The Dangers Of Blood Testing For Reproductive Hormones

Thrive-JeffBell_Close_Cropped_Headshot_10-29-2013For quite a few years I have been advocating and writing about the use of saliva testing instead of blood testing for measuring reproductive hormone levels.  There are several posts on this site that deal with this all-important area of health.  And I have several articles that are available upon request.

Here are links to several of the more general blog posts on this subject:

Why Saliva Testing?

Healthy Adrenals and Measuring Cortisol Levels

Recently several of my clients have asked for more detail about why saliva testing is so much safer and more accurate than blood testing for reproductive hormone testing and balancing.

First, let me recap a few basic but crucial principles:

Always Test First
It almost goes without saying that messing around with hormone balance without first testing and obtaining accurate results is playing with fire.  It is widely known that “Hormone Replacement Therapy”, also known as “HRT”, has a generally bad reputation.  There are several reasons for this.  I primary one is that most of the physicians who prescribed this form of therapy did so without first testing to see what the base hormone levels were before they started replacing what they thought were the “missing” hormone.  The results were disastrous for a high percentage of their patients.

It may seem shocking but in many cases, practitioners prescribed hormone replacement just based on a patient’s age, or a verbal description of their symptoms.  To be sure, age and symptoms are important to take into consideration, but there is no substitute for accurately measuring the existing hormone levels before implementing any balancing measures.

The error of balancing without first testing often was compounded by prescribing synthetics instead of bioidentical hormones.  Also the amounts they were prescribing were many times higher than they should have been.  (I have seen prescriptions for amounts that were more than 50 times what they should have been!)

Why Saliva Testing?
There are a number of reasons why saliva testing is absolutely the best way to test for reproductive hormone levels.  The most important reason why saliva testing is far more accurate than blood testing for reproductive hormone balance is that most reproductive hormones have a tendency to “bind” to the many organic molecules that are in the blood, which renders them no longer available for the body to use, yet they still show up as being present in blood tests.  This means that in almost all cases the amount of hormone detected by a blood test will actually be significantly greater than the amount of that hormone that is available to control the various functions within the body.  (More on this later.)

In contrast, saliva has almost no organic molecules for the hormones to bind to, so what you see is truly what you get.  Hormone levels detected by a saliva test are almost exactly the levels that are available for use in the body.

Another important reason for preferring saliva testing is that it can easily and accurately be done at home.  In contrast, one must go to a qualified lab to have a blood sample drawn when using blood testing.  Not only is this is inconvenient, but it also adds to the inaccuracies inherent in blood testing for reproductive hormones.  Ideally, for maximum accuracy and relevance, estradiol, progesterone, DHEA, testosterone *, and cortisol levels should be tested 30 minutes after awakening in the morning.  This is nearly, impossible if one has to travel outside the home to a lab to have a sample drawn.

If one is including cortisol tests in the test panel, (a good idea in most cases since cortisol is a “master hormone” that interacts with most other hormones in the body), it should be tested 4 different times throughout the day to get an accurate picture.  The first sample should be taken 30 after awakening in the morning.  The next cortisol sample should be taken immediately before the mid-day meal.  The next sample should be taken just before the evening meal.  The final and 4th sample should be collected at least 1 hour after the evening meal and just before bedtime.

Obviously, unless you live in a lab, following the above timing for collecting the 4 samples, using blood testing would be impossible.  It is easy if using saliva testing.

Ratios Rule
I have been asked why we can’t rely on blood testing and just factor in a percentage of the detected hormones that will be bound to organic molecules and therefore not available.  First of all, there is no reliable way to know what percentage of the reproductive hormones will be bound and what percentage will be free and therefore bioavailable or active.  Secondly, each of the hormones behave differently and tend to bind or remain free in different percentages.  For example, in a given person 30% of the estradiol may be bound and 45% of the progesterone may be bound.  But there is no practical way to really know that.

The challenge is compounded by the fact that for several of the most crucial reproductive hormones the ratios between them are actually far more important than the absolute levels.  This is especially true for the ratio between estradiol and progesterone.  When this ratio is out of range, it can lead to a host of serious health problems, including dysmenorrhea in women, increased risk of reproductive cancers in both men and women, and much more.

Is Reproductive Hormone Testing Important Even If I Am Past Reproductive Age?
You bet it is!  For our entire lives reproductive hormones regulate many of our biological and emotional processes in significant ways.  So this is not just about reproduction, although it is certainly crucial for that aspect of our lives.  Here are just a few aspects of our health that are profoundly affected our reproductive hormone balance states for most if not all of our lives:

  • Cancer risks for both men and women
  • Cardiac health
  • Sexual performance for both men and women
  • Emotional health
  • Bone density and skeletal health
  • Clear thinking and ability to focus
  • Energy levels
  • Athletic performance
  • Skin health
  • Immune system health
  • Resilience to handle stress
  • Weight management
  • Digestive health

As you can see, it pays to maintain a healthy reproductive hormone balance.  And for the reasons explained above, saliva testing is clearly the place to start.

Please check out the other blog posts about saliva testing that I mentioned at the beginning of this blog post.   Here are the links again:

Why Saliva Testing?

