Dr. Kelley prefers to use saliva testing to determine hormone levels in patients. The following explains a little bit more about saliva testing.

The Technology

In the past 20-30 years a number of research studies have validated saliva as a diagnostic medium to measure the unbound, biologically-active fraction of steroid hormones in the bloodstream. Saliva is a natural ultra-filtrate of blood, and steroids not bound by carrier proteins in the blood freely diffuse into saliva. The majority (90-99%) of steroid hormones in the blood are bound tightly to carrier proteins (cortisol-binding globulin, sex-hormone binding globulin, albumin) rendering them unavailable to target tissues. Steroids are very small lipophilic (fat-loving) molecules that, when released from the binding proteins and red blood cells in the blood, freely diffuse into tissues, which include the salivary gland. The steroid hormones most extensively studied in saliva are: Estrogens (Estradiol, Estrone, and Estriol), Progesterone, Androgens (DHEAS, Testosterone) and Cortisol for assessment of adrenal function.

Advantages

• Saliva measures the free, “bioavailable” fraction of steroid hormones that have moved out of the bloodstream and into the tissue
  Note: blood and urine measure total levels
• Saliva is the most reliable measurement of tissue uptake with topical hormone supplementation
• Painless, noninvasive and needle-free (stress of conventional blood draw can alter test results)
• Private (home collection kit) convenient for both patient and doctor allows for optimal collection time
• Hormones are stable in saliva at room temperature up to three weeks allowing for worldwide shipment
• Transport of saliva samples to laboratory requires no special handling
• Less expensive than conventional blood testing
• Ease of collection allows for routine monitoring of hormone levels and adjustment of hormone supplementation as needed

Clinical Utility

Saliva Testing can help your doctor:

• Identify hidden hormonal imbalances (deficiency or excess) associated with patient symptoms of menopause and andropause as well as reproductive disorders, chronic illness, and diseases of aging
• Link clinical symptoms to specific hormone imbalance(s)
• Maintain health and prevent disease through early detection of hormonal imbalance(s)
• Restore hormonal balance and patient quality of life using test results as a rational basis for treatment
• Monitor patient hormonal levels for “individualized” hormone replacement
• Track patient progress with comparative history reports provided with follow-up testing