Should you Consult an Anaesthetist for Thinning Hair?

In an online publication called Strong Women from 2022, I came across the following headline:

I had a full-body health MOT and finally got answers about some odd symptoms I’ve been experiencing.

(MOT is an abbreviation for Ministry of Transport and refers to tests on motor vehicles introduced in Britain in 1960 to check the condition of the brakes, tires, etc., to ensure roadworthiness. However, the human body is not a motor vehicle – it’s somewhat more compliated.)

The writer, a 33-year-old woman, underwent these tests because she was worried about her thinning hairline. She consulted Dr William Buxton, an NHS anaesthetist who in his spare time runs an outfit called Effect Doctors, and underwent a ‘Well Person Advanced Blood Profile’. According to their website, this is ‘comprehensive, covering a wide array of blood test biomarkers.’ It’s priced from a mere £350 and includes the following:

A Full Blood Count to assess anaemia, white cell count, and platelets, as well as tests for Kidney Function, Electrolyte levels, Liver Function, Thyroid Function, Inflammatory Markers (CRP), Bone Markers (calcium, phosphate, uric acid), Triglycerides, Cholesterol, Vitamin D, Ferritin (iron stores marker), Blood Glucose Level, and HbA1c, which indicates blood glucose levels over the previous 3 months. Additionally, the profile includes cancer markers: PSA (for men), which detects prostate cancer, and Ca 125 (for women), used to screen for ovarian, fallopian, and uterine cancers.

Now just a moment. It’s misleading to say the PSA test detects prostate cancer. It does nothing of the sort but might indicate the possibility of prostate cancer. It’s a pretty useless test, because men with high levels may have no cancer, and men with normal levels may still have cancer. For these reasons PSA testing has largely dropped out of favour for prostate cancer screening.

Furthermore, Dr Buxton, being an anaesthetist, I would venture to say doesn’t know much about hair loss – a not uncommon complaint seen in general practice – so what he does is ‘tests’. Lots of them. ‘Dr Buxton takes what feels like a lot of blood. Vile after vile [sic], he keeps draining away…and then it’s all over.’

This contains an interesting Freudian slip. The writer means ‘vial’, not ‘vile’. But, although to say such a procedure is vile would be rather exaggerated, there’s something troubling about this kind of approach. Dr Buxton apparently has no idea what’s wrong, so he does tests, whether they’re needed or not, to try to find out.

This is a fishing expedition, and there’s no evidence such an approach does any good in ostensibly healthy people. Tests for anaemia and thyroid deficiency would be reasonable in someone complaining of thinning hair, and the conclusion from this multiplicity of tests was, ‘Yes, your thinning hair is probably something to do with iron deficiency.’ And how did he reach that conclusion? Because her ferritin level (a measure of iron stores in the body) was said to be 24.8 ng/mL, which is at the low end of the normal range of 24 to 307 ng/mL for adult females, but it’s still normal. It’s also relevant that the good lady was already taking  supplemental oral iron, and her medical history included the facts that she was a vegan and a marathon runner, and that at one stage her periods had stopped for three years. Did Dr Buxton take these facts into account, and what would he have done with this information if he had? She might have benefitted from the doctor looking into whether she was overdoing her exercise regimen or experiencing a premature menopause, and advising her about iron-containing foods, and so on. Any self-respecting GP should be able to do this.

There’s no evidence that extensive testing in ostensibly healthy people does any good, other than to the doctor’s bank balance. Furthermore, such tests don’t tell you whether you’re healthy. They only tell you whether the tests are normal or not, which is not the same thing. Worse, they may well create anxiety by finding apparent abnormalities about which nothing can or need be done – except generate follow-up tests, more fees, and more anxiety. This is particularly so with ‘cancer markers’. Although they have a place in assessing treatment for cancer, there’s no evidence they save lives if used to try to diagnose prostate, ovarian, fallopian, or uterine cancers in symptomless people.

Promoting extensive testing such as Effect Doctors and other private clinics do, merely preys on people’s insecurities. Medical tests should be done for a reason, not as a routine or ‘just in case’.

Text © Gabriel Symonds