Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile | Specialist Doctor Report Included

Test ID: SB-646M | Saliva 4-Point Cortisol + Blood Spot LCMS Hormones 7 with SHBG + Full Thyroid & CardioMetabolic Panel

The Male Comprehensive Hormone, Thyroid & CardioMetabolic Profile is the most complete at-home health assessment available for men anywhere in the UK, measuring 24 key hormones and markers across four interconnected systems in a single kit: the full daily cortisol stress rhythm, a complete blood spot LCMS sex hormone panel including SHBG, the full thyroid panel including autoimmune antibodies, and a six-marker cardiometabolic panel. It is the only at-home test to combine a 4-point saliva cortisol assessment with blood spot LCMS sex hormones, SHBG, a full thyroid antibody panel, and fasting insulin — providing the complete androgenic-thyroid-metabolic picture that standard NHS testing cannot.

In men, testosterone, cortisol, thyroid hormones, SHBG, and insulin form a single integrated regulatory network where disruption to any system cascades through all the others simultaneously. The morning cortisol awakening response sets Leydig cell testosterone output, thyroid T3 activation, and insulin sensitivity for the entire day. Chronic cortisol elevation depletes testosterone via pregnenolone steal and direct Leydig cell suppression, elevates SHBG to inactivate the testosterone that remains, impairs thyroid T4-to-T3 conversion, and drives insulin resistance — all in parallel. Hypothyroidism independently suppresses Leydig cell function and compounds every symptom of androgen decline — but is missed by TSH alone when cortisol-driven T3 suppression is the mechanism. And SHBG — elevated by cortisol, thyroid disease, and oestradiol — determines how much testosterone is actually available to drive androgenic function. No standard blood panel tests all four systems together. This one does.

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

The Male Hormonal System: Why All Four Must Be Tested Together

• The 4-point cortisol rhythm is the master regulator of testosterone, thyroid, and metabolic function in men — the cortisol awakening response sets daily Leydig cell testosterone output, thyroid T3 activation, and insulin sensitivity before any other system operates; elevated cortisol at any time point suppresses testosterone via pregnenolone steal and direct Leydig cell inhibition, elevates SHBG to inactivate remaining testosterone, impairs thyroid T4-to-T3 conversion, drives insulin resistance, raises triglycerides, suppresses HDL, and elevates hsCRP; only four-time-point measurement maps the full daily rhythm — a single cortisol value cannot identify morning-normal/evening-elevated patterns, blunted awakening response with midday excess, or night cortisol elevation that suppresses overnight testosterone production and worsens Hashimoto’s autoimmunity
• SHBG is the bioavailability gatekeeper for testosterone in men — SHBG binds and inactivates testosterone regardless of its total production; elevated SHBG — driven by cortisol elevation, thyroid disease, oestradiol excess, age, and caloric restriction — means a man can have normal total testosterone but critically low free testosterone, producing full androgenic deficiency symptoms with a normal blood test result; SHBG measurement is essential for interpreting every testosterone result in men, and its combination with the 4-point cortisol and thyroid panel identifies the specific mechanisms driving SHBG elevation
• Thyroid dysfunction is a major and systematically missed cause of low free testosterone in men — hypothyroidism directly suppresses Leydig cell testosterone production, elevates SHBG (further reducing free testosterone), impairs the protein metabolism and energy generation that testosterone depends on, 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; and TSH alone misses all three patterns — making the full thyroid panel including FT3, FT4, TT4, TPO, and Tg antibodies, assessed alongside SHBG and cortisol, essential for any man with unresolved androgenic symptoms
• Insulin resistance and testosterone decline are mutually reinforcing, SHBG-mediated, and thyroid-compounded in men — elevated insulin drives visceral fat and aromatase-driven testosterone-to-oestradiol conversion; elevated oestradiol elevates SHBG and suppresses the HPG axis; hypothyroidism compounds insulin resistance through thermogenic and hepatic glucose metabolism impairment; fasting insulin is the earliest detectable marker of this process — elevated years before HbA1c becomes abnormal and directly linked to every downstream androgenic and cardiometabolic deterioration in men
• hsCRP is the convergence biomarker of all four systems in men — elevated simultaneously by low free testosterone (worsened by elevated SHBG), cortisol dysregulation at any time point, insulin resistance, visceral fat, oestradiol excess, and Hashimoto’s autoimmunity; a stronger independent predictor of cardiovascular events and all-cause mortality in men than LDL cholesterol; and a direct measure of the integrated inflammatory load that only a four-system assessment with SHBG can fully attribute and target

