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When we are testing for hormones, we really want to know what is going on inside of our cells, because that is where our health is. Salivary levels of hormones actually reflect the levels of hormones inside our cells better than blood levels do. In the blood, hormones come three different ways. One part is “free” - floating around in blood, not bound to anything, and ready for the cell to take up and use. This is the part of the hormone we want to know about. Regular labs don't test for the free portion of the hormone. When blood hormone levels are checked, the lab tests for the total value of the hormone. The total value is made up of the free portion, plus a portion of hormone bound to big carrier proteins which can't get past the cell membrane and can't be used by cells.
Saliva glands excrete their contents, so more of what is on the inside of the cell is now in our saliva. Saliva also doesn't have carrier proteins, which is why saliva levels of hormones are a better baseline test than blood.
The saliva test that Dr. Leila and her team typically order costs $171.00 and is not typically covered by insurance. It tests for most of our major hormones including cortisol, estrogen, progesterone, testosterone, and DHEA. Many patients can get it reimbursed in part by their insurance company if they submit their receipt to their insurance carrier as an “out-of-network lab expense.”