From the Doctor’s Desk: Salivary Hormone Testing Backed by Science

Testing hormones through saliva is backed by science. But don’t take my word for it. In fact, it is well supported in the medical literature and is the right thing to do.  Below are links to several abstracts regarding salivary hormone testing. Read them for yourself and learn about the science behind this form of hormone testing.

• Belkien LD, Bordt J, Moller P, Hano R, Nieschlag E. Estradiol in saliva for monitoring follicular stimulation in an in vitro fertilization program. Fertil Steril 1985;44:322.
• Bolaji II, Tallon DF, O’Dwyer E, Fottrell PF. Assessment of bioavailability of oral micronized progesterone using a salivary progesterone enzymeimmunoassay. Gynecol Endocrinol 1993;7:101-110.
• Campbell BC, Ellison PT. Menstrual variation in salivary testosterone among regularly cycling women. Horm Res 1992;37:132-136.
• Aardal-Eriksson E, Karlberg BE, Holm AC. Salivary cortisol- and alternative to serum cortisol determinations in dynamic function tests. Clin Chem Lab Med 1998;36:215-222.

These articles are published in well-respected journals; and if you notice, they are not recent.  Salivary testing of hormones has been well published in the medical literature for some time now.

Here are a few quotes from these studies:

• “…salivary cortisol may be used as an alternative parameter in dynamic endocrine tests.”
• “…assessment of ovarian function…can be performed precisely with the saliva estradiol assay.”
• “…saliva collection has provided the medical and research community with an excellent medium for the monitoring of plasma steroid levels.”

Nowhere else in medicine do we blindly treat people without assessing a baseline and post treatment level(s). Balance is the key; not one individual hormone. Unfortunately, the medical field is very slow to learn and change.

From the Doctor’s Desk: What’s All The Fuss About Saliva Testing?

Confused about saliva testing? Don’t worry, your physician may be just as confused.

I don’t mean to suggest that the science of saliva testing is new. In fact, the clinical use of saliva testing of hormones has been validated over the past 25+ years, and it is well documented in journal publications such as Gynecology Endocrinology, Journal of Clinical Endocrinology, and Menopause. I know, you’re probably not going to run out and subscribe to those now, but these journals are important to doctors. They range from hard-core bench research to more clinical research.

So why use saliva testing for hormones? The short answer is accuracy.

This is going to get technical, so stick with me. See, hormones in the blood stream are mostly bound to carrier proteins (95-99%) for transportation to target tissues. In this transportation form, hormones are inactivated and not available for use. Only when the hormone is released inside the cells of the target tissue does it begin to have an effect. Saliva testing allows us to see your hormone levels inside the cells at the tissue level. That is where these free hormones can cause symptoms like hot flashes, irritability, breast tenderness, and dry skin.

You’re probably wondering, “Then why isn’t every doctor checking my hormones with a saliva test?” Or even worse, you may have been told that saliva testing is dangerous or inaccurate. Unfortunately, physicians are slow to apply new evidence into practice. History has shown this before. The medical community knew vitamin C replacement prevented scurvy on long sea journeys for 193 years before action was taken.

Hopefully, we will not wait that long this go around.

The advantages of saliva testing

From the patient’s perspective, saliva testing is painless and costs less than conventional blood tests. It can also be collected at home.

From the doctor’s perspective, saliva testing is easier because samples remain stable at room temperature up to 3 weeks. Most important though, saliva testing evaluates the active hormone levels in your body.

After you have collected your saliva samples and mailed them off, DiagnosTechs laboratory will e-mail the results to our office in 5-7 business days.

In a follow-up appointment, we will go over the results with you and discuss a treatment plan unique to your individual needs. Most patients begin implementing this plan at the end of the follow-up appointment.

Further testing will be based on symptoms unique to each individual. Sometimes it is necessary to do additional testing of your thyroid, insulin levels, glucose levels, and cortisol levels.

You can learn more about salivary testing at www.salivatest.com.

Did you say saliva testing?

We use saliva testing to measure hormone levels at our Seasons offices. Naturally, the phrase “saliva testing” raises a few questions.

How do we collect your saliva? We don’t. You do it at home with saliva collecting kits. It isn’t a difficult process, but you do need to follow the directions carefully:

1. 30 minutes before collection, please do no eat or drink anything except water.
2. Rinse mouth thouroughly with cold water 3-4 minutes prior to saliva collection.
3. Following the collection schedule below, collect saliva in each of the 4 blue cap tubes to fill three quarters or more, excluding any foam. Take your time. Recap tubes and place into the zip lock bag.

Morning/Fasting 7 – 8 AM
Noon 11 – 1 PM
Afternoon 4 – 5 PM
Midnight 11 – 12 PM

Each saliva collection kit includes some “pour off tubes.” Here’s how they work.

Pour off enough saliva from the noon and/or afternoon tubes to fill 1/4 of the tubes labeled FL and FT3. Cap tubes tightly. Follow the mailing instructions. If you pour more, do not pour saliva back into the blue cap tubes.

Finally, on the day you are collecting saliva, there are a few things you want to avoid.

• Do Not Eat chocolate, onions, garlic, cabbage, cauliflower/broccoli.
• Do Not Drink coffee, tea, or caffeinated drinks (like coke, guarana, etc.)
• Do Not Use sublingual hormones or troches as of the night before collection.
• Avoid antacids, bismuth medications or mouth washes.
• Stop your current hormone therapy 72 hours prior to the saliva collection.