Test ID: SB-643 | Saliva 4-Point Cortisol + Blood Spot LCMS Hormones 7 with SHBG
The Male Hormone Health Test is the most comprehensive at-home hormone profile available for men, measuring 15 key hormones and markers via a combination of saliva 4-point cortisol and blood spot LCMS testing. It is designed to provide a clinically complete picture of androgenic health, adrenal stress load, oestrogen balance, and the binding protein that governs how much of your hormones are actually available to drive energy, performance, libido, and metabolic function.
What distinguishes this test is the inclusion of SHBG (Sex Hormone Binding Globulin) alongside the full sex hormone panel. SHBG determines the proportion of testosterone and oestradiol that is free and active versus bound and unavailable. Two men with identical total testosterone levels can have completely different symptoms depending on their SHBG — one bound and symptomatic despite “normal” results, one free and functional. This test measures both total and free hormone availability, delivering a level of clinical insight that standard NHS blood tests do not provide.
Test from home with confidence — no clinic visit required. Results within 3–5 working days.
Why This Test Is Uniquely Suited to Men
Male hormonal health is governed by the interaction between testosterone, oestradiol, progesterone, DHEAS, cortisol, and SHBG — not by total testosterone alone:
- SHBG determines your free testosterone — the only testosterone that matters — high SHBG (driven by ageing, low insulin, thyroid dysfunction, or alcohol) binds testosterone tightly, leaving insufficient free testosterone despite normal total levels; this is one of the most common causes of low-testosterone symptoms in men with “normal” blood results; low SHBG (driven by insulin resistance, visceral fat, or high androgens) releases excess free testosterone and oestradiol, increasing cardiovascular and prostate risk; without SHBG, total testosterone is clinically incomplete
- Oestradiol is essential in men but easily imbalanced — men need oestradiol for bone density, cardiovascular protection, cognitive function, and libido; but excess oestradiol — from aromatase activity in visceral fat, alcohol, or ageing — suppresses testosterone, causes gynaecomastia, drives water retention, reduces sexual function, and is directly exacerbated by low SHBG; only measuring oestradiol alongside testosterone and SHBG reveals whether the ratio is clinically appropriate
- Progesterone in men is the overlooked androgenic regulator — progesterone inhibits 5-alpha reductase, blocking the conversion of testosterone to DHT; it has direct anti-oestrogenic, neuroprotective, and anti-inflammatory effects; low progesterone in men increases DHT, driving scalp hair loss, prostate enlargement risk, acne, and anxiety; it also supports thyroid function and sleep quality in men
- DHEAS is the adrenal androgen reserve — the primary precursor for testosterone and oestrogen synthesis in peripheral tissues, declining from the mid-30s and depleted under chronic stress; low DHEAS is associated with fatigue, reduced testosterone precursor availability, low libido, poor stress resilience, and accelerated hormonal ageing; elevated DHEAS under stress or overtraining drives androgen excess and cardiovascular risk
- Cortisol suppresses testosterone at every level of the axis — through pregnenolone steal, direct Leydig cell suppression, and HPA axis dysregulation, chronic cortisol excess depletes testosterone, drives visceral fat and aromatase activity, elevates SHBG, and disrupts overnight testosterone production during deep sleep; the 4-point profile identifies the precise pattern and severity
- All three oestrogens reveal oestrogen metabolism, not just oestradiol — measuring oestrone (E1) — the adipose-derived oestrogen — alongside oestradiol (E2) and oestriol (E3) reveals whether excess oestrogen is being generated from visceral fat, how oestrogen is being metabolised, and whether the overall oestrogenic load is contributing to testosterone suppression and cardiovascular risk
What This Test Measures
Saliva — 4-Point Cortisol
- Cortisol (C) — Morning: The Cortisol Awakening Response — the morning surge that activates metabolism, sets testosterone availability, and establishes cognitive and physical readiness for the day. A blunted response signals adrenal burnout and impaired overnight recovery; an exaggerated response indicates high stress reactivity and morning testosterone suppression.
