Saliva Testing Literature References

Saliva is an easy-to-collect and reliable sample source for many biological studies. In some cases, it is even superior to other body fluids for measuring biomarker levels. This section lists references on the utility of saliva testing.

“Salivary levels of steroid hormones and other analytes that are protein-bound in serum reflect the unbound and active concentration of the hormone. Saliva can be used as a diagnostic specimen not only to obtain information more inexpensively and efficiently than serum, but also to provide information not readily available from serum testing.”

Hofman LF. Human saliva as a diagnostic specimen. J Nutr. 2001;131(5):1621S-5S. doi: 10.1093/jn/131.5.1621S.

“Although saliva has not yet become a mainstream sample source for hormone analysis, it has proven to be reliable and, in some cases, even superior to other body fluids.”

Gröschl M. Current status of salivary hormone analysis. Clin Chem. 2008;54(11):1759-69. doi: 10.1373/clinchem.2008.108910.

“Saliva offers a promising diagnostic alternative, compared to blood sampling, for screening for inflammatory, metabolic, and cardiovascular risk factors, particularly among pediatric and geriatric populations where blood sampling may be difficult.”

Desai GS, Mathews ST. Saliva as a non-invasive diagnostic tool for inflammation and insulin-resistance. World J Diabetes. 2014;5(6):730-8. doi: 10.4239/wjd.v5.i6.730.

“Late-night salivary cortisol measurements provide a sensitivity and specificity for the diagnosis of Cushing’s syndrome of more than 90%, and this procedure is emerging as possibly the simplest and most effective screening tool for patients in whom the diagnosis of hypercortisolism is suspected”.

Gardner D, Shoback D, eds. Greenspan’s Basic & Clinical Endocrinology. 8th ed. San Francisco, CA: McGraw Hill; 2007:364.

The Endocrine Society recommends late-night salivary cortisol (two measurements) as one possible initial test for Cushing’s syndrome (along with urine free cortisol and dexamethasone suppression testing).

Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-40. doi: 10.1210/jc.2008-0125.

The following links will direct you to the full text or abstract summary of the articles listed. These articles are obtained from the U.S. National Library of Medicine and National Institutes of Health.

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General

Gröschl M. The physiological role of hormones in saliva. Bioessays. 2009;31(8):843-52. doi:10.1002/bies.200900013

Gröschl M. Current status of salivary hormone analysis. Clin Chem. 2008;54:11 1759-1769. doi:10.1373/clinchem.2008.108910

Lewis JG. Steroid Analysis in Saliva: An overview. Clin Biochem Rev. 2006;27(3):139-46.

Hofman, LF. Human Saliva as a Diagnostic Specimen. Journal of Nutrition. 2001;131:1621S-1625S. doi:10.1093/jn/131.5.1621S

Tabak, LA. A Revolution in Biomedical Assessment: The Development of Salivary Diagnostics. J Dent Educ. 2001;65(12):1335-1339.

Quissell D. Steroid hormone analysis in human saliva. Ann N Y Acad Sci. 1993;694:143-145. doi:10.1111/j.1749-6632.1993.tb18348.x

Wilson DW, Walker RF, Griffiths K. Saliva as a medium for chronobiological studies: its particular potential in steroid endocrinology. Ann Ist Super Sanita. 1993;29(4):607-11.

Read GF, Walker RF, Wilson DW, Griffiths K. Steroid analysis in saliva for the assessment of endocrine function. Ann N Y Acad Sci. 1990;595:260-74. doi:10.1111/j.1749-6632.1990.tb34300.x

Walker RF, Read GF, Wilson DW, Riad-Fahmy D, Griffiths K. Chronobiology in laboratory medicine: principles and clinical applications illustrated from measurements of neutral steroids in saliva. Prog Clin Biol Res. 1990;341A:105-17.

Vining RF, McGinley RA. The measurement of hormones in saliva: possibilities and pitfalls. J Steroid Biochem. 1987;27(1-3):81-94. doi:10.1016/0022-4731(87)90297-4

Vining RF, McGinley RA. Hormones in saliva. Crit Rev Clin Lab Sci. 1986;23(2):95-146. doi:10.3109/10408368609165797

Vining RF, McGinley RA, Symons RG. Hormones in saliva: mode of entry and consequent implications for clinical interpretation. Clin Chem. 1983;29:1752-1756.

Riad-Fahmy D, Read GF, Walker RF. Salivary steroid assays for assessing variation in endocrine activity. J Steroid Biochem. 1983;19:265-272.

Aldosterone

Cardoso E, Persi G, González N, et al. Assessment of adrenal function by measurement of salivary steroids in response to corticotrophin in patients infected with human immunodeficiency virus. Steroids. 2007;72(4):328-334. doi:10.1016/j.steroids.2006.12.003

Contreras LN, Arregger AL, Persi GG, et al. A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin. Clin Endocrinol (Oxf). 2004;61(6):675-682. doi:10.1111/j.1365-2265.2004.02144.x

Androstenedione

Lønning PE, Dowsett M, Jacobs S, et al. Lack of diurnal variation in plasma levels of androstenedione, testosterone, estrone and estradiol in postmenopausal women. J Steroid Biochem. 1989;34(1-6):551-553. doi:10.1016/0022-4731(89)90143-x

Young MC, Walker RF, Riad-Fahmy D, Hughes IA. Androstenedione rhythms in saliva in congenital adrenal hyperplasia. Arch Dis Child. 1988;63:624-628. doi:10.1136/adc.63.6.624

Baxendale PM, Jacobs HS, James VHT. Plasma and salivary androstenedione and dihydrotestosterone in women with hyperandrogenism. Clin Endocrinol (Oxf). 1983;18(5):447-457. doi:10.1111/j.1365-2265.1983.tb02874.x

Wellen JJ, Smals AGH, Rijken JC, et al. Testosterone and androstenedione in the saliva of patients with Klinefelter’s syndrome. Clin Endocrinol (Oxf). 1983;18:51-59. doi:10.1111/j.1365-2265.1983.tb03186.x

Antigliadin Antibody IgA

Rujner J, Socha J, Barra E, et al. Serum and salivary antigliadin antibodies and serum IgA anti-endomysium antibodies as a screening test for coeliac disease. Acta Paediatr. 1996;85(7):814-817. doi:10.1111/j.1651-2227.1996.tb14157.x

Hakeem V, Fifield R, Al-Bayaty HF, et al. Salivary IgA antigliadin antibody as a marker for coeliac disease. Arch Dis Child. 1992;67(6):724-727. doi:10.1136/adc.67.6.724

Cortisol

Peters JR, Walker RF, Riad-Fahmy D, Hall R. Salivary cortisol assays for assessing pituitary-adrenal reserve. Clin Endocrinol (Oxf). 1982;17(6):583-92. doi:10.1111/j.1365-2265.1982.tb01631.x

Castro M, Elias PC, Quidute AR, Halah FP, Moreira AC. Out-patient screening for Cushing’s syndrome: the sensitivity of the combination of circadian rhythm and overnight dexamethasone suppression salivary cortisol tests. J Clin Endocrinol Metab. 1999;84(3):878-82. doi:10.1210/jcem.84.3.5521

Martinelli CE Jr, Sader SL, Oliveira EB, et al. Salivary cortisol for screening of Cushing’s syndrome in children. Clin Endocrinol (Oxf). 1999;51(1):67-71. doi:10.1046/j.1365-2265.1999.00749.x

Castro M, Elias PC, Martinelli CE Jr, et al. Salivary cortisol as a tool for physiological studies and diagnostic strategies. Braz J Med Biol Res. 2000;33(10):1171-1175. doi:10.1590/s0100-879×2000001000006

Gann PH, Giovanazzi S, Van Horn L, et al. Saliva as a medium for investigating intra- and interindividual differences in sex hormone levels in premenopausal women. Cancer Epidemiol Biomarkers Prev. 2001;10(1):59-64.

