By: Krista Borowski, RPh
Bio-identical hormone replacement therapy (BHRT) has many advantages, one of which is the ability to have a product custom made for you. A provider can prescribe specific doses to optimize therapy to balance your hormones and alleviate any symptoms you may have. There are several dosage forms available with the most often used forms being creams and preparations held in the mouth such as drops, tablet triturates, and troches. Before and after therapy is initiated, it is important to follow-up with testing in order to identify any imbalances. When hormones are delivered topically or in the mouth, a simple blood test from the lab will likely underestimate the hormones that are actually available for use. The steroid hormones typically used for BHRT, estrogen, progesterone, testosterone, and DHEA are best measured in saliva or capillary blood. This is because these hormones in the bloodstream are mostly bound (95-99%) to carrier proteins. When the hormones are bound, they are not available to act at the target tissues they are intended for. Only the unbound portion can freely diffuse into the target tissue so it can be used for its intended effect. One target tissue is the salivary gland, which is why saliva a good source for accurately measuring hormones and correlates with symptoms of hormone excess or deficiencies. The other reliable way to accurately measure hormone levels is through a dried blood spot test, which uses capillary blood from your finger. Depending on how the hormones are delivered depends on which test kit is most appropriate. If hormones are delivered topically, either the saliva or dried blood spot kit will work. If hormones are being delivered via the mouth in a sublingual route, a dried blood spot kit is recommended. This is because the hormones concentrate in the oral mucosa, which can result in a falsely high saliva concentration.
ZRT Laboratory offers a Saliva Test Kit and a Dried Blood Spot Test Kit to measure hormone levels.
The advantages of ZRT hormone test kits include:
- Measures the bioavailable (free) levels of steroid hormones
- Identifies hormone imbalances prior to symptoms or imbalances associated with symptoms
- Hormone levels can be assessed during supplementation
- Restoring hormone balance and patient quality of life using test results as a basis for treatment
The saliva test kit is also able to test cortisol levels throughout the day, while the dried blood spot test kit can test for morning cortisol, sex hormone binding globulin (SHBG), prostate-specific antigen (PSA), LH, FSH, vitamin D, IGF-1, thyroid testing (TSH, free T3, free T4, total T4, TPO antibodies, and thyroglobulin), cardiometabolic risk markers (fasting insulin, hs-CRP, HbA1c, triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol, and VLDL cholesterol), and toxic and nutritional elements (cadmium, mercury, lead, zinc, copper, selenium, and magnesium).
ZRT will provide an evaluation report that includes test results and ZRT analysis. The report can be used by an experienced health care provider to tailor an individual treatment plan for you. ZRT test kits are available at MD Custom Rx. Call or stop in to talk to one of our pharmacists about which test kit is appropriate for you and to learn about other tests that are available through ZRT.