Quick Facts
- Sample: Dried blood spot (finger stick)
- Fasting: Morning collection preferred; follow kit instructions
- Turn-around: 5–7 business days after lab receipt. May take longer based on weather, holiday, or lab delays.
Benefits
- All-in-one hormone and thyroid panel — seven sex and adrenal hormones plus thyroid markers in one test
- At-home collection — no lab visit; simple finger-stick blood spot sampling with pre-paid return mailer
- Advanced LC-MS/MS technology — superior accuracy and sensitivity for low-concentration hormones like estradiol
- Fast, confidential results — detailed results delivered online in 3–5 business days
- Monitor therapy easily — ideal for tracking hormone replacement or thyroid medication without stopping treatment
- Integrated endocrine insight — assess sex hormones, adrenal function, and thyroid health together
Who Is This Test For?
- Adults experiencing fatigue, weight changes, mood swings, or low libido
- Individuals with menstrual irregularities, hot flashes, or sleep disturbances
- People monitoring hormone replacement therapy or bioidentical hormone use
- Those on thyroid medication needing regular effectiveness checks
- Health-conscious individuals pursuing preventive metabolic and weight-management evaluations
- Anyone suspecting thyroid dysfunction or sex hormone imbalance
How It Works – Just 3 Steps
- Collect your sample at home — Use the lancet for finger-stick blood spots; follow kit instructions for timing and collection
- Mail it back — Place dried samples and completed paperwork in the pre-paid mailer; ship same day
- Get your results online — Access detailed results within 5–7 business days
FAQ
What hormones does this test measure? Estradiol, estrone, estriol, progesterone, testosterone, DHEA-S, cortisol, SHBG, TSH, free T3, free T4, TPO antibodies, thyroglobulin antibodies, and total T4.
Do I need to stop my medications before testing? No—ZRT reference ranges adjust for age, menstrual status, and supplementation, making this ideal for dose monitoring without stopping therapy.
Is at-home blood spot collection accurate? Yes—when properly collected and analyzed using LC-MS/MS in a CLIA-certified lab, dried blood spots provide clinically reliable measurements.
How should I time my collection? Morning collection is recommended; premenopausal women may need specific cycle-day timing per kit instructions for optimal sex hormone assessment.
Can this test detect thyroid problems? Yes—it measures TSH, free T3, free T4, and thyroid antibodies to screen for hypothyroidism, hyperthyroidism, and autoimmune thyroiditis.
More Details
What is the purpose of this test?
This comprehensive panel evaluates key sex hormones (estrogens, progesterone, testosterone), adrenal function (cortisol, DHEA-S), sex hormone-binding globulin (SHBG), and thyroid markers (TSH, free T3, free T4, thyroid antibodies). It helps identify hormonal imbalances that may contribute to fatigue, weight changes, mood disturbances, menstrual irregularities, and metabolic issues (Cleveland Clinic, 2023; American Thyroid Association, 2014).
The LC-MS/MS methodology improves analytical specificity and sensitivity for low-concentration hormones compared to many immunoassays, ensuring accurate measurement of complex steroid profiles (Rupa Health, LC-MS/MS validation studies). This integrated approach allows you and your provider to assess multiple endocrine systems simultaneously, supporting more efficient diagnosis and treatment monitoring.
Who would benefit from this test?
Adults with symptoms suggestive of thyroid dysfunction or sex hormone imbalance—including chronic fatigue, hair loss, weight gain, hot flashes, low libido, irregular periods, mood changes, or sleep problems—can benefit from this comprehensive evaluation. Those on hormone replacement therapy or thyroid medication needing regular monitoring will find the at-home collection particularly convenient (Endocrine Society, 2018; American Association of Clinical Endocrinology, thyroid guidelines).
Individuals pursuing preventive health or weight-management strategies also benefit, since estrogen, testosterone, cortisol, and thyroid hormones significantly influence metabolism and body composition. This panel is especially valuable when multiple endocrine systems may be involved in your symptoms.
When should I order this test?
