Progesterone Resource Center
Testing of Hormones
Why test saliva?
Because steroid hormones play such a vital role in maintenance of health, knowledge of an imbalance in any one or more hormones can help illuminate the cause of health problems and provide a rational basis for correcting the imbalance through diet, exercise, or hormone supplementation.
Are the levels of steroid hormones in blood and saliva the same? When the various glands manufacture the steroids they are released into the bloodstream bound to carrier proteins. Only a small fraction (1-5%) of a given amount of steroid hormone breaks loose from the carrier protein in the bloodstream and is free to enter target tissues. This free or unbound hormone is what we want to measure, since it is active or bioavailable to the target tissues such as the breast, uterus, brain, and skin.
Many studies in the scientific literature have shown that there is a strong correlation between the levels of steroid hormones in saliva and the bioavailable (free) levels of steroids in the bloodstream. The amount of steroid hormone that enters the salivary ducts and then saliva, is representative of the fraction of steroids in the bloodstream that are bioavailable to other tissues in the body.
Advantages of saliva vs blood testing of steroid hormones Saliva collection is easy, can be done anywhere, any time and at a much lower cost. Serum hormone testing is stressful, and the stress of a blood draw can sometimes alter the result. Blood has to be drawn at a doctor's office or drawing station, and it is more difficult to obtain samples at the desired times (e.g. early am), multiple times through the day or late evening. There is also an extra cost involved in drawing blood, independent of the cost for the test itself.
Hormones in saliva are exceptionally stable, allowing wide latitude in collection and shipment. Samples can be stored at room temperature for at least a week without loss of activity, so samples can be shipped to the testing facility by regular mail. Blood, on the other hand, must be kept cool on ice packs, increasing costs for shipping as well as the likelihood of error due to improper handling.
Finally, as outlined in the following section, saliva hormone testing allows you to take more control over your own health. Saliva testing may help you to gain insight into health problems before you see your doctor. It will also allow you to monitor an OTC hormone supplementation program (eg natural progesterone cream or DHEA are widely available at health food stores) if improvement in quality of life, disease prevention, or anti-aging is your goal.
How Can Saliva Hormone Tests Help You?
There are several ways salivary hormone tests can help you to take responsibility for, and optimize your health.
The first way is to help identify possible causes of health problems. Depending on the specific hormones involved, certain symptoms or groups of symptoms are usually present when hormonal imbalance exists. For example, contrary to popular belief, depression is not caused by a prescription drug deficiency, but it can be caused by an imbalance between estrogens and progesterone, low androgens like DHEA and testosterone, or high cortisol. Genetics, dietary factors or other environmental factors may cause this imbalance, in turn.
Accordingly, depression might also be reversed by supplementation with the appropriate hormone(s) and attention to other factors; hormone testing can be used to guide this therapy. If hormone balance is restored but symptoms persist, then one has to look elsewhere for the cause.
Hormone testing can be used to guide supplementation, to determine if an oral hormone supplement such as DHEA is being absorbed, and if the dosage is appropriate. Bioavailability of oral hormonal supplements can vary widely. The saliva test can also help you evaluate if estrogens are well balanced with progesterone following progesterone cream supplementation. Too much estrogen, relative to progesterone, leads to excessive tissue proliferation, whereas too much progesterone in the absence of adequate estrogen can exacerbate estrogen deficiency problems.
Saliva hormone testing can also be vital for rational disease prevention and anti-aging programs. Testosterone, for example, is an important hormone in both sexes, for the maintenance of cardiovascular and bone health. Identification of a low testosterone level and correction with diet, exercise, and/or hormone supplementation could help prevent the development of cardiovascular disease and osteoporosis.
Anti-aging medicine is still in it's infancy, but hormone supplementation is an important aspect of anti-aging; restoration and maintenance of hormone parameters at youthful levels is one strategy that may extend your healthspan (span of healthy, productive years). Hormone testing is crucial for this approach as it is imperative not to exceed levels that might lead to adverse side effects.
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