The Adrenal Stress Index™
The Female Hormone Panels™
The Male Hormone Panel™
The Top 4 Reasons to use Saliva Testing

We primarily use the state of the art "platinum standard" tests that have demonstrated a phenomenal ability to accurately measure hormones in the saliva. These tests are superior to serum progesterone and body temperature records.* We do use traditional blood tests in addition to the salivary procedures.

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The Adrenal Stress Index™
The adrenals are two small glands, each weighing 3 to 5 grams, that are located above the kidneys. The adrenals have one of the highest rates of blood flow per gram of tissue, and the highest content of Vitamin C per gram of any tissue in the body.

Each adrenal gland is composed of two separate functional entities. The outer zone, or cortex, accounts for 80% to 90% of the gland, and secretes adrenal steroids (Cortisol, DHEA(S) and Aldosterone). The inner zone, or medulla, comprises 10% to 20% of the gland, and secretes the catecholamines adrenaline and nor-adrenaline. Cortisol, DHEA and adrenaline are the three main adrenal stress hormones.

The Adrenal Rhythm & Its Importance
The human adrenal gland does not secrete its steroid hormones at a constant level throughout the day. The hormones are actually released in a cycle with the highest value in the morning and the lowest value at night. This is easily understood by looking at Figure 1. This 24-hour cycle is called the circadian rhythm. An abnormal adrenal rhythm can influence many functions of the body, some of which are listed below.



1. Energy production
Abnormal adrenal function can alter the ability of cells to produce energy for activities of daily living. People who have a hard time rising in the morning, or who suffer with a low energy level during the day, often have abnormal adrenal rhythms and poor blood sugar regulation.

The maintenance of a stable blood sugar level depends on food choice, lifestyle, adrenal function and insulin activity. This panel measures stress hormones and insulin, to help ferret out causes of fatigue, cravings and obesity.

2. Muscle & joint function
Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint breakdown with chronic pain.

3. Bone health
The adrenal rhythm determines how well we build bone. If the night cortisol level is elevated and the morning level is too high, our bones do not rebuild well, and we are more prone to the osteoporotic process. Stress is the enemy of the bones. In postmenopausal women, the effect of stress worsens due to the female hormone imbalances.

4. Immune health
Various immune cells (white blood cells) cycle in and out of the spleen and bone marrow for special conditioning, and possible nourishment and instructions. This immune system trafficking follows the cortisol cycle. So, if the cycle is disrupted, especially at night, then the immune system is adversely affected.
Short and long-term stress is known to suppress the immune response on the surfaces of our body as in lungs, throat, urinary and intestinal tract. With the reduction in the surface antibody (called secretory IgA), the resistance to infection is reduced and allergic reactions are believed to increase.

5. Sleep quality
The ability to enter REM sleep cycles, i.e. regenerative sleep, is interrupted by high cortisol values at night and in the morning. Chronic lack of REM sleep can reduce the mental vitality and vigor of a person and induce depression.

6. Skin regeneration
Human skin regenerates mostly during the night. With higher night cortisol values, less skin regeneration takes place. So, a normal cortisol rhythm is essential for optimal skin health (See Figure 2).



7. Thyroid function
The level of Cortisol at the cell level controls thyroid hormone production. Quite often, hypothyroid symptoms such as fatigue and low body temperature are due to an adrenal maladaptation.

8. Grain intolerance & stress
About 12-18% of the U.S. population suffers from a genetic intolerance to grain. Specifically, a high incidence occurs in Celtic, Germanic, and Nordic derivation. The gut becomes inflamed within 30 minutes after consuming the grains and this can lead to an adrenal stress response, increased cortisol and reduced DHEA.

(Several other functions that go beyond the scope of the pamphlet are also cortisol and DHEA dependent.)

The Adrenal Stress Index™ (ASI™)
Four saliva samples are used in the ASI™ for the following ten tests:

4 x Cortisol - Helps evaluate stress response
2 x Insulin - Helps investigate blood sugar control
DHEA - Helps determine stress adaptation
Secretory IgA - Helps evaluate toll on immunity
17-OH Progesterone -Helps determine adrenal reserve
Gluten Antibodies - Helps identify grain intolerance

Your health care provider can use the findings in this panel to recommend customized treatment and preventive measures that may include diet and lifestyle changes, hormones, botanicals and vitamins.

