The following are some frequently asked questions regarding the saliva collection instructions:
Many “anti-aging/wrinkle" creams contain the very hormones that we test. It is easy to contaminate a specimen by direct contact with the straw or tube or by absorption into the body, thus altering the results to an inaccurate higher level.
For the testing of estradiol, DHEA, progesterone, and testosterone, we take an equal amount of specimen from each tube and transfer it into a 5th tube, the pool, which is used for testing. This process ensures a more accurate overall average of the hormone level, compensating for the natural daily peaks and troughs of these analytes. If only one tube is collected at a random time of day, there is no way to know if the result reflects one of those daily fluctuations and is accurate. For cortisol, however, we want to catch those ups and downs, (the expected diurnal pattern) and test each tube individually.
Sublingual hormones are detected in saliva for a longer period than topical hormones. If these instructions are not followed, a true therapeutic level will not be reflected.
These days should reflect the luteal phase, which is the ideal time to measure both progesterone (which should be at its peak) and estradiol in order to calculate the most accurate ratio between the two.
While not required, we ask that patients fill out this section so that the doctor interpreting the test results takes symptoms into consideration as well as laboratory numbers. The same thing applies to the section of the requisition where we request information on hormones the patient is taking. Please instruct your patients that we only need information about hormones, not vitamins or any other supplements.
The ingestion of food is not the issue; it is the creation of as “clean" a specimen as possible. Food can create a more viscous or “junky" specimen and any particles can interfere with the testing process. While there are laboratory procedures to eliminate as much of this type of interference as possible, it is best to submit a sample taken when food residue is not in the mouth.
Understanding the importance of collecting a good sample is the first step to achieving the accurate and reliable results that have helped us set the standard for salivary testing!