- Cortisol (C) — Noon: Elevated noon cortisol in men promotes insulin resistance, visceral fat accumulation, and aromatase-driven testosterone-to-oestradiol conversion — directly raising SHBG and suppressing free testosterone availability in the most metabolically active part of the day.
- Cortisol (C) — Evening: Should be declining significantly to allow testosterone and growth hormone to begin rising during early sleep cycles. Elevated evening cortisol in men directly suppresses overnight hormonal recovery and elevates SHBG through hepatic cortisol-SHBG coupling.
- Cortisol (C) — Night: Elevated night cortisol suppresses the deep sleep phases during which the majority of daily testosterone is produced. It also promotes visceral fat accumulation and overnight blood sugar dysregulation — both primary drivers of aromatase activity and oestradiol excess in men.
Blood Spot — Full Sex Hormone Panel with SHBG (LCMS)
- Oestradiol (E2): Present in men via aromatase conversion of testosterone. Critical for bone density, cardiovascular health, and cognitive function — but excess oestradiol suppresses testosterone, causes gynaecomastia, increases water retention, and reduces libido. The oestradiol-to-testosterone ratio, interpreted alongside SHBG, is one of the most clinically important values in male hormonal health.
- Oestriol (E3): Reflects oestrogen conversion pathways and metabolic activity in men. Elevated E3 can indicate excessive aromatase activity or oestrogen precursor load; the ratio of E3 to E2 provides additional context for oestrogen metabolism beyond what E2 alone reveals.
- Oestrone (E1): Produced by conversion of androgens (particularly DHEAS) in adipose tissue. Elevated oestrone in men with visceral fat drives systemic oestrogenic load, compounds testosterone suppression, and is associated with increased cardiovascular and metabolic risk. A key marker for men carrying excess abdominal weight.
- Progesterone (Pg): Present in men in small but clinically important amounts. Acts as a natural 5-alpha reductase inhibitor, blocking DHT conversion from testosterone; has direct anti-oestrogenic, neuroprotective, and anti-inflammatory effects; and supports sleep quality and thyroid function. Low progesterone in men is associated with elevated DHT, prostate risk, scalp hair loss, anxiety, and poor sleep recovery.
- Testosterone (T): The primary male androgen — responsible for energy, libido, muscle mass, bone density, cognitive performance, and mood. Blood spot LCMS measures total testosterone; interpreted alongside SHBG, this provides the free testosterone estimate that determines whether symptoms of deficiency are likely. Both low and high-normal total testosterone carry different clinical implications depending on SHBG status.
- DHEAS (DS): The primary adrenal androgen precursor in men, declining steadily from the mid-30s. Low DHEAS reduces testosterone precursor availability, impairs stress resilience, and is associated with fatigue, reduced libido, and accelerated hormonal ageing. Elevated DHEAS — from adrenal overactivity or overtraining — drives androgen excess and raises cardiovascular inflammatory risk.
- Cortisol (C) — Blood Spot: Provides the absolute cortisol value that anchors the 4-point saliva cortisol profile and confirms adrenal output at the time of blood spot collection.
- SHBG (Sex Hormone Binding Globulin): The transport protein that binds testosterone and oestradiol, determining how much free (active) hormone is available to cells and tissues. High SHBG in men — driven by ageing, thyroid dysfunction, low insulin, or alcohol — reduces free testosterone and free oestradiol, producing symptoms of hormone deficiency with apparently normal total hormone levels. Low SHBG — driven by insulin resistance, visceral fat, or elevated insulin — releases excess free testosterone and oestradiol, driving androgen excess, cardiovascular risk, and oestrogen imbalance. SHBG is directly affected by cortisol, thyroid function, insulin, and liver health — making it a critical interpretive marker for the entire male hormone panel.
Who Should Consider This Test?
