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Saliva Hormone Analysis



We offer a wide selection of saliva hormone testing to meet your health concerns.

Advantages of Saliva Testing

  • Non-Invasive
  • No blood draw is needed; no risk to the patient
  • Convenient
  • Specimens can be easily collected at home or at work at any time of the day
  • Precise
  • Saliva measures the biologically active fraction of steroid hormone at the tissue level.
  • Since hormone levels may vary during the day or during the month, multiple specimens can be collected conveniently offering precise measurement.
  • Samples are stable for several weeks.

Saliva Testing At a Glance

All major steroid hormones, some peptide hormones, and antibodies can be readily detected and measured with reproducible results from a patient’s saliva.

Enzyme-linked immunosorbent assay (ELISA) is the most prevalent laboratory technique utilized in measuring various hormones, antigens, and antibodies within the saliva. The process involves using a prepared solution of antibody that is specific for a substance. The saliva sample is exposed to the solution that has the known antibody. If the substance tested for is present in the saliva, the antibody will bond to the substance and an enzyme linked chemical reaction will notify the scientist via a change in color. These test results may be designed to provide either qualitative (“positive vs. negative”) results or quantitative results (i.e. 5-50 nM/L, for example).

One of the profound advantages with saliva testing is that the saliva producing cells passively allow ONLY unbound steroid hormones into the salivary ducts. Therefore, saliva testing is a very affordable way to study active steroid hormone levels without the confounding artifact of having to separate the bound hormone from the unbound fraction.

It is this unbound hormone that exerts the activity that hormones are known for in various tissue beds throughout the body. If one is to measure total hormone levels in the blood serum, an extra step of mental extrapolation is required in order to try to predict how much of that total pool of hormone is actually having effects on a patient. Unfortunately, there is no predictable correlation between how much total hormone is in the blood serum and how much free hormone goes into the tissues and has a clinical effect on a patient.

Saliva testing specifically measures free, unbound hormone levels. This eliminates the need to make mental guesses concerning how much hormone a patient’s body is really being influenced by.

An additional, profound advantage of saliva testing is that it is non-invasive. If a substance can be identified and measured in the saliva, why submit a patient to venipuncture? In some clinical situations this may become necessary, but it is an unnecessary risk to take for an initial evaluation. Thousands of complications via venipuncture happen yearly and can result in transmission of blood born disease, puncture site inflammation and/or infection, pain, vein thrombosis, etc. Venipuncture is expensive, labor intensive, inconvenient, and carries the risk of adverse health outcomes.

In order to accurately study how hormones clinically affect a patient, it is necessary to look at hormone levels dynamically. In other words, hormone fluctuations are just as important as their level at any given one point in time. The practice of including a time component to the evaluation of a patient is called chronobiology. There are many well known chronobiological processes: sleep/wake cycles, seasonal mood changes, a woman’s monthly menstrual cycle, etc. It turns out that the adrenal glands are controlled by a daily cycle…as is the thyroid gland.

The hormones that influence many of the cycles in our lives can be viewed as markers to check if our body is in a healthy state from a standpoint of chronobiology. For example, multiple sample outpatient saliva testing allows a clinician to monitor the hormone regulation of a woman over her ENTIRE monthly cycle! This information can have profound diagnostic significance and can lead to therapeutic strategies over looked by one sample testing of her hormones.

In summary, enzyme linked laboratory analysis of the saliva has become scientifically accepted, clinically applicable, an excellent alternative to serum testing, the only way to reasonably study a patient’s chronobiology, and economically feasible.

Schedule your Hormone Consultation with Dr. Hoover today by calling 417-883-0115. This can be done in clinic or by phone.

Here is a partial list of our popular Saliva Hormone Panels:

Adrenal Stress Index™: Patient Overview

The Adrenal Rhythm and Its Importance

The human adrenal glands do not secrete steroid hormones at a constant level throughout the day. The hormones are actually released in a cycle, with the highest value in the morning and the lowest value at night when functioning properly. This 24-hour cycle is called the circadian rhythm and is depicted below in Figure 1. An abnormal adrenal rhythm can influence many functions of the body, some of which are described below.

