Below are some common questions regarding saliva testing. If you do not see your question please feel free to reach out directly to our sales team at


I am not a healthcare practitioner; can I still order a test?

Because saliva contains many components including and hormones and is simple and painless to collect, it provides an easy and accurate way to analyze the body’s hormone status. All that is required is a small sample of saliva collected in each of four tubes timed throughout the day. The tubes are snapped shut after collection and placed in the prepaid box for shipment back to the lab. The results will be returned to your health care provider within 5 business days after Generation Diagnostics receives your sample.

How accurate is saliva testing compared to blood and urine testing?

Most of the hormones traveling in the blood stream are bound to large carrier proteins that prevent the hormone from being used by the tissues of your body (interacting with its hormone receptor) and are called bound or inactive. These hormones are not used by the body thus inactive or non-bioavailable. Less than 5% of hormones are unbound to proteins. This small percentage of unbound hormone is called free, active or bioavailable hormones. When a hormone is bound to a protein it is too large to pass into the saliva gland; therefore the saliva gland acts as a natural sieve, sorting the bioavailable (free) hormones from the large, inactive protein-hormone complexes. For this reason, the hormones tested in saliva are the most accurate reflection of the amount of the hormone that is available for your tissues to use. Serum hormone levels include ALL of the hormone (“total”), the bound and unbound portions, and does not reflect what the body actually can use.

Urinary hormone levels are directly affected by liver and kidney function, and since the hormones present in urine are not the active hormones, but are actually the metabolites that the body is disposing of, this is not an ideal fluid for hormonal assessment. Furthermore, the ease of saliva collection enables multiple samples to be taken throughout the day which is essential when measuring the rhythm of cortisol (adrenal status) instead of a single data point, or the total amount produced in a 24 hour period.

Do herbal supplements/vitamins affect hormone levels?

Most herbal supplements and vitamins can be used without interruption when collecting saliva as long as they don’t contain any hormones in them. Watch for hormones such as DHEA that may be in many anti-aging or male health products. In addition, some topical creams and lotions may contain hormones in trace amounts without reporting so on the label. Because of this, it is best to avoid applying lotions or creams the night before and the morning of saliva collection. Use of routine cosmetics is permitted.

When can I test if I am taking hormones?

We encourage you to monitor the therapeutic levels of your hormones to monitor your dosage. Remember to read the saliva kit instructions. If you are using topical hormone supplementation it is important to stop using the hormones 12-24 hours before the first collection, if the hormones are dissolved under your tongue, then you should use the last dose 24-36 hours prior to collecting your saliva and if you are swallowing the hormones (on oral supplementation) you don’t need to adjust the timing at all, you can take the hormone on the day of the saliva collection. You can restart your regular supplementation AFTER you have completed all four samples. Please ask your practitioner if you have any questions specific to your hormone treatment plan.

 Should I test if I am sick?

In general, we would recommend that you try to test on a “typical day”, so if possible you should wait until you are not ill. Viruses such as colds and flues as well as bacterial infections are stressful to the body and therefore may affect the adrenal glands and cortisol levels.

 When should I test if I am taking birth control pills?

You can collect your samples anytime while using oral contraceptives, since they suppress some of your hormone levels and prevent cycling. When you are discontinuing the birth control pill, wait until days 19-23 of your second cycle. Remember to read the saliva kit instructions.

 When taking birth control pills, what tests are helpful?

Oral birth control pills work by suppressing ovulation and consequently result in low estradiol and progesterone levels and often low range testosterone levels. The synthetic progestins that are found in birth control pills are NOT measured by our test because they differ significantly in molecular structure from progesterone. Adrenal assessment including DHEA and diurnal cortisols can be very useful and important if you are taking birth control pills.

 When should I test if I am using over-the-counter cosmetic creams?

It’s a good idea to stop all creams 12-24 hours before collecting your first sample. Also – make sure that all door handles and faucets and regularly used surfaces have been wiped clean, contamination of a sample from over-the-counter creams is common. Check the ingredients on the tube and add to the list of supplements you are taking if you think it may contain hormones.

 I ate breakfast and/or brushed my teeth and then started collecting my saliva. Should I start over again?

Yes. Wash out the tube with water and leave to dry. Start to collect the next day instead. The timing of the morning sample is VERY important for measuring your morning cortisol. The natural peak is at 30 minutes after you wake up so watch the clock carefully so you can collect that first sample 30 minutes after you awake. Food particles in the saliva or trace amounts of blood that may result from teeth brushing can affect the hormone levels.

 I forgot to rinse my mouth before I collected my saliva. What should I do?

Rinsing your mouth helps to eliminate any food particles from the saliva sample and will remove mucus or film that may have developed in your mouth. You can still submit this sample or you can empty the saliva tube, rinse with warm water only and begin collection tomorrow.

Should vigorous exercise be avoided the day before saliva collection for cortisol (adrenal function)?

Please continue your routine as usual; the testing will give a clear picture of how your usual hormones function. If the exercise is typical for you, then proceed as usual. If you are planning on running a marathon the day before you plan to collect – it’s probably a good idea to wait 4 – 5 days after running to do your collection.

 I have diabetes. Can I eat in the morning before I take the test?

It is preferable to collect the sample 30 minutes after awakening and before breakfast. Please contact your health care provider for specific instructions if needed. Eating before the first saliva sample could cause the morning cortisol level to be affected.

Can I request my test results directly from Generation Diagnostics?

Generation Diagnostics works only with health care practitioners. Please contact the practitioner who gave you the kit to get your results.