What This Test Measures — 24 Markers Across Four Systems

Saliva — 4-Point Cortisol Profile (4 markers)

• Morning Cortisol (Cortisol Awakening Response): Sets Leydig cell testosterone output, thyroid T3 activation, SHBG hepatic synthesis rate, and insulin sensitivity for the entire day. An exaggerated morning response drives testosterone suppression, SHBG elevation, and morning insulin resistance; a blunted awakening response signals HPA burnout, impaired thyroid activation, and reduced Leydig cell responsiveness that persists through the day.
• Noon Cortisol: Elevated noon cortisol drives visceral fat deposition, impairs thyroid T4-to-T3 conversion, promotes aromatase-driven testosterone-to-oestradiol conversion, elevates SHBG, raises triglycerides via hepatic lipid dysregulation, and suppresses HDL — the direct mechanism by which chronic midday occupational stress accelerates androgenic decline and cardiometabolic deterioration 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, maintains insulin resistance into the night, and impairs thyroid cellular uptake — producing next-day fatigue, reduced recovery, and worsening androgenic and metabolic function regardless of the morning value.
• Night Cortisol: Suppresses the deep sleep phases during which the majority of daily testosterone is produced and growth hormone mediates fat metabolism. Drives overnight visceral fat accumulation, fasting insulin elevation, hsCRP rise, aromatase excess, and SHBG elevation — and directly worsens Hashimoto’s autoimmune activity through sleep-deprivation-mediated immune dysregulation.

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

• Oestradiol (E2): Present in men via aromatase conversion of testosterone. Essential 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, raises triglycerides, and elevates cardiovascular risk. The oestradiol-to-free-testosterone ratio — calculated using SHBG — is the primary androgenic and cardiometabolic health indicator in men. Measured by blood spot LCMS for the highest available accuracy.
• Oestriol (E3): Reflects oestrogen conversion pathways and aromatase activity in men. Elevated E3 indicates increased oestrogen precursor load or conversion; the E3-to-E2 ratio provides metabolic oestrogen context and aromatase activity assessment beyond what E2 alone reveals.
• Oestrone (E1): Produced by androgen conversion in adipose tissue. Elevated oestrone in men with visceral fat drives systemic oestrogenic load, compounds testosterone and HPG suppression, elevates SHBG, and is associated with increased cardiometabolic and inflammatory risk. A key indicator of adipose-driven hormonal disruption in men.
• 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 cardioprotective effects; supports insulin sensitivity, sleep quality, and thyroid function. Low progesterone in men is associated with elevated DHT, prostate risk, anxiety, and increased cardiometabolic inflammation.
• Testosterone (T): The primary male androgen — responsible for energy, libido, muscle mass, bone density, insulin sensitivity, HDL maintenance, and cardiovascular health. Measured by blood spot LCMS for the highest accuracy across the clinical range. Interpreted alongside SHBG to calculate free testosterone bioavailability — the clinically definitive androgenic assessment that standard blood tests 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 insulin-sensitising effects. The 4-point cortisol rhythm directly 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 cortisol validation and the most clinically complete cortisol assessment available in an at-home test. Confirms the diurnal pattern identified by the saliva rhythm with the precision of blood spot LCMS measurement.
• Sex Hormone Binding Globulin (SHBG): The bioavailability gatekeeper for testosterone in men. Elevated SHBG — driven by cortisol elevation, 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. SHBG is 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 — mechanisms only distinguishable when SHBG is measured alongside cortisol and thyroid markers.

