When a patient comes into clinic with a set of concerns, my passion and goal is to ask the right questions, and utilize the very best type of testing, in order to get to the root cause of what it going on.

Traditionally, regular labs are run. In some cases those are very helpful, but in other cases they are not. I do my best to test as accurately right up front, to figure out whether the patient has hormonal deficiencies or imbalances, or if they have infections and deficiencies in their gut.

Nearly 90% of our immune system resides in our gut, and hormones are made there as well, so there is a lot of cross over. Most medical concerns are complex, and more than just one thing. There are a lot of crossovers in what is causing your health issues, and you are very complex.

I do my best to get to the center, or root cause of your health and wellness by considering Bio-identical hormone replacement, but also other nutritional deficiencies, gut deficiencies, infections, parasites.

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ZRT Lab is just one of many highly specialized labs.  They are known as the GOLD STANDARD of hormone testing labs.  They test hormones by utilizing the absolute best type of testing all in one place. There are times when saliva is the best method, times when it is most ideal to test peripheral tissue/serum and times when we need to look at Urine for metabolites, and ZRT is a laboratory who truly does the most accurate testing possible specifically hormone related testing.

When a patient comes into clinic, and has had their hormones tested using blood or serum sampling, possibly in a traditional office, it is important to consider that our sex hormones don’t live there.  Hormones live in our tissue, so if a provider is testing blood, they are looking at what is used, nearly 100% bound and on its way out of your system.  This is why testing saliva is considered the best, most accurate, gold standard testing.  Salivary glands are tissue, and constantly cycling hormones, so the numbers are the most accurate in saliva in most cases.



Saliva testing is a non-invasive collection method where patients collect their saliva in plastic tubes in order to measure hormones like cortisol, estrogens, progesterone, and androgens. This non-invasive saliva collection is ideal for patients because it allows them to collect their sample in the privacy of their home or office.

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. 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 a good option for monitoring hormone therapy.

Some analytes cannot be tested using immunoassays, the methodology used for most of our saliva testing. For that reason, ZRT developed an LCMS Saliva Steroid Profile using liquid chromatography/tandem mass spectrometry (LC-MS/MS). This profile tests a broad range of bioavailable hormones and hormone metabolites in one convenient saliva sample collection. LCMS testing allows for accurate reporting of estrogens down to extremely low levels, such as those seen in men, children, and people using aromatase inhibitors, and includes a test for ethinyl estradiol, 3 hormone blockers, and melatonin. To learn more about what you can test with our LCMS Saliva Steroid Profile

ZRT is one of the first labs to measure hormones in saliva, and helped establish the method that made saliva hormone testing commercially viable for health care providers and patients around the globe.

Best Practices for Saliva Testing

ZRT measures hormones from a single morning sample, which represents the peak of daily hormone production – the optimal time to measure

Today’s Most Advanced Saliva Testing

Ranges Adjusted for Supplementation:
Unlike other labs, patients do not need to stop hormone supplementation to use ZRT’s testing because we have ranges adjusted for age, menstrual status and supplementation types. This is the ideal method for tracking the effectiveness of hormone treatments.

No Pooling:
ZRT does not pool patient samples, meaning that we don’t mix multiple daily samples together to get an average hormone level. Instead we measure hormones from a single morning sample, which represents the peak of daily hormone production – the optimal time to measure.

ZRT is the only lab to perform an extraction process for saliva testing, which separates hormones from background contamination. This is the only way to assure accurate test results for low-concentration hormones such as estradiol.

Setting Industry Standards:
ZRT initiated and manages the industry-wide standards program called the Saliva Proficiency Inter-laboratory Testing Program – which enables laboratories to regularly evaluate and improve saliva testing accuracy.


Dried blood spot is a form of collection where patients place blood drops on a filter card after a finger prick with a lancet. Once dry, blood spot cards are extremely stable for shipment and storage, and the dried blood format offers excellent correlation with serum tests.

Why Measure in Blood Spot?

Blood spot is ideal for measuring hormones and other analytes such as insulin, blood lipids, Vitamin D, thyroid hormones, and elements like magnesium. It offers distinct advantages over serum because it eliminates the need for a blood draw – saving patients time and money.

ZRT developed the science for accurately measuring hormones in dried blood spot and is currently one of the only labs to offer this method commercially.

