Hormone testing-- which is best?-- SALIVA or BLOOD?...

The answer to that really depends on which hormones you are testing!

Adrenal hormones are best tested via saliva-- no question about it.  The best for thyroid is blood. (see a blurb below and arm yourself with info -- be an educated empowered consumer of your health)!

The evaluation of hormone levels in the body is recognized by many physicians as an essential component of a diagnostic work-up. Unlike blood or urine hormone testing, saliva analysis assesses the biologically active compounds (free fraction form) at the cellular level.

Salivary hormone analysis represents what is clinically relevant and conveys the patient’s true hormonal activity, especially with multiple samples collected over the course of a day or more. In comparison, blood analysis assesses compounds as they travel through the blood serum, most of which are protein bound. When released from their protein carriers, the compounds become free. Measuring the concentration of non-bioavailable forms in urine or serum has minimal clinical relevance since the data is insufficient as to the concentration of the more significant free hormones in circulation.
Saliva hormones more accurately reflect tissue uptake and response of hormones delivered through the skin in creams or patches. Urine and blood assays significantly underestimate hormones delivered topically, often resulting in overdosing. Health professionals that choose to use topical hormone applications can most effectively monitor these therapies with salivary assays.
As a diagnostic fluid, saliva is the most convenient, non-invasive specimen available for the patient. Invasive procedures, such as blood draws, are not just extremely impractical when it comes to acquiring multiple samples; they also cause a stressful event on the body which can promote a release of cortisol, thus skewing the result for one event.


Thyroid hormones are best tested via blood.  And please, don't let your DOC medicate you on the basis of an incomplete thyroid panel!  There's more to it than what they learn in med school.  Most docs were trained to  medicate  based on TSH and T4 levels alone.  Click  here  if you would like to know how to THOROUGHLY EVALUATE your thyroid.

Don't just believe what you hear from your doc, or even this... dive in to the research yourself!  Here is a list of CURRENT medical references speaking to the clinical efficacy of salivary testing for hormones!

Brossard, J., et al. (2010). Free cortisol in plasma and saliva samples after synacthen testing in a routine exploration of patients in endocrinology.  Endocr Abstracts, 22, 36.
Caporossi, L., et al. (2010). Saliva as an analytical matrix: State of the art and application for biomonitoring.  Biomarkers, 15(6), 475-87.
Cardoso, E.M.L., et al. (2011).  Salivary testosterone for the diagnosis of androgen deficiency in end-stage renal disease.  Nephrol Dial Transplant, 26(2), 677-83.
Carroll, T.B., & Findling, J.W. (2010). The diagnosis of Cushing’s syndrome.  Rev Endocr Metab Disord, 11(2), 147-53.
Celec, P. & Ostatnikova, D. (2010). Infradian variations of salivary estradiol and prpogesterone in women.  Biol Rhythm Res, 41(2), 99-104.
Duplessis, C., et al. (2010). Salivary and free serum cortisol evaluation.  Mil Med, 175(5), 340-6.
Ekman, B., et al. (2010). Variable sensitivity to the glucocorticoid activity of cortisol in patients with primary adrenal insufficiency: Assessment with ACTH profiles.  Horm Metab Res, 42(13), 961-66.
Flück, C. (2011). Assessing the function of the human adrenal cortex.  In: Diagnostics of Endocrine Function in Children and Adolescents, Ranke, M.B. & Mullis, P.E., eds.  Basel, Karger, pp. 350-78.
Galbois, A., et al. (2010). Assessment of adrenal function in cirrhotic patients: Salivary cortisol should be preferred. J Hepatol, 52(6), 839-45.
Ghalaut, P., et al. (2010). Diagnostic applications of saliva.  J Clin Diag Res, 4(2), 2330-36.
Gonzalez-Sanchez, V.L., et al. (2010). Determination of the reference values of total testosterone, calculated free testosterone, calculated bioavailable testosterone and salivary testosterone in young, healthy population of the Mediterranean area.  Endocr Abstracts, 22, 533.
Gray, S.H., et al. (2010). Salivary progesterone levels before menarche: A prospective study of adolescent girls.  Endocr Res, 95(7), 3507-11.
Groschl, M. (2008). Current status of salivary hormone analysis.  Clin Chem, 54, 1759-69.
Guignat, L., & Bertherat, J. (2010). The diagnosis of Cushing’s syndrome: An Endocrine Society Clincal Practice Guideline: Commentary from a European perspective.  Eur J Endocrinol, 163(1), 9-13.
Liening, S.H., et al. (2010). Salivary testosterone, cortisol, and progesterone: Two-week stability, interhormone correlations, and effects of time of day, menstrual cycle, and oral contraceptive use on steroid hormone levels.  Physiol Behav, 99(1), 8-16.
Lima, D.P., et al. (2010). Saliva: Reflection of the body.  Int J Infect Diseases, 14(3), e184-188.
Malamud, D. (2011). Saliva as a diagnostic fluid.  Dent Clin North Am, 55(1), 159-78.
Manolopoulou, J., et al. (2010). Salivary aldosterone as a diagnostic aid in primary aldosteronism.  Horm Metab Res, 42(6), 400-5.
Miller, C.S., et al. (2010). Current developments in salivary diagnostics.  Biomark Med, 4, 171-89.
Moreno-Perez, O., et al. (2010). Validation of salivary testosterone as a diagnostic test in the hypthalamic-pituitary gonadal axis diseases.  Endocr Abstracts, 22, 532.
Mullan, K., et al. (2010). Is there value in routine screening for Cushing’s syndrome in patients with diabetes? Endocr Care, 95(5), 2262-65.
Perogamvros, I., et al. (2011). Corticosteroid-binding globulin regulates cortisol pharmacokinetics.  Clin Endocrinol (Oxf), 74(1), 30-36.
Perogamvros, I., et al. (2010). Salivary cortisone is a potential biomarker for serum free cortisol.  Endocr Care, 95(11), 4951-58.
Pfaffe, T., et al. (2011).  Diagnostic potential of saliva: Current state and future applications.  Clin Chem, 57, 675-87.
Raff, H., & Findling, J.W.  Biomarkers: Salivary cortisol or cortisone?  Nature Rev Endocrinol, 6(12), 658-60.
Sereg, M., et al. (2011). Diagnostic performance of salivary cortisol and serum osteocalcin measurements in patients with overt and subclinical Cushing’s syndrome.  Steroids, 76(1-2), 38-42.
Youssef, O., et al. (2011 ). Reliability of salivary testosterone measurements in diagnosis of PCOS.  Mid East Fert Soc J, 15(3), 183-87.