Bespoke Panel 10 combines thyroid function, the pituitary hormones FSH and LH, 17-hydroxyprogesterone (17-OHP), and metabolic tests: HbA1c, fasting glucose, insulin and a cholesterol profile. These are often requested together when hormonal and metabolic questions overlap, for example when irregular periods are being investigated by a clinician.
The panel supports a clinical assessment. It cannot diagnose a condition on its own; polycystic ovary syndrome, for example, is diagnosed using symptoms, examination and tests not included here.
What is measured
- Thyroid: TSH, free T4 and free T3
- Reproductive hormones: FSH and LH
- Adrenal steroid: 17-hydroxyprogesterone
- Blood sugar: HbA1c, fasting glucose and insulin
- Cholesterol profile: total, HDL, LDL and non-HDL cholesterol, triglycerides and the total cholesterol to HDL ratio
Useful for
- Clinician-directed investigation where thyroid and adrenal causes of symptoms need excluding
- Glycaemic and lipid checks, which international guidance recommends after a diagnosis of polycystic ovary syndrome
Sample: fasting, early-morning venous blood. Biomarkers: ten tests; the cholesterol profile reports several values. Price includes: laboratory analysis and the laboratory's results report with reference ranges. Interpretation is optional and priced separately.
Bespoke Panel 10
- TSH (measured): first-line thyroid marker.
- Free T4 and free T3 (measured): circulating thyroid hormones.
- FSH and LH (measured): pituitary control of the ovaries or testes; read by cycle stage.
- 17-hydroxyprogesterone (measured): cortisol precursor; raised in congenital adrenal hyperplasia.
- HbA1c (measured): average glucose over about two to three months.
- Fasting glucose (measured) and insulin (measured): read together.
- Total cholesterol, HDL cholesterol and triglycerides (measured).
- LDL cholesterol (usually calculated), non-HDL cholesterol and total cholesterol to HDL ratio (calculated).
An insulin resistance index (HOMA-IR) is not listed in this panel.
Thyroid
Pituitary TSH drives the thyroid to make T4, which tissues convert to the more active T3. TSH rises when thyroid hormones fall and falls when they rise, making it a sensitive first marker. An underactive thyroid can disturb periods and raise cholesterol.
FSH and LH
These pituitary hormones control follicle development and ovulation, and sperm and testosterone production in men. They vary across the cycle, rise after the menopause and are suppressed by hormonal contraception.
17-hydroxyprogesterone
17-OHP is a step in adrenal cortisol production. In congenital adrenal hyperplasia due to 21-hydroxylase deficiency, an enzyme block makes it accumulate and diverts production towards androgens. The milder non-classic form can appear in adolescence or adulthood with excess hair growth, acne and irregular periods that resemble polycystic ovary syndrome. Endocrine Society guidance recommends an early-morning 17-OHP as the screening test in people with symptoms.
Glucose, insulin and HbA1c
Fasting glucose shows the level at one moment, insulin shows how much hormone is holding it there, and HbA1c reflects the previous two to three months. Insulin resistance is common in polycystic ovary syndrome and raises the risk of type 2 diabetes.
The international PCOS guideline
The 2023 international guideline diagnoses polycystic ovary syndrome in adults when two of three features are present (androgen excess, ovulatory dysfunction, and polycystic ovaries on ultrasound or raised AMH) after excluding other causes, including thyroid disease, raised prolactin and non-classic congenital adrenal hyperplasia. It recommends checking glycaemic status and lipids at diagnosis. In 2026 the guideline network renamed the condition polyendocrine metabolic ovarian syndrome (PMOS), with recommendations unchanged.
This panel covers the thyroid, 17-OHP, glycaemic and lipid elements. It does not include testosterone, SHBG, prolactin or AMH.
Ranges vary between laboratories, and for FSH, LH and 17-OHP depend on sex, cycle stage and age. One result outside a range is a reason for review, not a diagnosis.
