Male Comprehensive Hormone Profile I | Specialist Doctor Report Included

Test ID: SB-644 | Saliva 4-Point Cortisol + Blood Spot LCMS Hormones 7 with SHBG + Full Thyroid Panel

The Male Comprehensive Hormone Profile I is an advanced at-home health assessment for men measuring 18 key hormones and markers across three interconnected systems: the full daily cortisol stress rhythm by 4-point saliva testing, a complete blood spot LCMS sex hormone panel including SHBG, and a full thyroid panel including autoimmune antibodies. Using saliva 4-point cortisol, blood spot LCMS sex hormones, SHBG, and a full thyroid antibody panel, this profile delivers the androgenic and thyroid picture that standard NHS testing cannot — without the cardiometabolic panel included in higher-tier profiles.

In men, the cortisol daily rhythm, testosterone, SHBG, and thyroid function are mechanistically inseparable. The morning cortisol awakening response sets Leydig cell testosterone output, hepatic SHBG synthesis, and thyroid T3 activation for the entire day. Cortisol elevation at any time point depletes testosterone via pregnenolone steal and direct Leydig cell suppression, simultaneously elevates SHBG to inactivate the testosterone that remains, and impairs thyroid T4-to-T3 conversion — all at once. Hypothyroidism independently suppresses Leydig cell function and compounds every symptom of androgen decline, yet is missed by TSH alone when cortisol-driven T3 suppression is the underlying mechanism. Hashimoto’s thyroiditis progresses in men for years before TSH becomes abnormal and is directly worsened by cortisol dysregulation at night. No standard blood panel tests all three systems together. This one does.

Test from home with confidence — no clinic visit required. Results within 3–5 working days.

Why Cortisol Rhythm, SHBG, and Thyroid Health Must Be Assessed Together in Men

• The 4-point cortisol rhythm is the master regulator of SHBG, free testosterone, and thyroid T3 activation in men — the morning cortisol awakening response determines Leydig cell testosterone output, hepatic SHBG synthesis rate, and thyroid T3 activation before any other system operates; elevated cortisol at any of the four time points depletes testosterone via pregnenolone steal and Leydig cell suppression, elevates SHBG to inactivate the testosterone that remains, and impairs T4-to-T3 conversion simultaneously; only four-time-point measurement reveals which phase of the day is driving the SHBG-mediated free testosterone deficiency and thyroid suppression
• SHBG is the most commonly missed cause of low testosterone symptoms in men with “normal” blood results — and is directly controlled by cortisol and thyroid status — elevated SHBG from cortisol excess, thyroid disease, oestradiol, age, or caloric restriction binds and inactivates testosterone regardless of how much the testes produce; a man with normal total testosterone but elevated SHBG has full androgenic deficiency symptoms; measuring SHBG alongside the 4-point cortisol rhythm and full thyroid panel identifies the specific mechanism driving SHBG elevation and the free testosterone consequences
• Thyroid dysfunction is a major and systematically missed cause of low free testosterone in men — and is driven by cortisol and SHBG changes measured in this panel — hypothyroidism directly suppresses Leydig cell testosterone production, elevates SHBG, and compounds every symptom of androgen decline; cortisol-driven T3 suppression produces identical effects with a normal TSH; Hashimoto’s is present for years before TSH becomes abnormal; all three patterns are invisible to TSH alone and directly measurable when assessed alongside the 4-point cortisol rhythm and SHBG
• Oestradiol excess, SHBG elevation, and HPG suppression are all cortisol-driven and thyroid-compounded in men — elevated cortisol drives visceral fat and aromatase-mediated testosterone-to-oestradiol conversion; excess oestradiol elevates SHBG and suppresses the HPG axis; hypothyroidism independently elevates SHBG and reduces Leydig cell responsiveness; the full sequence is only characterisable when all three systems are measured simultaneously
• Night cortisol elevation worsens Hashimoto’s autoimmunity and suppresses overnight testosterone production simultaneously in men — night cortisol suppresses the deep sleep phases during which testosterone is primarily produced; drives SHBG elevation through sleep-phase hepatic cortisol-SHBG coupling; impairs sleep-phase immune regulation, worsening TPO and Tg antibody activity; and directly accelerates Hashimoto’s progression through sleep-deprivation-mediated immune dysregulation — only detectable by the 4-point cortisol assessment in this panel

