Hormones 101

Why Our At-Home Testosterone Test is the Best

by Mike McAvennie11/12/2021

at-home assessment

Explaining everything you need to know about testing your T levels with our assessment.

Looking to test your testosterone levels? Hone’s at-home testing is one of the most advanced assessments on the market. It’s a simple, efficient and pain-free process that thoroughly tests not only your levels of testosterone, but also those of other vital hormones. And it does so in a convenient, reliable way from the comfort and privacy of your home.

You might ask, “Why do I need an at-home testing? What’s so important about my testosterone, anyway?” Well, it’s a vital component of what makes us men. Testosterone has a reputation of being “the sex hormone” since it’s the primary male hormone produced by the testes and it regulates the libido.

However, testosterone is so much more. It also helps build muscle mass and bone density. We develop stronger cognitive function and are better able to cope with stress. Our confidence and mood are improved, as are our energy and stamina.

When a male begins puberty, the pituitary gland starts churning out follicle stimulating and luteinizing hormones (LH), the latter of which energizes the testes to produce testosterone. Production increases until testosterone levels peak around early adulthood. When we enter our thirties, those levels decline gradually at a natural rate of up to 1.5 percent every year. If the decline is significantly steeper, however, all hormones have difficulty making the adjustment and become unbalanced. Worse, our physical, mental and emotional state that our testosterone helped build or maintain can drastically diminish.

A lot of men resign themselves to the belief that it’s all a part of growing older. The truth is, they’re exhibiting the symptoms of hypogonadism, more commonly referred to as testosterone deficiency, low testosterone or Low T. And it can be very treatable.


How Do I Know If I Have Low Testosterone?


Low T is sneaky—most of us don’t see the telltale signs right away, and the symptoms can vary with each individual. At first, you might think you’re just “a little run-down.” The problem is, it’s getting tougher and tougher to bounce back, or you actually start feeling worse. Before you know it, you have no energy, or at the very least a reduced ability in playing sports or exercising. Your muscles shrink while your waistband expands. Focusing at work or on just about anything becomes more difficult with each passing day. Your libido has pretty much disappeared, and you’ve begun cutting yourself off from family, friends, work colleagues, even just following a hobby or going out to do something fun. All of these things have put you into a deep funk or a mood so foul that loved ones are walking on eggshells because they don’t know what’s wrong.

Symptoms of Low Testosterone

These are the basic symptoms one may experience with low testosterone, and they’re easy to overlook if you don’t know what to look for:

  • Weight gain and fat redistribution around the midsection or breasts

  • Decreased muscle, strength and stamina

  • A diminished desire for sex or intimacy

  • A growing lack of energy and enthusiasm

  • Unable to concentrate or think clearly (commonly known as “brain fog”)

  • Loss or thinning of body and facial hair

  • Trouble sleeping, feeling constantly tired 

  • Increasing feelings of sadness, moodiness, irritability; unable to enjoy life in general

Then there are those who do see the signs, but they’re too embarrassed or afraid to discuss the problem. Hypogonadism tends to be labeled almost jokingly as “male menopause” (the more clinical term is andropause), but it isn’t considered as severe a problem as the form that women experience. There has also been a long-existing, pervading stigma that Low T isn’t a real ailment, even though growing research and reputable medical experts have increasingly refuted that over the past two decades. Regardless, such crude stigmas have discouraged males from discussing their low testosterone, even with loved ones and doctors, out of a deep-seated fear of being dismissed or seen as less of a man.

The problem is very real, men. Your body, mood and mindset are telling you this. With our at-home testing, Hone gives you the opportunity to let the science weigh in and confirm any suspicion of clinically significant hormone deficiencies.

What is Normal Testosterone for My Age?


There’s no good benchmark depending on your age, unfortunately. Results will range according to the individual, and there are multiple factors beyond age to consider – including underlying medical conditions and genetics – when determining a man’s T levels. Guidance from the American Urological Association (AUA) [1] identifies males with low testosterone when their total testosterone levels fall below 300 ng/dL (nanograms per deciliter) and they exhibit signs associated with clinical testosterone deficiency. That number is considered for males age 19 and older, and levels are expected to decrease gradually year over year once men enter their thirties.

This bears emphasizing: Age-related decreases in testosterone do not necessarily warrant hormone replacement. Exhibiting symptoms of low testosterone, however, does warrant testing and consulting with a physician about possible treatment options.

How Can I Check My Testosterone Level?

