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How I Do Hair Tissue Mineral Analysis (HTMA) Differently *old blogpost*

*from my old blog on this website, first published August 2017
**IMPORTANT NOTE - I have found that integrating specific blood tests to assess Poison/"Vitamin A", iron, copper, and zinc to be invaluable, so this article does not completely reflect my current approach!

Just to keep everyone on the same page, Hair Tissue Mineral Analysis, aka HTMA, is often referred to also as “hair analysis” or “hair mineral analysis”.  HTMA is simply a type of test, whereas it is in the interpretation and treatment where the real “magic” happens.  Links (for further reading) in this article are underlined like this.

First, I’m going to save the “why I use HTMA as my main test” for another article.  If you’d like to read about why I stopped using blood tests for long-term nutritional assessment and treatment (I absolutely still use them when applicable and useful), see this article.

My initial personal experience with HTMA was underwhelming.  While I was in naturopathic medical school, I did three Trace Elements Inc. (TEI) hair tests with a practitioner.  I took the standard lab-recommended supplements and followed the lab’s dietary recommendations, just as my practitioner instructed me to (honestly, since everything that I was to do was laid out for me in the lab report, and the practitioner basically just read back the report without any deeper interpretation, I wondered why I needed a practitioner at all).  For the record, I was not “sick”, I just wanted to optimize my own health—which in too many cases is when I hear about people’s health starting a downhill slide—but I digress.  Here’s the gist of what happened over that six-month period:  my hair mineral numbers “improved”, my energy decreased, and I was sick of all the dietary restrictions…so I quit.  Seemed a fairly easy decision based on how I was actually feeling, and we’ll go over each part of it here.  Suffice it to say, I felt that there was real untapped potential in using HTMA.  The test seemed like it could be valuable, it just seemed to me that it wasn’t being used right.

When I came back to HTMA almost a decade later, after getting a basic understanding of HTMA from a Malter Institute online course (I do recommend this course to give people a foundation, that said, I have taken my approach to analysis and treatment much further than what is taught in this course), I did something very different.  I looked at the typical lab supplement recommendations compared to the HTMA results.  Then, by combining everything I have learned, I figured out the REASON every single nutrient was included in the formulas and recommendations. I basically reverse-engineered the process to figure out the WHYs.  This is SERIOUSLY important in the HTMA world, as too many practitioners don’t know why they use certain nutrients, they just use what the lab says to.  I questioned and tested every single common ASSumption in HTMA and simplified it to the most important things.  Many of the things that are taught today are simply wrong (like the supposed epidemic of never-ending “hidden copper toxicity” and that bottomed-out potassium levels will somehow just fix themselves…they will absolutely NOT).

How did I figure all this out?  The combination of my own hair testing done every 5 weeks (normal re-tests are done every 3-6 months), background, education, research, pattern recognition abilities, sensitivity to my own body’s signals, and client feedback got me quite far, quite fast.  I think it was a case of me being ready to step into the right place at the right time to do the right thing.

Let’s go into how I approach HTMA (and general client interaction) differently.

#1.  I am much more concerned with how a person is feeling/improving, than I am about whether they showed improvement on the numbers of their hair test.  If that doesn’t make enough sense right off the bat, here’s an easier way to look at it.

Would you rather have perfect hair test numbers and feel like hot garbage?  OR…

Would you rather have imperfect hair test numbers and feel AMAZING?

I hope you see that the latter one is what we are ALWAYS after first.

The first HTMA that a person does is not necessarily indicative of how “messed up” they are.  Very sick people can have very good-looking first tests, and people who aren’t very sick can have tests that look quite “off”.  Think of the first test as the “tip of the iceberg”, and follow-up tests give us a deeper insight into what is lurking beneath the surface.  Tests that are initially way off can snap into line quickly, and some tests that look great at the start quickly (or slowly) reveal that there are deeper issues to be dealt with.

#2.  If a food or a supplement makes someone feel bad consistently, they should STOP taking it.  If you have seen practitioners who insist on you or others taking supplements (or meds) that make them feel bad, then you should probably see someone else who respects your individual physiology.  If you have been kicked out of practices because your body simply didn’t agree with the supps/meds they insisted on, then I’m going to tell you that the practitioner should be embarrassed at their lack of empathy, skills, and tools…NOT you.

I get many “sensitive people” in my practice, often the so-called “rejects” of other practitioners.  Here is what I have done with my approach to help us work together.

