LH ratios aren’t a robust test, aren’t accepted by any governing body alone as far as I’m aware, and are only a very weak indicator if you’re only testing urine. Testosterone to epitestosterone ratio is still the gold standard, and to fail that test you need a ratio about 3x above normal. The efficacy of these tests are also highly impacted by when the PEDs were last taken, and that’s true for all classes of PEDs, not just the bio identical ones.

There are also faaaaaar more PEDs than the labs test for. The state of PED testing is completely unreliable, and you really have to be an idiot to get caught. But that’s only if your PEDs are actually prohibited, which they often aren’t.