The Saliva Hormones and Urinary Hormones tests are restricted to ages 15 and older.
Vibrant’s Saliva Hormones and Urinary Hormones tests were validated in an adult population. Establishing reference intervals for saliva or urine sex hormones in pre-pubertal pediatric patients is challenging primarily due to the natural variability and low levels of these hormones before puberty. Several factors contribute to this difficulty:
- Hormonal Fluctuations: In pre-pubertal children, sex hormone levels are typically very low and can fluctuate significantly, even within a short period. These fluctuations are not as well-defined or consistent as those seen during or after puberty, making it difficult to establish a stable baseline or reference interval.
- Developmental Variability: The onset of puberty and sexual maturation varies widely among children, influenced by genetic, environmental, and nutritional factors. This variability means that the timing and extent of hormonal changes can differ greatly from one child to another, complicating the establishment of uniform reference ranges.
- Tanner Stages of Sexual Maturation: The Tanner stages describe physical development in children, adolescents, and adults. These stages, which range from Tanner stage 1 (pre-pubertal) to Tanner stage 5 (fully mature), are used to assess sexual maturation based on physical characteristics like breast development in girls and genital development in boys. However, the Tanner stages do not directly correlate with specific hormone levels. For example, a child in Tanner stage 1 may have a different baseline hormone level than another child at the same stage, due to individual differences in growth and development.
- Limited Data: There is a relative scarcity of comprehensive studies on sex hormone levels in pre-pubertal children, particularly in diverse populations. The limited data available may not fully represent the range of normal hormonal levels, leading to reference intervals that are not universally applicable or robust.
Due to these factors, creating standardized reference intervals for sex hormones in pre-pubertal pediatric patients is inherently challenging. Instead, healthcare providers often rely on individual patient assessments, clinical context, and comparative growth metrics, such as the Tanner stages, to understand hormonal development in children.