While there are many forms of hormonal testing, I use the gold standard of testing whenever possible. Hormones are stored in our tissues and fat, and not in our bloodstream. Rather than checking your serum, I prefer to test your tissues. To do so, I utilize highly specialized hormonal testing, using saliva and a finger poke. Hormonal testing is done annually. In doing the testing properly, we mitigate overdosing. We use bio-identical hormones, and not synthetic hormones that were used years ago such as birth control pills, which are not as safe, and they really are not good for you. Bio-identical hormones will be compounded specifically for your needs, to restore your health and vitality. They are good for your heart, brain, sex drive and a healthy weight. When properly balanced you restore a healthy weight, healthy metabolism, slow the rapid aging and improve your overall vitality.

request an appointment

Why Do We Test Hormones in Saliva? 

Steroid hormones in the bloodstream are 95-99% bound to carrier proteins, and in this form are unavailable to target tissues. When a provider looks at your blood or serum levels, they are looking at what is bound, used and on its way out, so it is not as accurate.  You risk being overdosed. Saliva testing measures the amount of hormone available to target tissues – the bioavailable amount. For this reason, saliva testing better relates to specific symptoms of excess or deficiency and is the gold standard option for monitoring hormone therapy.


Since 1998, ZRT has tested the hormones of 1.25 million women around the world.

  • Menopause is not a single point in time when hormone production is switched off, but a gradual decline that brings an end to female fertility. During menopause, a woman’s levels of estrogen and progesterone diminish – leading to a lack of menstrual periods.
  • A woman is considered to be in menopause when she’s had no menstrual cycles for 12 months.
  • The right balance of hormones is vital to a woman’s health. But in menopause, when levels are dropping, a deficiency of one hormone can trigger a relative excess of another and result in common imbalances such as:
  • Estrogen Dominance or Low Progesterone
  • Results in mood swings, migraines, fat gain in hips and thighs
  • Low Estrogen or Fluctuations of Estrogen
  • Triggers hot flashes, night sweats, palpitations, foggy thinking, memory lapse & vaginal dryness.
  • Low Testosterone or DHEA
  • Leads to decreases in bone or muscle mass, metabolism, energy, strength, stamina, exercise tolerance & libido.
  • High Cortisol
  • Results in insomnia, anxiety, sugar cravings, feeling tired but wired & increased belly fat.
  • Low Cortisol
  • Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves.
  • Neurotransmitter Imbalance
  • Changes in estrogen and progesterone levels can impact neurotransmitter levels. For instance, a drop in estrogen can result in a drop in serotonin.
  • Thyroid Imbalance
  • Changes in estrogen levels can lead to thyroid symptoms like slowed metabolism and always feeling cold. In fact, many women experiencing menopause will be diagnosed with hypothyroidism.
  • Low Vitamin D
  • Sufficient levels of Vitamin D, estrogen and testosterone are important for maintaining bone health in the menopause years.


ZRT has tested over 150,000 men experiencing hormone decline.

  • Men at mid-life are just as susceptible to an age-related drop in hormone production as their female counterparts. Andropause, the so-called male menopause, signifies the retreat of the key male hormone testosterone.
  • As a man ages, his body naturally makes less testosterone. In fact, by the time a man is in his mid-forties, testosterone levels can be down by 40%. Lifestyle factors such as excessive stress, weight gain and lack of exercise can lower levels even further – impacting stamina, drive, and virility.
  • Men tend to notice a subtle downward shift in strength and energy first, followed by lack of enthusiasm for life’s challenges like work and competition. A man may also lose interest in sex. The hidden imbalances contributing to these factors generally include:
  • Low Testosterone
  • Leads to decreased stamina and libido, fatigue & erectile dysfunction.
  • High Estrogen
  • Results in weight gain, increased chest and belly fat, hot flashes, night sweats & excessive need to urinate (BPH)
  • High Cortisol
  • Results in insomnia, anxiety, sugar cravings, feeling tired but wired & increased belly fat.
  • Low Cortisol
  • Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves.
  • Thyroid Imbalance
  • This condition is commonly missed in men and may often mimic symptoms of low testosterone.
  • Cardiometabolic Issues
  • This includes high blood pressure and diabetes and may mimic some symptoms of low testosterone – like fatigue or erectile dysfunction.
  • High DHT
  • Results in excessive need to urinate (BPH)hair loss, acne


30 million adults suffer from thyroid imbalance. Don’t let dysfunction go undiagnosed.

