Ok we know that the medical industry tells us things that are different from what we hear in the fitness industry. Recently I went to my doctor and asked him a few questions regarding my health.
One question was my nails were yellowing on the corners. What vitamin or mineral was i deficient in?
His response was to eat more jell-o because gelatin is great for your nails.
Question two was, i have been experiencing leg pain in my right leg on the lateral side.
His response was its just shin splints. OK first of all I know that shin splints are rarely caused by blunt trauma (I went off a 15 ft cliff while skiing) and two the pain is on the lateral side of my leg, while your shins are on the front.
Question three was I wanted to get my Cortisol tested. I requested to have my saliva tested and he told me that the test was worthless. Saying that the blood is more accurate. Here is what my nutritionist has to say on that one.
The questions was : Just talked to one of my clients who is married to an endocrinologist...she said the saliva tests aren't a good indicator of cortisol. Thoughts?
Here are my thoughts:
- My first recommendation would be for the Endocrinologist to pull studies that he makes recommendations off of and look at the methods in the studies. Saliva hormone testing is becoming more and more the norm. Especially when looking at topical (skin) applications of hormones (which much of hormone replacement is moving toward to reduce liver involvement)
- Second recommendation would be to do a pubmed search on Salivary Cortisol - to see there are close to 4000 references. Some may discredit saliva, but a vast majority will be to support the concept.
Serum levels are not inaccurate, and should be tested, but the saliva testing will show a "bioactive" form (non-coupled) of the hormone in question. This has to do with how the hormone is circulating in the system. In the blood, the hormones arent running around free, like hyper active children, but are carried through with carrier proteins, like children with those leash backpacks (hilarious). The coupled hormone cant get out of the blood and into the target tissue as easily, but the free one can. So, when doing a saliva measurement, it is measuring the free bioactive one and the hormone relationship with the tissue/organ.
Serum will still show levels if the "production" of hormone is off or if there is long term damage, but may not show how they are effecting the target tissue.
Keeping this in mind, saliva would serve as a preventative measurement, since it would show issues before blood would respond. (Meaning its a good predictor is long term issue).
I think this throws into perspective the difference between preventative and disease management. By the time we are looking at issues in the blood, we are closer to disease. The body will make great efforts to maintain balance in the blood. Which means it will create changes in other fluids before they hit the blood.
So I know this is a big stance to take. I understand that we need doctors and that they save lives. But our community needs to recognize fitness professionals as a valuable part of the healthcare continuum. We are the preventative care, the lifestyle change, and the quality of living experts. If you have questions regarding your health, don't just jump to a doctor. Ask a fitness professional or nutritionist for advice, and we will give you a solution, not a pill.