Order this panel when experiencing persistent, unexplained symptoms such as chronic fatigue, weight gain, hair loss, mood disturbances, or menstrual changes. It's also appropriate for assessing therapy response in those on hormone or thyroid treatment. Premenopausal women should time collection to specific menstrual cycle phases (often days 19–21 for progesterone assessment) per endocrine best practices and kit instructions.
Consider testing every 6–12 months for stable therapy monitoring, or more frequently when initiating or adjusting hormone or thyroid medications. Your healthcare provider can recommend optimal timing based on your individual clinical situation.
How do I interpret the results?
Results are reported with reference ranges derived from laboratory population data, often adjusted for age, sex, menstrual status, and hormone supplementation. Many reports include "optimal" ranges and physician-generated interpretive comments to help contextualize your values.
Within reference range:
- What it means: Hormone levels appear normal for your demographic
- Typical action: No immediate action; discuss persistent symptoms with your provider
Borderline or slightly abnormal:
- What it means: Possible early imbalance or subclinical dysfunction
- Typical action: Repeat testing in 3–6 months; evaluate symptoms and lifestyle factors
Significantly abnormal:
- What it means: Likely hormonal or thyroid disorder requiring evaluation
- Typical action: Consult healthcare provider; confirmatory testing or treatment may be needed
On therapy:
- What it means: Monitoring adequacy of hormone or thyroid replacement
- Typical action: Provider may adjust dose based on levels and symptom response
Abnormal or borderline values are decision aids, not standalone diagnoses—interpretation must consider your symptoms and medical history per professional endocrine and thyroid guidelines (American Thyroid Association, 2014; Endocrine Society, 2018).
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
Pre-test preparation
Follow kit instructions for timing—most hormone and thyroid tests are best collected in the morning to standardize results. If you take thyroid medication, test before taking your daily dose when possible. Premenopausal women should collect on specific cycle days as directed for accurate sex hormone assessment.
Wash hands thoroughly before collection. Use the provided lancet for finger-stick blood spots on the collection card; allow samples to dry completely per instructions. Complete all paperwork and place materials in the pre-paid mailer. Do not change or stop medications without clinician guidance—this test is designed to assess hormone levels while on therapy.
How often should I get tested?
Stable on hormone or thyroid therapy: Every 6–12 months
Starting or adjusting therapy: Every 6–12 weeks until levels stabilize
Unexplained symptoms: Baseline testing, then repeat in 3–6 months if results are borderline
Preventive health screening: Annually, or as recommended by your provider
Weight management evaluation: Baseline testing, then every 6–12 months to monitor progress
Your healthcare provider may recommend different intervals based on your clinical situation, symptom severity, and treatment response.
Why early detection matters
Approximately 4.6% of Americans have overt hypothyroidism, with up to 9–10% having subclinical disease, underscoring the value of thyroid screening (NHANES data via American Thyroid Association, 2012). Undiagnosed thyroid dysfunction is associated with increased cardiovascular risk and adverse pregnancy outcomes, making early detection clinically and economically beneficial.
About 10–15% of U.S. women have polycystic ovary syndrome (PCOS), a condition tied to androgen excess, SHBG alterations, and metabolic risk (Endocrine Society and NIH, PCOS prevalence 2016–2023). Hormonal and thyroid imbalances are common among individuals with resistant weight gain, prompting recommendations to assess these systems in weight-management evaluations.
Early identification allows timely intervention—whether through lifestyle modification, medication, or hormone therapy—potentially preventing progression to more serious metabolic, cardiovascular, or reproductive complications. The LC-MS/MS methodology used in this panel offers improved specificity over many immunoassays, with validation studies showing correlation coefficients above 0.9 and better performance at low hormone concentrations.
Related tests you may consider
Thyroid #3 Extreme Blood Test Panel — For persistent thyroid symptoms or abnormal TSH, a more detailed panel can help detect autoimmune thyroid disease, such as Hashimoto's or Graves' disease, with additional antibody testing.
Vitamin D, 25-Hydroxy — Vitamin D status influences thyroid function and hormone metabolism; testing helps optimize levels for endocrine health.
Comprehensive Metabolic Panel (CMP) — Kidney and liver function markers provide context for hormone metabolism and help rule out other causes of fatigue and metabolic symptoms.
