Yes, you can start over. Just rinse out the tube with hot water (no soap) let it air dry, and collect first thing the next morning before eating, drinking, brushing or flossing your teeth.

I’m having a difficult time collecting enough saliva to fill the tube.

If you are having difficulty collecting saliva we have a few recommendations. You can try pressing the tip of your tongue against your teeth very gently. This often works to stimulate saliva. You might try thinking about your favorite dessert-this works for some. If these methods don’t help, we recommend that you chew a sugar-free gum (unless you are testing for DHEA-Sulfate as these levels in saliva decrease when the saliva flow rate increases with chewing gum). Chew the gum for about five minutes to increase the saliva flow. Be sure to use only sugarless gum. If all else fails and you cannot collect enough in one day, cap the tube, put it in the freezer and add more saliva at the exact time the next morning until the tube is at least half full. You may continue collecting in this way for up to three days.

Why should vigorous exercise be avoided the day before saliva collection for cortisol (adrenal function)?

This is because hormone patterns can be altered significantly by vigorous aerobic workouts, like jogging, swimming, stair stepping and rollerblading. (This does not include light exercise, like walking the dog.) If you normally engage in strenuous exercise, skip a day before collecting your saliva. If you forget to skip a day and have already collected your saliva, you can rinse out the tube with hot water (no soap), let it air dry, and collect the next morning, at least 24 hours apart from exercise.

I forgot to rinse my mouth before I collected my saliva, what should I do?

A film develops in your mouth at night, which is the reason why we ask that you rinse out your mouth to remove that film before collection. But if you’ve already completed the process, go ahead and send in your kit. Make sure you have at least ½ - ¾ of the tube full. If you haven’t collected that much saliva, you can start over—rinse the tube out with hot water (no soap) and rinse your mouth out before collecting your saliva.

Should I stop taking my hormone supplements to take the saliva test?

No. You do not have to stop hormone supplementation to take the saliva test. In fact, it’s a good idea to use saliva testing as a method for evaluating the effects of the supplement program you are currently on. This allows you and your health care providers to monitor how well your body is metabolizing hormone therapy and make adjustments as needed. If you are presently supplementing with topical hormones (creams, gels or patches), which deliver hormones through the skin, saliva testing more accurately reflects these levels than other measurement methods such as blood testing. However, you will need to allow 12-24 hours from your last dose of hormones to the time you plan to collect your saliva; our ranges are based on 12-24 hours post-use of hormones.

How many days do I have to collect my saliva?

We recommend a one-time collection, within one hour after awakening in the morning before eating, drinking, flossing or brushing your teeth. Pre-menopausal women should collect in the luteal phase, the second half of their cycle (days 19-21) counting Day One as the first day of your period in a normal 28-day cycle. Women who are not having menstrual cycles or who have had a hysterectomy and are not taking hormones may collect at any time. Women taking hormones should collect toward the end of a hormone treatment cycle (you should collect saliva three to four days before you intend to stop using your hormones for that cycle). Women who take hormones every day can collect at any time of the month. If you have only recently started using hormones, saliva can be collected any day after you have been on hormone therapy for at least two to three weeks and before you intend to stop using your hormones for that cycle. Men who are not taking hormones can collect at any time. Men taking hormones should follow the same guidelines for women taking hormones. If you take hormones daily, saliva can be collected any day after you have been supplementing for at least two to three weeks.

How long should I be off my hormones before doing the test?

You should not be off your hormones. However, you will need to allow 12-24 hours from your last dose of hormones to the time you plan to collect your saliva. Saliva testing can indicate how well your body is metabolizing the hormones you are supplementing with; our ranges are based on 12-24 hours post use of hormones.

How are the large and small test tubes in the kit to be used?

The large test tube filled half to three-quarters full can test all the hormones including the A.M. (morning) reading of the adrenal hormone cortisol. People who have morning and evening fatigue may also want to test their P.M. (evening) cortisol level, which is where the second, smaller tube comes in. This is to be used to collect saliva just before bed in order to test the nighttime level. To do a complete adrenal function, cortisol is collected four times a day, morning, noon, evening and just before bed, hence there are four collection tubes in the kit.

When should I collect my saliva?

Collection guidelines depend on if you are pre-menopausal or post-menopausal. Pre-menopausal women should collect in the luteal phase (second half) of their cycle (days 19-21, counting day one as the first day of your period in a normal 28-day cycle). Women who are not having menstrual cycles or who have had a hysterectomy and are not taking hormones may collect at any time. Women taking hormones should collect toward the end of a hormone treatment cycle (you should collect saliva three to four days before you intend to stop using your hormones for that cycle). Women who take hormones every day can collect at any time of the month. If you have only recently started using hormones, saliva can be collected any day after you have been using hormones for at least two to three weeks or before you intend to stop using your hormones for that cycle.

Men who are not taking hormones can collect at any time. Men who are taking hormones should follow the same guidelines for women taking hormones.

If you take hormones daily, saliva can be collected any day after you have been using them for at least two to three weeks.