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 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, testosterone synthesis support, energy, and recovery in men. Low FT3 with normal TSH is the hallmark of cortisol-driven thyroid suppression — directly identifiable by correlating the 4-point cortisol rhythm with the FT3 result in a single integrated report.
• Free T4 (FT4): The thyroid’s primary output hormone. Low FT4 with normal TSH indicates early thyroid insufficiency — often preceding symptomatic hypothyroidism, testosterone suppression, and SHBG elevation 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 may be affected simultaneously.
• 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 metabolic deterioration; and directly worsened by insulin resistance and cortisol dysregulation — both measured by this panel across four time points and six cardiometabolic markers.
• 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-mediated immune dysregulation — directly measurable by the 4-point cortisol rhythm in this panel.

Blood Spot — CardioMetabolic Panel (6 markers)

• Fasting Insulin: The earliest detectable marker of insulin resistance in men — elevated years before HbA1c becomes abnormal. Directly promoted by cortisol at any time point, low free testosterone (worsened by elevated SHBG), visceral fat, and hypothyroidism. Elevated fasting insulin drives aromatase activity, increases oestradiol conversion and SHBG elevation, independently raises cardiovascular risk, and is closely linked to erectile dysfunction and androgenic decline. Also directly worsens Hashimoto’s thyroid antibody activity through systemic inflammation.
• HbA1c: Reflects average blood sugar over 8–12 weeks. Men with chronically elevated cortisol, low free testosterone, elevated SHBG, and hypothyroidism have markedly elevated risk of pre-diabetes and type 2 diabetes; HbA1c provides the medium-term blood sugar context that anchors the fasting insulin, cortisol, and thyroid interaction assessment.
• HDL Cholesterol: The protective cardiovascular fraction directly maintained by free testosterone and suppressed by SHBG-mediated testosterone deficiency, insulin resistance, cortisol elevation, and hypothyroidism — four pathways all assessed comprehensively by this panel.
• Triglycerides: Elevated by cortisol at any of the four time points, insulin resistance, oestradiol excess, and hypothyroidism simultaneously. Rise before LDL changes and are a primary cardiometabolic risk marker for men with visceral fat, hormonal decline, elevated SHBG, and thyroid dysfunction.
• Total Cholesterol: Directly elevated by hypothyroidism and low free testosterone. Rising cholesterol in men with fatigue, low libido, and elevated SHBG is frequently a combined hormonal, thyroid, and cortisol event rather than a dietary one — requiring the integrated assessment this panel provides.
• hsCRP (High-Sensitivity C-Reactive Protein): One of the strongest independent predictors of cardiovascular events and all-cause mortality in men. Elevated simultaneously by low free testosterone, SHBG-mediated androgenic deficiency, cortisol dysregulation at any time point, insulin resistance, visceral fat, oestradiol excess, and Hashimoto’s autoimmunity — all pathways directly and comprehensively assessed by this panel. The convergence biomarker of the male hormonal-thyroid-metabolic system.

Who Should Consider This Test?

This is the most appropriate test for men who:

• Have persistent fatigue, low energy, or exhaustion that does not improve with rest
• 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
• Experience sugar cravings, energy crashes, or afternoon slumps
• Have elevated cholesterol, triglycerides, or blood sugar on previous testing
• Struggle with insomnia, night waking, or unrefreshing sleep
• Are under chronic stress, burnout, or sustained high-pressure workload
• Have symptoms of low testosterone with normal or inconclusive standard blood test results
• Have been told their testosterone is “normal” but continue to have androgenic symptoms (high SHBG is frequently the explanation)
• Are currently on TRT and want to monitor SHBG, thyroid, oestradiol, and cardiometabolic markers alongside testosterone
• Have diagnosed or suspected Hashimoto’s thyroiditis or autoimmune thyroid disease
• Are on levothyroxine and want complete thyroid monitoring alongside SHBG and sex hormone levels
• Have had previous thyroid or hormone testing with results that do not match their symptoms
• Have a family history of thyroid disease, heart disease, diabetes, or metabolic syndrome
• Are men over 35 seeking the single most comprehensive at-home androgenic, thyroid, and cardiometabolic health assessment available

