Doctor's Data Inc

Hormones; saliva

Saliva testing is an easy and noninvasive way of assessing your patients hormone balancing needs, and is proving to be the most reliable medium for measuring hormone levels. Unlike serum tests, male and female hormone tests using saliva measure only hormones actively delivered to receptors in the body. Clinically, it is far more relevant to test these bioavailable hormones and provide an accurate reflection of the body’s active hormone levels. Learn more »


Turnaround Time

3 to 5 business days

Salivary Hormone Profiles

Click on any test name to learn more.

Comprehensive Plus Profile

Comprehensive Plus Profile

Total: 10 Tests (E1, E2, E3, Pg, T, D, Cx4)

The Comprehensive Plus Panel expands on the Comprehensive Hormone Panel and includes estrone (E1) and estriol (E3) plus the Estrogen Quotient. The Estrogen Quotient (EQ) is a simple ratio of the cancer protective E3 to the proliferative estrogens E1 and E2. The EQ provides an assessment of breast cancer risk, with a lower number (<1.0) indicating increased risk, and a higher number (>1.0) signifying a lower risk. For maximum protection, an optimal EQ is >1.5. Because the research on the Estrogen Quotient and the protective properties of estriol has not been done with men, this panel is currently recommended for women only. This panel should be considered for patients who have:

• Increased risk of developing breast cancer

• History of breast cancer or other hormonally sensitive cancers

• Personal or family history of autoimmune disease

• PCOS

E1, E2, E3, PG, T, D, CX4

Women's Health & Breast Profile

Women's Health & Breast Profile

Total: 10 Tests (E1, E2, E3, Pg, T, D, Cx4)

A comprehensive preventative breast health program extends beyond imaging and lifestyle optimization, and includes accurate assessment and comprehensive treatment of demonstrated hormone imbalances. Labrix offers the Women’s Health and Breast Panel as an accurate, non-invasive tool to advance risk prevention and support you in providing exceptional care to your patients.

The Women’s Health and Breast Panel evaluates foundational hormone and adrenal status. This panel provides an in-depth look at estrogen levels, conversion patterns and offers two risk assessment ratios (Estrogen Quotient and PG/E2 Ratio) and also a customized women’s health and breast health specific interpretation. This additional clinical information is essential to further the conversation with your patients about targeted treatment options such as BHRT, nutraceutical and herbal supplementation, as well as potential lifestyle modifications.

E1, E2, E3, PG, T, D, CX4

Comprehensive Hormone Profile

Comprehensive Hormone Profile

Total: 8 Tests (E2, Pg, T, D, Cx4)

The Comprehensive Hormone Panel is the starting point for initial assessment of hormonal status and endocrine function and includes estradiol (E2), progesterone, testosterone, DHEA and four cortisols. This panel is useful with male and female patients because it looks at the full diurnal cortisol pattern; it is especially important in patients who are experiencing the following symptoms in addition to the symptoms listed for the Basic Hormone Panel:

· Weight gain

• Multiple chemical sensitivity

• High blood sugar

• Elevated lipids (cholesterol and/or triglycerides)

• Insomnia

• Chronic fatigue

• Fibromyalgia

E2, Pg, T, D, Cx4

Short Comprehensive Profile

Short Comprehensive Profile

Total: 6 Tests (E2, Pg, T, D, Cx2)

This assessment is useful in men and women whose primary symptoms are related to sex hormone imbalances (elevated or depressed E2, P or T). The abbreviated adrenal panel that includes DHEA and the AM and PM cortisol levels provides a brief assessment of the level of involvement of adrenal dysfunction. Additionally, this condensed panel (like the Basic Hormone Panel) is often used for re-evaluation 2-3 months after hormone replacement has begun to monitor therapeutic values. The Short Comprehensive Panel should be ordered if the patient is suffering from:

• Fatigue

• Sleep disturbances

• Family history of breast cancer

• Brain fog

E2, Pg, T, D, Cx2

Basic Hormone Profile

Basic Hormone Profile

Total: 5 Tests (E2, Pg, T, D, C)

The Basic Hormone Panel provides a basic evaluation of the sex hormones and a brief glimpse at adrenal function with the AM cortisol level. This panel is useful when retesting patients who have begun hormone therapy, but we encourage use of the Comprehensive Panel for initial evaluation. This is the minimal test recommended for symptoms that include:

Men Experiencing:

· Decreased libido

• Erectile dysfunction

• Loss of stamina

• Decrease in mental sharpness

• Reduced muscle size

• Tearful episodes or increased moodiness

• Metabolic syndrome

• Prostate enlargement or cancer

• Hot flashes

• Irritability

Women Experiencing:

· Hot flashes

• Anxiety/Depression

• Night sweats

• Breast tenderness

• Irritability

• Forgetfulness

• Irregular menstrual cycles

• Vaginal dryness

• Urinary incontinence

• Uterine fibroids

• Increased facial / body hair

• Acne

E2, Pg, T, D, C

Comprehensive Adrenal Function Profile

Comprehensive Adrenal Function Profile

6 Tests (D, Cx4, sIgA)

SIgA is most often measured in feces or saliva. Measuring sIgA in feces can reveal information about gut immunity, inflammation, recent or current infections, and potential acute or chronic stress generally associated with GALT (gut-associated lymphoid tissue). SIgA measured in the saliva primarily provides insight into the body’s stress response, however there is some evidence that activated B cells can migrate from GALT to salivary glands, which could potentially demonstrate systemic inflammation and possibly link GI pathology via salivary sampling.

