Dr. Marie does NOT just give you a copy of the lab’s report… but rather, with over 22 years of experience in reading the lab’s reports, she delves into the the lab’s results and does a full write up (in ENGLISH! not “medical jargon”) to help you fully understand your results as it pertains to your current symptoms and life.
The most accurate way to check hormones – Tests Estradiol, Progesterone, DHEA, Testosterone & Cortisol X 4
SALIVA VERSUS DUTCH URINE TESTING
There is no published clinical data available yet for DUTCH urine tests and they are so complicated to interpret and find correlations with clinical symptoms.
I am not yet fully convinced of its clinical relevance, especially for clients who are supplementing with topical progesterone.
The major difference between salivary and urine metabolite testing is seen with topical application of progesterone and other steroids- urine does not show any significant change in hormone levels whereas we see a clear dose-dependent increase in salivary hormone levels. It is just not possible with urine testing to monitor clients who are using topical applications and topical dosing is the optimal way to apply natural hormones.
Something else to keep in mind is that urine testing doesn’t work for clients with compromised renal function as the hormone levels are to be corrected with creatinine levels. The degree of hydration also has a significant impact on the testing accuracy. How much water/ other fluids we consume every day differs from person to person. We find most men and women DOT NOT DRINK ENOUGH WATER!
Oral hormone supplementation is also difficult to monitor because of high levels seen in urine due to the first-pass effect. Therefore, it is difficult to get a better assessment of true bioavailable fractions, which is not the case with saliva. Salivary levels are a much better indicator of the bioavailable fraction of hormones, which correlate well with clinical symptoms!
Finally, clients using vaginal applications are absolutely not good candidates for dutch urine testing for obvious reasons, unless we ask those clients to discontinue their hormone use at least 4 days prior to sample collection.
SALIVA VERSUS SERUM HORMONE TESTING
Saliva testing is proving to be the most reliable medium for measuring adrenal/ovarian hormone levels.
We have seen numerous clients with seemingly conflicting results when doing both saliva and serum blood testing for natural hormone replacement. This tends to confuse both the client and their medical doctor (and sometimes me too!).
In an effort to put some understanding and comfort to both doctors and clients I’d like to offer the following as the best explanation I have for this “phenomena”.
Saliva testing is absolutely the most accurate test to determine steroid hormones (i.e. progesterone, estrogen, DHEA and testosterone) levels when attempting to determine who needs hormone replacement and to assist in monitoring the results.
Steroid hormones are fat soluble. This means that they dissolve in fat or oil and not water. Since oil and water do not mix, the body makes carrier proteins, called hormone binding globulins, that when attached to a fatty hormone will allow it to mix in water. This allows the fat soluble hormone to travel in the watery bloodstream.
Those steroid hormones attached or bound to carrier proteins in the blood are not active, only the unbound or free hormone molecules have the ability to cause the effect they were made to have on the body.
If we look at the hormone as a piece of candy that your taste buds can recognize, then the candy wrapper is the carrier protein surrounding the active hormone and protects the candy or the message of the hormone while it is bound and circulating. If we measure the amount of hormone or candy in the blood we will find that over 99% is wrapped, or “bound” as we refer to in scientific language. Your blood stream is your largest hormone reservoir in your body, but the hormones are inactive!
Once hormones are absorbed from your blood stream into your tissue, they lose their carrier protein and become active.
Your salivary glands contain the same concentration of active hormones as your tissues contain. If we measure the amount of hormone in the saliva we measure how much is unwrapped or active and able to deliver the flavor or the message of the hormone to the breast, uterus, ovaries, brain, and other organs of the body.
There are a number of factors that determine how much hormone, especially estrogen, is unwrapped and active in the body. Increased weight, diabetes, stress, low fiber/high fat diets can all increase the amount of estrogen that is active. If too much is active, you will produce symptoms associated with too much estrogen from the list below.
The total amount of estrogen (wrapped) in the blood can be high, normal, or low. It’s the unwrapped amount that we’re interested in.
Exercise, maintaining your ideal body weight, high fiber diets, eating the proper fats, eliminating stress, avoiding external estrogen can all decrease the amount of active estrogen in the body. Because there are so many variables it is impossible to know what the level of your individual hormones are without testing. This would be like looking at you and guessing what your blood sugar level is, or if your blood pressure is high, normal, or low. Since no doctor would treat your blood pressure or your blood sugar without first testing for your individual levels, no doctor should treat your hormone levels without first determining their exact amount so they can accurately be balanced or brought normal levels.
Not only can saliva determine the amount of active (“unwrapped”) estrogen, it can also determine the active amounts of progesterone, DHEA, testosterone, and cortisol (your stress hormone) . All of these hormone levels may be altered by menopause, your weight, your age, your stress level, your diet, and multiple other factors.
The bottom line: saliva provides a convenient, stress-free, way to collect a diagnostic body fluid from which to determine, and then monitor, the free or bio-available fraction of steroid hormones circulating in the bloodstream and entering tissues. In addition, saliva testing is the more accurate way to measure levels of human bio-identical hormones delivered topically through the skin to manage hormone imbalances. Utilizing blood testing prior to starting hormone replacement is also a tool for beginning someone on natural hormones.
But please monitor, at the minimum, every 6 months with saliva testing.
Note on CORTISOL testing: To diagnose cortisol deficiency, the physician or naturopath should consider symptoms first and the free cortisol levels second. A serum cortisol test shows the total cortisol in the blood, but this level is affected by the amount of cortisol-binding globulin. Serum free cortisol levels are available at some laboratories, but one’s cortisol level prior to being stuck with a needle after driving to a lab is not likely to represent one’s usual level. The best test of free cortisol levels in the blood throughout the day is a diurnal salivary cortisol profile.
Our testing kit checks the following key adrenal hormones: estradiol (estrogen), progesterone, testosterone, Dhea, Cortisol 4x (am, noon, pm, bedtime)
Whether you are checking your hormones for the first time or if you are monitoring the effectiveness of your natural bio- identical hormone creams… saliva is the best way to test.
This kit is sent to your home. You simply follow the easy directions on collecting saliva (stated in the kit) and it is then sent via postage directly to our lab for evaluation. We receive the results in 10-14 working days after their receipt of your saliva. Once we have the results we will contact you and set up an appointment to consult and go over all results and our recommendations for supplementation as needed.
Perfect for checking adrenal hormones in MEN & WOMEN!
THIS TEST IS NOT COVERED BY INSURANCE NO MATTER WHO ORDERS IT.
All testing charges are paid directly to us (you will not receive bills from the labs). Prices include Dr. Marie’s written evaluations based on over 20 years of experience. We do an extraordinary amount of back-end work on each individual test that is performed and personalized.