Saliva testing

[artfemme]

I continue to have an rT3 problem and my TSH and FREE levels remain low. My PCP has relented and given me a prescription for a 24 hour saliva test even though she has no idea what it is or how to interpret it. My understanding is that results can be sent to me...is that correct ? Does anyone have an opinion on the use of the saliva test for cortisol testing ? Is there a recommended reputable lab that anyone has used ? I live in the Los Angeles CA area.

Thanks for your help.

[Barb135]

Does it say on your Explanation of Benefits, what the lab charged the insurance company?  Mine EOB's always have the charge, the allowance, what insurance paid and what, if anything, I owe.

Thanks for the prices; I've considered doing cortisol and DHEA, since I was low on DHEA a few years ago.  Judging from what my lab charges my insurance company for most things, the prices you posted seem reasonable.

[artfemme]

I don't know what I'll get charged for it or if I'll be able to file a grievance for medical necessity and get it covered, since it's super-low,  I my thyroid is barely functioning right now and I have central hypo and/or conversion issues. I've only received a statement from the insurance co., not a bill. And who knows, it could just be a coding error on my gynecologist's part. When I get charged I'll try to remember to post it here.

As to the other labs, prices have gone up if you want multiple testing.

MyMedLabs charges $165 for :
6X cortisol and 3X DHEA
or
$135 for ZRT :
4X cortisol
1X DHEA

Canary Club charges $179 for :
4X cortisol
1X DHEA
1X testosterone
1X progesterone
1X estradiol
or
$109 for :
4X cortisol

[Barb135]

I've heard of both of those sited, but have not used either.  Hopefully, you will keep us posted on how it goes for you, so we'll have more resources for members.

I'm not surprised that insurance won't cover DHEA.  DHEA naturally declines with age, so insurance companies take that as a "normal" situation. Would you mind sharing the cost of the DHEA through your other lab? I'm just curious what the lab actually charged the insurance company for it.  I'm also curious if the lab will make you pay the same amount they charged the insurance company. Some labs will give you the same price the insurance company would pay, if they were paying for it.

Whatever you order online, would be sent directly to you, not your doctor and your results would also be sent directly to you.  Sometimes, it truly IS advantageous to pay out of pocket for some things.

Will be interesting to see how it all goes for you.

[artfemme]

Thanks Barb.

FYI to the community:
The following 2 sources have been recommended to me elsewhere for the 24 hour saliva test. You can Google them for the URLS :

Canary Club offers a free membership that allows you a discount on labs. They use ZRT Labs, which Barb mentions above. The cost is $109.00 according to my source.

MyMedLab offers the 24 hour saliva test and includes a DHEA test. The both, together, are also $109.00, again according to my source. Interestingly enough, my gynecologist recently tested my DHEA along with a bunch of other testing for inflammation and female hormones and billed my insurance. Just yesterday I got a statement from the insurance co. that they are not going to cover the DHEA test, even though my results came back severely below normal. So that will entail yet another fight with my insurance....had I known, I would have just used MyMedLab.

I will be looking into these 2 resources. Both will apparently mail you your labs directly. Both are reputable. And apparently it doesn't matter that they are not local to me, the return of the samples to them will be fast enough that they don't degrade.

I also learned that it will be necessary to abstain from all adrenal support supplements, steroids of any kind, and benzodiazepam or other tranquilizing substances for 2 weeks prior to testing. The instructions are online at those sites.

[Barb135]

The word "saliva", in itself, was not a clue for me, because we've had members whose doctors have ordered saliva tests; just not the 24 hour test that's generally recommended.  I know that it's a specialized test and not covered by insurance.  Had you asked for online resources, I could have pointed you in the right direction from the beginning; your original post implied that you were looking for something local.

When we have only the written word to go by, it's easy to be misunderstood.

If you haven't checked it out already, I just looked and it appears that healthcheckusa might not offer the 24 hour saliva test; it appears that they only offer blood tests, but I'm still checking into it.  

I have found that ZRT does offer the 24 hour cortisol test for $138.  Looking back through my lab reports, I did use this lab once, as well.

[artfemme]

Good thought, Courtney. I do have a good compounding pharmacist in my neighborhood.

Barb, you're right, it wasn't clear. I get so deep into this stuff that I don't realize that most people don't know that saliva testing is specialized and outside insurance norms. The key word for me was "saliva" but obviously not good enough.

Thanks for the healthcheckusa reference, will investigate.

[courtney48]

That's awful that your doc is retiring.  Good for her, but what a headache!  I can relate as my doctor relocated the same month I received lab results indicating hypothyroidism.  Is she able to refer you to someone?  

As far as saliva testing, which I've not done, I wonder if there is a holistic pharmacist that can help?  Where I live, we have a couple of great pharmacies/pharmacists.  One group does all kinds of hormonal saliva testing and bioidentical hormone stuff.  The other one specializes in tailored vitamin programs.  Anyway, maybe you could look into something like this in your area?

[Barb135]

No, you weren't making yourself clear, at least not to me.

As far as I know, both the sites I mentioned above are good ones and have been used with success by other members, or I wouldn't have mentioned them. I, personally, have used healthcheckusa.

Good luck.

[artfemme]

I guess I'm not being very clear. I KNOW that I'm going to have to order it through an online lab. I know that no insurance will cover it nor will Quest or Lab Corps or hospital labs do it.

I just have no idea which online labs are known to be reputable, or the names of any of them (healthcheck usa ? zrt ? These are good ones ?) and it would seem that since it has to be done by mail, it would be better to not have to send it across the country if there's a good online lab closer to wear I live.

[Barb135]

I know many people have ordered the 24 hr cortisol test from online sites with labs, such as healthcheckusa, zrt, etc....  these labs are not covered by insurance.  

Good luck on finding someone in your area that's had it done at a local lab.

[artfemme]

This is all getting complicated by the fact that my doctor is closing her practice in May and for the first time in over 15 yeas, I have to find a new practitioner.

None of the standard labs do this testing, only specialized labs. I was hoping to get a tip from someone who's done it.

Thanks.

[Barb135]

It may be different for different states, but typically, results can only be sent directly to you, if your doctor authorizes it; for instance when I have my thyroid labs, my endo writes on the lab order "copy pt", which means the lab can send  me a copy; otherwise they would not be able to and I would only be able to get the results from my doctor.

Supposedly, the 24 hour saliva test is best for cortisol; to my knowledge, most blood testing labs don't run those tests.  You'd have to call labs in your area to see which ones do.