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Our diagnostic workup typically includes: Heavy metal testing to identify toxic metal burden from mercury, lead, arsenic, and cadmium Comprehensive hormone panel (DUTCH test) to evaluate thyroid function, cortisol rhythm, DHEA, testosterone, and estrogen metabolism Nutrient testing to check for deficiencies in iron, ferritin, zinc, biotin, and vitamin D all essential for healthy hair cycling Inflammatory markers to assess systemic inflammation that may be damaging follicles Once we understand the full picture, we build a personalized protocol

In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered

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NSAIDs NSAIDs inhibit cyclooxygenase enzymes, reducing prostaglandin synthesis and thereby inflammation and pain