Finger Prick

Checking your testosterone, not to mention other hormone levels, has become easier than ever. You can get a blood test from your doctor, or you can test your testosterone levels at home. All of us have come to expect testing by the doctor to be thorough and accurate. Yet, in a world that has become extremely fast-paced, many of us see making an appointment, taking time off work and traveling to the doctor’s office as...well, a real time-suck (especially for those who live in well-populated, metropolitan locations). Testing at home, on the other hand, can be a considerable time-saver...provided the assessment is reliable.

That begs one to ask the question, “Are at-home test results reliable?” Thankfully, at least when it comes to Hone, the answer is yes.

At-home testing continues to become increasingly popular, and much more accurate with its results, thanks to continued refinements to the testing process. Of course, with improvement comes more options, and a slew of testosterone tests exist on the market today. With so many options now available, it’s perfectly understandable to wonder which testosterone test is the best. Here’s why the answer is Hone’s.


What Does Hone’s At-Home Testing Measure?


Biomarkers Tested

We’ve already established that salivary at-home tests only measure your free testosterone, but not your total T levels. Most assessments, in fact, can be rather limited in that they test only your testosterone. Hone, however, is one of the most comprehensive assessments available on the market. We test for a wide range of biological markers, or biomarkers, that are pivotal to maintaining normal levels of testosterone, including:

  • Total testosterone – the complete amount of testosterone, bound to SHBG or albumin, that’s produced by the testes

  • Free testosterone – the remaining testosterone that isn’t bound to a protein

  • Luteinizing hormone (LH) – directs its secretion into the testes, creating testosterone that produces sperm

  • Estradiol – modulates your libido, erectile function and spermatogenesis

  • Sex-hormone binding globulin (SHBG) – a protein that’s produced in the liver, SHGB binds to estrogen, dihydrotestosterone (DHT) and testosterone, then transports them in the blood as biologically inactive forms

  • Albumin – in addition to transporting hormones, vitamins and nutrients throughout your body, it accounts for about 60 percent of the total protein in the blood

  • Alanine aminotransferase (ALT) – an enzyme that converts food into energy 

  • Aspartate transaminase (AST) – an enzyme found in the liver, heart, kidney, red blood cells and skeletal tissue, released whenever muscle or liver damage occur.

What Does Hone’s Test Include?

Not all at-home tests are created equal, and Hone is the perfect example as to why that is. Many of today’s at-home assessments test your testosterone levels through your saliva. We, however, follow the tried-and-true, benchmark method of testing your blood, also known as serum.

What’s the difference between a testosterone blood test and a saliva test? You might be surprised. With a saliva test, the procedure varies depending on the product used, but the basic objective is that you spit saliva into a vial (or vials) and mail your collection to a laboratory for testing.

It seems promising, but are salivary test results as reliable as blood serum results? Sadly, no. Though they’re certainly easy to use, a 2020 study [2] reported that saliva tests are less expedient and less efficient than blood tests when it comes to accurately tracking hormone level changes. Furthermore, your reference levels aren’t reproducible, meaning each saliva test you take is bound to achieve a different result. Most importantly, saliva testing may be able to measure your free testosterone levels, but not your total testosterone levels. According to a 2014 study, [3] saliva testing measured consistently lower total hormone levels than those measured by blood serum testing.

Hone’s at-home test takes the uncertainty out of measuring your hormones. We not only follow the well-proven standard of testing your blood, but we do so in a way that’s as simple and pain-free as possible.

First, we provide all the materials required for your collection, including:

  • Safety lancets (4)

  • Alcohol prep pads (2)

  • Gauze pads (2)

  • Band-aids (2)

  • Blood sample collection card (1)

  • Blood sample return bag (1)

  • Prepaid return envelope (1)

  • Bio waste disposal bag (1)

  • Getting Started card (1)

  • Collection instructions (1)

  • Collection card template (1)

Assessment supplies

What Kind of Lab Does Hone Use for Analysis?

After following the instructions and collecting your sample with a lancet and a quick, simple prick of your pointer finger, you’ll package everything up into a prepaid return envelope and send it to one of our affiliated laboratories. For the record, Hone doesn’t use just any laboratory – these labs are accredited by the Clinical Laboratory Improvement Amendments (CLIA) and, where applicable, by the College of American Pathologists (CAP). CLIA are a set of federal standards overseen by the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS). In regulating laboratory testing, CLIA requirements mandate that clinical labs obtain certification from the CMS before they can accept human samples for diagnostic testing. CAP operates in a similar manner, though their laboratory standards not only meet, but often exceed CLIA requirements. These criteria ensure that labs affiliated with Hone produce the highest quality test results. The labs conduct testing to ensure blood from a finger prick is equivalent to venous puncture over a wide range of temperatures.

