Serum Saliva And Urine Testing


Serum testing hormones, is considered to be the ideal measuring standard for hormones and has been accepted by the conventional medical community. This test requires little patience, is a very simple collection and has unshakable reference ranges. It is perfect for testing peptide hormones, like: FSH, LH, prolactin, fasting insulin and thyroid hormones, which include, T3 and thyroid antibodies. I can also measure the sex hormone binding globulin (SHBG) and cortisol binding globulin (CBG). Serum testing, has a limited utility for sex hormones most of them have no distinction made in serum between bound and free hormone.


Estradiol, estrone, estriol, and progesterone are reported as total hormone and free hormones assays that are not commonly available. When this happens the results may be confusing, do to an abundance of bound hormone that make hormone levels look normal or even higher than normal.  In the other hand, if a free hormone level is low, it can make the patient be functionally deficient, even if it has a normal total hormone level. Serum testosterone can be used as an exception and is available as total and free, it can be useful for assessing hormone balance.


Saliva testing has become in the past decade a popular petition among patients of functional medicine. It is a non-invasive technique and completely accessible to the  practitioners like Naturopathic physicians, chiropractors and acupuncturists when the state doesn't give them the licensed necessary to do blood tests or even just draw blood. Its a big advantage for both parties. Its possible to do multiple saliva collections over a period of day or up to a month, that help expose abnormal hormonal patterns, like a shortened luteal phase. Even thought it can theoretically be detected thru a Serum test, it is logistically awkward.


This kind of testing can also be used to examine the balance and flow of estrogens and progesterone in women during their menstrual cycle. In the other hand, it evaluates cortisol secretion patterns by the multiple samples taken over a period of a day and evening. It is so versatile that it can measure free hormones, which makes it a better measurement than Serum testing in the evaluation for unsupplemented hormone status. Pregnant women also benefit from it. Saliva estriol spikes around two weeks before the start of labor and can be used to identify those women who are in risk of preterm labor.


Measuring hormones urine is quiet common for research purposes, however not so much for clinical practice, like serum and saliva testing are. Usually a urine test is taken over a 24 hour period. Its important that the patient collects a urine sample that is secreted over night and with deep sleep, in order to test growth hormones and melatonin. Its a very economical and reliable way to evaluate steroid hormone metabolites. 14,15. This method has gain popularity between practitioners since the 1980´s when Dr. Jonathan Wright made it a clinical practice.


 Not all urine hormone testing methods are identical. Serial single-point urine collection does not explain the individual differences in hormone secretion in patients with irregular or non-traditional schedules, for example: Shift workers. A 24 hour urine collection is important, because it accounts for a full day and night of hormone secretion. This cuts down the possibilities for false or altered results in elevated or depressed levels, that are usually obtain when a single point collection occurs at a peak of the patients secretory cycle.

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