Advantages of the ASI™

1. The test is non-invasive & can be performed wherever you are.
2. Saliva is collected under real life conditions. There are no stressful blood draws and no gallon sized urine containers to carry around for 24 hours.
3. With blood and urine testing, a number of borderline adrenal conditions are missed due to lack of sensitivity. This is not the case with the ASI™ because samples are taken within one circadian cycle and the more definitive free fraction is measured.
4. The ASI™ is an in-depth test, such that options for treatment are expanded by 400-500% over serum and urine test results.

Note: The ASI™ was invented and introduced by Diagnos-Techs, Inc. in 1989. All other panels offered on the market are copies.

Abnormal adrenal rhythm can influence:

• Energy Production
• Bone Health
• Immune System Health
• Sleep Quality
• Skin Regeneration
• Thyroid Function
• Muscle and Joint Function

Do you need the ASI™ Test?
To determine if the ASI™ is the appropriate test for assessing your health condition, ask your physician for a stress questionnaire. The score can help your doctor determine a course of action.

The ASI™ is mostly ordered for individuals that suffer from:

• Chronic stress and related health problems
• Lack of vitality and energy
• Muscle and joint pain
• Hypoglycemia
• Migraine headaches
• Osteoporosis
• Sleep disturbances
• Poor memory
• Alcohol intolerance
• Stress maladaptation
• Low sex drive
• Low body temperature

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The Female Hormone Panels™ *

The ovaries are a very important part of the female reproductive organs. The ovaries are located on the right and left side of the pelvic cavity next to the uterus. Each weighs about 15 grams. The human female is born with immature ovaries which gradually mature until the start of menstruation signals a fully functional reproductive system.

The Cyclical Pacing of the Ovaries
The human ovary releases its hormones in a cyclical manner which is referred to as the menstrual cycle. The average cycle is about 26-30 days. The timing and pacing of hormone release is governed by GnRH, FSH & LH, hormones from the hypothalamus and pituitary gland in the brain. The two major classes of ovarian hormones released during the menstrual cycle are Estrogens and Progesterone, which are known as female steroid sex hormones. The major and most active Estrogen released is Estradiol, while the major Progestin is Progesterone.

The female cycle has 3 physiologic phases (see Figure 1):

1. The follicular phase starts with the onset of menstrual blood flow and is of variable length. This phase is normally characterized by both low Estrogen and Progesterone output.
2. The ovulation phase is 1 to 3 days long and the human ovum (egg) is released in this phase. This phase is characterized by high estrogen levels.
3. The luteal phase is rather constant in length, 12-14 days, and ends with menses. Compared to the follicular phase, the luteal phase is characterized by high Progesterone concentrations and a moderate increase in Estrogens.

Functions of Female Sex Hormones
Estradiol and Progesterone affect several target organs involved in a successful conception and pregnancy. Additionally, these hormones maintain a number of secondary sexual characteristics such as reduced body hair, soft skin texture, a higher voice pitch, possible release of certain pheromones, etc..

Target Organs of Estrogen & Progesterone

1. The Uterus
Estradiol prepares the uterus for conception and produces a 3-5 fold increase in the thickness of its inner lining, and also promotes uterine gland development and mucus secretion. Progesterone causes a swelling of the uterine lining, an increase in glycogen (a complex sugar) content, and an increase in the mucus secreted by the uterus. If conception does not occur, the uterine lining is shed, resulting in the menstrual flow.
2. Fallopian Tubes
Sex hormones stimulate the fallopian tubes to move the egg toward the uterus. The fallopian tubes also secrete nutritious fluids that nourish the egg, the sperm and ultimately the embryo when fertilization occurs.
3. Vagina
Estrogens promote the thickening of the vaginal lining and increase its secretions, which makes the lining more resistant to infections.
4. Breasts
Before puberty, the breasts grow only in proportion to the rest of the body, but under the influence of Estradiol and Progesterone during puberty, the breasts develop to maturity. During the menstrual cycle, excess Estradiol causes breast swelling and tenderness.
5. Bones
In the adult female, Estradiol and Progesterone play an important role in the inhibition of osteoporosis and improve the incorporation of calcium and magnesium into bone. This is why doctors prescribe Estrogen for menopausal women.
6. Kidney
Estrogens cause the body to retain sodium which results in fluid buildup. Conversely, Progesterone causes a loss of excess sodium and retained fluid. Before the period begins, there may be a relative excess of Estrogen over Progesterone which commonly leads to several of the PMS associated complaints.
7. Liver
Estradiol has stimulatory effects on liver proteins which may reduce thyroid hormone availability and increases the risk for cardiovascular disease. Estradiol also slows the process of liver detoxification of various harmful substances.
8. Miscellaneous
Estradiol can elevate blood sugar in certain susceptible individuals. Progesterone can increase the appetite and has a general calming effect on the nervous system, especially at night.