Energy Production

Abnormal adrenal function can alter the ability of cells to produce energy for the activities of daily life. People who have a hard time rising in the morning, or who suffer from low energy throughout the day, often have abnormal adrenal rhythms and poor blood sugar regulation.

The maintenance of a stable blood sugar level depends on food choice, lifestyle, adrenal function and insulin activity. The Adrenal Stress Index™ panel measures stress hormones and insulin, to help ferret out the causes of fatigue, cravings and obesity.

Muscle and Joint Function

Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint wasting with chronic pain.

Bone Health

The adrenal rhythm determines how well we build bone. If the night and morning cortisol levels are elevated, our bones do not rebuild well, and we are more prone to osteoporosis. Stress is the enemy of the bones. In postmenopausal women, the effect of stress worsens due to female hormone imbalances.

Immune Health

Various immune cells (white blood cells) cycle in and out of the spleen and bone marrow. The immune system trafficking follows the cortisol cycle. If the cycle is disrupted, especially at night, then the immune system is adversely affected.

Short- and long-term stress is known to suppress the immune response in the lungs, throat, urinary tract and intestines. With reduction in the surface antibody (called secretory IgA), the resistance to infection is reduced and allergic reactions are believed to increase.

Sleep Quality

The ability to enter REM sleep cycles and experience regenerative sleep is interrupted by high cortisol values at night and in the morning. Chronic lack of REM sleep can reduce a person’s mental vitality, vigor and induce depression.

Skin Regeneration

Human skin regenerates mostly during the night. With higher night cortisol values, less skin regeneration takes place. Therefore a normal cortisol rhythm is essential for optimal skin health.

Thyroid Function

The level of cortisol at the cell level controls thyroid hormone production. Often, hypothyroid symptoms such as fatigue and low body temperature are due to an adrenal maladaptation.

Grain Intolerance and Stress Response

Approximately 12-18% of the U.S. population suffers from a genetic intolerance to grains, such as wheat, rye or barley contained in cereals, breads and pasta. A high incidence occurs in people with Celtic, Nordic, non-caucasian and Mediterranean ethnicity. The gut becomes inflamed within 30 minutes after consuming grains, and this can lead to an adrenal stress response, increased cortisol and reduced DHEA.

Chronic Fatigue Syndrome (CFS)

A common HPA axis defect in CFS is impaired corticotrophin release. As a result, low cortisol and eventual adrenal atrophy may be observed. Depleted adrenals with flat rhythms are often seen on the ASI™ panel. Simultaneous use of several therapies can help improve the debilitating effects of CFS.

Glycemic Dysregulation

Chronic hypoglycemia can impair normal adrenal function by repetitive overstimulation of cortisol production. Recurring exposure to high cortisol will impair insulin activity, and invariably lead to insulin resistance and beta-cell exhaustion (diabetes). The ASI™ panel investigates the insulin-cortisol relationship under real-life conditions to allow targeted and meaningful interventions. This panel is useful in the following clinical situations: rapid weight gain and obesity, deranged blood lipids, sugar blues, early diabetes and associated emotional disturbances.

Allergies/Autoimmune Disorders

More than fifty years ago, Dr. W. Jefferies (author of Safe Uses of Cortisol) discovered that patients with environmentally triggered allergies and autoimmune diseases dramatically benefited when given cortisol for other purposes. More recently, German researchers reported that disruption of the adrenal axis and cytokine relationships lead to predisposition and aggravation of autoimmune diseases. The findings of the ASI™ help identify patients with autoimmune diseases and adrenal problems who can benefit from cortisol supplements.

Depression/ADD

Several recent publications report a hyperactive HPA axis in depressed patients. Elevated midnight salivary cortisol is now considered one of the best tests in diagnosing endogenous depression. Other anomalies in cortisol rhythm usually accompany the midnight elevation. On the other hand, cortisol elevations and rhythm disruptions throughout the day are typical of attention deficit disorders (ADD). The anomalous cortisol findings in depression and ADD can be diagnosed successfully with the ASI™. Subsequent interventions to rectify the time-specific cortisol elevations (during the day or night) are usually effective when applied under proper supervision.

