Test ID: SB-646 | Sample Type: Saliva + 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 LCMS - Sex Hormones and SHBG: 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.
Blood Spot - CardioMetabolic Panel: Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP.
24 markers total - the most complete at-home health profile available for women, combining 4-point saliva cortisol, blood spot LCMS sex hormones including SHBG, a full autoimmune thyroid panel, and a six-marker cardiometabolic panel in a single kit.
Related Symptoms
Persistent fatigue, unexplained weight gain, PMS, heavy or irregular periods, perimenopausal or menopausal symptoms, PCOS, insomnia, night sweats, anxiety, brain fog, low libido, hair thinning, sugar cravings, elevated cholesterol or triglycerides, chronic stress, burnout, or told hormone or thyroid results are normal but symptoms persist.
Who Should Consider This Test?
- Persistent fatigue or exhaustion that does not improve with rest or sleep
- Unexplained weight gain or difficulty losing weight despite diet and exercise
- PMS, heavy, irregular, painful, or absent periods
- Perimenopausal or menopausal symptoms: hot flushes, night sweats, vaginal dryness, low mood
- PCOS or symptoms associated with insulin resistance or androgen excess
- Low libido, poor energy, or reduced motivation
- Brain fog, poor concentration, or anxiety
- Insomnia, night sweats, or unrefreshing sleep
- Hair thinning, dry skin, or feeling cold
- Sugar cravings, energy crashes, or elevated cholesterol or triglycerides on previous testing
- Chronic stress or burnout
- On HRT, the contraceptive pill, or levothyroxine and wanting comprehensive monitoring
- Diagnosed or suspected Hashimoto's thyroiditis, oestrogen dominance, or thyroid disease
- Told hormone or thyroid results are normal but symptoms persist (elevated SHBG is frequently the explanation)
- Women seeking the single most comprehensive at-home hormonal, thyroid, and cardiometabolic health assessment available
Why This Test Is Particularly Important for Women
- SHBG is the bioavailability gatekeeper for every sex hormone in women - elevated SHBG binds and inactivates oestradiol and testosterone regardless of their total production; cortisol, thyroid disease, oestrogen, and insulin independently alter SHBG; a woman with normal oestradiol and testosterone but elevated SHBG has the hormonal symptoms of deficiency - this is only detectable when SHBG is measured alongside sex hormones
- The 4-point cortisol rhythm is the master regulator of all three other systems - elevated cortisol at any time point suppresses progesterone, impairs thyroid T4-to-T3 conversion, elevates SHBG, promotes visceral fat and insulin resistance, raises triglycerides, suppresses HDL, and elevates hsCRP; only four-time-point measurement reveals morning-normal or evening-elevated patterns that a single value cannot detect
- Thyroid dysfunction in women is systematically under-detected by TSH alone - cortisol-driven T3 suppression produces functional hypothyroidism with normal TSH; Hashimoto's is present for years before TSH becomes abnormal and is directly worsened by cortisol and insulin resistance; oestrogen and SHBG changes alter thyroid hormone binding; all these interactions are only visible when all four systems are assessed simultaneously
- Fasting insulin is the earliest detectable marker of insulin resistance in women - elevated years before HbA1c or fasting glucose becomes abnormal, directly driven by cortisol, progesterone deficiency, oestrogen decline, and PCOS, and worsening every other system on this panel
- hsCRP is the convergence biomarker of all four systems - elevated simultaneously by cortisol dysregulation, progesterone deficiency, Hashimoto's autoimmunity, insulin resistance, and visceral fat; 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 saliva at four time points (morning before 9am, noon, evening, night) for the cortisol panel, and a finger-prick blood spot for the sex hormones, thyroid, and cardiometabolic markers; cycle timing guidance 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 24 marker results with female-specific reference ranges
- Visual charts for your 4-point cortisol daily curve, all sex hormones and SHBG, the full thyroid panel, and all six cardiometabolic markers
- Integrated clinical interpretation of how cortisol rhythm, sex hormones, SHBG, thyroid markers, and cardiometabolic results interact as a single female hormonal-metabolic system by a Hormone Specialist PhD Doctor
- SHBG-adjusted sex hormone bioavailability assessment
- Cortisol-thyroid T3 and Hashimoto's autoimmunity assessment in cortisol, insulin, 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
Why do I need SHBG tested alongside sex hormones?
SHBG binds and inactivates oestradiol and testosterone. A woman with elevated SHBG - from cortisol, thyroid disease, oestrogen excess, or HRT - has full hormonal deficiency symptoms despite normal-range total sex hormone levels. SHBG is essential for interpreting every sex hormone result and for calculating true bioavailable hormone status.
Why test all four systems together?
In women these systems form a single integrated regulatory network. Cortisol suppresses progesterone and impairs thyroid T3 conversion; insulin resistance worsens with cortisol elevation and oestrogen decline; SHBG elevation inactivates sex hormones; Hashimoto's is worsened by cortisol and insulin. Testing them together reveals the root cause of symptoms that remain unexplained when each system is assessed in isolation.
Can I use this test if I am on HRT, the contraceptive pill, or levothyroxine?
Yes. HRT and the pill profoundly elevate SHBG and affect thyroid hormone binding and lipid profiles - which is precisely why this comprehensive panel provides more clinically meaningful information than standard blood tests for women on hormonal treatment. Follow the timing guidance in your kit.
When should I collect my samples during my cycle?
Guidance on optimal cycle timing for both saliva and blood spot samples is included in the kit instructions.
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.
