Several hormones play an important role in women’s overall hormonal health and balance. Saliva testing is a non-invasive method for measuring estradiol (E2), total testosterone, progesterone, Dehydroepiandrosteron (DHEA) and cortisol. Estradiol (E2) is the most potent form of estrogen. Estradiol is released by the ovaries during menstruating years and by the adrenals and fat cells in older females. Estrogen plays an important role in neurotransmitter production, pain perception and tissue growth. Measurement of E2 forms an integral part of the assessment of reproductive function in females, including assessment of infertility, oligo-amenorrhea, and menopausal status.
Progesterone is also made primarily by the ovaries. The adrenal glands, peripheral nerves, and brain cells produce lesser amounts of progesterone. Progesterone is a diuretic and enhances the sensitivity of the body to insulin. During menstruating years, ovulation results in a mid-cycle surge of luteinizing hormone (LH) followed by an increase in progesterone secretion, peaking between day 21 and 23. If no fertilization and implantation has occurred by then, supplying the corpus luteum with human chorionic gonadotropin-driven growth stimulus, progesterone secretion falls, ultimately triggering menstruation.
Testosterone is manufactured in the ovaries and adrenals and supports a healthy libido and sexual function, but it is also imperative for maintaining a healthy body composition and lean body mass. Having healthy levels of testosterone has also been linked to maintaining healthy blood cholesterol levels as well as brain health and motivation/drive. Adequate testosterone is also essential for healthy bone metabolism.
Dehydroepiandrosteron (DHEA) is the principal human C-19 steroid. DHEA has very low androgenic potency, but serves as the major direct or indirect precursor for most sex steroids. DHEA is secreted by the adrenal gland and production is at least partly controlled by adrenocorticotropic hormone (ACTH). Cortisol (a glucocorticoid) is released by the adrenal glands, usually in response to stress. Elevated cortisol levels function to slow down metabolism to conserve energy for vital "fight or flight" functions such as blood pressure or heart rate. Elevated cortisol also slows down immune function and works against insulin to keep circulating levels of glucose in the blood stream longer for perceived "fight or flight" actions.
The thyroid gland is an essential part of the endocrine system which works in concert with the brain and nervous system to control vital organ systems. The thyroid is a butterfly shaped organ that sits at the base of the neck which releases hormones that control metabolism, or how the body uses energy. Thyroid hormones regulate essential body functions such as breathing, heart rate, muscle contractions, nervous system actions, menstrual cycle and body weight. When thyroid hormones are out of balance symptoms may include hair loss, weight gain or weight loss, dry skin, cold hands/feet/nose, fatigue, and even anxiety symptoms. The Female Hormone Health Panel will evaluate Triiodothyronine (fT3), Free thyroxine (fT4), TSH and TPO.
Free thyroxine is measured together with free Triiodothyronine and thyroid-stimulating hormone when thyroid function disorders are suspected. Free thyroxine (fT4) comprises a small fraction of total thyroxine. The fT4 is available to the tissues and is, therefore, the metabolically active fraction. Elevations in fT4 can indicate hyperthyroidism, while decreases cause hypothyroidism. Free T3 is the active form of thyroid hormone that regulates metabolic activity. The determination of TPO antibody levels is the most sensitive test for detecting autoimmune thyroid disease (e.g., Hashimoto thyroiditis, idiopathic myxedema, and Graves disease) and detectable concentrations of anti-TPO antibodies are observed in most patients with these disorders. The highest TPO antibody levels are observed in patients suffering from Hashimoto thyroiditis. In this disease, the prevalence of TPO antibodies is about 90% of cases, confirming the autoimmune origin of the disease. These auto-antibodies also frequently occur (60%– 80%) in the course of Graves disease.
Hormone levels measured in saliva reflect the circulating level of free steroid rather than total levels and represent the bioavailable fraction available to the tissues. This is the hormone fraction that has already been delivered to salivary glands and then diffused passively into saliva. Therefore, measuring free hormone in the saliva is a better measure of the bioavailable fraction as compared to the protein-bound hormone in circulating blood, which “might” be delivered to the tissues. There have been several arguments and questions raised about the accuracy and validity of hormone levels measured in saliva versus serum/plasma and what is the correlation, if any, between the two. Numerous studies have established a significant correlation between serum and saliva for hormone measurements.