Saliva
Large male hormone profile
This profile measures oestradiol, testosterone, and DHEA in men via saliva testing.
€ 200,00
All tests
Hormones · Saliva
Testosterone
The free testosterone in saliva; follows a daily rhythm and cannot be compared one to one with testosterone in blood.
At a glance
- Measured in saliva
- In 2 test panels
- Check the preparation
Explanation
Testosterone: what is measured?
In men, testosterone is made mainly in the testicles, and in women in small amounts in the ovaries and adrenal glands. In blood, most of it is bound to SHBG and albumin; saliva contains only the free part. Testosterone has a daily rhythm: the value is highest in the morning and falls during the day. In women, the values in saliva are so low that they are hard to measure accurately.
What can it detect?
- A rough indication of the amount of free testosterone, although total testosterone and SHBG in blood say more about this
- Use of testosterone, for example as a gel, although the saliva value is then often falsely high
Result
What does the result mean?
Testosterone too high
A raised value is often caused by testosterone gel or cream, which can contaminate the saliva via the hands or mouth, or by bleeding gums, or eating or drinking just before collecting. Anabolic agents and DHEA supplements also raise the value. In women, a raised value can fit PCOS, with symptoms such as excess hair growth, acne and irregular menstruation; this is assessed with a blood test.
Testosterone too low
A lower value is normal later in the day and gradually decreases with age in men. Overweight, lack of sleep, illness, a lot of alcohol and medicines such as opiates and corticosteroids also lower the value. In men, a repeatedly low testosterone in blood with symptoms such as less interest in sex, erection problems and fewer morning erections can fit testosterone deficiency. A low saliva value without such symptoms says little.
After an abnormal result
With symptoms that fit testosterone deficiency, the GP has testosterone measured in blood in the morning and repeats the measurement if the value is low, if needed with SHBG, LH and FSH. In women with symptoms of too much male hormone, testosterone and SHBG in blood follow. An abnormal saliva value without symptoms usually does not lead to further tests.
Reliability
How reliable is the test?
The value in saliva cannot be compared one to one with blood, and there are few agreed cut-off values for saliva. What an abnormal saliva value means has been little studied. The time of collection strongly affects the result, because testosterone is highest in the morning. According to the guidance of the Dutch Society for Endocrinology (NVE), testosterone deficiency in men is diagnosed from symptoms and a repeatedly low total testosterone in blood, taken in the morning, possibly with SHBG to calculate free testosterone.
What can affect the result?
- Timing: collect in the morning, preferably before 10 o'clock, at the agreed time; with night shifts or an irregular sleep pattern, the daily rhythm is shifted.
- Collecting: do not eat, drink, smoke or brush your teeth just before collecting; brushing your teeth and blood from the gums can strongly disturb the result. Rinse your mouth with water about ten minutes beforehand.
- Testosterone gel or cream can contaminate the sample and give a falsely high result; anabolic agents and DHEA raise the value.
- In women, the values in saliva are so low that measurement methods are inaccurate; reference values differ between laboratories.
Preparation
- Fill the first tube straight after waking up and the next ones after 30 and 60 minutes. Do you have a cycle and not use the pill? Do the test on day 19, 20 or 21 (with a cycle of 26 to 29 days). If you use the pill, do the test at the start of your pill-free week.
- Do not eat, drink, smoke or brush your teeth until after the third tube. Do not use mouthwash or dental floss that day.
- Do you use hormone preparations such as hydrocortisone or progesterone? Then stop 48 hours beforehand, in consultation with your doctor.
- Stop supplements that affect hormones, such as maca, 5 days beforehand.
Who it is for
Who is the test useful for?
Useful for
In men with symptoms such as less interest in sex, erection problems or fewer morning erections, testosterone in blood taken in the morning says more than a saliva value. In women with excess hair growth, acne or irregular menstruation, testosterone and SHBG in blood say more. Not suitable as a measure of energy, muscle building or vitality. In people without symptoms, an abnormal value says little.
How common is it?
Testosterone deficiency with symptoms occurs in about 2 to 6 in 100 men over 40, more often at older ages and with overweight. In women, PCOS is the most common cause of too much male hormone. How often an abnormal testosterone in saliva occurs in people without symptoms is not known.
NVE guidance on hypogonadism in adult men
Drawbacks and risks
- An abnormality without symptoms means little, but a 'low' value can wrongly be seen as a reason for testosterone or supplements; testosterone without a proven deficiency has side effects and suppresses your own production and fertility.
- A falsely abnormal value due to the timing or method of collection can cause unnecessary worry.
Get tested
Testosterone: test panels
Testosterone is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results