BACK

Many medical doctors question the effectiveness of sublingual steroid hormones such as testosterone and progesterone. They say that these hormones are not appreciably absorbed into the bloodstream from the sublingual lozenge form and therefore, they do not have a significant physiological effect. This argument is based on the traditional medical training that when these hormones are used sublingually, they do not significantly raise the "blood" levels of the hormones. This is not only what doctors have been taught, but also what has been reinforced by the pharmaceutical industry, which sells high-impact, unnatural (not bio-identical) steroid hormones.

From most of the medical community's perspective, the pharmaceutical perspective is the end of the argument. That is an understandable way to deal with the fact that neither doctors nor anyone else can keep up with the speed of biochemical and medical discoveries. Much less breakthroughs in the wellness and prevention industry where doctors would not typically be advised. It's really up to doctors who are willing to expand their knowledge in this area or the patient in most cases can become knowledgeable about his or her problem and attempt to educate themselves and afterwards, offer information to the doctor.

In contrast to conventional medicine, in the wellness industry, a small group of scientists and alternative Natrue-O-Paths as well as some medical doctors have been successfully improving the health of women and men by balancing hormones by using bioidentical hormone therapy. With the use of saliva 30-day panel testing that has the patient collect 11 different samplings in home at prescribed times and methods. This method is far superior to serum blood testing because of a woman's cycle. Men do not cycle but most free testosterone is taken up by the red blood cells as we explain further on.

The dosage of these hormones is adjusted by analyzing the results of saliva tests and referring to the questionnaire utilizing a method of compounding called micronization of the correct dosages of hormones.

OBJECTIVES

This report has two primary objectives:

(1) to determine whether saliva testing or blood testing is more accurate for steroid hormones, and
(2) to determine whether sublingual application of steroid hormones does or does not raise blood concentrations of the hormones.

To achieve these objectives it is necessary to know some of the scientific details that support each position.

WHAT ARE STEROID HORMONES?
An endocrine steroid hormone is a chemical substance that is formed in a gland and is carried in the blood to target cells to exert specific physiological effects.

A steroid is any of numerous compounds that is derived from cholesterol. Cholesterol, itself, is derived from acetyl groups (a unit containing two carbon atoms) by a complex enzymatic process. The acetyl groups are formed in the biochemical processing of food into energy. The hormone pathway starting with cholesterol is below:

Although steroid hormones are present in the body in extremely low concentrations (parts per trillion in the blood and saliva), they exert potent physiological effects on sensitive tissues. The steroid hormones act on target cells to regulate gene expression and consequent protein biosynthesis. All steroid hormones are lipophilic (fat-soluble) and most are carried in the aqueous bloodstream bound to carrier proteins, which are water-soluble. However, a small amount of steroid hormones are being carried in the aqueous part of the bloodstream not bound to anything. These "free" hormones are available to enter cells.

The "free" steroid hormones can diffuse through the target cell membrane, which is made of fat and readily allows the passage to the interior of the cell. The hormone is attracted to high-affinity steroid receptor proteins. The hormone-receptor complex is then translocated into the nucleus of the cell, which contains the genetic information. A particular genetic process is initiated in which specific proteins are synthesized. Those proteins go on to exert physiological effects that are then attributed to the steroid hormone.

BLOOD
Since this report is concerned with blood analysis, it is important to understand the general composition and characteristics of blood. Blood is a fluid consisting of red and white cells suspended in an aqueous plasma. The cells make up about 45 percent of the mixture (called the "hematocrit"), and the watery plasma is about 55 percent of the mixture. The majority of cells in the blood are red blood cells (erythrocytes). The most important constituent of the red blood cell is hemoglobin whose main function is to transport oxygen from the lungs to the somatic (body) cells.

The other cells in blood are white blood cells (leukocytes) that include platelets. The white blood cells are nearly twice the size of red blood cells and are concerned with immunity. For example, the white cells can engulf bacteria and foreign particles in a process called "phagocytosis."

The platelets function to control bleeding after an injury. The platelets liberate serotonin when the blood vessels are damaged. This causes small blood vessels (capillaries) to strongly contract, which reduces bleeding.

The blood also contains fibrinogen and other factors that cause blood to clot. The fibrinogen is a soluble protein precursor of fibrin, which is an insoluble protein that forms the main part of a blood clot.

Another interesting aspect of blood is how much glucose (sugar) it contains. A normal blood glucose reading of 90 mg/dl translates to about 5 grams in the whole bloodstream throughout the body. When a soft drink or morning cereal containing 30-40 grams of sugar comes down the hatch, it overwhelms the balance and stability of the glucose being supplied to all the cells of the body. The pancreas quickly secretes insulin to drive down the glucose, and a wild, unbalanced cycling occurs. This hyper-dose of sugar affects smaller bodies (young children) in ways that create Attention- Deficit-Hyperactivity-Disorder (ADHD). It is commonly treated in traditional medicine, not by removing the source of sugar nutritional changes, but by drugging the child with amphetamines (Ritalin). We have an instrument that measures and analyzes the body's food triggers utilizing biofeedback. This report will identify foods that will cause your insulin to rise and will advise what to eat and to stay away from.

