How Accurate Are Saliva Testosterone Tests (Can I Trust It?)

James Cunningham, BSc, CPT
Published by James Cunningham, BSc, CPT | Staff Writer & Senior Coach
Last updated: December 12, 2023
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Saliva testosterone tests are commonly used to check for low testosterone. I was curious about their accuracy compared to blood tests.

So, I spent several weeks finding relevant research papers and finally consulted my medical friend for a professional opinion.

Keep reading to learn about these tests and how to increase your testosterone levels.

Quick Summary

  • Saliva testosterone tests measure the amount of testosterone in saliva, which can be used to estimate the amount of testosterone in the body.
  • Saliva testosterone tests are slightly less accurate than blood testosterone tests.
  • Salivary testosterone (Sal-T) reliably indicates serum free testosterone, with male reference intervals at 93-378 pmol/L and female intervals at 5-46 pmol/L.
  • From my experience, saliva testosterone tests are a practical starting point, but comprehensive blood tests are crucial for a definitive evaluation.

Is Saliva Testosterone Testing Accurate?

A doctor holding a saliva test for testosterone

Saliva testosterone testing is accurate enough to tell you if you should make an appointment with a doctor. I personally tested saliva testosterone kits to gauge their accuracy.

They were helpful in suggesting a doctor's visit was necessary, but not sufficient for a full diagnosis.

Benefits of Saliva Testosterone Tests

Saliva testing is easy to perform at home. You can order them online and get results back within a week.

At-home saliva tests are also accessible for many people who don’t have access to health insurance or blood tests.

A doctor may be able to estimate salivary and serum concentrations of testosterone from a saliva sample, but the estimated serum total testosterone will be an estimate, not a measurement.

How Do Saliva Testosterone Tests Work?

A doctor taking saliva samples for testosterone test

These tests measure testosterone in saliva, hinting at overall levels. Testosterone in blood is either free (unbound) or bound. Saliva tests detect the free form.

For example, testosterone can bind to sex hormone-binding globulin (SHGB).

According to the National Library of Medicine, unbound testosterone can diffuse from your blood vessels into your saliva. At the same time, testosterone attached to cells that carry it where it is needed is too large to diffuse [1].

That said, saliva testing will tell you the amount of testosterone that has diffused into your saliva but cannot give you information on testosterone that is bound or used in your body.

Saliva samples provide a non-invasive method for measuring salivary testosterone levels, allowing for convenience and ease of collection compared to traditional blood tests.

Saliva testosterone tests offer insight into the unbound fraction of testosterone that has diffused into saliva, indirectly indicating bioavailable testosterone.

Note that saliva tests only free testosterone, not bound or active forms. They're convenient for monitoring levels in research and clinics.

Saliva Tests vs. Blood Tests

A doctor looking at a blood test in a lab

Blood tests accurately measure total testosterone, including the bound form. They're detailed enough for diagnosis and exploring treatment options.

Saliva tests are a good option if you want a basic understanding of your hormone levels.

For example, if you are trying a testosterone booster and want to understand how effective it has been or if you want to know if you have an extreme hormone imbalance.

Salivary hormone analysis will give you the necessary information to determine your next steps.

For diagnostic purposes, a doctor will likely take a blood sample.

What Are the Symptoms of Low Testosterone?

The symptoms of low testosterone are reduced libido, lower muscle mass, reduced strength, increased body fat, low mood, and fatigue [2].

Low testosterone is also associated with an increased risk of:

  • Obesity
  • Diabetes
  • Hypertension
  • Osteoporosis [3]

While men and women share the majority of the symptoms associated with low testosterone, women are also at risk of hirsutism, a condition that causes excessive body hair.

How Can You Navigate Low Testosterone From Home Remedies to Testosterone Replacement Solutions?

A doctor with a clipboard reading about low testosterone levels

You should talk to a healthcare provider as soon as possible if you believe you may have low testosterone levels, either because you are exhibiting symptoms or because of saliva test results.

Observations gathered in our Fountain TRT review also emphasize the importance of professional consultation.

There is no cure for chronic testosterone deficiency, but treatment is available.

The National Library of Medicine mentions that you may need hormone replacement therapy, or more specifically, testosterone replacement therapy (TRT) [4, 5].

In many cases, you can regulate your hormone levels at home with diet changes, increased exercise, or natural testosterone boosters.

“There may be certain lifestyle changes to help increase testosterone levels, such as adding resistance exercise and losing weight.”
– Joseph Brito III, M.D. urologist at Yale Medicine

FAQs

What Is The Most Accurate Test For Testosterone

The most accurate test for testosterone is a blood test, which will include serum concentrations in the results.

How Long Is a Saliva Sample Good for Testosterone?

A saliva sample for testosterone is good for 24 hours at room temperature or 28 days if frozen at -4 Fahrenheit (-20 Celcius).

If a saliva sample is not frozen within 24 hours or is kept at a higher temperature, the results may be skewed or inaccurate.

What Hormones Can Be Checked With a Saliva Test?

Hormones that you can check with a saliva test include estrogens, progesterone, androgens, cortisol, and melatonin.


References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029560/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793809/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948422/
  4. https://www.ncbi.nlm.nih.gov/books/NBK493191/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/
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