Primarily, I don’t use big combination supplements.  Why?  Because if a sensitive person has a negative reaction to 1 nutrient out of a 12-nutrient supplement, then they can’t take it.  Which nutrient did they react to?  Heck if anyone knows!  The practitioner might then say to keep trying to take it in spite of them feeling awful, or that if they can’t take it then they are probably not suitable for the program.  Completely unacceptable in my opinion.

What I have done with my programs is use single nutrient supplements from the very start.  If you don’t know what I mean, here’s an example.  Instead of using a supplement that has zinc & magnesium & B6 (commonly known as ZMA) in it, I would prescribe these things as separate zinc, magnesium, and B6 supplements (only IF they were all called for!).  Some examples of the benefits of this approach are as follows:

  • Nearly everyone will benefit from magnesium. Magnesium can be taken in many different ways, from pills to lotions to sprays to baths to foot soaks.  Magnesium pills are available in many different chelated forms—which can greatly influence absorption and/or secondary benefits and/or negative reactions—so why be limited to the chelate form chose for you in the combo supplement?  Also, if you only wanted more magnesium (or less), why have to take more or less zinc and B6 just to do that?
  • Men & women often need significantly different amounts of zinc. Magnesium can be limited by bowel tolerance (too much magnesium for a person will cause temporary diarrhea).  Definitely not everyone needs a bunch of extra B6!  Hopefully you see the wrench this threw in.
  • The form of B6 typically used in ZMA products is not good (pyridoxine HCl). Pyridoxal 5-phosphate (P5P) is preferable.  Why use an inferior product when we don’t have to?  Next, P5P is one of the strongest copper antagonists (lowers both “good” and “bad” copper) out there, and zinc is also a copper antagonist.  If someone was deficient in “good” copper (that’s a whole other discussion), and they take zinc and P5P just to get their magnesium, do you see how this will aggravate the “good” copper deficiency?

Look, everyone is different.  The HTMA gives us a very good idea of what would likely help and the directions we want to nudge the body in.  If someone feels bad on a product, I always tell them that they have my complete permission to stop that supplement.  If they feel comfortable doing so after some time off from that supplement, then I encourage a short trial of it again to confirm that it really was the source of their issue.  Avoidance and reintroduction is considered the gold standard test for food sensitivities/intolerances/allergies, so we use it here too!  My next request is that they email me about the reaction, as that can give me more insight into what is really going on “under the water” (remember the iceberg analogy from above?) and into what may be good and not good for them in the future.

The body is always trying to tell us something.  We simply need to listen better.

#3.  Detox and retracing, the reality versus the lie.  This is HUGE, so pay attention.  I get ex-clients from the biggest names in the HTMA field.  They have been on their program, doing the supplements, eating the overly-restrictive neurosis-inducing diet, shooting coffee up their butt (aka coffee enemas), and sweating in infrared saunas until they become a puddle.  Sounds fun, right?  Not to me, personally.

The problem is, with the clients I have seen who have done this (and I have had enough of them to see the pattern, all with the same story), is that anywhere after a solid year or two of getting worse and worse, they just kept being told it was “detox”or “retracing” and it would end soon.  2 YEARS of feeling worse, not better.  Pardon me while I call BULLSHIT.

Here is what a real detox looks like, and I get people to do this without shooting coffee up their butt or infrared saunas!  First, before a detox starts, the person will always notice some sort of improvement in how they feel.  This is the body “gaining energy”, if you will, to do the clean-up work that needs to be done.  Once the body has reached the point it needs to, it starts the detox process.  I do not ever have to “put people on a detox”, I just give their body the tools it is asking for via the HTMA and it does it on its own.  I did a whole podcast on detox myths and facts, you would do well to listen to it.  When detoxing, the body will temporarily show signs of “not normal” things coming out of it (uh, that’s the definition of detox, natch), which can look like any/all of the following:

  • Bowel changes – changes in smell, the trend is towards looser bowels
    • NOTE: Taking laxative herbs and/or massive doses of magnesium (another laxative, I don’t care if it has ozone added or whatever) and having induced diarrhea DOES NOT imply you are detoxing anything AT ALL. It means you took laxatives. Don’t fool yourself.
  • Urine changes – darker than normal urine, cloudy urine, changes in smell
  • Body odor – a body odor can appear suddenly, and because it is coming from out of the pores (typically armpits and groin) it can seem resistant to washing (ex. Getting out of the shower, smelling your armpits, and then wondering if you remembered to wash them, which you did).
  • A metallic taste in the mouth.
  • Insomnia, sometimes to the point of no sleep for an entire night. The strange pattern I have noticed with this is that the person is not anywhere near as tired as they think they should be the next day, considering they may not have slept at all that night.
  • A feeling of wetness inside the ears upon awakening.
  • Particularly with iron overload detoxing, we can see increases in irritability and frustration (when the iron comes out of the liver), and/or increases in joint pains (when the iron comes out of the joints).

