Hair Tissue Mineral Analysis is an incredible tool! It doesn’t just give you a snapshot of the absolute mineral values in your hair. It allows you to gain insight into your unique metabolism and neuroendocrine function as expressed by relative minerals relationships.

Understanding mineral dynamics and how minerals affect our metabolism, hormonal balance, and neutrotransmitter function is what makes HTMA so unique as a lab.

I’ve found these so-called “neuroendocrine ratios” to be very accurate and hugely helpful in determining how best to help a client coming to me to heal migraine. For example, I have never had the thyroid ratio in an HTMA report be inconsistent with other thyroid labs that clients receive from their other health care providers. My mentor Dr. Rick Malter, PhD, has written this article on the clinical reliability of the HTMA test.

The HTMA neuroendocrine ratios give me valuable insights that help to guide the nutritional balancing plan. These ratios are in no way equivalent to blood tests that can measure hormone and antibody levels, but they do reveal a direct and simple explanation for how a person’s metabolism may be compromised due to mineral imbalances and how that neuroendocrine function can be restored by improving the ratios.

Let me show you a few examples from a sample lab:

Here we see an example of the absolute levels of a person’s major nutritional elements.

Here we see the major neuroendocrine ratios.

The Ca/P Ratio – Metabolic Type Ratio


This is the first ratio that I look at to determine a person’s overall metabolic type – either fast or slow. There are four subtypes within fast and slow. A person’s metabolic type is determined by the amount of calcium relative to phosphorous in their system. Elevated calcium relative to phosphorous is characterized by a slower metabolic rate and posterior pituitary dominance, which leads to an overall parasympathic state. Clients with excess calcium will benefit from more phosphorous and other calcium antagonists. They may also benefit from nutrients that help calcium to get into the right places (ie, back into the bone).

A person with a faster metabolism will be in a sympathetic state, with a lower ratio of calcium to phosphorous. This pattern is characterized by anterior pituitary dominance, and these people will benefit from more calcium or other calcium mineral synergists.

To learn more about the 8 metabolic subtypes, read my blog post “Understanding Your Metabolic Type.”

The Na/K Ratio – The Stress Response Ratio

This ratio is very important because it helps me to understand what stage of stress my clients are in. Sodium and potassium both reflect various stages of stress.

When sodium is in excess of potassium above 5/1, this indicates widespread inflammation and the alarm stage of stress. The adrenal cortical hormone aldosterone causes the body to retain sodium, so higher levels of sodium express robust adrenal activity and a vigorous initial stress response.

When excess cortisol is released (as compared to aldosterone), potassium is retained at the expense of sodium. This leads to a low na/k ratio. A low na/k ratio reflects the resistance stage of stress. In other words, the body is dealing with a prolonged stress.

If the prolonged stress becomes chronic as in chronic pain conditions like migraine, the na/k ratio can get very low, leading to a “burnout” phase of stress. This is characterized by salt-wasting, which can also occur from the presence of heavy metals in the system.

For the most part (with a few exceptions), migraineurs tend to have both low sodium and potassium, and are in the burnout phase of stress or heading in that direction. Because the adrenal glands communicate with the liver it is essential that migraineurs replenish sodium and potassium and rest often so as to preserve their adrenal cortex and kidney’s ability to retain minerals and communicate effectively with other organ systems.

The Ca/K Ratio – The Thyroid Ratio

I wrote last week about the role that minerals play in thyroid health and migraine headache.

Calcium slows down metabolic function, and potassium speeds it up. Therefore, people with elevated calcium levels in relation to potassium tend towards slower hypothyroid function and parathyroid dominance, while those with low calcium in relation to potassium have a faster metabolism lending towards hyperthyroid in extreme cases, and low parathyroid levels.

From looking at these ratios, I can know that someone with slow thyroid function will be supported by more potassium (and other minerals like phosphorous, zinc, and magnesium that lower calcium) – and someone with fast (or hyperthyroid) function will need more calcium (or other minerals like copper that raise calcium).

Iodine also plays an important role in thyroid function and it is valuable to look at other mineral relationships besides Ca/K in determining how to help support a person’s thyroid function. Iodine, for example, can only be utilized once halides have been dumped and in the presence of sufficient copper.

The Zn/Cu Ratio – The Hormonal & Vitality Ratio

I’ve written about copper and zinc and their role in migraine headache here. Helping people to improve their copper/zinc ratio is perhaps one of the most tangible ways to get them out of the woods with migraine.

This ratio is one of the most important, and also difficult ratios to interpret, because of the possibility of “hidden” copper. Luckily, although copper may be hidden, there are many other indicators within the mineral profile to detect likely hidden copper. This hidden copper is then revealed on the hair retest.

Frequently, however, this ratio is straightforward to interpret because copper toxicity is overt. Copper toxicity is a major cause (though certainly not the primary cause) of migraine headache. Because excess copper is usually in biounavailable form, copper toxicity has some similar manifestations as those with low copper, though copper-toxic folks generally have more anxiety and yeast-related issues.

