Your hormones do not operate in isolation. Testosterone affects cortisol. Cortisol affects thyroid. Thyroid affects oestrogen. Testing one hormone without the others is like reading one chapter of a book and assuming you know the story.
Most "hormone tests" check testosterone or oestradiol alone. That tells you one number without any context. Here are the 9 hormones TrueVitals tests and why each one matters.
| Hormone | What It Controls | Why It Matters | Panel |
|---|---|---|---|
| Testosterone | Energy, muscle, libido, mood, bone density | Low T causes fatigue, low mood, poor recovery, weight gain. Needs SHBG context to assess free (available) levels. | All panels |
| SHBG | Binds testosterone and oestrogen, regulating availability | High SHBG = less available testosterone even if total looks normal. Low SHBG can indicate insulin resistance. | All panels |
| Oestradiol | Bone health, cardiovascular protection, brain function, reproductive health | Essential for fertility assessment, menopause staging, and monitoring HRT. Relevant in men too: high oestradiol affects mood and body composition. | Ultimate |
| Progesterone | Cycle regulation, sleep quality, mood stability, pregnancy maintenance | Low progesterone disrupts sleep, worsens anxiety, and causes irregular cycles. Day 21 testing confirms ovulation. | Ultimate |
| LH | Signals gonads to produce sex hormones | Elevated LH with low testosterone suggests primary gonadal failure. Low LH with low testosterone suggests pituitary or hypothalamic cause. Changes the treatment pathway entirely. | Ultimate |
| FSH | Follicle development (women), sperm production (men) | Rising FSH is the earliest marker of ovarian reserve decline and approaching menopause. In men, elevated FSH indicates testicular dysfunction. | Ultimate |
| Prolactin | Lactation, immune modulation, reproductive function | Elevated prolactin causes irregular periods, low libido, and fatigue. Can indicate pituitary adenoma. Most providers do not test it. | Ultimate |
| Cortisol | Stress response, glucose regulation, immune function, inflammation | Chronic elevation suppresses testosterone, disrupts sleep, drives visceral fat accumulation. Low cortisol indicates HPA axis burnout. | All panels |
| DHEA-S | Precursor to testosterone and oestrogen, adrenal reserve marker | Declines with age. Low DHEA-S with high cortisol = chronic adrenal stress. Provides context for cortisol interpretation. | All panels |
TrueVitals also calculates free androgen index (FAI) from your testosterone and SHBG results. The Advanced panel includes testosterone, SHBG, cortisol, and DHEA-S. The Ultimate panel adds oestradiol, progesterone, LH, FSH, and prolactin for the complete endocrine picture.
Hormones exist in a web of feedback loops. Each one influences the others. Testing testosterone without cortisol, SHBG, and thyroid gives you a number without a story. Here are three examples of why context changes everything.
A man presents with fatigue, low libido, and poor recovery. His testosterone comes back at 12 nmol/L, below optimal. Most services would flag this as low testosterone and suggest he sees his GP about TRT. But his cortisol is 680 nmol/L (high) and his DHEA-S is declining. The low testosterone is being driven by chronic cortisol elevation. Treating the stress response (sleep, workload, training volume) brings testosterone back up without medication. Without cortisol and DHEA-S, you would treat the symptom and miss the cause.
A woman has total testosterone of 1.8 nmol/L, which looks normal. But her SHBG is 120 nmol/L (very high, often seen with the oral contraceptive pill). SHBG binds testosterone tightly, leaving very little free and bioavailable. Her free androgen index is critically low. She has symptoms of low testosterone (fatigue, low libido, poor muscle tone) despite a "normal" total. Without SHBG, nobody sees the problem.
Irregular periods, fatigue, weight gain, and low mood. The obvious suspects are oestradiol and progesterone. But subclinical hypothyroidism (normal TSH, low Free T3) disrupts the entire endocrine cascade. It slows oestrogen metabolism, affects SHBG production, disrupts ovulation, and directly causes fatigue and weight gain. Treating the thyroid resolves the "hormonal" symptoms without touching reproductive hormones. Without full thyroid testing, you chase the wrong system.