Gröschl M, Rauh M, Schmid P, Dörr HG. Relationship between salivary progesterone, 17-hydroxyprogesterone, and cortisol levels throughout the normal menstrual cycle of healthy postmenarcheal girls. Fertil Steril. 2001;76(3):615-617. doi:10.1016/s0015-0282(01)01960-4

Törnhage CJ. Reference values for morning salivary cortisol concentrations in healthy school-aged children. J Pediatr Endocrinol Metab. 2002;15(2):197-204. doi:10.1515/jpem.2002.15.2.197

Jacks DE, Sowash J, Anning J, et al. Effect of exercise at three exercise intensities on salivary cortisol. J Strength Cond Res. 2002;16(2):286-289.

Krause W, Mueller U, Mazur A. Measurement of steroid levels in saliva in a population-based survey of lifestyle, medical conditions, marriage, sex life and hormone status in aging men: a feasibility study. Aging Male. 2002;5(4):203-215.

Putignano P, Toja P, Dubini A, et al. Midnight salivary cortisol versus urinary free and midnight serum cortisol as screening tests for Cushing’s syndrome. J Clin Endocrinol Metab. 2003;88(9):4153-4157. doi:10.1210/jc.2003-030312

Kivlighan KT, Granger DA, Schwartz EB, et al. Quantifying blood leakage into the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2004;46(1):39-46. doi:10.1016/j.yhbeh.2004.01.006

Assies J, Visser I, Nicolson NA, et al. Elevated salivary dehydroepiandrosterone-sulfate but normal cortisol levels in medicated depressed patients: preliminary findings. Psychiatry Res. 2004;128(2):117-122. doi:10.1016/j.psychres.2004.05.016

Contreras LN, Arregger AL, Persi GG, et al. A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin. Clin Endocrinol (Oxf). 2004;61(6):675-682. doi:10.1111/j.1365-2265.2004.02144.x

Garde AH, Hansen AM. Long-term stability of salivary cortisol. Scand J Clin Lab Invest. 2005;65(5):433-436. doi:10.1080/00365510510025773

Trilck M, Flitsch J, Lüdecke DK, Jung R, Petersenn S. Salivary cortisol measurement–a reliable method for the diagnosis of Cushing’s syndrome. Exp Clin Endocrinol Diabetes. 2005;113(4):225-230. doi:10.1055/s-2005-837667

Rosmalen JG, Oldehinkel AJ, Ormel J, et al. Determinants of salivary cortisol levels in 10-12 year old children; a population-based study of individual differences. Psychoneuroendocrinology. 2005;30(5):483-495. doi:10.1016/j.psyneuen.2004.12.007

Grossi G, Perski A, Ekstedt M, et al. The morning salivary cortisol response in burnout. J Psychosom Res. 2005;59(2):103-111. doi:10.1016/j.jpsychores.2005.02.009

Nater UM, Youngblood LS, Jones JF, et al. Alterations in diurnal salivary cortisol rhythm in a population-based sample of cases with chronic fatigue syndrome. Psychosom Med. 2008;70(3):298-305. doi:10.1097/PSY.0b013e3181651025

Scheer FA, Buijs RM. Light affects morning salivary cortisol in humans. J Clin Endocrinol Metab. 1999;84(9):3395-3398. doi:10.1210/jcem.84.9.6102

Stones A, Groome D, Perry D, et al. The effect of stress on salivary cortisol in panic disorder patients. J Affect Disord. 1999;52(1-3):197-201. doi:10.1016/s0165-0327(98)00058-5

Read GF, Wilson DW, Campbell FC, et al. Salivary cortisol and dehydroepiandrosterone sulphate levels in postmenopausal women with primary breast cancer. Eur J Cancer Clin Oncol. 1983;19(4):477-483. doi:10.1016/0277-5379(83)90110-4

Vining RF, McGinley RA, Maksvytis JJ, Ho KY. Salivary cortisol: a better measure of adrenal cortical function than serum cortisol. Ann Clin Biochem. 1983;20 (Pt 6):329-335. doi:10.1177/000456328302000601

Williams H, Read GF, Verrier-Jones ER, Hughes IA. Effect of inhaled beclomethasone dipropionate on saliva cortisol concentrations. Arch Dis Child. 1984;59(6):553-556. doi:10.1136/adc.59.6.553

Allolio B, Hoffmann J, Linton EA, et al. Diurnal salivary cortisol patterns during pregnancy and after delivery: relationship to plasma corticotrophin-releasing-hormone. Clin Endocrinol (Oxf). 1990;33(2):279-289. doi:10.1111/j.1365-2265.1990.tb00492.x

Lo MS, Ng ML, Azmy BS, Khalid BA. Clinical applications of salivary cortisol measurements. Singapore Med J. 1992;33(2):170-173.

McDowell SL, Hughes RA, Hughes RJ, Housh TJ, Johnson GO. The effect of exercise training on salivary immunoglobulin A and cortisol responses to maximal exercise. Int J Sports Med. 1992;13(8):577-580. doi:10.1055/s-2007-1024568

Tunn S, Möllmann H, Barth J, et al. Simultaneous measurement of cortisol in serum and saliva after different forms of cortisol administration. Clin Chem. 1992;38(8 Pt 1):1491-1494.

Aardal E, Holm AC. Cortisol in saliva–reference ranges and relation to cortisol in serum. Eur J Clin Chem Clin Biochem. 1995;33(12):927-932. doi:10.1515/cclm.1995.33.12.927

Barrou Z, Guiban D, Maroufi A, et al. Overnight dexamethasone suppression test: comparison of plasma and salivary cortisol measurement for the screening of Cushing’s syndrome. Eur J Endocrinol. 1996;134(1):93-96. doi:10.1530/eje.0.1340093

Goodyer IM, Herbert J, Altham PM, et al. Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation. Psychol Med. 1996;26(2):245-256. doi:10.1017/s0033291700034644

Schwartz EB, Granger DA, Susman EJ, et al. Assessing salivary cortisol in studies of child development. Child Dev. 1998;69(6):1503-1513.