ZRT’s convenient blood spot collection eliminates blood draw needles, blood draw fees and the need to see a phlebotomist. Patients can collect their sample at home at the time that suits them. Research also shows that blood spot is more accurate than serum for measuring blood hormone levels in patients supplementing topically. Unlike other labs, patients do not need to stop hormone supplementation to use ZRT’s testing because we have ranges adjusted for age, menstrual status and supplementation types. This is the ideal method for tracking the effectiveness of hormone treatments.


Dried urine is a form of collection where patients saturate a filter card with a urine sample. Once dry, urine cards are extremely stable for shipment and storage, and this method eliminates the need for jug urine collection.

Why measure in urine? Urine testing is the best way to measure adrenal and sex steroid hormone by-products and their respective metabolic pathways, providing a gauge for understanding the body’s hormone metabolism. Urine testing is also the preferred method for testing elements like iodine and heavy metals like arsenic and cadmium. Additionally, it’s the most common method for testing neurotransmitters.

Accurately measuring hormones in dried urine is another scientific first pioneered by ZRT.

Easiest Method for Urine Testing

ZRT’s dried urine method offers a discreet, at-home testing alternative and eliminates the hassles of all-day jug urine collection. Patients collect urine on a filter strip up to four times during the day. Dried strips are shelf-stable for 30 days and easy to mail back to the lab for analysis.

Unlike other labs, patients do not need to stop hormone supplementation to use ZRT’s testing because we have ranges adjusted for age, menstrual status, and supplementation types. This is the ideal method for tracking the effectiveness of hormone treatments.


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 Focused Assessment

ZRT’s heavy metals and essential elements testing provides the most accurate test results. Using ICP-MS, the gold standard for element analysis, allows for high specificity and sensitivity into the parts-per-trillion.

Does Sample Type Matter for Elements Testing?

Heavy metals and essential elements affect different systems of the body, so it makes sense that they can’t all be measured in the same body fluid.

For example, urinary cadmium is the best measure of accumulated exposure, while blood spot assesses only recent exposure. Urine is the only appropriate medium for arsenic.

Dried Urine
ZRT’s dried urine method offers a discreet, at-home testing alternative and eliminates the hassles of all-day jug urine collection. Patients collect urine on a filter strip twice during the day. Dried strips are shelf-stable for 30 days and easy to mail back to the lab for analysis.

Dried Blood Spot
Allows testers to collect samples in the privacy of their own homes and is simple and nearly painless, avoiding a trip to the phlebotomist.


  • Sleep disturbances
  • Fertility
  • Menstrual cycle mapping
  • Stress management
  • Weight management and more


Digestive Health/DNA of your guts Microbiome:

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Research overwhelmingly indicates that gut health impacts overall health. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic and neuroendocrine functions. Assessing GI health with the proper tools can help practitioners get to the root cause of chronic illness.

The GI-MAP (Microbial Assay Plus) is unique in the field of comprehensive stool testing. It relies exclusively on quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria, fungi, and more, by targeting the specific DNA of the organisms tested.

The Industry’s Leading Comprehensive Stool Test Just Got Better!

Why Is Quantification Using qPCR Technology So Important?

Unlike other comprehensive stool tests on the market, the GI-MAP can provide practitioners with truly quantitative results. qPCR offers a much more accurate way to detect and quantify clinically relevant organisms than standard PCR, culture, microscopy, or DNA sequencing-based methods. Accurately assessing how much of an organism’s DNA is present in a patient’s stool sample is essential for helping practitioners to determine the clinical significance of pathogenic organisms and dysbiosis patterns.

qPCR’s Reliability, Reproducibility, and Use in Clinical Research

Order GI-MAP although qPCR is becoming more commonplace in in-vitro diagnostics (IVD), we are the only laboratory in the United States exclusively using qPCR technology for advanced comprehensive stool testing. This technology is used routinely in clinical and academic research because it provides highly-accurate quantification, as well as high levels of sensitivity and specificity. Standard PCR technology doesn’t offer the same level of sensitivity, or the ability to express precise numerical results.

The GI-MAP also provides consistently reproducible results. Reproducibility is of crucial importance to the practitioners and patients that rely on the efficacy of the GI-MAP. To achieve it, we perform rigorous quality control, and have validated all molecular target quantification assays to meet or exceed FDA standards.

