Ep. 116: What an HTMA Test Actually Reveals (That Standard Labs Miss) And How Practitioners Can Use It

In this practitioner focused episode, Dr. Heather Finley breaks down what Hair Tissue Mineral Analysis (HTMA) actually measures, why it captures things that standard blood serum testing misses, and how practitioners can use it to understand a client's cellular mineral status, oxidation rate, and toxic metal burden. 

She also addresses the hard questions about HTMA validity directly, including the lab variability research, the lack of a universal clinical standard, and AMA non-recognition.

Topics covered: how HTMA differs from bloodwork, the Big 8 minerals and significant ratios, oxidation rate and metabolic typing, hidden copper toxicity, HTMA validity and the JAMA studies, lab selection (TEI vs. ARL), and how to start using HTMA in clinical practice.

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Transcript

Dr. Heather Finley 0:03

Welcome to the Love Your Gut Podcast. I'm your host, Dr. Heather Finley, registered dietitian and gut health specialist. I understand the frustration of dealing with GI issues because I've been there and I spent over two decades searching for answers for my own gut issues of constipation, bloating, and stomach pain. I've dedicated my life to understanding and solving my own gut issues. And now I'm here to guide you. On this podcast, I'll help you identify the true root causes of your discomfort. So you can finally ditch your symptoms for good. My goal is to empower you with the knowledge and tools you need so that you can love your gut and it will love you right back. So if you're ready to learn a lot, gain a deeper understanding of your gut and find lasting relief. You are in the right place. Welcome to the love your gut podcast.

0:56

I want you to think about a client you've been working with for a while, or maybe this client is you. She eats well. You know this because you've gone through this with her. She's not skipping her supplements. She's doing the things, and she can't gain any traction. Her labs come back, quote-unquote, fine. Her TSH is in range. Her iron is good. Her ferritin might be low, but her CBC is unremarkable. And every appointment, some version of the same conversation happens is, "I don't even know what else to try." I wanna talk to you today. This is mostly for practitioners, but if you're a client that relates to anything that I just said, listen in to this as well. I wanna talk to you today about what almost certainly is missing from that picture, and why it's missing not from effort. So welcome back to the Love Your Gut podcast. I am so excited to talk today about one of my favorite topics, which is minerals and HTMA, or hair tissue mineral analysis. Now, if you have been listening for a while, you may have caught our mineral series back in episodes, I believe it was 88 through 92. I have gotten so much feedback on these episodes, especially the one that I did with my mom, and since then, I've gotten a lot of questions from practitioners, "Heather, how do I use this in my practice? How do I explain HTMA to clients? What can HTMA tell me that I can't get from regular blood work?" So that's exactly what I wanna cover today. And I wanna say up front, I'm going to address the hard questions about HTMA as well, like validity concerns, lab variability issues, why, this test is not recognized by some institutions, because I think it's helpful to chat through all of this, and h- helpful to just understand the full context. So just heads up, before we get in, if you're a practitioner and this topic resonates with you, I wanna make sure you know about my live training next Thursday, June 18th. I am hosting a live training called The HTMA Edge. If you are at all curious about HTMA testing, how to use it, how to grow a more profitable practice through HTMA testing, and most importantly, how to get your clients faster and even better results, you need to be there. It is at noon on June 18th. This is specifically for practitioners. Details are at the end of the show notes. So let's just jump right into it. I wanna start with a scenario that I think will feel very familiar to so many people. Maybe you have a client that's been working with you for a few months, maybe longer. She came to you with fatigue, gut symptoms, maybe hormone stuff as well, hair loss, mood dysregulation. But this is a motivated client. She's doing everything. She's tracking her food and patterns. She's doing what you asked, and she's not feeling any better, or at least in the way that you think that she should. You've run the labs, you've looked at her thyroid, you've addressed all the obvious stuff, and you find yourself in a position that literally no practitioner wants to be in, genuinely just unsure of, like, what is going on That was me years before I had HTMA as a tool. I'd get to the end of my standard protocols, the ones that, you know, worked for most of my clients, and I would hit this ceiling with certain clients, and I couldn't figure out why. There was people doing everything right, and it was like, why is their body not responding? And the honest answer at the