What This Test Measures — 18 Markers Across Three Systems

Saliva — 4-Point Cortisol Profile (4 markers)

• Morning Cortisol (Cortisol Awakening Response): Sets Leydig cell testosterone output, hepatic SHBG synthesis rate, and thyroid T3 activation for the entire day. An exaggerated morning response drives testosterone suppression, SHBG elevation, and T3 impairment; a blunted awakening response signals HPA burnout, reduced Leydig cell responsiveness, and impaired thyroid T3 activation that persists through the entire day.
• Noon Cortisol: Elevated noon cortisol drives visceral fat deposition, aromatase-mediated testosterone-to-oestradiol conversion, SHBG rise, and impaired thyroid T4-to-T3 conversion during the peak metabolic activity window — the mechanism by which chronic midday occupational stress simultaneously suppresses free testosterone and thyroid function in men.
• Evening Cortisol: Should decline significantly to allow testosterone and growth hormone to rise during early sleep cycles. Elevated evening cortisol suppresses overnight testosterone production, elevates SHBG through hepatic cortisol-SHBG coupling, sustains thyroid T3 impairment, and independently elevates hsCRP — producing next-day fatigue, reduced recovery, and worsening androgenic and thyroid function regardless of morning values.
• Night Cortisol: Suppresses the deep sleep phases during which the majority of daily testosterone is produced; drives SHBG elevation through sleep-phase hepatic cortisol-SHBG coupling; impairs sleep-phase immune regulation controlling Hashimoto’s TPO and Tg antibody activity; and directly accelerates Hashimoto’s progression — making night cortisol the most underassessed driver of both testosterone deficiency and thyroid autoimmunity in men.

Blood Spot LCMS — Sex Hormones & SHBG (8 markers)

• Oestradiol (E2): Present in men via aromatase conversion of testosterone. Physiologically important for bone density, cardiovascular protection, and cognitive function — but excess oestradiol from visceral fat, cortisol elevation, or hypothyroidism suppresses testosterone via the HPG axis, elevates SHBG, causes gynaecomastia, and raises cardiovascular risk. The oestradiol-to-free-testosterone ratio, calculated using SHBG, is the primary androgenic health indicator in men. Measured by blood spot LCMS for highest accuracy.
• Oestriol (E3): Reflects oestrogen conversion pathways and aromatase activity in men. Elevated E3 indicates increased oestrogen precursor load or conversion activity; the E3-to-E2 ratio provides aromatase context beyond what E2 alone reveals.
• Oestrone (E1): Produced by androgen conversion in adipose tissue. Elevated oestrone in men with visceral fat or cortisol-driven adrenal excess drives oestrogenic load, compounds HPG suppression, elevates SHBG, and worsens thyroid autoimmune inflammation.
• Progesterone (Pg): Present in men in small but clinically important amounts. Acts as a natural 5-alpha reductase inhibitor, blocking DHT conversion; has direct anti-oestrogenic, anti-inflammatory, neuroprotective, and thyroid-supportive effects; supports insulin sensitivity, sleep quality, and SHBG normalisation. Low progesterone in men is associated with elevated DHT, prostate risk, anxiety, and worsened thyroid autoimmunity.
• Testosterone (T): The primary male androgen — responsible for energy, libido, muscle mass, bone density, insulin sensitivity, HDL maintenance, and thyroid function support. Measured by blood spot LCMS for highest accuracy. Interpreted alongside SHBG to calculate free testosterone bioavailability — the clinically definitive androgenic assessment that testosterone measurement without SHBG cannot provide.
• DHEAS (DS): The primary adrenal androgen precursor in men, declining from the mid-30s and depleted under chronic cortisol elevation. Low DHEAS reduces testosterone precursor availability, impairs stress resilience, and has direct anti-inflammatory and thyroid-supportive effects. The 4-point cortisol rhythm reveals the HPA dysregulation mechanism driving DHEAS depletion.
• Cortisol (C) — Blood Spot LCMS: The single blood spot cortisol measurement by LCMS provides a direct comparator to the 4-point saliva cortisol rhythm, enabling cross-matrix validation and confirming the diurnal pattern with blood spot LCMS precision — the most complete cortisol assessment available in an at-home test at this tier.
• Sex Hormone Binding Globulin (SHBG): The bioavailability gatekeeper for testosterone in men. Elevated SHBG — driven by cortisol, thyroid disease, oestradiol excess, age, and caloric restriction — binds and inactivates testosterone regardless of its total production, causing full androgenic deficiency symptoms in men with normal total testosterone values. Essential for calculating free testosterone, interpreting the oestradiol-testosterone ratio, and identifying whether low testosterone symptoms are driven by SHBG elevation, production failure, or HPG suppression — distinctions only possible when SHBG is measured alongside the 4-point cortisol rhythm and full thyroid panel.

