Hormone Measurement: Methods & Accuracy

The measurement and evaluation of hormone levels is an essential component of modern medical diagnostics. Hormone expert Dr. Wilden explains various methods of hormone measurement and evaluates them based on their accuracy.

Methods for Measuring Hormones

Today, there are different methods for determining hormone levels. These include:

• Blood tests: A blood sample is taken and the serum (liquid part of the blood) is analysed.
• Saliva tests: These measure hormone levels in saliva.
• Urine analyses: Hormone levels are determined through a urine sample.
• 24-hour urine tests: In this test, urine is collected over 24 hours to capture hormone levels over an extended period.

Advantages and Disadvantages of Hormone Saliva Tests

Many hormone saliva tests can be purchased online without medical consultation. However, there are some limitations to consider:

•  The test results are often a general interpretation of the results stored in the test software. There is then the possibility that the results are inaccurate or not entirely correct.
• Currently, saliva tests have not been sufficiently scientifically validated in terms of their accuracy and reliability.

There are widespread assumptions that saliva tests are more accurate because they measure the free fraction of sex hormones, which is allegedly the only fraction that actively works in the body. Companies often advertise with this claim.

However, this assumption is not correct. In fact, the free fraction represents only 8 to 10% of total hormones and does not reflect the actual function of the gonads (sex glands). Furthermore, these tests often lead to inaccurate measurements and result in confusing therapeutic approaches due to the complex relationships between different hormones.

Better Treatment Success Through Alternative Hormone Measurement Methods

Since only doctors can prescribe hormone therapy, a kind of marketing cycle develops around alternative diagnostic methods like saliva tests. The providers of these tests often also offer interpretations and therapy suggestions.

The patient then seeks out a doctor to prescribe the suggested therapy, which can lead to uncoordinated treatment.

Saliva tests can be useful for indicating potential deficiencies in a simple test. However, after starting therapy, it is often difficult to determine the exact dosage.

Based on my experience and two years of practical experience with authorized saliva tests in my private practice, I have found that the results of the Rimkus® method were significantly more convincing, which is why I prefer this type of treatment.

Some therapists achieve good results with saliva tests for hormone measurement, which is mainly due to their extensive clinical experience, not necessarily the precision of the saliva tests themselves. Typically, only low-dose hormone creams are used for treatment following this diagnostic method.

However, this method does not consider that the bound fraction of sex hormones – which is often responsible for clinical symptoms – can only be accurately measured through blood tests (SHBG-bound fraction).

Those were numerous technical terms. What you as a patient need to know: A comprehensive hormone therapy cannot be guided by saliva tests alone.

Advantages of 24-Hour Urine Measurement Compared to Saliva Tests

Measuring hormones in urine, specifically the analysis of 24-hour collected urine, is considered more reliable and effective compared to saliva tests. A major advantage of this method is that it can capture hormone fluctuations throughout the entire day and night.

My medical recommendation: In comparison, online tests based on dried urine strips (such as Dutch Tests), can be both expensive and more difficult to interpret.

Advantages and Disadvantages of Blood Hormone Measurements

Blood measurements provide an accurate representation of steroid hormones in the body. Approximately 90 percent of hormone production is bound to sex hormone-binding globulin (SHBG) and reflects the total hormone potential.

Similar to vitamin D, which is also a steroid hormone, the total 25-OH vitamin D value is measured and not just the free fraction.

1. For women in menopause, the timing of blood collection is not relevant.
2. While for younger women, the 20th day of the cycle is recommended. Control measurements are taken in serum, two hours after taking the morning hormone dose. In Perimenopause, the time before menopause, blood values without accompanying symptoms cannot be interpreted, as these values can vary daily.

Do you have further questions about hormone measurement? For further questions about bioidentical hormones, hormone therapy and hormone measurement, please contact us by email. Dr. Wilden will be happy to answer your questions on this topic. In our video consultation, Dr. Isabella Wilden will also be happy to answer your medical questions on this sensitive topic.