Can Saliva Testing Help to Pinpoint Hormone Imbalances?
An article about Saliva Tests appeared in this week’s “Aches & Claims” column (6/1) in the Wall Street Journal. It’s one of many tests that can be used to determine which hormones are out of balance and what supplements could be prescribed to alleviate menopausal symptoms such as hot flashes and insomnia. Typically, a doctor who specializes in naturopathic or integrative medicine, rather than your gynecologist, will be inclined to use this and other specialized lab tests since they require additional time and expertise to review and interpret them.
However, there is debate over their reliability due to a lack of industry standardization, according to the WSJ article. One physician, for example, who is a noted proponent of Hormone Replacement Therapy, called the Saliva Test “a pure waste of dollars,” and further dismissed it by explaining that a saliva test is “not needed since doctors treat the symptoms of hormone deficiency by starting with a low dose of hormone replacement and increasing it if symptoms don’t resolve.” That may be his preferred approach to hormone imbalances, but clearly not every woman can and wants to take hormones.
In a “clinical policy bulletin“, the insurance company, Aetna, states that “salivary hormone tests, while medically necessary for diagnosing Cushing’s syndrome, have not been proven to be valid alternatives to serum (blood) tests for the screening, diagnosis or monitoring of menopause or diseases related to aging,” and thus does not include them in their coverage. On the other hand, the website of the late Dr. John Lee, who advocated the use of natural hormones, states that “research indicates that the most accurate way to measure your hormone levels is through saliva.”
ZRT Labs, which sells Saliva Testing Kits to doctors only, offers information about “oral fluid testing” and video instruction for collecting a saliva sample. Their website also features a directory of health care providers that you can use to identify one in your area who can prescribe the test and review the results with you.
Great Article and follow up.
At our clinic we have been working with a functional nutritionist about the best way to determine excess/deficiency in our patients hormone levels and he is very involved with saliva testing.
I am glad to see that this is getting out more and more. The Specific Chiropractic Center is dedicated to improving their patients and having articles like yours is great!
Thanks Marsha for clarifying the benefits and limitations of saliva testing.
As in integrative and functional medicine doctor, who frequently prescribes bio identical hormones, I have found the saliva testing to sometimes be helpful but I think that all of the above references are a little bit right but not completely. Saliva testing is most useful when looking at diurnal cortisol which reflects the function of your adrenal glands. This is a well validated test and has been used by Nasa to test astronauts for stress as well as in studies regarding stress and cortisol levels. It is the best test we have to discern poorly functioning or over working adrenal glands. Regarding the sex hormones, a baseline saliva profile can be helpful and better reflects tissue levels of hormones. This is only useful if the person is NOT taking hormones. Once therapy begins, the testing is not very useful. Blood levels can fluctuate widely throughout the day but if hormones are chronically low which they frequently are this can be useful but once again when therapy begins, the levels can fluctuate widely and may not be very useful.
So the physician who says you should treat according to symptoms is correct with the caveat that I think it is good to know where you are starting and to assure that the levels are indeed low especially in men and that your patient desires to take hormones. Aetna is correct in that you are looking for elevated cortisol levels in Cushings syndrome so saliva is the best test. Blood levels are as good as anything if one wants to measure levels.
Its best to work with an experienced physician as there is lots of misinformation and differing opinions out there. Find a doctor who will work with you to provide you the best symptom relief that fits within your needs and wishes.
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