GI-MAP Allows for the Personalized Treatment Plans and Informative Retests

The GI-MAP’s accuracy and reliability allows practitioners to create personalized treatment protocols to address gut dysfunction based on which infections are urgent, which areas of the gut are already optimized, and which areas should be addressed after an infection is resolved.

Additionally, the quantification offers a remarkable ability to see how treatment modalities are working because a retest after treatment can show whether a parasite has resolved, dysbiosis has improved, and more.

Who Should Have the GI-MAP Comprehensive Stool Analysis Done?

Ask your doctor about GI-MAP

Almost every patient can benefit from a GI-MAP gut health assessment. Some patients are looking to achieve optimal health, while other patients have been chronically ill and frustrated without a diagnosis for years.

Some conditions that warrant testing are:

  • Autoimmune diseases
  • Digestive complaints, diarrhea, or constipation
  • Brain fog
  • Skin problems, like acne and psoriasis
  • Mood disorders, depression, and anxiety
  • Diabetes and weight loss issues

Do infants and Children Benefit from the GI-MAP?

Yes. The GI-MAP is commonly used in infants and children and can provide insight into conditions related to Attentional Deficit Hyperactivity Disorder, Autism, and digestive complaints.


IgE Allergy Explorer Provides Data Into the Following CategoriesThat Are Associated With IgE Reactions

  • Pollen, including grass, trees, and weeds.
  • Mites
  • Microorganisms and Spores, including yeast and mold.
  • Plant foods
  • Cereals, including wheat, rye, barley, and more.
  • Fruits and Vegetables
  • Nuts and Seeds, including component testing for peanuts, pecans, walnuts, poppy seeds.
  • Animal Food, including milk, eggs, seafood, and meat.
  • Insect Venoms, including component testing for wasps and honeybees.

Usually, extract and component food allergy tests are broken down into different food allergy tests. IgE Food Explorer provides the most extensive insight into both extracts and components using a simple at-home collection. It offers practitioners a new and robust tool for effective allergy management.

Who Can Benefit from IgE Allergy Explorer?

The IgE Allergy Explorer can benefit patients with any of the following symptoms could benefit from allergy testing:

  • Itchy mouth or oral irritation
  • Hives or eczema
  • Itching or swelling of skin
  • Nasal and sinus congestion
  • Wheezing or shortness of breath
  • Abdominal pain, diarrhea, nausea, or vomiting
  • History of allergic reaction
  • Fluctuations in heart rate

Can IgE Allergy Explorer be Used in Pediatrics? (Infants and Children)

Yes, blood testing for IgE antibodies is safe in children and often preferable to a scratch or food challenge test that may evoke a reaction. IgE Allergy Explorer evaluates both extract and components that are particularly useful when managing pediatric patients who are exhibiting allergic reactions.


Elevated IgG antibodies can promote systemic (whole-body) inflammation, leading to a variety of unwanted symptoms.

IgG Food Explorer tests immunoglobulin (IgG) antibodies to a variety of common foods. This extensive food sensitivity test can help practitioners pinpoint which foods may be driving symptoms and best prioritize and individualize a diet and lifestyle plan for patients.

Usually, eliminating foods that promote an IgG antibody response can reduce stress on the immune system, lower whole-body inflammation, and help heal the gut. An antibody-guided elimination diet is more reliable and preferable than generalized diet plans or exclusion diets based on food journaling and diet history alone.

IgG Food Explorer provides in-depth insight into adverse food reactions and the symptoms they create.

What Food Sensitivities Does the IgG Food Explorer Test Look For?

IgG Food Explorer Tests Antibody Response to Over 250 Food Extracts.

Molecular antigens for wheat gliadin and cow’s milk are also included for enhanced insight into the sensitivity of those two potentially immunogenic foods.

What Patients Can Benefit from Food Sensitivity Testing?

Food sensitivities are common and on the rise. As a result, most people can benefit from food sensitivity testing. The IgG Food Explorer can help patients who wish to optimize their health and those who have experienced chronic symptoms for years.

The range of symptoms related to food sensitivities is vast and varies for each patient.


