Hormone testing specifically the sex hormones including estrogen, progesterone, testosterone and distinguishing between serum (blood) vs. saliva vs urine tests.
Serum (blood): for sex hormones there is no distinction in serum between bound and unbound (free) hormones. It can be misleading in which hormone levels appear as normal or even high normal because of the amount of bound hormones. If free hormone level is low, the patient can be functionally deficient even with normal total hormone levels.
Saliva: Saliva test measures free, unbound, bioavailable biologically active hormones, which can be delivered to the receptors in the body’s tissues. Only unbound hormones are able to pass through into the saliva.
Urine: Measures the parent hormones and metabolites. Urine measures unbound hormone, reflecting bioavailable hormones and can measure hormone metabolites. Some estrogen metabolites have a protective effect on estrogen-sensitive tissues, other metabolites have a more carcinogenic effects. Measuring the hormone metabolites give us insight into what hormones are doing in the body.