Test ID: SB-644 | 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 — 4-Point Cortisol Profile: Morning, Noon, Evening, and Night Cortisol.
Blood Spot — Sex Hormones + SHBG (LC-MS/MS): Estradiol (E2), Estriol (E3), Estrone (E1), Progesterone, Testosterone, DHEAS, Cortisol, SHBG.
Blood Spot — Full Thyroid Panel: TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies.
18 markers total — a complete picture of the daily cortisol rhythm, androgenic balance including SHBG, and autoimmune thyroid function in a single at-home kit.
Related Symptoms
Persistent fatigue, unexplained weight gain, low libido, erectile dysfunction, poor exercise recovery, brain fog, low mood, feeling cold, dry skin, hair thinning, insomnia, chronic stress, burnout, symptoms of low testosterone with normal standard blood results, or told testosterone is “normal” but symptoms persist.
Who Should Consider This Test?
- Persistent fatigue that does not improve with rest or sleep
- Unexplained weight gain, particularly around the abdomen
- Low libido, erectile dysfunction, or reduced sexual performance
- Poor recovery from exercise or sustained high workload
- Brain fog, poor concentration, or low mood
- Feeling cold, dry skin, or hair thinning
- Insomnia, night waking, or unrefreshing sleep
- Chronic stress or burnout
- Told testosterone is “normal” but symptoms of androgen deficiency persist (elevated SHBG is frequently the explanation)
- Currently on TRT and wanting to monitor SHBG, thyroid, and estradiol alongside testosterone
- Diagnosed or suspected Hashimoto’s thyroiditis or autoimmune thyroid disease
- On levothyroxine and wanting complete thyroid monitoring alongside SHBG and sex hormone levels
- Men who want the complete cortisol-SHBG-testosterone-thyroid picture without a cardiometabolic panel
- Men over 35 seeking a comprehensive androgenic, SHBG, cortisol rhythm, and thyroid health baseline
Why This Test Is Particularly Important for Men
- The 4-point cortisol rhythm is the master regulator of SHBG, free testosterone, and thyroid T3 activation — each time point has distinct androgenic and thyroid consequences that a single cortisol measurement cannot identify
- SHBG is the most commonly missed cause of low testosterone symptoms in men with “normal” blood results — elevated by cortisol, thyroid disease, estradiol excess, age, and caloric restriction
- Thyroid dysfunction suppresses Leydig cell testosterone production and elevates SHBG — cortisol-driven T3 suppression produces identical symptoms with a normal TSH; Hashimoto’s is present years before TSH becomes abnormal
- Night cortisol elevation suppresses overnight testosterone production and worsens Hashimoto’s autoimmune activity simultaneously — detectable only by the 4-point cortisol assessment
- Both TPO and Tg antibodies are required for complete Hashimoto’s screening — some men have elevated Tg antibodies with normal TPO
How This Profile Differs From Other Tests
The Male Comprehensive Hormone Profile I (SB-644) provides the 4-point cortisol rhythm, full LC-MS/MS sex hormones + SHBG, and full thyroid panel — without the cardiometabolic panel. It is the ideal choice for men who want the complete cortisol-SHBG-testosterone-thyroid assessment, or who are adding targeted metabolic testing separately. For the cardiometabolic panel alongside this assessment, see the Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile (SB-646M).
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 18 marker results with male-specific reference ranges
- Visual cortisol rhythm chart showing your full four-point daily curve
- Visual charts for all sex hormones, SHBG, and the full thyroid panel
- Integrated clinical interpretation of how cortisol rhythm, testosterone, SHBG, estradiol, and thyroid markers interact as a single male hormonal system by a Hormone Specialist PhD Doctor
- SHBG-adjusted free testosterone bioavailability assessment
- Cortisol-thyroid T3 and Hashimoto’s autoimmunity assessment in cortisol and SHBG context
- 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
Does this test include cardiometabolic markers?
No. This profile covers the cortisol rhythm, sex hormones, SHBG, and full thyroid panel. For fasting insulin, HbA1c, HDL, triglycerides, cholesterol, and hsCRP alongside this panel, see the Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile (SB-646M).
Why is TSH alone not enough?
TSH measures the pituitary signal to the thyroid, not the active T3 reaching cells. Cortisol-driven T3 suppression produces functional hypothyroidism and Leydig cell testosterone suppression with a normal TSH. Hashimoto’s causes progressive thyroid damage for years before TSH becomes abnormal. SHBG elevation from thyroid disease further inactivates testosterone. All three patterns are invisible to TSH alone.
Why do I need SHBG alongside testosterone?
SHBG binds and inactivates testosterone. A man with elevated SHBG — from cortisol, thyroid disease, or estradiol excess — has full androgenic deficiency symptoms despite a normal total testosterone. This panel identifies both the SHBG level and, through the 4-point cortisol rhythm and thyroid panel, the most likely mechanism driving it.
Can I use this test if I am on TRT or levothyroxine?
Yes. This test monitors SHBG, estradiol, thyroid function, and cortisol rhythm alongside testosterone — essential for safe TRT management and accurate levothyroxine dosing.
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.
