Hair test pattern
Slow oxidation with low potassium and/or an elevated Na/K ratio
The core criteria with both labs' figures, the two reinforcing findings, and the rule that a four lows pattern also counts as sympathetic dominance.
Sympathetic dominance occurs when there is a slow oxidation rate combined with a low potassium level and/or an elevated Na/K ratio.
Slow oxidation, as ARL defines it, is Ca/K (the thyroid ratio) above 4 and Na/Mg (the adrenal ratio) below 4.17. Ideal Ca/K is 4 (ARL) to 4.2 (TEI); ideal Na/Mg is 4 (TEI) to 4.17 (ARL).
Ideal potassium is 10 mg% at both labs, and ideal Na/K is 2.4 (TEI) to 2.5 (ARL). The second criterion reads and/or: a low potassium level alone, an elevated Na/K alone, or both satisfy it. The pattern definition sets no Na/K cutoff. In the hair-test reading of autonomic balance, a Na/K above about 4 reads as sympathetic dominance and above 8 as extreme.
Trace Elements (TEI, Watts) uses sympathetic dominance for its Fast metabolic type; this pattern uses the term for a slow-oxidation finding. Both labs read a low Ca/P as a sympathetic state and a high Ca/P as a parasympathetic state (ideal Ca/P 2.5 ARL to 2.6 TEI). Burned-out sympathetic dominance is the low potassium of this pattern together with a Na/K under 2.5.
Two further findings are described as reinforcing the pattern rather than defining it:
Neither finding is required for the pattern to be present. Ideal Ca/Mg is 6.67 (ARL) to 7 (TEI), so a Ca/Mg of 9.5 is 42% above the ARL ideal and 36% above the TEI ideal. Poor eliminator status is read from its own defined criteria.
The pattern definition adds a second qualifying criterion:
Four lows is also considered a sympathetic dominance pattern.
A report therefore qualifies as sympathetic dominance through the four lows pattern even when the core criteria above are not met. Most hair test patterns in this system are mutually exclusive, and the step up and step down patterns exclude four lows explicitly.
ARL's Insight Into Children's Health (1990/1997) sets the four lows cutoffs at calcium below 40, magnesium below 6, sodium below 25 and potassium below 10 mg%. TEI's ideals for the same minerals are calcium 60 mg% (since 2008), magnesium 6, sodium 24 and potassium 10 mg%.
ARL's All-Four-Low document (1987) describes all-four-lows as exhausted fast oxidizers and reads the below-normal sodium and potassium as adrenal exhaustion after prolonged stress, with calcium and magnesium not rising as a buffer. A four lows report carries both readings, and the associations of both patterns apply.
The pattern is associated with a high physical activity reading and with fatigue, anxiety, overactive mind, fear and low mood trends. Written as the labs write them, these are trends of the mineral pattern — not conditions, not medical findings, and not statements about any individual.
Excessive sympathetic dominance is associated with overworking, compulsiveness, excessive thinking, and fearfulness, worry or anger trends, and with a nutrient-depletion trend from too little time in the parasympathetic state.
A hair tissue mineral analysis is a screening test for nutritional and toxic-element patterns. It does not diagnose, it does not establish a cause, and it does not measure what is circulating in blood today. Where the laboratory literature describes a trend, that trend belongs to the mineral pattern rather than to any person reading about it. Anything medical belongs with your own licensed provider.
On a four lows report, I read the sympathetic dominance associations as well as the four lows associations, because the definition assigns both.
I give this pattern less weight than a narrowly defined one. Its criteria accept a low potassium level or an elevated Na/K, and four lows qualifies by rule, so it appears on many reports.
A slow oxidation rate combined with a low potassium level and/or an elevated sodium/potassium ratio.
A Ca/Mg ratio over 9.5, and the presence of poor and very poor eliminators. Neither is required for the pattern to be present.
Yes. Four lows is also considered a sympathetic dominance pattern, so a four lows report carries both readings.
Yes. The criteria are satisfied by a low potassium level and/or an elevated sodium/potassium ratio, so either one can qualify.
A full hair tissue mineral analysis reports the oxidation rate, the four macrominerals and their ratios together, so the core criteria, the reinforcing Ca/Mg and the four lows cutoffs are all checked on the same report.
Published 2026-08-30 · Updated 2026-09-24
By Eileen Durfee — Practitioner, NBS (Nutritional Balancing Science), NASM-CPT; wellness educator, inventor and author.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. Hair tissue mineral analysis is a screening test and is not diagnostic; anything medical belongs with your own licensed provider. Wellness Shopping Online is operated by Nuco Enterprise Solutions LLC.
