Double High Ratio
Calcium/magnesium above 9.5 and sodium/potassium above 5 on the same chart
The pattern workbook defines the double high ratio with two cutoffs and reads it as reinforcing an elevated Na/K. Trace Elements' 1993 endocrine table lists almost the same combination for one adrenal reading.
The pattern workbook Eileen reads charts against defines the double high ratio as a calcium/magnesium (Ca/Mg) ratio greater than 9.5 together with a sodium/potassium (Na/K) ratio greater than 5. It reads the pattern as reinforcing the readings of an elevated Na/K, with an inflammation trend and an acute stress reading named among them.
The Ca/Mg ideal is 6.67 (Analytical Research Labs, ARL) to 7 (Trace Elements, Inc., 2010), so 9.5 sits about 1.4 times above it. The Na/K ideal is 2.4 (Trace Elements) to 2.5 (ARL), so 5 sits at double the ideal. The workbook uses the same two cutoffs elsewhere: a Ca/Mg over 9.5 reinforces its sympathetic dominance pattern, and four highs combined with both cutoffs is its own pattern.
Trace Elements' 1993 newsletter "Mineral Imbalance, Endocrines and Hair Tissue Mineral Analysis" lists increased anabolic adrenal cortical activity at an Na/K above 5, a sodium/magnesium (Na/Mg) ratio above 4 and a Ca/Mg above 10. Two of those three criteria match the double high ratio, with Trace Elements' Ca/Mg line set at 10 rather than 9.5. Its retention table shows the anabolic adrenal cortex retaining sodium, potassium, phosphorus, iron and manganese while increasing the excretion of calcium, magnesium and copper.
David Watts of Trace Elements set the alarm stage of stress at an Na/K of 5 or higher in 1990, driven by aldosterone and antidiuretic hormone, with sodium and water retention and an inflammatory process. Trace Elements' 2010 and 2018 newsletters repeat it: an Na/K above 5 indicates an inflammatory response may be in effect, an alarm stage of stress and increased aldosterone. A ratio that stays above 5 is the chronic alarm reading, with a chronic inflammation trend.
ARL grades the same side in bands: 2.5 to 4 is mild elevation with good adrenal function, 4 to 6 is moderate elevation with a tendency toward inflammation, and above 6 is severe elevation. ARL records the inflammation tendency as particularly marked when the ratio is greater than about 10, and states that a high Na/K is considered preferable to a low one.
ARL's Ca/Mg table reads 6.67 to 10 as good, 10 to 12 as a hypoglycemia trend and above 12 as a diabetes trend, so 9.5 sits just under ARL's first line. ARL's acceptable range in the pattern report Eileen issues is 4.5 to 8.5, which places 9.5 outside it, while Trace Elements' range of 3 to 11 places it inside. ARL's Fatigue document lists a Ca/Mg above 10 among its fatigue indicators, as carbohydrate intolerance.
Trace Elements' 2020 description of Slow Metabolic Type 2 gives the link between the two ratios. An elevated Na/K marks the alarm phase of stress; increased stress activates an adrenal response, particularly the pro-inflammatory hormones, which increases magnesium loss. The relative magnesium deficiency then enhances the stress response. A lower magnesium raises the Ca/Mg, so the two ratios can rise together. Watts' 1990 paper adds that magnesium deficiency promotes aldosterone production through hyperplasia of the zona glomerulosa.
ARL describes a high Na/K in a slow oxidizer as an acute stress response occurring within the exhaustion stage, and records that "this is a common occurrence". The double high ratio in slow oxidation, with four lows excluded, is the step down pattern covered in the step up and step down article.
ARL's document on a high Na/K lists hidden metals that raise the ratio even when the metal does not show on the test: copper, which elevates sodium and depresses potassium, plus cadmium, mercury and nickel, and at times aluminum, manganese and iron. ARL suspects hidden copper if potassium is below 4 mg% or calcium is over about 80 mg%.
ARL also names zinc and magnesium deficiency: zinc lowers sodium and raises potassium, and magnesium lowers sodium. It records that salt is secondary, and that a high ratio frequently occurs in people who consume no salt.
| Reading | Level | Reading attached | Source |
|---|---|---|---|
| Ca/Mg with Na/K | Above 9.5 with above 5 | Double high ratio | Pattern workbook |
| Na/K, Na/Mg, Ca/Mg | Above 5, above 4, above 10 | Increased anabolic adrenal cortical activity | Trace Elements, 1993 |
| Na/K | 5 or higher | Alarm stage; aldosterone; inflammatory response | Trace Elements, 1990 and 2010 |
| Na/K | 4 to 6, and above 6 | Moderate and severe elevation; inflammation tendency | ARL |
| Ca/Mg | 10 to 12 | Hypoglycemia trend | ARL |
| Potassium | Below 4 mg% | Hidden copper indicator | ARL |
Each row is a trend on the mineral pattern.
A hair tissue mineral analysis is a screening test for nutritional and toxic-element patterns. It reports mineral levels in milligrams percent (mg%) and the ratios between them, and it measures soft tissue rather than blood. Each reading averages roughly 2 to 3 months of hair growth, and samples are analyzed unwashed, because washing removes over 90% of the sodium and potassium in hair (Trace Elements). Where the laboratory literature describes a trend, that trend belongs to the mineral pattern rather than to any person reading about it.
The two ratios come first, Ca/Mg against 9.5 and Na/K against 5, with each one's distance from its ideal of 6.67 to 7 and 2.4 to 2.5. The oxidation rate follows, from Ca/K and Na/Mg, because the same two high ratios in slow oxidation make up the step down pattern.
Next: magnesium against 6 mg%, potassium against the 4 mg% hidden-copper line, and the copper, cadmium, mercury and nickel readings that raise sodium.
A Ca/Mg ratio greater than 9.5 together with an Na/K ratio greater than 5, as the pattern workbook defines it.
Trace Elements records that the pro-inflammatory adrenal response increases magnesium loss. Lower magnesium raises the Ca/Mg ratio.
ARL states that a high sodium/potassium ratio is considered preferable to a low sodium/potassium ratio.
Yes. ARL lists copper, cadmium, mercury and nickel, and at times aluminum, manganese and iron, as metals that raise sodium.
A full hair tissue mineral analysis reports the Ca/Mg and Na/K ratios with the magnesium, sodium and potassium levels behind them, which are the readings that define the double high ratio.
Published 2026-10-19 · Updated 2026-10-19
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. This article is for educational purposes only. Wellness Shopping Online is operated by Nuco Enterprise Solutions LLC.