Elevated levels of sIgA are associated with an upregulated, active immune or inflammatory response, and may be reflective of acute psychological and/or physical stressors. Chronic alcoholics, heavy smokers, and those with oropharyngeal carcinoma have also shown elevations in salivary sIgA.

Decreased levels of sIgA are commonly seen in individuals with low immune system functioning, and are a sign of chronic, ongoing psychological and/or physical stress (HPA axis dysfunction) to the body which has depleted sIgA reserves. SIgA declines with age, and can be seen with some chronic gastrointestinal disorders. Persistent low levels can help to explain why people can’t shift an immune problem like allergies, chronic skin conditions or infections. Lower levels have been associated with increased risk for periodontal disease and caries.

D, Cx4, sIgA

Adrenal Function Profile

Adrenal Function Profile

Total: 5 Tests (D, Cx4)

This panel provides a comprehensive view of adrenal function and includes 4 cortisol levels timed throughout the day as well as DHEA. Symptoms that would indicate ordering this panel include:

· Fatigue

• Nervousness

• Weakness

• Sugar cravings

• Insomnia

• Dizzy spells

· Headaches

• Decreased stamina

• Irritability

• Fibromyalgia

• Anxiety/Depression

D, Cx4

Diurnal Cortisol Profile

Diurnal Cortisol Profile

Total: 4 Tests (Cx4)

This panel is similar to the Adrenal Function Panel, but would be used in patients who do not require DHEA testing.

Cx4

Cortisol Awakening Response (CAR)

Cortisol Awakening Response (CAR)

Total: 3 tests (cortisol at 0-5 minutes after waking, 30 minutes, and 60 minutes)

This panel can be added to any saliva test. Requires a 6 tube collection kit, click here to order.

The cortisol awakening response is the natural rise in cortisol that is seen 30 to 40 minutes after awakening followed by a noticeable drop by 60 minutes. CAR can be utilized as a biomarker for assessment of the HPA axis function in routine clinical practice. CAR is influenced by overall HPA reactivity, as well as a person’s anticipation of stress.

The CAR involves a measure of the percent rise in cortisol from awakening to 30 minutes post-awakening and the expected decline in cortisol seen at 60 minutes. The Diurnal Cortisol Profile involves 4 cortisol samples taken at 30 minutes post-awakening, noon, dinner time, and bedtime. While the CAR can provide the best information on HPA axis reactivity and function, the Diurnal Cortisol Profile can identify dysregulation in the natural cortisol circadian rhythm.

Who tends to experience a low or blunted CAR?
Research has found that a lower cortisol response to awakening is often seen in individuals with:

· A high amount of psychosocial burnout

• Chronic fatigue

• PTSD

• Seasonal affective disorder (during winter)

• Nightshift work schedules

• Sleep apnea

• Short sleep cycles

• Chronic inflammation

• Adrenal insufficiency

• Lack of morning sunlight exposure

• Hippocampal damage or atrophy

• Amnesia (due to temporal lobe damage)

Who experiences a high CAR?
Factors associated with an elevated CAR include:

· Ongoing job-related and perceived stress (CAR is significantly higher on work days)

• Immediate access to light upon awakening

• Depression

• Ovulation phase of the menstrual cycle

• Sleep issues

• Older age

Cx3

Melatonin Profile

Melatonin Profile

Total: 3 Tests (Mx3)

The Melatonin Panel provides a snapshot of the sleep/wake cycle during a one day period. This panel (also can be added on to any saliva panel) is recommended for those experiencing sleep disturbances.

Mx3

Hormones: Estrone (E1), Estradiol (E2), Estriol (E3), Progesterone (Pg), Testosterone (T), DHEA (D), Cortisol (C), Melatonin (M), Secretory IgA (sIgA)


Analytes Tested

Click any analyte name for additional clinical information, including reference ranges, specimen collection, stability and rejection criteria.


Analyte CPT ABN Required
Estrone; saliva 82679 Yes
Estradiol; saliva 82670 Yes
Estriol; saliva 82677 Yes
Progesterone; saliva 84144 Yes
Testosterone; saliva 84402 Yes
DHEA; saliva 82626 Yes
Secretory IgA; saliva 82784 Yes
Cortisol; saliva 82530 Yes
Melatonin; saliva 83520 Yes

List price applies when filing with insurance or Medicare, or when billing a patient directly.

