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Submitted August 29, 2006 4:42pm
Saliva hormone testing allows you to measure your levels of
estradiol, progesterone, and testosterone. Comparing your female
hormone levels to the normal range for your age will help you and
your doctor evaluate how hormone replacement therapy will or has
changed your hormone levels.
Hormones can be tested through non-invasive tests from blood and
urine. Currently, saliva testing is able to test levels of
estradiol, estriol, estrone, progesterone, testosterone, DHT, DHEA,
melatonin and cortisol.
It is highly recommended to get a saliva test, for a base line level
to start with before starting any hormone therapy. Then the tests
should be repeated in 2 to 3 months. This way you will be able to
evaluate if Hormone Replacement Therapy has affected your levels. It
is then recommended to repeat the test again once a year while on
this therapy. It is suggested that you test for Estriol, Estradiol,
Estrone, Progesterone, Testosterone, Cortisol, DHEA, Melatonin, DHT
and Pyrilinks D (urine test) for bones.
It is also very important and well suggested, that you get your
hormones tested in your 30’s-40’s, before you have even entered
perimenopause or menopause, to establish your normal hormone levels,
and how your body metabolizes them. If you do the testing early, you
will then have something to compare yourself, when you felt good and
normal, to later when you begin menopause and your hormone levels
begin to fall. This can help your healthcare professional prescribe
the right dosages for you to get back on track.
Finding a satisfactory dose for you can take several months and
anything that you can do in advance to speed up the process will
only help you in the long run. Your doctor may see dozens of
patients that each need their own individual dose, so he will be
experienced in helping you find where you should be. Just make sure
that you tell him everything that changes, so you can aid him in his
prescriptions.
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Before a woman is about to ovulate, her saliva begins to form a
distinct fern-like pattern, which is determined when viewed under a
microscope. This change is due to an increase in the level of
estrogen that is present, which in turn causes an increase in
salinity. Salinity is what produces the fern-like appearance under
the microscope. This ferning pattern begins to appear around 3 days
prior to ovulation.
A “personal ovulation microscope” (e.g. Fertile Focus or Ovulook)
allow you to predict fertility by observing the visual changes that
take place in your saliva throughout your cycle. When you are on the
verge of ovulation, the visible make-up of a woman's saliva
undergoes several changes. This fern-like or ferning pattern can be
easily identified when examined under the power of a 40X to 60X
magnification lens - helping you predict ovulation and peak
fertility.
How Do Saliva Ovulation Predictors Work?
With the ovulation microscopes, you simply apply saliva to a slide
and wait five minutes. The slide is then inserted into the
magnifying scope, allowing you to determine if the fern-like pattern
is present and then predict ovulation. This ferning pattern can be
easily identified when examined under the power of the microscope,
helping you predict fertile or infertile times in your cycle.
According to research studies, saliva ovulation predictor tests are
98% accurate in clinical settings when all instructions are followed
correctly. Other advantages of saliva ovulation predictors stem from
the fact that they are re-usable, discreet, and easy-to-use.
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Saliva originates from the salivary glands, which are located under
the tongue and along the sides of the mouth. Saliva is made up of a
complex mixture of mucins, enzymes, antibodies, electrolytes, and
hormones, all of which play a part in the beginning process of
digestion and protect the oral mucosa.
The formation of saliva in the salivary ducts begins with
electrolytes (particularly sodium) being actively pumped into the
ducts by an energy dependent process. Water then diffuses by osmosis
into the duct to reestablish a physiological osmolality. Blood
components enter the watery fluid of the salivary duct by one of
three processes: active transport, ultra-filtration or passive
diffusion. Antibodies such as IgA and IgG are actively secreted into
saliva by an energy dependent process. Small charged molecules like
glucose enter saliva by ultra-filtration, the rate of entry of which
is inversely related to molecular size. Steroids and other small
neutral molecules not bound by blood proteins freely pass through
the membranes of the salivary gland into saliva by passive
diffusion.
The Passage of neutral steroids from the blood into the salivary
ducts is about 10 times faster than the flow rate of saliva. Because
of the rapid passive diffusion of steroids into the saliva ducts,
saliva hormone levels are not altered significantly when the flow of
saliva is increased with stimulants such as chewing gum. However,
when a steroid is rendered more polar by metabolic conjugation (eg,
sulfation, glycosylation) its rate of flow into saliva is
significantly slower resulting in lower concentrations of the
conjugated steroid as the saliva flow rate increases with use of
stimulants.
