Many online companies and consumer marketers have been pushing saliva testing to measure hormone levels. Saliva tests are easy to use and convenient, but how accurate are they? Most reputable doctors stopped using saliva testing over 10 years ago because they found the tests weren’t reliable. Many variables can affect the amount and quality of saliva and/or hormones present in the mouth: medications can drastically alter the amount of bound vs. free hormones in the saliva, antihistamines or dehydration will decrease the amount of saliva in the mouth available for testing, and other elements such as foods or supplements can also throw off the saliva test results.

The major drawback to saliva testing is that it can only measure the free hormones circulating in the body. Hormones are carried in the body in 3 ways: strongly bound to globulin, weakly bound to albumin, and unbound or “free”. Research has shown that both the hormones bound to albumin and the free hormones activate the steroid receptors, making them both “bioavailable” or available to the body for use. Relying on saliva tests, which only register part of the bioavailable hormones, would cause your doctor to prescribe the wrong strengths of hormones for you. This is why treatments relying on saliva testing often don’t relieve symptoms well or even cause other symptoms.

Serum (blood) testing remains the gold standard in fertility, endocrinology and menopause treatment settings.