Test ID: SB-643 | Sample Type: Dried Blood Spot + Saliva | Technology: LC-MS/MS | Results Time: 3–5 Working Days After Laboratory Receives Sample | Laboratory: ZRT Laboratory – CLIA Certified | Hormone Specialist Doctor Interpretation: Included | Suitable For: Adults and Children | Collect Sample At Home: No Clinic Visit Required
What Does This Test Measure?
Saliva — 4-Point Cortisol: Morning, Noon, Evening, and Night Cortisol.
Blood Spot — Full Sex Hormone Panel (LC-MS/MS): Estradiol (E2), Estriol (E3), Estrone (E1), Progesterone, Testosterone, DHEAS, Cortisol, SHBG.
15 markers total — a clinically complete picture of androgenic health, adrenal stress load, estrogen balance, and hormone bioavailability in a single at-home kit.
Related Symptoms
Persistent fatigue, low libido, erectile dysfunction, unexplained abdominal weight gain, poor exercise recovery, brain fog, low mood, insomnia, night waking, chronic stress, burnout, acne, scalp hair loss, gynaecomastia, or symptoms of low testosterone with normal standard blood results.
Who Should Consider This Test?
- Persistent fatigue that does not improve with rest or sleep
- Low libido, erectile dysfunction, or reduced sexual performance
- Unexplained weight gain, particularly around the abdomen
- Poor recovery from exercise or sustained high-pressure workload
- Brain fog, poor concentration, or low mood
- Insomnia, night waking, or unrefreshing sleep
- Chronic stress or burnout
- Acne, scalp hair loss, or gynaecomastia
- Symptoms of low testosterone with normal or inconclusive standard blood results
- Told testosterone is normal but androgenic symptoms persist (elevated SHBG is frequently the explanation)
- Currently on TRT and wanting to monitor estradiol balance, SHBG status, and cortisol rhythm alongside testosterone
- Men over 35 seeking a comprehensive androgenic and adrenal health baseline
Why This Test Is Particularly Important for Men
- SHBG is the most commonly missed cause of low testosterone symptoms in men with “normal” blood results — high SHBG binds and inactivates testosterone regardless of total production level; low SHBG releases excess free testosterone and estradiol, raising cardiovascular and prostate risk
- The 4-point cortisol profile reveals the complete daily adrenal rhythm — each time point (morning, noon, evening, night) has distinct consequences for testosterone, SHBG, and estradiol balance that a single cortisol measurement cannot identify
- Cortisol is the primary driver of SHBG elevation — chronic cortisol excess triggers hepatic SHBG synthesis, inactivating testosterone and amplifying androgenic deficiency symptoms even when total testosterone is within range
- Estradiol excess from visceral fat and aromatase activity suppresses testosterone, drives gynaecomastia, causes fat accumulation, and independently raises cardiovascular risk — measuring all three estrogens alongside SHBG reveals the full oestrogenic load
- DHEAS is the adrenal androgenic reserve marker — a sustained indicator of chronic stress and adrenal depletion that a single cortisol value cannot capture
Not Sure Which Test Is Right for You?
Email us at info@hormonelab.co.uk with your gender, age, symptoms, medications, and any current treatments. We will forward your enquiry to our doctors and respond within 24 hours.
How It Works
- Order your kit — delivered directly to your door
- Collect saliva at four time points (morning before 9am, noon, evening, night) and blood spot via finger-prick
- Post your samples to ZRT Laboratory using the return instructions provided
- Receive your full report by email within 3–5 working days
What You Receive
- All 15 marker results with male-specific reference ranges
- Visual charts for your 4-point cortisol curve and full sex hormone panel including SHBG
- Clinical interpretation of free vs bound testosterone and your estradiol-to-testosterone ratio
- Written interpretation by a Hormone Specialist PhD Doctor
- Personalised next-step recommendations
- Laboratory fee included — no hidden charges
Why We Use ZRT Laboratory
All testing is performed by ZRT Laboratory — a globally recognised, CLIA-certified diagnostic laboratory founded in 1998 by Dr. David Zava, PhD. ZRT has performed over 11 million tests and is trusted by healthcare professionals in 96+ countries.
- Pioneers of at-home dried blood spot (DBS) and saliva hormone testing
- Advanced LC-MS/MS technology for clinical-grade accuracy
- Qualified for the CDC Hormone Standardization (HoSt) Program
- Personalised reference ranges based on age and sex
Through our partnership with ZRT Laboratory, Hormone Lab UK delivers internationally recognised, research-backed hormone testing to people across the UK and Europe — from the comfort of home.
Frequently Asked Questions
Why is SHBG important for men?
SHBG determines how much testosterone is free and active versus bound and unavailable. Two men with the same total testosterone can have very different free testosterone depending on their SHBG — one functionally deficient despite “normal” results, one with excess free hormone driving prostate and cardiovascular risk. Without SHBG, a testosterone result cannot explain your symptoms.
Why do men need estrogen tested?
Men produce Estradiol (E2) through aromatase conversion of testosterone — a process that increases with visceral fat, alcohol, and ageing. Excess Estradiol (E2) suppresses testosterone, causes gynaecomastia, and drives fat accumulation. Measuring all three estrogens alongside testosterone and SHBG reveals the full oestrogenic load and its impact on androgenic balance.
Can I use this test if I am on TRT?
Yes. This test is particularly valuable for men on TRT who want to understand their estradiol balance, SHBG status, and cortisol pattern alongside testosterone. TRT increases aromatisation and can significantly alter SHBG — making a comprehensive panel essential for safe monitoring.
Why measure cortisol at four time points?
A single cortisol measurement cannot distinguish between adrenal burnout, high morning reactivity, evening elevation, or night excess — each with different effects on testosterone and SHBG. The 4-point profile captures the full daily adrenal rhythm.
Does the price include the laboratory fee?
Yes. The full laboratory analysis fee is included. There are no additional charges. You are only responsible for posting your samples to the laboratory.
How long is the kit valid for?
The kit must be used within 12 months of the purchase date.
