Are saliva tests accurate?

[spinn]

Before I see my doctor again, I need to have some tests done. I dont want to sacrifice any accuracy but am paying cash for this so wouldnt mind looking for a good price.

I have the Canary Club kit where they charge about $140 for all the tests I need. These are done by saliva. Are these accurate enough for a doctor to use?

I would hate to pay for them and have the doc tell me they are worthless, and then have to pay him twice as well.

If not, how should I go about finding a lab to do this? I am in the Washington DC area.

 

[fatsuperman]

I wanna know too...

subscribing to this thread!!!

 

[hardasnails1973]

I found studies done that salvia reflects accurate results based on blood tests. It will show you how much bioavailable hormones are to the body which are the true indicators.

 

[bbuck]

My Dr. says they are no good. In his practice he has run both and they were not even close to each other in comparison.

 

[spinn]

Not being a smart ass......but how do you know it is the saliva test that was "wrong", and not the blood test?

I use my last Dr as a contra indicator...since he says saliva tests are not accurate....I am almost certain they are

 

[hardasnails1973]

Ask yourself this question "how many drs do you know that check serum levels instead of acctually Free t-3, ft4" From my experience about 90% of them do not check free levels and just go by serum levels. Most people dealing with CFS have altered levels at the cellular level and not in the blood that is what makes it so difficult to convince a dr because they say "its all in your head" because blood work looks perfect. You could have a normal testosterone, thyroid,insulin, cortisol serum reading, but how much of it is available to the cell that is the question. My testosteorne was 660 but my i still suffered hypogonadism, untill they check the free it was then found to be way out of range

Testing: Saliva Vs. Blood | Too Late Schmart | August 2003

 

[spinn]

I am a bit confused. Does that mean that saliva tests check the free numbers?

So if this kit I got from Canary club says they test for "testosterone" that means free testosterone if done via saliva?

 

[hardasnails1973]

Salvia checks for FREE or Biological available to the body not what is floating round in the blood bound to a protein

 

[JanSz]

Here's a response published by me in our local newspaper:

2. Based on my symptoms and labwork, I have decided to begin HRT (Hormone Replacement Therapy). My doctor uses saliva testing for the hormones. Is saliva testing a good way to do it?

No one who is respected in my field relies on them. I have seen far too many examples of saliva testing reporting results which are absolutely impossible physiologically. Hormones measured in the saliva reflect what is found in the saliva glands—not that of the blood—and saliva glands produce their own hormones. Also, the powerful muscles of mastication (chewing) alter hormone levels in the saliva, and tiny micro-hemorrhages (bleeds) continually form in the mouth. Both situations contaminate the specimen. The only assays for which saliva is suitable is cortisol (the “stress hormone”), and melatonin (for sleep). In my practice, I routinely use blood tests for hormones, and even urine testing--which in some cases is the best way of all. This is how I best optimize a gentleman’s performance—at work and at play.

Which of the LabCorp tests is best suitable for Corticol testing? (I have bolded the 4 specimens as probable choice, but am not sure, I am not even sure if "4 specimens" is blood or urine test).
LabCorp Directory of Services

1: Cortisol
2: Cortisol, Urinary Free, ICMA
3: Cortisol, Urinary Free, by HPLC
4: Adrenocorticotropic Hormone (ACTH), Plasma
5: 17-Hydroxycorticosteroids and Creatinine Ratio, 24-Hour Urine
6: 17-Hydroxycorticosteroids, Urine
7: 11-Desoxycortisol
8: Cortisol, AM & PM
9: Cortisol, AM
10: Cortisol, PM
11: 17--Hydroxyprogesterone
12: Salivary Cortisol
13: Cortisol, 2 Specimens
14: Cortisol, 3 Specimens
15: Cortisol, 4 Specimens
16: Cortisol, 5 Specimens
17: Cortisol, 6 Specimens
18: Cortisol, 7 Specimens
19: Cortisol, 8 Specimens
20: 17-Ketogenic Steroids, 24-Hour Urine

 

[DeerDeer]

Urinary cortisol, AM/PM cortisol, ACTH are great options, as a reference adn for educational pruposes consider getting the saliva test as well.