Raff H, Raff JL, Findling JW. Late-night salivary cortisol as a screening test for Cushing’s syndrome. J Clin Endocrinol Metab. 1998;83(8):2681-2686. doi:10.1210/jcem.83.8.4936

Goodyer IM, Herbert J, Altham PM. Adrenal steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression. Psychol Med. 1998;28(2):265-273. doi:10.1017/s0033291797006314

Aardal-Eriksson E, Karlberg BE, Holm AC. Salivary cortisol–an alternative to serum cortisol determinations in dynamic function tests. Clin Chem Lab Med. 1998;36(4):215-222. doi:10.1515/CCLM.1998.037

Clements AD, Parker CR. The relationship between salivary cortisol concentrations in frozen versus mailed samples. Psychoneuroendocrinology. 1998;23(6):613-616. doi:10.1016/s0306-4530(98)00031-6

Johansson A, Henriksson A, Olofsson BO, Olsson T. Adrenal steroid dysregulation in dystrophia myotonica. J Intern Med. 1999;245(4):345-351. doi:10.1046/j.1365-2796.1999.00455.x

Fassett MJ, Lachelin GC, McGarrigle HH, Wing DA. Alterations in saliva steroid hormone levels after oral mifepristone administration in women with pregnancies of greater than 41 weeks’ gestation. Reprod Sci. 2008;15(4):394-399. doi:10.1177/1933719107310305

Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540. doi:10.1210/jc.2008-0125

Arregger AL, Cardoso EM, Tumilasci O, Contreras LN. Diagnostic value of salivary cortisol in end stage renal disease. Steroids. 2008;73(1):77-82. doi:10.1016/j.steroids.2007.09.001

Boscaro M, Arnaldi G. Approach to the patient with possible Cushing’s syndrome. J Clin Endocrinol Metab. 2009;94(9):3121-3131. doi:10.1210/jc.2009-0612

Raff H. Utility of salivary cortisol measurements in Cushing’s syndrome and adrenal insufficiency. J Clin Endocrinol Metab. 2009;94(10):3647-3655. doi:10.1210/jc.2009-1166

Bertagna X, Guignat L, Groussin L, Bertherat J. Cushing’s disease. Best Pract Res Clin Endocrinol Metab. 2009;23(5):607-623. doi:10.1016/j.beem.2009.06.001

Petrowski K, Herold U, Joraschky P, et al. A striking pattern of cortisol non-responsiveness to psychosocial stress in patients with panic disorder with concurrent normal cortisol awakening responses. Psychoneuroendocrinology. 2010;35(3):414-421. doi:10.1016/j.psyneuen.2009.08.003

Thomas NE, Leyshon A, Hughes MG, et al. The effect of anaerobic exercise on salivary cortisol, testosterone and immunoglobulin (A) in boys aged 15-16 years. Eur J Appl Physiol. 2009;107(4):455-461. doi:10.1007/s00421-009-1146-y

Deutschbein T, Unger N, Hinrichs J, et al. Late-night and low-dose dexamethasone-suppressed cortisol in saliva and serum for the diagnosis of cortisol-secreting adrenal adenomas. Eur J Endocrinol. 2009;161(5):747-753. doi:10.1530/EJE-09-0517

Gerritsen L, Geerlings MI, Beekman AT, et al. Early and late life events and salivary cortisol in older persons. Psychol Med. 2010;40(9):1569-1578. doi:10.1017/S0033291709991863

Bakkeheim E, Mowinckel P, Carlsen KH, et al. Reduced basal salivary cortisol in children with asthma and allergic rhinitis. Acta Paediatr. 2010;99(11):1705-1711. doi:10.1111/j.1651-2227.2009.01598.x

Deutschbein T, Unger N, Mann K, Petersenn S. Diagnosis of secondary adrenal insufficiency: unstimulated early morning cortisol in saliva and serum in comparison with the insulin tolerance test. Horm Metab Res. 2009;41(11):834-839. doi:10.1055/s-0029-1225630

Steptoe A, Gylfe A, Shamaei-Tousi A, et al. Pathogen burden and cortisol profiles over the day. Epidemiol Infect. 2009;137(12):1816-1824. doi:10.1017/S0950268809002738

Beko G, Varga I, Glaz E, et al. Cutoff values of midnight salivary cortisol for the diagnosis of overt hypercortisolism are highly influenced by methods. Clin Chim Acta. 2010;411(5-6):364-367. doi:10.1016/j.cca.2009.11.033

Liening SH, Stanton SJ, Saini EK, Schultheiss OC. Salivary testosterone, cortisol, and progesterone: two-week stability, interhormone correlations, and effects of time of day, menstrual cycle, and oral contraceptive use on steroid hormone levels. Physiol Behav. 2010;99(1):8-16. doi:10.1016/j.physbeh.2009.10.001

Deutschbein T, Unger N, Mann K, Petersenn S. Diagnosis of secondary adrenal insufficiency in patients with hypothalamic-pituitary disease: comparison between serum and salivary cortisol during the high-dose short synacthen test. Eur J Endocrinol. 2009;160(1):9-16. doi:10.1530/EJE-08-0600

Törnhage CJ. Salivary cortisol for assessment of hypothalamic-pituitary-adrenal axis function. Neuroimmunomodulation. 2009;16(5):284-289. doi:10.1159/000216186

Di Luigi L, Baldari C, Sgrò P, et al. The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy men. J Clin Endocrinol Metab. 2008;93(9):3510-3514. doi:10.1210/jc.2008-0847

Jessop DS, Turner-Cobb JM. Measurement and meaning of salivary cortisol: a focus on health and disease in children. Stress. 2008;11(1):1-14. doi:10.1080/10253890701365527

Restituto P, Galofré JC, Gil MJ, et al. Advantage of salivary cortisol measurements in the diagnosis of glucocorticoid related disorders. Clin Biochem. 2008;41(9):688-692. doi:10.1016/j.clinbiochem.2008.01.015

Lusa Cadore E, Lhullier FL, Arias Brentano M, et al. Salivary hormonal responses to resistance exercise in trained and untrained middle-aged men. J Sports Med Phys Fitness. 2009;49(3):301-307.

Carroll T, Raff H, Findling JW. Late-night salivary cortisol for the diagnosis of Cushing syndrome: a meta-analysis. Endocr Pract. 2009;15(4):335-342. doi:10.4158/EP09023OR

Doi M, Sekizawa N, Tani Y, et al. Late-night salivary cortisol as a screening test for the diagnosis of Cushing’s syndrome in Japan. Endocr J. 2008;55(1):121-126. doi:10.1507/endocrj.k07e-023

Cadore E, Lhullier F, Brentano M, et al. Correlations between serum and salivary hormonal concentrations in response to resistance exercise. J Sports Sci. 2008;26(10):1067-1072. doi:10.1080/02640410801919526

Granger DA, Cicchetti D, Rogosch FA, et al. Blood contamination in children’s saliva: prevalence, stability, and impact on the measurement of salivary cortisol, testosterone, and dehydroepiandrosterone. Psychoneuroendocrinology. 2007;32(6):724-733. doi:10.1016/j.psyneuen.2007.05.003

Castro Md, Moreira AC. Screening and diagnosis of Cushing’s syndrome. Arq Bras Endocrinol Metabol. 2007;51(8):1191-1198. doi:10.1590/s0004-27302007000800004

