Male Advanced Hormone, Thyroid & CardioMetabolic Test | Specialist Doctor Report Included

Test ID: SB-649 | Saliva LCMS Hormones 7 with Cortisol + Blood Spot Full Thyroid & CardioMetabolic Panel

The Male Advanced Hormone, Thyroid & CardioMetabolic Test is a comprehensive at-home health profile for men measuring 19 key hormones and markers across three interconnected systems: a full saliva LCMS sex hormone and cortisol panel, a complete blood spot thyroid panel including autoimmune antibodies, and a six-marker blood spot cardiometabolic panel. Using saliva LCMS (Liquid Chromatography–Mass Spectrometry) — the gold standard for bioavailable hormone measurement — this test reveals how male hormones, cortisol, thyroid function, and metabolic health interact to drive the symptoms that standard NHS blood panels consistently miss in men.

In men, testosterone, cortisol, thyroid hormones, and insulin form a single integrated regulatory network — one in which disruption to any system cascades through all the others. Cortisol depletes testosterone through pregnenolone steal and Leydig cell suppression, drives visceral fat and aromatase-driven oestradiol conversion, impairs thyroid T4-to-T3 conversion, and causes insulin resistance — all simultaneously. Hypothyroidism directly suppresses Leydig cell testosterone production and compounds every symptom of androgen decline — but is missed by TSH alone when cortisol-driven T3 suppression is the underlying mechanism. Insulin resistance promotes aromatase activity and testosterone decline, while elevated oestradiol feeds back to suppress the HPG axis. No standard blood panel tests all three systems together. This one does.

Test from home with confidence — no clinic visit required. Results within 3–5 working days.

Why Hormones, Thyroid, and Cardiometabolic Health Must Be Assessed Together in Men

• Low testosterone is both a cause and consequence of thyroid dysfunction and insulin resistance in men — hypothyroidism directly suppresses Leydig cell testosterone production; cortisol-driven T3 suppression produces functional hypothyroidism with a normal TSH; and insulin resistance promotes visceral fat and aromatase-driven testosterone-to-oestradiol conversion; all three mechanisms operate simultaneously in men with fatigue, weight gain, and low libido — and are invisible to any single-system test
• Cortisol is the central disruptor of all three systems simultaneously in men — through pregnenolone steal and Leydig cell suppression, cortisol depletes testosterone; through T4-to-T3 conversion impairment, it creates functional hypothyroidism; through hepatic insulin receptor dysregulation, it drives insulin resistance, visceral fat, triglyceride elevation, and hsCRP; and through direct Leydig cell and HPG suppression, it drives aromatase-mediated oestradiol excess — a five-way attack that only combined tri-system assessment can fully characterise
• Thyroid dysfunction is a major and systematically missed cause of low testosterone in men — hypothyroidism independently suppresses testosterone synthesis and impairs protein metabolism, recovery, and energy generation; cortisol-driven T3 suppression produces an identical symptom picture with normal TSH; Hashimoto’s thyroiditis is present in men for years before TSH becomes abnormal; and TSH alone misses all three patterns — making the full thyroid panel including FT3, FT4, TT4, TPO, and Tg antibodies essential for any man with unresolved fatigue, weight gain, or low testosterone symptoms
• Insulin resistance and testosterone decline are mutually reinforcing and thyroid-compounded in men — elevated insulin promotes visceral fat and aromatase-driven oestrogen conversion; low testosterone worsens insulin sensitivity; hypothyroidism compounds both processes by suppressing thermogenesis, reducing lean mass, and impairing hepatic glucose metabolism; fasting insulin is the earliest detectable marker — elevated years before HbA1c or fasting glucose becomes abnormal
• hsCRP is the convergence biomarker of all three systems in men — elevated simultaneously by low testosterone, cortisol dysregulation, insulin resistance, visceral fat, oestradiol excess, and Hashimoto’s autoimmunity; a stronger independent predictor of cardiovascular events and all-cause mortality in men than LDL cholesterol; and a direct measure of the integrated inflammatory load of the entire male hormonal-thyroid-metabolic axis

What This Test Measures — 19 Markers Across Three Systems

Saliva LCMS — Sex Hormones & Cortisol (7 markers)

