Many readers write to me asking about saliva and blood spot testing for thyroid and other hormones, and why it may be of interest to some patients and practitioners.
Recently, ZRT Laboratories launched its Comprehensive Hormone Profile home test kit, which combines saliva and blood spot testing in a home collection kit. The kit allows for same-day testing of the three major hormonal symptom areas - reproductive, thyroid and adrenal.
The Comprehensive Hormone Profile tests:
- Sex/Reproductive Hormones: Estradiol, Progesterone, Testosterone
- Adrenal Hormones: DHEA, Cortisol (AM, noon, evening and PM)
- Thyroid Hormones: TSH, FreeT3, FreeT4, TPO
Find out more about this important resource now.
Sex and adrenal hormones are collected in saliva, and thyroid hormones are tested by blood collection with a finger stick.
The following is a Q & A on saliva and blood spot self-testing for hormone levels, with information from Dr. Richard Shames, a holistic physician with expertise in thyroid and hormonal treatment, and Dr. David Zava, founder of ZRT Laboratory, a leading hormone testing company.
Question: How do Drs. Shames and Zava view the issue of thyroid tests?
Dr. Richard Shames: “A big part of the problem is that regular blood tests are not sensitive enough for diagnosis and treatment of the large number of people with mild to moderate thyroid abnormality. Their best use is for identifying and treating the relatively small number of people with severe thyroid dysfunction. Using insensitive, accurate tests is a terribly inept way to handle a skyrocketing thyroid epidemic.”
Dr. David Zava: “One of the reasons is that, conventionally, practitioners tend to test what insurance will cover, which means TSH only. By itself, this is a pretty useless test in most cases. I’m sure most practitioners have seen many patients with clear thyroid deficiency symptoms with a normal TSH. We see it more often than not. TSH is not a good marker for thyroid dysfunction. That’s why it is important to look at T4, T3, TSH, and thyroid antibodies (TPO), all in concert with the sex and adrenal hormones.”
Question: Why do. Drs. Shames and Zava feel that thyroid testing should also include a check of the adrenal and sex hormones?
Dr. David Zava: “Sometimes you will see people with perfectly normal thyroids but severe thyroid deficiency symptoms. Dr. Shames describes this in his book Feeling Fat, Fuzzy or Frazzled. The thyroid doesn’t work alone in the cells of the body. It requires a team of other hormones, one of the most important of which is cortisol. If cortisol is too low or too high -- caused by some kind of emotional, physical, chemical, or microbial stressor -- it may cause your thyroid hormone to work less efficiently in the tissues. Measuring the thyroid is only one piece of the puzzle. This is why it is so important to know what your other hormones are doing, to know what hormones or medications you are taking that may interfere with the thyroid hormone that’s in your body, and to know what stressors you perceive.”
Dr. Richard Shames: “Thyroid, adrenal and sex hormones are each like a leg of a 3-legged stool supporting our entire metabolism. If any one or more of the legs is weak or short, it throws everything else off balance. If the only leg corrected is the thyroid leg, but we ignore the other two, then it’s difficult – if not impossible – to achieve full metabolic balance.”
Question: How does this new testing assess thyroid, reproductive hormones and adrenal function simultaneously?
Dr. David Zava: “In the Comprehensive Hormone Profile, I’ve combined the new technology of saliva testing for adrenal and sex hormones, with new and accurate blood spot testing. One kit allows testing of estradiol, progesterone, and testosterone, DHEA, several cortisol levels, and T4, T3, TSH, and TPO all at the same time.
What I like about the finger-prick blood spot is that it gives values equivalent to blood drawn from the arm with less stress, time, and money spent. What I find amazing is that the hormones in that dried specimen are very stable at room temperature for at least a month, allowing for great latitude in shipping to the testing laboratory. Dried blood can be mailed without taking the same precautions as with liquid blood because the pathogens that potentially cause infections, such as the AIDS virus, are destroyed in the drying process.”
Question: How does Dr. Zava compare his laboratory’s use of capillary blood or saliva compared to the blood drawn from a vein (“venous blood”) used for regular blood tests?
Dr. David Zava: “It is more accurate. Capillary blood, drawn from the finger, or tested indirectly in saliva, is more reflective of what is actually being delivered to the tissues. For instance, I’ve found that venous blood grossly underestimates hormone delivered to tissues when a person is using topical therapy, such as hormone creams or patches.
Question: How are test results reported?
Dr. David Zava: “In addition to numerical test results, patients can answer a questionnaire about their symptoms, and receive a report, known as the ‘Symptom Profile,’ describing their likely hormone problems. The reason I developed the Symptom Profile is that practitioners would call me up and say ‘well, we have a hormone test result and I don’t know what it means.’ I would ask them about their patients’ symptoms. For convenience to the practitioner and patient I developed a list of the most common symptoms of deficiency and excess of each of the hormones we were testing and put them on a form such that the patient could report them as none, mild, moderate, or severe. We developed the Symptom Profile using Artificial Intelligence, or AI. Five to six years ago, as we looked at results and we would say ‘this person has cold body temperature, they have depression, they have fatigue, mostly in the evening, they have a number of symptoms associated with thyroid deficiency and those were listed and quantified.’ Using Artificial Intelligence, the actual lab numbers are evaluated in conjunction with the Symptom Profile, to determine whether there’s a match. When you have a match you know clinically that you’ve really got something.
If you don’t have a match, you are less likely to move forward. Say the person doesn’t have a low thyroid level and yet they have symptoms of thyroid deficiency. You might want to look at the adrenal glands first before you start treating with thyroid hormones. These symptoms are reported back to the practitioner to help them see what their patients were complaining about and if it was related to their hormone profile in any way. When a patient retests, the report also looks at their previous hormone levels as well as their past and current symptoms to see if improvements were made with whatever treatment regimen was implemented. If I had to pick anything I have done as “the most” creative, it would be the AI. It’s very powerful, and growing with each new scientific and clinical study. This empowers the patient and the doctor to get to the source of the problem a lot faster.”
Question: How can patients order their own tests?
Dr. Richard Shames: Patients who want to order their own tests can get the do so with ZRT at a substantial discount by joining a free patient group known as the Canary Club. After ordering the test kit, and sending samples back to the lab, they’ll receive their results, which include hormone levels, Symptom Profile, and clinical summary from ZRT Lab. A step-by-step interpretation guide is also available from the Canary Club.
Question: What should patients do with their results?
Dr. Richard Shames: Patients will usually take their results to a local practitioner to help in diagnosing and treating hormone imbalances. And patients who want to map out customized approaches to the thyroid/adrenal/sex hormone balancing can also get personalized coaching when needed.
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