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Commercial Hair Analysis:
A Cardinal Sign of Quackery

Stephen Barrett, M.D.

Hair analysis is a test in which a sample of a person's hair -- typically from the back of the neck -- is sent to a laboratory for measurement of its mineral content. This discussion concerns multielemental hair analysis in which a single test is used to determine values for many minerals simultaneously. This type of analysis used by chiropractors [A, B,]"nutrition consultants," physicians who do chelation therapy, and other dubious practitioners who claim that hair analyses can help them diagnose a wide variety of diseases and can be used as the basis for prescribing supplements.

Analysis of Proponent Claims

Proponents of hair analysis claim that it is useful for evaluating a person's general state of nutrition and health and is valuable in detecting predisposition to disease. They also claim that hair analysis enables a doctor to determine if mineral deficiency, mineral imbalance or heavy metal pollutants in the body may be the cause of a patient's symptoms. These claims are false.

For these reasons, multielemental analysis of human hair is not a valid technique for identifying an individual's current bodily excesses or deficiencies of essential or nonessential elements. Nor does it provide a valid basis for recommending vitamins, minerals, or other dietary supplements [2,3]

In the mid-1980s, there were about 18 laboratories doing commercial hair analysis in the United States. Today there are fewer. Some laboratories have belonged to the American Society of Elemental Testing Laboratories (ASETL). In 1982, ASETL began a program in which a well-known proficiency-testing service received and tabulated the data from analyses of identical hair samples sent to seven member laboratories. However, at the end of the year, the testing service refused to continue because the data were inconsistent and appeared to have no clinical significance.

In 1983 and 1984, I sent hair samples from two healthy teenagers to 13 of the commercial laboratories [4]. In 1985, I sent paired samples from one of the girls to five more labs. The reported levels of most minerals varied considerably between identical samples sent to the same laboratory, and from laboratory to laboratory. The laboratories also disagreed about what is "normal" or "usual" for many of the minerals, so that a given mineral value might be considered low by some laboratories, normal by others and high by others.

Most of the reports contained computerized interpretations that were voluminous and potentially frightening to patients. The nine labs that included supplement advice in their reports suggested them every time, but the types and amounts varied widely from report to report and from lab to lab. Many of the items recommended were bizarre mixtures of vitamins, minerals, nonessential food substances, enzymes, and extracts of animal organs. One report diagnosed 23 "possible or probable conditions," including atherosclerosis and kidney failure, and recommended 56 supplement doses per day. Literature from most of the laboratories suggested that their reports were useful in managing a wide variety of diseases and supposed nutrient imbalances. I concluded that commercial use of hair analysis in this manner is unscientific, economically wasteful, and probably illegal, and that even if hair analysis were a valuable diagnostic tool, it is doubtful whether the laboratory reports themselves were reliable.

In 1985, the public affairs committee of the American Institute of Nutrition/American Society for Clinical Nutrition issued a position paper on hair analysis. The paper concluded that although hair analysis may have some value for comparing population groups as to status of various minerals or assessing exposure to heavy metals, assessment of individual subjects appears to have "almost insurmountable difficulties." For this reason, said the paper, hair analysis might best be reserved for experimental studies designed to evaluate its potential as an indicator of nutrition status and perhaps for some public health surveys. Noting that about 100 articles a year are published on hair analysis, one nutritionist who reviewed the position paper suggested that the test's inherent limitations make much of the research useless [5].

Government Actions

Hair analysis was involved in a case prosecuted in 1980 by the Los Angeles City Attorney's Office. According to the official press release, Benjamin Colimore and his wife, Sarah, owners of a health-food store, would take hair samples from customers in order to diagnose and treat various conditions. Prosecution was initiated after a customer complained that the Colimores had said she had a bad heart valve and was suffering from abscesses of the pancreas, arsenic in her system, and benign growths of the liver, intestine, and stomach-all based on analysis of her hair. Two substances were prescribed, an "herbal tea" which turned out to be only milk sugar, and "Arsenicum," another milk-sugar product that contained traces of arsenic. Another sample of hair was taken when the customer returned to the store five weeks later. She was told that the earlier conditions were gone, but that she now had lead in her stomach. A government investigator received similar diagnosis and treatment. After pleading "no contest" to one count of practicing medicine without a license, the Colimores were fined $2,000, given a sixty-day suspended jail sentence, and placed on probation for two years.

In 1985, in response to a petition by the Federal Trade Commission (FTC), a federal judge issued a permanent injunction against Arthur, Ethel and Alan Furman and any business through which they might act. The order forbids "holding themselves out . . . to persons other than health professionals, as being able, on the basis of hair analysis, to measure accurately the elemental content of a person's body or to recommend vitamin, mineral or other dietary supplements which can correct chemical excesses and deficiencies in a person's body." As a result of the FTC action, the Furmans' laboratory closed and, until recently, direct adverrtising to the public has been rare. However, the FTC has not pursued the laboratories that serve practitioners because it feels that practitioner misconduct should be regulated by state agencies.

In 1986, Analytical Research Laboratories (ARL) of Phoenix Arizona signed a consent agreement with the New York State Attorney General to stop "soliciting and accepting hair specimens for laboratory examination where the purpose is to determine possible excesses of deficiencies in nutrient mineral levels or toxic metal levels in the body." The Attorney General acted because a health food store proprietor had been using hair analysis as the basis for recommending vitamin and mineral supplements. ARL had not been licensed to operate within New York State, and hair analysis for the purpose of determining nutrient levels is not legal there.

In 1986, Doctor's Data, a Chicago-based laboratory agreed to stop accepting human hair specimens from New York State unless it can obtain a permit from the New York State Department of Health. The company also agreed to pay $25,000 in costs and penalties. Action was taken because a bogus "nutrition consultant" had been using the test as a basis for prescribing vitamins, minerals, and other supplements.

Trace Elements, Inc., of Dallas, Texas, promotes "balancing body chemistry through hair tissue mineral analysis." The company claims to have developed "a precise nutritional therapeutic approach based on the recognition of eight individual biochemical types using elemental analysis of hair." It also sells "metabolic supplements synergistically formulated" for each of these types. It markets primarily through chiropractors.
Trace Mineral Systems, of Alexandria, Virginia, touts its $49.95 hair analysis as "the test that helps body chemistry" and markets it directly to the public. A recent magazine ad claimed that its test reports would show "the body's excesses, deficiencies & toxicities and the diseases associated with them." [6]

It is possible that the labs still doing commercial hair analysis have become more accurate since my investigations of the mid-1980s. However, even if hair mineral content is measured with 100% accuracy, it makes no difference because the results are not useful for measuring the body's nutritional status. Should you encounter a practitioner who claims otherwise, run for the nearest exit!

References

1. Lazar P. Hair analysis: What does it tell us? JAMA 229:1908-1909, 1974.
2. Hambidge KM. Hair analyses: Worthless for vitamins, limited for minerals. American Journal of Clinical Nutrition 36:943-949, 1983.
3. Klevay LM and others. Hair analysis in clinical and experimental medicine. American Journal of Clinical Nutrition 46:233-236, 1997.
4. Barrett S. Commercial hair analysis: Science or scam? JAMA 254:1041-1045, 1985.
5. Fosmire GJ et al. Hair analysis to assess nutritional status. AIN Nutrition Notes 21(4):10-11, 1985.
6. Trace Mineral Systems. Alternative Medicine Digest, Aug/Sept 1998, p 99.

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