Submitted September 2, 2006 11:24 am
Saliva hormone testing allows you to measure your levels of estradiol,
progesterone, and testosterone. Comparing your female hormone levels to the
normal range for your age will help you and your doctor evaluate how
bioidentical hormone
replacement therapy will or has changed your hormone levels.
Hormones can be tested through non-invasive
tests from blood and urine.
Currently, saliva testing is able to test levels of estradiol, estriol,
estrone, progesterone, testosterone, DHT, DHEA, melatonin and cortisol.
It is highly recommended to get a saliva test, for a base line level to
start with before starting any hormone therapy. Then the tests should be
repeated in 2 to 3 months. This way you will be able to evaluate if Hormone
Replacement Therapy has affected your levels. It is then recommended to
repeat the test again once a year while on this therapy. It is suggested
that you test for Estriol, Estradiol, Estrone, Progesterone, Testosterone,
Cortisol, DHEA, Melatonin, DHT and Pyrilinks D (urine test) for bones.
It is also very important and well suggested, that you get your hormones
tested in your 30’s-40’s, before you have even entered perimenopause or
menopause, to establish your normal hormone levels, and how your body
metabolizes them. If you do the testing early, you will then have something
to compare yourself, when you felt good and normal, to later when you begin
menopause and your hormone levels begin to fall. This can help your
healthcare professional prescribe the right dosages for you to get back on
track.
Finding a satisfactory dose for you can take several months and anything
that you can do in advance to speed up the process will only help you in the
long run. Your doctor may see dozens of patients that each need their own
individual dose, so he will be experienced in helping you find where you
should be. Just make sure that you tell him everything that changes, so you
can aid him in his prescriptions.
About Hormone Testing
August 25, 2006
There are several tests done to detect if you are going
through early menopause. Your doctor can perform these tests if you suspect
that you are experiencing symptoms of perimenopause. Some of these include:
FSH -follicle stimulating hormone
A blood test can be done to
determine the levels of FSH in your blood. Because your FSH levels rise
when your ovaries stop producing enough estrogen, high FSH levels can signal
that your body is entering menopause. This is the key test to determine your
stage of menopause.
Normal Menstruating
Follicular Phase 2.5 to 10.2
Midcycle Peak 3.4 to 33.4
Luteal Phase 1.5 to 9.1
Postmenopausal 23.0 to >116.3
Estrogen (Estradiol) Levels
Estradiol is the primary human estrogen. When your ovaries begin to
fail, your circulating estradiol levels drop. Doctors often give a serum
estradiol concentration test to measure the amount of estradiol in your
blood. If your estrogen levels are lower than normal, this is a signal of
ovarian failure, or, in other words, early menopause.
If your estradiol levels are lower than 50 picograms
per milliliter, you may still be having a period, but also may be
experiencing symptoms of low estrogen.
Non-menopausal:
Follicular Phase 24-138
Luteal Phase 19-164
Periovulatory 107-402
Postmenopausal:
No HRT
<36
With HRT
18-361
Another test is a thyroid
test. Many doctors will also recommend that you have your
thyroid tested when you suspect menopause. This is for two reasons: First,
many women in premature menopause also are at a higher risk for thyroid
problems. Second, many symptoms of thyroid disease overlap with menopausal
symptoms. In fact, thyroid diseases often interfere with menstruation.
Testing your thyroid will help determine whether you are in premature
menopause, or if you have a thyroid disease.
Last, is a
saliva test. Some doctors recommend saliva testing to measure
hormone levels. This isn't as widely used as blood testing, but some say
that it is quicker, less expensive and reliable. With salivary testing,
your doctor takes samples of your saliva to see the levels of hormones you
are producing and to determine if you have any deficiencies. Unlike the
blood tests, the saliva hormone tests will show the levels of "free"
hormones in your body. Free hormones are the hormones that aren't bound to
proteins, but instead are able to move into cells. Because about 95% or
more of your blood hormones are bound, the
saliva tests measure only the
remaining 1 to 5%. The results may be much lower than that which you see on
your blood test results.
September 1, 2006
Some people believe that with all the new information we have about
bioidentical hormones and its advantages that the testing should be standard
routine. But there are several factors why it’s not. First, it is not
"standard of care" or deemed medically necessary. This means that when you
have a problem that may be related to your cycle and the hormone
fluctuations that go with it, your doctor is not required to order a test to
measure your hormone levels before you are treated. Actually, they can
prescribe birth control pills or synthetic HRT at any time, with only
personal information or a feeling that these drugs may be right for you.