• Oestradiol (E2): Present in men via aromatase conversion of testosterone. Essential for bone density, cardiovascular protection, and cognitive function — but excess oestradiol from visceral fat, cortisol elevation, or hypothyroidism suppresses testosterone via the HPG axis, causes gynaecomastia, raises triglycerides, and elevates cardiovascular risk. The oestradiol-to-testosterone ratio is a primary androgenic and cardiometabolic health indicator in men. Measured by LCMS for the free, bioavailable fraction.
• Oestriol (E3): Reflects oestrogen conversion pathways and aromatase activity in men. Elevated E3 indicates increased oestrogen precursor load or conversion; the E3-to-E2 ratio provides metabolic oestrogen context beyond what E2 alone reveals.
• Oestrone (E1): Produced by androgen conversion in adipose tissue. Elevated oestrone in men with visceral fat drives systemic oestrogenic load, compounds testosterone suppression, and is associated with increased cardiometabolic and inflammatory risk. A key indicator of adipose-driven hormonal disruption in men.
• Progesterone (Pg): Present in men in small but clinically important amounts. Acts as a natural 5-alpha reductase inhibitor, blocking DHT conversion; has direct anti-oestrogenic, anti-inflammatory, and cardioprotective effects; supports insulin sensitivity, sleep quality, and thyroid function. Low progesterone in men is associated with elevated DHT, prostate risk, anxiety, and increased cardiometabolic inflammation.
• Testosterone (T): The primary male androgen — responsible for energy, libido, muscle mass, bone density, insulin sensitivity, HDL maintenance, and cardiovascular health. Saliva LCMS measures the free, bioavailable fraction — the clinically relevant value that drives androgenic function and correlates with symptoms, as opposed to total blood testosterone which includes the SHBG-bound, inactive fraction that can mask significant free testosterone deficiency.
• DHEAS (DS): The primary adrenal androgen precursor in men, declining from the mid-30s and depleted under chronic stress. Low DHEAS reduces testosterone precursor availability, impairs stress resilience, and has direct anti-inflammatory and insulin-sensitising effects. Elevated DHEAS under adrenal overactivation drives androgen excess and inflammatory cardiovascular risk.
• Cortisol (C): The central disruptor of testosterone, thyroid function, and metabolic health in men. Elevated cortisol suppresses Leydig cell testosterone production, impairs thyroid T4-to-T3 conversion, drives insulin resistance and visceral fat, raises triglycerides, suppresses HDL, and elevates hsCRP — while promoting aromatase-driven oestradiol excess and depleting DHEAS. Measured by saliva LCMS for the free, bioavailable fraction that drives these androgenic, thyroid, and metabolic effects.

Blood Spot — Full Thyroid Panel (6 markers)

• TSH: Essential first-line thyroid marker — but in men, TSH alone misses cortisol-driven T3 suppression, early thyroid insufficiency, and Hashimoto’s autoimmunity present years before TSH becomes abnormal. Necessary but not sufficient for any man with unresolved fatigue or low testosterone symptoms.
• Free T3 (FT3): The active thyroid hormone that drives metabolism, energy, testosterone synthesis support, and recovery in men. Low FT3 with normal TSH is the hallmark of cortisol-driven thyroid suppression — directly identifiable by combining the cortisol and FT3 results in a single integrated report.
• Free T4 (FT4): The thyroid’s primary output hormone. Low FT4 with normal TSH indicates early thyroid insufficiency — often preceding symptomatic hypothyroidism and testosterone suppression by years.
• Total T4 (TT4): Provides full T4 context including the bound fraction — important interpretive context for men on TRT where thyroid-binding proteins may be affected.
• TPO Antibodies (Anti-TPO): The primary diagnostic marker for Hashimoto’s thyroiditis in men. Frequently elevated years before TSH becomes abnormal; associated with progressive Leydig cell testosterone suppression, fatigue, and metabolic deterioration; and directly worsened by insulin resistance and cortisol dysregulation — both measured by this panel.
• Thyroglobulin Antibodies (Anti-Tg): Essential second Hashimoto’s marker. Some men have elevated Tg antibodies with normal TPO — making both necessary for complete autoimmune thyroid assessment and early detection of thyroid-driven testosterone suppression.

