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Thyroid Blood Tests vs. Saliva Testing

While most people with thyroid conditions receive thyroid blood tests such as a TSH, T3 and T4, etc., more and more people are also obtaining saliva tests.  What I’d like to do here discuss some of the benefits of both thyroid blood tests and saliva-based tests, and also reveal some of the potential disadvantages of receiving each of these tests.

Benefits Of Thyroid Blood Tests:  The first obvious benefit of receiving thyroid blood tests is that they can help to diagnose an existing thyroid condition.  So for someone who already has a hypothyroid or hyperthyroid condition, thyroid blood tests can be valuable in showing the blood levels of certain hormones.  For example, most people with a thyroid condition obtain a TSH blood test.  If the values fall below the desired reference range, then the person is said to have hyperthyroidism.  On the other hand, if the values are higher than the reference range, then the person is diagnosed with hypothyroidism.

The same concept applies with some other thyroid blood tests.  Free T3 and T4 are two other common thyroid blood tests.  These tests measure the levels of free circulating thyroid hormone, and are typically high in someone with hyperthyroidism, and low in someone with a hypothyroid condition (they are more frequently used in hyperthyroid conditions).

Tests for thyroid antibodies can also be performed to help determine if someone has an autoimmune thyroid condition, such as Graves’ Disease or Hashimoto’s Thyroiditis.  Two examples of these tests include TPO and TSI.  So for example, if someone with hypothyroidism has a positive TPO test, then they will be diagnosed with Hashimoto’s Thyroiditis.  On the other hand, if someone has hyperthyroidism and has high antibody levels, then Graves’ Disease will be the most likely diagnosis, although one needs to keep in mind that the absence of thyroid antibodies does not automatically rule out an autoimmune thyroid condition. 

Disadvantages Of Thyroid Blood Tests:  While there are some great benefits of thyroid blood tests, there are also a few potential problems with them.  First of all, they aren’t always accurate.  For example, many people who have negative tests are symptomatic, and have an obvious thyroid condition.  There are a few reasons why this is common.  First of all, one can’t solely rely on the reference ranges alone.  For example, if someone has hypothyroid symptoms but their thyroid blood tests are negative, this might be due to incorrect reference ranges used by the doctor.

Another reason why this happens is because thyroid blood tests detect the condition when it’s at the end-stage.  In other words, frequently the person becomes symptomatic before the actual thyroid blood tests become positive.   Because it takes a long time for most thyroid conditions to develop, it in turn will take time for the blood tests to show up as being positive.

As mentioned earlier, one also can’t rely on the tests for thyroid antibodies.  They tend to fluctuate, and so when someone tests positive for thyroid antibodies, it pretty much confirms that they have an autoimmune thyroid condition.  The opposite isn’t true though, as just because you test negative for thyroid antibodies doesn’t rule out you having an autoimmune thyroid disorder.

Benefits Of Saliva Testing:  As for the benefits of receiving saliva testing, one huge benefit is that this testing frequently will detect the underlying cause of the problem.  For example, there is a test called the Adrenal Stress Index test (ASI), which measures the levels of cortisol in the body according to the circadian pattern, as well as DHEA, and some other hormones.  With regards to the cortisol levels, these levels will provide a good indication as to whether someone has problems with their adrenal glands.  Frequently people with weakened adrenal glands will have very low cortisol levels in the morning, when it normally should be high.  Other people will have high cortisol levels.  In any case, compromised adrenal glands can potentially lead to thyroid conditions, and thus will need to be addressed in order to successfully restore the health of the thyroid gland.

There are other saliva-based tests that are very useful in detecting the underlying cause of one’s thyroid condition.  Another example is a male or female hormone panel, which will measure the levels of the sex hormones in the body.  An imbalance in one or more of these hormones can lead to many different issues, including thyroid conditions.  For example, if someone has an excess in estrogen or a progesterone deficiency, this can lead to a condition called Estrogen Dominance, which can create a lot of problems.  And once again, in order to eventually restore the health of anyone with a thyroid condition, this condition needs to be fixed.  And the same thing applies with other imbalances in the hormones.

Another benefit of saliva-based testing is that they are easy to obtain, and unlike blood tests, you can administer them from the comfort of your home.  I use a company called Diagnos-Techs for saliva testing, and the way this works is that you are sent a test kit with detailed instructions on how to collect the saliva samples.  You would simply collect the samples during different intervals of the day and place them in the vials provided, and then would refrigerate them until you were able to ship them.  Then you would place the vials containing the samples in a return shipping box provided by the company, and then ship them to the lab.  This is a much easier process than having to visit a doctor’s office or lab to get blood drawn.

Yet another benefit of saliva-based testing is that they are non-invasive.  Unlike blood tests, no needles are involved, and of course there is no blood drawn.  In fact, saliva-based tests are great to perform on children when you suspect problems with their adrenals, as well as other conditions, as most children won’t object to receiving such tests since they don’t involve any needles.

Disadvantages Of Saliva Testing:  There really aren’t too many disadvantages of receiving saliva-based testing, although there are some things you need to be aware of.  First of all, not all labs are the same, and so you definitely want to use a company that has a good reputation and uses valid reference ranges.  Another disadvantage is that before taking a sample, there are certain instructions you need to follow in order to receive accurate results.  For example, you shouldn’t brush or floss your teeth within a certain time frame before doing this testing, and depending on what tests you take there may be certain foods you will need to avoid eating the day of the test.   

How Accurate Are Saliva-Based Tests?

One question you may have is “how accurate are saliva-based tests?”  Studies show that these tests are actually very accurate.  However, one needs to understand that they are different from blood tests, so one can’t really compare the two.  For example, most blood tests involving hormones measure the bound protein.  However, saliva-based testing measures the free level of hormone. 

Of course if you were to ask your endocrinologist, or any other type of medical doctor to perform a saliva-based test, there is an excellent chance that he or she would refuse to do this.  There is even a chance they would question the accuracy of saliva-based testing, but the main reason for this would be due to lack of knowledge.  Although saliva-based tests are becoming more popular, they still aren’t being used by most medical doctors.  While I don’t see this changing in the near future, hopefully in the years to come a larger percentage of medical doctors will begin to incorporate this type of testing into their practices.

In summary, both thyroid blood tests, as well as saliva-based tests can be valuable.  Although I listed a number of disadvantages of thyroid blood tests, I do believe that anyone with a thyroid condition should receive both types of testing.  While thyroid blood tests usually do a good job of diagnosing someone’s condition (although not always), the saliva-based tests can help the doctor find the underlying cause of their condition, which of course can help to restore the patient’s health back to normal.

Other Articles You Might Like To Read:

Why You Can’t Rely Solely On Thyroid Blood Tests

Using Bioidentical Hormones To Restore Thyroid Health

5 Must Read Books For People With Thyroid Conditions

Goitrogens: Thyroid Inhibiting Foods You Should Avoid

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