What We Test
The FHP™ is a simple, non-invasive test. Eleven saliva samples are collected during specified time periods throughout the menstrual cycle.

The FHP,™ for the first time in routine medical practice, will allow both patient and doctor to actually view the profile of Estrogen and Progesterone simultaneously (See Figure 1). Diagnostic guesswork is minimized, and hormonal balance evaluation and customized treatment becomes a reality with the FHP.™

In addition, we report the cycle average for Testosterone and DHEA.

The expanded eFHP™ also includes 5 FSH & LH measurements to see if brain control and stimulation of the ovaries is optimal.

Applications of the Female Hormone Panel™

1. Detection of Luteal Phase Defect
There are at least three luteal phase defect patterns which are characterized by a reduced output of Progesterone that leads to Estrogen dominance. This imbalance is usually associated with PMS, Infertility, fibroids and other female hormonal problems and can be readily detected by our panels.
2. Hormonal Imbalance and PMS
Many women suffer from hormonal imbalance in the Estrogen to Progesterone ratio. Our panels can objectively evaluate the hormonal state with great accuracy which, in turn, provides specific insights for appropriate intervention or treatment to relieve hormonal imbalance and PMS related symptoms.
3. Customized Hormone Therapy
Presently, female hormone therapy is not individualized to the needs of each woman because current diagnostic tests do not provide sufficient data. Consequently, most women are empirically treated without regard to their individualized physiology and specific needs. The FHP,™ for the first time, will allow a clinician to customize therapy to each female patient.

Other Applications - The FHP™ can also be used to detect & monitor the following:

• Functional Infertility
• Influence of lifestyle (diet, exercise, etc.) on the cycle
• Menstrual problems originating in the brain
• Early pregnancy problems - spontaneous miscarriage
• Cycle irregularities, following the use of birth control pills
• Dysmenorrhea, i.e. painful and heavy periods
• Migraine headaches
• Endometriosis and cystic ovarian disease
• Early Osteoporosis

Advantages of the FHP™

1. Convenience: requires no blood draws, therefore no repeated clinic visits and avoids the inconvenience of the 24 hour urine collection.
2. Economy: the fee for the 11 sample test is less than that of 2 blood determinations or a urine analysis for Estrogen and Progesterone.
3. Physiological Accuracy: research has demonstrated that the free hormone fraction predominates in saliva. Hormones can be found free or bound to protein. The free hormone fraction is very important to ascertain because it is the bioactive fraction that most significantly influences living cells. The salivary female hormone levels correlate at 93% with the free hormones in the tissues.
4. One or two blood determinations or a 24 hour analysis of urine for these hormones cannot give an idea of the ovaries' hormonal productivity. The FHP™ gives a good approximation of the ovarian capacity over a whole cycle.

* In a study comparing saliva progesterone values to body temperature records and serum progesterone over three consecutive menstrual cycles in 41 women, the conclusion was: "Basal body temperature records or mid luteal serum progesterone measurements were less satisfactory indices of luteal function than a salivary progesterone profile." Finn.M.M., at al. Gynecol. Endocrinology 3:297-308 (1989)Traditional blood tests are utilized as well.

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The Male Hormone Panel

Traditionally, age-related male hormone changes were not considered problematic because fertility in men persists until an advanced age. In contrast, women undergo ovarian function failure and require multiple hormone replacements. More careful evaluation in males shows progressive age-related changes including:

• Decreased muscle mass & strength
• Decreased vigor, low energy
• Decreased libido
• Insomnia
• Nervousness & Depression
• Hair loss

These changes usually begin in the fourth and fifth decades and point towards hormone imbalances and deficiencies which may be considered the male equivalent of menopause, i.e. the Andropause.

What you can do about male hormone imbalance
Optimal health is dependent on the balance of hormones, and not just a single hormone. Currently, men with low androgen hormones can benefit from hormone replacement therapy. Also, men with imbalances in their androgen to estrogen and progesterone can also be hormone supplemented to achieve balance.

Supplemental hormones can be given by mouth, by injection, by skin patch, or by implant. Androgen supplementation, in states of deficit, improves fitness and produces a feeling of well being, with a reduction in abdominal fat and enhanced lean body mass.

Testosterone production in males is mainly a testicular function. Pituitary sex hormones (FSH & LH) stimulate and regulate this function. Specifically, LH (Luteinizing hormone) stimulates testosterone production in the testicles. This process is under negative feedback, meaning that testosterone levels regulate LH secretion. FSH (Follicle Stimulating Hormone) and testosterone stimulate sperm production.

