For 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:
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.
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:
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!
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.