Key Features

• 24-marker quad-system panel: 4-point saliva cortisol rhythm, blood spot LCMS sex hormones + SHBG, full thyroid panel, and full cardiometabolic panel — the most comprehensive at-home male health assessment available in the UK
• 4-point cortisol profile — morning, noon, evening, and night — the only measurement method that reveals the full daily cortisol rhythm and its effects on testosterone, SHBG, thyroid, and metabolic function
• Blood spot LCMS sex hormones — gold standard accuracy across the full androgenic range
• SHBG included — essential for calculating free testosterone, interpreting oestradiol-testosterone ratio, 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
• 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 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, thyroid, and cardiometabolic panels, following the detailed instructions. 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 24 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, the full thyroid panel, and all six cardiometabolic markers
• Integrated clinical interpretation of how your cortisol rhythm, testosterone, SHBG, oestradiol, thyroid markers, and cardiometabolic results interact as a single male hormonal-metabolic system
• SHBG-adjusted free testosterone bioavailability assessment — the definitive androgenic status calculation
• Oestradiol-to-free-testosterone ratio analysis in SHBG and cortisol context
• Cortisol-thyroid T3 conversion and Leydig cell interaction assessment — directly mapping each cortisol time point to FT3, SHBG, and functional testosterone suppression
• Hashimoto’s autoimmunity assessment (TPO + Tg antibodies) in cortisol, insulin, and SHBG context
• Insulin resistance pattern assessment (fasting insulin + HbA1c)
• Cardiovascular risk profile in full androgenic, SHBG, and thyroid hormonal 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?

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) + Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP (blood spot) — 24 markers in total.

How does this test differ from the Male Advanced Hormone, Thyroid & CardioMetabolic Test?

The Male Comprehensive Profile (SB-646M) adds three significant capabilities over the SB-649M: the full 4-point cortisol daily rhythm (morning, noon, evening, night) replacing a single cortisol value — essential for identifying which part of the day is suppressing testosterone, elevating SHBG, impairing thyroid T3 conversion, or driving cardiometabolic deterioration; SHBG measurement — the bioavailability gatekeeper that determines how much testosterone is actually free and active; and a blood spot LCMS cortisol comparator for cross-matrix validation. It is the most comprehensive at-home male health assessment available.

Why do I need SHBG tested alongside my testosterone?

SHBG binds and inactivates testosterone in the bloodstream. A man with normal total testosterone but elevated SHBG — driven by cortisol, thyroid disease, oestradiol excess, age, or caloric restriction — has the full symptoms of androgen deficiency 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. Without SHBG, testosterone results cannot be accurately interpreted.

Why is a 4-point cortisol rhythm more informative than a single cortisol measurement?

A single cortisol measurement cannot identify the pattern of cortisol dysregulation — whether the morning awakening response is blunted, whether cortisol peaks at midday or evening, or whether night cortisol is suppressing overnight testosterone production. A blunted morning + elevated evening pattern produces completely different effects on SHBG, thyroid T3, and insulin than an elevated morning + normal-decline pattern — yet both may show a similar single value. The four-point rhythm identifies exactly which phase of the day is driving the androgenic, thyroid, and metabolic components of your symptoms.

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

Yes — and this is the most appropriate test for men on TRT. TRT increases aromatisation, elevates oestradiol, raises SHBG, alters thyroid binding, and affects HDL and triglycerides — all directly assessed here. SHBG measurement alongside the 4-point cortisol rhythm identifies whether TRT dose adjustment, cortisol management, or thyroid optimisation is the most productive next step. Levothyroxine dosing is most accurate when FT3, FT4, and antibodies are assessed alongside SHBG and the cortisol that impairs T3 conversion.

Is this test suitable for men with Hashimoto’s or suspected thyroid disease?

Yes — this is the most comprehensive thyroid and androgenic assessment available in an at-home test for men. TPO and Tg antibodies are assessed alongside the 4-point cortisol rhythm and insulin markers that directly drive Hashimoto’s progression, the SHBG that reflects thyroid-driven testosterone inactivation, and the full cardiometabolic panel that quantifies the metabolic consequences of thyroid dysfunction.

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.