May Be Gut-Related Symptoms or Extraintestinal, but Are Not Limited to the Following:

Gut-Related Symptoms

  • Bloating
  • Diarrhea
  • Nausea
  • Constipation
  • Reflux
  • Irritable Bowel Syndrome (IBS)

Extraintestinal Symptoms

  • Autoimmune conditions
  • Skin symptoms, including:
  • Eczema
  • Atopic dermatitis
  • Rashes and urticaria
  • Bags under eyes
  • Headaches/migraines
  • Blood sugar imbalances
  • Musculoskeletal/Joint pain
  • Food Cravings
  • Behavioral symptoms, including:
  • Anxiety
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Mood swings
  • Autism Spectrum Disorder (ASD)

Understanding Food Sensitivities vs. Food Allergies

Food sensitivities and food allergies are not the same. Different arms of the immune system facilitate both conditions.

Food sensitivities are delayed reactions and elicit IgG antibodies, while food allergies are immediate, potentially life-threatening, mast-cell mediated, and often involve IgE antibodies.

It is best practice to measure IgG and IgE antibodies together as they independently create inflammation and play key roles in symptoms driven by food. A food can elicit an IgG sensitivity response, and an IgE antibody response, or both.

By understanding a patient’s food sensitivities, practitioners can tailor dietary protocols that can help resolve uncomfortable symptoms.

SpectraCell TESTING:


SpectraCell’s Micronutrient test provides the most comprehensive nutritional analysis available by measuring functional deficiencies at the cellular level. It is an assessment of how well the body utilizes 31 vitamins, minerals, amino/fatty acids, antioxidants, and metabolites, while conveying the body’s need for these micronutrients that enable the body to produce enzymes, hormones, and other substances essential for proper growth, development, and good health. Repletion recommendations are made based on need.

Why use the SpectraCell Micronutrient test?

What truly makes our test unique is that it measures the functional  level and capability of micronutrients present within white blood cells, where metabolism takes place and where micronutrients do their job—thus taking a person’s biochemical individuality into account. Unlike static serum measurements, which only assess the concentration of nutrients present outside of the cell (extracellular) and only provide a glimpse of your health, SpectraCell’s Micronutrient test is a long term assessment (4-6 months) that addresses the functional impact (performance) of micronutrients—what really matters.

Why is nutrient status important?

Virtually all metabolic and developmental processes that take place in the body require micronutrients, and strong evidence suggests that subtle vitamin, mineral, and antioxidant deficiencies can contribute to degenerative processes such as arthritis, cancer, cardiovascular disease, and diabetes.

Evaluating micronutrient status can therefore be the first step in identifying metabolic inadequacies while shedding light on the possible underlying causes of complex chronic conditions.

When should a micronutrient test be considered?

Extensive scientific and clinical studies spanning 50 years have repeatedly demonstrated that micronutrient deficiencies can adversely affect health. These deficiencies can set the stage for chronic disease and compromised immune health at any stage in life, particularly if they persist.

Clinical Applications:

  • Cancer
  • Cardiovascular disease
  • Diabetes
  • Neurological disorders/Alzheimer’s
  • Autism and other spectrum disorders
  • Mood disorders
  • Fatigue
  • Osteoporosis
  • Fertility issues
  • Weight issues
  • Sports performance optimization

What Micronutrients are measured?


  • Vitamin A
  • Vitamin B1
  • Vitamin B2
  • Vitamin B3
  • Vitamin B6
  • Vitamin B12
  • Biotin
  • Folate
  • Pantothenate
  • Vitamin C
  • Vitamin D3
  • Vitamin K2


  • Calcium
  • Magnesium
  • Manganese
  • Zinc
  • Copper

Amino Acids

  • Asparagine
  • Glutamine
  • Serine

Fatty Acids

  • Oleic Acid


  • Alpha Lipoic Acid
  • Coenzyme Q10
  • Cysteine
  • Glutathione
  • Selenium
  • Vitamin E

Carbohydrate Metabolism

  • Chromium
  • Fructose Sensitivity
  • Glucose-Insulin Metabolism


  • Choline
  • Inositol
  • Carnitine

Total Antioxidant Function

Immune Response Score


MTHFR is actually a very common genetic defect that affects nearly 50% of people mildly and approximately 25% of people seriously. People who have the genetic mutation can have one to four alleles that they inherit from each parent.  The MTHFR gene mutation test is quite important.  If you have done genetic testing in the past it typically shows up, or we can run the test through a regular medical lab.  The lab tells us which alleles you inherited and how many of each allele you have.

