Im sorry I cant help with your question but I do have a question for you. Your Salivary test did your endocrinologist do this test for you. Im going to see mine tomorrow night and was wondering if they do that type of test?
I was able to print a copy at my city library, so you might too.
Alternatively, you can view two representative graphs taken from the above paper, and provided in figure 2 of the following paper, full text at the URL below:
Each graph in figure 2 shows free cortisol vs salivary cortisol for an individual.
Unfortunately the below paper does not specify what was provided in the above paper, namely that the first graph comes from a person with high CBG and shows poor correlation, while the second graph comes from a person with normal to low CGB and shows excellent correlation.
I am not sure of the percentage of the human population whose CGB is high enough to cause a discrepancy between the two measurements.
The following research papers confirm that serum and salivary cortisol (not sex hormones) are highly consistent for people who aren’t already messing with their cortisol signaling. But we don’t know if these researchers specifically excluded those whose CBG was either too high or too low. Most likely they didn’t experience a volunteer with unusual CBG, ie:
a) Midnight Salivary Cortisol Versus Urinary Free and Midnight Serum Cortisol as Screening Tests for Cushing’s Syndrome
b) Saliva Collection Method Affects Predictability of Serum Cortisol
c) Salivary Cortisol in Critical Care Patients
SALIVARY TESTOSTERONE
There is a scientific reason for the discrepancy between testosterone concentrations in saliva versus testosterone concentrations in serum.
The reason is that saliva generating cells are unique in that they manufacture enzymes which specifically synthesize testosterone from the androstenedione which they absorb from the bloodstream.
The synthesis occurs via an enzyme present in the salivary gland cells called 17-hydroxysteroid oxidoreductase, or 17b-hydroxy-C19-steroid oxido-reductase, depending on which paper you read (below).
As a result, salivary testosterone concentrations / levels are always higher than serum bioavailable or free testosterone concentrations / levels.
As a result, salivary androstenedione concentrations / levels are always lower than serum free androstenedione concentrations / levels.
We need to combine the info from two 1990’s papers to explain this:
Title: Low Ratio of Androstenedione to Testosterone in Plasma and Saliva of Hirsute Women
Journal: Clinical Chemistry, Year 1992, Volume 38/9, pages 1819-1823
Author(s): L. M. J. W. Swinkeis, H. J.C. van Hoof, H. A. Ross, A. G. H. Smals, and T. J. Benraad
URL Full Text
Title: Human Meibomian Glands: A Histochemical Study for Androgen Metabolic Enzymes
Journal:
Author(s):
URL Full Text
This is a compelling explanation, but categorical proof would require some sort of radio-isotope-labeled molecules of androstenedione to be injected into the bloodstream, and detected in the salivary glands, and then shown to have been converted into radio-isotope-labeled testosterone within the salivary gland cells. This is expensive, and obviously won’t get funded by the labs wanting to sell salivary testosterone test kits.
Conclusion:
Based on the combination of these two papers, salivary testosterone concentration is a product of BOTH the serum testosterone concentration and the serum androstenedione concentration.
This makes salivary testosterone measurements not very useful as a biomarker for monitoring testosterone metabolism - which is what most people are looking for when purchasing a testosterone measuring test.
At best that makes salivary testosterone measurements a “qualitative” indicator of some sort of androstenedione / testosterone balance situation.
SALIVARY ESTRADIOL
After extensive discussions between our members and their medical professional advisers, the most frequent conclusions are that collectively we have a very high degree of confidence that serum sensitive E2 testing is representative of whole body E2 metabolism.
On the other hand salivary E2 testing always yields E2 results which are relativley much higher than serum sensitive E2 metrics. This is similar to the results for salivary T (testosterone) versus serum T.
After extensive discussions between our members and their medical professional advisers, the most frequent conclusions are we have not seen any reliable correlation between salivary E2 testing and serum sensitive E2 testing, and we know serum sensitive E2 metrics are very useful, so this doesn’t bode well for salivary E2 testing.
As discussed in the previous section re salivary T, the researchers who investigated the discrepancies between:
a) salivary T and serum T
and
b) salivary androstenedione and serum androstenedione
…did not go on to address the discrepancy between salivary E2 and serum sensitive E2.
Despite the lack of any compelling analysis, one highly likely explanation for the excess T (testosterone) found in the salivary gland cells is due to the presence of aromatase enzymes in the saliva-producing cells, which then synthesizes the excess T in those saliva-producing cells (discussed above), into excess E2.
As our members get more time to investigate the presence of aromatase enzymes in saliva-producing cells, we’ll discuss it and transpose any conclusions here, so if you have time to investigate this further, please do so and let me (chilln) know the outcome - via PM is best.
Copyright is retained by chilln: 2008, 2009, 2010, 2011
SALIVARY CORTISOL REFERENCES
Serum free cortisol matches very closely to salivary cortisol for average people without an excess of CBG (cortisol binding globulin).
My principal source is from a group of researchers with some very thorough technique:
Gozansky WS, Lynn JS, Laudenslager ML, Kohrt WM.
Salivary cortisol determined by enzyme immunoassay is preferable to serum total cortisol for assessment of dynamic hypothalamic-pituitary-adrenal axis activity.
Clin Endocrinol (Oxf) 2005;63:336-41.
I was able to print a copy at my city library, so you might too.
Alternatively, you can view two representative graphs taken from the above paper, and provided in figure 2 of the following paper, full text at the URL below:
Each graph in figure 2 shows free cortisol vs salivary cortisol for an individual.
Unfortunately the below paper does not specify what was provided in the above paper, namely that the first graph comes from a person with high CBG and shows poor correlation, while the second graph comes from a person with normal to low CGB and shows excellent correlation.
I am not sure of the percentage of the human population whose CGB is high enough to cause a discrepancy between the two measurements.
The following research papers confirm that serum and salivary cortisol (not sex hormones) are highly consistent for people who aren’t already messing with their cortisol signaling. But we don’t know if these researchers specifically excluded those whose CBG was either too high or too low. Most likely they didn’t experience a volunteer with unusual CBG, ie:
a) Midnight Salivary Cortisol Versus Urinary Free and Midnight Serum Cortisol as Screening Tests for Cushing’s Syndrome
b) Saliva Collection Method Affects Predictability of Serum Cortisol
c) Salivary Cortisol in Critical Care Patients
Some endocrinologists do it, as well as some progressive MDs and NDs (Naturopathic Doctors) and DOs (Doctor of Osteopathy - like the aforementioned Dr. Crisler - although he, in particular, appears not to be a fan).
Moonman - thanks for the info. Does anyone hear dispute Crisler’s position that saliva testing is bunk?