Blood Spot — Full Thyroid Panel (6 markers)

• TSH: Essential first-line thyroid marker — but in men, TSH alone misses cortisol-driven T3 suppression, thyroid-SHBG interactions, and Hashimoto’s autoimmunity present for years before TSH becomes abnormal. Necessary but not sufficient for any man with unresolved fatigue, low testosterone, or elevated SHBG.
• Free T3 (FT3): The active thyroid hormone that drives metabolism, energy, testosterone synthesis support, and recovery in men. Low FT3 with normal TSH is the hallmark of cortisol-driven thyroid suppression — directly identifiable by correlating each cortisol time point with the FT3 result in the integrated report.
• Free T4 (FT4): The thyroid’s primary output hormone. Low FT4 with normal TSH indicates early thyroid insufficiency — often preceding symptomatic hypothyroidism, SHBG elevation, and testosterone suppression by years.
• Total T4 (TT4): Provides full T4 context including the bound fraction — important interpretive context for men on TRT where thyroid-binding proteins and SHBG are affected simultaneously by oestradiol and cortisol changes.
• TPO Antibodies (Anti-TPO): The primary diagnostic marker for Hashimoto’s thyroiditis in men. Frequently elevated years before TSH becomes abnormal; associated with progressive Leydig cell testosterone suppression, SHBG elevation, fatigue, and poor recovery; and directly worsened by cortisol dysregulation at any time point — measurable alongside the 4-point cortisol rhythm in this panel.
• Thyroglobulin Antibodies (Anti-Tg): Essential second Hashimoto’s marker. Some men have elevated Tg antibodies with normal TPO — making both necessary for complete autoimmune thyroid assessment. Night cortisol elevation worsens Tg antibody activity through sleep-deprivation immune dysregulation — detectable only by the 4-point cortisol assessment in this panel.

Who Should Consider This Test?

This test is particularly relevant for men who:

