Saliva Testing

Saliva Testing

Saliva testing is a non-invasive collection method where patients collect their saliva in plastic tubes in order to measure hormones like cortisol, estrogens, progesterone, and androgens. This non-invasive saliva collection is ideal for patients because it allows them to collect their sample in the privacy of their home or office.

Why Test Hormones in Saliva?

  • Steroid hormones in the bloodstream are 95-99% bound to carrier proteins, and in this form are unavailable to target tissues.
  • Saliva testing measures the amount of hormone available to target tissues – the bioavailable amount.
  • For this reason, saliva testing better relates to specific symptoms of excess or deficiency, and is a good option for monitoring hormone therapy.
  • Some analytes cannot be tested using immunoassays, the methodology used for most of our saliva testing.
  • For that reason, ZRT Laboratory developed an LCMS Saliva Steroid Profile using liquid chromatography/tandem mass spectrometry (LC-MS/MS).
  • This profile tests a broad range of bioavailable hormones and hormone metabolites in one convenient saliva sample collection.
  • LCMS testing allows for accurate reporting of estrogens down to extremely low levels, such as those seen in men, children, and people using aromatase inhibitors, and includes a test for ethinyl estradiol, 3 hormone blockers, and melatonin.
  • ZRT Laboratory is one of the first labs to measure hormones in saliva, and helped establish the method that made saliva hormone testing commercially viable for health care providers and patients around the globe.

Best Practices for Saliva Testing

  • ZRT Laboratory measures hormones from a single morning sample, which represents the peak of daily hormone production – the optimal time to measure

Today’s Most Advanced Saliva Testing

Ranges Adjusted for Supplementation

  • Unlike other labs, patients do not need to stop hormone supplementation to use ZRT’s testing because ZRT Laboratory has ranges adjusted for age, menstrual status and supplementation types.
  • This is the ideal method for tracking the effectiveness of hormone treatments.

No Pooling

  • ZRT does not pool patient samples, meaning that we don’t mix multiple daily samples together to get an average hormone level.
  • Instead they measure hormones from a single morning sample, which represents the peak of daily hormone production – the optimal time to measure.


  • ZRT is the only lab to perform an extraction process for saliva testing, which separates hormones from background contamination. This is the only way to assure accurate test results for low-concentration hormones such as estradiol.

Setting Industry Standards

  • ZRT initiated and manages the industry-wide standards program called the Saliva Proficiency Inter-laboratory Testing Program – which enables laboratories to regularly evaluate and improve saliva testing accuracy.