The thyroid is a small butterfly-shaped gland that sits behind and below the Adam’s apple. A wide range of factors from hormone imbalances to mineral deficiencies, true gluten intolerance and environmental pollutants can interfere with thyroid production, leading to health problems.

Dysfunction is Notoriously Under-Diagnosed

The American Thyroid Association estimates that as many as 60% of people with thyroid disease are not aware of it. Statistics show that women are seven times more likely than men to develop thyroid problems, facing as much as a one in five chance of developing a problem particularly during the peri-menopause years when hormones start to fluctuate.

Remember, most doctors only check a TSH and T4 lab.  Most doctors only replace T4 which is typically Levothyroxine which is only replacing T4, which many people are not able to drop the iodine molecule and convert it to the usable form of T3.  This is a main reason, so many people are told their thyroid is “fine”, but if they can’t use it, they are truly hypothyroid.  Secondly, Levothyroxine is one generic medication that is not up to standard in my opinion or equivalent to the brand name or other options available.

Thyroid disease or dysfunction can explain a wide variety of symptoms.

Do these symptoms sound familiar?


  • Weight gain or inability to lose weight despite exercise and diet.
  • Feeling cold all the time (when others don’t)
  • Low energy and stamina, especially in the evening
  • Memory lapses or slow/fuzzy thinking
  • Dry, thinning, itchy skin.
  • Dry or brittle hair and nails
  • Hair loss
  • Irregular bowel habits
  • Menstrual irregularities


  • Sudden or significant weight loss
  • Rapid or irregular heartbeat
  • Sweating
  • Nervousness or irritability

Levels of key thyroid hormones can indicate whether there is a thyroid imbalance. These include:


Produced by the pituitary gland, TSH acts on the thyroid gland to stimulate production of the thyroid hormone thyroxine (T4).

Free T4 – Thyroxine

The predominant hormone produced by the thyroid gland, T4 is converted to its active form, T3, within cells.

Total T4 – Thyroxine

Total T4 includes both free T4 and protein-bound T4, and is an indicator of the thyroid gland’s ability to synthesize, process and release T4 into the bloodstream.

Free T3 – Triiodothyronine

T3 is the active thyroid hormone that regulates the metabolic activity of cells.

TPOab – Thyroid Peroxidase Antibodies

Thyroid peroxidase is an enzyme involved in thyroid hormone production. The body produces antibodies, including TPOab, that attack the thyroid gland in autoimmune thyroiditis and Hashimoto’s. Testing TPOab levels can diagnose these conditions.

Tgbn – Thyroglobulin

A protein rich in tyrosine, the residues of which when bound to iodine become the building blocks of T3 and T4. If iodine levels are low, thyroglobulin accumulates, thus high levels indicate insufficient iodine for healthy thyroid function.


Learn if you’re in the 86% of Americans who have suboptimal neurotransmitter levels.

Neurotransmitters are chemical messengers used by the nervous system to relay information from one nerve to another.

Optimal neurotransmitter balance is required to maintain proper health. Imbalances can cause the brain and the body to be over- or under-stimulated, producing neurological or psychological symptoms.

An Unmatched Collection of Tests

ZRT has determined that while parent neurotransmitters are helpful in assessing precursor availability, interpreting results based on those levels alone can result in undertreatment, treatment of the wrong part of the system, or overtreatment with direct precursors. It’s only by looking at the parent neurotransmitters with downstream metabolites that you can tell whether there is a systemic pattern.

Given the importance of these levels to correct interpretation of neurotransmitter results and subsequent treatment plans, ZRT Laboratory includes a range of 14 neurotransmitters and metabolites in its testing. This essential collection of tests is available only from ZRT – and not from any other lab.

How a Dysregulated Nervous System Impacts Health

Genetics, environment, chemicals, and nutritional deficiencies are a few factors that can impact neurotransmitter production. Once out of balance, the nervous system begins to compensate – which, in time, can lead to neurological or psychological symptoms.

Some of the more common psychological conditions today are known to be accompanied by neurotransmitter imbalances. However, it’s also possible for individuals to present with similar symptoms yet have unique foundational imbalances. Testing helps clarify these root issues.

