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SALIVA HORMONE ANALYSIS

Saliva as a Diagnostic Medium for Steroid Hormones

Over 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 Testing

  • Saliva reflects the biologically active (free) fraction of steroids in the bloodstream (unlike blood or urine which measures total levels)
  • Collection time is more controlled which is critical for baseline testing of hormones with diurnal variation and assessment of HRT dosing
  • Non-invasive, simple, safe, stress free, and painless
  • Private and convenient for patient and physician
  • Allows for multiple collections outside of hospital setting
  • Hormones stable in saliva at room temperature for at least 3 weeks
  • Transport of saliva to laboratory by regular US mail
  • Less expensive than blood testing

    Clinical Utility

    Baseline 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 Methods

    Hormones 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 Requirements

    Saliva: 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 Hormones

    Adequate 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.

    Hormones:

    North Bay Diagnostics has established methods and procedures to quantitate circulating levels of the following hormones:

    Estradiol Estriol Testosterone            DHT
    		 Cortisol
    Estrone Progesterone DHEA                     Melatonin

    Contact North Bay Diagnostics at 888-689-TEST (8378) to order your lab kit.

    Available Tests:

    North Bay Diagnostics offers the following salivary hormone panels. The lab kits are mailed directly to your home. Taking the hormone tests is easy - in most cases it involves only one saliva specimen, which can be done in minutes. The kit also includes a pre-addressed label. The customer is responsible for return shipping.  Test samples take 5 -10 buisness days to process.  Results are mailed or emailed.  Shipping to the customer is free.

    Custom Hormone Panel
    Choose from the following hormones: Estradiol; Estrone; Estriol; Progesterone; Testosterone; DHEA; DHT; Melatonin; Cortisol to customize a panel for your needs. 
    $47.00/one   $83.00/two   $120.00/three   $151.00/four   $182.00/five   $207.00/six   $233.00/seven   $259.00/eight


    Menopause Panel - Basic
    The Menopause Profile measures Estradiol, Progesterone, Testosterone, and DHEA. The Menopause Profile is recommended for peri or postmenopausal women experiencing hormone-related problems, including: mood changes, hot flashes, heavy menses, weight gain, low libido, insomnia, headaches, fatigue, bone loss, hair loss, or difficulty concentrating.
    $151.00 

    Menopause Panel - Extended
    The Menopause Panel - Extended measures Estrone, Estradiol, Estriol, Progesterone, Testosterone, and DHEA. It is the same as the Menopausal-Basic Panel, plus Estriol, and Estrone. The Menopause Panel - Extended is recommended for peri and post menopausal women that are currently using estriol or estrone (Hormone Replacement Therapy). This test can also be used to monitor breast cancer risk. Several epidemiological studies have shown that women who have an increased amount of estriol in relation to estradiol and estrone, have a decreased risk of developing breast cancer.
    $207.00

    Cycling Female Panel - Basic
    The Cycling Female Panel - Basic measures Estradiol, Progesterone, and DHEA. The Cycling Female Panel - Basic is recommended for premenopausal women with hormone troubles possibly related to progesterone deficiency or estrogen excess. Symptoms would include: PMS, mood changes, cramping, irritability, uterine fibroids, fibrocystic breasts, weight gain, headaches/migraines, heavy menses, fatigue, and low libido.
    $120.00 

    Cycling Female Panel - Extended
    The Cycling Female Panel - Extended measures Estradiol and Progesterone five times over a one month period, and Testosterone. Test results are reported graphically so peaks and depressions can be easily identified. The Cycling Female Panel - Extended is designed to uncover more complex problems associated with hormone imbalance among cycling females.
    $331.00

    Circadian Melatonin Panel
    The Circadian Melatonin Panel measures Melatonin four times over a one day period. The Circadian Melatonin Panel is recommended for patients interested in, or currently supplementing melatonin. Symptoms of melatonin disturbances would include: Poor sleep, poor immune system, fatigue.
    $151.00 

    Adrenal Stress Profile
    The Adrenal Stress Profile measures Cortisol four times over a one day period. Symptoms of cortisol deficiency and “adrenal burn-out” include: Fatigue, allergies, asthma, low blood pressure, carbohydrate craving, depression. Cortisol excess sometimes occurs in chronic high stress states, symptoms include: Feeling “wired and tired”, weight gain, high blood pressure, sleep trouble, anxiety. Elevated cortisol can increase risk of bone loss and heart disease.
    $151.00 

    Male Hormone Panel
    The Male Hormone Panel measures testosterone, di-hydro-testosterone (DHT) and DHEA. It is recommended for males of all ages with concerns of: low libido, hair loss, fatigue, loss of muscle mass, depression, prostate trouble, acne. For men supplementing testosterone, it is advisable that estradiol be monitored, as excess conversion of testosterone to estradiol in males has been linked to prostate cancer.
    $120.00

    References

    1. Ellison, P: Measurement of salivary progesterone. Ann N Y Acad Sci 1992;161-176
    2. Lipson, S & Ellison P: Development of protocols for the application of salivary steroid analysis to field conditions. American Journal of Human Biology:1989;1:249-255
    3. Dabbs JM, Salivary testosterone measurements: Collecting, storing and mailing saliva samples, Physiology & Behavior 1990;49:815-817
    4. Vining RF, McGinley RA, The Measurement of Hormones in Saliva: Possibilities and Pitfalls, J Steroid Biochem 1987;27:81-94
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