Blood Spot — CardioMetabolic Panel (6 markers)

• Fasting Insulin: The earliest detectable marker of insulin resistance in men — elevated years before HbA1c becomes abnormal. Directly promoted by cortisol excess, low testosterone, and visceral fat. Elevated fasting insulin drives aromatase activity, increases oestrogen conversion, raises cardiovascular risk, and is closely linked to erectile dysfunction and testosterone decline. Also worsens Hashimoto’s thyroid antibody activity through systemic inflammation.
• HbA1c: Reflects average blood sugar over 8–12 weeks. Men with chronically elevated cortisol, low testosterone, and hypothyroidism have markedly elevated risk of pre-diabetes and type 2 diabetes; HbA1c provides the medium-term blood sugar context that anchors the fasting insulin and thyroid interaction assessment.
• HDL Cholesterol: The protective cardiovascular fraction directly maintained by testosterone and suppressed by hypothyroidism. HDL falls with low testosterone, insulin resistance, cortisol elevation, and thyroid dysfunction — four pathways all assessed by this panel simultaneously.
• Triglycerides: Elevated by cortisol, insulin resistance, oestradiol excess, and hypothyroidism simultaneously — all four assessed here. Rise before LDL changes and are a primary cardiometabolic risk marker for men with visceral fat, hormonal decline, and thyroid dysfunction.
• Total Cholesterol: Directly elevated by hypothyroidism and low testosterone. Rising cholesterol in men with fatigue and low libido is frequently a combined hormonal and thyroid event rather than a dietary one — requiring the integrated assessment this panel provides.
• hsCRP (High-Sensitivity C-Reactive Protein): One of the strongest independent predictors of cardiovascular events and all-cause mortality in men. Elevated simultaneously by low testosterone, cortisol dysregulation, insulin resistance, visceral fat, oestradiol excess, and Hashimoto’s autoimmunity — all six pathways directly assessed by this panel. The convergence biomarker of the male hormonal-thyroid-metabolic system.

Who Should Consider This Test?

This test is particularly relevant for men who experience:

• Persistent fatigue or exhaustion that does not improve with sleep or rest
• Unexplained weight gain or difficulty losing body fat, particularly around the abdomen
• Low libido or reduced sexual interest
• Erectile dysfunction or reduced sexual performance
• Poor recovery from exercise, training, or sustained high workload
• Brain fog, poor concentration, or reduced cognitive sharpness
• Low mood, reduced motivation, or mild depression
• Feeling cold, temperature sensitivity, or slow metabolism
• Dry skin, hair thinning, or slow wound healing
• Sugar cravings, energy crashes, or afternoon slumps
• Elevated cholesterol, triglycerides, or blood sugar on previous testing
• Insomnia, night waking, or unrefreshing sleep
• Chronic stress, burnout, or sustained high-pressure workload
• Symptoms of low testosterone with normal or inconclusive standard blood results
• Currently on TRT and wanting to monitor thyroid, oestradiol, and metabolic markers alongside testosterone
• Diagnosed or suspected Hashimoto’s thyroiditis or autoimmune thyroid disease
• Previous thyroid or hormone testing with inconclusive or incomplete results
• Family history of thyroid disease, heart disease, diabetes, or metabolic syndrome
• Men over 35 wanting a comprehensive androgenic, thyroid, and cardiometabolic health baseline

Key Features

• 19-marker tri-system panel: saliva LCMS sex hormones and cortisol, full blood spot thyroid panel, and full blood spot cardiometabolic panel
• Saliva LCMS — gold standard for free, bioavailable testosterone, sex hormone, and cortisol measurement in men
• All three oestrogens (E1, E2, E3) for complete oestrogenic load and aromatase activity assessment
• Full 6-marker thyroid panel including TPO and Tg autoimmune antibodies for Hashimoto’s screening
• Cortisol measured by LCMS — directly linked to thyroid T3 conversion, Leydig cell testosterone suppression, and all six cardiometabolic markers
• Six cardiometabolic markers — fasting insulin, HbA1c, HDL, triglycerides, total cholesterol, hsCRP
• Results within 3–5 working days after lab receipt
• Expert analysis by a Hormone Specialist PhD Doctor
• Clear graphical and numerical results with personalised commentary
• All-inclusive price — laboratory fees included, no hidden costs
• Valid for 12 months from purchase

How It Works

1. Order the kit online — delivered directly to your door.
2. Collect your saliva sample for the full LCMS sex hormone and cortisol panel, and your blood spot sample via a simple finger-prick for the thyroid and cardiometabolic panels, following the detailed instructions. Morning saliva should be collected before 9am for optimal cortisol accuracy.
3. Post your samples to the lab using the return instructions in your kit.
4. Receive your results within 3–5 working days with specialist commentary and clear next-step guidance.