Thyroid
High TSH with low free T4 suggests an underactive thyroid; low TSH with high free hormones suggests an overactive one. A mildly abnormal TSH with normal free hormones is often temporary and is usually rechecked, in line with NICE guidance (NG145). Illness, pregnancy and some medicines affect results.
FSH and LH
These are reported separately against cycle-phase ranges; an LH to FSH ratio is not part of the international diagnostic criteria. Results during hormonal contraception are difficult to interpret.
17-hydroxyprogesterone
A normal early-morning value makes non-classic congenital adrenal hyperplasia unlikely. A raised value does not confirm it, as 17-OHP rises after ovulation and in pregnancy and varies by laboratory method. Borderline results need a specialist stimulation test, so discuss any raised result with your GP.
HbA1c and glucose
WHO recommends HbA1c 48 mmol/mol (6.5%) as the cut-off for diagnosing diabetes; in UK practice a result in this range without symptoms is usually confirmed by repeat testing. NICE PH38 uses 42–47 mmol/mol, or fasting glucose 5.5–6.9 mmol/L, to identify high risk, and fasting glucose of 7.0 mmol/L or above is in the diabetic range. HbA1c can mislead with anaemia, haemoglobin variants, kidney disease and pregnancy. The PCOS guideline notes an oral glucose tolerance test is the most accurate assessment.
Insulin and cholesterol
Fasting insulin has no agreed reference range and varies between assays; the international PCOS guideline advises that current insulin assays should not be used in routine care. Lipids are read within overall cardiovascular risk; NICE NG238 recommends specialist assessment for total cholesterol above 9.0 mmol/L or non-HDL above 7.5 mmol/L.
If a result needs medical attention, we will advise you to see your GP and, with your consent, Juvenology can write to them. Do not change any medicine, including contraception or thyroid treatment, on the basis of these results.
Irregular periods, unwanted hair growth, acne and weight change have many causes. Clinicians assessing them usually want to exclude thyroid disease and non-classic congenital adrenal hyperplasia and to understand metabolic health, which is where this combination is used.
- Alongside a GP assessment: share your results so your GP can add the tests not included.
- After a PCOS diagnosis: guidance recommends glycaemic checks at diagnosis and periodically afterwards.
Thyroid, glucose, HbA1c and cholesterol results are relevant to any adult. FSH, LH and 17-OHP are read differently in men and depend on cycle stage and contraception in women.
May be useful if
- a clinician has suggested these specific tests
- you have irregular periods or signs of androgen excess and want results to bring to a GP assessment
- you have polycystic ovary syndrome and want glycaemic and lipid checks
May not be the right choice if
- you are or may be pregnant: several results change in pregnancy
- you want one test to confirm or rule out polycystic ovary syndrome
- you have marked thirst, passing a lot of urine or weight loss: see your GP promptly, and seek urgent care if vomiting or drowsy
- you are under specialist care for a thyroid, adrenal or diabetes condition
Established: thyroid tests, HbA1c, fasting glucose and lipids are standard tools for thyroid disease, diabetes risk and cardiovascular risk, all of which become more common with age.
Associations: polycystic ovary syndrome is associated with higher long-term risk of type 2 diabetes, which is why guidance recommends ongoing metabolic checks. This is a population-level association, not a prediction for an individual.
Limits: fasting insulin indices are research tools of limited individual value, and none of these tests measures biological age.
- Fasting: at least 8 hours, water only, unless the laboratory advises otherwise.
- Timing: book the earliest appointment, as guidance recommends an early-morning 17-OHP.
- Cycle: if you have periods, test on days 2 to 5 (day 1 is the first day of bleeding), as 17-OHP rises after ovulation. If periods are absent or irregular, tell us and we will advise.
- Hormones and steroids: tell us about contraception, HRT or steroid medicines, which affect FSH, LH and 17-OHP. Do not stop them without your prescriber's advice.
- Thyroid medicines: follow your prescriber's advice about taking them on test day.
- Biotin: high-dose biotin can interfere with hormone immunoassays. Tell us if you take it.
