Estrogens (estrone, estradiol and estriol), progesterone, testosterone, DHEA-S and cortisol are routinely measured in saliva at ZRT. Why saliva? Steroid hormones in the bloodstream are mostly (95-99%) bound to carrier proteins (hormone-binding globulins, albumin), and in this form they are unavailable to target tissues. Only the unbound fraction freely diffuses into tissues, including the salivary gland. Hormone levels in saliva therefore represent the quantity of the hormone that is currently available to target tissues and actively exerting specific effects on the body. Because of this, salivary hormone levels often relate to specific symptoms of hormone excesses or deficiencies. Research at ZRT has demonstrated clear correlations between salivary hormone levels and reported symptoms. The rationale for and clinical utility of saliva testing is well documented.
The very small concentrations of salivary hormones (only 1 – 5% of the total hormone levels that include protein-bound hormone found in serum) necessitate extremely sensitive assay methods. This is a particular issue for estrogens, which are present in very minute quantities in saliva, especially in older populations such as postmenopausal women. ZRT is unique as the only commercial laboratory using extracted saliva testing for estrogens. Extraction removes contaminants that interfere with the assay and concentrates the sample, significantly improving assay sensitivity compared to the “direct” assay methods available commercially14. In fact, poor correlations between serum tests and non-extraction salivary estradiol assays have unfortunately led to some skepticism about saliva testing. Also, because of the extremely sensitive assays, it is important to avoid blood contamination of saliva as a result of oral injury, therefore tooth brushing must be avoided before collecting saliva for testing. Saliva testing may also not be appropriate for sublingual hormone users unless samples are obtained at least 36 hours after the last dose. Blood spot testing is a preferred option for these patients.
The Flowers group has been a life saver! They have helped me over come 7 years of illness in almost 4 months! So thankful for all of their knowledge and the compassion they have for their patients.
After years (decades) of thinking I was healthy (read: macho American male), and frustration of bad hormone levels, I became a patient of Dr. Flowers. In my fourth month of treatment, my body chemistry is within normal ranges, I have lost over 30 lbs., I have noticeably more energy, and am motivated to exercise every day. I am excited to see what I can be after year under Dr. Flowers care.
I’ve been seeing Dr. Flowers for about 9 months and I love the personal attention I get from him and the office staff! I am never rushed out nor have I ever had the “next” feeling you get with so many traditional Doctors’ offices these days. I love the more natural whole body approach to healing and would recommend him to anyone!
Dr Flowers and His nurse, Misty, are an amazing team. They are thorough, responsive and do an exceptional job of educating you so that you are motivated to be an active participant in your Plan of care. This is the first time my hormones have been balanced since before my total hysterectomy in 2004. I've suffered with severe migraine headaches since age 9 and have tried everything from medicines to acupuncture. After 4 months of HRT and herbal therapies with Dr Flowers my headaches are few and far between a 90% improvement. I'm still on the journey but there is not doubt that my quality of life has improved.
Love the welcoming atmosphere created by the staff and Dr. Flowers.
They gave me hope that I would be overcoming my issues and feeling better soon.
I love the individual attention I received from Dr. Flowers and the time he allotted for my visit.
There is a lot of one on one time with both Doctor and Nurses and I feel that my concerns and comments are heard.
liked the personal attention given by Misty and Dr. Flowers. I appreciated the hour block of time where I could sit down and really go over all the lab results and treatment plan. Never felt rushed. Always feel like