Saliva Hormone Testing Kit - Test 2 Or 4
Hormones
Saliva testing is a convenient, inexpensive, and above
all, accurate means of testing steroid hormones.
Scientific studies have shown a strong correlation
between steroid hormone levels in saliva and the amount of
hormone in the blood that is active or "bioavailable."
It is this fraction of total hormone that is free to enter
the target tissues in the brain, uterus, skin, and
breasts.
Saliva testing can be done anywhere anytime. Testing
that relies on blood drawn in the doctor's office makes it
harder to obtain samples at specific times (such as in the
early morning) or multiple times during the day.
In addition, hormones in saliva are exceptionally
stable and can be stored at room temperature for up to a
week without affecting the accuracy of the result. This
offers maximum flexibility in sample collection and
shipment.
Hormones you can choose to test from in saliva include:
- Estradiol (E2)
- Estrone (E1)
- Estriol (E3)
- Progesterone (Pg)
- Testosterone (T)
- DHEA-S (Ds)
- Cortisol (C)
This kit includes 4 prepaid tests, but you can test as
many hormones as you like. Each additional hormone costs
$35; you just have to include a check to ZRT Labs with
your sample for the additional hormone(s). For example,
you can order the Female/Male Saliva Profile I (E2, Pg, T,
DS, & C), which is 5 hormones, and include a check for
$35 with your sample. You could also choose to test E2,
Pg, T, DS, plus a diurnal Cortisol (Female/Male Saliva
Profile II), and include a check for $70 with your sample.
Estrogens (estrone, estradiol and estriol),
progesterone, testosterone, DHEA-S and cortisol are
routinely measured in saliva at ZRT. Why saliva? Steroid
hormones in the bloodstream are mostly (95-99%) bound to
carrier proteins (hormone-binding globulins, albumin), and
in this form they are unavailable to target tissues. Only
the unbound fraction freely diffuses into tissues,
including the salivary gland. Hormone levels in saliva
therefore represent the quantity of the hormone that is
currently available to target tissues and actively
exerting specific effects on the body. Because of this,
salivary hormone levels often relate to specific symptoms
of hormone excesses or deficiencies.
Research at ZRT has demonstrated clear correlations
between salivary hormone levels and reported symptoms. The
rationale for and clinical utility of saliva testing is
well documented. The very small concentrations of salivary
hormones (only 1– 5% of the total hormone levels that
include protein-bound hormone found in serum) necessitate
extremely sensitive assay methods. This is a particular
issue for estrogens and testosterone, which are present in
very minute quantities in saliva, especially in older
populations such as postmenopausal women. ZRT is unique as
the only commercial laboratory using extracted saliva
testing for estrogens and testosterone.
Extraction removes contaminants that interfere with the
assay and concentrates the sample, signifi cantly
improving assay sensitivity compared to the “direct”
assay methods available commercially. In fact, poor
correlations between serum tests and non-extraction
salivary estradiol assays have unfortunately led to some
skepticism about saliva testing. Also, because of the
extremely sensitive assays, it is important to avoid blood
contamination of saliva as a result of oral injury,
therefore toothbrushing must be avoided before collecting
saliva for testing. Saliva testing may also not be
appropriate for sublingual hormone users unless samples
are obtained at least 36 hours after the last dose. Blood
spot testing is a preferred option for these patients.
Conversely, when some hormones, notably progesterone, are
administered topically, saliva levels can rise higher than
serum levels. This is because progesterone is carried on
the surface of red blood cells to target tissues including
the salivary glands, where there is rapid uptake and
release of the hormone into tissues and saliva, leaving
very little hormone in the venous blood returning from the
tissues.
Tissue levels of progesterone have been found to be
very high after topical progesterone use19-21, and a
biological response can be demonstrated, e.g., the
reduction of endometrial cell
Advantages
- Saliva testing, unlike serum tests, measures the
bioavailable (“free”) levels of steroid hormones,
correlating with symptomatology and potential
deficiency
- Samples are collected by the patient at home,
allowing convenient timing of collection especially
for cortisol, which must be measured at specifi c
times of the day or night
- Convenience of collection allows frequent sampling,
e.g., during a menstrual cycle to determine fertility
problems
- Hormone levels can be assessed during topical
hormone supplementation
- Saliva collection avoids the stress of a blood draw,
which can affect levels of cortisol
- Hormones are stable in saliva at room temperature
for up to 2 weeks, allowing for worldwide shipment and
convenient mailing of samples for testing
- Saliva testing is less expensive than conventional
serum testing proliferation caused by estrogen
therapy.
Serum testing for progesterone therefore grossly
underestimates the amount of progesterone that is
being delivered to tissues when progesterone is
applied topically to the skin.
DHEA-S, the sulfated storage form of DHEA, is
measured rather than DHEA because its levels are more
stable (DHEA has a much shorter half life in blood)
and at ZRT it has been found to correlate very well
with reported clinical symptoms. However, as a
conjugated hormone that does not diffuse into saliva
as rapidly as the unconjugated hormones measured in
ZRT’s other hormone assays, its passage into saliva
is flow rate dependent and therefore fl ow stimulants
such as gum chewing are not advised prior to saliva
collection.
Research at ZRT shows good correlations between
salivary hormone levels and dosages of hormones given
exogenously. Saliva testing is therefore a good option
for monitoring hormone therapy and adjusting dosages
if necessary.
Saliva testing can help providers:
- Identify hormone imbalances prior to the
appearance of symptoms or disease
- Identify specific hormone imbalances associated
with symptoms
- Establish hormone baselines prior to surgery or
beginning therapy
- Monitor hormone levels while supplementing,
allowing for individualized hormone dosing
- Track patient symptoms and hormone levels using
ZRT’s comparative history reports provided with
follow-up testing
