March 2, 2016
Contamination:
The Good, the Bad and the Ugly

Fresh off the heels of the Academy Awards in Hollywood, let’s have a little fun and set the scene for drama, intrigue, and… exogenous exposure? Contamination of a saliva sample, although relatively rare, can be avoided with patient education, which may have you feeling like Singin' in the Rain again!

Scene 1: It is a day like any other in your practice. Your patient’s hormone results are ready for viewing, and as you open the report, something doesn’t seem quite right. You’ve tested hundreds of patients, yet this test makes the hairs on your neck prickle with horror. “Elevated testosterone – that’s not possible,” you think to yourself.

It is possible to see very elevated hormone levels with salivary testing. When using reasonable supplementation dosages and following proper dosage intervals, these elevations are likely due to The Usual Suspects: contamination and/or exogenous exposure.

Contamination of a saliva sample occurs when the saliva or the collection tube comes into contact with a topical or sublingual hormone supplement. This can happen two ways: through exposure to one’s own supplemented hormones, or to someone else’s supplemented creams or gels. Hormones are prescribed in milligram (mg) dosages, which are noted as 103. The sensitive testing equipment at Labrix is designed to measure salivary hormones, which are in much smaller concentrations. To be specific, the sample is measured in picograms or 1012. If any part of a milligram formula makes its way into the sample, it will corrupt the sample.

Scene 2: A busy, well-lit gym, full of people of all ages. A few women are walking and running on treadmills, while a young man is adjusting a weight machine. Suddenly, the dreaded moment occurs: a man finishes up his workout, and walks out the front door… without wiping down the machine. Oh, the horror!

Unexpected elevations in hormone levels may also be seen with exogenous exposure to hormones. This can be particularly problematic with people who come into contact with ET! (exogenous testosterone) Research has shown virilization in both women and children as a result of exogenous exposure to testosterone gels. Fortunately, symptoms receded when exposure was eliminated.

Cortisone-based medications such as topical cortisone creams will elevate cortisol levels. Similarly, some “anti-aging creams” and cosmetics contain hidden sources of hormones (usually estriol and/or progesterone) which can result in elevated hormone levels.

To prevent this, Labrix recommends the topical hormone user have a designated bathroom and/or towels, separate from other family members. If this is not possible, one should regularly wipe down faucets and surfaces and do a lot of handwashing. (For a full list of Labrix’s contamination-prevention protocol, log onto labrix.com, Healthcare Provider Resources/Practicalities). Research confirms that handwashing after application, as well as applying hormones to areas that can be covered with clothing, helps to prevent exposure. Additional, unexpected exposure points can be shared gym equipment, and hands-on practitioners who may be using hormone creams such as massage therapists, chiropractors and acupuncturists.

Simply put, the best precaution to ensure accurate results is handwashing after applying hormones, and handwashing on the day of testing. Even research supports the need for this act of simple hygiene to prevent spread of topical hormones to oneself and others. The Labrix collection process is so simple, it can be easy to forget! Follow this award-worthy script to ensure your patients collect their samples properly and contamination issues will be Gone with the Wind.

References:
  • De Ronde, Willem. Hyperandrogenism after transfer of topical testosterone gel: case report and review of published and unpublished studies. Human Reproduction, Vol.24, No.2 pp. 425 – 428, 2009.
  • Stahlman, Jodi et al., Effect of application site, clothing barrier, and application site washing on testosterone transfer with a 1.62% testosterone gel. Current Medical Research and Opinion. Volume 28, Issue 2, 2012.
  • Kathriresan, Anupama S.Q., MD, Carr, Bruce R MD, Attia, George R MD. Virilization from partner’s use of topical androgen in a reproductive-aged woman. American Journal of Obstetrics and Gynecology. Volume 205, Issue 3, Pages e3-e4. September 2011.
  • Cavender, Richard MD and Fairall, Melissa MSW, LICSW. Precocious Puberty Secondary to Topical Testosterone Transfer: A Case Report. The Journal of Sexual Medicine. Volume 8, Issue 2, pages 622-626, February 2011.
  • Archer JSM. Estrogen and mood change via CNS activity. Menopausal Med. 1999;7(4):4-8.
  • McKuen BS, Alves BS. Estrogen action in the central nervous system. Endocrin Rev .1999;20:279-307.

Labrix Clinical Spotlight Series:
Menopause: Fatigue, Insomnia, & Weight Gain

Labrix Director of Clinical Services Robyn Kutka ND discusses common symptoms associated with menopause, and outlines an effective and straightforward testing and treatment approach for female patients.




Labrix Core Training

Join the hundreds of practitioners who have attended Labrix live training events and learn more about these exciting opportunities directly from a Labrix attendee and Dr. Jay Mead, Medical Director and co-founder of Labrix.



Labrix
Core Training:
Atlanta
Atlanta, GA
March 5, 2016

Labrix will be conducting the annual Core Training in Atlanta. Registration is $150 and upon completing this one day training, you will receive a $100 credit on your testing account. Register for Atlanta Core Training today.


Labrix
Core Training:
Chicago
Chicago, IL
October 8, 2016

Can't make it to Atlanta? Labrix staff physicians will be in Chicago on October 8th to present Core Training. Registration is $150 and upon completing this one day training, you will receive a $100 credit on your testing account. Register for Chicago Core Training today.

AAEM
Irving, TX
March 31-April 2

Come visit the Labrix booth at the American Academy of Environmental Medicine conference in Irving, Texas, this spring.


SHEICON
Scottsdale, AZ
April 21-24, 2016

Labrix will be in Arizona for the SHEICON conference on April 21-24. Come chat with the our booth representative and learn more about testing with Labrix.


A4M
Hollywood, FL
May 19-21, 2016

Labrix Account Representative Tom Lasota will be exhibiting at the A4M conference in May. Swing by our booth to find out what's new with Labrix in 2016.