Confusing Study Results: Saliva Testing "Adequate" For Free Testosterone, Yet Way Off For Cortisol!?

Many of us spend a fortune on "hormone optimization", but when it comes to actually testing our levels, most of us are pretty cheap: "200$ for labs? No way I rather buy another test booster for that money - won't hurt, I guess!" And even, if we finally decide to test our testosterone levels, we will usually choose the cheapest and most convenient testing method: saliva testing. But is this an adequate way of assessing one's hormonal status? Although these tests have been around forever, nobody appears to be sure how reliable they actually are. A recent study (Caenegem. 2011) from the University Hospital of Ghent, Belgium, attempts to provide answers.

The researchers tested two saliva collection methods, chewing on a cotton swab (Salivette, Sarstedt) and passive drooling on 30 healthy males with a median age of 27 years (range 19–65 years) and compared their findings against serum levels, which were measured on the same occasion. Here are their results:

For cortisol, we observed a mean positive bias of 65% for passive drooling versus Salivette. In addition, cortisol determined on passive drooling samples correlated much worse with calculated free cortisol than cortisol analyzed on the cotton samples (respectively r=0.34 versus r=0.70). However, for testosterone passive drooling correlated well with the calculated free fraction (r=0.66). A positive bias of 21% for testosterone collected by passive drooling versus Salivette was observed. In contrast to earlier reports, we found no artefactually high testosterone results with the cotton-based collection method.

Obviously, these results seem to indicate that saliva testing for testosterone is a good, while saliva testing for cortisol is a bad idea, BUT these results are in fact intrinsically flawed. By just calculating free serum values instead of using equilibrium dialysis to actually measure them, the scientists' control values and with them their assessment of the "appropriateness" and "inappropriateness" of salivary testosterone, respectively cortisol testing are questionable. 

From what I hear from practitioners like Dr Crisler, it is highly advisable to spend the extra cash to have measured (not calculated) serum testosterone levels as reliable baseline and 4x saliva cortisol profiles to see where your levels are at throughout a 24h period. Arguably, this is yet another case in which a questionable study design leads to results which refute common practice and aggravate a confusion around hormonal testing procedures which affects practitioners and patients, alike.

News on USP Labs' "Pink Magic": High Dose Massularia Acuminata Increases Testosterone and Makes Bucks Horny as Hell

Faithful readers of the SuppVersity will probably remember my short write-up on USP Labs Test Booster "Pink Magic". Now that the initial fuss about how "brilliant" and "unique" the product is, is over there is finally another study on the efficiency of its main ingredient, a shrub called massularia acuminata.

Two scientists from Nigeria (Yakubo. 2011) published an article on the "Effect of Aqueous Extract of Massularia acuminata Stem on Sexual Behaviour of Male Wistar Rats" in the January issue of Evidence Based Complementary Alternative Medicine. The scientists found that supplementation with 500 and 1000mg/kg body weight (equivalent to 6.8g and 13.6g) of an aqueous extract of the stem of the botanical...

... increased the frequencies of mount and intromission. In addition, the ejaculation latency was significantly prolonged (P < .05). The latencies of mount and intromission were reduced significantly whereas ejaculation frequency increased. The extract also reduced the postejaculatory interval of the animals. Computed percentages of index of libido, mounted, intromitted, ejaculated and copulatory efficiency were higher in the extract treated animals compared to the distilled water-administered control whereas the intercopulatory interval decreased significantly.

In short: the rats were horny as hell ;-) But there was more to it:

The extract also significantly (P < .05) increased the serum testosterone content of the animals except in those administered with 250mg/kg body weight on days 1 and 3.

In view of these results it is interesting to have a look at the amount of massularia in Pink Magic. Unfortunately, USP provides no data on the amount of the individual ingredients - so, we only know that there is 1.6g of a mixture of massularia and two other botanicals in one serving. Massularia is mentioned first which tells us that it should be the main ingredient. So, let's be generous and assume that there is 1.0g of massularia per serving. USP recommends 3 servings per day. This would amount to 3.0g of massularia, which has now been clinically proven to be insufficient; and what's more even with 6.8g/day (equivalent to 500mg/kg in rats) the increase in testosterone (cf. Table 1) is still almost negligible.

Table 1: Effect of aqueous extract of Massularia acuminata stem on serum testosterone concentrations of male rats. (Yakubo. 2011)

What about all the positive feedback on various message boards, then? Well, we do not know how the dosing protocol used in rats eventually translates to human beings. The above calculation is based on a standard human equivalence dose formula, the accuracy of which is certainly questionable. Thus, the results of the study are actually good news for USP Labs, as they prove that massularia which, by the way is not a USP Labs exclusive anymore, actually works.

Date Palm (Phoenix dactylifera) as a Natural Test Booster and Ergogenic

A very recent study (Saddiq. 2010) published in the Journal of the International Society for Horticultural Science found that the seeds of Phoenix dactylifera can raise testosterone, norepenephrine (NE), dopamine (DA) and GABA levels and may counteract the negative effect of prednisolone administration in rats.

[...] the daily oral administration of pits of date palm caused the maximal increase in NE, DA and GABA content that was found in the brain stem after 2 weeks. The daily oral administration of methylprednisolone caused a decrease in NE, DA and GABA content found in the brain stem after 2 weeks. Moreover, the daily oral administration of pits of date palm and methylprednisolone caused an increase in NE content found in the brain stem after 2 weeks. The daily oral administration of pits of date palm and methylprednisolone caused a significant increase in testosterone level in serum blood of male albino rats.

While all this sounds promising, further studies would have to clarify whether it needs the cortisol-like effects of prednisone for the testosterone-boosting effect of the date seeds to take place or whether taking adequate amounts of pits of date palm would provoke similar (or even superior) increases in testosterone in rats and, most importantly, in men. Be that as it may, even the increase in neurotransmitters (NE, DA, GABA) certainly could provide real-world benefits for athletes, as well as people suffering from fatigue.