Ahn RS, Lee YJ, Choi JY, et al. Salivary cortisol and DHEA levels in the Korean population: age-related differences, diurnal rhythm, and correlations with serum levels. Yonsei Med J. 2007;48(3):379-388. doi:10.3349/ymj.2007.48.3.379

Cardoso E, Persi G, González N, et al. Assessment of adrenal function by measurement of salivary steroids in response to corticotrophin in patients infected with human immunodeficiency virus. Steroids. 2007;72(4):328-334. doi:10.1016/j.steroids.2006.12.003

dos Santos E, dos Santos JE, Ribeiro RP, et al. Absence of circadian salivary cortisol rhythm in women with anorexia nervosa. J Pediatr Adolesc Gynecol. 2007;20(1):13-18. doi:10.1016/j.jpag.2006.10.011

Wirth MM, Meier EA, Fredrickson BL, Schultheiss OC. Relationship between salivary cortisol and progesterone levels in humans. Biol Psychol. 2007;74(1):104-107. doi:10.1016/j.biopsycho.2006.06.007

Törnhage CJ, Alfvén G. Diurnal salivary cortisol concentration in school-aged children: increased morning cortisol concentration and total cortisol concentration negatively correlated to body mass index in children with recurrent abdominal pain of psychosomatic origin. J Pediatr Endocrinol Metab. 2006;19(6):843-854. doi:10.1515/jpem.2006.19.6.843

Patacchioli FR, Monnazzi P, Simeoni S, et al. Salivary cortisol, dehydroepiandrosterone-sulphate (DHEA-S) and testosterone in women with chronic migraine. J Headache Pain. 2006;7(2):90-94. doi:10.1007/s10194-006-0274-6

Marcus-Perlman Y, Tordjman K, Greenman Y, et al. Low-dose ACTH (1 microg) salivary test: a potential alternative to the classical blood test. Clin Endocrinol (Oxf). 2006;64(2):215-218. doi:10.1111/j.1365-2265.2006.02451.x

Whembolua GL, Granger DA, Singer S, et al. Bacteria in the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2006;49(4):478-483. doi:10.1016/j.yhbeh.2005.10.005

Viardot A, Huber P, Puder JJ, et al. Reproducibility of nighttime salivary cortisol and its use in the diagnosis of hypercortisolism compared with urinary free cortisol and overnight dexamethasone suppression test. J Clin Endocrinol Metab. 2005;90(10):5730-5736. doi:10.1210/jc.2004-2264

Vogeser M, Durner J, Seliger E, Auernhammer C. Measurement of late-night salivary cortisol with an automated immunoassay system. Clin Chem Lab Med. 2006;44(12):1441-1445. doi:10.1515/CCLM.2006.244

Gozansky WS, Lynn JS, Laudenslager ML, Kohrt WM. Salivary cortisol determined by enzyme immunoassay is preferable to serum total cortisol for assessment of dynamic hypothalamic–pituitary–adrenal axis activity. Clin Endocrinol (Oxf). 2005;63(3):336-341. doi:10.1111/j.1365-2265.2005.02349.x

Oskis A, Loveday C, Hucklebridge F, et al. Diurnal patterns of salivary cortisol across the adolescent period in healthy females. Psychoneuroendocrinology. 2009;34(3):307-316. doi:10.1016/j.psyneuen.2008.09.009

Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing’s syndrome. Nat Clin Pract Endocrinol Metab. 2008;4(6):344-350. doi:10.1038/ncpendmet0837

Dehydroepiandrosterone [DHEA and DHEA-S]

Read GF, Wilson DW, Campbell FC, et al. Salivary cortisol and dehydroepiandrosterone sulphate levels in postmenopausal women with primary breast cancer. Eur J Cancer Clin Oncol. 1983;19(4):477-483. doi:10.1016/0277-5379(83)90110-4

Porola P, Virkki L, Przybyla BD, et al. Androgen deficiency and defective intracrine processing of dehydroepiandrosterone in salivary glands in Sjögren’s syndrome. J Rheumatol. 2008;35(11):2229-2235. doi:10.3899/jrheum.080220

Spaan M, Porola P, Laine M, et al. Healthy human salivary glands contain a DHEA-sulphate processing intracrine machinery, which is deranged in primary Sjögren’s syndrome. J Cell Mol Med. 2009;13(7):1261-1270. doi:10.1111/j.1582-4934.2009.00727.x

Lusa Cadore E, Lhullier FL, Arias Brentano M, et al. Salivary hormonal responses to resistance exercise in trained and untrained middle-aged men. J Sports Med Phys Fitness. 2009;49(3):301-307.

Gavrilova N, Lindau ST. Salivary sex hormone measurement in a national, population-based study of older adults. J Gerontol B Psychol Sci Soc Sci. 2009;64 Suppl 1(Suppl 1):i94-i105. doi:10.1093/geronb/gbn028

Cadore E, Lhullier F, Brentano M, et al. Correlations between serum and salivary hormonal concentrations in response to resistance exercise. J Sports Sci. 2008;26(10):1067-1072. doi:10.1080/02640410801919526

Granger DA, Cicchetti D, Rogosch FA, et al. Blood contamination in children’s saliva: prevalence, stability, and impact on the measurement of salivary cortisol, testosterone, and dehydroepiandrosterone. Psychoneuroendocrinology. 2007;32(6):724-733. doi:10.1016/j.psyneuen.2007.05.003

Ahn RS, Lee YJ, Choi JY, et al. Salivary cortisol and DHEA levels in the Korean population: age-related differences, diurnal rhythm, and correlations with serum levels. Yonsei Med J. 2007;48(3):379-388. doi:10.3349/ymj.2007.48.3.379

Patacchioli FR, Monnazzi P, Simeoni S, et al. Salivary cortisol, dehydroepiandrosterone-sulphate (DHEA-S) and testosterone in women with chronic migraine. J Headache Pain. 2006;7(2):90-94. doi:10.1007/s10194-006-0274-6

Whembolua GL, Granger DA, Singer S, et al. Bacteria in the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2006;49(4):478-483. doi:10.1016/j.yhbeh.2005.10.005

Assies J, Visser I, Nicolson NA, et al. Elevated salivary dehydroepiandrosterone-sulfate but normal cortisol levels in medicated depressed patients: preliminary findings. Psychiatry Res. 2004;128(2):117-122. doi:10.1016/j.psychres.2004.05.016

Kivlighan KT, Granger DA, Schwartz EB, et al. Quantifying blood leakage into the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2004;46(1):39-46. doi:10.1016/j.yhbeh.2004.01.006

Krause W, Mueller U, Mazur A. Measurement of steroid levels in saliva in a population-based survey of lifestyle, medical conditions, marriage, sex life and hormone status in aging men: a feasibility study. Aging Male. 2002;5(4):203-215.