Oh, and let’s not forget that your test results are also physician reviewed. When you order a Hone at-home test, your order includes a virtual, face-to-face consultation with a certified physician. These doctors are licensed in the home state of their patients, and they specialize in endocrinology, urology, internal medicine and hormone optimization. Once you receive your lab results, you’ll schedule your consultation with the doctor, who will be able to go over them with you and make recommendations regarding treatment.


What Are the Pros and Cons of a Blood Test?


All tests, whether in a doctor’s office or at home, have their advantages and drawbacks. Hone’s at-home hormone testing was engineered to optimize the advantages and keep the disadvantages to a minimum. Let’s first cover the preparation considerations:

1. You must fast 10 to 12 hours before testing, which is a standard procedure for many medical tests. You can drink as much water as you wish while you fast, and being at home means you can enjoy a meal as soon as you’ve collected your sample.

2. It’s important you complete your test no later than 10 a.m. Your testosterone levels peak between the hours of 7 and 10 a.m., then steadily decline throughout the day. Testing during morning hours helps ensure that your at-home testing provides as accurate a measurement of your hormone levels as possible.

3. Though you’re using just a tiny lancet to prick your ring finger, sticking oneself with any kind of needle can make some of us squeamish.

4. Collecting your blood sample onto the collection card requires a little patience and a lot of attention. If your sample seeps past the designated marking on the card, or you have trouble providing an adequate amount of blood onto the card, it may compromise the accuracy of your test results.

5. Let the blood on your collection card fully dry for at least an hour before placing it in the return bag and mailing it to the lab. Make sure you’ve set some time aside the morning you test yourself.

6. No test is perfect. Errors, though rare, do happen, and unaccounted-for variables, either at the lab or on your end, can produce unexpected results. That’s why we double check each result with the physician and ensure follow-up testing to confirm any diagnosis that requires you to go on a form of treatment. This may seem like a drawback initially, though we do everything to make certain you receive the most accurate results possible.

Why the Upsides of At-Home Blood Testing Outweigh the Downsides:

1. You can take your test in the privacy and comfort of your own home (or wherever you’re most comfortable). It’s in your hands.

2. When the instructions are followed correctly, Hone’s at-home test is extremely reliable, and its results accurate.

3. At-home tests are very affordable, and oftentimes less expensive than having a blood test done at a laboratory or a doctor’s office.

4. Blood testing can help doctors evaluate how well your hormones and other bodily functions are working, or diagnose other conditions before symptoms start to develop. Acquiring this information can help make treatment preventative as well as curative.

5. Blood testing at home and its ease of use encourages many of us to become more engaged in our personal health, and motivates us to follow up with a physician once we get the results.

6. Follow-up blood testing helps you and your doctor to monitor the progress of your treatment and make adjustments to your dosage as necessary.


How Do I Get My Results?


When you register your at-home test within our secure patient portal on the Hone site, you’ll have exclusive access to all records, tests and consultations with your Hone physician. That includes the results from the sample you collected with your testing.

Results may vary, though we work with our affiliated labs to make your test results available to you within three to five business days after they receive your sample. Depending on when you mail your collection, the lab should receive it within 24 to 48 hours. (Your sample is preserved in special packaging that keeps it viable for several days.) Combining that with the turnaround time, you’re looking at a five- to seven-business day window before you’re notified that your results are available.


What If My Testosterone is Low?


If your test results show your testosterone levels are clinically deficient—meaning well below normal levels—your Hone physician will review the results with you, tell you what the levels mean, discuss how you’re feeling and recommend forms of treatment. Sometimes the treatment may consist of changes in diet and exercise or supplements. Yet, when the numbers are too low, the doctor is likely to make a recommendation that you undergo hormone replacement therapy (HRT).

If the doctor recommends HRT, Hone will require confirmatory testing with a second at-home test or we can write you a LabCorp requisition. You will perform the same procedure as the initial test and send your collection to our affiliated labs. Your doctor and Hone will review those lab results when they become available; if the secondary results confirm the original diagnosis and recommended treatment, the doctor will document and issue a valid, current, electronic prescription for treatment.


What If My Testosterone is High?


Now, what if your test results come back and show your testosterone is too high, elevated beyond what’s clinically considered to be within normal levels? It means that your brain is likely telling your pituitary gland to decrease testosterone production, since it thinks it already has plenty. It can, and does, happen on occasion. Symptoms can include:

  • Headaches

  • Inordinate growth of body hair, or hirsutism

  • Low sperm count

  • Impotence

  • Shrinkage of testes

  • Enlarged prostate, urinary issues

  • Unexpected changes in blood pressure

  • Obstructive sleep apnea (OSA)

If your levels come back too high, your Hone-affiliated physician will recommend further testing and some lifestyle changes to help bring down your testosterone. Should additional testing confirm the first result, the doctor will discuss next steps with you and determine if you’ll require medication to lower your T levels. High testosterone can be just as dangerous as low testosterone—if left untreated, you could increase your risk for heart or liver disease, or you may not realize you have an underlying medical issue that could have serious effects on your health.


