The ultimate saliva hormone testing guide
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Written by Base Medical Team
Updated over a week ago

Everything you need to know about saliva hormone testing

What exactly can you learn about your health from a simple spit sample? A whole lot, as it turns out!

We tend to think about biomarker testing in terms of hospital visits, big needles, and bigger blood draws, but the advancing technologies and techniques around saliva testing are making it a promising alternative for at-home hormone testing.

Here’s what you should know about saliva hormone testing: how accurate it is, where you can get it done, and how it can help you take your health and wellness into your own hands.

What hormones are tested with saliva?

Saliva testing has been around for a long time and has been used for a broad range of purposes, from the ancestry DNA testing that brought it to the forefront of at-home consumer testing to diagnosing the COVID-19 virus.

But one of the most valuable assets of saliva testing comes from its ability to test your hormone levels.

Hormones are chemical messengers that travel throughout your body and influence everything from your mood to your digestion. As such, any imbalances to your hormones can leave you feeling decidedly “off,” manifesting as a variety of nonspecific symptoms like brain fog, fatigue, and mood swings. At worst, these hormone imbalances can even indicate a more serious underlying health issue.

So because they’re such an important measurement for your overall health and wellbeing, getting a hormone test is one of the best ways to get to the bottom of what’s going on, and saliva testing is one of the simplest and least painful ways to do it.

Some hormones that can be tested using saliva samples include:

  • Cortisol, your “stress hormone” that influences your stress response and your metabolism

  • Estrogen, a major female sex hormone

  • Testosterone, a major male sex hormone

  • DHEA (Dehydroepiandrosterone), an adrenal hormone that is a precursor to other important hormones

  • Melatonin, a hormone responsible for helping you get drowsy and go to sleep

Is saliva hormone testing accurate?

Saliva is a complex biological fluid, just like blood. It contains many of the same components that you would find in blood, including antibodies, enzymes, and hormones. These components actually get into your saliva from your blood by passing through the spaces in between your cells.

In less complicated terms, this means that many of the same biomarkers that you would find in a blood sample are also going to be found in a saliva sample!

This doesn’t necessarily mean that the same levels that are going to be found in a blood test are going to be the same as what you would find in a lab test. The presence of certain biomarkers might be more concentrated in your blood than in your saliva. However, several studies over the course of decades have proven that the biomarker levels found in both saliva samples and blood serum samples show a good amount of correlation.

Saliva vs. blood hormone testing

Interesting to note: In some cases, saliva does tend to be an even better test than blood samples. Blood samples tend to take the spotlight when it comes to biometrics testing, but saliva testing is also very accurate --- some would argue superior --- for testing certain hormones.

This is because hormones can present themselves in two different forms: active and inactive. Active hormones are also referred to as “free” hormones because they aren’t bound to any proteins. This means that they are actively carrying out their hormonal “duties.” On the other hand, inactive hormones are bound to proteins and thus not currently working. The only hormones that can make it into your saliva are the active form, since they aren’t bound to any proteins. Meanwhile, both active and inactive hormones are present in a blood sample.

So blood sample tests generally reflect the total hormone levels in your body, while the saliva samples show only the active hormone levels since they are free to travel through into your saliva from the blood. This means that saliva samples could give you a more accurate understanding of how your hormones are currently affecting you, rather than a total hormone level reading that would generally come from a blood test.

One excellent example of this is the measurement of cortisol, the “stress hormone” that is produced by your adrenal glands. Researchers have found that salivary cortisol levels were highly accurate and increased more rapidly in response to adrenal function tests than serum cortisol levels. They ultimately concluded that because of this accuracy, saliva testing is likely a better way to measure adrenal function than blood tests!

It also helps that saliva testing is so much less invasive than blood testing. Because the prospect of taking a blood draw can be highly stressful for some patients, saliva testing offers a much more painless collection option that is less likely to spike your cortisol levels and give an inaccurate reading.

Best time of day to do saliva hormone testing

Because many of your hormone levels naturally fluctuate throughout the day, the timing of your sample collection does matter. The best time to take your samples really depends on which hormones you’re looking to get more information on.

For example:

  • Your cortisol levels generally spike and hit their peak early in the morning, then slowly decrease throughout the day and especially as it hits nighttime and you start to get ready for bed. In this case, it’s wise to submit a couple of samples throughout the day to see how your cortisol changes over time. If you’re taking a cortisol test to get to the bottom of brain fog and flagging energy levels, this can help determine whether chronic stress and/or adrenal fatigue are issues.

  • Testosterone is also at its highest during the first half of the day. It’s best to take your testosterone tests between 7am-10am, since taking it later on in the day could give the false impression of having low testosterone levels.

This is another reason why saliva tests could be considered superior to blood tests for many different applications. With the ease and accessibility of saliva testing, you don’t have to reschedule your busy morning to get to the hospital in the prime early hours, or drag yourself to the testing site multiple times a day, in order to get the most accurate hormone testing results.

Where to get saliva test kits

If you’re looking to get a saliva test to decipher what’s going on with your health, you have a couple of different options.

There’s the traditional route, which means making an appointment with your doctor, talking about your ailments and symptoms, and getting a saliva test if they deem it appropriate.

However, modern technologies and the age of digitalized personal health solutions has made it even easier and more convenient than ever to get a saliva test kit delivered to your door. With these at-home tests such as Base, you can simply order a kit to be delivered to your house, submit your saliva samples (aka spitting into the provided collection tube), and send the samples via mail to a lab to be analyzed. This means that it’s easier than ever to take control of your health and get your biomarkers tested from the comfort of your own home!

Simply put: If you’re trying to put your finger on what’s causing those more vague and nonspecific symptoms like low libido, low energy, or chronic exhaustion, an at-home saliva test is a great place to start.

Base offers several testing areas, including Sleep, Sex Drive, Stress, Diet, and Energy, to help you get clear and measurable answers for what’s behind your own symptoms.

Cost of saliva hormone testing

Another major perk of saliva hormone testing is that it tends to be relatively inexpensive, especially when compared to blood tests. With Base’s at-home tests, you can get a full test kit subscription for $59.95 per shipment (and free shipping). If you want to keep a measure of your progress and track improvements over time, Base makes it easy to take follow-up tests so that you can see whether your hormone levels are moving in the right direction — and make the appropriate changes accordingly.

How to use a saliva test kit at home

Taking a saliva test at home is by far the easiest and most convenient way to collect a sample and get valuable biomarker information in return. Here’s how:

  • Remember, the time of day that you take your hormone test matters. Depending on which test you choose to do, you may only need to take one sample, or your test kit could include several tubes to take samples at different times of the day.

  • Eating, drinking, smoking, brushing your teeth, and chewing gum can all contaminate your sample. Refrain from doing these activities or anything else that could alter your results for at least an hour prior to collecting your spit sample. However, make sure you’re staying hydrated prior to that period so that you can generate enough spit.

  • When you’re ready to take your test, simply open up your test tube and start spitting! Tubes will have a mark to indicate when you’ve collected enough sample for testing.

  • Repeat if necessary throughout the day.

  • Once your samples are collected, mail them off to the lab to be analyzed. The sooner the better here: saliva samples contain biological materials that can change the longer they stay in the tube. Get it to the lab as quickly as you can for the most accurate testing.

  • Keep an eye out for your results and guidance for making data-driven improvements to your health.

Collecting blood samples in a lab or a hospital might still be the best option for accurate biomarker testing, but saliva hormone testing is proving to have several merits of its own. Its convenience, accuracy, and cost-effectiveness means that saliva tests are taking at-home biomarker tracking to the next level.

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