 

[spinn]

Looks like I will be getting the blood tests. How do I go about finding a good, but inexpensive lab in my area?

 

[JanSz]

Before I see my doctor again, I need to have some tests done. I dont want to sacrifice any accuracy but am paying cash for this so wouldnt mind looking for a good price.

LabCorp is where I do my tests.
I think of quality and consistency of results.
More important (to me) is that I can go to their blood collection places rather than having my blood shipped (next day) from doctor's office. Some tests need fresh samples.
The other criteria, I learned to use the same lab, after seeing what happened to my tests when using
doctors office (spoiled samples)
hospital lab (some tests done in local lab, some shipped to few other labs) have to deal with units conversion, long waiting time, uncompleted tests, repeated tests.

 

[spinn]

Every question leads to another question ..lol.

My doctor, for now at least, is more concerned about thyroid and adrenal function because that is his specialty.

Will these urine tests provide the accuracy I need?

 

[JanSz]

Which of the LabCorp tests is best suitable for Corticol testing? (I have bolded the 4 specimens as probable choice, but am not sure, I am not even sure if "4 specimens" is blood or urine test).
LabCorp Directory of Services

1: Cortisol
2: Cortisol, Urinary Free, ICMA
3: Cortisol, Urinary Free, by HPLC
4: Adrenocorticotropic Hormone (ACTH), Plasma
5: 17-Hydroxycorticosteroids and Creatinine Ratio, 24-Hour Urine
6: 17-Hydroxycorticosteroids, Urine
7: 11-Desoxycortisol
8: Cortisol, AM & PM
9: Cortisol, AM
10: Cortisol, PM
11: 17--Hydroxyprogesterone
12: Salivary Cortisol
13: Cortisol, 2 Specimens
14: Cortisol, 3 Specimens
15: Cortisol, 4 Specimens
16: Cortisol, 5 Specimens
17: Cortisol, 6 Specimens
18: Cortisol, 7 Specimens
19: Cortisol, 8 Specimens
20: 17-Ketogenic Steroids, 24-Hour Urine

Urinary cortisol, AM/PM cortisol, ACTH are great options, as a reference adn for educational pruposes consider getting the saliva test as well.

We have to keep in mind that 24 hour urines won't catch adrenal fatigue.

So now I know what not to do, but I still do not know what to do.

Since I could not wait any longer for the answer on proper LabCorp cortisol test,
I asked my good doc to write script for
Cortisol 4 specimens.

Any comments? I am not really sure what/how is going to be tested, does the results of this test will be useable in evaluation of my adrenals?

 

[JanSz]

Be prepared, such serial testing can still miss it. Labs are one part, albeit important, of the process of diagnosis.

Just got from LabCorp. Had blood drawn for the following:
Total Estrogens
estrone
Estradiol, sensitive
Progesterone
Pregnenolone
Total Testosterone
Free Testosterone
DHT (dihydrotestosterone)
prolactin, serum
SHGB, serum
Thyroid Stimulating Hormone (TSH)
Free triiodothyroxine (T3)
Total T3
Free T4
DHEA Sulfate
Hematocrit

Hit a snag with Cortisol, 4 Specimens.

I had a more complete test earlier, April 06.
This is "short" version.

At a blood LabCorp, nice ladies, told me that there must be equal time span (at this moment it is unspecified) between each draw. After first (baseline) draw I need to go to doctor's office to receive Dexamethasone shot. Next (3) draws have to be done at equal time intervals. Not sure how to specify those intervals. Most available time I have on Mondays, Lab Corp is open 7AM to 6PM and there should be a nurse at my doctor's office around 10AM or 11AM. Possibly I can talk my doc into giving me the vial with medicine so I can have a nurse at LabCorp giving me injection or maybe I would self inject.
Decissions, decissions.

