Saliva testing is a noninvasive collection method in which patients collect their saliva in plastic tubes to measure hormones such as cortisol, estrogens, progesterone, and androgens. This non-invasive saliva collection is ideal for patients because it allows them to collect their samples in the privacy of their homes or office.
Why do we analyze hormones in saliva?
Steroid hormones in the bloodstream are 95-99% bound to carrier proteins and thus are unavailable to target tissues. Saliva tests measure the amount of hormone available to target tissues – the bioavailable amount. For this reason, the saliva test is best related to specific symptoms of excess or deficiency and is a good option for monitoring hormone therapy.
Some analytes cannot be tested using immunoassays, the methodology used for most of our saliva tests. For that reason, ZRT developed an LCMS saliva steroid profile using liquid chromatography/tandem mass spectrometry (LC-MS/MS). This profile analyzes a wide range of bioavailable hormones and hormone metabolites in one convenient collection of saliva samples.
The LCMS test allows accurate reporting of estrogens down to extremely low levels, such as those seen in men, children, and people using aromatase inhibitors, and includes a test for ethinylestradiol, 3-hormone blockers, and melatonin. ZRT is one of the first laboratories to measure hormones in saliva and helped establish the method that made salivary hormone testing commercially viable for healthcare providers and patients around the world.
The most advanced saliva tests today
- Supplementation adjusted ranges:
Unlike other labs, patients do not need to stop hormone supplementation to use ZRT tests because we have ranges adjusted for age, menstrual status, and types of supplementation. This is the ideal method for tracking the effectiveness of hormone treatments.
- No grouping:
ZRT does not pool patient samples, which means we do not pool multiple daily samples to get an average hormone level. Instead, we measured hormones from a single morning sample, which represents the peak of daily hormone production, the optimal time to measure.
ZRT is the only laboratory that performs an extraction process for saliva testing, which separates hormones from background contamination. This is the only way to ensure accurate test results for low concentration hormones like estradiol.
- Establishment of industry standards:
ZRT initiated and manages the industry-wide standards program called the Interlaboratory Saliva Proficiency Testing Program, which enables laboratories to evaluate and improve the accuracy of saliva tests on a regular basis.