Should You Get Your Hormones Tested?

If you think your hormones might be out of balance – and let’s be honest, many people’s are – then it might be time to pursue hormone testing with your doctor. But it’s more complicated than, say, a cholesterol test. There are many different hormones to test, and many different ways to go about it. Below you’ll see a great breakdown of the types of testing available and why different types are better for different hormones.

 Hormone Testing Options

Q: What is the best way to test my hormones? I see that there are different methods such as saliva, blood, and urine.

A: I am constantly asked this question regarding the various methods available for hormone testing. Unfortunately, there’s not a simple answer because each of the methods has unique pros and cons. The question is compounded by the fact that doctors and researchers have differing opinions on which testing method is the best.

So what is the truth? Each of the methods for testing hormones has its pros and cons. Each method can provide valuable and important information, but because the information is different for each method, the method(s) you use should be determined by your diagnostic needs.

Some conditions are easy to test for, such as menopause, which typically only needs one testing method, any of which can work fine.

Other conditions, such as when a woman is struggling with terrible perimenopausal symptoms, are more difficult to test for because hormone levels change daily and are hard to pin down. Since a blood test is only a snapshot in time, the 24-hour urinary hormone test or multiple saliva tests done in spaced intervals can often provide more helpful information.

In certain complex situations, more than one testing method may be needed.

The 24-Hour Urinary Panel

The 24-hour urinary hormone panel has several positive qualities. First, it provides the average hormone level over a 24-hour period, removing the variable of daily fluctuations in one’s hormone levels. It also tests for all three estrogens (estrone, estradiol, and estriol) and provides additional helpful information, such as the levels of 2/16 hydroxyestrone ratio and 2-methoxyestradiol (suspected to have anticancer qualities). Although the test is more expensive than blood or saliva, it tests more hormones and hormone metabolites than any blood or saliva panel, which results in a higher level of information that is especially helpful in difficult cases.

Even though it has so many benefits, the 24-hour urinary hormone panel has a few limitations as well. The main problem is that it only measures the hormones the body is excreting in the urine. And while excreted hormones often correlate with tissue and blood levels, this is not always the case. This method is also inconvenient because it requires a person to collect all their urine over a 24-hour period.
– via

As you can see above, the 24 hour urinary panel might be necessary for some people to get a big picture look at their own internal balance, but for many others, a blood or saliva test will be the better choice. Worried about your cortisol levels? Your doctor will likely recommend an at-home saliva test. Concerned about your reproductive hormone balance? Then a blood test will be your first line of defense.

For each person and each new situation, a unique approach needs to be taken, and working with the right doctor could make all the difference in the world to make sure you get as thorough and accurate a workup as possible.

Blood Testing Or Saliva Testing? It Depends…

Traditionally, lab work refers to checking serum or blood levels. However, there are other methods of evaluating hormone levels such as saliva. There are pros and cons to both of these evaluation methods:

  • Blood Testing – Blood is inconvenient for many as you need to have a health care provider order the labs for you, you have to go to a location to have the labs drawn, and if insurance doesn’t cover the labs, they can be quite pricey. However, blood analysis is very accurate and tests, as well as testing facilities and labs, are highly regulated. So, with blood levels, you know you are getting reliable results.
  • Saliva Testing – Saliva or sputum tests can often be ordered by patients themselves or by non-medically licensed individuals. They are more convenient because the tests can be done at home and without scheduling an appointment, and many times the cost is not as high as blood tests. However, sputum and saliva can give you unreliable results.

Multiple studies have shown hormone levels vary significantly when salivary testing is done using cotton and polypropylene collection devices. Cotton collection devices or “rolls” result in elevated estradiol and testosterone levels, while polypropylene rolls result in lower estradiol and testosterone levels. Research has also found that small amounts of blood from the oral mucosa, variance in collection of the samples, and storage of the samples after they are collected can cause irregularities and inaccuracy as well. Furthermore, even if the samples are collected in the most perfect of circumstances, salivary levels of hormones vary so quickly and drastically they cannot be considered accurate. In fact, most insurance companies will not cover the cost of these tests because of these problems.

Now, sputum testing for cortisol is a completely different story. Salivary cortisol measurements have been studied and are considered reliable enough to use to diagnose adrenal diseases like Cushing’s syndrome. Cortisol levels seem to be more stable and have less variance than sex hormones regardless of collection devices and storage.

So, two things to remember:

  • Saliva for cortisol is great.
  • Blood levels for hormones like estrogen, testosterone, progesterone, and other sex hormones are your best bet.

– via Breaking Muscle

Do you think it’s time to get your hormones tested?