Granger DA, Schwartz EB, Booth A, et al. Assessing dehydroepiandrosterone in saliva: a simple radioimmunoassay for use in studies of children, adolescents and adults. Psychoneuroendocrinology. 1999;24(5):567-579. doi:10.1016/s0306-4530(99)00013-x

Goodyer IM, Herbert J, Altham PM. Adrenal steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression. Psychol Med. 1998;28(2):265-273. doi:10.1017/s0033291797006314

Goodyer IM, Herbert J, Altham PM, et al. Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation. Psychol Med. 1996;26(2):245-256. doi:10.1017/s0033291700034644

Lac G, Lac N, Robert A. Steroid assays in saliva: a method to detect plasmatic contaminations. Arch Int Physiol Biochim Biophys. 1993;101(5):257-262. doi:10.3109/1381345930900392

Swinkels LM, Ross HA, Smals AG, Benraad TJ. Concentrations of total and free dehydroepiandrosterone in plasma and dehydroepiandrosterone in saliva of normal and hirsute women under basal conditions and during administration of dexamethasone/synthetic corticotropin. Clinical Chemistry, 1990;36(12):2042–2046. https://doi.org/10.1093/clinchem/36.12.2042

Di Luigi L, Baldari C, Sgrò P, et al. The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy men. J Clin Endocrinol Metab. 2008;93(9):3510-3514. doi:10.1210/jc.2008-0847

DPD

Nishizawa Y, Miura M, Ichimura S, et al. Executive summary of the Japan Osteoporosis Society Guide for the Use of Bone Turnover Markers in the Diagnosis and Treatment of Osteoporosis (2018 Edition). Clin Chim Acta. 2019;498:101-107. doi:10.1016/j.cca.2019.08.012

Eastell R, Szulc P. Use of bone turnover markers in postmenopausal osteoporosis. Lancet Diabetes Endocrinol. 2017;5(11):908-923. doi:10.1016/S2213-8587(17)30184-5

Vesper HW, Audain C, Woolfitt A, et al. High-performance liquid chromatography method to analyze free and total urinary pyridinoline and deoxypyridinoline. Anal Biochem. 2003;318(2):204-211. doi:10.1016/s0003-2697(03)00241-0

Yu SL, Ho LM, Lim BC, Sim ML. Urinary deoxypyridinoline is a useful biochemical bone marker for the management of postmenopausal osteoporosis. Ann Acad Med Singap. 1998;27(4):527-529.

Ross PD, Knowlton W. Rapid bone loss is associated with increased levels of biochemical markers. J Bone Miner Res. 1998;13(2):297-302. doi:10.1359/jbmr.1998.13.2.297

Ju HS, Leung S, Brown B, et al. Comparison of analytical performance and biological variability of three bone resorption assays. Clin Chem. 1997;43(9):1570-1576.

Follicle Stimulating Hormone (FSH) & Luteinizing Hormone (LH)

Loewit K, Huber J, Ortlieb A, et al. Speichel-LH als Ovulationsindikator: Vergleich zwischen Speichel-LH, Serum-LH und Ultraschallbefund [Salivary LH as an ovulation indicator: comparison between salivary LH, serum LH and ultrasonic findings]. Geburtshilfe Frauenheilkd. 1987;47(11):800-802. doi:10.1055/s-2008-1036050

Bribiescas RG. Age-related differences in serum gonadotropin (FSH and LH), salivary testosterone, and 17-beta estradiol levels among Ache Amerindian males of Paraguay. Am J Phys Anthropol. 2005;127(1):114-121. doi:10.1002/ajpa.20079

Immunoglobulin A (IgA)

McDowell SL, Hughes RA, Hughes RJ, et al. The effect of exercise training on salivary immunoglobulin A and cortisol responses to maximal exercise. Int J Sports Med. 1992;13(8):577-580. doi:10.1055/s-2007-1024568

Van Anders SM. Gonadal steroids and salivary IgA in healthy young women and men. Am J Hum Biol. 2010;22(3):348-352. doi:10.1002/ajhb.20997

Seemann R, Hägewald SJ, Sztankay V, et al. Levels of parotid and submandibular/sublingual salivary immunoglobulin A in response to experimental gingivitis in humans. Clin Oral Investig. 2004;8(4):233-237. doi:10.1007/s00784-004-0280-5

Thomas NE, Leyshon A, Hughes MG, et al. The effect of anaerobic exercise on salivary cortisol, testosterone and immunoglobulin (A) in boys aged 15-16 years. Eur J Appl Physiol. 2009;107(4):455-461. doi:10.1007/s00421-009-1146-y

Melatonin

Nowak R, McMillen IC, Redman J, Short RV. The correlation between serum and salivary melatonin concentrations and urinary 6-hydroxymelatonin sulphate excretion rates: two non-invasive techniques for monitoring human circadian rhythmicity. Clin Endocrinol (Oxf). 1987;27(4):445-452. doi:10.1111/j.1365-2265.1987.tb01172.x

Bagci S, Mueller A, Reinsberg J, et al. Saliva as a valid alternative in monitoring melatonin concentrations in newborn infants. Early Hum Dev. 2009;85(9):595-598. doi:10.1016/j.earlhumdev.2009.06.003

Zhou JN, Liu RY, van Heerikhuize J, et al. Alterations in the circadian rhythm of salivary melatonin begin during middle-age. J Pineal Res. 2003;34(1):11-16. doi:10.1034/j.1600-079x.2003.01897.x

Progesterone

Liening SH, Stanton SJ, Saini EK, Schultheiss OC. Salivary testosterone, cortisol, and progesterone: two-week stability, interhormone correlations, and effects of time of day, menstrual cycle, and oral contraceptive use on steroid hormone levels. Physiol Behav. 2010;99(1):8-16. doi:10.1016/j.physbeh.2009.10.001

Kivlighan KT, Granger DA, Schwartz EB. Blood contamination and the measurement of salivary progesterone and estradiol. Horm Behav. 2005;47(3):367-370. doi:10.1016/j.yhbeh.2004.12.001

Ishikawa M, Sengoku K, Tamate K, et al. The clinical usefulness of salivary progesterone measurement for the evaluation of the corpus luteum function. Gynecol Obstet Invest. 2002;53(1):32-37. doi:10.1159/000049408

Chatterton RT Jr, Mateo ET, Hou N, et al. Characteristics of salivary profiles of oestradiol and progesterone in premenopausal women. J Endocrinol. 2005;186(1):77-84. doi:10.1677/joe.1.06025

Mylonas PG, Makri M, Georgopoulos NA, et al. Adequacy of saliva 17-hydroxyprogesterone determination using various collection methods. Steroids. 2006;71(3):273-276. doi:10.1016/j.steroids.2005.11.005

Gann PH, Giovanazzi S, Van Horn L, et al. Saliva as a medium for investigating intra- and interindividual differences in sex hormone levels in premenopausal women. Cancer Epidemiol Biomarkers Prev. 2001;10(1):59-64.