The reasons why hormone testing, and prescribing natural hormones, is not
standard practice has more to do with patent law and the pharmaceutical
industry than anything else. There is also the fact that most medical
schools have until recently ignored natural hormones as an option in
treating women's hormonal imbalances. Drug companies are out to make money.
Natural, plant-based hormones cannot be patented and marketed as exclusive
products, therefore giving no advantage to the pharmaceutical companies.
Even though safe, plant-based sources for making bioidentical natural
progesterone and estrogen are readily available, pharmaceutical companies
rarely use them (although the harm and findings of new studies about
synthetic hormones is beginning to propel them in that direction). Instead
they use lab-formulated synthetic progestins and estrogens to make their HRT
formulas. When sales representatives talk with doctors, they offer flashy
brochures and literature about double-blind studies conducted and/or
financed, of course, by the drug companies. For some drugs, such as Viagra,
manufacturers appeal directly to consumers, who in turn request that their
healthcare providers prescribe these drugs.
Nobody is advertising for the use of natural hormones to medical offices
because, at least for now, there is no money to be made. In fact, mainstream
healthcare providers who are familiar enough with natural hormones to
prescribe seem to be in the minority. So it is no surprise that mainstream
medical practitioners are reluctant to initiate hormone testing to determine
dosing for medicines they know little or nothing about.
The same goes for natural supplements and herbal remedies. These
alternatives have neither private funding nor representatives hounding
medical offices to tout their benefits. If medical providers want to find
out about these alternatives, they must do just as you are doing, and
educate themselves. Given their hectic schedules, time constraints, and
demanding practices, it isn't too surprising that most healthcare
practitioners haven't done so.
Most likely, the use of bioidentical hormones will eventually come into use
because patients are going to demand it, many are already. Women are
justifiably scared of synthetic
HRT, and more information is getting out
that therapy using natural, bioidentical hormones is a safe and effective
alternative for relieving unpleasant symptoms.
Medical practitioners who lack education about
hormone testing and treatment
with the natural alternatives nevertheless claim that hormone testing is
inaccurate because levels change constantly as a woman cycles through the
month. It’s true that hormone levels do fluctuate and every woman is unique,
but those facts don't cancel the value and accuracy of carefully conducted
hormone testing, especially through
saliva testing. It is being done
successfully and has been absolutely invaluable in my medical practice and
those of informed colleagues across the nation.
September 5, 2006
Your healthcare professional may order a saliva cortisol test when symptoms
of Cushing’s syndrome and Addison’s disease are present. Both Cushing’s
syndrome and Addison’s disease are serious adrenal disorders. Both testing
of the urine as well as saliva are common testing methods for excess
cortisol production. Once your healthcare professional has determined an
abnormal level of cortisol, further testing will be done in order to
determine cause and severity of the deficiency or excessiveness.
Symptoms of Cushing’s syndrome that may lead to a saliva cortisol test
include:
- Obesity
- Muscle wasting
- Muscle weakness
Symptoms of Addison’s disease that may indicate the need to perform a saliva
cortisol test include:
- Weakness
- Fatigue
- Increased pigmentation
- Others
For people with a normal cycle of cortisol levels, the levels are higher in
the morning, and lower at night. If you work a night job, this pattern will
not be maintained, and people with Cushing’s will also not maintain a normal
pattern. Increased or normal cortisol concentrations in the morning, with
levels that do not drop in the afternoon and evening suggest that your body
is overproducing cortisol. If this excess cortisol is suppressed during a
dexamethasone suppression test, it suggests that the excess cortisol is due
to increased pituitary ACTH production. If it is not suppressed, then the
increased cortisol could be due to an ACTH-producing tumor outside of the
pituitary, a problem with the adrenal gland, or a medication that the
patient is taking.
If the adrenal glands are overactive, then a patient may have
Cushing’s
syndrome, with symptoms and signs caused by prolonged exposure to the
effects of too much cortisol. This may be due to excess production of
cortisol by the adrenal glands, which is frequently due to a benign adrenal
tumor, or excess ACTH stimulation, due to a pituitary or other
ACTH-producing tumor. It can also be seen in patients who must take
corticosteroid medications, such as those used to treat asthma. If decreased
cortisol production is due to adrenal damage, then the patient is predicted
to have Addison’s disease.
