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Why Use Saliva Testing

Why is saliva used for hormone testing?

Saliva is a biological specimen that is easy to obtain, does not require special treatment after collection and can be transported at room temperature. For these simple reasons, saliva has rapidly gained in popularity for diagnostic investigations by medical practitioners but also for use in the home.

The endocrine organs (for example the adrenal gland) produce and secrete hormones into the blood stream that travel around the body to their site of action (for example the ovaries). In the blood however, the hormones are mostly bound to binding proteins which prevent the hormone from activating its receptor at the target tissue. So when a hormone is attached to its binding protein it is biologically inactive.

Measurements of steroid hormones in blood can give a false representation of the level of biologically active hormone because it does not distinguish between bound and unbound fractions. In saliva, only the free, unbound hormone is present, therefore representing the level of active hormone and giving a truer picture of hormone function.

Another key advantage of saliva testing is its practicality for tracking the secretion pattern of hormones that are released in pulses during the day – these hormones should show distinct daily patterns.

Typical examples of pulsatile hormones are the adrenal hormone cortisol, which rises in the morning and falls at night, and the pineal hormone melatonin, which is high at night but low in the morning. Multiple tubes are provided for convenient sample collection at predefined times of day.

Saliva hormone testing is also recommended for monitoring hormone levels following hormone replacement therapy (HRT) that is administered topically (e.g. in a cream, gel or patch) and can be used to help determine the correct dose of hormone supplementation, in consultation with a medical specialist.

How accurate is hormone saliva testing?

Very! Aside from the practical aspects of saliva hormone testing, the tests are widely accepted in the medical profession to provide an accurate and reliable measure of hormone levels at the time of collection.

Once the saliva specimen arrives at the laboratory, it undergoes rigorous testing that is both sensitive and highly specific to the hormone being tested. The advanced technology can detect very low levels of a given hormone and employs antibody binding methods that lead to only the specific hormone of interest being measured (avoiding false positives). The laboratory applies strict quality control checks ensuring that their test results are high quality and accurate.

The popularity of saliva hormone testing has led to the establishment of well-defined hormone reference ranges in healthy individuals, meaning that hormone results can be compared against the most relevant typical range.  Factors such as sex, age and menopausal status all affect normal hormone ranges, and can be adjusted for, providing an accurate assessment of hormone profile relative to expected norms.

What forms of androgens do you test?

The body produces multiple forms of androgens that serve important physiological roles in both men and women. At TestoChecker two major types of androgens can be tested:

DHEA-S/DHEA test

DHEA-S (dehydroepiandrosterone-sulfate) and DHEA (dehydroepiandrosterone) are androgens that are made in the adrenal glands. The sulfate (-S) group on DHEA helps to stabilise and store DHEA in the blood until it is needed. Measuring DHEA-S in saliva is therefore a reliable measure DHEA production and an indicator of adrenal function in both men and women. DHEA is the precursor of multiple steroid hormones including the sex hormones, estrogen and testosterone. Therefore, DHEA is an important hormone for sexual function, but is also related to bone health, mood, metabolism and maintenance of energy levels.

Testosterone test

Testosterone is made in the testes and the ovaries, from precursors made in the adrenal gland (DHEA). Therefore, poor adrenal function can lead to lowered testosterone production. Testosterone has potent masculinising actions, which is why it is predominantly made in men (but smaller amounts are needed in women). Testosterone influences sex drive, fertility and mood. It also boosts muscle growth and bone strength and contributes to energy and fitness.

What forms of estrogens do you test?

The body produces multiple forms of estrogens that serve important physiological roles in both men and women. Estrogens are made in multiple tissues including the reproductive organs (ovaries and testes), but also liver, fat, adrenal glands and the brain. At TestoChecker three major types of estrogens can be tested:

Estrone (E1) hormone test

Estrone is a weak form of estrogen mainly produced in fat cells and a small amount in the reproductive organs. Estrone is produced in both sexes and can act in its own right or be converted into estradiol (E2). During menopause, when estradiol levels fall sharply, estrone can compensate somewhat for the decline in estradiol.

Estradiol (E2) hormone test

Estradiol is the most potent acting and abundant form of estrogen that is predominantly produced by the ovaries and testes (smaller amounts in men). Estradiol is converted from testosterone and plays an important role in building and maintaining bone mineral density and strength. Estradiol is responsible for fat deposition and has roles in cardiovascular health. In women, estradiol regulates reproductive function including puberty and breast development, and has an essential role in the menstrual cycle, peaking prior to ovulation.

Estriol (E3) hormone test

Estriol is the weakest form of estrogen and has a role during pregnancy. Estriol is mostly made in the placenta and is the most abundant form of estrogen during pregnancy. Estriol may contribute to morning sickness and block the action of other forms of estrogen including estradiol (E2).