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Hair Loss Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Hair Loss Testing:

• A. Hormone Level Testing

What is a Hormone Level Testing -Testosterone?

A testosterone test checks the level of male hormone (androgen) in the blood. Testosterone affects sexual features and development. In men, it is made in large amounts by the testicles. In both men and women, testosterone is made in small amounts by the adrenal glands; and, in women, by the ovaries.

Indications and Contraindications

A Hormone level testing for testosterone is used to evaluate male and female conditions such as:

• Precocious puberty
• Infertility
• Tumor marker for ovary and testicle tumors
• Ambiguous sex characteristics
• Decreased sex drive
• Erectile dysfunction
• Delayed puberty
• Irregular period for women
• Baldness

How do you prepare for a Hormone level testing for testosterone?

There are no special preparations required for this test.

How does it feel? How long will it take?

The hormone level test for testosterone is a painless procedure that usually lasts for a few minutes, about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein on your arm to draw blood. After the test, a small amount of throbbing might occur on the needle site.

Expected effects after the test:

Normally, there are no major effects after the test. In most cases, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may also occur.

Special instructions after the test:

After drawing the blood, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, do warm compresses few times a day. You may resume your regular diet and your daily activities after the test.

Interpretation of Results:

Normal Findings:

Normal levels of testosterone fall between 3-10 ng or 10-35 nmol/L (SI units). Levels in the same man vary according to time of day, season and exercise.

Normal levels of testosterone in women are less than 1 ng/mL (SI units).

In prepubertal boys and girls, normal levels of testosterone are 0.05-0.2 ng/ml (SI units)

Abnormal Findings

Increased levels of testosterone can indicate the following conditions:

Males:

• Hyperthyroidism
• Testicular tumors
• Encephalitis
• Pinealoma
• Congenital adrenal hyperplasia
• Excessive amount of testosterone by-product dihydrotestosterone causes male pattern baldness

Females:

• Ovarian tumor
• Adrenal tumor
• Congenital adrenocortical hyperplasia
• Polycystic ovaries
• Excessive amount of testosterone by-product dihydrotestosterone causes male pattern baldness

Decreased levels of testosterone in males indicate the following conditions:

• Hepatic cirrhosis
• Primary and secondary hypgonadism
• Hypothalamic disease
• Pituitary disease
• Klinefelter’s syndrome

B. Post Provocation Urine Element Testing

What is the Post Provocation Urine Element Testing?

For diagnosis of the presence of certain toxic element burdens, post provocation testing is recommended.  This involves urine collection following oral or intravenous administration of chelating or complexing agents that mobilize elements from otherwise slowly exchanging tissue pools. For example, non-provoked levels of cadmium, mercury, and lead may not be indicative of deep tissue stores and only reflect ongoing or very recent exposure.

Indications and Contraindications

Analysis of elements in urine provides diagnostic information on potentially toxic elements such as lead, mercury, cadmium, nickel, beryllium, arsenic and aluminum, and assessment of the efficiency of renal reabsorption of essential elements such as magnesium, calcium, sodium and potassium.

Urine element analysis is an invaluable tool for the diagnosis or confirmation of toxic element burden and monitoring of detoxification therapy.

How do you prepare for the Post Provocation Urine Element Testing?

It is recommended to do this test early in the morning as soon as you wake up. Completely empty the bladder before doing this test. Do not eat 1 hour prior to the testing. You may only drink a few amounts of water. Avoid taking vitamin and mineral supplements for more accurate results.

How does it feel? How long will it take?

The chelating agents may be administered orally to provoke urinary levels of elements. If administered intravenously, you will feel nothing at all from the needle while chelating agents are being given or you may feel a quick sting or pinch depending on your sensitivity to pain. Administration of chelating agents will only last for a few minutes. However, collection of the urine sample will be done over the next six to 24 hours depending on your physician’s recommendations.

Expected effects after the test:

This test is painless and simple. Normally, you will not feel any side effects after the test.

Special instructions after the test:

If chelating agents were administered intravenously, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, do warm compresses few times a day.

For the next six hours, you may only drink 0.5-1.5 liters of water. You may only eat one hour after administration of chelating agents.

You will be given a container that will be used for collecting your urine sample over the next six to 24 hours. Follow instructions given to you on how to seal and transport the urine sample. Be careful not to contaminate the urine sample.

Practice good hygiene when collecting your urine sample. Wash your hands with soap and water at all times.

You may resume your regular diet after urine sample collection.

Results:

Results of a test are usually available in 10-12 days. Below are some of the most common toxic metals that accumulate in the body:

Metals	Normal levels	Indications
Arsenic	≤50 µg/L	Arsenic toxicity can lead to: respiratory tract infection, liver dysfunction, stomatitis, and hair loss
Copper	25 µg/24 h	Copper toxicity may lead to to: cirrhosis, hepatitis, renal dysfunction, hemolytic anemia, alopecia, multiple sclerosis, hair loss
Iron	<300 µg/dL	Iron toxicity can lead to: birth defects, diabetes, hepatitis, cirrhosis of the liver, arthritis
Lead	≤70 µ/dL	Lead toxicity can lead to anemia, cognitive impairment, vitamin D deficiency
Mercury	20 µg/L	Mercury toxicity can lead to: kidney damage, adrenal gland dysfunction, thyroid dysfunction
Nickel	≤500 µg/L	Nickel toxicity can lead to: kidney dysfunction, Hemorrhages, malaise
Silver	2.6 µg/L	Silver toxicity can lead to development of tumors
Thallium	<3 µg/L	Thallium toxicity can lead to: Alopecia, ataxia diplopia, pleuritic chest pain

Notes:

Contamination during urine sample collection may alter the results for heavy metals. Specimen should immediately be transported to the laboratory for accuracy or refrigerated if it cannot be processed right away.

Positive results for heavy metal test must be confirmed by repeating the procedure.

The Right Diagnosis and Treatment for Hair Loss

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Hair Loss

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.