Female Advanced Hormone, Thyroid & CardioMetabolic Test | Specialist Doctor Report Included

Test ID: SB-649 | Saliva LCMS Hormones 7 with Cortisol + Blood Spot Full Thyroid & CardioMetabolic Panel

The Female Advanced Hormone, Thyroid & CardioMetabolic Test is a comprehensive at-home health profile for women measuring 19 key hormones and markers across three interconnected systems: a full saliva LCMS sex hormone and cortisol panel, a complete blood spot thyroid panel including autoimmune antibodies, and a six-marker blood spot cardiometabolic panel. Using saliva LCMS (Liquid Chromatography–Mass Spectrometry) — the gold standard for bioavailable hormone measurement — this test reveals how female hormones, cortisol, thyroid function, and metabolic health interact to drive the symptoms that standard NHS blood panels consistently miss in women.

In women, these three systems are not independent — they form a single integrated regulatory network. Cortisol suppresses progesterone and creates oestrogen dominance while simultaneously impairing thyroid T4-to-T3 conversion and driving insulin resistance. Oestrogen decline in perimenopause removes both thyroid-binding protection and insulin-sensitising effects simultaneously. Hashimoto’s thyroiditis produces symptoms identical to oestrogen deficiency, insulin resistance, and adrenal burnout — and is missed by TSH alone. And insulin resistance worsens thyroid autoimmunity and accelerates every cardiometabolic risk factor. 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 Hormones, Thyroid, and Cardiometabolic Health Must Be Assessed Together in Women

• Cortisol is the central disruptor of all three systems simultaneously in women — cortisol elevation suppresses progesterone via pregnenolone steal, creating oestrogen dominance; impairs thyroid T4-to-T3 conversion, producing functional hypothyroidism with normal TSH; drives insulin resistance, visceral fat, triglyceride elevation, and hsCRP; and depletes DHEAS, accelerating hormonal ageing and cardiometabolic deterioration — a four-way attack that only a combined hormonal-thyroid-metabolic assessment can fully characterise
• Thyroid dysfunction in women is systematically under-detected by TSH alone — cortisol-driven T3 suppression, oestrogen-related changes in thyroid hormone binding, and Hashimoto’s autoimmunity (present for years before TSH becomes abnormal) are all missed by standard thyroid testing; thyroid dysfunction in women produces symptoms identical to oestrogen deficiency, insulin resistance, and adrenal burnout — making differentiation impossible without the full panel including FT3, FT4, TT4, TPO, and Tg antibodies tested alongside sex hormones and cortisol
• Oestrogen decline removes both thyroid-binding and metabolic protection simultaneously in women — oestradiol supports thyroid hormone binding, T3 activity at the cellular level, and insulin sensitivity; as E2 declines in perimenopause, thyroid symptoms emerge or worsen even without thyroid disease progression; simultaneously, HDL falls, triglycerides rise, and hsCRP elevates in a directly hormonal cardiovascular risk pattern; testing oestrogen alongside thyroid markers and cardiometabolic indicators reveals which system is driving symptoms
• Insulin resistance worsens thyroid autoimmunity and is hormonally amplified in women — elevated insulin drives systemic inflammation that directly worsens Hashimoto’s TPO and Tg antibody activity; simultaneously, PCOS-driven insulin resistance is present even in lean women; luteal phase progesterone naturally reduces insulin sensitivity; and postmenopause removes oestrogen’s insulin-sensitising effect; fasting insulin is the earliest detectable marker of this process, elevated years before HbA1c becomes abnormal
• hsCRP connects all three systems in women — elevated by cortisol dysregulation, insulin resistance, oestrogen decline, progesterone deficiency, and Hashimoto’s autoimmunity simultaneously; it is a stronger independent predictor of cardiovascular disease in women than LDL cholesterol, and is a direct target for integrated hormonal, thyroid, and metabolic intervention

What This Test Measures — 19 Markers Across Three Systems

Saliva LCMS — Sex Hormones & Cortisol (7 markers)

