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Saliva Hormone Testing

picture shows Tandem Mass Spectrometer.

It comes as a bit of a surprise to some when they learn that standard serum (blood) testing protocols cannot quantify low concentrations of steroid androgen hormones in a direct way. Having only experienced traditional blood testing themselves, people understandably considering it a Gold Standard, and for many pathologic investigations, it most definitely is.

“The measurement of testosterone (T) in plasma or serum, as done in most laboratories, suffers from a number of serious problems.” – Endocrine Society Position Statement.

But when it comes to hormones things are a little more complex. You see, hormones in general, are inactive. They are bound to proteins, rendering them dormant, and so, inactive. Of all the hormones in our bodies, less than 5% is in fact reported to be circulating freely, and some that 5% can be viewed in ever increasingly minute detail in our saliva. Eventually this “free” component of the hormone will infiltrate the entire body, including our hair (more below).

So let’s look a brief look at the pros and cons of saliva when testing hormones.

Reliable measurements in saliva hormone testing

The Endocrine Society published an official position statement outlining how reliable measurements in serum testing either need an additional extraction step, or need to be completed using chromatographic methods, such as tandem MS or GCMS for testing hormones (sophisticated and very expensive equipment). This casts doubt on the validity of blood testing for the active, bioavailable hormones.

Because blood testosterone is bound, to calculate the active/free component labs must utilize the Vermeulen equation, which provides them with an indirect final free t result.

Saliva on the other hand grants us a clear window-view of our active hormones moving and shaking in real time. This is known as a direct result.

Limitations of Saliva 

Saliva as a specimen type has it’s own limitations. Whilst it would be great to be able to test FSH levels (follicular stimulating hormone) for assessment of the health of the hormone’s required for conception and during pregnancy, we cannot. Nor can we measure the dopamine hormone using saliva. Fortunately for everyone, saliva testing is limited to only those applications for which it has gained scientific approval, and that number is relatively small.

Another issue with providing a saliva sample collection is the quality of the saliva is critical to the outcome of the test. In fact, a poor quality saliva sample won’t make it past the gate at the lab, AKA ‘rejected’. The saliva required must come from the mouth cavity only, and not the throat or chest area. This can be tricky for people who experience persistent airways limitation of some kind. For this reason it’s made clear in the materials TestoChecker™ provide that delaying the test in cases where a person is experiencing cold, flu or other temporary illness is strongly advised. This advice is mirrored in all saliva hormone test kit instruction.

Saliva – More important than we thought

Whilst saliva as a test specimen type for hormonal imbalance testing is no ‘perfect science’, and certainly isn’t the only viable option for testing hormones, it’s non-invasive and can be done anytime, anywhere. Multiple samples can be collected at sequential time points day or night. With the correct protocols applied at both collection and transportation stages, a suitably accredited laboratory with the right equipment (see above) can yield consistently accurate results using saliva.

Hair, urine and saliva viable and increasingly affordable testing methods, their durability and portability make them perfectly suited to contactless at-home hormone testing. 

Thank you for reading.

TestoChecker®, Why guess – just test!

Disclaimer:   TestoChecker® provide saliva hormone test kits in Australia and willingly disclose has vested interest in the popularity of saliva hormone testing.

Sources cited: Wong DT. Salivary diagnostics powered by nanotechnologies, proteomics and genomics. J Am Dent Assoc. 2006 Mar;137(3):313-21. doi: 10.14219/jada.archive.2006.0180. PMID: 16570464.

Revised: 29.09.2023