Hormones

Why 24-Hour Urine Hormone Testing?

No single specimen type answers every hormone-related question. Serum, saliva, and urine each provide different information. The value of 24-hour urine hormone testing is its ability to combine measurement of hormone production with extensive assessment of hormone metabolism while integrating hormone excretion across an entire day.

See More Than the Parent Hormone

Using highly sensitive mass spectrometry methods, 24-hour urine testing can measure parent hormones together with many of their downstream metabolites.

These metabolites provide information that cannot be obtained by simply measuring estradiol, testosterone, progesterone, or cortisol alone. They can reveal how hormones are being metabolized through pathways involving estrogen hydroxylation and methylation, androgen metabolism, and cortisol/cortisone metabolism.

Understanding these pathways can provide important additional context when evaluating hormone physiology and monitoring hormone replacement therapy.

Capture an Entire Day

Hormone production is dynamic. Concentrations can change with circadian rhythms, sleep and waking, activity, stress, meals, and episodic or pulsatile secretion.

A blood draw or single-catch urine specimen represents one moment in time. A properly collected 24-hour urine specimen integrates hormone and metabolite excretion across the entire collection period, reducing the influence of short-term fluctuations and providing a broader perspective on daily hormone production and metabolism.

Measure Hormones That Are Difficult to Assess in Blood

Many steroid hormone metabolites circulate at very low concentrations but are concentrated through urinary excretion. Urine therefore provides an excellent matrix for measuring a broad spectrum of steroid metabolites and examining relationships among parent hormones and their metabolic products.

This expanded view is particularly valuable when the question is not simply “How much hormone is present?” but also “What is happening to that hormone after it is produced or administered?”

The Right Specimen for the Right Question

24-Hour Urine
Best suited for comprehensive assessment of steroid hormone production and metabolism, including estrogens, androgens, progestins, corticosteroids, and their metabolites. It provides an integrated full-day measurement and is collected non-invasively at home.

Serum
Remains the preferred or established specimen for many endocrine measurements, including LH, FSH, IGF-1, insulin, thyroid markers, and other peptide and protein hormones. Serum is also appropriate when a circulating hormone concentration at a defined point in time is the information needed.

Saliva
Measures selected free hormones and can be useful when multiple timed collections are desired, particularly for examining the daily pattern of cortisol. Its narrower analyte range and dependence on collection conditions make it less suited to comprehensive steroid metabolite assessment.

Understanding Hormone Testing Specimens

A More Complete View of Steroid Hormone Physiology

For steroid hormone assessment, concentration is only part of the story. Production, metabolism, clearance, and the relationships among hormones and their metabolites can all contribute meaningful information.

24-hour urine testing brings those pieces together, providing practitioners with a broader view of the hormone landscape and better information for informed patient management.

Urine Hormone Profiles 2026

MVL Steroid Pathways 2025

Meridian Valley Lab was the first commercial laboratory to develop urine hormone testing for clinical practice. With a 40+ year track-record of providing reliable, clinically useful results, we are your best choice for hormone testing that will give you the information you need to improve your patients’ hormonal health while reducing potential hormone-related risks. Our association with Dr. Jonathan Wright and contracted Physicians allows us to observe the relationship between lab results and clinical outcomes. Our Consulting Physicians are unmatched in providing consultations that are both educational and immediately actionable.