Saliva Testing for Thyroid Evaluation

One of the biggest controversies facing a person with thyroid problems relates to how to get accurate and useful testing. It is important to be tested to verify a diagnosis that thyroid is indeed your problem, and to have a baseline from which to direct therapeutic efforts. Testing is also useful in re-evaluation from time to time to determine the effectiveness of therapies chosen, and perhaps to dictate a new medicine or new direction if the prior one has not been fully effective.

Currently this process of testing for thyroid status is woefully inadequate for a great many thyroid sufferers. First of all, it is likely that many millions of people who have a treatable thyroid problem are being denied diagnosis and treatment because of lack of test accuracy. Moreover, people who are being treated are being denied fully effective or proper treatment in a great many cases because again the blood tests are not nearly as accurate as they need to be.

A test hopefully gives the practitioner information about how much thyroid hormone is available at that place in the body where thyroid hormone does its job, and how well its working. The current blood tests do neither! They simply are an indicator of how much thyroid hormone is floating in the bloodstream. This is NOT what a doctor ideally needs to know. For instance, I - as a thyroid practitioner - would like to know how much thyroid hormone has gotten from the bloodstream into the tissues, where it would actually do its work.

In the past few years we have been able to get closer to this goal by utilizing saliva testing instead of blood testing. After close to 30 years of using the "old tests," we decided it was time to listen to our naturopathic and nutritional practitioners who had been using saliva testing for close to two decades for these conditions.

Here's what we've learned:

  1. Blood testing is expensive
  2. Blood testing is painful
  3. Blood testing is inconvenient (you have to go to a lab, during their hours)
  4. Blood test accuracy is in question (the American Association of Clinical Endocrinologists and the National Academy of Clinical Biochemistry have for the last few years been trying to change the range of normal on the TSH test, with perhaps resistance from HMOs and other third-party payors)
  5. There is a better alternative -- saliva testing
  6. Saliva testing can be performed in the convenience and comfort of your own home, using a home test kit that is mailed to you
  7. Giving a saliva sample is most often comfortable and easy.
  8. Saliva may be more accurate because it actually measures the level of the hormone in the tissues, where hormones work (hormones don't do their work in the bloodstream)
  9. The amount of hormone in blood is not always the same as the amount that might be in tissues
  10. The cost of saliva testing is much less than blood testing
Here's How It Works

When you measure a hormone in saliva, you're actually measuring the bio-available hormone.
Hormones in blood are tightly bound to plasma proteins. Only a tiny fraction, usually less than 1% of what is in the blood enters the tissues. This fraction changes from time to time, perhaps depending on whether you're combatting other illness or feeling healthy.

For instance, a woman taking estrogen or birth control pills will have a higher level of TBG (thyroxine binding globulin) in the bloodstream because of her medication. This will result in less bio-available thyroid actually reaching her tissues, regardless of what the blood tests say. People in this group, for instance, are frequent visitors to our clinic in the San Francisco area, having been told by doctors at medical centers and even at Mayo Clinic that their thyroid blood tests are perfectly normal. When they visit us and obtain saliva testing as well as blood testing, the saliva test is often much more revealing of the patients' actual clinical state.

The World Health Organization has recently approved saliva testing for AIDS, a worldwide epidemic. It is an easy and obvious way to help diagnose problems in millions of people accurately and easily. The National Institutes of Health has been finding that saliva testing for adrenal hormones are more useful than are the blood tests.

Numerous published scientific articles attest to the accuracy of this testing (for references, see our book Feeling Fat, Fuzzy or Frazzled, page 75). These articles explain that saliva testing is accurate, often paralleling blood testing but with more definition to the actual situation. In certain instances, it shows to be superior to blood testing, and it has many advantages in convenience and cost. Our book also refers you to various websites that will share very detailed information on the accuracy of this testing. These are fully credentialed and certified labs each with a several decade history of professional care.

Here's An Example

Recently in our San Rafael CA practice, we saw a patient who had been to doctor after doctor for complaints of severe fatigue, chilliness, and hair loss. She was told repeatedly that her thyroid tests were normal, that her problems could not be due to low thyroid. No other diagnosis or treatment, however, had been of any help to her.