My periods are irregular, when should I test?

If you have just had a period, count out nineteen days, using the first day you start to bleed as day one. If you have not had a period for several months and you are not supplementing with hormones, collect your saliva any day. If you are supplementing with hormones, collect saliva about 3-4 days before you stop taking your hormones.

I have diabetes and have to eat when I get up, can I eat before I take the test?

This depends on which hormones you are testing. If you are testing cortisol, eating will compromise the test but you may nibble on something before the test if you are not doing the cortisol test. Just make sure to wait about 5 minutes after eating and rinse your mouth well before spitting in the tube.

How much saliva do I need to collect?

You need at least 3 milliliters of saliva in the tube which is about ½ - ¾ full (not including bubbles).

I want more tubes to do extra testing; can I use a tube from my son’s science kit?

No, our tubes are made especially for saliva collection and we cannot guarantee the quality of the sample if it arrives in anything but these tubes. We will be happy to mail you an additional tube. If you collect your evening sample in a glass jar and freeze it until the tube arrives, that will also be acceptable. Make sure you mark the date and time you collected your sample on the glass jar and transfer that information to the tube when it arrives.

My kit will not be here by the 19^th day of my cycle; do I have to wait another month to take the test?

No, you may collect your sample in a glass jar (baby food jars work well) and put it in the freezer, marked with the date and time of collection, until the kit arrives. Then just thaw the sample, pour it into the tube(s) and mail to us. Make sure you write on the requisition that the sample had been previously frozen.

INSURANCE & BILLING ISSUES:

Will you bill my insurance carrier or do I have to?

We can bill most insurance companies including Medicare. The services must be prescribed by a licensed health care provider who will need to include along with a prescription, a UPIN# and the relevant ICD-9 diagnosis codes.

What do I need to send in with my insurance (Medicare)?

You will need a Doctor’s prescription (order), his/her UPIN #, and ICD-9 (diagnostic) codes. You will also need to send us a copy of the front and back of your insurance card, and the signed authorization form enclosed with your test kit information.

Is ZRT Laboratory a participating provider with my insurance?

ZRT is not a participating provider with any insurance.

I need the diagnosis codes to bill my insurance; can you provide them to me?

You need to call your physician for that information. We only have the procedure codes.

What does the cost of saliva hormone testing include?

The cost/per hormone for the saliva test includes: the home test kit with collection tubes in a postage-paid mailer box, processing of the saliva sample(s) in our laboratory, test results with interpretation, and help interpreting results as needed with credentialed physicians and/or customer educators on staff.

THE VALUE OF SALIVA TESTING:

How accurate is saliva testing compared to blood and urine testing?

Saliva testing has been used in scientific testing for decades and has been shown to be highly accurate. The World Health Organization (WHO) has used this method of hormone testing in worldwide comparisons of breast cancer among women living in industrialized vs. non-industrialized countries. Many studies in scientific literature have shown a strong correlation between the levels of steroid hormones in the blood stream and the “bioavailable” (free) levels of steroid hormones in saliva.

Saliva testing is the most reliable way to measure free, bioavailable hormone activity— those hormones actually doing their job at the cell level. Most blood tests do not measure “bioavailable” hormone levels. In addition, saliva hormone testing more accurately reflects tissue uptake and response of hormones delivered (topically) through the skin, in creams, gels, or patches. Blood and urine assays significantly underestimate hormones delivered topically, often resulting in overdosing. When a person does the testing, we ask him/her to fill out a listing of symptoms according to severity; we also ask for information about menstrual history and current hormone usage so as to set the expected ranges. When the final report is put together symptoms are classified according to the category of hormone imbalance they fall into and are correlated with tested hormone levels. In the rare case that test results do not correlate with symptoms, the test is repeated for accuracy.

Is a saliva test beneficial for women taking birth control pills? What is a suggestion for these women who do not intend to stop taking the pill but show symptoms of low progesterone and testosterone?

The saliva test can be beneficial for anyone using hormones and/or contraceptives. It is not uncommon for saliva testing to identify hormonal imbalances in women using contraceptives. A suggestion for a woman using contraceptives with symptoms of low progesterone and testosterone might be to test these two hormones to identify whether an imbalance exists and to what extent. When testing progesterone, it is important to test estradiol at the same time to establish a ratio. Saliva test results could then serve as a guideline to help the patient and healthcare provider adjust the dosage of hormone in the birth control pill accordingly.

Why test hormones in Saliva?

Because steroid hormones play such a vital role in maintenance of health, knowledge of an imbalance in any one or more hormones through saliva testing can help to illuminate the cause of health problems and provide a rational basis for correcting the imbalance through diet, exercise and/or appropriate hormone supplementation with physician guidance. Saliva is the most reliable way to measure free bio-available hormone activity, those hormones actually doing their job at the cell level. Most blood tests do not measure bio-available hormone levels. And, very importantly, saliva testing more accurately reflects uptake and response of topical hormone supplementation delivered through the skin in creams, gels or patches. Blood and urine assays significantly underestimate hormones delivered topically, often leading to overdosing.

