Challenges to Testing

The only medically recognized form of "copper toxicity" is Wilson's Disease, for which specific test markers and visual cues (ie: Kayser-Fleischer rings) can provide an accurate diagnosis.   However, while WD is quite rare, the copper toxicity discussed on this website is much more common, yet testing is more difficult.  As copper accumulates in the body, the liver is the primary storage location, followed by the brain and other body tissue.   Notice the key words there - "storage location".  Excess copper does not stay in blood.  That which is not excreted, ends up being tightly stored in the body.  This is why, when a person goes in and has a typical blood draw, it is unlikely to show the copper toxicity condition. If copper is actively circulating at the time of the blood draw, then yes, the condition can be discovered.  However, more often than not, stored copper is not actively circulating. 

This is where the HTMA (Hair Tissue Mineral Analysis) can be so useful.  The benefits of HTMA are discussed more on the Testing page. The challenges to testing however, revolve around 5 areas:

1. The dismissal of HTMA as an accurate screening test
2. The inability of most practitioners to properly interpret HTMA data
3. The assumption by the public that HTMA test data can simply be read at face value
4. The various forms of "hair analysis" on the market, not all of which are suited for this purpose. 
5. The very nature of copper being stored means that any testing short of a liver biopsy will have inherent limitations.

Let's address each of these factors individually.

1. The dismissal of HTMA as an accurate screening test.  Much of this confusion stems from the two studies done in 1985 and 2001, subsequently published by JAMA, that on the surface seemed to discredit the accuracy of HTMA.  These studies are often referred to by those who love to call HTMA "quackery", yet who are unaware of the history behind those studies.  The author of the first study was found by the California Appeals Court to be "biased and unworthy of credibility", while the studies themselves violated almost all acceptable protocol for testing.  Yet, despite that, the data, when closely analyzed, still reflected clear mineral patterns and a high accuracy of .999% when comparing the two leading labs ARL and TEI.  This history, and the data set, is provided in more detail in the article linked here.

Likewise, HTMA is not meant to be done just once, nor to be looked at as a panacea for all that ails a person. It's a test that monitors the movement of the mineral system over time. A single HTMA is just a snapshot in time.  The movement of minerals can only be seen through repeated testing.  Simply doing one HTMA and then claiming "it doesn't work" because symptoms still exist would be like doing a single blood test and then claiming "the blood test doesn't work" because symptoms still exist. This then leads into the challenges behind healing itself which are addressed more on this page.   HTMA provides an unparalleled screening test, yet there is so much more to healing a complex condition than just doing a screening test and taking some supplements.  Yet, the assumption that healing is that simple is then further used to discredit the validity of HTMA when a person hasn't miraculously healed. 

2. Any medical professional can open up an account at an HTMA testing lab and order the test. However, a medical degree alone does not qualify a person to be able to interpret HTMA data.  Unlike a blood test, HTMA is not a test that should be read at face value.  While a chart looks deceptively simple, the interpretation of the data is extremely complex and requires specialized study, and experience.  Even amongst health practitioners who offer HTMA within their services - from medical doctors to naturopaths to nutritionists - not all have been properly trained to interpret the data, and commonly (unintentionally) end up misguiding their patients when they simply read the results at face value.  To give a clear and simple example, consider magnesium, which is commonly "high" in an HTMA.  So often, an untrained practitioner, or an automated report, will simply say "you have high magnesium", yet they are not considering the possible causes behind that high magnesium.  For example, if magnesium is being lost from the cell, due to stress, or bone-calcium loss, that increased circulating magnesium can show up high in the HTMA, even though the person is losing magnesium from the cell.  Likewise, contamination factors also need to be considered.  What if the patient recently had Epsom salt bath water exposure?  That could falsely elevate the hair magnesium level.  The point is, proper interpretation by a qualified HTMA expert is essential.

3. Many people who believe they have copper toxicity order the HTMA, and often the HTMA copper level comes back as "low".  This completely confuses people, as they automatically then assume there is no copper issue at all. However, copper can be low in an HTMA even with copper toxicity, and in fact this is very common, especially if metabolic energy is insufficient to mobilize the body's stored copper.  Once again, proper interpretation is essential, along with consideration given to various individual factors including health history, medications, exposures, etc.  All too often, a person will simply order a hair analysis, get an automated report or read the results at face value, and become more confused than ever.  They automatically assume a high level of an element means a toxicity, or a low or normal level means they are fine. (If one is spending money on a hair analysis, it's important to work with a trained practitioner to help guide you with interpretation).

4. There are numerous forms of "hair analysis" on the market.  People often order the wrong type of test, assuming all hair analysis is the same, and then complain that the test is not worthwhile!  It’s imperative to understand that not all hair analysis is the same.  In fact, one red flag that a person discrediting hair analysis doesn’t actually understand hair analysis is if they are referring to hair analysis as a catch-all term in their dismissal of the test.   Some forms of hair analysis are a lot more valid than others, especially for the purpose of understanding minerals and copper, while some other forms of hair analysis certainly do call into question their validity.  

Let’s consider the difference between what could be considered regular hair analysis, versus nutritional hair analysis.  Hair analysis really, is simply any test that analyzes the contents in hair. But just looking at what’s high or low in the hair, at face value, doesn’t necessarily reflect what’s happening in the body.  With regular hair analysis, the focus is typically more on the toxic metals, or sometimes the nutrient levels but with disregard to the actual causes behind the levels.  There generally isn’t much focus on the relationships between minerals, or the relationship between minerals and metals.  This is where a test, even if it includes a value for copper, isn't necessarily ideal for understanding copper toxicity. Key nutrients such as calcium, magnesium, sodium, potassium, etc are often not included in tests that are focused just on toxic element exposures. 

Nutritional hair analysis, on the other hand, is more focused on the nutrient elements, along with the relationships between minerals and metals. These relationships between pairs of minerals is key to understanding the implications for health, and especially so when it comes to copper toxicity. Nutritional hair analysis is concerned with gaining insight into endocrine system status, the body’s detox ability, cellular function, disease states, and of course, the relationship between imbalances.’

Some hair analysis services are focused on food sensitivity testing, not specific mineral levels.  Some forms will test minerals but just give a "range", rather than specific numerical data.  Other services may test for a few scattered minerals but not a complete profile.   The point is, there are many hair analysis services on the market, and all too commonly people order the wrong type of hair analysis for their purpose (in this case understanding copper toxicity), and they end up getting even further confused or misled, and then dismiss HTMA as "not being valid".  Choosing the right type of HTMA, and working with the right lab, is key for upholding the integrity and reliability of HTMA, as well as gaining an understanding into copper status and copper toxicity.

5. The very nature of copper being stored means that any testing short of a liver biopsy will have inherent limitations. Of course, no one would voluntarily do a liver biopsy (invasive, painful, expensive...). We are therefore left with the three main testing options as explained on the Testing page -blood, urine, and hair.  All, in fairness, have their shortcomings, and no test, by itself, provides a complete picture. Ideally, all three tests could be run to gain better insight. However, in terms of bang for buck, the HTMA, when properly tested and interpreted, provides the best window into understanding copper toxicity and copper's effects on the body's mineral system as a whole.  It is, however, not a panacea, nor diagnostic. It is merely a screening tool, and needs to be considered in that context. Furthermore, not all health issues can be seen through HTMA, or are caused by a specific mineral imbalance.  For example, if gut issues are a primary symptom, a functional test such as the GI Map can offer more insight into that specific area.  There are many avenues to explore in terms of further testing for insight into specific areas. However, returning to copper specifically, the HTMA is a great place to start the exploration due to its affordability and the wealth of information it can provide.