Hormone testing: Blood vs. Saliva

There are several different ways of measuring the hormones in a person’s body. Here at Arizona Natural Medicine ® , we primarily use blood and saliva tests to evaluate hormone levels. Especially in cases of perimenopause, menopause, irregular or painful menses, PMS, low libido, erectile dysfunction or fertility issues, hormone testing can be an effective way to determine how hormones are playing a role in your condition and what can be done about it.

Both blood and saliva have their advantages and are both viable ways to look at hormone levels. Which test is most appropriate can be determined by your doctor.

Most blood and serum tests look only at the level of hormones that are present in a person’s tissues. This is known as “bound hormone levels”. Saliva testing looks at the “unbound hormone levels”, which are the hormone levels that are available to be used by the body’s tissues. Saliva testing of hormones gives us a better idea of the levels of hormones that are actually influencing the tissues, rather than just the level of hormones that are present in the tissues.

Saliva testing has some advantages over blood testing. Saliva specimen collection does not require a blood draw and the collections are convenient and can be done at home. The ability to collect more than one specimen is another advantage of saliva testing because this can give providers more information than a single collection. This is especially useful with cortisol testing, in the evaluation of adrenal function, that requires 4 samples to be collected in a day.

On the other hand, new research of hormones in the blood suggest blood levels represent protein “bound hormones levels”, as well as, free fractions ( “unbound hormone levels”) to provide a complete picture of the biologically active hormones. Blood testing has been the gold standard when diagnosing or monitoring response to hormone therapies. Traditional blood work in capable of testing bound and some (but not all) of free hormone levels.

At Arizona Natural Medicine ® , our physicians, are versed in interpreting both blood and saliva hormone levels. When looking at blood hormone levels we look at a more thorough array of hormones and some in their active or “free” forms. For example, we test both the free and total levels of testosterone which gives us a better understanding of what effect the biologically active free form is having on your libido, energy and mood. We also may test additional hormones unlike many physicians, such as all three forms of estrogen (Estrone, Estriol, Estradiol), DHEA sulphate which is a precursor to other sex hormones, along with traditional levels of FSH, LH and Progesterone. Another advantage of blood testing is that it is usually covered by insurance, whereas saliva testing often is not.

We have found that both blood and salivary testing of hormones can be very effective in the diagnosis, treatment and management of hormone related conditions. Which test is most appropriate can be determined by your doctor.