Saliva testing is painless – NO NEEDLES. It negates the need for blood drawing, which all too often causes stress that can alter the accuracy of test results. And saliva collection is easy. It can be done anyplace and at the optimal time of day for hormone collection. Our labs’ state-of-the-art saliva testing methods and reporting can be used to identify hidden hormone imbalances that once corrected can lead to improvement of chronic health problems. Saliva testing can be used to retest and monitor hormone levels periodically in order to maintain balance, health and well-being.

My husband has symptoms of low testosterone; can saliva hormone testing help?

Saliva testing can measure your husband’s present hormone levels to identify the extent to which his testosterone is low. Our test reports indicate an expected range so that your husband can compare his levels to the normal range. Saliva testing can also identify additional androgen hormone levels (such as DHEA-s and Cortisol) that may be contributing to a low testosterone reading; this provides a more comprehensive picture. Your husband will receive a complete interpretation of hormone test results and if need be can discuss them with a credentialed physician on staff at our laboratories. We can also provide informational materials for his physician and/follow-up resources.

THE LOGISTICS OF SALIVA TESTING:

I live in California. Can you test my saliva?

Due to recent notification of California State Health Law (Business and Professions Code Chapter 3, sec 1246.5), we must have a prescription from a California physician/health care provider. (M.D., N.D., D.C.,D.O.,R.D.,N.P. LA.c. and Pharm.D./R.PH.) in order to process your saliva sample. As of September 2002 (Senate Bill 577), such lab tests may also be ordered by complementary/alternative health care practitioners "not providing services that require medical training." If you can provide us with a copy of a prescription for saliva testing from your one of the above practitioners, we will be happy to mail you a saliva test kit and process your results.

Can you send my test results to me via e-mail?

Yes, we do have the capability to e-mail test results upon request. However, to receive results by email you must have a current version of Acrobat reader. We can also send test results via mail or fax. Please provide your email, address, and/or fax number to receive your results via your preferred method.

What is included in the saliva test kit?

The saliva test kit is self-contained including saliva collection instructions, a symptom checklist that your health care provider will use in determining which hormones you need to test and of course the tubes for collecting your saliva. The kit is in a postage-paid box that you mail back to our lab.

How do you set your expected ranges? What are they based on?

Our hormone target ranges are based on a highly significant number of individuals representing each of the defined populations as well as controlled population studies of women using a specified dosage of hormone supplementation. Variations in ranges refer to the wide individuality of hormone levels and are based upon the sex, age, and menstrual status (cycling or not cycling). We also take a complete hormonal history, which includes specific hormone supplementation, dosage and timing to assign expected ranges. In people taking hormones, our ranges are based on 12-24 hours post-hormone use.

Can I send my saliva sample in by regular mail or should it go priority?

Hormones in saliva are stable for two weeks, so samples can be mailed back to us by regular mail. You can send it priority mail if you wish to ensure rapid delivery.

How long is the saliva sample stable for testing?

Hormones in saliva are exceptionally stable, allowing wide latitude in collection and shipment. Samples can be stored at room temperature for at least two weeks without loss of activity, so samples can be shipped to the laboratory by regular mail. Blood on the other hand, must be kept cool on ice packs, increasing costs for shipping as well as the likelihood of error due to improper handling.

When will my test results be returned and what is involved?

Your test results are returned to you and/or your health care provider within 7 -10 working days of receipt. The 2-page test result includes a graph that clearly shows you where your hormone levels fall within set ranges—either in range, or out of range. A second graph details self-reported symptoms that are catalogued according to the hormonal imbalance they fall into. Symptoms are also correlated with the hormone levels identified through saliva testing. Please note that the test results ordered by a healthcare provider are not returned to the patient unless specifically requested when the order is placed.

How often should I test my hormones?

If you are following a treatment program to balance your hormones and are using hormone supplementation it is a good idea to retest in 3-6 month intervals for purposes of monitoring. This allows your physician to track your progress (or lack of) and to make necessary adjustments in the dosage of hormone therapy for optimal results. Another reason for retesting in 3-6 month intervals is if you are still experiencing symptoms. Once your hormone levels are balanced testing your hormones once a year will be adequate.

Background - Patient Info - Test Instructions - Hormone Overview - Health Care Provider

FAQ & Answers - Which Hormones Do I Test For - Only $30/Hormone - See Listing

NOTE: California Residents - Business and Professions Code 1246.5 Requires That Any Test that has not been approved by the Federal Food and Drug Administration for sale to the public without a prescription as an Over-The-Counter Test kit must be ordered by a Licensed physician acting on a patient's behalf. All orders for test kits within the state of California

NOTE: New York State Residents New York State health law prohibits the testing of certain specimens collected in or mailed from New York, and prohibits the transmission of data from our laboratory to NY physicians or residents. Therefore, direct receipt of lab results for NY residents is not possible.

International Residents & Orders: Extra shipping charges may be added for international orders. Patients will be contacted by e-mail or telephone to approve charges.