Avenues - Winter 2004

Saliva Tests for Cortisol and Other Hormones: Questions and Resources

Does the concentration of cortisol in saliva accurately reflect the cortisol level in blood?
Yes, when compared to the amount of cortisol in blood samples. A number of studies have suggested over 90% correlations between concentrations of cortisol in blood and saliva.

Is the level of cortisol in saliva affected by the amount of saliva I can produce?
No. Studies comparing salivary cortisol levels obtained under minimal and maximal flow rates clearly show that the cortisol levels in saliva do not depend on saliva flow rate.

Are there any medications or foods that will alter saliva cortisol test results?
Prednisone and other steroid drugs interact with test methods used to measure cortisol levels and can lead to inaccurately high results. Drinking highly acidic foods, such as fruit juices or coffee, immediately before taking the saliva cortisol test may also lead to inaccurately high cortisol results.

Is refrigeration of the saliva samples necessary? Will freezing saliva samples affect the cortisol test results?
No. Salivary cortisol is stable at room temperature for up to two weeks, but because the saliva sample will contain moisture, it should be sent to the laboratory as soon as possible. Freezing saliva samples will not affect the cortisol test results.

How often should I test my hormone levels?
If you are following a treatment program to balance your hormones and are using hormone supplementation, it is often recommended that you test in three to six month intervals for monitoring purposes. This allows your health care practitioners to track your progress and make necessary adjustments to your hormone therapy dosage.

How accurate is saliva testing as compared to blood or urine testing?
Saliva tests have been used in scientific testing for decades and have been shown to be highly accurate. The World Health Organization, for example, has used this method of hormone testing in worldwide comparisons of breast cancer among women living in industrialized versus non-industrialized countries. In terms of accuracy, many studies in the scientific literature have shown a strong correlation between the levels of steroid hormones in the blood stream and the bio-available (free) levels of steroid hormones in saliva – hormones actually doing their job at the cellular level. In fact, saliva testing is the most reliable way to measure this free, bio-available hormone activity.

Where can I get saliva hormone testing kits?
» ZRT Laboratory. Beaverton, Oregon. (503) 466-2445. www.salivatest.com
ZRT's Hormone Hotline is a 24-hour taped audio-library with a growing list of topics on every aspect of hormone balance and testing: (503) 466-9166.

» Great Smokies Diagnostic Laboratory. Asheville, North Carolina. (800) 522-4762 (for doctors), (888) 891-3061 (for consumers). www.gsdl.com

» Aeron Lifecycles. San Leandro, California. (800) 631-7900. www.aeron.com

» Diagnos-Techs, Inc. Kent, Washington. (800) 878-3787. www.diagnostechs.com

How do I know which hormone tests to order?
Speak with your healthcare provider or contact the ZRT Laboratory customer educators at (503) 466-2445. A general suggestion for both men and women is to get tests for the major hormones: estradiol, progesterone, testosterone, DHEA-S, cortisol morning, and cortisol night. All of these hormones listed are relevant to both breast and prostate cancers, the two most common hormonally related cancers. The hormones cortisol and DHEA-S are commonly used in assessing stress levels.

Where can I learn more about saliva testing of hormones?
A useful bibliography on the efficacy of saliva testing is available online at www.salivatest.com/journals/saliva_ref.html

A note to residents of New York: New York State health law prohibits the testing of specimens collected in or mailed from the State of New York. The law also prohibits the transmission of data from any laboratory to New York physicians or residents that is not approved, licensed, and examined by the State.

A note to residents of California: California State health law requires that the testing of any specimen collected or mailed from California be accompanied by a written order from a health care professional licensed in California to order laboratory tests. This includes medical doctors (MD), licensed acupuncturists (LAc), registered pharmacists (RPh), osteopaths (DO), nurse practitioners (NP), chiropractors (DC), and registered dietitians (RD). California consumers not working with a licensed health care professional should contact a compounding pharmacist in their area or contact a health provider.

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