Other Frequently Asked Questions About At-Home Testosterone Testing


There’s a ton of information to digest, and it can be a bit overwhelming. So please know that we at Hone are happy to answer any and all of your questions, day or night, by emailing support@honehealth.com. You can also contact us by phone (833-444-4483) Monday through Friday, 9 a.m.-6 p.m. EST. We’re here to help.

Before you do contact us, though, we invite you to check out our FAQ (Frequently Asked Questions) section on the Hone website. It may already have the answers to your questions, including the following:

  • When will I receive my at-home testosterone test? Once you’ve ordered your test and the order has been processed, we’ll email you a link to track your shipment. Our tests are shipped only on weekdays, and any orders placed after 3 p.m. EST will ship the next business day.

  • How much does your at-home test cost? Hone’s at-home test is arguably the most affordable on the market, and the cost covers more than just the box. Our test, normally $60, is currently available for $45. That cost not only includes the shipping of our test and its contents, but it also covers a virtual consultation with a Hone physician (which, on its own, can normally run an additional $50).

  • Is this covered by my insurance? Do you accept HSA/FSA card payments? Our at-home testosterone test and services are not covered by insurance at this time. Oftentimes, insurances won’t cover such services, and in those few instances that they might, you’ll find that our prices are likely comparable, if not actually lower, than your copay. Also consider the fact that your test, consultations and prescriptions are all taken care of from the comfort of your home; there’s no travel required on your part, saving you both time and money. You’ll also be happy to learn that Hone does accept Health Savings Account (HSA) and Flexible Spending Account (FSA) card payments. That can add up to being a huge, pre-taxed advantage that keeps your out-of-pocket expenses to a minimum.

  • Can I speak with a medical professional before ordering your at-home test? We’re here to help you, and we’re always happy to connect you with a medical professional. Please email support@honehealth.com to inquire.

  • Should I stop taking any medications or supplements before taking my test? We do not recommend you discontinue any medication until you’ve first contacted your physician. If you have any questions regarding a specific medication, please email support@honehealth.com and we’ll gladly answer.

  • What time should I test my blood? It’s very important that you collect your sample no later than 10 a.m. As per guidance from the American Urological Association (AUA),[1] the preeminent professional association for the advancement of urologic patient education and research, your testosterone is at its peak levels in the morning, between the hours of 7 a.m. and 10 a.m. This is the optimal time frame for you to collect your sample before your levels gradually decline throughout the rest of the day. This should also provide ample time for your sample to completely dry before you package and mail your collection to our labs.

  • What if I have trouble drawing blood from my finger for the test? What should I do? First, please take comfort in the knowledge that although it may be infrequent, having a little trouble in collecting your sample is not an uncommon issue with any at-home blood test. There could be a variety of factors as to why you may be having difficulty, but there’s rarely a reason that prohibits you from successfully drawing blood as outlined in our instructions. Here are a few ideas to help you increase blood flow and produce enough of a sample to satisfy lab requirements:

    • Drink plenty of water before collecting your sample. You can drink as much water as you wish during the 10 to 12 hours you fast beforehand. The main thing is to stay hydrated.

    • Warm hands produce better blood flow. Before you do your test, thoroughly rinse your hands or shower in warm water.

    • You can help promote adequate blood flow by swinging your arms by your side or running in place a few minutes before collecting your sample.

    • The best spot for your lancet puncture is just off the center of the finger pad, which is the fleshy underside of the end of the finger. Many people think the tip of the finger is the ideal location, but that is not the case.

    • Use the safety lancet while keeping your finger against a firm surface. This helps you achieve the proper depth when depressing the lancet.

    • If a drop of blood doesn’t form after puncturing, gently massage your wrist down to the fingertip.

    • If you’re still having difficulty, use another lancet on a different finger.

    If you’re unsure whether or not you’ve accurately collected your sample, we’re happy to review a photo of your sample on the card, to confirm whether or not it’s sufficient for processing by the lab. You can email the photo at support@honehealth.com.