Gröschl M, Rauh M, Schmid P, Dörr HG. Relationship between salivary progesterone, 17-hydroxyprogesterone, and cortisol levels throughout the normal menstrual cycle of healthy postmenarcheal girls. Fertil Steril. 2001;76(3):615-617. doi:10.1016/s0015-0282(01)01960-4

O’Leary P, Feddema P, Chan K, et al. Salivary, but not serum or urinary levels of progesterone are elevated after topical application of progesterone cream to pre-and postmenopausal women. Clin Endocrinol (Oxf). 2000;53(5):615-620. doi:10.1046/j.1365-2265.2000.01130.x

Carey BJ, Carey AH, Patel S, et al. A study to evaluate serum and urinary hormone levels following short and long term administration of two regimens of progesterone cream in postmenopausal women. BJOG. 2000;107(6):722-726. doi:10.1111/j.1471-0528.2000.tb13331.x

Wren BG, McFarland K, Edwards L, et al. Effect of sequential transdermal progesterone cream on endometrium, bleeding pattern, and plasma progesterone and salivary progesterone levels in postmenopausal women. Climacteric. 2000;3(3):155-160. doi:10.1080/13697130008500109

Chatterton RT Jr, Mateo ET, Lu D, Ling FJ. Interpopulational differences in the concentrations and ratios of salivary and serum progesterone. Fertil Steril. 2006;86(3):723-725. doi:10.1016/j.fertnstert.2006.01.034

Hughes IA, Read GF. Control in congenital adrenal hyperplasia monitored by frequent saliva 17OH-progesterone measurements. Horm Res. 1984;19(2):77-85. doi:10.1159/000179870

Choe JK, Khan-Dawood FS, Dawood MY. Progesterone and estradiol in the saliva and plasma during the menstrual cycle. Am J Obstet Gynecol. 1983;147(5):557-562. doi:10.1016/0002-9378(83)90016-9

Gavrilova N, Lindau ST. Salivary sex hormone measurement in a national, population-based study of older adults. J Gerontol B Psychol Sci Soc Sci. 2009;64 Suppl 1(Suppl 1):i94-i105. doi:10.1093/geronb/gbn028

Klebanoff MA, Meis PJ, Dombrowski MP, et al. Salivary progesterone and estriol among pregnant women treated with 17-alpha-hydroxyprogesterone caproate or placebo. Am J Obstet Gynecol. 2008;199(5):506.e1-506.e5067. doi:10.1016/j.ajog.2008.03.003

Celec P, Ostaniková D, Skoknová M, et al. Salivary sex hormones during the menstrual cycle. Endocr J. 2009;56(3):521-523. doi:10.1507/endocrj.k09e-020

Fassett MJ, Lachelin GC, McGarrigle HH, Wing DA. Alterations in saliva steroid hormone levels after oral mifepristone administration in women with pregnancies of greater than 41 weeks’ gestation. Reprod Sci. 2008;15(4):394-399. doi:10.1177/1933719107310305

Núñez-De La Mora A, Bentley GR, et al. The impact of developmental conditions on adult salivary estradiol levels: why this differs from progesterone. Am J Hum Biol. 2008;20(1):2-14. doi:10.1002/ajhb.20698

Wirth MM, Meier EA, Fredrickson BL, Schultheiss OC. Relationship between salivary cortisol and progesterone levels in humans. Biol Psychol. 2007;74(1):104-107. doi:10.1016/j.biopsycho.2006.06.007

Gandara BK, Leresche L, Mancl L. Patterns of salivary estradiol and progesterone across the menstrual cycle. Ann N Y Acad Sci. 2007;1098:446-450. doi:10.1196/annals.1384.022

Chatterton RT Jr, Zujewski J, Mateo ET, et al. Effect of raloxifene on salivary sex steroid concentrations in premenopausal women. J Endocrinol. 2006;191(3):599-604. doi:10.1677/joe.1.06791

Sufi SB, Donaldson A, Gandy SC, et al. Multicenter evaluation of assays for estradiol and progesterone in saliva. Clin Chem. 1985;31(1):101-103.

Wang DY, Fantl VE, Habibollahi F, et al. Salivary oestradiol and progesterone levels in premenopausal women with breast cancer. Eur J Cancer Clin Oncol. 1986;22(4):427-433. doi:10.1016/0277-5379(86)90108-2

Wang DY, Knyba RE. Salivary progesterone: relation to total and non-protein-bound blood levels. J Steroid Biochem. 1985;23(6A):975-979. doi:10.1016/0022-4731(85)90055-x

Lu Y, Bentley GR, Gann PH, Hodges KR, Chatterton RT. Salivary estradiol and progesterone levels in conception and nonconception cycles in women: evaluation of a new assay for salivary estradiol. Fertil Steril. 1999;71(5):863-868. doi:10.1016/s0015-0282(99)00093-x

Sumiala S, Tuominen J, Huhtaniemi I, Mäenpää J. Salivary progesterone concentrations after tubal sterilization. Obstet Gynecol. 1996;88(5):792-796. doi:10.1016/0029-7844(96)00287-6

Finn MM, Gosling JP, Tallon DF, et al. Follicular growth and corpus luteum function in women with unexplained infertility, monitored by ultrasonography and measurement of daily salivary progesterone. Gynecol Endocrinol. 1989;3(4):297-308. doi:10.3109/09513598909152469

Adekunle AO, Kim JB, Collins WP, Whitehead MI. Progesterone in saliva as an index of ovarian function. Int J Gynaecol Obstet. 1989;28(1):45-51. doi:10.1016/0020-7292(89)90543-2

Vuorento T, Lahti A, Hovatta O, Huhtaniemi I. Daily measurements of salivary progesterone reveal a high rate of anovulation in healthy students. Scand J Clin Lab Invest. 1989;49(4):395-401. doi:10.3109/00365518909089113

Perry LA, Wathen N, Chard T. Saliva levels of oestradiol and progesterone in relation to non-protein-bound concentrations in blood during late pregnancy. Horm Metab Res. 1987;19(9):444-447. doi:10.1055/s-2007-1011848

Young MC, Robinson JA, Read GF, et al. 170H-progesterone rhythms in congenital adrenal hyperplasia. Arch Dis Child. 1988;63(6):617-623. doi:10.1136/adc.63.6.617

Meulenberg PM, Hofman JA. Salivary progesterone excellently reflects free and total progesterone in plasma during pregnancy. Clin Chem. 1989;35(1):168-172.

Darne J, McGarrigle HH, Lachelin GC. Saliva oestriol, oestradiol, oestrone and progesterone levels in pregnancy: spontaneous labour at term is preceded by a rise in the saliva oestriol:progesterone ratio. Br J Obstet Gynaecol. 1987;94(3):227-235. doi:10.1111/j.1471-0528.1987.tb02359.x

Petsos P, Ratcliffe WA, Heath DF, Anderson DC. Comparison of blood spot, salivary and serum progesterone assays in the normal menstrual cycle. Clin Endocrinol (Oxf). 1986;24(1):31-38. doi:10.1111/j.1365-2265.1986.tb03251.x

Nahoul K, Scholler R. Comparison of saliva and plasma 17-hydroxyprogesterone time-course response to hCG administration in normal men. J Steroid Biochem. 1987;26(2):251-257. doi:10.1016/0022-4731(87)90079-3

O’Rourke MT, Ellison PT. Salivary measurement of episodic progesterone release. Am J Phys Anthropol. 1990;81(3):423-428. doi:10.1002/ajpa.1330810311

Schramm W, Smith RH, Craig PA, et al. Determination of free progesterone in an ultrafiltrate of saliva collected in situ. Clin Chem. 1990;36(8 Pt 1):1488-1493.

