Literature References

Song M, Bai H, Zhang P, et al. Promising applications of human-derived saliva biomarker testing in clinical diagnostics. Int J Oral Sci. 2023;15(1):2. doi:10.1038/s41368-022-00209-w

“The review mostly addresses the proceedings from 2016 to 2022, to shed light on the promising usage of saliva testing in clinical diagnostics. We recap the recent advances following the category of different types of biomarkers, such as intracellular DNA, RNA, proteins and intercellular exosomes, cell-free DNA, to give a comprehensive impression of saliva biomarker testing.”

Emami A, Hallinder H, Theorell T, et al. The Feasibility and Acceptability of In-Home Saliva Collection for Stress in Persons With Dementia and Their Family Caregivers. Biol Res Nurs. 2022;24(3):308-315. doi:10.1177/10998004221076554

“This study supports the feasibility of in-home saliva collection for stress biomarker assay and the need for further investigation into self-administered collection of stress biomarkers with a particular focus on dementia care dyads living at home.”

Shakeeb N, Varkey P, Ajit A. Human Saliva as a Diagnostic Specimen for Early Detection of Inflammatory Biomarkers by Real-Time RT-PCR. [published correction appears in Inflammation 2022;45(2):930]. Inflammation. 2021;44(5):1713-1723. doi:10.1007/s10753-021-01484-1

“Saliva is a biofluid with clinical significance that can be easily collected and stored and is proved to be ideal for early detection of systemic diseases. As saliva is a repository of multiple biomarkers, it can be used in rapid tests, point-of-care (POC) devices, or other standard clinical laboratory operations. Molecular diagnostics using saliva has advanced into a sophisticated and established science, and now it is renowned as a central player in clinical areas and biomedical technology. Saliva collection being a relatively stress-free and non-invasive process can be regarded as a potential alternative diagnostic fluid…”

Boroumand M, Olianas A, Cabras T, et al. Saliva, a bodily fluid with recognized and potential diagnostic applications. J Sep Sci. 2021;44(19):3677-3690. doi:10.1002/jssc.202100384

“Human whole saliva is a bodily fluid that can be obtained easily by noninvasive techniques. Specimens can be collected by the patient also at home in order to monitor health status and variations of several analytes of clinical interest. The contributions to whole saliva include secretions from salivary glands and, among others, from the gingival crevicular fluid that derives from the epithelial mucosa. Therefore, saliva is currently a relevant diagnostic fluid for many substances, including steroids, nonpeptide hormones, therapeutic drugs, and drugs of abuse.”

Lasisi TJ, Lawal FB. Preference of saliva over other body fluids as samples for clinical and laboratory investigations among healthcare workers in Ibadan, Nigeria. Pan Afr Med J. 2019;34:191. doi:10.11604/pamj.2019.34.191.18738

“This survey has indicated that the majority of the health care workers knew the various uses and advantages of saliva as a specimen for clinical and laboratory investigation. However, few indicated previous use for clinical as well as laboratory investigation especially in the area of research. The ability to use saliva to monitor a patient’s health and disease states is a highly desirable goal for health promotion and health care research. However, additional education and practical implementation strategies are necessary to address perceived barriers.”

Langelaan MLP, Kisters JMH, Oosterwerff MM, et al. Salivary cortisol in the diagnosis of adrenal insufficiency: cost efficient and patient friendly. Endocr Connect. 2018;7(4):560-566. doi:10.1530/EC-18-0085

“A novel diagnostic algorithm, including early morning salivary cortisol analysis can reduce the numbers of ACTH stimulation tests in patients suspected of AI. This patient-friendly method can thereby reduce total health care costs.”

Dhima M, Salinas TJ, Wermers RA, et al. Preference changes of adult outpatients for giving saliva, urine and blood for clinical testing after actual sample collection. J Prosthodont Res. 2013;57(1):51-56. doi:10.1016/j.jpor.2012.09.004

“Overall, saliva remained as the most highly preferred sample to donate despite a decline in patients’ preferences of saliva donation after sample collection. The results of the study are promising for future widespread patient acceptance of saliva as a diagnostic fluid.”

