Hormone Health Hub: Expert Insights on Testing, Balance & Better Living — Testosterone Deficiency

Low testosterone in older men, often referred to as “male menopause” or even “andropause” is fairly well known — and testosterone replacement therapy in this age group has not been without its share of controversy, particularly with respect to heart health. Proper testing and dosing are all-important, as well as understanding a man’s physiology and all the factors that affect testosterone levels. For example, when giving testosterone transdermally it is critical to use testing methods such as dried blood spot or saliva to properly assess absorption of testosterone into the body, avoiding the problem of overdosing to achieve “normal” serum levels. But while...

When it comes to topical testosterone therapy, more is not always better. Dr. Allison Smith of ZRT Laboratory explains the U-shaped curve phenomenon — where both too little and too much testosterone produce the same symptoms — and why starting at low doses and titrating carefully is essential. She also outlines the key markers to check when a man’s testosterone numbers look good on paper but his symptoms persist.

An FDA-approved testosterone gel was shown to significantly increase cardiovascular risk in older men — but does this mean testosterone therapy is dangerous? ZRT Laboratory’s research suggests the real problem lies in how testosterone is measured. Venous serum testing dramatically underestimates tissue exposure to topical testosterone, leading to pharmacological overdosing that goes undetected. This article explains why the testing method matters as much as the dose.

Hormonal contraception suppresses ovarian function, which means saliva and blood spot hormone test results will appear artificially low — but this doesn’t mean hormone levels at the tissue level are low. This guide explains how to interpret hormone test results correctly when using the pill, patch, ring or IUD, and when to collect your sample for the most meaningful data.

Explore why many men on topical testosterone replacement therapy may be unintentionally over-dosed due to outdated serum testing methods and misunderstood dosing principles. Learn how saliva and dried blood spot testing better reflect bioavailable testosterone delivered to tissues, why physiological dosing matters, and how excessive testosterone may suppress natural hormone production, reduce receptor sensitivity, and negatively affect long-term symptom management and hormonal balance.