De Crée C, Lewin R, Ostyn M. The monitoring of the menstrual status of female athletes by salivary steroid determination and ultrasonography. Eur J Appl Physiol Occup Physiol. 1990;60(6):472-477. doi:10.1007/BF00705039

Lu YC, Chatterton RT Jr, Vogelsong KM, May LK. Direct radioimmunoassay of progesterone in saliva. J Immunoassay. 1997;18(2):149-163. doi:10.1080/01971529708005810

Delfs TM, Klein S, Fottrell P, et al. 24-hour profiles of salivary progesterone. Fertil Steril. 1994;62(5):960-966. doi:10.1016/s0015-0282(16)57058-7

Harris B, Lovett L, Newcombe RG, et al. Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II. BMJ. 1994;308(6934):949-953. doi:10.1136/bmj.308.6934.949

Harris B, Lovett L, Smith J, et al. Cardiff puerperal mood and hormone study. III. Postnatal depression at 5 to 6 weeks postpartum, and its hormonal correlates across the peripartum period. Br J Psychiatry. 1996;168(6):739-744. doi:10.1192/bjp.168.6.739

Moran DJ, McGarrigle HH, Lachelin GC. Lack of normal increase in saliva estriol/progesterone ratio in women with labor induced at 42 weeks’ gestation. Am J Obstet Gynecol. 1992;167(6):1563-1564. doi:10.1016/0002-9378(92)91740-2

Finn MM, Gosling JP, Tallon DF, et al. The frequency of salivary progesterone sampling and the diagnosis of luteal phase insufficiency. Gynecol Endocrinol. 1992;6(2):127-134. doi:10.3109/09513599209046396

Bolaji II, Tallon DF, O’Dwyer E, Fottrell PF. Assessment of bioavailability of oral micronized progesterone using a salivary progesterone enzymeimmunoassay. Gynecol Endocrinol. 1993;7(2):101-110. doi:10.3109/09513599309152488

Wingfield M, O’Herlihy C, Finn MM, et al. Follicular and luteal phase salivary progesterone profiles in women with endometriosis and infertility. Gynecol Endocrinol. 1994;8(1):21-25. doi:10.3109/09513599409028453

Tulppala M, Björses UM, Stenman UH, et al. Luteal phase defect in habitual abortion: progesterone in saliva. Fertil Steril. 1991;56(1):41-44. doi:10.1016/s0015-0282(16)54413-6

Lipson SF, Ellison PT. Normative study of age variation in salivary progesterone profiles. J Biosoc Sci. 1992;24(2):233-244. doi:10.1017/s0021932000019751

Wang DY, Fantl VE, Habibollahi F, et al. Salivary oestradiol and progesterone levels in premenopausal women with breast cancer. Eur J Cancer Clin Oncol. 1986;22(4):427-433. doi:10.1016/0277-5379(86)90108-2

Voss HF. Saliva as a fluid for measurement of estriol levels. Am J Obstet Gynecol. 1999;180(1 Pt 3):S226-S231. doi:10.1016/s0002-9378(99)70706-4

Testosterone & Dihydrotestosterone (DHT)

Ohzeki T, Manella B, Gübelin-De Campo C, Zachmann M. Salivary testosterone concentrations in prepubertal and pubertal males: comparison with total and free plasma testosterone. Horm Res. 1991;36(5-6):235-237. doi:10.1159/000182171

Arregger AL, Contreras LN, Tumilasci OR, et al. Salivary testosterone: a reliable approach to the diagnosis of male hypogonadism. Clin Endocrinol (Oxf). 2007;67(5):656-662. doi:10.1111/j.1365-2265.2007.02937.x

Di Luigi L, Baldari C, Sgrò P, et al. The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy men. J Clin Endocrinol Metab. 2008;93(9):3510-3514. doi:10.1210/jc.2008-0847

Lusa Cadore E, Lhullier FL, Arias Brentano M, et al. Salivary hormonal responses to resistance exercise in trained and untrained middle-aged men. J Sports Med Phys Fitness. 2009;49(3):301-307.

Cadore E, Lhullier F, Brentano M, et al. Correlations between serum and salivary hormonal concentrations in response to resistance exercise. J Sports Sci. 2008;26(10):1067-1072. doi:10.1080/02640410801919526

Celec P, Ostaniková D, Skoknová M, et al. Salivary sex hormones during the menstrual cycle. Endocr J. 2009;56(3):521-523. doi:10.1507/endocrj.k09e-020

Porola P, Virkki L, Przybyla BD, et al. Androgen deficiency and defective intracrine processing of dehydroepiandrosterone in salivary glands in Sjögren’s syndrome. J Rheumatol. 2008;35(11):2229-2235. doi:10.3899/jrheum.080220

Thomas NE, Leyshon A, Hughes MG, et al. The effect of anaerobic exercise on salivary cortisol, testosterone and immunoglobulin (A) in boys aged 15-16 years. Eur J Appl Physiol. 2009;107(4):455-461. doi:10.1007/s00421-009-1146-y

Miskovic V, Schmidt LA. Frontal brain oscillatory coupling among men who vary in salivary testosterone levels. Neurosci Lett. 2009;464(3):239-242. doi:10.1016/j.neulet.2009.08.059

Gavrilova N, Lindau ST. Salivary sex hormone measurement in a national, population-based study of older adults. J Gerontol B Psychol Sci Soc Sci. 2009;64 Suppl 1(Suppl 1):i94-i105. doi:10.1093/geronb/gbn028

Bribiescas RG, Hill KR. Circadian variation in salivary testosterone across age classes in Ache Amerindian males of Paraguay. Am J Hum Biol. 2010;22(2):216-220. doi:10.1002/ajhb.21012

Liening SH, Stanton SJ, Saini EK, Schultheiss OC. Salivary testosterone, cortisol, and progesterone: two-week stability, interhormone correlations, and effects of time of day, menstrual cycle, and oral contraceptive use on steroid hormone levels. Physiol Behav. 2010;99(1):8-16. doi:10.1016/j.physbeh.2009.10.001

Wellen JJ, Smals AG, Rijken JC, et al. Testosterone and delta 4-androstenedione in the saliva of patients with Klinefelter’s syndrome. Clin Endocrinol (Oxf). 1983;18(1):51-59. doi:10.1111/j.1365-2265.1983.tb03186.x

Sannikka E, Terho P, Suominen J, Santti R. Testosterone concentrations in human seminal plasma and saliva and its correlation with non-protein-bound and total testosterone levels in serum. Int J Androl. 1983;6(4):319-330. doi:10.1111/j.1365-2605.1983.tb00546.x

Baxendale PM, Jacobs HS, James VH. Plasma and salivary androstenedione and dihydrotestosterone in women with hyperandrogenism. Clin Endocrinol (Oxf). 1983;18(5):447-457. doi:10.1111/j.1365-2265.1983.tb02874.x

Schürmeyer T, Nieschlag E. Effect of ketoconazole and other imidazole fungicides on testosterone biosynthesis. Acta Endocrinol (Copenh). 1984;105(2):275-280. doi:10.1530/acta.0.1050275

Khan-Dawood FS, Choe JK, Dawood MY. Salivary and plasma bound and “free” testosterone in men and women. Am J Obstet Gynecol. 1984;148(4):441-445.