Wonder if all this Cortisol test is not too much trouble in view of Dr. John comment. May be I should just drop the cortisol test, try Isocort (I have it in front of me) and see if it makes a difference.

If you reading this, Dr John, I would appreciate your advice.

 

[JanSz]

This serial draw is meant for the Dexamethasone Suppression test. You inhibit ACTH production with supplemented corticosteroid, then look to see if cortisol goes down. If it doesn't, that means the adrenals are off doing their own thing. Not good.

I want to make this point perfectly clear: I did not mean to say tests have no value. I run them by the boatload every day. It's just that we have to appreciate it is the interpretation of the labwork (the REAL reason for our medical training, NOT just knowing what and how to order them). With particular respect to this disease process, a negative test does not mean you do not have it. If I remember my Stats class correctly, this is known as Negative Predicative Power.

The reason for the above is that in Adrenal Fatigue, they "sputter"--sometimes they respond appropriately, sometimes they don't. If you don't catch it when they aren't, you missed it by labs. That is where listening to the patient comes in.

Thank you for sheding light on this.
--------------
I have a real problem, low T and ED, that is succesfuly addressed by Androgel 2 packs per day plus AI on as needed basis plus Cialis.
I also have a room for improvement situation.
Somewhat low body temperature, low energy in couple of afternoon hours and TSH=2.985 on test done 6 mo ago. At that time Cortisol=18.5, it was one blood draw, 8AM, so I am assuming it was either test #1 or #9 from the list of tests available from LabCorp. List posted by me 10-20-2006, 09:55 AM
http://anabolicminds.com/forum/male-anti-aging/53752-saliva-tests-accurate.html#post647906

I should have my new blood tests results within a week. I will be missing Cortisol results since I asked for 4 specimens test (LabCorp) and I see that it is too much trouble to go thru since I am not familiar enough myself, and do not want to stress good will of my GP as he is already helping me more than he normally does with his patients. I am writting my own list of tests.

Dr John, I read your answer as:
"in my situation, carefull trial use if Isocort may provide enough information and therefore, for now I could skip Cortisol test. But if I want to use LabCorp then their test #XXXXX is sufficient" Please fill in for the XXXXX.
.
.
.

 

[Mr.50]

Dr. John,

Can you elucidate here what the best method for testing (whether blood or saliva) for adrenal exhaustion? Including the technique (blood or saliva), how many draws (or spits) per day, a good place to order the saliva tests to do at home (if this turns out to be of any use at all)? I am really considering testing myself for adrenal fatigue but I am hoping to get some reliable preliminary information on my own because I have limited insurance currently (student) and I am not quite sure the Doctors in my area will take me seriously.

Any feedback is appreciated.

Thanks.

Mr.50

 

[Mr.50]

Anyone have any response to this?

Mr.50

Dr. John,

Can you elucidate here what the best method for testing (whether blood or saliva) for adrenal exhaustion? Including the technique (blood or saliva), how many draws (or spits) per day, a good place to order the saliva tests to do at home (if this turns out to be of any use at all)? I am really considering testing myself for adrenal fatigue but I am hoping to get some reliable preliminary information on my own because I have limited insurance currently (student) and I am not quite sure the Doctors in my area will take me seriously.

Any feedback is appreciated.

Thanks.

Mr.50

 

[glg]

I did the in home spit test. came out of a lab in GA, 4 vials timed approx 4 -5 hrs apart. tested Cortisol & DHEA, results came back on a time line graphs as well as numerical data. Not to hard to do the kit came with all the return paperwork, pre paid thru FedEx w/freezer block, styro container etc. I ordered it thru my D.O. that is kinda moving me into TRT. The results were low but she hasn't started me on anyhing for it yet. she wanted me to up some of my supplements and started me on an Androderm patch first.

