Four Highs Pattern

Four highs, sometimes also called four high electrolyteslf, is one of the most common and important metabolic imbalances seen on hair mineral analyses.  It is seen mainly in adults, and more commonly in women.  This article explains some of its important causes, symptoms and the meanings of the pattern in most cases.

Definition.   Four highs pattern is present when all four of the following conditions exist on one test:

1) Calcium level above about 40 mg% or 400 parts per million

2) Magnesium greater than 6 mg% or 60 parts per million

3) Sodium above 25 mg% or 250 parts per million, and

4) Potassium greater than 10 mg% or 100 parts per million.

NOTE:  It is critical for accuracy that the hair is not washed at the laboratory.  If the hair is washed, the sodium and potassium readings in particular are almost always incorrect.  Most laboratories in America and Canada wash the hair.


Important variants: three highs, two highs and many cases of fast oxidation in an adult. Three possible variants of this pattern are:

  • Three highs.
  • Wrong two highs.  This is when the two high numbers are calcium and potassium, calcium and sodium, magnesium and sodium, or magnesium and potassium
  • A fast oxidizer pattern, particularly in adults, may also be a type of four highs pattern.This unusual situation is discussed at the end of this article.


Two patterns superimposed. Four highs is a combination of two components:

  1. The high calcium and magnesium indicate an underlying slow oxidation or exhaustion pattern.
  2. Superimposed on this pattern are high sodium and potassium readings.  These indicate an alarm reaction, or fight-or-flight reactionoccurring at the same time.

The combination indicates what may be called a secondary alarm reaction.  Extraordinary stress of some kind is causing a partially effective stress response in a slow oxidizer.  It is not unlike a second wind that runners may experience after they have run part of the way through a race.

The pattern is also called a slow oxidizer under stress.  This term is applied because in essence one is a slow oxidizer.  However, some type of stress is present that is causing elevated levels of sodium and potassium.

Any oxidation rate may be present.  The oxidation rate in cases of four highs may be fast, slow or mixed.  In other words, the four highs pattern is independent of the oxidation type and oxidation rate.  Usually, however, the oxidation rate, whether fast, slow or mixed, is not too extreme.

If fast oxidation is present, we call it a temporary fast oxidation state because the pattern basically always resolves to slow oxidation, usually within 4-12 months and sometimes less.



The types of stressors that can cause a four highs pattern include:

  • Toxic metals.This is a very common cause.  Often these include, at least to some degree, hidden or overt copper, aluminum, manganese, and/or iron toxicity.
    Others possible toxic metals that may contribute include lead, cadmium or nickel toxicity.
  • Lifestyle Stress.This can be anything from one’s job or family situation to a high-stress lifestyle.
  • Diet, perhaps. It appears that a diet high in carbohydrates may contribute to the pattern in some cases.  Too much bread, for example, may interfere with calcium, magnesium, and particularly zinc and contribute to the pattern.
  • Nutritional deficiencies.Often these include iodine deficiency, which is very widespread and often worse among women.  Iodine is replaced by fluoride, chlorine compounds and bromides that may contribute to the pattern.
  • Stilted, a psychological cause.Visually, four highs appears like a person walking on stilts.  The word stilted means a little pompous or puffed up, perhaps holier-than-thou, stiff, but unsure of oneself.
    This psychological tendency occurs in a few cases, and may be due to a psychological compensation for trauma or perhaps even for fatigue.  If the psychological tendency is strong, it may respond slower.


Most people are very uncomfortable in a four highs pattern and feel better when they come out of the pattern.  However, a subset of people like the pattern, perhaps because they like a balanced oxidation rate and they have learned how to keep it balanced.  I call these individuals delicate souls, because they are quite sensitive to their oxidation rate and will go to some length to keep it fairly balanced in a four highs pattern.

These are usually bright, middle-aged women, in my experience, age 40 or older.  They are often somewhat depressed and angry underneath, and do not want to face the depressing feelings that often accompany a significantly slow oxidation rate.

They use various means to keep themselves in a four highs situation.  This might be caffeine use, getting upset about things, tensing the musculature, running around a lot, doing a lot of exercise, or something else that keeps their adrenal glands in a stimulated state.

In these cases, the three highs/four highs pattern may not resolve as quickly to slow oxidation.  Also, if it does resolve quickly, which happens at times, these individuals can become quite upset and even angry with the practitioner for “making them feel worse”.  This is interesting because most people feel better when they emerge from a three highs/four highs pattern.

One could say that these individuals do not want to “crash land” in slow oxidation, as it causes feelings of great fatigue and perhaps depression or even despair.


At times, as a person exits a four highs pattern, the person “crashes” down into a very slow oxidation pattern.  The person feels very tired and depressed, usually.  It is an unpleasant situation.

How long does it take for a crash landing or important shift in the oxidation rate to occur after one begins a four highs program?  The answer is that each person is different.  Sometimes it can happen within a few weeks, although most often it takes a few months or more.  In most cases, there is no crash landing.  The person “lands safely” in slow oxidation on a retest in a few months, and then the healing program must then be changed to reflect this shift.


