Hormone testing

The advantages of saliva hormone testing...

Stress-free
Noninvasive (no needles)
Less expensive/more convenient for health care provider and patient
Optimized for collection any time of day/month, any place
No special processing (eg, centrifugation, ice-packs) prior to shipment
Hormones stable in saliva for prolonged period of time
Convenient shipment by regular US mail
More representative than serum of total bioavailable steroid hormone levels

The disadvantages of saliva hormone testing...

Technically more challenging: need 10-20 x sensitivity
Interfering substances-food, beverages
Saliva easily contaminated with topical hormones on lips or hands
Spurious results with peridontal disease (more problem with chewing gum)
Lack of familiarity (serum is gold standard)
Sublingual use of hormones often leads to inaccurate (high) results
No proficiency testing (CAP, AAB) that reflects saliva hormone levels
Topical application of hormones results in saliva levels higher than serum

The table below is Figure 4 from Dr Zava's article on saliva hormone testing.

Figure 4: Typical Symptoms of Hormonal Imbalance: EX= Excess / DEF = Deficiency

	Estrogen		Progesterone		Androgen		Cortisol
	EX	DEF	EX	DEF	EX	DEF	EX	DEF
Hot flashes		x		x		x
Night sweats		x		x		x
Vaginal dryness		x		x		x
Incontinence		x				x
Foggy thinking		x		x		x	x
Memory lapses		x		x		x	x
Tearful		x		x		x
Depressed		x	x	x		x	x
Heart palpitations		x		x		x	x	x
Bone loss		x		x		x	x
Sleep disturbances	x	x		x			x
Headaches	x	x	x	x
Aches/pains				x		x
Fibromyalgia						x		x
Morning fatigue						x	x	x
Evening fatigue						x	x	x
Allergies						x	x
Sensitivity to chemicals						x	x	x
Stress	x	x		x			x	x
Cold body temperature	x			x			x	x
Sugar craving	x			x			x	x
Elevated triglycerides	x			x		x	x
Weight gain (waist)					x		x
Decreased libido	x		x	x		x	x
Loss of scalp hair				x	x		x
Increased facial/body hair				x	x			x
Acne				x	x
Mood swings (PMS)	x			x
Tender breasts	x		x	x	x
Bleeding changes	x		x	x
Nervous	x			x			x
Irritable	x			x	x		x
Anxious	x			x			x
Water retention	x		x	x			x
Fibrocystic breasts	x			x
Uterine fibroids	x			x
Weight gain (hips)	x			x
Endometriosis	x			x
Candida	x		x	x

References

(1.) Vining, RF, McGinley, RA, The Measurement of Hormones in Saliva: Possibilities and Pitfalls, J Steroid Biochem 27: 8 1-94, 1987.

(2.) ibid.

(3.) Read GF. Status report on measurement of salivary estrogens and androgens. Ann NY Acad Sci, 146-160, 1993.

(4.) Kurz H, Trunk H, Weitz B. Evaluation of method to determine protein-binding of drugs: equilibrium dialysis, ultracentrifugation, gel filtration. Drug Res 27: 1373-80, 1977.

(5.) Vittek J, L'Hommedieu DG, Gordon GD, Rappaport SC, Southren AL. Direct radioimmunoassay (RIA) of salivary testosterone, correlation with free and total serum testosterone. Life Sciences 37: 711-716,1985.

(6.) Read, GF, Walker, RF, Wilson, DW, Griffiths, K, Steroid Analysis in Saliva for the Assessment of Endocrine Function, Ann NY Acad Sci 595: 260-274, 1990.

(7.) Collins, WP. Assays for estrogens and progestogens. In: Estrogens and Progestogens in Clinical Practice, Eds: I.S. Fraser, Ct al. Churchill/Livingstone 1998, pp 321-338.

(8.) Dabbs, JM, Salivary Testosterone Measurements: Reliability Across Hours, Days, and Weeks, Physiol Behav 48: 83-86, 1990.

(9.) Lipson SF, Ellison PT. Development of protocols for the application of salivary steroid analyses to field conditions. Am I Human Biology 1:249-255, 1989.

(10.) Dabbs JM. Salivary testosterone measurements: collecting, storing, and mailing saliva samples. Physiology & Behavior 49: 815-817, 1991.

(11.) Zava, DT. Unpublished results, ZRT Laboratory.

(12.) O'Leary P, Foddema P. Chan K, Taranto M, Smith M, Evans, S. Salivary, but not serum or urinary levels of progesterone are elevated after topical application of progesterone cream to pre- and postmenopausal women.

(13.) Burry KA, Patton PE, Hermsmeyer K. Percutaneous absorption of progesterone in postmenopausal woman treated with transdermal estrogen. 'Am J Obstet Gynecol 180: 1504-11, 1999.

(14.) Devenuto F, Ligon DF, Friedrichsen DH, Wilson ML. Human erythrocyte membrane. Uptake of progesterone and chemical alterations. Biochim Biophys Acta 193:3647, 1969.

(15.) Koefoed P. Brahm I. The permeability of the human red cell membrane to steroid sex hormones. Biochim Biophys Acta 1195: 55-62, 1994.

(16.) Chang K-I, Lee LTY, Linares-Cru.z G, Fournier 5, de Lignieres B. Influences of percutaneous administration of estradiol and progesterone on human breast epithelial cell cycle in vivo. Fertility Sterility 63: 785-791, 1995.

(17.) Miles RA, Paulson RI, Lobo RA, Press MA, Dahmoush L, Sauer MV. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertility and Sterility 62: 485490, 1994.

(18.) Bulletti C, de Ziegler D, Flamigni C, Giacomucci E, Polli V. Bolelli G, Franceschetti F. Targeted drug delivery in gynaecology: the first uterine pass effect. Hum Reprod 12(5): 1073-1079, 1997.

(19.) Fanchin R, de Ziegler D, Bergeron C, Righini C, Torrisi C, Fydman R. Transvaginal administration of progesterone. Obs Gyn 1997;90:396-401.

(20.) Cicinelli E, Petruzzi D, Scorcia P. Resta L. Effects of progesterone administered by nasal spray on the human postmenopausal endometrium. Maturitas 18: 65-72, 1993.

(21.) Lee, JR. Natural Progesterone; The Multiple Roles of a Remarkable Hormone. BLL Publishing, Sebastapol, CA, 1993.