Q.  Hello! I love your website and refer to it for great guidance with supplements. Recently I read your page on progesterone with great interest. What is your opinion on blood vs. saliva testing for progesterone levels? I ask because my saliva test showed high progesterone levels and my blood test showed low normal range. Which in your opinion is more accurate? I do not have any symptoms of high progesterone, quite the opposite. When taken off progesterone for 5 months I had severe insomnia, anxiety, depression, etc. just as I did prior to starting the hormone. I am perimenopausal.

A.   I think hormone level testing, either by blood or saliva, is overdone and often unnecessary. Plus, different labs can give different results and there is no guarantee that the laboratory where it is being done will give accurate results. There can be discrepancies between saliva and blood testing and often blood testing is more accurate but not always. Even if the results are consistent, different doctors will use the same results to recommend different dosages. I prefer to base hormone usage and dosage on symptom relief and to use the lowest amount and the least frequency that works for the patient rather than trying to seek an optimal blood or saliva test level.