Saliva Hormone Testing for Males and Females

Why is saliva better than blood analysis?

There are many reasons why saliva is quickly overtaking blood as the diagnostic tool of choice. First, saliva testing is far more economical. This is due in large part to the viability of saliva, which requires no special storage during shipping. Further, saliva has a shelf life of 4-6 weeks at room temperature, making it cheaper to store before and after shipping. The ease of collecting saliva also makes it a better diagnostic choice than blood. This advantage is amplified in cases where multiple sample collection over a period is required (i.e. female cyclical evaluations, sleep and cortisol diurnal through nocturnal assessments, etc.). Therefore, using saliva makes it far more convenient for patients to provide samples. Finally, saliva is more definitive when evaluating hormone levels because it measures free levels, providing a better picture of what is occurring at the cellular level.

What are you able to detect in saliva?

As the use of saliva as a diagnostic tool grows, more and more techniques emerge that allow for the detection. Currently, numerous techniques exist for evaluating steroid hormone and immunoglobulin levels in saliva. Saliva also is used to measure illicit drug and alcohol levels. Finally, there is some exciting research being conducted that uses saliva as a tool to determine genetic defects, pre-dispositions to cavities, and even for cancer diagnosis.

What steroid hormone levels are you able to detect in saliva?

Free, bio-available or “active” forms of steroid hormones are the levels that are normally present in saliva. In the body, it is the free levels of hormones that passively diffuse into cells, initiating transcription and producing their desired effect. Therefore, the advantage to using saliva to measure hormone levels then is that you are getting a better picture of the situation at the cellular level. Conversely, blood testing usually measures the total hormonal concentration, which is largely the inactivated form, albumin bound.

How does saliva filter out the protein bound steroids and other molecules that exist in the blood?

The mechanism for this is quite simple. The salivary glands that produce saliva are composed of acinar cells that come into contact with capillaries. Small, lipophilic molecules like free steroids are able to cross the acinar cellular membrane and enter saliva via passive diffusion, whereas the larger lipophobic protein bound hormones are too big to diffuse through the cellular membrane and thus remain in the blood stream.

Can I use saliva to monitor hormone replacement therapy?

Yes, the use of saliva testing allows for not only a more accurate picture of hormonal imbalances, but also allows an effective way to monitor the efficacy of hormone replacement therapy. Research has shown that salivary hormones levels dramatically increase after just 4-6 hours of hormone therapy. These spikes are less clear in blood testing.

What about sublingual hormone replacement therapy?

Yes, saliva testing offers the same advantages for sublingual delivery efficacy testing as it does for trans-dermal therapies, showing a marked increase in hormone levels post treatment administration. However, because some hormones tend to accumulate in salivary glands, it is important to wait at least 36 hours after sublingual use before providing a saliva sample.

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