Quick Facts
- Sample: Dried urine (filter cards)
- Fasting: Not required
- Turn-around: 5–7 business days after lab receipt. May take longer based on weather, holiday, or lab delays.
Benefits
- Comprehensive hormone map – evaluates sex-steroid metabolites, adrenal patterns, and sleep hormones in one panel
- Private at-home collection – skip office visits and blood draws with convenient dried-urine strips
- Personalized ranges – results adjusted for your age, sex, and hormone therapy status
- Actionable insights – identifies estrogen metabolism patterns and cortisol/melatonin curves linked to risk and symptoms
- Therapy monitoring – track how your body metabolizes hormone replacement or bioidentical regimens
- Direct access – order online, receive detailed results, share with your own clinician
Who Is This Test For?
- Adults experiencing unexplained fatigue, mood changes, or weight gain despite normal standard labs
- Perimenopausal or menopausal women with hot flashes, sleep disturbance, or cognitive symptoms
- Men with andropause symptoms such as low libido, energy decline, or muscle loss
- Individuals on hormone replacement therapy who want detailed monitoring of metabolism
- People with chronic sleep issues or suspected circadian rhythm disruption
- Those at increased breast or prostate cancer risk seeking preventive hormone insights
- Anyone exploring adrenal dysfunction or chronic stress-related hormone imbalance
How It Works – Just 3 Steps
- Collect at home – saturate filter-paper strips with urine at four to five specified times (morning, mid-day, evening, bedtime), let dry, and place in the prepaid mailer
- Ship to the lab – mail your samples using the included packaging; dried strips are stable at room temperature during transit
- Review results – receive your detailed report online within 5-7 business days; share findings with your healthcare provider for personalized next steps
FAQ
What does this test measure? This panel uses GC-MS to profile estrogen, progesterone, androgen, and glucocorticoid metabolites, plus LC-MS/MS to measure diurnal free cortisol, cortisone, and melatonin metabolites throughout the day.
Do I need to stop my hormone therapy before testing? Usually not—reference ranges are often adjusted for hormone supplementation, so you can test while on therapy; confirm with your clinician before making any changes.
When will I get my results? Most labs return results several business days after receiving your dried-urine samples; you'll receive a detailed report with interpretation guidance and reference ranges.
Can this replace my regular blood work? No—urine metabolite profiles complement but don't replace routine blood tests for thyroid, diabetes, or overt adrenal disorders; abnormal findings should be confirmed by standard diagnostic methods.
How accurate is dried-urine testing? GC-MS and LC-MS/MS are highly specific analytical methods; when samples are collected correctly and processed in a CLIA-certified lab, results are reliable for clinical interpretation.
More Details
What is the purpose of this test?
This comprehensive panel evaluates how your body produces and metabolizes key sex hormones—estrogens, progesterone, androgens—and adrenal/sleep-related hormones like cortisol, cortisone, and melatonin over a full day. By capturing both total hormone production and downstream metabolic pathways, it helps identify patterns linked to symptoms such as fatigue, mood swings, weight gain, sleep disturbance, and perimenopausal or andropausal changes (ZRT Laboratory). The test is especially valuable for understanding estrogen-dominant states, unfavorable estrogen metabolism ratios, adrenal dysregulation, and circadian rhythm disruption—factors associated with increased breast, prostate, cardiometabolic, and stress-related risks.
The following is included in this test kit:
Estrogens & Estrogen Metabolites
- Estradiol (E2)
- Estrone (E1)
- Estriol (E3)
- 2-Hydroxyestradiol (2-OH E2)
- 2-Hydroxyestrone (2-OH E1)
- 4-Hydroxyestradiol (4-OH E2)
- 4-Hydroxyestrone (4-OH E1)
- 16α-Hydroxyestrone (16aOH E1)
- 2-Methoxyestradiol (2-MeO E2)
- 2-Methoxyestrone (2-MeO E1)
- 4-Methoxyestradiol (4-MeO E2)
- 4-Methoxyestrone (4-MeO E1)
Environmental Estrogen (Xenoestrogen)
Progesterone & Neurosteroid Metabolites
- Pregnanediol (Pgdiol)
- Allopregnanolone (AlloP)
- Allopregnanediol (AlloPd)
- 3α-Hydroxyprogesterone (3aHP)
- 20α-Hydroxyprogesterone (20aHP)
Corticosteroids & Precursors
- Deoxycorticosterone (DOC)
- Cortisone (Ccn)
- Cortisol (Crtn ×5)
Androgens & Androgen Metabolites
- Testosterone (T)
- Epitestosterone (Epi-T)
- Dihydrotestosterone (5α-DHT)
- Androstenedione (Adione)
- Androsterone (Andro)
- Etiocholanolone (Etio)
- 5α-Androstane-3α,17β-diol (5a3a)
Progestins / Corticosteroid Metabolites
- Tetrahydrocorticosterone (ThC)
- Tetrahydrocorticosterone normalized (ThCn)
Glucocorticoids (Diurnal Measures)
- Free Cortisol (FC ×4)
- Free Cortisol, normalized (FCn ×4)
Melatonin
- 6-Sulfatoxymelatonin (MT6s ×4)
Who would benefit from this test?
