HTMA Testing

Hair Tissue Mineral Analysis (HTMA Testing)

Why do minerals matter?

Homeostasis in your mineral (aka electrolyte) status is essential for vital functions including heartbeat, breathing, muscle contraction and more. This happens because the balance of minerals like sodium, potassium, magnesium, and calcium creates electricity to make your body function through the constant firing of positive and negative charges. Blood values must be kept within a tight range in order to keep these involuntary reactions happening— simply put, to “keep the lights on” in your body.

Minerals are so vital for human functioning, but here’s the kicker, we don’t make them inside the body like we do certain other micronutrients and metabolites (think vitamins, fatty acids, amino acids, etc.)

We MUST get minerals through the diet— the foods and drinks we consume are vessels for mineral intake. 

Let me back it up a bit and discuss the differences of blood versus tissue testing, the benefit of having both sets of data, and why this “old dog” (ME! LOL) is learning a new trick.

There are a few ways to assess blood values:

  • Serum/plasma: outside of the cell. For many minerals, serum values reflect around 1% of what is truly in the body and is kept at the tightest range. 
  • RBC/WBC: inside the cell. Internal mineral levels tend to reflect a larger percentage off mineral storage, but levels are also kept in a pretty strict range. 
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The balance of optimal levels of minerals/electrolytes fuel several aspects of optimal function like:

  • Taking up nutrients, hormones, glucose into the cells to produce energy
  • Allows cells to properly communicate with one another
  • Form certain hormones like insulin 
  • Quench the stress response
  • Maintain fluid balance inside and outside the cells (if you’re feeling “puffy”, you may have mineral imbalances)
  • Create thyroid hormones

… and so much more!

Think of mineral status sort of like a seesaw. The center of the seesaw is subject to less variability. Too much variability would be detrimental to health (this would be like the serum values), the middle of the seesaw can swing a little more (this would be the RBC/WBC values). And, lastly, the ends of the seesaw would experience the most range in levels (this would be the tissue levels).

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Top contributors to electrolyte/mineral imbalances:

  • Stress
  • Losses (like sweating)
  • Poor intake of minerals
  • High intake of certain minerals with lower intake of others (think high sodium versus low potassium diets AKA high processed foods with fewer whole-form foods)
  • Decreased absorption (intestinal issues)
  • Medications 
  • … and more

You may have noticed that stress tops the list! Stress influences electrolytes in part by the action of aldosterone, which is secreted by the adrenal glands that are also responsible for cortisol and adrenaline secretion, and leads to shifts in minerals including, but not limited to, potassium and magnesium excretion and sodium retention. Over time, the body begins to compensate for losses and retention and the inevitable imbalances by sending minerals to the tissues for storage excess OR recruiting the tissues when levels in the blood get too low. 

Let’s recap a little: 

  • Mineral balance is delicate.
  • We must obtain minerals through the diet.
  • Stress depletes minerals very quickly.
  • The Standard American Diet is notoriously low in minerals (soil depletion, poor nutrient density of foods, lack of diversity of diet, etc.)
  • Blood labs don’t effectively capture the likely level of mineral status because blood levels must be maintained to keep you alive

Over time, chronic stress can lead to chronic mineral deficiency and imbalances.

Tissues, like hair, are used as either a pool when resources are low or a reservoir when values are too high. The main objective is to maintain blood values and keep those vital functions status quo at all cost. The stakes of blood electrolytes being dysregulated are too high, so the tissues come to the rescue to help calm the waters.

Testing tissues helps to identify:

  • Mineral deficiencies: because it is important to have enough
  • Mineral imbalances: because the balance of minerals is critical for optimal cellular function

By assessing tissue levels minerals, we can identify where on the stress-spectrum one may be— either in the frantic, “fast” state of stress or the exhausted, burned-out, “slow” side of stress. This is evidenced by either high levels of minerals (which often initially happens) or low levels of minerals (which is usually a sign of burn out). 

Let’s depict what happens to minerals different different stages of stress:

  • Alarm: minerals leave from inside the cell, go the the extra-cellular space (which can be dangerous), so then they’re excreted via the urine and also sent to the tissues
  • Adaptive: the body is leveling out and adapting to stress creating balance in blood and tissues
  • Burnout: low levels of minerals in the tissues as the body draws upon the tissues to keep blood levels stable

Neutral or Adaptive State: minerals in blood (intra- and extra-cellular) are balanced with tissues 

Minerals in the extra-cellular space, intra-cellular space, and tissues are balanced.

Alarm State: minerals begin to leave the intra-cellular space and to extra-cellular. This can be dangerous to have such an imbalance, so minerals are then shunted to be excreted via urine and stored into the tissue temporarily. 