Test any day. Morning fasted blood draw (before 10am) for the most consistent testosterone and cortisol readings. Both follow diurnal patterns and peak in the early morning. Avoid alcohol for 48 hours and intense exercise for 48 hours before testing.
Day 2 to 5 of your cycle (day 1 = first day of period) gives the best baseline for oestradiol, LH, FSH, and testosterone. Progesterone is best tested on day 21 to confirm ovulation. If you want to test everything in one draw, day 2 to 5 is the standard recommendation. Your report adjusts interpretation based on the cycle day you provide.
Test any day. Your results will be interpreted in the context of irregular cycling. FSH and LH ratios can help identify PCOS (high LH-to-FSH ratio) or premature ovarian insufficiency (elevated FSH).
Test any day. If you are on transdermal oestrogen or testosterone, test the morning before your next application. If on oral HRT, test 12 hours after your last dose. FSH above 30 IU/L with low oestradiol confirms post-menopausal status.
A standalone hormone test checks 3 to 6 markers. A TrueVitals Ultimate panel checks 114, including all 9 hormones plus the systems that influence them. Iron status affects energy and thyroid function. Insulin resistance affects SHBG and testosterone. Vitamin D affects mood and bone density. Inflammation affects cortisol and immune function.
Testing hormones alongside cardiovascular health, metabolic function, liver and kidney function, nutritional status, and inflammatory markers reveals the complete picture. Your AI-powered report cross-references all of them and explains the connections in plain English.
This is why TrueVitals does not sell a standalone "hormone panel." Your hormones are part of a bigger system. Testing them in isolation gives you fragments. Testing them alongside everything else gives you understanding. See how our reports connect the dots.
Critical for sleep, mood, and cycle health. Most providers skip it entirely.
Elevated prolactin causes fatigue, irregular periods, and low libido. Can indicate pituitary issues. Rarely tested privately.
The ratio reveals whether low sex hormones are a gonadal or brain problem. Most tests check neither.
Calculated from testosterone and SHBG. Total testosterone alone is misleading without it.
Adrenal reserve marker. Provides essential context for interpreting cortisol. Declines with age.
Thyroid directly regulates hormonal balance. TSH alone misses conversion problems and autoimmune disease.
A complete hormone panel should include testosterone, SHBG (to calculate free testosterone), oestradiol, progesterone, LH, FSH, prolactin, cortisol, and DHEA-S. Full thyroid (TSH, Free T3, Free T4, antibodies) should be tested alongside as it directly affects hormonal balance. TrueVitals Ultimate includes all of these.
Your GP can test specific hormones if clinically indicated, but a comprehensive panel covering all reproductive, adrenal, and thyroid hormones simultaneously is not available through routine NHS care. A private comprehensive blood test is the most efficient way to assess your complete hormonal status. See our NHS vs private comparison.
Day 2 to 5 for baseline reproductive hormones (oestradiol, LH, FSH, testosterone). Day 21 for progesterone to confirm ovulation. If your periods are irregular or absent, test any day. Men can test any day with a morning fasted draw.
Hormones are influenced by iron status, thyroid function, insulin sensitivity, inflammation, vitamin D, and liver function. A standalone hormone test gives you numbers without context. A comprehensive panel reveals the systems driving those numbers. Your TrueVitals report cross-references over 6,400 interactions to explain the connections.
The Ultimate panel (114 biomarkers, £349) includes all 9 hormones plus full thyroid, insulin, iron studies, and every other system that influences hormonal health. The Advanced panel (74, £269) includes testosterone, SHBG, cortisol, and DHEA-S but not the complete reproductive hormone set. Compare all panels.
9 hormones plus full thyroid and 100+ supporting markers. AI-powered cross-system analysis. Results in 48 hours.
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