Vittek J, L’Hommedieu DG, Gordon GG, et al. Direct radioimmunoassay (RIA) of salivary testosterone: correlation with free and total serum testosterone. Life Sci. 1985;37(8):711-716. doi:10.1016/0024-3205(85)90540-5

Navarro MA, Villabona CM, Blanco A, et al. Salivary excretory pattern of testosterone in substitutive therapy with testosterone enanthate. Fertil Steril. 1994;61(1):125-128. doi:10.1016/s0015-0282(16)56464-4

Gray PB, Yang CF, Pope HG Jr. Fathers have lower salivary testosterone levels than unmarried men and married non-fathers in Beijing, China. Proc Biol Sci. 2006;273(1584):333-339. doi:10.1098/rspb.2005.3311

Uchida A, Bribiescas RG, Ellison PT, et al. Age related variation of salivary testosterone values in healthy Japanese males. Aging Male. 2006;9(4):207-213. doi:10.1080/13685530601060461

Whembolua GL, Granger DA, Singer S, et al. Bacteria in the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2006;49(4):478-483. doi:10.1016/j.yhbeh.2005.10.005

Nahoul K, Rao LV, Scholler R. Saliva testosterone time-course response to hCG in adult normal men. Comparison with plasma levels. J Steroid Biochem. 1986;24(5):1011-1015. doi:10.1016/0022-4731(86)90354-7

Christiansen K, Knussmann R. Sex hormones and cognitive functioning in men. Neuropsychobiology. 1987;18(1):27-36. doi:10.1159/000118389

Johnson SG, Joplin GF, Burrin JM. Direct assay for testosterone in saliva: relationship with a direct serum free testosterone assay. Clin Chim Acta. 1987;163(3):309-318. doi:10.1016/0009-8981(87)90249-x

Ruutiainen K, Sannikka E, Santti R, et al. Salivary testosterone in hirsutism: correlations with serum testosterone and the degree of hair growth. J Clin Endocrinol Metab. 1987;64(5):1015-1020. doi:10.1210/jcem-64-5-1015

Lønning PE, Dowsett M, Jacobs S, et al. Lack of diurnal variation in plasma levels of androstenedione, testosterone, estrone and estradiol in postmenopausal women. J Steroid Biochem. 1989;34(1-6):551-553. doi:10.1016/0022-4731(89)90143-x

Dabbs JM Jr. Salivary testosterone measurements: reliability across hours, days, and weeks. Physiol Behav. 1990;48(1):83-86. doi:10.1016/0031-9384(90)90265-6

Navarro MA, Aguiló F, Villabona CM, et al. Salivary testosterone in prostatic carcinoma. Br J Urol. 1989;63(3):306-308. doi:10.1111/j.1464-410x.1989.tb05194.x

Campbell BC, Ellison PT. Menstrual variation in salivary testosterone among regularly cycling women. Horm Res. 1992;37(4-5):132-136. doi:10.1159/000182297

Read GF. Status report on measurement of salivary estrogens and androgens. Ann N Y Acad Sci. 1993;694:146-160. doi:10.1111/j.1749-6632.1993.tb18349.x

Jinrui H, Itoh N, Nitta T, et al. [Changes in the salivary testosterone level in aged] Hinyokika Kiyo. 1994;40(9):807-811.

Granger DA, Shirtcliff EA, Booth A, et al. The “trouble” with salivary testosterone. Psychoneuroendocrinology. 2004;29(10):1229-1240. doi:10.1016/j.psyneuen.2004.02.005

Navarro MA, Nolla JM, Machuca MI, et al. Salivary testosterone in postmenopausal women with rheumatoid arthritis. J Rheumatol. 1998;25(6):1059-1062.

Tschöp M, Behre HM, Nieschlag E, et al. A time-resolved fluorescence immunoassay for the measurement of testosterone in saliva: monitoring of testosterone replacement therapy with testosterone buciclate. Clin Chem Lab Med. 1998;36(4):223-230. doi:10.1515/CCLM.1998.038

Granger DA, Schwartz EB, Booth A, Arentz M. Salivary testosterone determination in studies of child health and development. Horm Behav. 1999;35(1):18-27. doi:10.1006/hbeh.1998.1492

Ellison PT, Bribiescas RG, Bentley GR, et al. Population variation in age-related decline in male salivary testosterone. Hum Reprod. 2002;17(12):3251-3253. doi:10.1093/humrep/17.12.3251

Krause W, Mueller U, Mazur A. Measurement of steroid levels in saliva in a population-based survey of lifestyle, medical conditions, marriage, sex life and hormone status in aging men: a feasibility study. Aging Male. 2002;5(4):203-215.

Kivlighan KT, Granger DA, Schwartz EB, et al. Quantifying blood leakage into the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva. Horm Behav. 2004;46(1):39-46. doi:10.1016/j.yhbeh.2004.01.006

Sakaguchi K, Hasegawa T. [Analysis of salivary testosterone by liquid chromatography-tandem mass spectrometry: correlation with serum bioavailable testosterone and aging] Rinsho Byori. 2005;53(5):388-394.

Bribiescas RG. Age-related differences in serum gonadotropin (FSH and LH), salivary testosterone, and 17-beta estradiol levels among Ache Amerindian males of Paraguay. Am J Phys Anthropol. 2005;127(1):114-121. doi:10.1002/ajpa.20079

Mita K, Matsubara A, Usui T. [Measurement of salivary testosterone by a simple enzyme immunoassay procedure] Nihon Hinyokika Gakkai Zasshi. 2005;96(6):610-616. doi:10.5980/jpnjurol1989.96.610

Patacchioli FR, Monnazzi P, Simeoni S, et al. Salivary cortisol, dehydroepiandrosterone-sulphate (DHEA-S) and testosterone in women with chronic migraine. J Headache Pain. 2006;7(2):90-94. doi:10.1007/s10194-006-0274-6

Mason A, Wallace AM, Macintyre H, et al. Undetectable salivary testosterone in young women with premature ovarian failure. Clin Endocrinol (Oxf). 2006;64(6):711-714. doi:10.1111/j.1365-2265.2006.02537.x

Van Anders SM, Watson NV. Menstrual cycle irregularities are associated with testosterone levels in healthy premenopausal women. Am J Hum Biol. 2006;18(6):841-844. doi:10.1002/ajhb.20555

Lazarou S, Reyes-Vallejo L, Morgentaler A. Wide variability in laboratory reference values for serum testosterone. J Sex Med. 2006;3(6):1085-1089. doi:10.1111/j.1743-6109.2006.00334.x

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