The Comprehensive Male Profile I by ZRT Laboratory is a comprehensive hormone test designed to assess various aspects of male health and hormonal balance. This test analyzes key hormones in male physiology including testosterone, estrogen, cortisol, DHEA-S, and thyroid hormones, providing valuable insights into reproductive health, metabolism, energy levels, and stress response. It also includes a PSA, or prostate specific antigen, a marker used to inform doctors of an individual’s need for further prostate cancer screening. [14.]
The Comprehensive Male Profile II differs from the Comprehensive Male Profile I in its use of blood spot testing rather than saliva testing for steroid sex hormones. This difference makes this test ideal for patients who use sublingual or troche hormone replacement: in this setting it is difficult to know how much of the supplemented hormone directly saturates oral mucosa, which could result in falsely elevated hormone levels.
Additionally, the Comprehensive Male Profile II may be more appropriate for patients who do not produce much saliva, and/or are resistant to venipuncture.
Overall, the Comprehensive Male Profile II by ZRT Laboratory offers a non-invasive and convenient way to assess male hormonal status. The results can help identify hormone imbalances associated with symptoms such as fatigue, low libido, weight gain, mood swings, and muscle loss, guiding personalized treatment strategies for improved overall health and well-being.
By identifying hormonal imbalances or deficiencies, healthcare providers can tailor treatment strategies to address specific hormonal concerns, alleviate symptoms, and optimize overall health and well-being in men. [11., 17.] Moreover, regular monitoring of hormone levels through this comprehensive profile enables healthcare providers to track progress, adjust treatment plans as needed, and ensure optimal hormonal balance and health outcomes for their patients.
The Comprehensive Male Profile I by ZRT Laboratory tests several biomarkers crucial for assessing men's health:
Testosterone: Testosterone levels are vital for male reproductive health, libido, muscle mass, bone density, and overall well-being. Low testosterone levels can lead to symptoms such as low libido, fatigue, and erectile dysfunction and early aging. [11.]
Estradiol: Estradiol, a form of estrogen, plays a role in regulating libido, bone density, and cognitive function in men. [5., 18.] Knowing their estrogen level may be important in men receiving testosterone replacement therapy, or men with a family or personal history of gynecomastia (male breast enlargement). [16.]
Cortisol: Cortisol is a stress hormone produced by the adrenal glands that plays a critical role in the body's stress response, metabolism, immune function, and energy levels. Dysregulation of cortisol levels can lead to adrenal dysfunction and contribute to symptoms such as fatigue, insomnia, and mood disturbances [McEwen]. By testing salivary levels of cortisol at 4 time points in a 24 hour period, this test maps out the individual’s diurnal cortisol rhythm and may provide insight into chronic stress, sleep disturbances, immune or digestive dysfunction, and more. [1.]
DHEA-S (Dehydroepiandrosterone Sulfate): Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands (and in smaller amounts in the ovaries and testes); a sulfate group is added to DHEA in the adrenal glands and the liver, forming DHEA-S. DHEA-S can be converted into other hormones, including estrogen and testosterone. It plays a role in regulating mood, energy levels, and overall hormonal balance. It can be used as a marker for adrenal function, stress response, and overall energy and resiliency levels. [2.]
Thyroid Hormones: (TSH, Free T3, Free T4, anti-TPO antibodies): Thyroid hormones, T3 and T4, are essential for regulating metabolism, energy production, and overall health and body functions. TSH, thyroid stimulating hormone, is a hormone made in the pituitary gland which stimulates thyroid hormone production and release in the thyroid gland. Abnormalities in thyroid hormone levels can lead to symptoms such as fatigue, weight changes, and mood disturbances. [GARBER] Assessing an individual’s level of anti-TPO antibodies is an important step to rule out Hashimoto’s thyroiditis, an autoimmune thyroid condition that causes eventual hypothyroidism. [10.]
Prostate-Specific Antigen (PSA): PSA levels are important for monitoring prostate health and screening for conditions such as prostate cancer and benign prostatic hyperplasia (BPH). Patients should discuss results with their healthcare provider within the context of their age, family history, demographics, and lifestyle. [14.]
These biomarkers provide insights into various aspects of men's health, including reproductive function, adrenal health, stress response, metabolism, and overall well-being.
As mentioned above, blood spot testing for hormone assessment is ideal for patients who use sublingual or troche hormone replacement: in this setting salivary testing could result in falsely elevated hormone levels. Additionally, the Comprehensive Male Profile II may be more appropriate for patients who do not produce much saliva, and are resistant to venipuncture.