Prompt payment pricing applies when billing to a physician account or prepayment is received with the test.

Doctor's Data offers profiles containing multiple analytes. *Multiple analytes may be billed under a single CPT code. Many analytes can be ordered individually. Pricing may vary. Click on a specific analyte for more information or read our detailed billing and payment policies.

The CPT codes listed on our website are for informational purposes only. This information is our interpretation of CPT coding requirements and may not necessarily be correct. You are advised to consult the CPT Coding Manual published by the American Medical Association. Doctor's Data, Inc. takes no responsibility for billing errors due to your use of any CPT information from our website.

Sign in at the top of any page to view pricing and order tests. Or click here to create an account. You may also contact us for assistance placing an order.

This test is useful for:

  • Male and Female hormone tests are ideal for men and women concerned with changing hormone levels as a result of age
  • Cycling women experiencing PMS symptoms, perhaps related to a hormonal imbalance, may benefit from a female hormone test
  • Peri- and post-menopausal women concerned with their estradiol and progesterone levels for replacement considerations
  • Those wishing to monitor their hormone levels following replacement therapy (oral, sublingual or topical), and subsequently regulate their supplement levels
  • Anyone with symptoms involving fatigue, insomnia, stress, immunity problems, blood sugar problems, and an overweight body should be tested for cortisol levels as well as "sex" hormones

Detailed Information

Hormones are powerful molecules essential for maintaining physical and mental health. We frequently think of estrogen as being a female hormone, and testosterone as being a male hormone. But men AND women make both, plus several more that need to be in balance for optimum health. An imbalance of any one hormone can throw your physical and mental health out of balance, causing aggravating and even serious health problems.

One size does not fit all when it comes to hormones! For decades western medicine has prescribed hormone replacement therapy as if everyone needed the same thing and the same amount. Nothing could be further from the truth. Your hormones are like your fingerprints and in order to achieve optimal health, you need to know what your specific imbalances are. Female and male hormone tests can help identify these imbalances.

There are several ways to test for hormones (saliva, serum and urine), but the state-of-the-art method is through saliva. This is because only the active portions of hormones are measured and it is these portions that determine how individuals feel. So if your patient is seeking bio-identical hormone replacement (BHRT), you'll need to know active hormone levels. In addition, if using a topical (transdermal) hormone preparation for treatment, saliva testing is the most accurate tool to measure and monitor hormone status.

Why Use Saliva?

Appreciating the reliability of saliva testing is based on understanding the difference between steroid hormones in saliva and in serum. This difference is based on whether or not the hormones are bound to proteins in the medium used for testing. The majority of hormones exist in one of two forms: free (5%) or protein bound (95%). Only the free hormones are biologically active, or bio-available, and available for delivery to receptors in the body. Protein bound hormones do not fit the receptors and are considered non-bioavailable. When blood is filtered through the salivary glands, the bound hormone components are too large to pass through the cell membranes. Only the unbound hormones pass through and into the saliva. Saliva testing measures the bioavailable hormone - the clinically relevant portion delivered to the receptors in the tissues of the body.

Salivary hormone levels are expected to be much lower than serum levels, as only the unbound hormones are being measured. When healthcare providers measure serum hormone levels and prescribe hormone replacement therapy based on those results, patients are often overdosed. If the patients receive a male or female hormone test using saliva, the results are extraordinarily high and create confusion resulting from a lack of correlation between the two methods.

This discrepancy becomes especially important when monitoring topical, or transdermal, hormone therapy. Studies show that this method of delivery results in increased tissue hormone levels (thus measurable in saliva), but no parallel increase in serum levels. Therefore, serum female and male hormone tests cannot be used to monitor topical hormone therapy.

Saliva measures the "unbound" biologically active or free hormone levels in the body:
When blood is filtered through the salivary glands, the bound hormone components are too large to pass through the cell membranes of the salivary glands. Only the unbound hormones pass through and into the saliva. What is measured in the saliva is considered the "free", or bioavailable hormone, that which will be delivered to the receptors in the tissues of the body.

Serum measures the "protein bound" biologically inactive hormone levels in the body:
In order for steroid hormones to be detected in serum, they must be bound to circulating proteins. In this bound state, they are unable to fit into receptors in the body, and therefore will not be delivered to tissues. They are considered inactive, or non-bioavailable.

Only saliva testing measures topically dosed hormones:
The discrepancy between free and protein bound hormones becomes especially important when monitoring topical, or transdermal, hormone therapy. Studies show that this method of delivery results in increased tissue hormone levels (thus measurable in saliva), but no parallel increase in serum levels. Therefore, serum testing cannot be used to monitor topical hormone therapy.

For a male or female hormone test, reach out to Doctor's Data.

Endocrinology

Find out more