• Oestradiol (E2): The primary premenopausal oestrogen — protecting cardiovascular health, bone density, insulin sensitivity, thyroid hormone binding, and mood stability. Declining E2 in perimenopause simultaneously triggers hormonal symptoms, thyroid vulnerability, and the cardiovascular risk shift that characterises the menopausal transition. Measured by LCMS for the free, bioavailable fraction.
• Oestriol (E3): Reflects oestrogen conversion and metabolic activity. The E3-to-E2 and E3-to-E1 ratios reveal how oestrogen is being processed — relevant for both cardiovascular and cancer risk assessment in women.
• Oestrone (E1): The dominant postmenopausal oestrogen, produced by adipose conversion of androgens. Elevated E1 in women with higher body fat drives oestrogenic load and metabolic inflammation; declining E1 in lean postmenopausal women reflects total oestrogenic deficit and accelerating thyroid and cardiometabolic vulnerability.
• Progesterone (Pg): The essential counterbalance to oestrogen — anti-inflammatory, cardioprotective, thyroid-supportive, and insulin-sensitising. Low progesterone from anovulation, chronic stress, luteal phase deficiency, or perimenopause drives oestrogen dominance, worsens insulin resistance, elevates hsCRP, and allows cortisol-driven thyroid suppression to go unopposed.
• Testosterone (T): Essential in women for energy, libido, muscle mass, and metabolic rate. Low testosterone reduces lean mass and worsens insulin resistance; elevated testosterone in PCOS drives insulin resistance, visceral fat, and cardiometabolic risk directly. Measured by LCMS for bioavailable fraction accuracy.
• DHEAS (DS): The primary adrenal androgen precursor in women, declining from the mid-30s. Low DHEAS reduces oestrogen and testosterone precursor availability, impairs stress resilience, and has direct anti-inflammatory and insulin-sensitising effects. DHEAS decline is a significant contributor to the thyroid and cardiometabolic deterioration of perimenopause and postmenopause.
• Cortisol (C): The central disruptor of all three systems in women. Elevated cortisol suppresses progesterone, impairs thyroid T4-to-T3 conversion, drives insulin resistance and visceral fat, raises triglycerides, suppresses HDL, and elevates hsCRP — while depleting DHEAS. Measured by saliva LCMS for the free, bioavailable fraction — the physiologically active cortisol that drives these hormonal, thyroid, and metabolic effects.

Blood Spot — Full Thyroid Panel (6 markers)

• TSH: Essential first-line thyroid marker — but in women, TSH alone misses cortisol-driven T3 suppression, oestrogen-related thyroid binding changes, and Hashimoto’s autoimmunity present years before TSH becomes abnormal. Necessary but not sufficient.
• Free T3 (FT3): The active thyroid hormone — the most clinically important marker for women with thyroid symptoms and normal TSH. Low FT3 with normal TSH is the hallmark of cortisol-driven thyroid suppression — directly measurable by combining the cortisol and FT3 results in a single report.
• Free T4 (FT4): The thyroid’s primary output hormone. Low FT4 with normal TSH indicates early thyroid insufficiency — particularly relevant for women on HRT or the contraceptive pill, which increase thyroid-binding globulin and alter T4 availability.
• Total T4 (TT4): Provides full T4 context including the bound fraction — important for women where oestrogen levels affect thyroid hormone binding and the free-to-total T4 ratio.
• TPO Antibodies (Anti-TPO): The primary diagnostic marker for Hashimoto’s thyroiditis in women. Frequently elevated years before TSH becomes abnormal; associated with progressive thyroid decline, fatigue, weight gain, and depression; and directly worsened by insulin resistance and cortisol dysregulation — both measured by this panel.
• Thyroglobulin Antibodies (Anti-Tg): Essential second Hashimoto’s marker. Some women have elevated Tg antibodies with normal TPO — making both necessary for complete autoimmune thyroid assessment.

Blood Spot — CardioMetabolic Panel (6 markers)

• Fasting Insulin: The earliest detectable marker of insulin resistance in women — elevated years before HbA1c becomes abnormal. Directly driven by cortisol excess, low progesterone, oestrogen decline, and PCOS. Elevated fasting insulin promotes visceral fat, raises triglycerides, suppresses HDL, worsens thyroid antibody activity, and drives the PCOS hormonal cycle. The single most actionable early metabolic marker for women with hormonal and thyroid symptoms.
• HbA1c: Reflects average blood sugar over 8–12 weeks. Women’s risk of pre-diabetes and type 2 diabetes rises markedly in perimenopause and postmenopause; HbA1c contextualises the fasting insulin result with medium-term blood sugar trajectory and anchors the thyroid-metabolic interaction assessment.
• HDL Cholesterol: The protective cardiovascular fraction supported by oestradiol and suppressed by hypothyroidism. HDL falls with oestrogen decline, insulin resistance, cortisol elevation, and thyroid dysfunction — four pathways all assessed by this panel simultaneously.
• Triglycerides: Elevated by cortisol, insulin resistance, oestrogen decline, and hypothyroidism simultaneously — all four assessed here. Often rise before LDL changes and are a primary cardiometabolic risk marker particularly relevant for perimenopausal, postmenopausal, PCOS, and hypothyroid women.
• Total Cholesterol: Directly elevated by both oestrogen decline and hypothyroidism. Rising cholesterol in perimenopausal or postmenopausal women is frequently a combined hormonal and thyroid event rather than a dietary one — requiring the integrated assessment this panel provides.
• hsCRP (High-Sensitivity C-Reactive Protein): A stronger independent predictor of cardiovascular disease in women than LDL cholesterol. Elevated by cortisol dysregulation, insulin resistance, oestrogen decline, progesterone deficiency, and Hashimoto’s autoimmunity — all five directly assessed by this panel. The convergence biomarker of the female hormonal-thyroid-metabolic system.

Who Should Consider This Test?