As with saliva testing, blood spot testing can be done from home, avoiding the stress and inconvenience of a trip to a lab or phlebotomist’s office. It also avoids the potential aversion to venipuncture.
Blood spot testing has been shown to correlate well with serum hormone levels. [7., 15., 20.]
The Comprehensive Male Profile I by ZRT Laboratory can benefit various groups of individuals, including:
Men experiencing symptoms related to hormonal imbalances: in men, testosterone levels naturally begin to decline with age, usually beginning around the mid-40’s. Fatigue, changes in libido, mood swings, weight gain, and the development of metabolic syndrome and osteoporosis may be signs of hidden hormone imbalance. [17.]
Men with high levels of chronic stress, suspected thyroid disorders or autoimmune conditions: as the profile includes both a diurnal cortisol curve and a thyroid panel including anti-thyroid peroxidase (anti-TPO) antibodies, this test sheds light on potential thyroid/adrenal imbalances which may cause troubling hormone imbalance symptoms. [9., 12., 19.]
Men undergoing hormone replacement therapy or testosterone supplementation: the Comprehensive Male Profile I by ZRT Laboratory can be used to monitor hormone levels and optimize treatment outcomes. Salivary testosterone levels are recognized as a valid testing approach to assess testosterone levels in men. [3., 6.]
Men interested in preventive healthcare and optimizing their overall well-being: hormone imbalance in men may be an underlying factor in age- and lifestyle-related conditions including metabolic syndrome, loss of muscle mass, low libido, and others. Assessing hormonal balance and metabolic health can help uncover these factors. [4., 11.]
Patients using certain medications including steroids should consult their healthcare provider regarding optimal collection timing. Avoidance of certain medications, 7-keto DHEA supplements and anti-aging facial creams for up to 3 days prior to testing may be necessary.
Patients using hormone replacement therapy should collect samples according to the schedule below, unless otherwise directed by their healthcare provider.
Samples should be shipped as soon as possible after collection to ensure accurate results.
Various guidelines exist for those using different forms of hormones or steroids, emphasizing proper timing and avoidance of certain substances before testing. People taking glucocorticoids should consult their healthcare provider before making any changes in their dosing schedule.
The general recommendations for people using hormone replacement is as follows:
If you use topical or oral hormones:
Apply/take any night dosage at least 12 hours prior to your morning collection.
Avoid applying hormones with your bare hands for at least 2 days prior to collection.
Avoid using hormones on your face, lips, and neck.
Change your sheets, pillowcases, and hand towels the night before collection.
Avoid touching any surfaces which may be contaminated with hormones prior to collection; this includes faucets, hand towels, cabinet doors, etc..
If you use hormone patches, pellets, or injectables,
Test halfway between doses.
Example: 3 days after a once-a-week patch, or 6 weeks after insertion of pellets dosed every 3 months.
If you use sublingual hormones or troches,
Talk to your healthcare provider. It is not recommended that you take this test.
If you are taking steroids (glucocorticoids, prednisone, etc.), talk to your healthcare provider about appropriate timing.
Blood spot collection involves washing hands, pricking the finger, and saturating the filter paper with blood drops.
The blood spot card should be left to air dry for at least 4 hours before packaging.
Saliva collection involves collecting samples at specific times and using provided tubes to pool saliva.
Saliva should be collected in the morning upon waking, before lunch, before dinner, and before bed.
Samples should be shipped back to the lab as soon as possible after collection, ensuring they remain dry and intact during transit.
Proper packaging and labeling are essential to facilitate the shipping process.
Results are typically available 3-5 business days after samples are received at the lab.
Healthcare providers will notify patients when results are ready and schedule follow-up appointments to discuss them
[1.] Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017 Sep;83:25-41. doi: 10.1016/j.psyneuen.2017.05.018. Epub 2017 May 24. PMID: 28578301; PMCID: PMC5568897.
[2.] Al-Aridi R, Abdelmannan D, Arafah BM. Biochemical diagnosis of adrenal insufficiency: the added value of dehydroepiandrosterone sulfate measurements. Endocr Pract. 2011 Mar-Apr;17(2):261-70. doi: 10.4158/EP10262.RA. PMID: 21134877.