What Your Report Includes

• All 19 marker results with male-specific reference ranges
• Visual charts for all six sex hormones, cortisol, the full thyroid panel, and all six cardiometabolic markers
• Integrated clinical interpretation of how your testosterone, oestradiol, progesterone, DHEAS, cortisol, thyroid markers, and cardiometabolic results interact as a single male hormonal-metabolic system
• Free testosterone assessment based on bioavailable LCMS measurement
• Oestradiol-to-testosterone ratio and total oestrogenic load analysis
• Cortisol-thyroid T3 conversion and Leydig cell interaction assessment — directly connecting cortisol to FT3 and functional testosterone suppression
• Hashimoto’s autoimmunity assessment (TPO + Tg antibodies) in cortisol and insulin context
• Insulin resistance pattern assessment (fasting insulin + HbA1c)
• Cardiovascular risk profile in full androgenic and thyroid hormonal context (HDL, triglycerides, cholesterol, hsCRP)
• Specialist commentary by a Hormone Specialist PhD Doctor
• Personalised next-step recommendations

Frequently Asked Questions

What does this test measure?

Oestradiol (E2), Oestriol (E3), Oestrone (E1), Progesterone, Testosterone, DHEAS, Cortisol (saliva LCMS) + TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies (blood spot) + Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP (blood spot) — 19 markers in total.

How is this different from the Male Comprehensive Hormone, Thyroid & CardioMetabolic Test?

This test (SB-649M) uses a single LCMS cortisol measurement alongside the sex hormone panel, rather than the four-point cortisol daily rhythm profile included in the SB-652M. It provides comprehensive androgenic, thyroid, and cardiometabolic assessment in a single morning saliva collection — the ideal choice for men who want the complete tri-system panel without the multi-timepoint collection protocol. The SB-652M is recommended for men who specifically want to map their full daily cortisol awakening response and diurnal rhythm.

Why is TSH alone not enough to assess thyroid health in men?

TSH measures the pituitary signal to the thyroid — not the active thyroid hormone reaching cells. Cortisol-driven T3 suppression produces functional hypothyroidism with a normal TSH — the most commonly missed thyroid pattern in men under chronic occupational or psychological stress. Hashimoto’s autoimmunity causes progressive thyroid damage and Leydig cell testosterone suppression for years before TSH becomes abnormal. Both patterns are invisible to TSH alone and are directly assessed by this panel alongside the sex hormones and cortisol that drive them.

Can I use this test if I am on TRT or levothyroxine?

Yes. This test is particularly valuable for men on TRT who want to monitor thyroid markers, oestradiol balance, insulin sensitivity, and inflammation alongside testosterone. TRT increases aromatisation, can alter thyroid binding, HDL, and triglycerides — all directly assessed here. Levothyroxine dosing is most accurate when FT3, FT4, and thyroid antibodies are assessed alongside the cortisol that impairs T3 conversion.

Is this test suitable for men with Hashimoto’s or suspected thyroid disease?

Yes — this is a comprehensive thyroid assessment including both TPO and Tg antibodies for complete Hashimoto’s screening, alongside the cortisol and insulin markers that directly drive autoimmune thyroid activity and Leydig cell testosterone suppression.

When will I get my results?

Within 3–5 working days after your samples reach the laboratory.

Are there hidden costs?

No. Laboratory analysis and specialist review are fully included. You are responsible for postage to the lab.

How long is the kit valid?

12 months from purchase.

Why We Partner with ZRT Laboratory

At Hormone Lab UK, every home test kit is analysed by ZRT Laboratory, a globally recognised, CLIA-certified diagnostic and research laboratory specialising in hormone testing, thyroid testing, fertility testing, adrenal function, neurotransmitter analysis, cardiometabolic health, heavy metals, and wellness testing. Founded in 1998 by renowned biochemist and breast cancer researcher Dr. David Zava, PhD, ZRT has become one of the world’s leading laboratories for advanced functional health testing.

With more than 11 million laboratory tests performed and healthcare professionals in over 96 countries relying on its expertise, ZRT is recognised for scientific excellence, analytical accuracy, and continuous innovation. The laboratory pioneered at-home saliva hormone testing, introduced the first commercially available dried blood spot (DBS) hormone tests, and developed Dried Urine Testing (DUTS), helping make advanced laboratory diagnostics more accessible and clinically meaningful.

Every sample is analysed using state-of-the-art LC-MS/MS and ICP-MS technology under rigorous quality control standards. ZRT collaborates with the CDC, NIH, and leading universities, supporting ongoing research and advances in laboratory medicine.