This test is particularly relevant for men who experience:
- Persistent fatigue or exhaustion that does not improve with rest or sleep
- Low libido or reduced sexual interest
- Erectile dysfunction or reduced sexual performance
- Unexplained weight gain or difficulty losing body fat, particularly around the abdomen
- Poor recovery from exercise, training, or sustained high workload
- Brain fog, poor concentration, or reduced cognitive sharpness
- Low mood, reduced motivation, or mild depression
- Insomnia, night waking, or unrefreshing sleep
- Chronic stress, burnout, or sustained high workload
- Feeling cold all the time or temperature sensitivity
- Dry skin, hair thinning, or slow wound healing
- Acne, oily skin, or scalp hair loss alongside other hormonal symptoms
- Gynaecomastia or breast tissue sensitivity
- Symptoms of low testosterone with normal standard blood results
- Currently on TRT and wanting a comprehensive hormonal picture including SHBG and oestradiol
- Family history of prostate disease, cardiovascular disease, or metabolic syndrome
- Men over 35 wanting a complete androgenic and stress hormone health baseline
Key Features
- 15-marker combined saliva cortisol and blood spot LCMS hormone panel
- SHBG included — the only way to assess free hormone availability and the true androgenic picture
- All three oestrogens (E1, E2, E3) measured for complete oestrogen metabolism and oestrogenic load assessment in men
- 4-point cortisol profile revealing the full daily adrenal rhythm and its impact on testosterone and SHBG
- 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
- Order the kit online — delivered directly to your door.
- Collect your saliva samples at four time points (morning, noon, evening, night) and your blood spot sample via a simple finger-prick, following the detailed instructions provided. Morning saliva should be collected before 9am for optimal cortisol accuracy.
- Post your samples to the lab using the return instructions included in your kit.
- Receive your results within 3–5 working days, with specialist commentary and clear next-step guidance.
What Your Report Includes
- All 15 marker results with male-specific reference ranges
- Visual charts for your 4-point cortisol daily curve and full sex hormone panel including SHBG
- Clinical interpretation of your free versus bound testosterone based on your SHBG result
- Analysis of your oestradiol-to-testosterone ratio and oestrogenic load
- Specialist commentary by a Hormone Specialist PhD Doctor
- Personalised next-step recommendations
Frequently Asked Questions
What does this test measure?
4-point Cortisol (saliva: morning, noon, evening, night) plus Oestradiol (E2), Oestriol (E3), Oestrone (E1), Progesterone, Testosterone, DHEAS, Cortisol, and SHBG (blood spot LCMS) — 15 markers in total.
Why is SHBG important for men?
SHBG determines how much of your testosterone is free and active versus bound and unavailable. Two men with identical total testosterone of 20 nmol/L can have very different free testosterone — one with high SHBG may be functionally testosterone-deficient despite “normal” results; one with low SHBG may have excess free testosterone driving prostate and cardiovascular risk. Without SHBG, a testosterone result alone cannot tell you whether your symptoms are explained by your hormone levels.
Why do men need oestrogen tested?
Men produce oestradiol through aromatase conversion of testosterone — a process that increases with visceral fat, alcohol, and ageing. Oestradiol is essential for bone health, cardiovascular protection, and cognitive function in men, but excess oestradiol suppresses testosterone, causes gynaecomastia, and drives fat accumulation. Measuring all three oestrogens alongside testosterone and SHBG reveals the full oestrogenic load and its impact on androgenic balance.
Can I use this test if I am on TRT?
Yes. This test is particularly valuable for men on TRT who want to understand their oestradiol balance, SHBG status, and cortisol pattern alongside testosterone. TRT increases aromatisation and can significantly alter SHBG — making a comprehensive panel essential for monitoring therapy safely and optimally.
Why measure cortisol at four time points?
A single cortisol measurement cannot distinguish between adrenal burnout (low flat curve), high reactivity (elevated morning peak), evening elevation (suppressed overnight testosterone), or night excess (disrupted deep sleep and testosterone production). The 4-point profile captures the full adrenal daily rhythm and reveals how cortisol is specifically affecting your testosterone, SHBG, and oestrogenic balance.
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.