  1. Initial stress can cause minerals to spill into the serum which can be dangerous. Therefore, the kidneys work to excrete excesses, so the tissues can also act as a reservoir for overflow.
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2. The minerals will be excreted via urine, sweat, and/or stored in the tissues.

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3. Below reflects how the excess minerals in the serum can be sent to the tissues.

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This is what it looks like on an HTMA test for someone to be ACTIVELY stressed: You can see here that the results are showing elevated sodium and magnesium. During times of stress, the cells push out magnesium to quench the stress response. The body also tends to retain sodium during active stress. This particular patient was about to move, working long shifts late into the evening, struggling with health issues, had a partner who traveled often, and was drinking alcohol regularly. She didn’t FEEL particularly stressed out. Why? Stress hormones can feel good and actually be addictive.  A lot of times, people who are actively stressed may not realize the level of stress they’re under until they reach the point of burnout, which comes after long-periods of time being in a high stress state.

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Burnout: after periods of prolonged stress, the body can burn through mineral resources as it is constantly trying to create stress hormones (including cortisol and adrenaline) as well as dampen the inflammatory effects of chronically high levels of stress hormones. This can lead to an overall depletion in minerals.

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This is what burnout can look like: Someone in the state of burnout will often feel exhausted allllllll the time. Beyond that, those who are at the point of burnout often deal with health issues like food sensitivities, brain fog, poor motivation, gut issues, and more. 

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Your Metabolic Type: 

The “metabolic type” shows a person’s oxidation rate or the rate at which their cells are able to produce energy from the food nutrients introduced into the cells. A “slow” type would reflect a slower metabolism (takes longer to produce energy AKA slower metabolism) while a “fast” type would be the opposite (cells produce energy at a more rapid rate).

  • Slow Type: more exhausted state of the stress response. Common characteristics: fatigue, low body temp, low blood pressure, low blood pressure— especially upon standing, pear-shaped body, cold extremities, slower metabolism. A “slow” type is a protective adaptation that slows down bodily functions to preserve energy for the ongoing stressors. Think of it this way: if you lost your job, would you go buy a Ferrari or would you save your money?
  • Fast Type: chronic stimulation of the adrenal glands (AKA being in “fight or flight”). The “fast” type tends to have a faster metabolic burn rate and be in the go-go-go state of stress.
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Significant Ratios

The balance of different minerals compared to one another can shed insight into cellular functions.

  • Nervous system: Calcium/Phosphorus: Phosphorus is involved in almost every reaction of metabolism. Higher levels of calcium relative to phosphorus can show parasympathetic dominance (slow metabolism)
  • Cellular Vitality: Sodium/Potassium: Every cell has a sodium/potassium pump that allows flow of hormones, glucose, and nutrients into and out of the cell. It gives an idea of the vitality, or health, or our cells.
  • Thyroid: Calcium/Potassium: High calcium relative to potassium will frequently indicate a trend toward hypothyroidism (under-active thyroid). This doesn’t diagnose hypothyroidism, but can shed insight into how well your cells are utilizing thyroid hormones. Potassium helps to sensitize the cells to thyroid hormones and facilities the uptake of thyroid hormones into the cells, but calcium antagonizes this action. This can explain why blood labs (which look OUTSIDE the cell) could look totally normal, but you may still feel hypothyroid. The cells may not be taking up thyroid hormones effectively. 
  • Adrenal Health: Sodium/Magnesium: The adrenal glands play an essential role in regulating sodium retention and excretion. Magnesium has a reciprocal relationship with stress wherein stress can deplete magnesium and magnesium depletion can perpetuate the stress response due to the role of magnesium in quenching the stress response.
  • Copper: Zinc Balance: The balance of copper to zinc is crucial for hormone balance, iron regulation, immune support, energy production, and more. Zinc and copper have an antagonistic relationship meaning that too much of one can deplete the other.
  • Blood Sugar: Ca/Mg: The balance of calcium and magnesium help to regulate the release of insulin as well as the cellular sensitivity to the effects of insulin. High or low levels of calcium and magnesium as well as calcium:magnesium imbalances can create blood sugar dysregulation at the cellular level which can lead to feelings of “hanger”, blood sugar dips, fatigue, and weight struggles.
  • Iron: Copper Balance: Copper is a critical part of iron balance inside the body. Iron is required for energy production, thyroid hormone creation, and much more. Iron deficiency (in the absence of heavy periods, fecal blood losses, inadequate iron intake, gastrointestinal malabsorption, etc.) can often be traced back to having suboptimal levels of minerals including copper (as well as Vitamin A, zinc, and magnesium) that support the reticuloendothelial system (RES AKA iron recycling system).
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A view of macro-minerals and micro-minerals:

  • Macro-minerals: minerals we need in larger amounts (potassium, sodium, calcium, magnesium)
  • Micro- minerals: minerals we need in smaller amounts (copper, selenium, chromium, etc.) 
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