Quick Facts
- Sample: Dried urine
- Fasting: Not required; follow collection timing instructions
- Turn-around: 5-7 business days after lab receipt. May take longer based on weather, holiday, or lab delays.
Benefits
- Comprehensive hormone metabolism insight — measure dozens of estrogen, progesterone, androgen, and adrenal metabolites in one test
- Convenient at-home collection — no blood draw required; simple urine collection on filter paper
- Advanced GC-MS technology — highly specific detection of low-concentration steroid metabolites and environmental compounds like BPA
- Personalized risk assessment — evaluate estrogen detoxification pathways linked to breast and prostate cancer risk
- Treatment monitoring made easy — track hormone therapy effects with age- and treatment-adjusted reference ranges
- Direct access testing — order online, collect at home, receive secure results to share with your clinician
Who Is This Test For?
- Women experiencing perimenopausal or menopausal symptoms (hot flashes, irregular cycles, weight gain, insomnia)
- Individuals on or considering bioidentical hormone replacement therapy
- People with personal or family history of breast or prostate cancer
- Those with unexplained fatigue, low libido, or mood changes unresolved by standard hormone tests
- Patients with suspected adrenal dysfunction or chronic stress
- Anyone seeking detailed hormone metabolism analysis for preventive health planning
How It Works – Just 3 Steps
- Order your kit online — receive a prepaid test kit with filter-paper collection strips and detailed instructions
- Collect urine at home — saturate strips at specified times, let dry completely, then mail back in prepaid packaging
- Review your results — access secure electronic results within days and discuss findings with your healthcare provider
FAQ
What hormones does this test measure? It quantifies parent sex hormones (estrogen, progesterone, testosterone) plus numerous metabolites including estrogen detoxification pathways (2-OH, 4-OH, 16-OH), cortisol, cortisone, DHEA, and BPA exposure.
Do I need to stop my hormone therapy before testing? Most patients can continue therapy; ZRT uses treatment-adjusted reference ranges to interpret results while you're on hormones. Confirm with your provider.
How is dried urine different from blood testing? Dried urine captures hormone metabolites and detoxification patterns not measured in standard blood tests, revealing how your body processes and eliminates hormones.
Can this test diagnose cancer or endocrine disease? No. It's a functional assessment showing metabolism patterns that influence risk; diagnosis requires clinical evaluation, imaging, and standard diagnostic testing per NCCN and Endocrine Society guidelines.
How long are dried urine samples stable? Dried samples are highly stable at room temperature during shipping and storage, making them ideal for convenient at-home collection.
More Details
What is the purpose of this test?
The U-324 uses gas chromatography/mass spectrometry (GC-MS) to measure how your body produces and breaks down hormones, especially estrogens and cortisol. It reveals metabolic pathways linked to hormone-driven cancer risk, adrenal dysfunction, and hormone therapy response (ZRT Laboratory). With over 10 million tests completed worldwide, ZRT's CLIA-certified lab provides detailed insight into hormone balance beyond what standard blood tests show (ZRT Laboratory, 2024).
This test kit includes the following:
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)
Glucocorticoid Metabolites
- Tetrahydrocortisol (TC)
- Tetrahydrocortisol, normalized (TCn)
- Tetrahydrocortisone (ThC)
- Tetrahydrocortisone, normalized (ThCn)
Androgens & Androgen Metabolites
- Dehydroepiandrosterone (D)
- Androstenedione (Adione)
- Androsterone (Andro)
- Etiocholanolone (Etio)
Potent Androgens
- Testosterone (T)
- Epitestosterone (Epi-T)
- Dihydrotestosterone (5α-DHT)
- 5α-Androstane-3α,17β-diol (5a3a)
Glucocorticoid
Who would benefit from this test?
This test helps people with symptoms of hormone imbalance—hot flashes, irregular cycles, weight changes, insomnia, low libido—and those on hormone therapy seeking detailed monitoring (ZRT Laboratory). It's particularly valuable for individuals with personal or family history of breast cancer (lifetime risk ~13% for U.S. women, or 1 in 8) or prostate cancer (~299,010 new U.S. cases estimated in 2024), as estrogen metabolism patterns influence risk (American Cancer Society, "Breast Cancer Facts & Figures 2023–2024", 2023; "Cancer Facts & Figures 2024", 2024).