- Illness: consider rebooking if unwell, as acute illness affects thyroid results and glucose.
Choose how your sample is taken when you book. We confirm the collection option, any collection fee and the expected turnaround time before you book.
- Juvenology Clinic, Maidstone (82 King Street, Maidstone ME14 1BH): Available.
- Partner collection location, including London: Available on request. We confirm availability for your postcode before you book.
- Postal home finger-prick kit: Not available for this test.
Sample: Venous blood sample (serum for hormones and lipids; whole blood for HbA1c; glucose tube type as confirmed by the laboratory)
Collection notes: Fast for at least 8 hours (water only). Early-morning appointment, as 17-OHP is highest in the morning. If periods are present, test on cycle days 2 to 5. Not offered as a postal kit: insulin degrades with haemolysis or delayed separation and glucose falls in unseparated samples.
The price of this test covers laboratory analysis and the laboratory's results report. The report lists each result beside the laboratory's reference range.
Beyond the blood test: optional support, priced separately
- Personalised written interpretation report: £50
- General consultation: £50
- Results consultation (results discussion and follow-up advice): £100
- Personalised programme: from £150, after we assess whether a programme suits you
Consultations are with Marina, an NMC-registered nurse with an Executive MSc in Longevity from the Geneva College of Longevity Science. She explains what your results show and how they relate to lifestyle. No prescription service is offered with these tests.
If a result suggests you need medical follow-up, we will recommend that you see your GP and, with your consent, can provide a letter to take with you. A blood test cannot rule out every condition. If you have symptoms, speak to your GP or NHS 111, and call 999 in an emergency.
Can this panel diagnose polycystic ovary syndrome?
No. Diagnosis needs clinical assessment and usually testosterone, SHBG, prolactin and sometimes ultrasound or AMH. This panel provides the exclusion and metabolic elements.
Why is 17-OHP included?
Non-classic congenital adrenal hyperplasia can mimic polycystic ovary syndrome, and guidance names it as a condition to exclude. An early-morning 17-OHP is the recommended screening test.
I take the contraceptive pill. Can I still test?
Yes, but the pill suppresses FSH and LH, limiting what they show. The thyroid, glucose, HbA1c and cholesterol results remain informative.
Does the insulin result show insulin resistance?
Not on its own. Assays differ and there is no agreed cut-off, so it adds context alongside glucose and HbA1c.
Is interpretation included in the price?
The price covers analysis and the laboratory's report. You can add an optional personalised written interpretation report (£50) or a results consultation (£100).
Is a home finger-prick kit available?
No. Insulin degrades in haemolysed or delayed samples and glucose falls in unprocessed blood, so a fasting venous sample processed promptly is needed.
- Teede HJ, et al., on behalf of the International PCOS Network. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology & Metabolism, 2023;108(10):2447–2469. https://doi.org/10.1210/clinem/dgad463
- International Evidence-based Guideline for the assessment and management of polyendocrine metabolic ovarian syndrome (formerly polycystic ovary syndrome) 2023, renamed 2026. Monash Centre for Health Research and Implementation, Monash University. https://www.monash.edu/medicine/mchri/pcos/guideline
- Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism, 2018;103(11):4043–4088. https://academic.oup.com/jcem/article/103/11/4043/5121049
- Thyroid disease: assessment and management (NG145). National Institute for Health and Care Excellence, 2019. https://www.nice.org.uk/guidance/ng145
- Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus: Abbreviated Report of a WHO Consultation. World Health Organization, 2011. https://www.ncbi.nlm.nih.gov/books/NBK304267/
- Type 2 diabetes: prevention in people at high risk (PH38). National Institute for Health and Care Excellence, 2012, updated 2017. https://www.nice.org.uk/guidance/ph38
- Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238). National Institute for Health and Care Excellence, 2023. https://www.nice.org.uk/guidance/ng238
- Insulin. Lab Tests Online UK (Association for Laboratory Medicine), accessed 2026. https://labtestsonline.org.uk/tests/insulin