This test is particularly relevant for women who experience:

• Persistent fatigue or exhaustion that does not improve with rest
• Unexplained weight gain or difficulty losing weight despite diet and exercise
• Feeling cold, temperature sensitivity, or slow metabolism
• Hair thinning, dry skin, or brittle nails
• Sugar cravings, energy crashes, or afternoon slumps
• Elevated cholesterol or triglycerides on previous testing
• PMS, heavy, irregular, or absent periods
• Perimenopausal or menopausal symptoms: hot flushes, night sweats, low mood
• Low libido or reduced sexual interest
• Brain fog, poor concentration, or memory issues
• Anxiety, irritability, or emotional volatility
• Insomnia, night waking, or unrefreshing sleep
• Chronic stress or burnout
• Diagnosed or suspected PCOS, Hashimoto’s thyroiditis, or oestrogen dominance
• Currently on HRT, the contraceptive pill, or levothyroxine
• Previous thyroid or hormone testing with inconclusive or incomplete results
• Family history of thyroid disease, diabetes, heart disease, or metabolic syndrome
• Women over 35 wanting a comprehensive hormonal, thyroid, and cardiometabolic health baseline

Key Features

• 19-marker tri-system panel: saliva LCMS sex hormones and cortisol, full blood spot thyroid panel, and full blood spot cardiometabolic panel
• Saliva LCMS — gold standard for bioavailable sex hormone and cortisol measurement in women
• All three oestrogens (E1, E2, E3) for complete oestrogen metabolism and dominance assessment
• Full 6-marker thyroid panel including TPO and Tg autoimmune antibodies for Hashimoto’s screening
• Cortisol measured by LCMS — directly linked to thyroid T3 conversion and all six cardiometabolic markers
• Six cardiometabolic markers — fasting insulin, HbA1c, HDL, triglycerides, total cholesterol, hsCRP
• 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 sample for the full LCMS hormone and cortisol panel, and your blood spot sample via a simple finger-prick for the thyroid and cardiometabolic panels, following the detailed instructions. Guidance on optimal cycle timing and morning collection for cortisol accuracy is included.
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 19 marker results with female-specific reference ranges
• Visual charts for all six sex hormones, cortisol, the full thyroid panel, and all six cardiometabolic markers
• Integrated clinical interpretation of how your sex hormones, cortisol, thyroid markers, and cardiometabolic results interact as a single female hormonal-metabolic system
• Oestrogen-progesterone dominance ratio analysis
• Cortisol-thyroid T3 conversion interaction assessment — directly connecting cortisol to FT3 and functional thyroid status
• Hashimoto’s autoimmunity assessment (TPO + Tg antibodies) in cortisol and insulin context
• Insulin resistance pattern assessment (fasting insulin + HbA1c)
• Cardiovascular risk profile in full female hormonal and thyroid context (HDL, triglycerides, cholesterol, hsCRP)
• Specialist commentary by a Hormone Specialist PhD Doctor
• Personalised next-step recommendations

Frequently Asked Questions

What does this test measure?

Oestradiol (E2), Oestriol (E3), Oestrone (E1), Progesterone, Testosterone, DHEAS, Cortisol (saliva LCMS) + TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies (blood spot) + Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP (blood spot) — 19 markers in total.

How is this different from the Female Comprehensive Hormone, Thyroid & CardioMetabolic Test?

This test (SB-649F) uses a single LCMS cortisol measurement alongside the sex hormone panel, rather than the four-point cortisol daily rhythm profile included in the SB-652F. It provides comprehensive hormonal, thyroid, and cardiometabolic assessment in a single collection — the ideal choice for women who want the complete three-system panel without the multi-timepoint saliva collection protocol. The SB-652F is recommended for women who specifically want to map their full daily cortisol curve.

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

TSH measures the pituitary signal to the thyroid — not the active thyroid hormone reaching cells. Cortisol-driven T3 suppression produces functional hypothyroidism with a normal TSH. Hashimoto’s autoimmunity causes progressive thyroid damage for years before TSH becomes abnormal. Oestrogen-related changes in thyroid hormone binding alter T4 availability without affecting TSH. All three of these patterns — the most common causes of thyroid symptoms in women — are invisible to TSH alone and are directly assessed by this panel.

Can I use this test if I am on HRT, the contraceptive pill, or levothyroxine?

Yes. HRT and the pill significantly affect oestrogen, progesterone, thyroid binding globulin, HDL, and triglycerides. Levothyroxine dosing is most accurate when FT3, FT4, and thyroid antibodies are assessed alongside the sex hormones and cortisol that affect thyroid conversion and binding. This panel provides the complete integrated picture that standard monitoring tests cannot.

Is this test suitable for women with PCOS or Hashimoto’s?

Yes — this test is particularly valuable for both. PCOS is fundamentally a condition of insulin resistance, androgen excess, and oestrogen-progesterone imbalance — all directly assessed here alongside thyroid antibodies, which are elevated at higher rates in women with PCOS. Hashimoto’s is screened by TPO and Tg antibodies alongside the cortisol and insulin markers that drive autoimmune thyroid activity.

When in my cycle should I collect?

Guidance on optimal cycle timing is included in your kit. For most women, collection in the luteal phase (days 19–21 of a 28-day cycle) provides the most clinically meaningful progesterone and oestrogen values. Morning collection is recommended for optimal cortisol accuracy.

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.