Because only a small fraction of steroids in blood are considered
bio-available, saliva, which has many free, or bio-available
steroids, is considered to be the best method of measuring hormones.
In blood, 95-99% of the steroids are bound up by binding proteins
such as sex hormone binding globulin (SHBG), cortisol binding
globulin (CBG), and albumin. The small fraction of steroids not
bound is considered the free fraction, or that which is
bio-available as blood percolates through the capillary beds of
tissues. The free or bio-available fraction of steroids in blood
enters the salivary gland and the salivary duct by passive diffusion
just as they enter other tissues of the body. Hence, saliva provides
a convenient diagnostic fluid from which to monitor, non-invasively,
the bio-available fraction of steroid hormones circulating in the
bloodstream and entering tissues. "Rule-of-thumb"--saliva hormones
represent 1-5% of serum.
When steroid hormones are produced endogenously or are taken orally
the salivary level of any particular steroid generally ranges from
about 1-5% of the levels found in serum. The exception to this
"rule-of-thumb" is when steroid hormones are delivered topically
through the skin, where salivary hormones often exceed levels
measured in serum.
Saliva Laboratory Testing: The Advantages and Disadvantages
There are numerous advantages to using saliva to test for steroid
hormones compared to blood serum or plasma. But there are also
disadvantages.
Advantages:
Collecting a saliva sample has ease to it since it can be done
anytime, and anywhere. A blood sample has restrictions of the
doctor’s office, and these settings can be stressful.
Saliva contains exceptionally stable steroid hormones, which allows
for convenient collection and shipment at room temperature by
inexpensive means. Serum, on the other hand, requires qualified
personnel (phlebotomist), special procedures (needles and serum
collection tubes) and equipment (centrifuge and lab space to house
it) as well as specialized shipping vessels (ice pack) and express
delivery (overnight). Moreover, hormone concentrations can vary
depending on the time of day and month making it especially
difficult to schedule optimal collection times with serum. Overall,
the conveniences in testing salivary hormones makes it better for
patients in lower overall costs, as well as lower costs for the
health care provider, and insurance carrier.
Disadvantages:
The collection of saliva samples is more technically challenging
than serum testing of steroids. Although salivary testing has many
advantages over serum testing, there are still some disadvantages to
saliva testing that should be acknowledged.
Technically, saliva testing is more challenging than blood testing,
limiting the number of laboratories that are capable of performing
the tests. Blood levels of steroid hormones are, on average, about
10 to 100 times higher than saliva levels and commercial test kits
and ranges are based on these higher serum hormone levels. For
example, most commercial test kits for estradiol provide standards
and a sensitivity range within the expected serum levels of about 10
to 200 pg/mi. Salivary estradiol levels range from about 0.5 to 5
pg/mi, much lower than the standards and assay sensitivity provided
by commercial kits. Therefore, laboratories performing saliva
testing must have the technical expertise to either create their own
tests or modify commercial test kits. Significant technical hurdles
beyond the technical expertise of most commercial testing laboratory
personnel must be overcome to make this transition.
Certain components can interfere with the testing of saliva. Foods,
beverages such as coffee, and drugs taken just before collecting
saliva can interfere or cause a transient shift in hormone levels.
Mucins in saliva can interfere with the test, causing spuriously
high levels. Some chewing gums and cottons used for saliva
collection contain substances that interfere with some saliva tests,
resulting in erroneously high hormone levels. Sugar in regular
chewing gum can interfere with some saliva tests. Chewing gum or
other physical agents (eg, parafilm) used to increase the flow of
saliva can also cause more bleeding of the gums, especially if the
individual has advanced periodontal disease. Since 95-99% of
hormones are blood-bound, small amounts of blood in saliva could
cause significant changes in hormones that are not truly
representative of the bio-available fraction of the hormone.
The saliva tests can in some cases be contaminated from the hands or
lips from the use of topical hormones, and should be avoided before
the collection of a saliva sample.
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Submitted September 2, 2006 11:24 am
Saliva hormone testing allows you to measure your levels of the
hormones estradiol, progesterone, and testosterone. Comparing your
female hormone levels to the normal range of hormones for your age
will help you and your doctor evaluate how bioidentical hormone
replacement therapy will or has changed your hormone levels.
