Review: At-Home Saliva Hormone Testing

Saliva hormone testing is something I’ve wanted to do for a very long time. Serum (blood) hormone testing is notoriously unreliable, which is why we’re all starting to catch on that saliva (or urine) is the way to go.

And, WOW, is it revealing…

The Test

I go through a local compounding pharmacy for my compounded T4 thyroid hormone. (Synthroid is the devil. Never again.) When I picked up my last batch of T4 in December, a sign stating the pharmacy now offers saliva hormone testing for hormone replacement therapy grabbed my attention.

I filled out a profile of my symptoms, my cycles, etc. for the pharmacy, and they sold me a hormone testing kit.

Now here’s where it gets fun. I actually have a pretty severe case of ADHD. This means that not only can I not find the receipt for the test, I also forgot to take pics of the kit when I was testing. Yep, I’m special.

I can say with absolute certainty that the test is from ZRT Laboratory. They have information about it here. Yes, the info is a tad confusing. What I took away from it was “good test, you take”.

I got just the regular saliva hormone test kit without blood or any of that. As of this writing, it’s listed at the top of the kits on that page.

The kit itself concluded:

  • directions
  • a form to fill out
  • several plastic vials
  • labels for the vials
  • a plastic envelope to mail the sample to the lab
  • a shipping label

Overall, very straight-forward and simple.

The Collection

The pharmacist instructed me to do the test on day 19 of my cycle. That was January 31, 2021.

I started with the directions. Yes, reading all of the collection directions all the way through before doing the collection is a good thing. You have to do it right after waking up. You have to rinse your mouth and wait. Don’t brush your teeth.

And this is the part where, as much of a fan as I am of this test and the results it gave me, I explain why I will never do one again.

Saliva grosses me out. Seriously grosses me out. And, apparently, that does include my own. The test requires drooling into the plastic vial until it is half-full. I took about half an hour to collect the sample, and by the end of it I had taken a Zofran and was sitting on my toilet with a cold washcloth pressed to the back of my neck. Because full-throttle nausea.

(Next time I’m just going to do urine.)

After collection was finally finished, I stoppered the vial and made sure it was labeled correctly. The lab uses UPS for its shipping, but I wasn’t going into town to do errands for a few days. So I froze my sample. Yes, this is very important. If you can’t ship your sample right away, you should stick in the freezer. Warning my partner not to knock my saliva tube over before it got a chance to freeze was a lot of fun. Poor guy, he endures a whole bunch of crap with a beautiful smile.

The Results

I shipped the sample around February 4, and ZRT Laboratory received it on the 10th. Then I was notified by the pharmacy about a week later that the results were back. I headed over to the pharmacy a few days later to pick them up.

hormone test results

I was surprised, but then I wasn’t. It looks like my estradiol and progesterone are good, until you realize that, yes, I am still estrogen dominant, but just a little bit. I was very heartened to see that the ratio of the two was so close to being in a good range. That was kind of the end of the good news, though.

Low testosterone explains things like why my libido just seems to go on a vacay with distressing frequency. It also explains some of my low energy and weight problems, I’m sure.

Low DHEAS (which, I think, is basically low DHEA) causes similar awful symptoms, like low libido, low energy, malaise, etc. Probably because it’s a precursor to testosterone.

Low cortisol in the morning causes one to turn into a zombie until after noon. Trust me on this one. Cortisol is supposed to rise when you first wake up so you can get up and get your day going before tapering off and gradually falling to low levels at night. It’s miserable when this doesn’t happen the right way. When morning cortisol is low, it can indicate an issue with circadian rhythm. I strongly suspect that in my case and have for years. (As of this writing, I’m going through sleep testing. The clinic is first screening me for sleep apnea, but after that we’ll be looking for other sleep issues.)

My Recommended Hormone Regimen

When the hormone testing results came back, the pharmacist gave me his recommendations for HRT and supplements that he believed would make me feel better.

Only a couple of the “scripts” are actually prescription. My doctor’s office signed off on the prescription ones. I did end up filling them all through the pharmacy, and I take them as directed.

Ashwaganda – an adaptogenic herb, which means it helps your body balance stress hormones. This is to help with the cortisol.

Pantothenic acid – vitamin B5, to help with energy.

Progesterone 100mg – our good buddy progesterone in capsule form. I take this about an hour before I go to sleep. It does seem to make my sleep more restful.

Testosterone cream – with a little estradiol and progesterone, it’s primary purpose is, of course, to raise my basement level testosterone levels.

I had reservations about the cream because the little bit of estradiol in it. I told the pharmacist how hard I’ve worked to reduce estradiol over the past couple of years. He assured me that it’s only a very small amount and that my body needs it in the cream. I grudgingly agreed. So far, so good.

Life on Hormone Replacement Therapy

… is not too bad so far! As of this writing, I’ve been doing the regimen for about a month, and I have seen some improvements:

Libido – is up! And it’s been much more consistent.

Sleep – is better and deeper. I was pretty miserable all through February. My partner got a new job, and he’s been waking up earlier, which means I’m waking up earlier and spending most of my day stumbling around, spacing out, and struggling to stay awake. And this is why I decided to seek out a sleep clinic. It seems to be improving, though. I absolutely dreaded time change on top of changing my sleep schedule already, because it always screws with me so much. Fortunately, we’re a few days in, and I don’t seem to be much worse for wear.

Energy – is still pretty darned meh. See above section on sleep.

Excercise – is better when I can get it. Maybe I’m imagining things, but I could swear the testosterone is making my HIIT so much easier.

Period – was much less heavy. It was still painful, though. It’s not because of cramps. I don’t really cramp until after my period. Instead I get pelvic pain when I’m on my period. It never really got severe, which is an improvement. Not sure if this is related to any of the new stuff I’m taking. Anyway, future periods will be telling. I may end up doing updates here.

Speaking of cramping after my period, one big area of disappointment for me is the post-period cramp-and-sludge. I had hoped that progesterone would help with that, because it never goes past ovulation. I was thinking (hoping) that just maybe because of progesterone. Guess not. (I am currently working on adapting my body to a supplement that should help finally clear that up, but that’s another post for another day.)

Conclusion

Saliva hormone testing has been a (mostly) positive experience, and I say do it if you have period problems. It’s worth it. You never know what you may find out.

Update

So, this post has taken a bit longer to write and put out there than I anticipated. (What can I say? Nothing sucks time and energy quite like chronic disease.) And shortly after I started this post I had to stop using the testosterone cream because I ovulated and then went up 2 cup sizes. Not to mention the pain. OUCH.

I called my pharmacist, and he said to stop using the cream on cycle day 25. We agreed it sounded like my estradiol was too high again. I knew that if I didn’t do something I was in for some nasty PMS. So I stopped the cream around cycle day 15.

About a week and half later, I’m still up about 1 cup size, but the pain is much better. Had some irritability (not a common PMS symptom for me), appetite problems, fatigue, and cravings the past few days. Of course, my spring migraine season is in full gear, so those things could very well have been migraine symptoms. When it all flares up at the same time, who knows what causes what?

I digress… My plan for next cycle (in 2 days? 3? I just never really know) is to use 1 pump of the cream every night, instead of the prescribed 3 pumps, starting on cycle day 1. The next time I get the cream filled, I’m telling the pharmacist that he must take out the estradiol. We’ll see how all of this goes.

I kinda miss the libido. 🙁

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