Saliva testing – advantages and concerns

Saliva testing – advantages and concerns

Created On
Dec 07 2020
Last Updated
Aug 23 2023

In some cases, saliva testing can be a good alternative to blood test. Learn more about the concerns and advantages of using saliva tests.


There are questions whether blood draw is always necessary for a health test.

In some cases, a saliva sample can be a non-invasive and stress free alternative while providing equally high quality results. A cortisol stress hormone test with saliva sample is good example.

Saliva samples provide clear advantages over blood whenever it's possible to test with saliva.

They can be collected at home and sent to the lab without requiring you to visit the clinic or lab. This is especially important for tests requiring multiple samples throughout the day or on a regular basis.

Most children, and a significant adult population, are afraid of venipuncture (i.e., needles). The sudden adrenal spike as a response to the stress of blood collection can interfere with the results. Saliva sample collection is obviously better choice in cases where a blood draw is almost impossible. For example, in athletes during training or among seniors with thin veins, or cases needing multiple sample collections during sleep in the night.

Why saliva testing is not popular?

The main concern regarding a saliva based test is the variation in results, either from the labs or the way samples are collected.

There are possible ways to close these concerns.

Labs that test thousands of human samples, regularly compare their results with their peers, and monitor the trends of their most frequent patients are highly reliable due to close control of the variations. In order to maintain their quality, the labs are required to be CLIA-certified every two years. CDC, in partnership with CMS and FDA monitors the CLIA program and clinical laboratory quality.

Another key sources of variations in results is the time of the day for saliva samples collection. Testosterone levels are highest in the morning and then decline during the day. That’s why one should collect a saliva sample early morning within 30 minutes of waking up, without brushing their teeth, or eating and chewing. See our detailed instructions for sample collection here.

Carefully collecting the samples with strict guidelines can avoid any variations in results.

Credibility of saliva testing

There is credible research published, e.g., by The American Association for Clinical Chemistry, showing that saliva-based tests have proven to be reliable and, in some cases, even superior to other body fluids samples.

Because saliva testing has evolved in last few decades, the old school of blood based testing still tends to keep faith in their old methods. That should not force patients to go through the painful experience of a blood draw, especially for kids and those with fear of needles.

A note of caution

There is a note of caution though. Clinical interpretation of the results is a challenge. The tests are good first step to confirm or overrule the cause of symptoms at a rather inexpensive and expedited way. But a thorough follow up should always be part of the full diagnosis.




Order a 24-hour cortisol test.

More from our health blogs:

All About Cortisol - a brief summary of the stress hormone.

Cortisol: Risk Factors - key facts and the risks related to high cortisol levels.

Five Telltale Signs of High Cortisol Levels - learn about the common signs.

Why Morning Cortisol and its Collection Time are so Important? - learn why morning levels are crucial.

The Most Common Effects of High Cortisol Levels - know what chronic high stress can do to you.

All About Testosterone - a comprehensive review of the male hormone.