Test ID: SB-645 | 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 — CardioMetabolic Panel: Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP.
18 markers total — a clinically integrated picture of the cortisol rhythm, androgenic balance, hormone bioavailability, and cardiometabolic risk in a single at-home kit.
Related Symptoms
Persistent fatigue, unexplained abdominal weight gain, low libido, erectile dysfunction, poor exercise recovery, brain fog, low mood, sugar cravings, energy crashes, elevated cholesterol or triglycerides on previous testing, insomnia, chronic stress, burnout, 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
- Unexplained weight gain, particularly around the abdomen
- Low libido, erectile dysfunction, or reduced sexual performance
- Poor recovery from exercise or sustained high-pressure workload
- Brain fog, poor concentration, or low mood
- Sugar cravings, energy crashes, or afternoon slumps
- Elevated cholesterol, triglycerides, or blood sugar on previous testing
- Insomnia, night waking, or unrefreshing sleep
- Told testosterone is “normal” but continuing to experience androgenic symptoms
- Currently on TRT and wanting to monitor SHBG, estradiol, and cardiometabolic markers
- Family history of heart disease, diabetes, or metabolic syndrome
- Men over 35 seeking a comprehensive hormonal and metabolic health baseline
Why This Test Is Particularly Important for Men
- The 4-point cortisol rhythm determines free testosterone via SHBG — cortisol elevation at any time point triggers hepatic SHBG synthesis, binding and inactivating testosterone regardless of how much the testes produce
- SHBG is essential for calculating free testosterone — two men with identical total testosterone can have completely different androgenic status depending on SHBG
- Cortisol drives every cardiometabolic risk marker simultaneously — insulin resistance, visceral fat, estradiol excess, triglyceride elevation, HDL suppression, and hsCRP rise are all cortisol-mediated
- Fasting insulin is the earliest detectable marker of insulin resistance — elevated years before HbA1c becomes abnormal, directly linked to erectile dysfunction and declining androgenic function
- hsCRP is the convergence biomarker of cortisol dysregulation, SHBG-mediated testosterone deficiency, and insulin resistance — a stronger independent predictor of cardiovascular events 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) 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
- Charts for all sex hormones, SHBG, and all six cardiometabolic markers
- SHBG-adjusted free testosterone bioavailability assessment
- Integrated clinical 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
Does this test include thyroid assessment?
No. This profile assesses the cortisol rhythm, sex hormones, SHBG, and cardiometabolic markers. For thyroid assessment alongside this panel, see the Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile.
Why do I need SHBG alongside testosterone?
SHBG binds and inactivates testosterone. A man with normal total testosterone but elevated SHBG — caused by cortisol, estradiol excess, age, or caloric restriction — has full androgenic deficiency symptoms despite a “normal” result. SHBG is the most common reason men are told their testosterone is normal but continue to experience fatigue and low libido.
Why is a 4-point cortisol more informative than a single measurement?
A single cortisol value cannot identify which part of the day is driving androgenic or cardiometabolic deterioration. Each time point — morning, noon, evening, night — has different hormonal and metabolic consequences and different intervention targets.
Can I use this test if I am on TRT?
Yes. This test is particularly valuable for men on TRT wanting to monitor SHBG, estradiol, cortisol rhythm, and cardiometabolic markers alongside testosterone.
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.