time was, like, I just didn't have a good enough map, and that really started to affect my confidence. And I talk about this a lot. When you don't have confidence as a practitioner, that affects every area of your business, not just your clients, but also it affects how you market your services. How can you confidently market your business if you don't feel confident you can get people results, right? So becoming a confident practitioner is your number one business skill. You have to feel confident in what you know and how you can provide a transformation for people so that you can confidently give people what they're asking for. So the question that often people start asking is: What if the testing itself is the problem? You know, what if the reason that these clients look fine is because we're actually looking in the wrong place? Not because they're actually fine. Nobody's body is supposed to be bloated and looking pregnant by the end of the day. Nobody's supposed to have their hair falling out. There's obviously a reason why, and it just takes turning over other stones to figure out what's going on under the surface. So really, that is what led me to HTMA, both my own stuff as well as client stuff, and I will say that this test has single-handedly changed the clinical picture of so many cases that usually would feel really stuck So what I eventually realized is that standard blood testing is very good at telling you what's going on right now, in this moment. But what it's really terrible at is telling you what's been accumulating, what's been depleting, what's been dysregulating at the cellular level for the last several months. There are- these are two completely different conversations. So in no way am I saying HTMA is superior to blood work, because it's not. It's just looking at a different thing. So most of us need a combination of both to really see how it's integrating together. So most standard labs are looking at blood serum. So this is a snapshot of what's circulating in the blood right now. And blood serum is tightly regulated. Your body will do everything that it can to keep those levels looking normal. Mineral levels in the blood are, are buffered very hard because wildly fluctuating serum mineral levels would cause serious problems. That's the stuff that we learn about in school, right? If potassium is off in the blood, you're likely in the ER. There is a serious issue. So the catch is that regulation means that deficiencies and imbalances can be hidden for months or even years at the serum level. While at the tissue level, your cells could be quietly starving or drowning in a particular mineral. So HTMA gives us a window into the cell's mineral activity, not the blood's. And that is a completely different conversation. So you can think of it this way. A blood test is like checking your checking account balance. HTMI- HTMA is like looking at your actual spending patterns, your savings history, your debt load over the last three years. So one tells you what's available right now. The other tells you what has been happening So we're not just looking at what the balance is today, it's what has the balance been over the last three-ish months when we're looking at an HTMA test. So the real clinical value is that HTMA can tell, c- it can surface cellular issues months, sometimes even years before they ever show up in the blood. That's a whole case for running it as a preventable clinical support tool, right? So for practitioners, this is where the opportunity is. We spend so much time with our clients being reactive, waiting for something to show up on blood work before we act, but HTMA actually allows you to get ahead of it and address things before they become a serious problem. So what HTMA does is it analyzes the mineral content of a small hair sample, specifically at the root end, so the closest to your head, and that captures what has been deposited over the last 90 to 120 days. So hair forms from the follicle, which is bathed in blood and lymph and extracellular fluid. So as the hair mineralizes and hardens, it locks in a record of what's been happening metabolically. So the big eight nutritional minerals that we care most about not that we don't care about all of them, but the, the top eight would be calcium, magnesium, sodium, potassium, copper, zinc, phosphorus, and iron. These are all probably minerals that you know about, you know what they do, you know where you can get them from. These eight minerals, and specifically the ratios between them, tells us the most about what has been going on in somebody's body and how it's actually functioning. Now, there's also significant ratios. So this is really where HTMA shines, because HTMA matters so much more about the ratios versus just a standard mineral level. It's the relationships between them. So the calcium-magnesium ratio tells us about blood sugar regulation, cardiovascular function. The sodium-magnesium ratio reflects adrenal function. The calcium and potassium ratio reflects thyroid function The sodium-potassium ratio tells us about stress response and possible inflammatory potential. The zinc-copper ratio is one of my favorite