 

Female Hormone Panel™ (FHP™): Patient Overview

The Cyclical Pacing of the Ovaries

The human ovary releases its hormones in a cyclical manner, which is referred to as the menstrual cycle. The average cycle is 26-30 days. The timing and pacing of hormone release is governed by GnRH, FSH and LH, hormones from the hypothalamus and pituitary glands in the brain. The two major classes of ovarian hormones released during the menstrual cycle are estrogens and progestogen, also known as the female steroid sex hormones. The major and most active estrogen released is estradiol, while the major progestogen is progesterone.

The Female Cycle has Three Physiologic Phases:

Phases of Female Cycle

1. The follicular phase starts with the onset of menstrual blood flow and is of variable length. This phase is normally characterized by both low estrogen and progesterone output.
2. The ovulatory phase is 1 to 3 days long, and the human ovum (egg) is released in this phase. This phase is preceded by high estrogen and LH levels.
3. The luteal phase is rather constant in length, 12-14 days, and ends with menses. In contrast to the follicular phase, the luteal phase is characterized by high progesterone concentrations and a moderate increase in estrogens.

Functions of Female Sex Hormones

Estradiol and Progesterone affect several target organs involved in successful conception and pregnancy. Additionally, these hormones maintain a number of secondary sexual characteristics, such as reduced body hair, soft skin texture, a higher voice pitch and possible release of certain pheromones.

Target Organs of Estrogen and Progesterone

The Uterus – Estradiol prepares the uterus for conception, produces a threefold to fivefold increase in the thickness of its inner lining and also promotes uterine gland development and mucus secretion. Progesterone causes a swelling of the uterine lining, an increase in glycogen (a complex sugar) content and an increase in the mucus secreted by the uterus. If conception does not occur, the uterine lining is shed, resulting in the menstrual flow.

Fallopian tubes – Sex hormones stimulate the Fallopian tubes to move the egg toward the uterus. The Fallopian tubes also secrete fluids that nourish the egg, the sperm and ultimately the embryo when fertilization occurs.

Vagina – Estrogens promote the thickening of the vaginal lining and increase its secretions, which makes the lining more resistant to infections.

Breasts – Before puberty, the breasts grow only in proportion to the rest of the body, but under the influence of estradiol and progesterone during puberty, the breasts develop to maturity. During the menstrual cycle, excess estradiol causes breast swelling and tenderness.

Bones – In the adult female, Estradiol and Progesterone play an important role in the inhibition of osteoporosis and improve the incorporation of calcium and magnesium into bone. This is often why doctors prescribe Estrogen for menopausal women.

Kidney – Estrogens cause the body to retain sodium, which results in fluid buildup. Conversely, progesterone causes a loss of excess sodium and retained fluid. Before the period begins, there may be a relative excess of estrogen over progesterone, which commonly leads to several of the PMS-associated complaints.

Liver – Estradiol has stimulatory effects on liver proteins which may reduce thyroid hormone availability and increases the risk for cardiovascular disease. Estradiol also slows the process of liver detoxification of various harmful substances.

Miscellaneous – Estradiol can elevate blood sugar in certain susceptible individuals. Progesterone can increase the appetite and has a general calming effect on the nervous system, especially at night.

What We Test

The Female Hormone Panel™ is a simple, non-invasive test. Eleven saliva samples are collected during specified time periods throughout the menstrual cycle.

Using this panel the first time in routine medical practice, both patients and doctors can view the profiles of estrogen and progesterone simultaneously. Diagnostic guesswork is minimized, and hormonal balance evaluation and customized treatment becomes a reality. In addition, we report the cycle average for testosterone and DHEA. The expanded panel also includes five FSH and LH measurements to see if brain control and stimulation of the ovaries are optimal.