Adults experiencing unexplained fatigue, suspected adrenal dysfunction, perimenopausal or menopausal complaints, andropause symptoms, PMS, or persistent sleep issues often benefit from this detailed hormone profile (ZRT Laboratory). It's particularly useful for individuals on hormone replacement therapy who want to monitor how their bodies metabolize these hormones and ensure favorable metabolism patterns. People with personal or family history of hormone-sensitive cancers, metabolic syndrome features, or chronic stress may use results to guide preventive lifestyle and treatment strategies. Working with a provider experienced in functional hormone management maximizes the clinical value of this panel.
When should I order U-341?
Consider ordering as a baseline before starting hormone replacement therapy, when symptoms suggest hormone imbalance despite normal standard labs, or when conventional testing hasn't explained your concerns (ZRT Laboratory). Follow-up testing is often recommended three to six months after starting or changing hormone, sleep, or stress-management therapies to assess your response and confirm that metabolism patterns look favorable. Periodic monitoring in long-term hormone management helps track trends and optimize treatment rather than reacting to isolated values. Avoid testing during acute illness, and consult your clinician about optimal timing if you're still menstruating.
How do I interpret the results?
Your lab report flags each biomarker as low, within, or above reference ranges adjusted for age, sex, and sometimes hormone therapy status. It typically includes commentary on estrogen metabolism patterns (such as 2-hydroxy versus 16-hydroxy ratios), diurnal cortisol and cortisone curves throughout the day, and nocturnal melatonin metabolite levels (ZRT Laboratory). Values slightly outside reference ranges may or may not be clinically meaningful—interpretation depends on your symptoms, medical history, and other lab work. Always review results with a licensed healthcare provider who can correlate findings with your clinical picture and recommend confirmatory testing or interventions.
Low 2-OH / 16-OH estrogen ratio:
- What it means: Potentially unfavorable estrogen metabolism pattern
- Typical action: Increase cruciferous vegetables; consider DIM or I3C supplementation under provider supervision
Flattened cortisol curve:
- What it means: Blunted diurnal rhythm, possibly due to chronic stress or adrenal dysregulation
- Typical action: Evaluate stress management and sleep hygiene; rule out adrenal insufficiency with standard testing
Elevated evening cortisol:
- What it means: Delayed cortisol decline that may interfere with sleep
- Typical action: Address evening stressors; reduce caffeine and alcohol; consider behavioral interventions
Low nocturnal melatonin metabolite:
- What it means: Reduced melatonin production associated with sleep disturbance
- Typical action: Optimize sleep environment, limit blue light exposure; discuss melatonin supplementation with a provider
High 4-OH estrogen metabolites:
- What it means: Increased activity in a potentially higher oxidative stress estrogen pathway
- Typical action: Evaluate antioxidant status, consider methylation support; review findings with a clinician
Approximately 75% of U.S. women report vasomotor or other menopausal symptoms, and up to 50% experience significant sleep disturbance during menopause transition, making accurate hormone assessment critical for quality of life (North American Menopause Society 2022).
Pre-test preparation
Follow your lab's specific guidance on collection timing—typically a normal workday schedule. Avoid collecting samples during acute illness, as stress hormones can be transiently elevated (ZRT Laboratory). For menstruating women, certain cycle days may be recommended depending on clinical questions. Discuss any medications or supplements with your clinician beforehand; high-dose biotin, exogenous steroids, or melatonin supplements may interfere with interpretation. You don't need to stop hormone therapy unless directed, since ranges are usually adjusted. Moderate caffeine and alcohol intake as you normally would unless instructed otherwise, so results reflect your typical state.
How often should I get tested?
- Baseline before hormone therapy: Once before starting treatment
- Active hormone therapy adjustment: 3–6 months after each major change
- Stable long-term hormone therapy: Annually or as symptoms change
- Monitoring preventive interventions: 6–12 months after lifestyle or supplement changes
- Investigating new symptoms: As clinically indicated, in consultation with provider
- Chronic stress or sleep disorder management: Every 6–12 months to track progress
Why early detection matters
Identifying unfavorable estrogen metabolism patterns, adrenal dysregulation, and circadian disruption before they manifest as serious disease allows for targeted preventive strategies. Research links certain estrogen-metabolite ratios with altered breast cancer risk—one in eight U.S. women will develop invasive breast cancer over their lifetime, supporting the value of metabolite profiling in at-risk groups (American Cancer Society 2023). Subclinical hypercortisolism and chronic HPA-axis dysregulation associate with increased cardiometabolic risk, including higher rates of hypertension, type 2 diabetes, and central obesity (Endocrine Society clinical reviews 2020–2023). Approximately 10–30% of the general population reports chronic insomnia symptoms, with circadian rhythm or melatonin abnormalities implicated in many cases (Sleep Research Society 2021). Early identification enables lifestyle modifications—improved sleep hygiene, stress management, diet, exercise—and supervised hormone or supplement strategies that can reduce symptom burden, healthcare utilization, and long-term disease risk.
Related tests you may consider
Thyroid #3 Extreme Blood Test Panel – Evaluates thyroid function, which strongly influences sex hormones, adrenal hormones, energy, and mood; helps differentiate thyroid-driven symptoms from sex-steroid or adrenal imbalances.
CardioMetabolic Profile, Serum - Doctor's Data Kit – Tracks lipids, insulin resistance, and inflammation; complements hormone testing by assessing cardiometabolic risk influenced by sex hormones and cortisol patterns.
Adrenal Function Saliva Panel - Labrix Test Kit – Measures hormones like cortisol and DHEA directly in saliva, which reflects free, bioactive hormone levels at specific times of day. It captures the circadian pattern of adrenal hormones.