ratios. That tells us about hormone information, so estrogen versus progesterone, testosterone. This is not diagnostic, so we're not saying, "Oh, your calcium to potassium ratio is off, so you have thyroid issues." No, it's saying, "Your thyroid could be struggling because your calcium's too high in relation to your potassium, so potassium's not getting into the cell, and we need potassium for thyroid conversion." So one nuance worth noting is just a normal mineral level doesn't always mean a functional mineral level. This is one of the core principles. So Dr. Paul Ek is one of the big mineral guys. That's one of the core principles, is a high mineral level can be just as damaging as a low one. Copper, for instance. This is a common one with iron issues. It can be, appear low or normal on a hair test, and actually just represent significant biounavailable copper that's buried in the tissue. That's what we call hidden or latent copper toxicity. It's one of the most unidentified patterns that we see. Same thing with toxic metals. So HTMA also maps out toxic metal burden, so it looks at things like lead, mercury, arsenic, aluminum, et cetera, and it shows what the body is releasing from the tissues. So this is hugely valuable, because blood levels of hea- heavy metals often will be normal even when there's significant tissue accumulation present. We see some wild things on HTMA testing, especially in our clients who live near, coal mining factories. We see a lot of this in our clients that live in Utah, uranium, et cetera. and so, like, environment is a big thing here The next thing that I wanna chat through is oxidation rate. What it is, and why it really matters. The, the piece that I think is very practitioner-specific and also underappreciated is that HTMA gives you the oxidation rate, or they call it the metabolic type. A lot of our clients will see this and be like, "I knew I had a slow metabolism," 'cause it'll say fast ox or slow ox. And this doesn't necessarily mean anything about your metabolism. It's really more showing, like, how efficiently the body is converting food and nutrients into energy at the cellular level. Basically, how is the body responding to stress, birth- both internal and external? So a fast oxidizer through this calcium and phosphorus ratio is someone is gonna show lower calcium lower magnesium, higher sodium, higher potassium. This person tends toward adrenal hyperactivity. They burn through nutrients quickly. They're in more of, like, an active state of stress. A slow oxidizer, which is the more common pattern that we see, is the opposite. So they typically have higher calcium lower magnesium, lower sodium, lower potassium. Sometimes the magnesium is high, showing they're burning through a lot. They're often in more of this parasympathetic dominant state, dealing with s- just sluggish thyroid, sluggish adrenal function. This is your exhausted, brain fogged, constipated, burnt out, uh, client who seems to do everything right but can't gain ground. Sound familiar, right? So the clinical implication here is you cannot support a fast oxidizer the same way that you would support a slow oxidizer. The protocol is completely different because a fast oxidizer is in more of an active state of stress, whereas the slow oxidizer is just burnt out and tired. So giving a slow oxidizer a supplement stack that a fast oxidizer is taking can actually make them worse. This is why just generic protocols don't work. This is why you can't do a group program for, like, detox, or you can't do a group program for, like, specific things because everybody's body is different. And this is where data can be so helpful to see what does somebody actually need because we have to customize it to their specific bioindividuality So there are also subtypes within each oxidation rate. We've got slow one through fast four. This is something that, I'm not gonna get into too much. we also have fast one through fast four as well. And this is basically just based on whether the thyroid and adrenals are sluggish or overactive. So each subtype between fast ox and slow ox has its own pattern, its own clinical picture, its own support priorities. That, we're gonna go more into that on the mineral training on June 18th. it's too much to go into on a podcast episode where I can't show you anything. But it can just be a good starting place to see kinda where's your client on the stress scale. So I want to walk you through just where, how this actually looks in practice and, like, where you would go from here. So we'll just give an example of a client who by most measures is doing everything right. They understand nutrition. They are eating well, resting, they've done standard blood work. Their, their TSH is, within normal range. Their iron is, is normal. Their CBC is normal. But they're just so exhausted in a way that they can't describe. Exhaustion has kind of become their baseline. Maybe they're gaining weight despite no real changes in their diet. This is a common thing we hear from our clients that are in perimenopause, is they're like, "I don't know what happened to my metabolism overnight." Maybe they're just more