Applications of the Female Hormone Panel™

Detection of Luteal Phase Deficit There are at least three luteal phase-deficit patterns which are characterized by a progesterone/estrogen imbalance. This imbalance is usually associated with PMS, infertility, fibroids and other female hormone-related problems and can be readily detected by our panels.

Hormonal Imbalance and PMS Many women suffer from hormonal imbalance in the estrogen to progesterone ratio. Our panels can define the hormonal state with exquisite accuracy which, in turn, provides specific insights for appropriate intervention to relieve hormonal imbalance and PMS-related symptoms.

Customized Hormone Therapy Presently, female hormone therapy is not individualized to the needs of each woman, because current diagnostic tests do not provide sufficient data. Consequently, most women are empirically treated without regard to their individualized physiology and specific needs. The FHP™, for the first time, will allow a clinician to customize therapy to each female patient.

Other Applications

The FHP™ can also be used to detect and monitor the following:

  • Functional infertility
  • Influence of diet, exercise and other lifestyle factors on the cycle
  • Menstrual problems originating in the brain
  • Early pregnancy problems, such as spontaneous miscarriage
  • Cycle irregularities, following the use of birth control pills
  • Dysmenorrhea, that is painful and heavy periods
  • Migraine headaches
  • Cystic ovarian disease
  • Early osteoporosis

Advantages of the FHP™

Convenience: Requires no blood draws, therefore no repeat clinic visits, and avoids the inconvenience of the 24-hour urine collection.

Economy: The fee for the 11-sample test is less than that of two blood determinations or a urine analysis for estrogen and progesterone.

Physiological accuracy: Research has demonstrated that the free hormone fraction predominates in saliva. Hormones can be found free or bound to protein. The free hormone fraction is very important, because it is the bioactive fraction that most significantly influences living cells. The salivary female hormone levels correlate at 93% with the free hormones in the tissues.

One or two blood determinations or a 24-hour analysis of urine for these hormones gives only an idea of the ovaries’ hormonal productivity. The FHP™ provides a view of the ovarian capacity over a whole menstrual cycle.

Do you need the FHP™?

To determine if the FHP™ is the appropriate test for your hormone-related problems, consult with your physician or healthcare provider.

  • If either infertility or PMS are of concern to you, ask your doctor about the Expanded Female Hormone Panel™.
  • Our expanded panel not only reveals any hormonal imbalances, but also accurately indicates the basis of the problem.
  • Hormone balancing is reduced to simple scientific principles using our well-structured report and recommendations.

 

Menopausal Hormone Panels™: Patient Overview

 

Literally, menopause means the cessation of the monthly menstrual cycle; it signals the end of a woman’s natural childbearing years. Menopause is neither a disease nor an illness—it is a natural and usually gradual change in glandular function. It has its origins in the beginning of menses and culminates in a series of hormonal changes that result in the cessation of menstrual flow. This transition produces a variety of bodily manifestations and symptoms, due to changes in the production of hormones and the timing of their release.

The right balance of hormones is important to long-term emotional, mental and bodily health

Various body parts undergo change and can produce one or more of the following symptoms:

Endocrine

  • Bleeding irregularities
  • Vaginal dryness
  • Hot flashes or sweats
  • Changes in sex drive

Nervous system

  • Insomnia
  • Nervousness or irritability
  • Headaches
  • Mood changes
  • Depression

Metabolic changes

  • Skin aging or cosmetic changes
  • Osteoporosis
  • Altered fat and carbohydrate metabolism
  • Atherosclerosis

What Can You Do About It?

There are several therapeutic options which may minimize or even eliminate many of the symptoms:
• Treat symptoms using synthetic hormones without hormone-level testing.
• Treat symptoms using natural hormones without any testing.
• Treat and correct symptoms using natural hormones with testing for hormone levels before and after treatment.

Hormone levels from woman to woman can vary from 200% to 1,500%!

What Do We Test For and What Does It Tell You?

We test for male and female natural hormones. One, two, six or eight of them, depending on your need. We utilize your saliva as a sample for measuring hormones, such as testosterone, DHEA, progesterone, estriol, estrone, estradiol.