Key thing here to detox is that it is TEMPORARY and passes on its own.  We did not purposely try to start it, and that cycle (yes, there can be multiple cycles, the first one is typically the most intense) will complete itself in its own time.  Detox cycles are usually measured in days or at most a week or two…if you think you are having a detox cycle that is lasting a month or more, I’d say you’re probably wrong and that something you are doing is making you feel bad.

Retracing is quite simple and follows the same pattern.  Client is on the program, noticing some improvements.  Once the body is ready, a retracing phase (a return of old symptoms) begins.  It goes away nearly as quickly as it comes.  One classic sign of retracing is that nothing seems to make it go away faster or relieve the symptoms…old tricks and tools that used to work don’t seem to help this time…it just goes away in its own time, usually lasting less than 2 weeks if that.

With both retracing and detox, there is one MAJOR requirement for me to believe that this is what happened.  The person MUST feel better than they did before the retracing or detox, like they reached a new level of health (or they returned to a higher level of health that they recall from their past).  If someone thinks they went through a retracing or detox, yet cannot tell you that they feel noticeably better after it was all over (worst case is that the supposed retracing or detox didn’t ever seem to end), then that was not what happened or was happening.

#4.  Nutritional balancing.  If you have worked with a practitioner who does this approach and you only felt worse along the way, I’m going to tell you why, in no uncertain terms.  It mainly has to do with complete mismanagement of calcium and potassium.

First, there is the blanket recommendation for these folks to take 5000 IU of Vitamin D3 per day.  Those of you who know me, know that I could go off on a massive tangent about calcium and Vitamin D3 (oh wait, I already did in this podcast).  I’m going to make this short for those who aren’t yet familiar.  Vitamin D3 on hair tests will consistently and aggressively raise hair calcium levels (a surrogate marker for cell/tissue calcium levels, if you weren’t aware) and decrease potassium and boron levels to next to nothing.  The hair calcium level will not come down, ever, by any significant amount while one is taking Vitamin D3 supplements (this goes for the magickal cod liver oil and eating Vitamin D-fortified foods and multivitamins too). If you ever wondered why your high calcium levels just NEVER seemed to come down…well, I just told you.

High hair calcium levels mean that everything in the body is SLOWING DOWN.  Energy levels decrease in both the body and the brain (low energy in the brain looks like depression and anxiety, two sides of the same coin).  Blood sugar gets less stable.  Thyroid symptoms appear and/or get worse.  Joints get stiff and crack/pop.  Digestion slows down, which can show up as decreased stomach acid production and/or constipation.  Basically, think of high hair calcium in a human very much like rust on a machine.  Sure, it still runs, but it is just so much slower and requires so much more energy to do the same work (hence your constant fatigue).  Let me make this very clear…if Vitamin D3 is taken when a person has normal or high hair calcium levels, that person will eventually get worse and worse.  Maybe you noticed that once your doctor who put you on Vitamin D supplements was finally happy that your levels had come up to where they wanted them (which was too high a level anyway, that’s for another article though), was right around the same time your health and/or thyroid completely tanked?  These things are intimately connected.

Next, potassium deficiency and how to induce it in people.  Let’s go through some of the hallmarks of this misguided approach that destroys potassium levels in the tissues over time:

