Ask Larry:

Question:

Tell me more about the Saliva test kits. Are they helpful for men? And what purpose would they assist with? How much for the test? Are they done through your office?

Larry’s Response: There are numerous reasons I’ve STOPPED recommending testing for hormones.

• The process is costly.
• Test values are dependent on the levels of hormone in the saliva, which changes throughout the day.
• The measured values are compared to other people and based on averages. I think it is good to compare a value today to what is was FOR me when I was 21 – not what it is for the average of people.
• Just knowing a number doesn’t always relate directly to how a person feels or functions – regardless of how much we’d like it to be that way. Measuring things like sodium, potassium, carbon dioxide, sugar, and so on, are helpful because we know from experience what healthy levels are. The ranges are very narrow – and don’t change much over the years.

Many practitioners believe in the test values so much that they “chase the numbers” by adjusting dosing of hormone supplements, which ends up confusing the health issues instead of clarifying them. A true clinician talks to his/her patients and establishes goals for how the person FEELS, not for what numbers they obtain on their recent test.
I know patients whose doctors tell them they are “fine” when their thyroid test report is in the acceptable range – even when the patient reports they feel like dirt.

Getting specific about testosterone, testing can identify men who have levels such that the doctor can be justified in ordering a testosterone supplement. After that, the job of finding the correct form of testosterone and the correct dose should be a clinical evaluation but it usually ends up with a follow-up test and an adjustment.

In my experience, saliva testing does as well – or even better – than blood testing (I have an article on this here). However, the STANDARD for testing remains a blood test, often because insurance companies are more likely to pay for a blood test.

While the accuracy of a blood test can be suspect, it is what the doctors use – and what the insurance companies pay for. Testosterone is a controlled prescription item and must be ordered by a doctor. That means a person needs to comply with the rules the doctor imposes if he expects to get an order for testosterone. Generally, that means at least one office visit, test costs, interpretation costs, a prescription, and follow-ups on a regular basis – with more testing to see if the dosing is correct.

I recently published a blog titled, “No more saliva tests, no more consultations“. Feel free to read it.

In a nutshell, I can still sell saliva test kits, but I have minimal faith in them as a diagnostic tool, and I don’t get involved in interpreting the results any longer. There are some excellent doctors who will work with their patients and help them achieve the health they desire. They’re out there and not too difficult to locate. They are not inexpensive, but their results are good. The better ones pescribe compounded testosterone supplements instead of the commercial drug products.

I don’t know if this answers your basic questions. If not, don’t hesitate to write again.