I tend to think of copper as the feminine mineral and zinc as the masculine mineral, as copper is needed for estrogens and zinc for testosterone and progesterone. This is a simplistic way of seeing things (since zinc is also needed for estrogens and progesterone), but still a worthwhile analogy because of the way that women’s hormones can get seriously compromised when zinc gets too low or high.

High zinc in relation to copper will result in elevated testosterone and progesterone relative to estrogens, while elevated copper will result in higher estrogens compared to progesterone and testosterone. This is complicated by the fact that there are many estrogen mimickers in our environment.

Because hormonal birth control and the copper IUD both raise copper at the expense of zinc, we could say that hormonal birth control deprives women of their own masculine energy. Women do need testosterone for mood, energy, and keeping migraines at bay.

Copper and zinc have a fascinating relationship because they are both synergistic and antagonistic. In the right ratios, copper and zinc work together beautifully in many enzyme processes related to connective tissue health, neuroendocrine function, antioxidant defense (MnSod) and hormonal balance.

The Na/Mg Ratio – The Adrenal Ratio

This ratio is often viewed in relation to the Stress Response Ratio as both ratios reveal a lot about adrenal cortical activity. As already mentioned in the Stress Response Ratio, aldosterone is the hormone that triggers the kidneys to retain sodium. Magnesium is important for mediating the stress response – magnesium is easily lost during stress and helps to create resilience in stressful situations. Therefore people with a high sodium to magnesium ratio will tend to have increased adrenal cortical activity while those with a low sodium to magnesium ratio will have a weaker adrenal response or more parasympathetic response.

The Ca/Mg Ratio – The Blood Sugar Ratio

An imbalanced Ca/Mg ratio usually indicates excessive carbohydrates in the diet. 

Calcium and magnesium are regulated by the thyroid, parathyroid, and adrenal glands. Both of these minerals play a role in blood sugar regulation and insulin production in the body. Individuals with higher calcium have slower thyroid function which in turn overactivates the parathyroid glands, leading to higher insulin levels in the blood. Those with low calcium in relation to magnesium have the opposite pattern, with low insulin levels and low blood sugar coinciding with elevated adrenal cortical production (as we know, these adrenal hormones play a big role in blood sugar balance in the body) . Even when a person is low in both minerals, the mineral ratio can be insightful to evaluate how to balance blood sugar.

The mineral chromium also plays a role in blood sugar balance so I look at this mineral’s value alongside the Blood Sugar Ratio when considering how to support a person’s blood sugar balance. Chromium deficiency can lead to low blood sugar while high levels of insulin and glucose can both deplete chromium levels.

The Fe/Cu Ratio – The Bacterial/Viral Ratio

At face value, this ratio is very valuable because excess iron is the cause of many many health conditions. Iron is acidifying and can lead to a tissue environment in the body that is conducive to bacterial infections, which explains why this ratio is called the Bacterial/Viral ratio. This ratio can reveal hidden factors such as likely bacterial infection (such as a tooth abcess) in those with a high Fe/Cu ratio. Or, it can reveal a tendency towards more viral infections when the iron to copper ratio is low. Copper actually has some antiviral action but because copper lowers zinc (an even more important antiviral), an elevated copper level often leads to low zinc and viral susceptibility.

In practice, I very rarely see people with elevated iron to copper. More commonly in my coaching practice with migraineurs, I see very low absolute levels of both iron and copper, which makes sense, since copper is needed to get iron into the cell. Both copper and iron are transported into the cell for cellular ATP production through the enzyme ceruloplasmin. This ratio is super valuable because it can be an indicator of how well ceruloplasmin is working. My approach with this ratio is to focus on the nutritional cofactors for increasing ceruloplasmin production. The benefit of this is that anemic individuals can often get improvements in their iron levels without direct supplementation of iron. Actually I never suggest iron as a supplement due to its acidifying nature. Often improving a person’s copper levels or copper bioavailability is sufficient to resolve the anemia and get the iron into the right place.

Additional Ratios

There are other mineral ratios that are also valuable and revealing. For the most part, in this category I only look at the Cu/Mo, or “Copper Toxicity Ratio”, which is important since both copper deficiency and toxicity can play a huge role in migraine headache, as copper is needed for enzymes that synthesize histamine and the estrogens. The Cu/Mo ratio is also valuable for understanding why a person may be copper deficient, since an elevation of molybdenum can lead to copper deficiency and therefore anemia and other problems, which I recently outlined in my blog post “My Crash Course in Molybdenum.”

Bottom Line: HTMA Rocks!

I hope you’ve found this little primer on the ratios insightful. It’s really quite profound what a little clip of hair can reveal about your inner workings and how to support your health. If you’re interested in getting your own hair analyzed, check out my Coursework + HTMA bundle. It’s a great place to start if you’re ready to understand your own unique mineral profile, how minerals are playing a role in your migraine pattern, and how to heal your migraines holistically.