Why measure male hormones?
Measurements of hormones can be used in two general ways.

1. To estimate the body's own production-baseline test
2. To measure levels of hormones after supplementation-therapeutic
     monitoring

Baseline measurements will show normal and abnormal levels of six distinct hormones shown in boxes (See Diagram 1). If levels are too low, too high or hormone ratios are outside of expected limits, an objective treatment plan can be developed for the individual. Symptoms are not a substitute for measuring hormone levels because many symptoms may involve non-hormonal factors.

Using appropriate tests for monitoring hormone therapy is crucial in establishing the appropriate dosing regimen. This reduces the chance of undesirable side-effects and maximizes beneficial effects. For example, excessive use of androgens (testosterone, androstenedione, DHEA and testosterone derivatives) can activate subclinical prostatic tumors which are androgen-dependent. Monitoring is especially important in older males. By the age of 70, at least 50% of men have subclinical prostate cancer. These are especially susceptible to growth stimulation by androgens.

The roles of the six hormones we test are highlighted below:

DHEA - Is the precursor for both male and female hormones. Also, it is an anti- stress hormone produced by the adrenal glands. Unmonitored intake can easily alter the delicate balance between male to female hormones.

Androstenedione - Is a weak male hormone (androgen) and a precursor of both male & female hormones. Unmonitored intake in men can cause excessive female hormone production with minimal male hormone production. In women, unmonitored intake usually causes excess male hormone production with body & facial hair stimulation.

Testosterone - Is the main testicular androgen and is a precursor to the highly potent dihydrotestosterone male hormone. Excessive amounts of testosterone promote hardening of the blood vessels, aggression, prostate problems and increase in total cholesterol.

Dihydrotestosterone (DHT) - Is made from testosterone in certain tissues. The rate of its production is controlled by the level of free active progesterone. Excess DHT causes prostate enlargement and thinning of scalp hair.

Progesterone - This hormone is important in both sexes. It is a natural calming agent to our nervous system. It also keeps in check excessive DHT production and counterbalances the effects of excessive estrone. Unmonitored intake can lead to breast enlargement, depression and weight gain.

Estrone - Is an estrogen that both sexes produce in the fat cells. The more fat, the more estrone which in turn itself promotes fat deposits. It is produced from androstenedione and excess of estrone can cause breast enlargement and contributes to prostate enlargement. In males, a certain low level of estrone is mandatory to balance the androgens.

What we test & what it tells you
Using your saliva sample, the regular MHP™ panel measures six hormones: DHEA, Androstenedione, Testosterone, Dihy-drotestosterone, Estrone & Progesterone. The eMHP™ panel measures these six hormones plus FSH & LH. The hormone levels in saliva refiect the active tissue concentrations, while blood contains mostly protein bound hormones, whose active levels can only be estimates at best. Urine contains both the active hormones and numerous metabolites and can only be used to gain gross estimate of hormone production over time. Active fraction measurements from saliva are superior to blood and urine total hormone levels in diagnosis and treatment.

This test is for you if you are...

1. Middle aged and having:

o impaired libido
o erectile dysfunction
o baldness and/or extremity hair thinning
o fat accumulation around the waist
o urinary symptoms: pain and/or frequency; urgency; interrupted stream
o change in sleeping habits
o lack of enthusiasm for life
o increase in bad cholesterol, decrease in good cholesterol
o your Dr. tells you that you have osteoporosis

2. Young and having:

 o impaired libido
o erectile dysfunction
o early baldness
o inability to lose weight

How do you benefit?
There are five distinct areas that you will benefit from using the saliva tests:

1. They are affordable and less expensive than blood or urine tests. You save $250 - $300 on six hormones.
2. Collection procedure spares you the biohazards and pain of venipunctures.
3. Results are more clinically reflective of your hormone status and needs.
4. Results can lead to an individualized and customized treatment plan using natural hormones.
5. You will minimize overdosing and underdosing. This will ensure that you use only the proper hormones in the appropriate amounts. With salivary hormone testing, guesswork is minimized.

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The Top 4 Reasons to use Saliva Testing

1. Economy

Salivary tests cost less than similar serum tests
Tests are CPT coded and third party reimbursable (insurance &
Medicare)

2. Convenience

No venipuncture (NO Needles)
No biohazard
Excellent patient compliance/ease of gathering sample
Convenient home collection
Stable specimen

3. Scientific Superiority

Free Fraction determinations reflect clinical condition
Ease of collection allows frequent monitoring

4. Practicality

Quick results and turnaround, within 5 to 7 working days