Many people with thyroid and autoimmune thyroid conditions have a hormone imbalance. While most people I consult with haven’t received any type of hormone testing, some people have had such testing, and usually it has been serum testing done by their medical doctor. While this type of testing can be useful, there are some flaws you need to be aware of. Although you might think this doesn’t pertain to you, just keep in mind that many people have an underlying hormone imbalance but are unaware of it. So just in case you ever need to receive any type of hormone testing, I would take a few minutes to read this information carefully.
The Differences Between Serum & Saliva Testing
I’ve discussed this in other articles and posts before, so I won’t go into much detail here. But the primary difference between the blood tests and the saliva tests is that most blood tests measure the bound form of the hormone, while saliva testing measures the free form of the hormone. 99% of the hormones in the bloodstream are in the bound form, and are released when necessary. But it’s the 1% of the free hormone that we need to look at with regards to these tests. Of course the free hormone can be looked at under serum tests. This is obvious when looking at the thyroid hormone levels, as with serum testing one can look at the Total T3 or T4, or the Free T3 or T4. Similarly, it is possible to look at the free levels of estrogen and progesterone. The problem is that it is more expensive, and therefore most medical doctors simply order the bound form of the hormone when it comes to estrogen and progesterone.
This is why I recommend saliva-based testing. While such testing isn’t cheap, it’s less expensive than the free serum tests. Another advantage is that it’s non-invasive, and you can do it from the comfort of your own home. Some question the accuracy of this test, but the main questions arise simply because we’re so accustomed to blood tests. So we make the assumption that blood tests must be more accurate than saliva tests, or else medical doctors would recommend saliva-based testing to all of their patients. But as usual, it all comes down to the training they receive in medical school, as you probably have guessed that they don’t teach medical doctors about saliva testing in school, and so it shouldn’t be a surprise that most medical doctors frown upon such testing.
One-Sample Testing In Cycling Women Is Inadequate
Another major flaw with conventional testing of hormones is the following: taking a one-sample test of a cycling woman doesn’t give a complete picture of what is happening with her hormones. I can understand using serum testing on a menopausal women, although once again, one should evaluate the free form of the hormone. On the other hand, it doesn’t make sense to draw a one-sample test for someone whose hormone levels are in a constant state of fluctuation. I’m not suggesting that one-sample testing of cycling women is completely useless, as there is some value, but it’s definitely not sufficient to see if someone has an existing hormone imbalance. Just because a woman doesn’t have an imbalance at one point during her cycle doesn’t mean doesn’t have an imbalance at other points.
For example, if you are a cycling woman and you visit your medical doctor for a one-sample serum test on day #17 of your cycle, and if everything looks fine, this doesn’t mean there isn’t an imbalance on day #11, day #21, etc. Keep in mind that the in the first half of the cycle, estrogen is the dominant hormone, and then in the second half of the cycle progesterone is supposed to be the dominant hormone. So at the very least you would want two samples taken a few weeks apart. But even this wouldn’t be sufficient, which is why a saliva-based cycling female hormone panel will require a cycling women to collect a saliva sample every few days of her cycle.
One of the big reasons why you want to obtain multiple samples is because you’re looking at the output of these hormones throughout the cycle. This is especially true in the second half of the cycle when progesterone is the dominant hormone, as you want to look at the total output of progesterone, and not just the levels on a specific day.
Monitoring The Levels Of Someone Taking Bioidentical Hormones
More and more doctors recommend bioidentical hormones to their patients. What many don’t understand is that these hormones are in the free form, yet most medical doctors use serum tests to follow-up on these patients, which as you know by now only detect the bound form of the hormone. What commonly happens is that people who use natural estrogen, progesterone, and testosterone creams will overdose, but the serum tests won’t reveal this because they’re only showing the bound form of the hormone. So if they’re going to use serum testing to monitor their patients who are taking bioidentical hormones, they should look at the free form of the hormone.
So hopefully you now have a better understanding of the differences between serum-based hormone testing and saliva-based hormone testing. While the serum-based tests have some value when it comes to menopausal women, you need to remember that they don’t measure the free form of the hormone. And when it comes to testing the sex hormone levels in cycling women, a one-sample serum test won’t give a complete picture of what’s happening. Finally, when taking bioidentical hormones, if someone is overdosing then serum-based testing won’t reveal this since bioidentical hormones are in the free form of the hormone.