I don't remember what the total cost was as I had several out of pocket tests done at the same time.

 

[Mr.50]

glg any chance you remember the company name and how to order the test?

Mr.50

I did the in home spit test. came out of a lab in GA, 4 vials timed approx 4 -5 hrs apart. tested Cortisol & DHEA, results came back on a time line graphs as well as numerical data. Not to hard to do the kit came with all the return paperwork, pre paid thru FedEx w/freezer block, styro container etc. I ordered it thru my D.O. that is kinda moving me into TRT. The results were low but she hasn't started me on anyhing for it yet. she wanted me to up some of my supplements and started me on an Androderm patch first.

I don't remember what the total cost was as I had several out of pocket tests done at the same time.

 

[xr650r]

Saliva Tests

My Doc says he prefers the saliva test because it is better at measuring "Free Test levels". The saliva test is what he has used for years and is the most comfortable with in terms of interpretation. He also lifts weights on a regular basis (competed in the past as well) and has the build that most 20 year olds would kill for, not bad for a guy that is 50 and been on HRT for 10 years.

IMHO the lab work weather blood or saliva is just a tool used for interpretation of what is really going on and like most tools everyone has their favorite. Also, as Dr John has made mention of, the lab itself can have a large impact on outcome of the results.

XR650 :bb:

 

[glg]

My test was done thru
Genova Diagnostics
63 Zillicoa st
Asheville, NC

my D.O ordered the kit, I paid $106 thru her.

It came in the mail with all the necessary info and prepaid return.

I don't know where I put the page that has their ph# and website info.

 

[Mr.50]

Sounds like a pretty good price. I wonder if you can order the test form them if you are not a health care practitioner?

Mr.50

My test was done thru
Genova Diagnostics
63 Zillicoa st
Asheville, NC

my D.O ordered the kit, I paid $106 thru her.

It came in the mail with all the necessary info and prepaid return.

I don't know where I put the page that has their ph# and website info.

 

[spinn]

Genova Diagnostics: Home

That appears to be the site for that company. I dont see any mention of testing though.

 

[Mr.50]

But Dr. John can you give me a confirmation that for cortisol tests you think saliva is the most reliable or is it just somewhat reliable and serum is still better?????? I am just wondering befor I go get any of the tests done.

Mr.50

The only ones pushing those studies are people who make money from them.

The simple fact is saliva does not mirror what is in the blood. It mirrors what is in the saliva glands--and the saliva glands make their own hormones from precursors. There are other problems as well.

There isn't anyone I respect in this business who uses them for hormones other than cortisol.

 

[spinn]

I will know in a few weeks...I have to get 9 tests done, only three of which my dr really needs.

For ft3, ft4 and tsh I am going to get both saliva and blood tets. I am paying cash and cant afford all 9 for both. The canary club charges $141 for all 9; blood tests cost a lot more.

Also....Lab Corp tried to charge me $207 for an FT3 test while Healthcheck usa charges $25.

Lab Corp CEO is the one who is sick....not me.

 

[Mr.50]

I can not find one of the "order yourself" labs that has a draw facility near me. The closest one is 20 miles away I think from Direct Labs. I live right outside of Boston. If anyone has any leads its appreciated.

Mr.50

I will know in a few weeks...I have to get 9 tests done, only three of which my dr really needs.

For ft3, ft4 and tsh I am going to get both saliva and blood tets. I am paying cash and cant afford all 9 for both. The canary club charges $141 for all 9; blood tests cost a lot more.

Also....Lab Corp tried to charge me $207 for an FT3 test while Healthcheck usa charges $25.

Lab Corp CEO is the one who is sick....not me.

 

[xr650r]

Anyone relying on saliva testing should learn of the mechanisms which result in hormones being released into the saliva. Same is a very poor biomarker of either serum levels or actual tissue activity.

Dr. John can you post any links to these where I could read up on this?