Hormones can be tested through non-invasive tests from blood and
urine. Currently, saliva testing is able to test levels of
estradiol, estriol, estrone, progesterone, testosterone, DHT, DHEA,
melatonin and cortisol.
It is highly recommended to get a saliva test, for a base line level
to start with before starting any hormone therapy. Then the tests
should be repeated in 2 to 3 months. This way you will be able to
evaluate if Hormone Replacement Therapy has affected your levels. It
is then recommended to repeat the test again once a year while on
this therapy. It is suggested that you test for Estriol, Estradiol,
Estrone, Progesterone, Testosterone, Cortisol, DHEA, Melatonin, DHT
and Pyrilinks D (urine test) for bones.
It is also very important and well suggested, that you get your
hormones tested in your 30’s-40’s, before you have even entered
perimenopause or menopause, to establish your normal hormone levels,
and how your body metabolizes them. If you do the testing early, you
will then have something to compare yourself, when you felt good and
normal, to later when you begin menopause and your hormone levels
begin to fall. This can help your healthcare professional prescribe
the right dosages for you to get back on track.
Finding a satisfactory dose for you can take several months and
anything that you can do in advance to speed up the process will
only help you in the long run. Your doctor may see dozens of
patients that each need their own individual dose, so he will be
experienced in helping you find where you should be. Just make sure
that you tell him everything that changes, so you can aid him in his
prescriptions.
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August 25, 2006There are several tests done to detect if you are going through
early menopause. Your doctor can perform these tests if you suspect
that you are experiencing symptoms of perimenopause. Some of these
include:
FSH -follicle stimulating hormone
A blood test can be done to determine the levels of FSH in your
blood. Because your FSH levels rise when your ovaries stop producing
enough estrogen, high FSH levels can signal that your body is
entering menopause. This is the key test to determine your stage of
menopause.
Normal Menstruating
| Follicular
Phase |
2.5 to 10.2 |
| Midcycle Peak |
3.4 to 33.4 |
| Luteal Phase |
1.5 to 9.1 |
| |
|
|
Postmenopausal |
23.0 to >116.3 |
Estrogen (Estradiol) Levels
Estradiol is the primary human estrogen. When your ovaries begin to
fail, your circulating estradiol levels drop. Doctors often give a
serum estradiol concentration test to measure the amount of
estradiol in your blood. If your estrogen levels are lower than
normal, this is a signal of ovarian failure, or, in other words,
early menopause.
If your estradiol levels are lower than 50 picograms per milliliter,
you may still be having a period, but also may be
experiencing symptoms of low estrogen.
Non-menopausal:
| Follicular
Phase |
24-138 |
| Luteal Phase |
19-164 |
| Periovulatory |
107-402
|
Postmenopausal:
| No HRT |
<36 |
| With HRT |
18-361 |
Another test is a thyroid test. Many doctors will also recommend
that you have your thyroid tested when you suspect menopause. This
is for two reasons: First, many women in premature menopause also
are at a higher risk for thyroid problems. Second, many symptoms of
thyroid disease overlap with menopausal symptoms. In fact, thyroid
diseases often interfere with menstruation. Testing your thyroid
will help determine whether you are in premature menopause, or if
you have a thyroid disease.
Last, is a saliva test. Some doctors recommend saliva testing to
measure hormone levels. This isn't as widely used as blood testing,
but some say that it is quicker, less expensive and reliable. With
salivary testing, your doctor takes samples of your saliva to see
the levels of hormones you are producing and to determine if you
have any deficiencies. Unlike the blood tests, the saliva hormone
tests will show the levels of "free" hormones in your body. Free
hormones are the hormones that aren't bound to proteins, but instead
are able to move into cells. Because about 95% or more of your blood
hormones are bound, the saliva tests measure only the remaining 1 to
5%. The results may be much lower than that which you see on your
blood test results.
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September 1, 2006
Some people believe that with all the new information we have about
bioidentical hormones and its advantages that the testing should be
standard routine. But there are several factors why it’s not. First,
it is not "standard of care" or deemed medically necessary. This
means that when you have a problem that may be related to your cycle
and the hormone fluctuations that go with it, your doctor is not
required to order a test to measure your hormone levels before you
are treated. Actually, they can prescribe birth control pills or
synthetic HRT at any time, with only personal information or a
feeling that these drugs may be right for you.
