Measurement of Steroid Hormones in Saliva

Analysis of hormone levels in saliva is accurate, convenient and affordable.

History of Hormone Measurement

Historically, there were few methods sensitive enough to measure steroid hormones in blood or saliva. For that reason many hormones were measured in urine. These measurements provided useful information to the clinician since they reflected the actual production rates in the body over a period of time. Urinary free cortisol and urinary free estradiol, and testosterone were considered indicators of the respective blood levels.

All that has changed over the last 25 years. Today, many studies validate the use of saliva for measurement of hormones such as testosterone, estradiol, progesterone, DHEA and cortisol.

Disadvantages of Urine and Blood Serum for Hormone Measurements

Urinary measurements of hormones are used less frequently for several reasons. The main disadvantage of this method is that, for the analysis, all urine eliminated over a 24-hour period must be collected. This can be difficult to do when you are at work, go to school or have children to pick-up. It can even be difficult and inconvenient to do at home.

Most hormones are now measured in serum or plasma using RIA or ELISA assays. These methods are reliable and sensitive and provide accurate results about the hormonal status of a patient, however, the usefulness of blood testing measurements is limited.

The primary limitation is that blood testing measurements represent total hormone levels, the sum of ''free'' (bioavailable) and ''bound'' hormones, so the results of a blood test are less precise than saliva testing. Another disadvantage of this approach is the fluctuation of blood hormone levels. Multiple blood samples are often necessary to overcome this limitation.

Free Versus Bound Hormones

Hormones circulate through the blood in both a ''bound'' and a ''free'' form. The majority of steroid hormones in the blood, 95-99%, have already been used by the body and are bound to carrier proteins such as cortisol binding globulin (CBG), sex-hormones binding globulin (SHBG) and albumin. In this bound form they are unavailable to ''do work'' on target tissues.

The remaining 1-5% of hormone concentration in blood represents the free or bioavailable hormone that is available to ''do work'' in the body. It binds to the steroid receptors and elicits biochemical effects. For this reason, knowledge of free hormone levels is desirable in a number of clinical situations.

Despite the clinical usefulness, measurements of free hormone levels in blood are not routinely employed. The major drawbacks are the technical difficulties and the high cost of the assays.

Measuring Free Hormones in Saliva

Saliva is proving to be an excellent diagnostic medium to measure free steroid hormones. Saliva is a natural ultrafiltrate of blood, and steroids not bound by carrier proteins freely diffuse into saliva. Since the concentration of carrier proteins in saliva is extremely low, measurements in saliva for the most part represent the free fraction of the hormone.

Women's Health America (WHA) has developed a series of sensitive assays, which allow the analysis of steroid hormones in saliva. The tests have great accuracy, are reliable, and provide detailed information on the hormone status of a patient. They are also affordable and convenient to use. Test kits are mailed to patients, allowing them to collect saliva samples in the privacy of their own home. Samples are then mailed back to the lab for evaluation, and the patient's doctor receives results in a few days.

Restore^® Saliva Testing

WHA's Restore testing combines saliva hormone testing with urine NTx analysis to determine rate of bone loss. Restore^® testing results can be used to determine the correct hormonal balance for each patient on an individual basis. The consulting pharmacists at Madison Pharmacy Associates are available to work with healthcare providers to develop any hormonal medications needed.