• Have persistent fatigue or exhaustion that does not improve with rest or sleep
• Experience unexplained weight gain or difficulty losing body fat, particularly around the abdomen
• Have low libido or reduced sexual interest
• Experience erectile dysfunction or reduced sexual performance
• Have poor recovery from exercise, training, or sustained high workload
• Experience brain fog, poor concentration, or reduced cognitive sharpness
• Have low mood, reduced motivation, or mild depression
• Feel cold, have temperature sensitivity, or notice a slow metabolism
• Have dry skin, hair thinning, or slow wound healing
• Struggle with insomnia, night waking, or unrefreshing sleep
• Are under chronic stress, burnout, or sustained high-pressure workload
• Have been told their testosterone is “normal” but continue to experience androgenic symptoms (elevated SHBG is frequently the explanation)
• Have diagnosed or suspected Hashimoto’s thyroiditis or autoimmune thyroid disease
• Are on TRT and want to monitor SHBG, thyroid function, and oestradiol alongside testosterone without full cardiometabolic assessment
• Are on levothyroxine and want complete thyroid monitoring alongside SHBG and sex hormone levels
• Have had thyroid or hormone testing with normal results that do not match their symptoms
• Want the complete cortisol-SHBG-testosterone-thyroid picture without a cardiometabolic panel
• Are men over 35 seeking a comprehensive androgenic, SHBG, cortisol rhythm, and thyroid health baseline

How This Profile Differs From Other Hormone Lab UK Tests

The Male Comprehensive Hormone Profile I (SB-644M) provides the 4-point cortisol rhythm, full LCMS sex hormones + SHBG, and full thyroid panel — without the cardiometabolic panel (fasting insulin, HbA1c, HDL, triglycerides, cholesterol, hsCRP). It is the ideal choice for men who want the complete cortisol-SHBG-testosterone-thyroid assessment without cardiometabolic markers, or who are adding targeted metabolic testing separately.

Men who want the cardiometabolic panel alongside this assessment should consider the Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile (SB-646M), which adds six cardiometabolic markers to this complete panel.

Key Features

• 18-marker tri-system panel: 4-point saliva cortisol rhythm, blood spot LCMS sex hormones + SHBG, and full thyroid panel including TPO and Tg antibodies
• 4-point cortisol profile — morning, noon, evening, and night — the only method revealing the full daily cortisol rhythm and its SHBG-mediated and thyroid-mediated effects on free testosterone in men
• Blood spot LCMS sex hormones — gold standard accuracy across the full androgenic range
• SHBG included — essential for calculating free testosterone and identifying the mechanism of androgenic deficiency in men with normal total testosterone
• All three oestrogens (E1, E2, E3) for complete oestrogenic load and aromatase activity assessment
• Full 6-marker thyroid panel including TPO and Tg autoimmune antibodies for Hashimoto’s screening
• Results within 3–5 working days after lab receipt
• Expert analysis by a Hormone Specialist PhD Doctor
• Clear graphical and numerical results with personalised commentary
• All-inclusive price — laboratory fees included, no hidden costs
• Valid for 12 months from purchase

How It Works

1. Order the kit online — delivered directly to your door.
2. Collect your saliva samples at four time points (morning, noon, evening, night) for the cortisol rhythm panel, and your blood spot sample via a simple finger-prick for the LCMS hormone, SHBG, and thyroid panels. Morning saliva should be collected before 9am for optimal cortisol awakening response accuracy.
3. Post your samples to the lab using the return instructions in your kit.
4. Receive your results within 3–5 working days with specialist commentary and clear next-step guidance.

What Your Report Includes

• All 18 marker results with male-specific reference ranges
• Visual cortisol rhythm chart showing your full four-point daily curve
• Visual charts for all six sex hormones, SHBG, and the full thyroid panel
• Integrated clinical interpretation of how your cortisol rhythm, testosterone, SHBG, oestradiol, and thyroid markers interact as a single male hormonal system
• SHBG-adjusted free testosterone bioavailability assessment — the definitive androgenic status calculation
• Oestradiol-to-free-testosterone ratio analysis in SHBG and cortisol context
• Cortisol-SHBG coupling assessment — mapping each time point to SHBG elevation and free testosterone suppression
• Cortisol-thyroid T3 conversion and Leydig cell interaction assessment — mapping each cortisol time point to FT3 and functional testosterone suppression
• Hashimoto’s autoimmunity assessment (TPO + Tg antibodies) in cortisol and SHBG context
• Night cortisol – Hashimoto’s progression and testosterone suppression risk assessment
• Specialist commentary by a Hormone Specialist PhD Doctor
• Personalised next-step recommendations

Frequently Asked Questions

What does this test measure?