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[6.] Dabbs JM. Salivary testosterone measurements: Reliability across hours, days, and weeks. Physiology & Behavior. 1990;48(1):83-86. doi:https://doi.org/10.1016/0031-9384(90)90265-6
[7.] Edelman A, Stouffer R, Zava DT, Jensen JT. A comparison of blood spot vs. plasma analysis of gonadotropin and ovarian steroid hormone levels in reproductive-age women. Fertil Steril. 2007 Nov;88(5):1404-7. doi: 10.1016/j.fertnstert.2006.12.016. Epub 2007 Mar 26. PMID: 17368453; PMCID: PMC2175208.
[8.] Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, Pessah-Pollack R, Singer PA, Woeber KA; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028. doi: 10.4158/EP12280.GL. Erratum in: Endocr Pract. 2013 Jan-Feb;19(1):175. PMID: 23246686.
[9.] Hong H, Lee J. Thyroid-Stimulating Hormone as a Biomarker for Stress After Thyroid Surgery: A Prospective Cohort Study. Med Sci Monit. 2022 Nov 10;28:e937957. doi: 10.12659/MSM.937957. PMID: 36352753; PMCID: PMC9664770.
[10.] Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto's thyroiditis in adults: A systematic review and meta-analysis. Front Public Health. 2022 Oct 13;10:1020709. doi: 10.3389/fpubh.2022.1020709. PMID: 36311599; PMCID: PMC9608544.
[11.] Kelly DM, Jones TH. Testosterone: a metabolic hormone in health and disease. J Endocrinol. 2013 Apr 29;217(3):R25-45. doi: 10.1530/JOE-12-0455. PMID: 23378050.
[12.] Mancini A, Di Segni C, Raimondo S, Olivieri G, Silvestrini A, Meucci E, Currò D. Thyroid Hormones, Oxidative Stress, and Inflammation. Mediators Inflamm. 2016;2016:6757154. doi: 10.1155/2016/6757154. Epub 2016 Mar 8. PMID: 27051079; PMCID: PMC4802023.
[13.] McEwen BS, Seeman T. Protective and damaging effects of mediators of stress. Elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci. 1999;896:30-47. doi: 10.1111/j.1749-6632.1999.tb08103.x. PMID: 10681886.
[14.] National Cancer Institute. Prostate-Specific Antigen (PSA) Test. National Cancer Institute. Published March 11, 2022. https://www.cancer.gov/types/prostate/psa-fact-sheet
[15.] Shirtcliff EA, Reavis R, Overman WH, Granger DA. Measurement of gonadal hormones in dried blood spots versus serum: verification of menstrual cycle phase. Horm Behav. 2001 Jun;39(4):258-66. doi: 10.1006/hbeh.2001.1657. PMID: 11374911.
[16.] Tan RS, Cook KR, Reilly WG. High estrogen in men after injectable testosterone therapy: the low T experience. Am J Mens Health. 2015 May;9(3):229-34. doi: 10.1177/1557988314539000. Epub 2014 Jun 13. PMID: 24928451.
[17.] Tsujimura A. The Relationship between Testosterone Deficiency and Men's Health. World J Mens Health. 2013 Aug;31(2):126-35. doi: 10.5534/wjmh.2013.31.2.126. Epub 2013 Aug 31. PMID: 24044107; PMCID: PMC3770847.
[18.] Vilaca T, Eastell R, Schini M. Osteoporosis in men. Lancet Diabetes Endocrinol. 2022 Apr;10(4):273-283. doi: 10.1016/S2213-8587(22)00012-2. Epub 2022 Mar 2. PMID: 35247315.
[19.] Wondisford FE. A direct role for thyroid hormone in development of the adrenal cortex. Endocrinology. 2015 Jun;156(6):1939-40. doi: 10.1210/en.2015-1351. PMID: 25978599; PMCID: PMC4430608.
[20.] Worthman CM, Stallings JF. Hormone measures in finger-prick blood spot samples: new field methods for reproductive endocrinology. Am J Phys Anthropol. 1997 Sep;104(1):1-21. doi: 10.1002/(SICI)1096-8644(199709)104:1<1::AID-AJPA1>3.0.CO;2-V. PMID: 9331450.
The Comprehensive Male Profile II provides a broad assessment of sex, adrenal, and thyroid hormone levels. Unlike the Comprehensive Male Profile I, it tests only diurnal cortisol in saliva and tests all sex and thyroid hormones with a dried blood spot sample.
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On December 11th, join Dr. Terry Wahls in a 
