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Photograph of saliva test tubes

What is a Saliva Test?

A saliva test is a non-invasive method for determining a patient’s hormone levels that can be done in the comfort of the patient’s home. Saliva tests can look at the same hormones that a blood test can (estrogens, progesterone, testosterone, DHEA, and cortisol) and offer the patient more convenience and flexibility than traditional blood tests.

Why use a Saliva Test?

Steroid hormones (estrogens, progesterone, testosterone, DHEA) are present throughout our bodies. The hormones found in our blood serum are mostly all bound to carrier proteins (95-99%). When a hormone is bound to a carrier protein it is not available to be used by the cells within the body’s tissues. Only the small amount of unbound hormones can move into the tissues (including salivary glands) where they have their effects.1

Dr. Eldred Taylor, M.D. describes this process by saying, “Serum is the train that transports the hormones, and saliva is the neighborhood the hormones live in.”2

By testing the saliva, we are looking at the active hormones in a person’s body rather than all the inactive hormones found in the blood serum.

How do Blood Test Results Compare to Saliva Test Results?

Typically, we will recommend a topical cream to administer a patient’s hormone dose. By doing so, we can use lower hormone doses and reduce the amount of unwanted hormone metabolites.

When hormones are delivered topically, serum testing will often underestimate the amount of hormones that a patient has available. This is due to the rapid uptake of the hormones into the target tissues, and leaves little in the blood serum to be bound to carrier proteins. Unfortunately, this has led many practitioners to doubt the reliability of saliva testing or topical administration of steroid hormones.1

However, saliva test results have shown a 10-fold increase above blood serum with a topically administered dose of Progesterone.3 These results show that the progesterone was indeed absorbed and that the blood serum failed to adequately reflect that absorption.

What Hormones are Tested with a Saliva Test?

At Collier Compounding, we utilize a Saliva Test Kit provided by ZRT Laboratory. The primary saliva test that we use for women includes: Estradiol, Progesterone, Testosterone, DHEA, and a Morning Cortisol level. This test gives us a good picture of an individual woman’s hormone levels.

For men, we use a test that will check: Testosterone, Estradiol, and a Morning Cortisol level. Although we offer the full panel of hormone testing to men, these three levels typically give us the information we need to properly assess a man’s hormone balance.

How do a complete a Saliva Test?

The ZRT Saliva Test kits are available anytime at our Collier Compounding location. One of our trained team members will go over the test kit with you and answer any questions you may have. The test is completed at home first thing in the morning (for the morning cortisol level). Each kit comes with an envelope and pre-paid UPS shipping label that will ensure your saliva sample is sent directly to the ZRT Lab. Once processed, ZRT will send your test results to us and we will call you to set up your consultation appointment. Consultations typically last about an hour, so be sure to block off enough time for your appointment.

If you want more details on purchasing a saliva kit, check out How to Get Started with BHRT.

Does Insurance Cover a Saliva Test?

Unfortunately, we are unable to bill your insurance for your saliva test kit. The simple answer is that the saliva test is a medical test and as a pharmacy we cannot bill that side of your insurance.

You may try contacting your insurance company directly to determine if you can submit a manual claim for the saliva test kit. Be sure to find out from them what information and documentation you need to submit a claim. However, the likelihood of this being successful is slim.

How much does a Saliva Test Cost?

If you have any questions with regard to specific pricing for a saliva test or have any additional questions about saliva testing, feel free to call us any time at (479) 935-4336.


2 Taylor, Eldred; Are Your Hormones Making You Sick?: A Woman’s Guide to Better Health Through Hormone Balance; 2000

3 Du JY, Sanchez P, Kim L, Azen CG, Zava DT, Stanczyk FZ. Percutaneous progesterone delivery via cream or gel application in preimenopausal women: a randomized cross-over study of progesterone levels in serum, whole blood, saliva, and capillary blood. Menopause 2013; 20:1169-75.