4-point saliva cortisol (morning, noon, evening, night) + Oestradiol (E2), Oestriol (E3), Oestrone (E1), Progesterone, Testosterone, DHEAS, Cortisol, SHBG (blood spot LCMS) + TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies (blood spot) — 18 markers in total.

Does this test include cardiometabolic markers?

No. This profile covers the cortisol rhythm, sex hormones, SHBG, and full thyroid panel. Men who also want fasting insulin, HbA1c, HDL, triglycerides, cholesterol, and hsCRP should consider the Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile (SB-646M), which adds six cardiometabolic markers to this complete panel.

Why is TSH alone not enough to assess thyroid health in men?

TSH measures the pituitary’s 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 — the most commonly missed thyroid pattern in men under chronic occupational or psychological stress. Hashimoto’s autoimmunity causes progressive thyroid damage and testosterone suppression for years before TSH becomes abnormal. SHBG elevation from thyroid disease further inactivates testosterone, compounding androgenic deficiency without changing TSH. All three patterns are invisible to TSH alone and directly assessed by this panel.

Why do I need SHBG alongside my testosterone result?

SHBG binds and inactivates testosterone. A man with normal total testosterone but elevated SHBG — caused by cortisol, thyroid disease, oestradiol excess, age, or caloric restriction — has full androgenic deficiency symptoms despite a “normal” blood test result. SHBG is the most common reason men are told their testosterone is normal but continue to experience fatigue, low libido, and poor recovery. This panel identifies both the SHBG level and, through the 4-point cortisol rhythm and full thyroid panel, the most likely mechanism driving it.

Can I use this test if I am on TRT or levothyroxine?

Yes. This test is valuable for men on TRT who want to monitor SHBG, oestradiol, and thyroid function alongside testosterone without full cardiometabolic assessment. TRT increases aromatisation, raises oestradiol, and elevates SHBG — reducing the free testosterone benefit of treatment. Levothyroxine dosing is most accurate when FT3, FT4, and antibodies are assessed alongside the SHBG and cortisol that affect T3 conversion and thyroid hormone binding.

Is this test suitable for men with Hashimoto’s?

Yes. This profile includes both TPO and Tg antibodies for complete Hashimoto’s screening, alongside the 4-point cortisol rhythm that identifies which phase of the day is driving autoimmune thyroid progression — particularly night cortisol, which worsens Hashimoto’s through sleep-deprivation immune dysregulation and simultaneously suppresses overnight testosterone production.

When will I get my results?

Within 3–5 working days after your samples reach the laboratory.

Are there hidden costs?

No. Laboratory analysis and specialist review are fully included. You are responsible for postage to the lab.

How long is the kit valid?

12 months from purchase.

Why We Partner with ZRT Laboratory

At Hormone Lab UK, every home test kit is analysed by ZRT Laboratory, a globally recognised, CLIA-certified diagnostic and research laboratory specialising in hormone testing, thyroid testing, fertility testing, adrenal function, neurotransmitter analysis, cardiometabolic health, heavy metals, and wellness testing. Founded in 1998 by renowned biochemist and breast cancer researcher Dr. David Zava, PhD, ZRT has become one of the world’s leading laboratories for advanced functional health testing.

With more than 11 million laboratory tests performed and healthcare professionals in over 96 countries relying on its expertise, ZRT is recognised for scientific excellence, analytical accuracy, and continuous innovation. The laboratory pioneered at-home saliva hormone testing, introduced the first commercially available dried blood spot (DBS) hormone tests, and developed Dried Urine Testing (DUTS), helping make advanced laboratory diagnostics more accessible and clinically meaningful.

Every sample is analysed using state-of-the-art LC-MS/MS and ICP-MS technology under rigorous quality control standards. ZRT collaborates with the CDC, NIH, and leading universities, supporting ongoing research and advances in laboratory medicine.