Greabu M, Battino M, Mohora M, et al. Saliva–a diagnostic window to the body, both in health and in disease. J Med Life. 2009;2(2):124-132.

“As a diagnostic fluid, saliva offers distinctive advantages over serum. Furthermore, saliva may provide a cost-effective approach for the screening of large populations. Gland-specific saliva can be used for diagnosis of pathology specific to one of the major salivary glands. Whole saliva, however, is most frequently used for diagnosis of systemic diseases. As we enter the era of genomic medicine, sialochemistry will play an increasingly important role in the early detection, the monitoring and progression of the systemic and oral diseases. We reviewed the current data within literature and of our research concerning clinical potential of the saliva.”

Gröschl M. The physiological role of hormones in saliva. Bioessays. 2009;31(8):843-852. doi:10.1002/bies.200900013

“A number of carefully performed studies give examples of important physiological hormonal activity in saliva. Steroids, such as androgens, act as pheromones in olfactory communication of various mammalian species, such as facilitating mating behavior in swine or serving as odor cues for rodent nestlings. Salivary peptide hormones, such as epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha), and amines such as melatonin, are involved in the regulation of inflammatory processes and in the promotion of cell proliferation, and contribute to a rapid wound healing in the oropharyngeal epithelia.”

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

“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.”

Jezova D, Hlavacova N. Endocrine factors in stress and psychiatric disorders: focus on anxiety and salivary steroids. Ann N Y Acad Sci. 2008;1148:495-503. doi:10.1196/annals.1410.050

“Glucocorticoids and other steroids produced in the adrenal cortex are altered in chronic stress situations associated with enhanced anxiety. A useful tool to evaluate changes in adrenal steroids during stress and anxiety under both laboratory and real-life stress situations is determination of steroids in saliva. The main advantages of this technique are its noninvasiveness and its measurement of biologically active free hormone levels.”

Koka S, Beebe TJ, Merry SP, et al. The preferences of adult outpatients in medical or dental care settings for giving saliva, urine or blood for clinical testing. J Am Dent Assoc. 2008;139(6):735-740. doi:10.14219/jada.archive.2008.0255

“Subjects regarded the donation of saliva as more comfortable and convenient than that of blood or urine at the doctor’s (physician’s or dentist’s) office, and they reported that saliva and urine are easiest to collect at home compared with blood.”

Lewis JG. Steroid analysis in saliva: an overview. Clin Biochem Rev. 2006;27(3):139-146.

“The first report of steroid analysis in saliva was more than thirty years ago. Since that time its popularity has increased due to the attractiveness of non-invasive, repeated and simple stress-free sampling. It has proved a popular sampling fluid for psychobiology, sports medicine, pharmacology and paediatric studies as well as in the area of complementary medicine. In the diagnostic laboratory, salivary progesterone and oestradiol have been used for assessing ovarian function and 17α-OH progesterone for the diagnosis of congenital adrenal hyperplasia (CAH).”

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

“Human saliva can be easily obtained by noninvasive techniques and contains many analytes of interest for screening, diagnosis and monitoring. These include steroid and other nonpeptide hormones, therapeutic drugs, drugs of abuse and antibodies. Numerous studies in the past 40 y have shown correlations between serum and saliva levels. Both diurnal and monthly profiles of hormone levels parallel traditional serum patterns. Multiple specimens for steroid hormone analysis can be easily collected by the patient, at home, to monitor fertility cycles, menopausal fluctuations, stress and other diurnal variations. Drug doses can be monitored without inconvenient and costly visits to blood-drawing facilities. Antibody levels can be determined to screen for infectious diseases. Saliva can be collected directly by spitting into a tube or with one of several devices, each of which has its own special advantages and disadvantages. 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.”

Tabak LA. A revolution in biomedical assessment: the development of salivary diagnostics. J Dent Educ. 2001;65(12):1335-1339.

“Since the early 1900s, saliva has proven to be a noninvasive medium from which to measure a wide range of hormones, pharmaceuticals, and antibodies. It has also proven to be a convenient source of host and microbial DNA. As we enter the era of genomic medicine, increasing use of salivary diagnostics will help catalyze a shift from disease diagnosis to health surveillance.”

