This is a common question and a very important one. If you don't get this one right, you will waste your money, time and efforts. You need to count on getting accurate results and be able to have results that you can USE to Take Action to Make Things Right!
There are 4 different ways to test your hormones
- Venous Blood (from your arm)
- Blood Spot (from a finger stick)
Ok! Let's do this and tackle this very important question!
Venous Blood measures the amount of hormones in your blood.
This is a problem all by itself - to start with! It is far more helpful to know the levels of your hormones INSIDE your tissues than to simply measure the number of hormones floating around in your blood. The actual number of hormones that your tissues have is GREATER than the amount measured in your blood! So BLOOD Testing can be dangerous for you in the hands of an Inexperienced physician.
Though Experienced Doctors can do a pretty good job adjusting your hormone treatment, they are using far more of their "experience" than they are using your Hormone Blood Lab results.
And their experience is valuable, and costly, as it should be.
You see, Blood Labs have established reference ranges that make up 95% of the population. So this is a real problem for doctors who want to go beyond thinking farther then the nose on their face.
Let’s examine what that statement means.
If 95% of the population fall within the reference ranges provided by Blood Labs, it means that only 5 % fall outside this reference range with 2.5% of the population having too high of levels and 2.5% of the population having too low of levels.
But Anti-Aging / Functional Medicine Physicians, AND Smart Savvy patients know these reference ranges are far too broad and include "normal" as essentially ZERO hormones present - because Blood Labs were set up to think completely conventionally - meaning after Menopause you may have essentially zero levels of a hormone so therefore that falls in the "Normal Reference Range" since every woman goes through menopause - it's normal!
When you have blood work done by a Conventional Doctor, you might even experience something like this:
"Your problems aren't coming from your hormones because SEE... your hormones are normal," as they show you the results of your BLOOD work. What good is that?
Saliva measures the level of hormones that are most closely representing the level in your TISSUES. This is what we want. In addition to that, we also know that if you use a TOPICAL treatment of hormone supplementation (which is now known to be the best form of hormone supplementation - bypassing the liver), blood will not adequately measure the levels of hormones! Saliva or Blood Spot are the only ways to TRULY measure your hormone levels when you are using TOPICAL hormone replacement.
It has taken many years to figure out why saliva is more accurate than blood and it has been confusing doctors, even Anti-Aging doctors, for many years. Finally, the research has identified that TOPICALLY applied hormones travel MOSTLY in the lymphatic system and NOT the blood system. The hormones are taken up by the tissues and released slowly into mostly the lymphatic system - which is NOT measurable in the blood!
Making it even more difficult for patients is that Saliva isn't well known in the Conventional Doctor community. This can be very confusing to patients since their doctors tell them Saliva isn't the right form of testing. And it can drive us Anti-Aging / Functional Medicine doctors bazzerk!
However, this IS the method of Hormone Specialty Laboratories, and the method of choice - PARTICULARLY if you plan to supplement with bioidentical hormones - OR already do!
It's not a surprise. You won't find SEX hormone saliva tests at Quest or Lab Corp. You will find Sex Hormone Saliva Tests at Specialty Hormone Lab companies - that primarily ONLY test hormones! For instance, the one I always use for myself and patients, as well as offer on my website - ZRT Laboratories. (You can find out more about Saliva Hormone testing on my website, as well as purchase a saliva kit there as well.)
- BLOOD SPOT:
Blood spot is a fairy new way to test hormone levels that was designed by Specialty Hormone Labs and they are also quite accurate.
But, the reason they are more accurate than Venous Blood is because the Specialty Hormone Labs recognize the proper Reference Ranges, and provide this with the results.
There is a second reason Blood Spot is more accurate than Venous Blood too. When you get your blood drawn from your arm, the blood sits in a tube and what happens to the hormones is anyone's guess at that point. Some of the vials of blood make it to the lab within an hour, or less if you're lucky. Other's may take much longer. As the blood sits in the tube, the levels of hormones can change by breaking down. This too can underestimate the real tissue levels you actually have!
Blood Spot is a finger prick and dries very quickly. The blood is stabilized almost immediately and thus the level measured is the true level from that blood "spot."
The reason blood spot seems to correlate better with saliva testing is 2-fold.
First, it is due to the immediate drying of the blood, thus stabilizing the level very quickly. Second, a blood spot does NOT come from venous blood. it comes from Venous CAPILLARY blood.
Venous Capillaries are tiny tiny vessels that are at the very tail end of the line of veins. Capillaries are so small and so great in number, that this is where the exchange of nutrients and Oxygen takes place. AND intertwined within the Capillaries are LYMPHATIC vessels!
That's right! The Capillaries and the Lymphatic system are intertwined and are constantly sharing nutrients, hormones and all of the chemicals carried through out the body! And for this reason, Blood Spot can pick up more accurate Hormone Levels in the body when one is using TOPICAL hormones.
The regular Venous system won't pick up the Topical Hormone levels appropriately because the Hormones don't travel in the venous system! They travel in the Lymphatic system! YOU HEARD IT HERE! (But it will take another 15 years before you'll hear that from your Conventional Doctor!)
Urine is a wonderful way to test METABOLITES of Hormones. BUT NOT levels of the actual hormones themselves. Urine testing will NOT give you accurate hormone levels as they fluctuate constantly in the Urine based on the metabolic processing at any given time.
However, with that said, Urine can provide the most comprehensive testing of the metabolic breakdowns of your hormones - which can be a critical piece of the puzzle if you tend to have elevated Hormones such as Estrone. Using Urine for metabolites is also a good idea if you have had breast cancer or other female cancer, or if you have a strong family history of a female cancer.
So that's the 4 types! Now you see why I am so PRO-Saliva with Blood spot as my second choice.