Over the past several decades, research has shown that saliva can be used to measure the free or “unbound” biologically active fraction of steroid hormones as they appear in the bloodstream.

Saliva testing is a convenient, inexpensive, and above all, accurate means of testing steroid hormones. Scientific studies have shown a strong correlation between steroid hormone levels in saliva and the amount of hormone in the blood that is active or "bio-available." It is this fraction of total hormone that is free to enter the target tissues in the brain, uterus, skin, and breasts.

Saliva testing can be done anywhere anytime. Testing that relies on blood drawn in the doctor's office makes it harder to obtain samples at specific times (such as in the early morning) or multiple times during the day. In addition, hormones in saliva are exceptionally stable and can be stored at room temperature for up to a week without affecting the accuracy of the result. This offers maximum flexibility in sample collection and shipment.

Saliva tests are available to measure levels of Estradiol, Progesterone, Testosterone, DHEA-S and Cortisol.

In the past 20-30 years a number of research studies have validated saliva as a diagnostic medium to measure the free or "unbound" biologically active fraction of steroid hormones(estrogen,progesterone,etc.) in the bloodstream. The World Health Organization has been using saliva testing for over 15 years. The steroid hormones most extensively studied in saliva are: Estrogens (Estradiol, Estrone, and Estriol), Progesterone, Androgens (DHEA and Testosterone), and Cortisol.

Some ADVANTAGES of saliva testing compared to serum testing:

• Saliva shows the free, unbound fraction of steroid hormones in the bloodstream-it is these biologically active fractions that are bio-available to the tissues throughout the body.Blood and urine tests measure total levels.
• Collection times can be more optimal which is very important for baseline hormone testing and assessment of HRT dosing. Note: Some hormones naturally fall by 50-90% during the course of the day so collection time is important. Hormone production is optimal in the morning and less susceptible to variation caused by stress, eating and drinking, and exercise.
• Painless, noninvasive, simple, safe, and needle-free.
• Private and convenient for both the patient and doctor.
• Hormones are stable in saliva at room temperature for 7-10 days.
• Transport of saliva to laboratory by regular US mail.
• Less expensive than blood testing. 

These tubes hold 12ml of liquid. The laboratory needs about 2.5ml to test up to 7 hormones. About 1% of tests are repeated for quality control measures to ensure results are accurate and precise. It would behoove patients to collect at least 5ml (1/2 full) of saliva or more to avoid the possibility of a recollect should the sample need to be repeated.

The bottom line: The patient must collect at minimum 2.5ml (about 1/4 full).

These tubes hold 7ml of liquid. The laboratory needs only 1ml (about 1/4 full) for testing. The 1ml aliquot used for this test is sufficient for any repeat testing that may be needed.  The bottom line: The patient must collect at minimum 1ml.