When should I order U-324?
Order this test when standard hormone panels don't fully explain symptoms, when starting or adjusting hormone replacement therapy, or when assessing cancer risk modifiers related to estrogen metabolism and adrenal function (Endocrine Society, 2023). For premenopausal women, timing may be coordinated with menstrual cycle day; for postmenopausal women or men, testing can occur anytime (ZRT Laboratory).
How do I interpret the results?
Results compare your hormone metabolites to age-, sex-, and treatment-adjusted reference ranges. Key patterns include estrogen detoxification pathways (2-hydroxy vs. 4-hydroxy or 16-hydroxy routes) and cortisol-cortisone balance (ZRT Laboratory). Always review with a licensed clinician who integrates symptoms, medications, and guideline-based risk factors (NCCN, "Breast Cancer Risk Reduction Guidelines", 2024; Mayo Clinic, 2023).
High 4-OH or 16-OH estrogens:
- What it means: Potentially genotoxic pathways elevated
- Typical action: Discuss lifestyle changes, supplements, or risk-reduction strategies with provider
High 2-OH estrogens:
- What it means: Favorable protective detoxification pathway
- Typical action: Continue supportive nutrition and lifestyle; monitor periodically
Elevated cortisol metabolites:
- What it means: Possible adrenal hyperactivity or chronic stress
- Typical action: Consider stress management, sleep optimization, and further adrenal workup if indicated
Low cortisol/cortisone:
- What it means: Possible adrenal insufficiency or HPA axis dysregulation
- Typical action: Coordinate with provider for additional testing (ACTH stimulation, imaging) and symptom review
Late-night salivary cortisol and 24-hour urinary cortisol show >90% sensitivity for Cushing syndrome screening in many studies, supporting the clinical utility of cortisol metabolite measurement (Mayo Clinic, 2023).
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
Maintain your typical routine unless your provider specifies holding certain hormones or medications; many patients continue hormone therapy because ZRT uses treatment-adjusted ranges (ZRT Laboratory). For premenopausal women, coordinate collection with menstrual cycle day as directed. Avoid excessive fluid intake or alcohol immediately before collection. Collect urine at specified times (often multiple spots across the day), saturate filter-paper strips completely, and allow to dry at room temperature before sealing in the provided pouch (Endocrine Society, 2023).
How often should I get tested?
- Starting or adjusting hormone therapy: 3–6 months initially, then annually once stable
- Cancer risk monitoring with family history: Annually, or as recommended by your oncology/prevention team
- Adrenal dysfunction management: Every 3–12 months depending on treatment response and symptoms
- General wellness and prevention: Every 1–2 years, or when symptoms change
Why early detection matters
In the U.S., an estimated 297,790 new invasive breast cancer cases and 55,720 ductal carcinoma in situ cases were expected in women in 2023, underscoring the importance of modifiable estrogen-related risk factors (American Cancer Society, "Breast Cancer Facts & Figures 2023–2024", 2023). Understanding your estrogen metabolism patterns allows you and your provider to implement evidence-informed strategies—maintaining healthy weight, limiting alcohol, engaging in regular physical activity, and consuming fiber-rich and cruciferous vegetable diets—that favor safer hormone detoxification and lower breast cancer risk (ACS, 2023; NCCN, 2024). For adrenal health, consistent sleep, stress management, and balanced nutrition support stable cortisol patterns and can prevent progression to metabolic or cardiovascular complications (Mayo Clinic, 2023).
Related tests you may consider
Adrenocortex Stress Profile, Saliva - Genova Test Kit — Evaluates cortisol production patterns throughout the day and DHEA in the morning sample to differentiate adrenal output from downstream hormone metabolism and better characterize stress-related fatigue.
Estradiol (E2) Sensitive Blood Test — Measures circulating estradiol levels to complement urinary estrogen metabolite findings, particularly useful when assessing estrogen balance or therapy response.
Progesterone Blood Test — Assesses serum progesterone levels to provide direct hormone concentration data alongside progesterone metabolite patterns identified by GCMS testing.
