SALIVA HORMONE ANALYSIS
Saliva as a Diagnostic Medium for Steroid HormonesOver the past 20-30 years numerous research studies have validated the use of saliva as a diagnostic medium to measure the biologically active fraction of steroid hormones in the bloodstream. Saliva is an excellent medium to measure steroids because it is a natural ultrafiltrate of blood, and steroids not bound by carrier proteins in the blood freely diffuse into saliva. Only about 1-10% of the steroids in blood are in the unbound or free form, and it is this fraction that diffuses into target tissues of the body, and into saliva. The majority (90-99%) of steroid hormones in the blood are bound to carrier proteins (cortisol binding globulin, sex-hormone binding globulin and albumin) and are unavailable to target tissues. The process of passive diffusion of non-bound (free) steroid hormones occurs because these small molecules are of a low molecular weight (less than 400 daltons) and are relatively nonpolar, thus enabling them to freely diffuse from blood to saliva. The steroid hormones that have been studied most extensively in saliva include estrogens (estradiol, estrone, and estriol), progesterone, androgens (DHEA, testosterone), and cortisol.With the recent availability of saliva steroid hormone testing, the medical community has rapidly begun to accept saliva as a preferred method to blood for steroid hormone testing. North Bay Diagnostics now provides the clinical community with state-of-the-art services for testing the steroid hormone content of saliva. Advantages of Saliva vs. Serum TestingClinical UtilityBaseline measurement of hormone levels in saliva provides an accurate assessment of climacteric changes for the peri and post menopausal woman. Natural hormone replacement therapy and the use of pharmaceutical products can be measured in saliva. Monitoring trough level (hormone level just prior to next dose) following a period of therapeutic intervention (2-4 weeks of continuous therapy) permits titration of individual hormone dosages to maximize clinical effect and minimize dose related side effects. The influence of precursor hormones thought to elevate primary hormones through an endocrine cascade can be evaluated.In men and women, the age related decline of hormones such as testosterone, DHEA, and melatonin can be assessed and monitored. Laboratory studies have established the expected ranges for normal, unsupplemented saliva hormone levels of DHEA and testosterone for each decade of life in both men and women. Hormone level change associated with prescription or over-the-counter supplementation can be evaluated and titrated to the desired level. Changes in hormone levels associated with the different routes of hormonal administration (oral, transdermal creams, patches, subcutaneous, sublingual, transvaginal, suppositories, etc.) can be accurately measured in saliva. Therapeutic target ranges of free salivary hormone levels have been established by North Bay Diagnostics for transdermal, oral and patch therapy. Test MethodsHormones in saliva are assayed by radioimmunoassay which uses the competition between radioactive and non-radioactive hormone for a fixed number of antibody binding sites to determine the concentration present in the specimen.Specimen RequirementsSaliva: 7 ml is requested. Following collection, saliva should be either frozen or shipped to North Bay Diagnostics within 1 day of collection. Saliva is stable at ambient temperature for at least 3 weeks and a specimen received within that time is acceptable.Overview of Sex Steroid HormonesAdequate levels and an appropriate balance of the steroid hormones (estrogens, progesterone, testosterone, DHEA, and cortisol) are necessary for maintaining optimal health and well being in both females and males. This family of steroid hormones supports a wide range of essential physiological functions. Variation in these hormones plays a large role in the changes seen in life cycle events such as aging. There has been interest in supporting such hormone activity by dietary changes, herbal use, and medications. Quantitative measurement of steroid hormones in saliva allows a non-invasive way to establish baseline hormone levels and monitor the impact of hormonal intervention.Available TestsNorth Bay Diagnostics has established methods and procedures to quantitate circulating levels of the following hormones:
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