Test ID: SB-649F | Sample Type: Saliva + Dried Blood Spot | 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 — Sex Hormones & Cortisol (LC-MS/MS): Estradiol (E2), Estriol (E3), Estrone (E1), Progesterone, Testosterone, DHEAS, Cortisol.
Blood Spot — Full Thyroid Panel: TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies.
Blood Spot — CardioMetabolic Panel: Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP.
19 markers total — a complete picture of female sex hormone balance, cortisol, autoimmune thyroid function, and cardiometabolic risk in a single at-home kit.
Related Symptoms
Persistent fatigue, unexplained weight gain, feeling cold, hair thinning, dry skin, sugar cravings, energy crashes, elevated cholesterol or triglycerides on previous testing, PMS, heavy or irregular periods, perimenopausal or menopausal symptoms (hot flushes, night sweats, low mood), low libido, brain fog, anxiety, insomnia, chronic stress, burnout, or diagnosed or suspected PCOS, Hashimoto’s thyroiditis, or estrogen dominance.
Who Should Consider This Test?
- Persistent fatigue or exhaustion that does not improve with rest
- Unexplained weight gain or difficulty losing weight despite diet and exercise
- Feeling cold, temperature sensitivity, or slow metabolism
- Hair thinning, dry skin, or brittle nails
- Sugar cravings, energy crashes, or afternoon slumps
- Elevated cholesterol or triglycerides on previous testing
- PMS, heavy, irregular, or absent periods
- Perimenopausal or menopausal symptoms: hot flushes, night sweats, low mood
- Low libido or reduced sexual interest
- Brain fog, poor concentration, or memory issues
- Anxiety, irritability, or emotional volatility
- Insomnia, night waking, or unrefreshing sleep
- Chronic stress or burnout
- Diagnosed or suspected PCOS, Hashimoto’s thyroiditis, or estrogen dominance
- Currently on HRT, the contraceptive pill, or levothyroxine
- Previous thyroid or hormone testing with inconclusive or incomplete results
- Family history of thyroid disease, diabetes, heart disease, or metabolic syndrome
- Women over 35 wanting a comprehensive hormonal, thyroid, and cardiometabolic health baseline
Why This Test Is Particularly Important for Women
- Cortisol is the central disruptor of all three systems simultaneously — suppressing progesterone and creating estrogen dominance, impairing thyroid T4-to-T3 conversion (producing functional hypothyroidism with normal TSH), driving insulin resistance, visceral fat, triglyceride elevation, and hsCRP, and depleting DHEAS — a four-way attack visible only when all three systems are assessed together
- Thyroid dysfunction in women is systematically under-detected by TSH alone — cortisol-driven T3 suppression, estrogen-related changes in thyroid hormone binding, and Hashimoto’s autoimmunity (present years before TSH becomes abnormal) are all missed by standard thyroid testing; differentiation requires FT3, FT4, TT4, TPO, and Tg antibodies tested alongside sex hormones and cortisol
- Estrogen decline removes thyroid-binding and metabolic protection simultaneously — as Estradiol (E2) falls in perimenopause, thyroid symptoms emerge even without thyroid disease progression; HDL falls, triglycerides rise, and hsCRP elevates in a directly hormonal cardiovascular risk pattern
- Insulin resistance is hormonally amplified in women and worsens thyroid autoimmunity — elevated insulin drives systemic inflammation that directly worsens Hashimoto’s TPO and Tg antibody activity; fasting insulin is the earliest detectable marker, elevated years before HbA1c becomes abnormal
- hsCRP connects all three systems in women — elevated simultaneously by cortisol dysregulation, insulin resistance, estrogen decline, progesterone deficiency, and Hashimoto’s autoimmunity; a stronger independent predictor of cardiovascular disease in women than LDL cholesterol
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 your saliva sample (morning before 9am for optimal cortisol accuracy) and blood spot via finger-prick. Guidance on optimal cycle timing is included
- 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 19 marker results with female-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 sex hormones, cortisol, thyroid markers, and cardiometabolic results interact as a single female hormonal-metabolic system
- Estrogen-progesterone dominance ratio analysis
- Cortisol-thyroid T3 conversion interaction and Hashimoto’s assessment in cortisol and insulin context
- Insulin resistance pattern assessment (fasting insulin + HbA1c)
- Cardiovascular risk profile in full female hormonal and thyroid context
- Integrated 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
How is this different from the Female Comprehensive Hormone, Thyroid & CardioMetabolic Test (SB-652F)?
This test (SB-649F) uses a single cortisol measurement alongside the sex hormone panel, rather than the four-point cortisol daily rhythm profile in the SB-652F. It is the ideal choice for women who want the complete three-system panel without the multi-timepoint saliva collection protocol. SB-652F is recommended for women who specifically want to map their full daily cortisol curve.
Why is TSH alone not enough to assess thyroid health in women?
TSH measures the pituitary signal to the thyroid, not the active hormone reaching cells. Cortisol-driven T3 suppression produces functional hypothyroidism with a normal TSH. Hashimoto’s causes progressive thyroid damage for years before TSH becomes abnormal. Estrogen-related changes in thyroid hormone binding alter T4 availability without affecting TSH. All three patterns are invisible to TSH alone.
Is this test suitable for women with PCOS or Hashimoto’s?
Yes. PCOS is fundamentally a condition of insulin resistance, androgen excess, and estrogen-progesterone imbalance — all directly assessed here alongside thyroid antibodies. Hashimoto’s is screened by TPO and Tg antibodies alongside the cortisol and insulin markers that drive autoimmune thyroid activity.
Can I use this test if I am on HRT, the contraceptive pill, or levothyroxine?
Yes. HRT and the pill affect estrogen, progesterone, thyroid binding globulin, HDL, and triglycerides. Levothyroxine dosing is most accurate when FT3, FT4, and thyroid antibodies are assessed alongside the sex hormones and cortisol that affect thyroid conversion and binding.
When in my cycle should I collect?
Guidance on optimal cycle timing is included in your kit. For most women, collection in the luteal phase (days 19–21 of a 28-day cycle) provides the most clinically meaningful progesterone and estrogen values. Morning collection is recommended for optimal cortisol accuracy.
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.