The reasons why hormone testing, and prescribing natural hormones,
is not standard practice has more to do with patent law and the
pharmaceutical industry than anything else. There is also the fact
that most medical schools have until recently ignored natural
hormones as an option in treating women's hormonal imbalances. Drug
companies are out to make money.Natural, plant-based hormones
cannot be patented and marketed as exclusive products, therefore
giving no advantage to the pharmaceutical companies. Even though
safe, plant-based sources for making bioidentical natural
progesterone and estrogen are readily available, pharmaceutical
companies rarely use them (although the harm and findings of new
studies about synthetic hormones is beginning to propel them in that
direction). Instead they use lab-formulated synthetic progestins and
estrogens to make their HRT formulas. When sales representatives
talk with doctors, they offer flashy brochures and literature about
double-blind studies conducted and/or financed, of course, by the
drug companies. For some drugs, such as Viagra, manufacturers appeal
directly to consumers, who in turn request that their healthcare
providers prescribe these drugs.
Nobody is advertising for the use of natural hormones to medical
offices because, at least for now, there is no money to be made. In
fact, mainstream healthcare providers who are familiar enough with
natural hormones to prescribe seem to be in the minority. So it is
no surprise that mainstream medical practitioners are reluctant to
initiate hormone testing to determine dosing for medicines they know
little or nothing about.
The same goes for natural supplements and herbal remedies. These
alternatives have neither private funding nor representatives
hounding medical offices to tout their benefits. If medical
providers want to find out about these alternatives, they must do
just as you are doing, and educate themselves. Given their hectic
schedules, time constraints, and demanding practices, it isn't too
surprising that most healthcare practitioners haven't done so.
Most likely, the use of bioidentical hormones will eventually come
into use because patients are going to demand it, many are already.
Women are justifiably scared of synthetic HRT, and more information
is getting out that therapy using natural, bioidentical hormones is
a safe and effective alternative for relieving unpleasant symptoms.
Medical practitioners who lack education about hormone testing and
treatment with the natural alternatives nevertheless claim that
hormone testing is inaccurate because levels change constantly as a
woman cycles through the month. It’s true that hormone levels do
fluctuate and every woman is unique, but those facts don't cancel
the value and accuracy of carefully conducted hormone testing,
especially through saliva testing. It is being done successfully and
has been absolutely invaluable in my medical practice and those of
informed colleagues across the nation.
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September 5, 2006
Your healthcare professional may order a saliva cortisol test when
symptoms of Cushing’s syndrome and Addison’s disease are present.
Both Cushing’s syndrome and Addison’s disease are serious adrenal
disorders. Both testing of the urine as well as saliva are common
testing methods for excess cortisol production. Once your healthcare
professional has determined an abnormal level of cortisol, further
testing will be done in order to determine cause and severity of the
deficiency or excessiveness.
Symptoms of Cushing’s syndrome that may lead to a saliva cortisol
test include:
- Obesity
- Muscle wasting
- Muscle weakness
Symptoms of Addison’s disease that may indicate the need to
perform a saliva cortisol test include:
- Weakness
- Fatigue
- Increased pigmentation
- Others
For people with a normal cycle of cortisol levels, the levels are
higher in the morning, and lower at night. If you work a night job,
this pattern will not be maintained, and people with Cushing’s will
also not maintain a normal pattern. Increased or normal cortisol
concentrations in the morning, with levels that do not drop in the
afternoon and evening suggest that your body is overproducing
cortisol. If this excess cortisol is suppressed during a
dexamethasone suppression test, it suggests that the excess cortisol
is due to increased pituitary ACTH production. If it is not
suppressed, then the increased cortisol could be due to an
ACTH-producing tumor outside of the pituitary, a problem with the
adrenal gland, or a medication that the patient is taking.
If the adrenal glands are overactive, then a patient may have
Cushing’s syndrome, with symptoms and signs caused by prolonged
exposure to the effects of too much cortisol. This may be due to
excess production of cortisol by the adrenal glands, which is
frequently due to a benign adrenal tumor, or excess ACTH
stimulation, due to a pituitary or other ACTH-producing tumor. It
can also be seen in patients who must take corticosteroid
medications, such as those used to treat asthma. If decreased
cortisol production is due to adrenal damage, then the patient is
predicted to have Addison’s disease.
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