  • First, a generally low-carb diet is suggested. Animal protein and tons of non-starchy vegetables.  A general rule I have found is that the higher the carbohydrate content of a fruit or vegetable, the more potassium it contains.  Therefore, a diet that avoids higher-carbohydrate fruits and vegetables will almost be guaranteed to be potassium deficient to start with.
  • There is also the completely unscientific, unfounded, nonsensical concept of “TOXIC POTASSIUM” in foods (and even all the water supplies!) from the use of N-P-K fertilizers. While excessive nitrogen and phosphorus from fertilizers can absolutely be a problem, the potassium is not.  It is sorely needed by people, actually!  The idea of “toxic potassium” is simply not true, and the lack of any scientific references on articles that discuss this is your first clue.
  • There is a fear instilled in clients on this program that potassium supplements are DANGEROUS and COULD KILL YOU. Remember folks, even water can kill you if you drink enough of it!  Most potassium supplements on the market are 99mg of potassium per pill (we use a 200mg potassium pill if/when we do use them at all).  An avocado has around 1100mg of potassium.  So, 11 standard potassium pills = 1 avocado.  Heard of anyone dying from guacamole hyperkalemia (high blood potassium) lately?  I didn’t think so.  Now, for those who do my program, potassium supplements are only used if we need to AFTER trying to get as much potassium as one can from high-potassium foods and our “50/50 salt” recipe, and even then we only do trials of them if they are showing continuing symptoms of potassium deficiency (cramping in the feet or calves at night, or feeling like one has an energy crash within 30 minutes after eating a normal-sized meal are strong symptoms of potassium deficiency) .  Even the Institute of Medicine (IOM) has said about food-based intakes of potassium: “There was no evidence of chronic excess intakes in apparently healthy individuals to compel establishing a Upper Limit for potassium.” This doesn’t mean to go out and overdose on potassium pills, and it also shows that potassium is nowhere near as dangerous as some say.
  • Next, there is the “shooting coffee up one’s butt”, aka coffee enemas. Can these have some benefit?  Possibly.  Are they necessary?  Not in my opinion.  Can they cause problems?  Absolutely.  Here is the reality…by doing enemas of any type, one is putting fluid into the intestinal system.  Eventually, after the water or coffee has “interacted” enough with your bowels, you will excrete it.  Looks like diarrhea, right?  The whole point of the enemas is theoretically to “pull” things into the water or coffee that was pumped up there, right?  Ever hear about how excessive bouts of diarrhea will “deplete electrolytes”, aka minerals like calcium, magnesium, sodium, and POTASSIUM?  I’m going to tell you that causing diarrhea from above (laxatives) or from below (enemas) is very depleting to your potassium levels (among other minerals, of course).
  • Infrared saunas and excessive sweating (without proper mineral repletion) will aggravate the potassium deficiency.
  • Finally, there is the use of high-dose Vitamin D3 supplements. Vitamin D3 supplements cause the body to waste/lose potassium.  This is much more obvious on HTMA than in blood tests.

To summarize, these folks are put on a potassium-deficient dietary approach, encouraged to fear potassium in general, told to do coffee enemas that cause the body to lose potassium, told to do infrared saunas causing more potassium loss, and given Vitamin D3 supplements that cause the body to waste whatever potassium it does have left.  To put it quite bluntly, when I get these clients (thank goodness they still saw the value in HTMA despite the failed approach they were put on) and I get them to eat lots more high-potassium foods and get off the Vitamin D3 supplements, things like anxiety, insomnia, and swelling/edema (all can be related to potassium deficiency) all just fade away.

#5.  The “hidden copper toxicity” boogeyman.  There are so many issues (and outright mythology) put out there on this topic that I can’t do it justice in a couple paragraphs.  There is “good” copper (inside the cell) and there is “bad” copper (outside the cell).  This is a gross oversimplification, of course.  We want more of the former, and less of the latter.  This is actually fairly easy to fix now that I’ve figured it out…it only took me 4 years of sifting through research to do that though! All I can say is this…if your HTMA showed LOW copper, yet your practitioner had you constantly treating “hidden copper toxicity” with copper antagonists—which include but are not limited to zinc, selenium, B2, B3, B5, B6, and/or molybdenum—and you seemed to always start feeling worse as soon as you took any amount of these things, I have bad news for you.  You were not “detoxing hidden copper”.  You had a “good” copper deficiency (you may or may not have ever had a “bad” hidden copper toxicity at all) and as soon as you took any of these copper antagonists it was throwing you deeper and deeper down the “good” copper deficiency hole.  Continually taking copper antagonists (especially when the hair copper level is low and keeps getting lower test after test) will eventually cause major “good” copper deficiency.  I bet there are many of you out there now realizing that this is exactly what happened to you. Since many of the “hidden copper toxicity”-obsessed practitioners actually believe that a low hair copper level is a SIGN of “hidden copper toxicity”…I’m not sure exactly when they would stop attacking this imaginary problem that they can’t see.

In conclusion, I do many things differently than other practitioners (I only know this from my own clients’ feedback).  Don’t expect to hear any of the things I’m writing here from other HTMA practitioners, although I've been giving seminars to practitioners this year, so the word is getting around ?.  If you are interested in working with me on your health, please see our contact page.

Dr. Garrett Smith, the "Nutrition Detective"
Licensed Naturopathic Physician (NMD) in Arizona
NutritionDetective.com, home of the Love Your Liver program
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