Test ID: SB-646M | 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
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 — Full Thyroid Panel: TSH, Free T3, Free T4, Total T4, TPO Antibodies, Thyroglobulin Antibodies.
Blood Spot — CardioMetabolic Panel: Fasting Insulin, HbA1c, HDL Cholesterol, Triglycerides, Total Cholesterol, hsCRP.
24 markers total — the most comprehensive at-home male health profile available in the UK, covering the full daily cortisol rhythm, androgenic balance including SHBG, autoimmune thyroid function, and cardiometabolic risk in a single kit.
Related Symptoms
Persistent fatigue, unexplained weight gain, low libido, erectile dysfunction, poor exercise recovery, brain fog, low mood, feeling cold, dry skin, hair thinning, sugar cravings, energy crashes, elevated cholesterol or triglycerides on previous testing, insomnia, chronic stress, burnout, symptoms of low testosterone with normal standard blood results, or told testosterone is “normal” but symptoms persist.
Did You Know?
SHBG binds and inactivates testosterone regardless of its total production level. A man with normal total testosterone but elevated SHBG — driven by cortisol, thyroid disease, or estradiol excess — experiences full androgenic deficiency symptoms while his blood test appears normal. The 4-point cortisol rhythm identifies exactly which phase of the day is driving SHBG elevation, thyroid T3 suppression, insulin resistance, and testosterone inactivation — mechanisms that no single-timepoint test can reveal.
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 workload
- Brain fog, poor concentration, or low mood
- Feeling cold, dry skin, hair thinning, or slow metabolism
- Sugar cravings, energy crashes, or afternoon slumps
- Elevated cholesterol, triglycerides, or blood sugar on previous testing
- Insomnia, night waking, or unrefreshing sleep
- Chronic stress or burnout
- Told testosterone is “normal” but symptoms of androgen deficiency persist (elevated SHBG is frequently the explanation)
- Currently on TRT and wanting to monitor SHBG, thyroid, estradiol, and metabolic markers alongside testosterone
- Diagnosed or suspected Hashimoto’s thyroiditis or autoimmune thyroid disease
- On levothyroxine and wanting complete thyroid monitoring alongside SHBG and sex hormone levels
- Family history of thyroid disease, heart disease, diabetes, or metabolic syndrome
- Men over 35 seeking the single most comprehensive at-home androgenic, thyroid, and cardiometabolic health assessment available
Why This Test Is Particularly Important for Men
- The 4-point cortisol rhythm is the master regulator of testosterone, SHBG, thyroid function, and metabolic health — each time point has distinct androgenic and cardiometabolic consequences that a single cortisol measurement cannot identify
- SHBG is the bioavailability gatekeeper for testosterone — essential for calculating free testosterone and identifying why men with “normal” total testosterone have full androgenic deficiency symptoms
- Thyroid dysfunction suppresses Leydig cell testosterone production and elevates SHBG — cortisol-driven T3 suppression produces identical symptoms with a normal TSH; Hashimoto’s is present years before TSH becomes abnormal
- Insulin resistance and testosterone decline are mutually reinforcing, SHBG-mediated, and thyroid-compounded — fasting insulin is the earliest detectable marker, elevated years before HbA1c becomes abnormal
- hsCRP is the convergence biomarker of all four systems — elevated simultaneously by low free testosterone, SHBG-mediated androgenic deficiency, cortisol dysregulation, insulin resistance, and Hashimoto’s autoimmunity
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 24 marker results with male-specific reference ranges
- Visual cortisol rhythm chart showing your full four-point daily curve
- Visual charts for all sex hormones, SHBG, the full thyroid panel, and all six cardiometabolic markers
- Integrated clinical interpretation of how cortisol rhythm, testosterone, SHBG, estradiol, thyroid markers, and cardiometabolic results interact as a single male hormonal-metabolic system by a Hormone Specialist PhD Doctor
- SHBG-adjusted free testosterone bioavailability assessment
- Cortisol-thyroid T3 and Hashimoto’s autoimmunity assessment in cortisol, insulin, and SHBG context
- 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
Why do I need SHBG tested alongside testosterone?
SHBG binds and inactivates testosterone. A man with elevated SHBG — from cortisol, thyroid disease, or estradiol excess — has full androgenic deficiency symptoms despite a normal total testosterone. Without SHBG, testosterone results cannot be accurately interpreted or free testosterone calculated.
Why is a 4-point cortisol rhythm more informative than a single measurement?
A single value cannot identify whether the morning awakening response is blunted, whether cortisol peaks at midday or evening, or whether night cortisol is suppressing overnight testosterone production. The four-point rhythm identifies exactly which phase is driving androgenic, SHBG, thyroid, and metabolic components of your symptoms.
Can I use this test if I am on TRT or levothyroxine?
Yes — this is the most appropriate test for men on TRT. It measures SHBG, estradiol, cortisol rhythm, thyroid markers, and cardiometabolic markers alongside testosterone, providing the complete picture needed for safe and effective TRT monitoring.
Is this suitable for men with Hashimoto’s or suspected thyroid disease?
Yes — TPO and Tg antibodies are assessed alongside the 4-point cortisol rhythm and insulin markers that directly drive Hashimoto’s progression, plus SHBG that reflects thyroid-driven testosterone inactivation.
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.
