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Saliva Testing for Thyroid Evaluation

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Updated July 13, 2006

Saliva Testing for Thyroid Evaluation
One of the biggest controversies facing a person with thyroid problems relates to how to get accurate and useful testing. It is important to be tested to verify a diagnosis that thyroid is indeed your problem, and to have a baseline from which to direct therapeutic efforts. Testing is also useful in re-evaluation from time to time to determine the effectiveness of therapies chosen, and perhaps to dictate a new medicine or new direction if the prior one has not been fully effective.

Currently this process of testing for thyroid status is woefully inadequate for a great many thyroid sufferers. First of all, it is likely that many millions of people who have a treatable thyroid problem are being denied diagnosis and treatment because of lack of test accuracy. Moreover, people who are being treated are being denied fully effective or proper treatment in a great many cases because again the blood tests are not nearly as accurate as they need to be.

A test hopefully gives the practitioner information about how much thyroid hormone is available at that place in the body where thyroid hormone does its job, and how well its working. The current blood tests do neither! They simply are an indicator of how much thyroid hormone is floating in the bloodstream. This is NOT what a doctor ideally needs to know. For instance, I - as a thyroid practitioner - would like to know how much thyroid hormone has gotten from the bloodstream into the tissues, where it would actually do its work.

In the past few years we have been able to get closer to this goal by utilizing saliva testing instead of blood testing. After close to 30 years of using the "old tests," we decided it was time to listen to our naturopathic and nutritional practitioners who had been using saliva testing for close to two decades for these conditions.

Here's what we've learned:

  1. Blood testing is expensive
  2. Blood testing is painful
  3. Blood testing is inconvenient (you have to go to a lab, during their hours)
  4. Blood test accuracy is in question (the American Association of Clinical Endocrinologists and the National Academy of Clinical Biochemistry have for the last few years been trying to change the range of normal on the TSH test, with perhaps resistance from HMOs and other third-party payors)
  5. There is a better alternative -- saliva testing
  6. Saliva testing can be performed in the convenience and comfort of your own home, using a home test kit that is mailed to you
  7. Giving a saliva sample is most often comfortable and easy.
  8. Saliva may be more accurate because it actually measures the level of the hormone in the tissues, where hormones work (hormones don't do their work in the bloodstream)
  9. The amount of hormone in blood is not always the same as the amount that might be in tissues
  10. The cost of saliva testing is much less than blood testing
Here's How It Works

When you measure a hormone in saliva, you're actually measuring the bio-available hormone. Hormones in blood are tightly bound to plasma proteins. Only a tiny fraction, usually less than 1% of what is in the blood enters the tissues. This fraction changes from time to time, perhaps depending on whether you're combatting other illness or feeling healthy.

For instance, a woman taking estrogen or birth control pills will have a higher level of TBG (thyroxine binding globulin) in the bloodstream because of her medication. This will result in less bio-available thyroid actually reaching her tissues, regardless of what the blood tests say. People in this group, for instance, are frequent visitors to our clinic in the San Francisco area, having been told by doctors at medical centers and even at Mayo Clinic that their thyroid blood tests are perfectly normal. When they visit us and obtain saliva testing as well as blood testing, the saliva test is often much more revealing of the patients' actual clinical state.

The World Health Organization has recently approved saliva testing for AIDS, a worldwide epidemic. It is an easy and obvious way to help diagnose problems in millions of people accurately and easily. The National Institutes of Health has been finding that saliva testing for adrenal hormones are more useful than are the blood tests.

Numerous published scientific articles attest to the accuracy of this testing (for references, see our book Feeling Fat, Fuzzy or Frazzled, page 75). These articles explain that saliva testing is accurate, often paralleling blood testing but with more definition to the actual situation. In certain instances, it shows to be superior to blood testing, and it has many advantages in convenience and cost. Our book also refers you to various websites that will share very detailed information on the accuracy of this testing. These are fully credentialed and certified labs each with a several decade history of professional care.

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