Healthy Adrenals and Measuring Cortisol Levels/

If you are testing for the first time, we recommend the 8-test panel, known as Profile III. The health investment for this comprehensive test panel is $327.00, plus $10.00 for shipping anywhere within the continental United States of America. This includes the doctor’signature to authorize the test, and a complimentary evaluation of your results. This is a $550.00 value.

To your health!

Jeff Bell

Note: If you are outside the continental United States, please DO NOT use the Buy Button above. Instead please e-mail me to request a custom quote. Not only are the shipping costs increased for testing outside the United States, but there may be legal restrictions depending on your location.

*  Testosterone is the only one of the primary reproductive hormones that can be accurately tested via blood sampling.  Most labs these days are capable of differentiating between “free testosterone” and “bound testosterone” in the blood.  However, saliva testing eliminates the need for that step, and will still be inherently more accurate.  Further, since the other reproductive hormones need to be tested using saliva sampling, it makes sense to go ahead and include the testosterone in that same test rather than having a separate blood test.

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  1. Jeff Bell
    Posted October 9, 2012 at 9:16 am | Permalink

    Thanks for a great comment. I have a question for you: Does a significant portion of the progesterone that does get into the blood serum wind up bound to the many organic molecules that are normally in the blood serum, and therefore become rendered not bioavailable? Dr. John Lee, M.D., who developed and taught most of the information that the practice of bio-identical natural hormone balance is based on, said that it di. He maintained that this was a primary reason not to rely on blood testing. He taught that this was an issue for the whole set of reproductive hormones, except for testosterone, because testosteronoe has less tendancy to bind to organic molecules and because it is not as difficult when analyizing a blood sample between bound testosterone and free testosterone. However since the other reproductive hormones need to be tested via saliva, anyway, one might as well include the testosterone via the saliva along with the estradiol, progesterone and DHEA that must be tested via saliva.

    I also want to clarify that although your comment addresses using saliva testing to measure hormone absorption of transdermal creams after a balancing program has begun, I feel that the most important testing must be done before any balancing work is attempted. And that must be done via saliva testing. Not testing at all, and just relying on a description of symptoms before prescribing hormones is one of the worst mistakes that conoventional medical practitioners made. This led to some of the more terrible outcomes from the whole practice of hormone replacement therapy (HRT), which damaged the health of many thousands of people. To reiterate, follow-up testing is highly recommended. But the most important testing is checking the existing hormone levels BEFORE you begin trying to balance or correct them. Of course, that must be done using saliva testing in order to produce reliable results.

    Since saliva testing can be expensive and is often not covered by health insurance, many people are not eager to do a lot of follow-up testing. However, if possible, I do highly recommend it. One way to know for sure if follow-up testing is mandatory or just desireable is to maintain a “hormone symptom journal” for a period of time before and after any balancing program is begun. If one is using only bioidentical hormone balancing substances and if they are used only in physiological doses, and if the symptoms are completely gone, it may be safe to forgo follow-up testing for up to a year. This is a decision that I recommend you make with the guidance of your practitioner. Again, if you can afford follow-up testing I do recommend it.

    To your great health!
    Jeff Bell

  2. darla
    Posted February 24, 2013 at 7:00 am | Permalink

    I went thru the BioIdentical Hormone and it was incredible. But because the meds were compounded and given our current government the prices are no longer covered on my health plan i i seriously cant afford 250 a month. Any ideas on doing this a bit cheaper for those of us that wont take HRT but cant afford the full blown BHRT

    • Jeff Bell
      Posted February 24, 2013 at 11:31 am | Permalink

      Hi Darla,

      Without knowing what specific compounded hormones you were using I cannot say for sure that there is a significantly less expensive way to accomplish the same results, but most likely there is. I would need to have the specifics, including your most recent saliva test results. In most cases, people can achieve great results for well under $100 a month. And since the overall health ramifications are so far reaching and profound most people find a way to do that once they feel the results. If you want to contact me directly with some details I will see if I can help you. You can e-mail me at:

      Also, you raise a general issue that is near and dear to my heart: How can we create a better means for people who choose to use natural health solutions to be able to afford them? In many cases the real costs are far less than those for conventional medicine, yet people are often all but forced to choose conventional medicine over natural and holistic solutions because their out-of-pocket costs are beyond their means. For example, the someone facing a serious case of cancer can often burn through a quarter of a million dollars in convnetional medical costs in a year or so, and still have a poor outcome. In contrast, a similar cancer can often be treated, using holistic means for less than $30,000 and achieve a far better outcome. I could bring up lots of other examples. My point is that the total costs for holistic and natural health solutions are often far less expensive than conventional medical approaches, and yet can yield much better outcomes. This is because they more often address the root cause of the problem, enlist the body’s own immune system and built-in “repair mechanisms” to solve the problem, rather than employing the most expensive and complex artificial technology.

      So how about this: Why isn’t there a form of health insurance that covers holistic and natural health? Since the real costs are often so much lower it seems that there ought to be a way to cover this. Anyway, if anyone reads this post and has some ideas about how to promote this idea, please post them or e-mail me. In fact, I will create a separate blog post about this and maybe we can get some dialog going that could help to promote this idea.

      To your great health!

      Jeff Bell

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