When she came to our clinic, I was immediately able to validate the fact that her prior lab tests were indeed "totally normal", in fact she showed (on paper) an excellent thyroid panel, including TSH, total T4, total t3, T3 uptake, thyroid antibodies, free T4 and free T3.

This is more testing than most folks receive, and it all showed normal.

I advised her to simply go home and do the *Canary Club saliva panel, which includes TSH, Free T4, Free T3, and thyroid peroxidase antibody testing. When she came back with her results, they were not at all normal. Her saliva TSH was high, not like the "normal" results on her blood testing. And what's more, the TPO antibody by saliva showed positive.

This was a woman who was indeed suffering with the standard Hashimoto's low thyroid. I now had a diagnosis for her, and started her on the thyroid therapy that had been so helpful to another person in her immediate family. She responded beautifully, with the fatigue, chilliness, and hair loss. Within 5-6 weeks, she was feeling terrific, and has been ever since.

How to Get Tested?

We have worked with the labs involved to create a special panel of testing that measures the important gland functions, and negotiated for access to a special, lower group rate for tests.

Generally you can get around 12 tests performed for what one blood test often costs!

The sensitive saliva testing can help you to evaluate if you really DO have a thyroid, adrenal, or sex gland problem. If your doctor doesn't believe you, but you still feel lousy, you can order these tests.

We've coordinated this by forming a patient advocacy group, called the Canary Club, that allows you to get high quality saliva measurements of thyroid, adrenal, and sex gland hormones, at the reduced group rate cost.

What Is the Canary Club?

The Canary Club is a consumer advocacy group we created for the purpose of helping millions of people to obtain the information they need in order to feel better when they may be challenged by the current epidemic of gland-related hormone hormone disruption. In other words, it is YOUR club.

Your membership in the Canary Club is free. We've created the Club because we feel it's important for patients to have an opportunity to learn and speak out about endocrine-disrupting chemicals and their effects on the thyroid, adrenal and reproductive hormones.

It was created for people like you, who know or suspect that something is wrong with their hormones and metabolism, but feel that they're not getting accurate information.

Why Join the Canary Club?

Membership is free. It doesn't cost you anything.

You'll have access to reduced cost, high-quality saliva testing.

It is also easy to do, and it allows your voice to join with the voices of millions of others -- all in the same situation -- to create a mighty voice for healthy change.

  • More people deserve to have access to this higher quality testing
  • Doctors can be encouraged to listen more to their patients with multiple uncomfortable symptoms, perhaps changing their tune so we all get better care
  • As we grow, we can become politically active regarding pollution and our health
Here are the simple steps to getting started:
  1. First join the Canary Club. It's free and easy - just log onto
  2. Read our book Feeling Fat, Fuzzy or Frazzled so you will understand more about the relationship among these critical hormone producing glands.
  3. Get your tests done
  4. When you receive your test results, you can review the discussion about how to interpret these on our website at and also on the site.
You can then identify natural solutions, and medications when necessary, to address any imbalances or deficiencies.

As advisors to the club, we are also available to support you in feeling your best. If, after reviewing your results and reading and learning about these topics, you still require more personalized help, we are available to help you via telephone coaching or in-office medical appointments. For more information on this see and go to the section on appointments.

Thank you for your curiosity, your interest, your commitment to your health. Help us to help millions more, by reaching out to other patients. Let them know about the testing. Share information about helpful websites, books, and articles. Let them know about the Canary Club. Speak out, and do what you can to be involved. Together we will turn the tides on endocrine disruption causing gland problems.

Be part of the solution!

Here's wishing you all health and happiness; you deserve it.

Drs. Richard and Karilee Shames are authors of the innovative books ThyroidPower and Fat, Fuzzy and Frazzled? For several decades, they have been practicing holistic and integrative medicine, with a focus on thyroid, adrenal, hormonal and immune balance. For more information on their background, books, medical practice and coaching services, see

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