Steroid hormone levels found in the blood are mostly bound to carrier proteins. as much as 95% of the time. As long as they are attached to these proteins, they are considered inactive and unable to absorb into target tissues. Only steroid hormones that are unbound or disconnected from these proteins are able to absorb into target tissues and have their natural effect on our bodies. Essentially, what is displayed in blood is not a direct correlation to your level of tissue hormone absorption. Especially for topically applied hormones, monitoring levels via blood oftent leads to overdosing. For this reason, we only use salivary or urine hormone levels for management of your BHRT.
Unlike blood testing, salivary hormone testing calculates the bioavailable or “free” levels of steroid hormones. Going further, urine testing of hormones can even check hormone metabolites and give the patient a closer look at how their steroid hormones are metabolizing. These two specialized tests give us a more accurate level of your tissue absorption of hormones, which then we are able to customize your care to your needs through your ongoing bio-identical hormone replacement therapy treatments.