Dr. Sarrel discusses the most effective testosterone deficiency test.
If we were going to think about what to test when we suspect there’s a deficiency of testosterone, it’s really very simple. There are lots of different blood tests, but the simple is called a bioavailable testosterone. That’s a blood test, not a salivary test. It’s a little bit of a sophisticated test, but in fact there’s one laboratory in the country that does it for the whole United States. So your physician or your lab would send it on, and it would be measured. The bioavailable testosterone appears to be the most reliable of all the tests.
Some doctors have suggested doing salivary testing. The problem with testing saliva is it varies tremendously in the course of the day, and so you could get a value at 6:00 a.m. and another value at 9:00 and another value at noon and another value at 3:00 and another value at 6:00, and they are all over the place. And the only studies that have shown that salivary testing is of any degree of reliability is if they are at least four different samples taken during the day, optimally six, all put into one little tube for saliva, and then that’s tested and that has some correlation with the blood level.
Our own experience has been, we drew a thousand samples of blood and a thousand matching samples of saliva, and we tested the first hundred to see how they would compare. There was no correlation whatsoever, and most people who do salivary testing in a research setting, in a scientific setting, in a well-controlled setting, have concluded this is not the way to go. That was originally said by the investigators in Edinburough who invented the technique in the 1980s, and they gave up on it, and at Yale we gave up on it, too.
So I do not advocate salivary testing. I think women are having salivary testing, paying for salivary testing, saliva testing, and I think it’s a rip-off, quite frankly. I think it’s just a way to make money from women and abuse them. That’s my opinion.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.