The brain-derived regulating hormones FSH and LH, are also measured to help assess efficacy of control and feedback between the brain and ovaries. Measurement of FSH and LH is included in the expanded panel, the ePostM™ as well as in the ePeriM™.

Saliva hormone values reflect the tissue concentration of your hormones. Blood and serum contain the total hormone, but your tissues are only bathed with the active or effective fraction as found in saliva. Active fraction measurements are superior to blood and urine measurements both in diagnosis and treatment.

How Can We Help You?

Let us take a common example:

A woman suffers from several symptoms—migraines, hot flashes and emotional fragility. She is having irregular periods, one every 6-8 months. Her doctor treats her with natural estrogens, but he does not do any testing to determine quantities or types of hormones that will meet her specific needs. The symptoms are under control, but her risks are increased.

Risks of treatment without actual testing of hormone levels includes:

  • Increased blood pressure
  • Endometrial cancer (uterine cancer)
  • Fibroid growth
  • Gallbladder disease
  • At least twice the risk of breast cancer over 15 years

What could we have found out if we had tested her saliva hormone levels? We would have known that she has too much estrogen, not enough progesterone to balance the estrogen, low DHEA and marginal testosterone.

But she felt good on the estrogen, many will say. Yes, however, the silent killers (cancer, blood pressure, heart disease) rarely make anyone feel badly at the start. Her best course is a new treatment plan, designed around the objective saliva hormone measurements.

Ask your healthcare provider for the Menopausal Hormone Panel™ (PostM™) or the expanded panel — ePostM™—to measure your hormones.

Arbitrarily given hormones may deal with the symptoms while posing other serious health risks

How Do You Benefit?

There are five distinct ways that you can benefit from using the saliva tests in the Menopausal Hormone Panels™:

  1. They are more affordable than blood or urine tests. Blood testing for six hormones costs $250-$300 more than saliva testing.
  2. The collection procedure spares you the pain of venipunctures with a needle.
  3. Results are more clinically reflective of your hormone status and needs.
  4. Results can lead to an individualized and customized treatment plan using natural hormones.
  5. You will minimize overdosing and underdosing. This will ensure that you use only the proper hormones in the appropriate amounts.

With salivary hormone testing, guesswork is a part of the past.

  • The Post-Menopause Hormone Panel™ (PostM™) helps determine the risk of disease in your breast or uterus, and also allows for individualized recommendations on how to minimize this risk.
  • Taking hormones without analysis and a determination of the true need for specific hormones entails unnecessary risk of possible serious side effects.
  • The correct hormone panel along with the assistance of your doctor will aid in the prevention and treatment of osteoporosis.
  • Our test helps you know for certain whether you are in menopause or in perimenopause.

 

Male Hormone Panel™: Patient Overview

What You Can Do About Male Hormone Imbalance

Optimal health is dependent on a balance of hormones, not just a single hormone. Currently, men with low androgen hormones can benefit from hormone replacement therapy. Men with imbalances in their levels of androgen to estrogen and progesterone can also benefit from hormone supplements.

Supplemental hormones can be given by mouth, injection, skin patch or implant. Androgen supplementation, in states of deficit, improves alertness and produces a feeling of well-being, with a reduction in abdominal fat and enhanced lean body mass.

Testosterone production in males is mainly a testicular function. The pituitary sex hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) stimulate and regulate this function. Specifically, LH stimulates testosterone production in the testicles. This process is under negative feedback, meaning that testosterone levels regulate LH secretion. FSH and testosterone stimulate sperm production.

Why Measure Male Hormones?

Measurements of hormones can be used in two general ways:
• To estimate the body’s own production as a baseline test.
• To measure levels of hormones after supplementation in therapeutic monitoring.

Baseline measurements show normal and abnormal levels of six distinct hormones, shown in the boxes in Diagram 1. If the levels are too low, too high or hormone ratios are outside of expected limits, an objective treatment plan can be developed for the patient. Symptoms are not a substitute for measuring hormone levels, because many symptoms may involve non-hormonal factors.