Now that we have reviewed some about the nature of steroid hormones and blood, what is it like for those hormones to travel in the bloodstream?

STEROID HORMONES IN THE BLOOD

Let us use testosterone as an example that is representative of all steroid hormones. Over 90% of the testosterone in the bloodstream is carried by water-soluble proteins (sex hormone binding globulin [SHBG] and albumin). The testosterone bound to those proteins is not readily bioavailable to target tissues because it is on its way to the liver for excretion in bile, which enters the intestines when fat is eaten. Along the intestines, about 90% of the bile and testosterone is reabsorbed and recycled to the liver for new processing - thus conserving these valuable biochemicals.

Part of the testosterone-SHBG and testosterone- albumin complexes that went to the liver is converted into water-soluble chemicals that are excreted in the urine. Sometimes, a urine specimen is used to estimate the testosterone in the blood.

Less than 10% of total testosterone is bioavailable. More than 80% of this bioavailable (called "free") testosterone travels in the blood attracted to (adsorbed on) fatty red blood cell membranes. The other 20% of bioavailable testosterone (2% of total testosterone) is unbound traveling in the plasma, and is readily available to stimulate target tissues.

THE FALLACY OF BLOOD TESTS FOR STEROID HORMONES

When blood is drawn from a vein (low pressure going to the heart), it contains plasma and red and white blood cells. To analyze the blood, the plasma is separated from the blood cells by centrifugation. Since the plasma still contains clotting factors, an anticoagulant is added. This, then, is the plasma used for blood analysis. If the blood is allowed to coagulate, the cell-depleted fluid phase, devoid of fibrinogen, is called "serum." The serum may also be used for analysis. In either case, the blood being analyzed does not contain the red blood cells that held the free hormones. What is being analyzed are hormones that are attached to binding proteins from the liver and is not bioavailable.

When hormones are tested via saliva and/or applied sublingually, they are part of the equation as being present in the body and when applied in sublingual lozenge are absorbed into the bloodstream as "free" hormones. They have not been packaged with a binding protein by the liver because the liver did not have access to the hormones. Most of the "free" hormones are taken up by the red blood cell membranes, which are not analyzed by a common blood test.

Conclusion: Common blood tests that use plasma or serum are not accurate for assessing bioavailable steroid hormone concentrations because neither the plasma nor the serum contains the red blood cells, which hold the bioavailable hormones.

SALIVA REFLECTS THE BIOAVAILABLE CONCENTRATION OF HORMONES PRESENT IN THE BLOODSTREAM

Some background on saliva. There are three salivary glands in the mouth that produce about two pints of saliva per day. The saliva is about 99.5% water and 0.5% solute. Saliva is used for chewing, swallowing and the initiation of digestion by the enzyme amylase, which begins the breakdown of carbohydrates. In addition, for the most part saliva is protective against pathogens. It is antibacterial, antifungal and antiviral to a certain degree. That's probably why rubbing saliva on an injury feels so good. Saliva also contains immunoglobulin-A, which provides protection for the eyes, nose, throat, intestines and lungs from infectious diseases.

The secretion of saliva is entirely under the control of the nervous system. Sympathetic nervous system stimulation dominates during stress, resulting in dryness of the mouth. During dehydration, the salivary glands stop secreting to conserve water and resulting in dryness of the mouth and this contributes to the sensation of thirst.

The salivary glands have an extremely high blood flow, which is about ten times that of an equal mass of contracting skeletal muscle. Researchers have found that the "free" hormones from the red blood cells and plasma readily filter through the saliva glands into saliva where they can be measured accurately (in parts per trillion).

Conclusion: Saliva reflects the bioavailable level of hormones present in the bloodstream, therefore saliva testing is a far more accurate and relevant test than blood when measuring bioavailable steroid hormones.

The following graph is of a 42-year-old woman before bioidentical hormone therapy and the second is after being on the program for 90 days.

This is before taking BHRT This is after taking BHRT

There is strong opinion that if bioidentical hormone therapy and saliva testing were available 50 years ago that today there would be very little endometrial, uterine or breast cancer. These things are available today and yet many doctors are unaware of them and still others are unwilling to alter their thinking from medical training they received and therefore are very slow to adapt to new technologies.

BHRT bioidentical hormone replacement therapy

[disclaimer] “These statements have not been evaluated by FDA. Treatments or
products are not intended to diagnose, treat, cure or prevent any disease.”