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Basically, the
goal of saliva hormone monitoring is to determine whether or not hormone
replacement therapy or another form of intervention is appropriate for you.
If you are already taking hormones, testing will allow you to adjust
dosages, both optimizing benefits and minimizing risks. The concept of
hormone dosing and titration (dosage adjustment) is new and constantly
evolving towards providing the optimal level of replacement for health and
vitality.
Our current gender and age-based saliva hormone ranges are
guidelines for targeting a hormone level that gives and sustains optimal
health. Ranges given for postmenopausal and older populations are
representative of normal, unsupplemented hormone levels and not necessarily
those which will provide maximum well being. For example, an estradiol level
of 0.7 pg/ml falls within the normal range for a postmenopausal woman, but
is probably insufficient for heart and bone protection. Titration to more
youthful target ranges is important to discuss with your healthcare
provider.
Your Test Results
The test results report form consists of the following:
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Saliva hormone levels for the requested hormones
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Graphic summary of hormone levels which is
particularly helpful if you have tested the same hormone more than once
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Easy-to-read age, gender and treatment specific
Expected Saliva Hormone Ranges
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Specimen collection time and date
Your Results and the Ranges
Saliva hormone target ranges are based on a highly significant number of
individuals representing each of the defined populations and provide an
excellent means for comparison.
Individual and Physiological Variability
Some of the ranges may seem broad, but this variation aptly points out the
wide individuality of hormone levels.
For each of us, our baseline hormone
levels reflect our sex, our age and our genetic background. Women have much
higher levels of the estrogens and progesterone than men, and cycling women
have higher levels than those of menopausal women who have ceased cycling.
Men, in general, have higher levels of testosterone and DHEA than women, but
in both sexes the level of each drops dramatically with age. Cortisol levels
remain constant throughout our lifetime, regardless of sex or age.
Importance of the Time of Collection
The ranges represent saliva hormone levels from specimens collected in the
early morning. This fact is important because several of the hormones (such
as testosterone, cortisol and DHEA) express ‘diurnal variation’ which means
that levels drop over the course of the day and are replenished by the body
overnight. If your saliva collection was not done in the early AM, it is
important to make note of the time difference so it can be taken into
consideration when evaluating your results. It is possible that your
healthcare provider requested an alternative collection time to assess other
aspects of supplementation so it is important to review timing factors. If
that was the case, follow the recommendations of your healthcare provider.
Location Within the Ranges if You are not
Supplementing
For optimal health considerations, the ideal target within your appropriate
saliva hormone range is from the middle to the high level. For example, if
you are a 51-year-old postmenopausal woman and your testosterone value is 14
pg/ml, you might discuss with your healthcare provider the possibility of
supplementation.
Hormone Levels that Fall at the Low End of or Below the
Established Saliva Ranges
Saliva hormone levels below or at the very low end of the established range
indicate sub-optimal values, and hormone replacement therapy (HRT) should be
discussed with your healthcare provider. HRT is available in a wide variety
of hormonal preparations and dosages. They can be taken orally, through the
skin, under the tongue or vaginally.
Ideal HRT target ranges should be
established through a dialog with your provider. For example, if your
testosterone or DHEA level is lower than your age-specific range, do you
supplement back to your age range or, perhaps, back to a more youthful
range?
Hormone Levels that Rise Above the Established Saliva
Ranges
If any of your saliva hormone levels is above the range bear in mind the
following:
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Hormone supplementation will cause high levels and
thought should be given to decreasing the dose.
-
If your AM cortisol value is high, it could be the
result of a single, stressful event. This elevation is a normal
physiological response. But, chronically high cortisol levels can be
harmful to long term health.
-
If any of your hormone values is higher than the
range or falls within a much more youthful range (20 to 29 years), it is
no cause for alarm and probably means you are healthy. However, if your
result is exceptionally high, exceeding the physiologic range for a 20 to
29-year-old, it is a good idea to discuss this issue with your healthcare
provider.
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