Steroid Profile, Saliva (LC-MS/MS)
Code:90331
| Includes | Cortisone Cortisol Androstenedione Dehydroepiandrosterone Testosterone, free Estradiol, free Progesterone, free 17-hydroxyprogesterone |
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Analysis details
Methodology
- Liquid chromatography–tandem mass spectrometry (LC-MS/MS)
Expected Turnaround Time
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Special Instructions
- Avoid caffeine, alcohol, and strenuous exercise for 24 hours before and throughout saliva collection.
- Do not smoke during the 60 minutes prior to collection.
- Rinse the mouth with water and wait 10 minutes before collecting the specimen.
- For 30 minutes before collection, do not eat, brush or floss teeth, use mouthwash, or chew gum.
- Consult the treating clinician about whether to pause sedatives, cortisone acetate, estrogens, oral contraceptives, or topical/systemic glucocorticoids before collection, as these agents may raise cortisol; any medication changes must be directed by the clinician.
How to use
Steroid Profile, Saliva (LC-MS/MS)—also referred to as a salivary steroid hormone profile or salivary sex steroids panel—is used to assess adrenal and gonadal function and the activity of the hypothalamic–pituitary–adrenal and hypothalamic–pituitary–gonadal axes. Clinical applications include evaluation of disordered puberty (precocious or delayed), female reproductive concerns such as menstrual irregularity, abnormal uterine bleeding, infertility, and pregnancy complications, and male presentations including gynecomastia, erectile dysfunction, and infertility. The panel supports monitoring of steroid hormone therapy, hormonal assessment during assisted reproductive technology cycles, and workup of metabolic or water–electrolyte abnormalities when an endocrine etiology is suspected. Measurement of salivary cortisol and cortisone facilitates appraisal of diurnal variation.
Limitations
Steroid hormones, encompassing corticosteroids and gonadal steroids, are synthesized from cholesterol and act via lipid-soluble mechanisms to regulate metabolism, vascular tone, reproductive function, and the stress response. Because biosynthetic pathways are interconnected, diagnostic assessment is often more informative when multiple steroids are measured together rather than a single analyte. This salivary steroid profile quantifies free cortisol and cortisone; androgens (androstenedione, dehydroepiandrosterone, and free testosterone); estrogens (free estradiol); progestogens (free progesterone); and 17-hydroxyprogesterone, providing an integrated view of adrenal and gonadal steroidogenesis. Salivary cortisol and cortisone follow a circadian rhythm that should be incorporated into interpretation. The LC-MS/MS method achieves high analytical specificity through chromatographic separation coupled with mass-selective detection of individual steroids.
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| Indications | Workup of female reproductive concerns, including irregular menses, abnormal uterine bleeding, infertility, or pregnancy complications, Assessment of male reproductive issues such as gynecomastia, erectile dysfunction, or infertility, Evaluation of abnormal pubertal timing, including early onset or delayed progression, Hormone profiling during assisted reproductive technology cycles, Assessment of menopausal vasomotor symptoms accompanied by mood changes, insomnia, or atypical bleeding, Investigation of metabolic or water–electrolyte disturbances when an endocrine cause is considered |
Specimen Requirements
| Specimen | Saliva |
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| Container | Sterile Saliva Collection Tube |
References
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Koal T, Schmiederer D, Pham-Tuan H, Röhring C, Rauh M. Standardized LC-MS/MS based steroid. J Steroid Biochem Mol Biol. 2012 Apr;129(3-5):129-38.
Soldin SJ, Soldin OP. Steroid hormone analysis by tandem mass spectrometry. Clin Chem. 2009 Jun;55(6):1061-6.
Vieira JG, Nakamura OH, Carvalho VM. Determination of cortisol and cortisone in human saliva by a liquid chromatography-tandem mass spectrometry method. Arq Bras Endocrinol Metabol. 2014 Nov;58(8):844-50.
Zhang K, Fent K. Determination of two progestin metabolites (17α-hydroxypregnanolone and pregnanediol) and different classes of steroids (androgens, estrogens, corticosteroids, progestins) in rivers and wastewaters by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Sci Total Environ. 2018 Jan 1;610-611:1164-1172.