Hair Testosterone Test
About this test
ELISA — gender-aware reference ranges. Wellness reading.
What this test can show
Hair testosterone reflects longer-term androgen levels accumulated in the hair, giving a stable, retrospective view rather than the moment-to-moment swings seen in blood.
Sample type
Hair — head, proximal 3 cm
Hair testosterone analysis captures approximately three months of cumulative androgen exposure — a time-integrated view that single-point serum testing cannot replicate. It can be informative where long-term androgen status is of interest and single serum results are hard to interpret, a context the practitioner evaluates using their own clinical judgment and any other diagnostics they order.
Key points
- Months of cumulative exposure, not a single moment. Hair grows ~1 cm/month, capturing roughly three months of integrated free-androgen levels.
- Independent of diurnal and cycle-phase variation. Unlike serum testosterone — which fluctuates with time of day, menstrual-cycle phase and acute stress — hair reflects long-term tissue exposure.
- Informative where long-term androgen status is of interest and single-point serum results are hard to interpret — a context the practitioner weighs with their own clinical judgment and any other diagnostics they order.
- Complementary to Hair Mineral Analysis. The Zn:Cu ratio in HMA influences hormone metabolism — pairing the two provides a fuller endocrine picture.
Why hair, not just serum
Both methods have their place — a clinician investigating an acute presentation may still need a serum draw. But for following long-term androgen levels, the signal in a single serum draw is often hidden behind day-to-day variation. Hair testosterone smooths the signal across months, exposing trends single-point sampling can miss.
Serum is a snapshot: diurnal variation (up to a 30% swing), cycle-phase variation in women, acute-stress suppression, and SHBG-related interpretation challenges all complicate it. Hair integrates over months: ~1 cm captures ~30 days, a standard 3 cm sample reveals 90 days of trend; it reflects the free (unbound) hormone fraction, bypassing SHBG complexity, and is stable to single-day variability.
What practitioners track over time
The test reports long-term androgen levels that a practitioner may consider alongside their own clinical assessment and any serum testing they order. It is most often used where single-point serum results are hard to interpret and a time-integrated view of androgen status is of interest.
Because hair integrates the signal across months, it can surface trends that intermittent serum draws — with their diurnal, cycle-phase and acute-stress variability — may miss. What, if anything, a trend means is for the ordering practitioner to decide in the context of the whole patient.
A practitioner may use this analysis to follow hair testosterone levels over time during an androgen-modulating regimen, including testosterone-replacement monitoring. Any interpretation, and any decision about further testing or treatment, rests with the ordering practitioner.
Methodology
Hair samples are decontaminated to remove surface deposits (sebum, sweat, environmental residues) without disrupting incorporated hormone, then mechanically homogenized to release internalized testosterone for extraction. Quantification is by enzyme-linked immunosorbent assay (ELISA) — a validated, antibody-based immunoassay calibrated against a standard curve with in-house quality controls at each run, suited to the picogram-per-milligram hormone concentrations found in hair. As with any antibody-based assay, cross-reactivity can occur, so results are read observationally in the context of the whole clinical picture.
CanAlt’s standard analysis uses the proximal 3 cm from the scalp (the most recent ~3 months of growth). Concentrations are influenced by hair growth rate, pigmentation (in some studies), recent chemical treatments and the segment analyzed.
Companion services
Hair Cortisol Analysis: long-term HPA-axis activity from the same hair-sample window — chronic stress can suppress androgens.
Hair Mineral Analysis: the Zn:Cu ratio influences androgen metabolism (zinc is required for testosterone synthesis; copper antagonizes the relationship).
Heavy Metals Hair Analysis: endocrine disruptors — particularly cadmium and lead — interfere with hormone-synthesis pathways.
Regulatory & scope
Performed at CanAlt’s ISO 15189 Plus™ accredited medical laboratory in Mississauga, Ontario. Hair testosterone is not covered under CanAlt’s Ontario Laboratory and Specimen Collection Centre Licensing Act licence and is offered for research and educational purposes only, is not intended to diagnose, prevent or treat any disease, and should not be used for clinical decision-making. Reference ranges are sex- and age-specific and are provided for research context.
- Long-term androgen tracking from a single hair sample — a time-integrated view rather than a single-moment serum snapshot.
- Following androgen trends over months where a practitioner is tracking a presentation or an androgen-modulating regimen (including testosterone-replacement monitoring), alongside their own clinical assessment.
How does this differ from a serum testosterone draw?
Serum testosterone is a snapshot — what’s circulating at the moment of the draw, with substantial diurnal, cycle-phase and acute-stress variability. Hair testosterone is integrated — what’s been incorporated into the growing hair shaft over the past three months. Most practitioners use them as complementary tests: serum for the acute window, hair for the chronic trajectory.
How much hair is needed?
Approximately 1 inch from the nape of the neck — about 100 mg (roughly a pencil-width clump), less than HMA requires. For very fine or short hair, multiple smaller samples can be combined.
Can hair testosterone be used in male patients?
Yes, on the same research and educational basis as for female patients – potentially as an educational supplement following testosterone replacement therapy over time. For a first-line assessment of low male testosterone, serum testosterone with paired SHBG, LH and FSH remains the standard panel for the assessment of low testosterone or for monitoring therapy.
What about hair treatments — dyes, perms, bleach?
Chemical treatments can alter steroid-hormone concentrations in hair. Collect hair not chemically treated within the previous 4–6 weeks, or note recent treatments on the requisition. Bleaching has the largest effect; dyeing and perming are more variable.
Is hair testosterone affected by topical or oral testosterone therapy?
Yes, predictably — both routes eventually appear in hair as the systemic hormone reaches the growing follicle, making it of potential research and educational value in circumstances where TRT is being monitored. Topical application directly to the scalp could contaminate the sample at the collection site; nape-of-neck collection minimizes this.
How often should it be retested?
Where results are being compared over time, re-test 3–6 months apart so new growth is captured.
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