Common neurotransmitter-related causes of health issues often involve the following scenarios:

Anxiety & Depression

Neurotransmitter imbalances are often associated with anxiety and depression, specifically Glutamate (panic attacks), PEA, Histamine, Serotonin, as well as Epinephrine & Norepinephrine.

Chronic Fatigue

An imbalance between excitatory and inhibitory neurotransmitters can lead to persistent fatigue.


GABA, Dopamine and Serotonin are three chemical messengers commonly linked to disorders like ADD, ADHD & OCD.


Imbalances in Glutamate, Histamine, Dopamine, GABA and Serotonin are often linked to sleep disturbances and insomnia.


Imbalances in Serotonin, Dopamine, Norepinephrine and GABA are often involved in cases of PMDD (pre-menstrual dysphoric disorder) and severe PMS.


Hormones that don’t break down properly in the body can increase the risk for certain cancers – like breast cancer.

Urinary hormone metabolites testing provides a unique diagnostic view that no other hormone testing offers.

Because it assesses both parent hormones and their corresponding metabolites, it reveals how the body is breaking down key hormones like estrogens, progestogens, androgens, cortisol, and melatonin.

This testing gives insight into whether we are fully detoxifying our hormones, which is important because some hormones can be carcinogenic if they don’t break down properly – leaving us more at risk for a variety of diseases, like cancer.

Why the Focus on Estrogen Metabolism?

A growing conversation in the medical community centers on estrogen metabolism and the risk for hormone-driven cancers. With every published study, there is increasing evidence that the amount of estrogen we make and how our bodies process (metabolize) this estrogen has significant implications for cancer risk. In women, this is breast cancer. In men, it’s prostate cancer.

Measuring hormone levels, as well as the resulting by-products (metabolites) is a simple, non-invasive way to better understand our risks.

When is it a good idea to consider urinary hormone metabolite testing? In cases where someone has:

  • Family history of hormone-dependent cancers – like breast or prostate cancer
  • Normal saliva cortisol levels but still experiencing symptoms of adrenal dysfunction.
  • Symptoms of hormonal imbalance such as weight gain and insomnia
  • Symptoms of PCOS, such as acne and excess facial hair
  • Symptoms of menopause and ready to begin hormone replacement therapy.
  • Symptoms of estrogen dominance while on physiological replacement dosages of therapy

Most Complete Urine Hormone Testing

While other labs offer similar testing, ZRT’s urine hormone testing is the most complete available.

More Tests:
With 44 unique markers, ZRT’s urine hormone profiles are more comprehensive than any other lab’s.

More Estrogens:
ZRT assesses a total of 13 estrogens, including 2-Methoxy and 2-Hydroxy, 4-Hydroxy and 4-Methoxy and 16a-Hydroxy estrogens. We test more 4-Hydroxy metabolites than any other lab.

More Androgens:
ZRT assesses a total of 8 androgens, which is more than most labs offer.

ZRT is one of few labs to include an assessment of BPA in its urine hormone testing.

Diurnal Cortisol:
ZRT provides diurnal patterns for both cortisol and cortisone, which help get to the root of stress-related issues. It’s also ideal for those unable to collect a saliva sample for diurnal cortisol.

Diurnal Melatonin:
Diurnal Melatonin: ZRT is the only lab to include a diurnal pattern for melatonin, which helps evaluate sleep-related issues.


Heavy metal exposure is on the rise. Common sources include cigarettes, seafood, rice, well water & dental fillings.

These toxic elements can significantly increase our risk of developing conditions like dementia, infertility, diabetes and cancer. They are also known to cause damage to the liver, kidneys and brain, as well as the cardiovascular, nervous and endocrine systems.

Essential elements are abundant, too, and only healthy when they are within optimal ranges. Nutrients like copper, iodine, magnesium, selenium and zinc are critical for enzymes that synthesize neurotransmitters and activate hormones. Bromine and lithium, while not currently classified as “essential” elements, have been shown to play a positive role in health but are also potentially toxic at excessive levels.

Why Test Heavy Metals & Essential Elements?

Getting too much, and sometimes too little, of various elements has consequences for our overall health.

Who should consider heavy metals and essential elements testing? Anyone who:

  • Smokes
  • Has exposure to private well water or aging pipes.
  • Is concerned about heavy metals in foods like vegetables, rice and seafood.
  • Has mercury dental work.
  • Lives in an older home or near an industrial area
  • Has thyroid-related health issues.