
4. The nutrient block matters only when several markers move together. One low value among ten is noise; low iron with low zinc and low B12 points at absorption rather than at diet, which is a gastroenterology question Zheng 2023.

What it cannot settle, and what would

Stepping up from the basic panel does not buy a diagnosis of pattern hair loss. Androgenetic alopecia remains a clinical diagnosis made on distribution and trichoscopy, and Canadian consensus guidance treats it that way — management is decided by pattern and stage, not by an androgen concentration Landells 2025. Five hundred dollars of blood cannot substitute for a scalp examination Singh 2021.

It cannot separate chronic telogen effluvium from early female pattern loss, which is the single commonest diagnostic problem in women with diffuse thinning and normal bloods. That separation is made on scalp examination, part width and trichoscopy, and sometimes on biopsy Asghar 2020.

A wide nutrient panel mostly finds deficiencies that are not causing your hair loss. Most of these markers reflect circulating concentrations rather than tissue stores, and a mildly low value in a well-nourished adult is a common incidental result Zheng 2023. Correcting it is reasonable; expecting regrowth from it is not.

And it cannot tell you the panel was worth buying. If the basic workup was genuinely clean — ferritin above 50 ng/mL, normal thyroid, normal blood count — the incremental yield of the comprehensive version is small, and the informative next step is dermatological rather than biochemical Singh 2021.

Draw conditions that decide whether the money is wasted

Same morning draw as the basic panel, with three changes that come from the extra markers.

1. Biotin off for 72 hours, and this panel has more to lose by it. Streptavidin-based immunoassays cover TSH, free T4 and several of the added hormones here, and biotin moves them in different directions at once Li 2020. On a $525 panel that is a very expensive supplement.
2. Declare finasteride, dutasteride, minoxidil and any oral contraceptive on the form. A 5-alpha-reductase inhibitor is expected to drop Total & Free DHT substantially, and reading that as pathology is the commonest misinterpretation of this panel Landells 2025.
3. Stop supplements 3 to 7 days before the nutrient block, and iron for 5 to 7. Circulating micronutrient concentrations track recent intake, so a panel taken an hour after the morning stack measures the stack Zheng 2023.

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

Four branch points, and the follicle sets the clock on all of them.

• Thyroid Antibodies (TPO + TgAb) positive with a normal TSH (Thyroid-Stimulating Hormone): not a cause of today's shedding, but a reason to recheck TSH annually rather than to start thyroid hormone Klubo-Gwiezdzinska 2022.
• Ferritin between 30 and 70 ng/mL with a raised hs-CRP (High-Sensitivity C-Reactive Protein): uninterpretable as it stands. Treat the inflammation or wait it out and redraw both when CRP is under 1 mg/L Luo 2023, then judge the iron Lin 2023.
• Several nutrient markers low together: stop supplementing individually and investigate absorption — celiac serology and a gastroenterology opinion — because a shared cause is more likely than five separate dietary gaps Zheng 2023.
• Everything normal: the biochemical route is finished. Book trichoscopy, and expect any treatment started now to be judged at 6 to 9 months, because that is one hair cycle and no earlier assessment is meaningful Asghar 2020.

Sources read for these sections

• Landells I. A Canadian Consensus on Androgenetic Alopecia: Approach and Management.. J Cutan Med Surg 2025 · PMID 40986632
• 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
• Asghar F, et al. Telogen Effluvium: A Review of the Literature. Cureus 2020 · PMID 32607303
• Lin CS, et al. Diagnosis and treatment of female alopecia: Focusing on the iron deficiency-related alopecia. Tzu Chi Medical Journal 2023 · PMID 38035053
• Luo H, et al. A Practical Guide to Adjust Micronutrient Biomarkers for Inflammation Using the BRINDA Method. Journal of Nutrition 2023 · PMID 36792034
• Klubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment. Polish Archives of Internal Medicine 2022 · PMID 35243857
• Zheng J, et al. Biomarkers of Micronutrients and Phytonutrients and Their Application in Epidemiological Studies. Nutrients 2023 · PMID 36839326
• 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