anxious than they normally are. They just feel depleted. They might say something like, "My, my mind is racing. My body just wants to collapse. Like, by the end of the day, I'm just done." So this is a standard client that we see and I can think of one that we saw even, like, this week. When we run an HTMA, what we typically find is they're a slow oxidizer, so that calcium to phosphorus ratio is well above the range of 2.6. Their calcium levels are really high in their tissues, and that can just indicate tissue calcification and kind of like a mineral lockup. Calcium is rigid, right? It's what helps with bones. So calcium can just block everything. So it's gonna block magnesium from actually working from a constipation standpoint. It's gonna block the bowels. It's gonna block the thyroid Typically, we'll, we will also see potassium being very low. These are clients that have, like, kind of been stressed their whole lives. Potassium is the most common mineral that we see depleted when we're stressed, and that also is going to affect the thyroid. We'll see depleted adrenals. We'll also see a zinc-to-copper ratio really low, which just raises significant flags for copper imbalance. When we work through all of this, what we can find is like, okay, blood work l- looks fine, but the HTMA tells a completely different story. And that part is so important because while these clients, they've probably already invested significant time, money, energy into figuring out why they feel the way that they do, and they haven't gotten any answers. And the cool part is when you actually know how to support somebody's minerals based on HTMA testing, which really can be done very simply through food modifications, through actually addressing just what multivitamin they're taking or what specific supplements they're taking, it, it doesn't have to be overly complicated. The cool part is you start to see changes really quickly, especially in energy. Typically, if someone comes to us with kind of that exhausted, depleted pattern, within a few weeks, all of a sudden they're like, "I feel like the lights have just been turned back on. My body is actually finally feeling like it's back online." And then things just continue to improve from there. We started seeing this so much several years ago when we really started incorporating HTMA into our practice, especially for our constipated clients. These were the clients that were taking 1,200 milligrams of magnesium every day, and they're like, "Why am I still so constipated?" We'd look at HTMA, we're like, "Well, of course you're still constipated. Your calcium is so high, your sodium is so low, your boron is so low." Those two things both affect how you're gonna absorb magnesium. And it was very clear, and all of a sudden we're cutting down the magnesium dose, supporting these other minerals. All of a sudden they're not constipated anymore. And so we're just shortening the timeline of actually getting people the results that they want. So one thing that I wanna address just kinda head-on is, like, the HTMA validity questions, because if you're a practitioner, you've probably heard people say, "Oh, it's not a valid test," or just heard some skepticism about HTMA. Maybe you've had colleagues that are like, "No, this is not a test that we use." I, I think that it's worth a discussion. So I wanna go through some of the main ones. Number one, like, lab variability. The most legitimate concern is all the variability within the labs. There are many different published studies. These studies are fairly old, but from JAMA, the, there's a 1985 study, a 2001 study. They found significant variability across labs. So at face value, that sounds hopeless, right? But here's what actually happened. In that study, the researcher collected hair by cutting a long piece, washing it then dividing it and sending it to 13 labs. That is not how HTMA works. You cut fresh growth from your roots, and you do not wash your hair. The biggest reason that there's lab variability is because you do not need to chemically wash the hair. You're just getting a hair sample. The lab that you use should not wash the hair. So one of the labs that we use, or the only lab that we use, is Trace Elements Lab. You can also use Analytical Research Labs, their lab is great as well. They do not wash the hair. And actually, interestingly enough, Trace Elements Lab is owned by a dietician, as of, I think, maybe, like, 18 months ago. So lab variability is a problem in the HTMA space. The fix is knowing which lab to use. Trace Elements has been testing their hair for close to 40 years. I think Analytical Research Labs is, like, 45 years. Neither of them washes the samples chemically. They have rigorous verification processes for elevated toxic metals. Their results are highly consistent with each other. And so just do your research and use a correct lab. Another question that I often get is, like, the lack of universal clinical standards. So that there's no governing body that has an established universal reference range for HTMA interpretation. What I'd say is, like, the clinical framework we use, so the work of Dr. Paul Ek, Dr. Watts, at