Using appropriate tests for monitoring hormone therapy is crucial in establishing the appropriate dosing regimen. This reduces the chance of undesirable side effects and maximizes beneficial effects. For example, excessive use of androgens (testosterone, androstenedione, DHEA and testosterone derivatives) can activate subclinical prostatic tumors which are androgen-dependent. Monitoring is especially important in older males. By the age of 70, at least 50% of men have subclinical prostate cancer. These individuals are especially susceptible to growth stimulation by androgens.

The roles of the seven tested hormones are highlighted in the following descriptions of each:

DHEA – Is the precursor for both male and female hormones— and anti-stress hormone produced by the adrenal glands. Unmonitored intake can easily alter the delicate balance between male and female hormones.

Androstenedione – Is a weak (androgen) and a precursor to both male and female hormones. Unmonitored intake in men can cause excessive female hormone production with minimal male hormone production. In women, unmonitored intake usually causes excess male hormone production with body and facial hair stimulation.

Testosterone – Is the main testicular androgen and is a precursor to the highly potent dihydrotestosterone male hormone. Excessive amounts of testosterone promote hardening of the blood vessels, aggression, prostate problems and an increase in total cholesterol.

Dihydrotestosterone (DHT) – Is made from testosterone in certain tissues. The rate of its production is controlled by the level of free active progesterone. Excess DHT causes prostate enlargement and thinning of scalp hair.

Progesterone – Is a hormone important to both men and women. It is a natural calming agent to our nervous system. It also keeps in check excessive DHT production and counterbalances the effects of excessive estrone. Unmonitored intake can lead to breast enlargement, depression and weight gain.

Estrone – Is an estrogen that both men and women produce in the fat cells. The more fat, the more estrone, which in turn promotes fat deposits. It is produced from androstenedione, and excess of estrone can cause breast enlargement and contribute to prostate enlargement. In males, a certain low level of estrone is mandatory to balance the androgens.

Estradiol – Is another estrogen that is much more powerful than estrone. It is partially formed in the testes but mostly in the perepheral tissues from both the testicular and adrenal androgens.

What We Test and What It Tells You

Using a saliva sample, the regular MHP panel measures seven hormones: DHEA, androstenedione, testosterone, dihydrotestosterone, estrone, estradiol and progesterone. The expanded panel measures these seven hormones plus FSH and LH. The hormone levels in saliva reflect the active tissue concentrations, while blood contains mostly protein- bound hormones, whose active levels can only be estimated at best. Urine contains both the active hormones and numerous metabolites and can only provide a gross estimate of hormone production over time. Active fraction measurements from saliva are superior to blood and urine for use in diagnosis and treatment.

This Test is For You if You Are:

Middle-aged and experiencing any of these conditions:

  • Impaired libido
  • Erectile dysfunction
  • Baldness and/or extremity hair thinning
  • Fat accumulation around the waist
  • Urinary problems such as pain, frequency or urgency— or interrupted stream
  • Changes in sleeping habits
  • Lack of enthusiasm for life
  • Increase in bad cholesterol—decrease in good cholesterol
  • Osteoporosis

Young and experiencing any of these conditions:

  • Impaired libido
  • Erectile dysfunction
  • Early baldness
  • Inability to lose weight

How Do You Benefit?

There are five distinct ways that you can benefit from using the saliva tests in the Male Hormone Panel:

  1. They are affordable and less expensive than blood or urine tests. You save $250 – $300 on seven hormones.
  2. The collection procedure spares you from the biohazards and pain of venipunctures.
  3. Results are more clinically reflective of your hormone status and needs.
  4. Results can lead to an individualized and customized treatment plan using natural hormones.
  5. You will minimize overdosing and underdosing. This will ensure that you use only the proper hormones in the appropriate amounts. With salivary hormone testing, guesswork is minimized.

Use the Male Hormone Panel to help restore well-being, vitality and passion for life. Taking hormones without an evaluation of the actual need for specific hormones entails risks that are both serious and unnecessary. With two additional tests for LH and FSH, our expanded Male Hormone Panel can accurately identify the origin of the most common male hormone problems.