When it comes to hormone and biomarker testing, the accuracy of results depends heavily on the analytical method used by the laboratory. Not all testing technologies are equal—each has strengths, limitations, and ideal use cases. Below is a clear breakdown of the three most common laboratory testing methods used today: EIA, ECLIA, and Mass Spectrometry.
Enzyme Immunoassay (EIA)
Enzyme Immunoassay (EIA) is one of the oldest and most widely used laboratory testing methods, having been in use for over 50 years. It is an antibody–antigen–based technique, typically performed on 96-well plates.
Key characteristics:
- Moderate specificity and sensitivity
- Low cost and easy to scale
- Suitable for simple hormone measurements
- Limited accuracy for complex hormone pathways or low-level analytes
Limitations:
EIA can struggle with cross-reactivity and interference from similar molecules, making it less reliable for detailed hormone profiling or precision testing.
Best used for:
Basic screening tests where cost efficiency is more important than ultra-high precision.
Electrochemiluminescence Immunoassay (ECLIA)
Electrochemiluminescence (ECLIA) is a more advanced antibody–antigen–based method, first adopted widely in the early 2000s. It is now commonly used by large reference laboratories for automated serum hormone testing.
Key characteristics:
- Improved specificity and sensitivity compared to EIA
- Cost-effective and highly automated
- Works well for endogenous (naturally produced) steroid hormones
- Fast turnaround times
Limitations:
ECLIA significantly underestimates hormone levels from topical or transdermal hormone therapies, as it does not accurately reflect tissue uptake or bioavailability.
Best used for:
Routine blood testing of endogenous hormones in large-scale clinical laboratories.
Mass Spectrometry (LC-MS, GC-MS, ICP-MS)
Mass spectrometry is considered the gold standard for hormone and micronutrient analysis. Instead of relying on antibodies, it measures analytes—or fragments of analytes—based on their mass-to-charge ratio, providing unparalleled accuracy.
Key characteristics:
- Extremely high sensitivity and specificity
- Wide linear range and minimal cross-reactivity
- Ideal for complex hormone panels and low-level measurements
- Capable of distinguishing nearly identical molecules
Limitations:
- High equipment and operational costs
- Requires highly trained technical staff
- Slower adoption due to complexity
Best used for:
Advanced hormone profiling, functional medicine testing, research applications, and situations where precision is critical.
Summary: Choosing the Right Testing Method
| Method | Accuracy | Cost | Best Use |
|---|---|---|---|
| EIA | Moderate | Low | Basic screening |
| ECLIA | High (serum hormones) | Low–Moderate | Automated clinical testing |
| Mass Spectrometry | Very High | High | Complex, precision hormone analysis |
Why Testing Method Matters
The testing technology used can significantly influence results, clinical interpretation, and treatment decisions. For complex hormone imbalances, therapy monitoring, or functional health assessments, mass spectrometry offers the most reliable insight, while EIA and ECLIA may be suitable for routine or initial evaluations.
Understanding these differences empowers patients and clinicians to choose the most appropriate test for their specific health goals.
ZRT Laboratory and Mass Spectrometry: A Longstanding Commitment to Precision
ZRT Laboratory first implemented mass spectrometry testing in the early 2000s, initially for vitamin D analysis. Since that time, ZRT has continuously expanded its mass spectrometry capabilities to support a broad range of testing across multiple sample types.
Today, ZRT utilises LC-MS, GC-MS, and ICP-MS systems to analyse:
- Saliva
- Dried blood spot
- Dried urine
- Hormones, elements, and neurotransmitters
Nearly all research samples analyzed by ZRT for steroid hormones are tested using mass spectrometry, reflecting its widespread acceptance as the gold standard within the academic and scientific communities. ZRT’s methodologies are supported by an extensive body of peer-reviewed research publications, underscoring the laboratory’s leadership in advanced hormone testing.