  • Can I still order a test if I’m already taking testosterone? If you’re currently on testosterone through another firm but are considering switching over to Hone, you can certainly order our at-home test. Once your lab results are available and you schedule a consultation with a Hone doctor, we encourage you to provide a copy of blood work that shows your pre-TRT levels, meaning your original levels before undergoing any hormone treatment. This way, the doctor can make the necessary comparisons and determine how well your current treatment is working. If you’ve been taking testosterone in the form of a cream or gel, their oily residue will remain on your hands for quite a while, no matter how much you wash them. Because the testing requires a blood sample from a finger prick, your lab results could be compromised. Therefore, we recommend that you go to a local laboratory, like LabCorp, to have your total and free testosterone levels drawn through your arm rather than through your finger. You will forward those lab results to Hone as well as the following:

    • A copy of your pre-TRT blood work, so the physician can see your natural levels before treatment

    • A photo of the prescription cream or gel you’re using

    All materials can be uploaded into your Hone patient portal prior to your consultation with the physician. You can also email them to labs@honehealth.com.

  • Is follow-up testing required? If your initial test measures clinically significant hormone deficiencies and your Hone doctor makes a recommendation for testosterone replacement therapy (TRT), it is mandatory for you to undergo confirmatory testing with Hone to verify the doctor’s first analysis. If the second test results confirm the same or very similar findings, you will be prescribed treatment as outlined by your doctor. Because testosterone is a controlled substance, it’s imperative that you and Hone adhere to these strict guidelines. Furthermore, hormone retesting and follow-up consultations with your Hone doctor after 90, 180 and 360 days is mandatory. Failure to comply with either of these requirements can result in delayed shipment of your medication. Hone will notify you well in advance when it is nearly time for you to retest and reschedule your follow-up appointments.

  • Do you ship to all 50 states? At this time, in compliance with individual state regulations, Hone’s services are only available in 36 states. However, we are rapidly growing and will continue to do so in the coming months. If you try to order a test on the Hone website in a state we currently don’t service, you will be  immediately notified and prompted to provide your name, email and state. Once you click the “Continue” button, you will be registered with us. That way, as soon as Hone does expand to cover your state, you will receive an email notifying you that our services are available.


References:

[1] Mulhall JP, Trost LW, Brannigan RE, Kurtz EG, Redmon JB, Chiles KA, Lightner DJ, Miner MM, Murad MH, Nelson CJ, Platz EA, Ramanathan LV, Lewis RW. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018 Aug;200(2):423-432. doi: 10.1016/j.juro.2018.03.115. Epub 2018 Mar 28. PMID: 29601923.

[2] Adebero T, McKinlay BJ, Theocharidis A, Root Z, Josse AR, Klentrou P, Falk B. Salivary and Serum Concentrations of Cortisol and Testosterone at Rest and in Response to Intense Exercise in Boys Versus Men. Pediatr Exerc Sci. 2020 May 1;32(2):65-72. doi: 10.1123/pes.2019-0091. Epub 2019 Nov 25. PMID: 31770720.

[3] Kozloski MJ, Schumm LP, McClintock MK. The utility and dynamics of salivary sex hormone measurements in the National Social Life, Health, and Aging Project, Wave 2. J Gerontol B Psychol Sci Soc Sci. 2014 Nov;69 Suppl 2(Suppl 2):S215-28. doi: 10.1093/geronb/gbu123. PMID: 25360023; PMCID: PMC4303088.

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Frequently Asked Questions

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Who are the physicians on Hone?

Hone works with board-certified endocrinologists, urologists, internal medicine and other types of physicians who specialize in helping men address medical issues associated with their hormone levels.

is it safe?

Our physicians create your personalized medical plan using your blood measurements. They will clearly explain the benefits and possible side-effects of your treatment. The Hone care team will check in along the way to make sure everything is going according to plan. You can reach your physician through our secure portal if you have any questions or concerns at any point.

Does it work for everyone?

Hone treatments work for most people but there is no guarantee. Depending on your treatment it may take a few weeks to a few months to see results. Your physician will explain your treatment options as well as what to expect from your medication. We work closely with you to find the right solution, and if we can't we refer you out.

How long does it take to work?

Some will experience results immediately while others may need a couple of months to fine tune their solution. We are all different on the inside, but your Hone physician will create a plan specifically for you.

Is Hone the fountain of youth?

Here's the thing. We can't turn you into your 25 year old self again. Aging is normal and testosterone is not a fountain of youth. But addressing clinically significant hormone deficiencies can go far in giving you more energy and making you feel ready and excited to take on the many years ahead.

Do I need an in-person exam?

Most consultations are completed through an online video consultation with your physician, however if an in-person visit is deemed necessary we will arrange a complimentary concierge visit to your home at your earliest convenience.