People frequently ask:
“What is the real difference between blood, urine, and saliva hormone testing?”
Here is the precise breakdown:
Blood measures circulating levels — hormone delivery in the bloodstream at that snapshot in time.
Urine reflects metabolic clearance — what the body has processed and excreted. Efficient liver/kidney clearance shows higher urinary metabolites; slower clearance can indicate prolonged tissue exposure.
Saliva captures free, bioavailable hormone — the unbound fraction that is actively available to enter tissues and exert effects at the receptor level.
No single test is inherently superior. Each answers a distinct question:
Delivery → blood
Metabolism and elimination → urine
Tissue-level activity and bioavailable fraction → saliva
Symptoms do not originate in circulation; they manifest in tissues.
When the core question is “Why do I feel this way despite ‘normal’ labs?” — the most relevant insight often comes from what is actually reaching and acting on target tissues.
After more than two decades in practice, the principle remains unchanged:
Accurate hormone optimization begins with asking the right question and selecting the test that measures what truly matters.
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