A matched pair
Two patterns, mirrored, and neither can contain four lows
One rides a double low ratio in fast oxidation, the other a double high ratio in slow. The exclusion they share is part of both definitions.
Step up occurs with a double low ratio pattern — low Ca/Mg and low Na/K — together with fast oxidation and an increase in the first four minerals to the right.
Three components, and the third is easy to misread. "The first four minerals to the right" refers to the plotted order on the report, not to a change over time. The pattern is read across the page as well as against the ideal values.
Four lows cannot be present. This is an explicit exclusion in the definition, not an observation about how it usually appears.
Step down occurs with a double high ratio pattern — elevated Ca/Mg and elevated Na/K — together with slow oxidation.
And the same exclusion applies: four lows cannot be present.
Read side by side, the mirroring is exact. Step up is two low ratios in a fast rate; step down is two high ratios in a slow rate. Same two ratios, opposite directions, opposite rates.
An exclusion written into a definition is a stronger statement than a tendency, and it does something practical: it stops a four lows pattern from being read as a step in either direction.
Four lows has its own criteria and its own family of related patterns. Where the macrominerals are all below ideal, that is the reading — not a step. Two patterns cannot both claim the same report, and the definitions settle it rather than leaving it to judgement.
The workbook records that zinc can balance the sodium/potassium ratio in the step down pattern.
That is a specific, narrow observation about one mineral in one pattern, and it is worth keeping narrow. It is not a recommendation, a dose or a protocol, and nothing here should be read as one — supplementation belongs with the practitioner reading your actual report.
The literature associates the step up pattern with a diabetes trend, a cardiovascular trend, a blood pressure trend, a stroke trend and a kidney trend, alongside a copper deficiency reading and possible iron, manganese or cadmium toxicity. Step down carries a thyroid trend, a hypoglycemia trend and an adrenal reading.
These are trends in the laboratory sense — a direction a mineral pattern points, written the way the labs write them on the report itself. A trend is not a diagnosis, not a prediction, and not a statement that anybody has anything. The iron/copper relationship is one of the readings behind the step up list.
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.
I read these two as a pair, always, because half the information is in which one it is not. Two low ratios in a fast rate and two high ratios in a slow rate are different reports that a quick glance can blur together.
The exclusion is the part I hold to hardest. If the macrominerals are all below ideal, I am reading four lows and I stop looking for a step. The definition says it plainly and it saves a lot of arguing with a page.
A double low ratio pattern — low Ca/Mg and low Na/K — with fast oxidation and an increase in the first four minerals to the right. Four lows cannot be present.
A double high ratio pattern — elevated Ca/Mg and elevated Na/K — with slow oxidation. Four lows cannot be present.
The exclusion is written into both definitions. Where all four macrominerals are below ideal, that is a four lows reading rather than a step in either direction.
They mirror each other: the same two ratios moving in opposite directions, each tied to the opposite oxidation rate.
A full hair tissue mineral analysis reports both ratios and the oxidation rate together, which is what distinguishes these two patterns from each other.
Published 2026-08-30 · Updated 2026-08-30
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.