Trace Elements, researchers like Dr. Malter, they represent decades of clinical observation, refinement. Dr. Watts, who founded Trace Elements Lab, has been doing research and studies on this for years and years and years, and that's the lab that now a dietician has taken over. So it's been 40 years of developing clinical science, into more of a mainstream testing way. Part of the problem, I believe, is funding. So the research investment that flows into pharmaceutical-adjacent diagnostic labs has not flowed into functional mineral testing. That doesn't make this wrong. It just means that the standard of care, especially in our healthcare system, is focused on reaction versus prevention, which is really what HTMA is, is it's catching patterns in the hair or in the tissues way before they ever show up in the blood I think that HTMA is best understood as a screening and clinical support tool. It's not diagnostic in the conventional sense. It's not used to diagnose disease. It's used to understand cellular mineral patterns to give nutritional protocols, to flag areas worth investigating, and that is what we have to frame it as. I'm never diagnosing somebody with a thyroid issue based off of their HTMA test. I can't even diagnose people as a dietitian. I think one of the biggest disservices to HTMA testing is that there are a lot of untrained people using it, making alarming claims, handing clients a list of supplements based on computer-generated reports that they don't actually understand, and it gives the tool a really bad name, and most importantly, it can harm people. HTMA is a very sophisticated client tool, and you cannot take the mineral levels at face value. You have to understand how minerals interact with each other. I have taken hours and years of training on HTMA to actually understand it, and did that well before I ever started utilizing it with clients because it is so nuanced. And so unfortunately, there are people out there providing recommendations, quote-unquote, based on HTMA, and they really don't understand the lab. Part of what I offer in Gut Practitioner, is training on HTMA and how to actually understand the test, how to collapse the time that it took me to understand the test so that you can start using it, ethically and responsibly with your clients. So if you are a practitioner listening and thinking, "Okay, I wanna learn this," what I, where I would start is, number one, just understand that HTMA accuracy is largely a function of the practitioner analyzing it. The lab gives you the raw data. Interpreting the ratios, identifying loss patterns, recognizing hidden copper toxicity, understanding how oxidation rate works, that's the skill. That's what takes training. Number two is lab selection matters. Some labs chemically wash the hair, like I said. The labs that I use and trust are Trace Elements and then, if needed, Analytical Research Labs. Their reports are almost identical and then third is you don't have to offer s- HCMA as a standalone. Many practitioners integrate it into packages t- for test kits, a result session, protocol support, retest, et cetera. That's where really the magic happens is you can see the pattern shifting. The most powerful test, I think, that we often see is the second test. We, we like to see how the body has responded to what we have done, and what the next step is in their support. So all that to say, HCMA is such a powerful tool when it is used correctly and when you understand the context, when you understand your client, when you understand how it all goes together. So I hope that this gave you just a real foundation for understanding HCMA, what it measures, why it surfaces things that standard labs miss, and then where the tool just has limitations. It's not a perfect test. No test is perfect. So just a quick recap. Blood serum testing has limits for mineral assessment. HCMA is gonna look more at cellular patterns when it comes to minerals. It'll look at ratios, toxic metals. It'll look at oxidation rate, and it really can help shape every protocol decision. It can help shape what we're actually deciding to do. And really for us, it's the difference- addressing minerals is the difference between someone making progress and not making progress. It's very hard for somebody to respond, especially to a GI protocol if they have SIBO or something else, if their body is so depleted and doesn't have the energy to do so. If you look at any metabolic process in the body, they all require minerals. So this is a skill that you need to learn as a practitioner. And if you're thinking that you wanna learn this properly, you can come live on June 18th to my practitioner-focused training on HCMA. I will walk you through even more in depth the test, how to use it, all the things, the different patterns that you can learn, and how it can help you build your confidence as a practitioner, build your confidence in your business. So I cannot wait. It's one week from today when this episode is coming out, so grab your spot. I'll see you next week. I hope to see you, live on the training, and I will also see you on the next episode of the Love Your Gut podcast.