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

“Despite the aforementioned complications, noninvasive saliva collection has provided the medical and research community with an excellent medium for the monitoring of plasma steroid levels. This noninvasive method has permitted the evaluation and assessment of a multitude of endocrine studies that would have been extremely difficult, if not impossible, using other more familiar methods.”

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):607-611.

“This paper indicates the potential of saliva as a medium for chronobiological studies. It has principally focussed on the work of the Tenovus Institute for Cancer Research, at the University of Wales College of Medicine over the past decade or more, particularly for steroid hormones, so as to give an authoritative viewpoint based on practical experience.”

Read GF, Walker RF, Wilson DW, Griffiths K. Steroid analysis in saliva for the assessment of endocrine function. Ann N Y Acad Sci. 1990;595:260-274. doi:10.1111/j.1749-6632.1990.tb34300.x

“The development of highly sensitive immunoassays has however initiated the birth of a new exciting era in clinical endocrinology. Despite pioneering work by Shannon and his colleagues in the mid-1960s, suggesting the possible role of salivary steroid analysis for the assessment of adrenal function, the nonspecific Porter-Silber colorimetric procedure failed to realize the potential value of this form of analysis. Over the last few years, a research initiative at the Tenovus Institute in Cardiff has been directed to establishing the credibility of salivary steroid analysis and to determine its potential for the investigation of the endocrine status of an individual subject or patient by these relatively noninvasive procedures.”

Walker RF, Read GF, Wilson DW, et al. Chronobiology in laboratory medicine: principles and clinical applications illustrated from measurements of neutral steroids in saliva. Prog Clin Biol Res. 1990;341A:105-117.

“A number of chronobiological principles, as they pertain to the practice of laboratory medicine, have been discussed. Without doubt, salivary steroid assays are valuable tools for use in clinical studies, not necessarily as a single time-qualified sample but more often as a series of samples that will describe the underlying endocrinological time-structure. It is also important to appreciate that melatonin, certain drugs, and many dietary constituents such as phyto-oestrogens, are among the myriad of substances that can be monitored, and so hold great promise for the chronobiologist interested in the use of saliva as a sampling medium, both in the present and in the future.”

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

“As well as reviewing the state of our knowledge of the salivary concentration of many hormones this review outlines a number of “rules of thumb” concerning the presence of hormones in saliva, their saliva/plasma relationship and the potential usefulness of assays of their salivary concentration.”

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

“Since the collection of saliva is noninvasive, nonstressful and usually very convenient there have been many recent studies examining the clinical relevance of measuring various hormones in saliva. It now appears that the measurement of most unconjugated steroids in saliva will provide clinically useful data…”

Riad-Fahmy D, Read GF, Walker RF. Salivary steroid assays for assessing variation in endocrine activity. J Steroid Biochem. 1983;19(1A):265-272.

“Salivary sampling regimens are non-invasive, and therefore facilitate dynamic tests of hormone function and assessment of biological rhythms. Concentrations of neutral steroids in saliva are independent of flow rate and appear to reflect the non-protein-bound, ‘free’ fraction. Comparison of replicate determinations of quality control pools with determinations of samples collected at 2 min intervals allows the significance of short-term fluctuations in cortisol and testosterone secretory activity to be estimated. Samples collected at 15 min intervals provide a convenient way to estimate circadian rhythms, particularly in young children. Determination of salivary progesterone concentrations in samples collected by women daily, over extended periods of time, provides a valuable means of assessing ovarian function. Such assays may be used to monitor ovulation-induction therapy.”

Vining RF, McGinley RA, Symons RG. Hormones in saliva: mode of entry and consequent implications for clinical interpretation. Clin Chem. 1983;29(10):1752-1756.

“Assay of hormones in saliva would be more convenient than assay in blood, but there is no information on the route by which hormones enter saliva, information that would provide insight into the clinical value of such assays. We have examined the mode of entry of various hormones into saliva. The results suggest that unconjugated steroids enter saliva by diffusing through the cells of the salivary glands and that their concentration in saliva does not depend on the rate of saliva production.”

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

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

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

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

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

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.

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

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

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

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

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

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