Hormone testing

When assessing endocrine function, can saliva sampling provide the same reliability/validity as sampling through blood?

Saliva captures the 'free cortisol'. The rest of the compound is biologically inactive. Perhaps for this reason relying on saliva sampling has been shown to be of more relevance in research, with stronger effect sizes in athletic performance. The same holds for Testosterone. In fact, recent research shows that, compared to total testosterone, free testosterone is more strongly associated with systolic blood pressure across a range of studies (Yang et al., 2019).

For the Cortisol Awakening Response (CAR) what do we mean by "awake"?

To be “awake” means that you are fully conscious, you know who and where you are; you are in a state that is clearly different from when you were sleeping even though you may still feel tired. If you wake up during the middle of the night and plan to go back to sleep, do not begin sampling. Please only begin when you are awake for the final time before you plan to get up for the day.

What if I had a bad night’s sleep before a hormone test day?

It is ok if you struggled falling asleep; it is above all the hours before waking up that concern us. If you had an uneasy wake-up and do not feel you have a clear time point for when you went from “asleep to awake”), it is better to defer the testing to a different day. The questionnaire will ask you to enter information about sleep quality, which will be taken into account when analysing the data. For hormone stress packs, this is not as important as for stress packs, where the cortisol awakening response is of interest.

What if I delay or forget a cortisol sampling?

Cortisol secretion takes a little time to be detectable in saliva and is therefore forgiving if you miss the first sampling in the morning by a few minutes. However, if more than eight minutes pass after you wake up before you give your first sample, please defer to a different day. For sports testing that requires testing of testosterone in function of your workout, if is important that you time sampling in close relation to the workout, since sampling intervals are smaller. If you have performed sampling and then forget the last samples of the test, you will likely have to discard the samples and start over. If this is the case, contact Persometrics and we will ship a new sample kit to you.

Are hormone levels affected by heat after they have been sampled? Do I need to keep the samples cold?

The hormone of interest will keep stable in saliva for up to a week at room temperature. We recommend you put the samples in the fridge (especially during the warm season), until they are shipped (maximum 24 hours later). Full instructions are given inside the pack.

Will a different night/day pattern affect the diurnal cortisol tests?

Our norms are based on an average European adult population with no discrimination of profession, but who in average woke up between 6 and 8 and to fell asleep between 22:00 and midnight. Research has shown that the cortisol awakening response is robust in relation to wake-up time. However, since some people follow different diurnal patterns (due to night shifts or jetlags, for instance) we ask that all samples be taken in relation to wake-up time, including the "afternoon" and "evening" samples.

This means that you can still use the diurnal cortisol kits even if your night/day patterns are a little 'off'.

Full instructions are provided with the test packs.

What if I forgot the saliva sampling procedure this morning and as a consequence started sampling late?

It is important that the first saliva sample provided within the first 8 minutes of waking up. The reason we can allow a few minutes is that it takes time for cortisol to secrete into saliva. Further, we fact that you provide a further 2 (and not just one, as is done by some other labs) gives us some flexibility of the formulae to catch the desired information. However, if you forgot the sampling and it took more than 6-8 minutes we do recommend deferring the testing to a different day.

How do you measure burnout?

Our algorithm combines data from questionnaires and from saliva samples. These two are combined, because neither can be 100% reliable. In short, then, we measure burnout through analying the interaction of hormonal and psychological factors.

How can endocrine hormone testing help physical exercise performance and progress?

A high intensity workout leads to increases in both Testosterone and Cortisol in young to middle-aged men. Testosterone is an anabolic hormone, which increases protein synthesis, whereas cortisol is a catabolic hormone that inhibits protein synthesis. For this reason, researchers have hypothesized, tested and shown that the ration between these two hormones affects performance and adaptations of high intensity workout routines, such as a CrossFit (r) sessions and weight lifting sessions. Our tests can help you optimise your intensity, select the time of day for training, and identify other factors that may inhibit muscle adaption, such as diet.

Persometrics Relative testosterone and cortisol levels surrounding a workout

Can I start the stress test questionnaire over again?

We have removed the possibility to skip backwards to review responses in the questionnaire. This was done both to comply with psychological testing protocol and for security reasons . If for whatever reason you need to void your results and start over, please contact Persometrics so we can reset the questionnaire for you.

What do you mean by intra-individual analysis? Why do you suggest it?

Intra-individual refers to a comparison of two states within the same person. Since everyone is different, and there are often too many factors to control or change, we suggest in our sports kits to do a change before and after an intervention of your own choice. What is best, going low-carb or going high-carb? Vegan or paleo? Perhaps the question is flawed even from the beginning. Do not look for the best diet, but, rather, look for the best diet for you.


Where do you deliver

We currently deliver to Switzerland, Norway, Liechenstein and most of the European Union, reliability of postal service being the main factor here. See map below.

How do you manage to keep delivery costs so low? What's the catch?

We try to keep packaging to a minimum. Smaller packaging not only helps save the environment in line with our "Reduce-Reuse-Recycle-Offset" policy, but also means that delivery costs can be kept down. Please do bear this in mind also when you open your parcel, which may not include as much wrapping as you are used to. It is safe for transport but does not include more paper, carton and plastic than is necessary. Incidentally, we try to reuse plastic when we can too!

What do you do to avoid plastic? What have you done for the environment?

Plastic has become a global problem, and we do everything we can to avoid it. In fact, we even try to reuse plastic protection tubes. Plastic straws are also an issue. We are currently testing whether paper straws can replace plastic without lowering the validity of the test results. This is done in cooperation with Daacro, which in turn is affiliated with the University of Trier, Germany.

Persometrics plastic straws used in hormone sampling

How do you measure burnout?

Our algorithm combines data from questionnaires and from saliva samples. These two are combined, because neither can be 100% reliable. In short, then, we measure burnout through analying the interaction of hormonal and psychological factors.

How do you distinguish PTSD, Adrenal Fatigue Syndrome, Depression and Burnout?

Many behavioural symptoms are the same for PTSD (post-traumatic-stress-disorder), Adrenal Fatigue Syndrome, Depression and Burnout, such as a difficulty getting up in the morning or a lack of motivation in general. However, questionnaires and HPA (hypothalamic-pituitary-adrenal) reactions allows for a better distinction. Such distinctions further helps identify optimal therapeutic decisions to overcome difficulties (the behavioual symptoms).

Where do you get your hormone reference ranges from?

Our hormone references are based on analysed samples from Persometrics' partner laboratory, Daacro. We rely on research obtained from hundreds of labs across the world, but for the purpose of actual norms we use those obtained from our partner laboratory, because minor variation will exist between labs. The samples used to create the norms were obtained from hundreds of participants, or patients in the Trier area. We report both male and female norms when applicable.

Will you still deliver to the UK after brexit?

We are awaiting the outcome of negotiations between the UK and the EU. We aim to continue to deliver to the UK but there will in all likelihood be in increase in our prices.