Blood versus Saliva
When the various glands manufacture the steroids they are
released into the bloodstream bound to carrier proteins.
Only a small fraction (1-5%) of a given amount of steroid
hormone breaks loose from the carrier protein in the
bloodstream and is free to enter target tissues. This free
or unbound hormone is what we want to measure, since it is
active or bioavailable to the target tissues such as the
breast, uterus, brain, and skin.

Many studies in the scientific literature have shown that
there is a strong correlation between the levels of steroid
hormones in saliva and the bioavailable (free) levels of
steroids in the bloodstream. The amount of steroid hormone
that enters the salivary ducts and then saliva, is
representative of the fraction of steroids in the
bloodstream that are bioavailable to other tissues in the
body.
Advantages of saliva vs blood testing of steroid
hormones
Saliva collection is easy, can be done anywhere, any
time and at a much lower cost. Serum hormone testing is
stressful, and the stress of a blood draw can sometimes
alter the result. Blood has to be drawn at a doctor's office
or drawing station, and it is more difficult to obtain
samples at the desired times (e.g. early am), multiple times
through the day or late evening. There is also an extra cost
involved in drawing blood, independent of the cost for the
test itself.
Hormones in saliva are exceptionally stable, allowing wide
latitude in collection and shipment. Samples can be stored
at room temperature for at least a week without loss of
activity, so samples can be shipped to the testing facility
by regular mail. Blood, on the other hand, must be kept cool
on ice packs, increasing costs for shipping as well as the
likelihood of error due to improper handling.
Finally, as outlined in the following section, saliva
hormone testing allows you to take more control over your
own health. Saliva testing may help you to gain insight into
health problems before you see your doctor. It will also
allow you to monitor an OTC hormone supplementation program
(eg natural progesterone cream or DHEA are widely available
at health food stores) if improvement in quality of life,
disease prevention, or anti-aging is your goal.
How Can Saliva Hormone Tests Help You?
There are several ways salivary hormone tests can help
you to take responsibility for, and optimize your health.
The first way is to help identify possible causes of health
problems. Depending on the specific hormones involved,
certain symptoms or groups of symptoms are usually present
when hormonal imbalance exists. For example, contrary to
popular belief, depression is not caused by a prescription
drug deficiency, but it can be caused by an imbalance
between estrogens and progesterone, low androgens like DHEA
and testosterone, or high cortisol. Genetics, dietary
factors or other environmental factors may cause this
imbalance, in turn.
Accordingly, depression might also be reversed by
supplementation with the appropriate hormone(s) and
attention to other factors; hormone testing can be used to
guide this therapy. If hormone balance is restored but
symptoms persist, then one has to look elsewhere for the
cause.
Hormone testing can be used to guide supplementation, to
determine if an oral hormone supplement such as DHEA is
being absorbed, and if the dosage is appropriate.
Bioavailability of oral hormonal supplements can vary
widely. The saliva test can also help you evaluate if
estrogens are well balanced with progesterone following
progesterone cream supplementation. Too much estrogen,
relative to progesterone, leads to excessive tissue
proliferation, whereas too much progesterone in the absence
of adequate estrogen can exacerbate estrogen deficiency
problems.
Saliva hormone testing can also be vital for rational
disease prevention and anti-aging programs. Testosterone,
for example, is an important hormone in both sexes, for the
maintenance of cardiovascular and bone health.
Identification of a low testosterone level and correction
with diet, exercise, and/or hormone supplementation could
help prevent the development of cardiovascular disease and
osteoporosis.
Anti-aging medicine is still in it's infancy, but hormone
supplementation is an important aspect of anti-aging;
restoration and maintenance of hormone parameters at
youthful levels is one strategy that may extend your
healthspan (span of healthy, productive years). Hormone
testing is crucial for this approach as it is imperative not
to exceed levels that might lead to adverse side effects.