Hormone Testing – Saliva or Blood? Depends.

Photo credit: Ambro

Head to your doctor because you’ve been feeling off, forgetful, sweaty, waking up in the middle of the night, increasingly stressed, unfocused, irritable and she might tell you you’re in peri or in full menopause. Or perhaps you’ve had a complete hysterectomy and your doctor wants you on hormone replacement therapy.

Or, maybe your cortisol (the stress hormone) levels are way off the charts, a condition that is all too common today, that and adrenal fatigue.  Cortisol in small doses as the fight or flight reactive hormone alerts you to take action. And, like all hormones it’s just doing its proper job. But, at chronically high levels, as in the case of chronic stress, cortisol can harm your sleep and your health.

Whatever is going on your doctor (or you) may want to test your hormones along with a number of other factors.

Click here for saliva hormone testing kits
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer

How? Likely via a blood test. Yet, while not invalid, conventional blood serum tests are not as accurate as saliva to measure certain hormones.

Saliva testing

According to ZRT labs:

When the various glands manufacture the steroids they are released into the bloodstream bound to carrier proteins. Only a small fraction (1-5%) of a given amount of steroid hormone breaks loose from the carrier protein in the bloodstream and is free to enter target tissues.

This free or unbound hormone is what we want to measure, since it is active or bioavailable to the target tissues such as the breast, uterus, brain, and skin. Many studies in the scientific literature have shown that there is a strong correlation between the levels of steroid hormones in saliva and the bioavailable (free) levels of steroids in the bloodstream.

Click here for saliva hormone testing kits
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer

ZRT labs also offers at home blood spot testing which is convenient and at times less costly than the blood serum tests your doctor orders.

Blood spot testing

The development and application of blood spot testing allows monitoring of hormone levels, cardiometabolic markers and Vitamin D.  The convenient collection of blood from a tiny nick of the finger, allows for flexibility of testing at the right time of day, month or following hormone therapy.  Blood Spot testing provides results on par with those from serum tests but without the cost and inconvenience of conventional blood draws, making it beneficial for both patient and practitioner.

ZRT labs offers saliva, blood spot and combo tests. This ZRT labs chart compares which tests are done in saliva and/or blood spot.

Hormone or Analyte	Saliva	Blood Spot
Estradiol (E2)
Progesterone (Pg)
Testosterone, free
Testosterone, total
DHEA-S (DS)
Cortisol, AM (C1)
Cortisol, Diurnal (C1, C2, C3, C4)
Estriol (E3)
Estrone (E1)
Follicle stimulating hormone (FSH)
Luteinizing Hormone (LH)
Insulin-like Growth Factor (IGF-1)
Insulin, fasting
Triglycerides (TG)
Hemoglobin A1C (HbA1c)
High Sensitivity C-Reactive Protein (hs-CRP)
Total Cholesterol (CH)
LDL Cholesterol
HDL Cholesterol
VLDL Cholesterol
Prostate specific antigen (PSA)
Sex hormone binding globulin (SHBG)
Thyroid peroxidase antibodies (TPO)
Thyroid stimulating hormone (TSH)
Triiodothyronine (T3), free
Thyroxine (T4), free
25-hydroxy vitamin D2
25-hydroxy vitamin D3

So, you have choices depending on what you want to measure:

1. Go to your doctor. Doc orders standard blood to test hormones, etc, (ideal for measuring cholesterol, vitamin D etc, but not all hormones as you can see from above).
2. Depending on what you want to test, you can order your own saliva and/or blood spot test from ZRT labs either directly or through a provider (depends on what is cheaper, if your insurance covers the labs if ordered by a doctor or you buy the kit directly and bring the results to your doctor).

But, if you want saliva and/or blood spot testing and your doctor won’t order them for you, take all this into your own hands.

Order your own from ZRT, bring the results to her, or ideally to a physician who understands saliva testing and will discuss options to re-balance your hormones, cholesterol and/or vitamin D levels.