Having this genetic mutation basically means you are unable to bring in proteins, and break them down into amino acids, and it means you are much less likely to be able to use B vitamins.  MTHFR also means you lack the methyl donor required for most cellular function, including your Methylation cycle, citric acid cycles, as well as neurotransmitters and hormonal cycles.  People who have the MTHFR gene mutation are much more likely to suffer from PCOS, typically frontal/center hair loss, metabolic syndrome, tingling fingers and toes etc.

MTHFR can cause a wide array of health conditions, ranging from blood clots and cancer to autism and migraines. It is vital that you are seen by a provider who routinely treats MTHFR gene mutations and that you are given proper treatment and care. You may have the mutation and not find out unless you undergo genetic testing or have a health issue.

MTHFR stands for methylenetetrahydrofolate reductase. It’s getting attention due to a genetic mutation that may lead to high levels of homocysteine in the blood and low levels of folate, B vitamins and other vitamins.

Its main function is to provide your body with instructions in creating the MTHFR protein, which helps your body produce folate which is necessary for you to create DNA.

There’s been concern that certain health issues are associated with MTHFR mutations, so testing has become more mainstream over the years.

MTHFR gene variants

You can have either one or two mutations — or neither — on the MTHFR gene. These mutations are often called variants. A variant is a part of a gene’s DNA that’s commonly different, or varies, from person to person.

Having one variant (heterozygous) is less likely to contribute to health issues. Some experts believe that having two mutations (homozygous) may lead to more serious problems.

There are two variants, or forms, of mutations that can occur on the MTHFR gene. The specific variants are:

  • C677T: About 30-40% of the American population may have a mutation at gene position C677T. Roughly 25% of people of Hispanic descent and about 20% of Caucasian descent are homozygous for this variant.
  • A1298C: There’s limited research regarding this variant. However, found that A1298C is found in 7 to 14 percent in North American, European, and Australian populations. In comparison, the variant is far less common in Hispanic and Asian populations.

It’s also possible to acquire both C677T and A1298C mutations and have one copy or two copies of each.

Gene mutations are inherited, which means you acquire them from your parents. At conception, you receive one copy of the MTHFR gene from each parent. If both have mutations, your risk of having a homozygous mutation is higher.

However, in cases where a person holds two copies of the C677T mutation or one copy of each mutation, they may be at risk of high homocysteine (an amino acid) levels, which may affect the body’s function.

Symptoms of an MTHFR mutation

Symptoms vary from person to person and from variant to variant. If you do a quick internet search, you’ll likely find many websites claiming MTHFR directly causes a number of conditions.

More than likely, unless you have problems or have testing done, you’ll never become aware of your MTHFR mutation status since sadly it is not typically checked.

Health conditions and MTHFR mutation

It’s worth noting that the health conditions linked to MTHFR depend on your type of mutation and how many copies you contain.

Conditions that have been proposed to be associated with MTHFR include:

Testing for MTHFR mutations

Keep in mind that genetic testing may not be covered by your insurance. Call your insurance provider if you’re considering getting tested to ask about costs.

Other causes of high homocysteine include:

  • hypothyroidism
  • conditions like diabetes, high cholesterol, and high blood pressure
  • obesity and inactivity

From there, the treatment will depend on the cause and doesn’t necessarily take into account MTHFR. The exception is when you’ve been diagnosed with all the following conditions at the same time:

  • high homocysteine levels
  • a confirmed MTHFR mutation
  • vitamin deficiencies in folate, choline, or vitamins B12, B6, or riboflavin
  • Tingling fingers and toes
  • Typically, frontal/center hair-loss etc…

In these cases, your doctor may suggest supplementation to address deficiencies along with medications or treatments to address the specific health condition. You may also have additional antibodies against B vitamins, and this will be addressed in lab testing and you will most likely be given a compounded injection to introduce a methylation donor.  It is very unlikely that you will be able to take B vitamins orally.  You will notice that your brain actually turns on, and you will have a whole lot more energy. This condition is very treatable.