The symptoms associated with a four highs pattern follow the following tendencies:

  • A mixture of fast and slow oxidation symptoms.For example, one may have irritability, anxiety or insomnia combined with fatigue and depression, perhaps.  Symptoms may also alternate if the oxidation rate is unstable, which is often the case.  One could experience a type of bipolar picture for this reason.
  • Inflammation. Inflammatory symptoms such as pain, high blood pressure, fluid retention, weight gain, gum disease and others may be present.   Gum disease is usually an indicator of overall impaired health.
  • Metabolic syndrome.  This is so common with this pattern that one wonders if eating too many carbohydrates somehow lowers zinc, perhaps, and raises sodium and potassium to help create this pattern.  This can cause frank diabetes in some cases.
  • Demineralization.Sodium, along with potassium to some degree, are the body’s main solvent minerals.  They are monovalent cations that, due to their structure, can dissolve out some of the divalent minerals from the tissues, including calcium and magnesium.  Perhaps this is one reason, along with copper imbalance and other mineral deficiencies, that osteoporosis and osteopenia may occur with this pattern.
  • Low thyroid and impaired adrenal gland activity.This is usually the underlying condition with a four highs pattern.  Symptoms may include weight gain, hot flashes, osteoporosis, osteopenia, fatigue, depression, dry skin and hair, sweet cravings, hair loss or others.
  • Copper toxicity.  Copper imbalance is almost always present with a four highs pattern.  Symptoms of this may include depression, anxiety, mood swings, irritability, anger, headaches, skin rashes or others.  Copper imbalance may also contribute to osteoporosis.
  • Sympathetic dominance symptoms.Four highs with a sodium/potassium ratio greater than about 2 is always associated with sympathetic dominance.   Symptoms may include hot flashes, stress, fatigue, anxiety, worry and others.
  • Stress symptoms.  Everyone with a four highs pattern has a lot of stress in the body.  This may be due to biochemical factors such as toxic metals, or it may be due to one’s lifestyle, diet or other factors.
    Symptoms might include an elevated cholesterol level, which is often just a stress indicator and not a need for drugs.  Other symptoms can include constipation, acid reflux or heartburn, muscle cramps, food cravings, and impaired circulation.
  • Walking on stilts.Some people have a delicate nature, as explained above, and a rough analogy here is a person walking on stilts.  Four highs always looks like this visually.  One is biochemically ungrounded.  This causes, in some people, feelings of instability, anxiety and even bipolar symptoms.  With proper nutritional support, they will “come back down to earth” and the anxiety usually vanishes when the pattern is resolved into slow oxidation.


              Four highs is considered the easiest transition pattern from fast to slow oxidation to resolve using a thorough healing program.  In other words, the person needs to transition into a simple slow oxidation pattern and this is one of the easiest patterns to transition out of and back into slow oxidation.

It is called a resistance-to-change pattern because some clients do not want to move into slow oxidation, and that is why the pattern persists on retests, at times.


This is an unusual term, perhaps, since a four highs pattern would seem, by definition, to be dependent upon the first four macromineral numbers being obviously elevated.  However, what is meant by hidden four highs is that even if a hair mineral test appears to be simply a slow oxidizer pattern (with the calcium and magnesium elevated, and the sodium and potassium lower than the ideal levels), one may still have the symptoms and conditions present that are discussed in this article about four highs.

In other words, the sodium and potassium levels, while lower than the ideal levels, are still pushed upward by various stress factors, and so the physical symptoms and psychological attributes associated with a four highs pattern may occur.

Also, on a retest the person may indeed move into much slower oxidation as the extra stress is removed and the sodium and potassium levels fall further.  Also, the calcium and magnesium levels may rise as well.

Indeed, this can help explain why the oxidation rate may slow down greatly on a retest.

A term that is also sometimes used to describe this situation is a slow oxidizer on crutches.  In other words, the person is a slow oxidizer, but, in fact, toxic metals or other stress factors are propping up the oxidation rate – usually raising the sodium and potassium levels – the way crutches help keep a person standing up when they are weak or ill.  As the crutches are removed, the oxidation rate may, on a retest, become even slower temporarily.  This is like letting go of one’s crutches as one’s broken leg heals.  At first, one may be a little shaky and weaker without the crutches, but this soon passes.


At times, a person will go into a four highs pattern on a retest.  This is usually a retracing process and is not much of a concern.

Kidney stress.  At times, a four highs pattern on a retest is a kidney stress pattern.  This means that the body is eliminating toxic metals through the kidneys, and this places some strain on the kidneys temporarily.  As a result, the sodium and potassium levels increase when a person is in a slow oxidation state.  This is what often produces the four highs pattern.  Indeed, there can be some kidney irritation affecting the levels of sodium and potassium.

Another cause for four highs pattern on a retest is an increase in adrenal and thyroid glandular activity in a person with slow oxidation.

Another cause for four highs pattern on a retest is a slowing of the oxidation rate in a person who was, or may still be in a state of fast oxidation.  In this case, the calcium and magnesium levels rise, producing the four highs pattern.  This is almost always a transition from fast to slow oxidation, and is generally a very positive shift in the body chemistry.

In all three cases above, the situation is always temporary because four highs pattern tends to be a temporary pattern sustained by kidney stress, the presence of toxic metals, or perhaps by some other stress factor.