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The popularity of saliva testing abounds. You can buy it on Amazon, you can buy it from Direct Labs. Your doctor, nutritionist or acupuncturist may offer this test. Heck, I even used to offer this test.

Saliva testing has long been employed by the alternative health community because it shows the bioavailable free fraction of unbound cortisol. 95% of cortisol in the blood is bound to a protein carrier, but the cortisol in saliva is not bound, thus its popularity

But this free fraction of saliva is only a very small percentage of total production. What you don’t see from a saliva test is total daily production, otherwise known as metabolized (or total) cortisol, which comprises about 80% of total production.

Only having the ability to see free cortisol would be fine if it always matched the metabolized cortisol pattern. But the two markers often do not match.

In fact, a discordant pattern between free and total cortisol is extremely common.

Here’s an example of low free cortisol with high metabolized cortisol:

picture of cortisol metabolism

If the above client had been directed to take licorice root or hydrocortisone for her low free cortisol based on the results of a salivary cortisol (remember, saliva testing ONLY shows free cortisol), without seeing that her adrenals were actually producing cortisol just fine (as shown by her high metabolized cortisol value of over 6000), she probably would’ve felt a lot worse.

The second reason why DUTCH testing is far better than saliva testing is that it shows how your body is breaking down estrogen. Since the ultimate biologic affect of estrogen depends on how you are metabolizing it, this is crucial information. Blood and saliva testing can not show this information, only urine testing.

picture of estrogen metabolism on dutch test

This above picture is an example of someone who was not creating the good type of estrogen, which is 2-OH. She should be making at least 70% of 2-OH but she was only making 23.2%.

The good thing, is that this is can be changed with diet, lifestyle and targeted supplements.

So, in summary, these are the 2 primary reasons why DUTCH testing is the better

1. It looks at both free and total cortisol. Without the total cortisol measurement, you are left to guess what the adrenals are really doing.

2. It shows how you are metabolizing (or put simpler, what your body is doing with) your estrogen.

Many women seek like the idea of testing because it is proactive. It feels good to be taking your health into your own hands and doing something as significant as testing, to move forward.

Every woman should do a DUTCH test. Don’t waste money on saliva testing. The science has evolved. Lots of books and blogs are outdated….they just don’t know about DUTCH testing yet.