The DUTCH test is a comprehensive urine test for sex hormones, adrenal hormones and organic acids. Naturopathic physicians use DUTCH to help create personalized treatment plans to improve hormone health by assessing levels and imbalances.
The DUTCH test also measures cortisol and melatonin, providing insights into the circadian rhythm and stress response. This allows for a more complete picture of the patient’s hormone status and helps formulate the most effective treatment plan possible.
Sex Hormones
Unlike blood testing, which gives you a snapshot of hormone levels at one point in time, the DUTCH test looks at how your hormones are metabolized and processed over a 24 hour period. This allows for a more complete assessment of the entire hormonal picture. DUTCH offers a comprehensive look at sex hormone metabolites including estrogen, progesterone and testosterone as well as cortisol metabolites. It also measures the overall diurnal pattern of free cortisol as well as a variety of nutritional organic acids (OATs) which offer insights into nutritional deficiencies, oxidative stress, gut dysbiosis, melatonin and neuroinflammation.
DUTCH also evaluates the metabolites of a key adrenal hormone called dehydroepiandrosterone or DHEA-S. Low DHEA-S is associated with fatigue, joint pain, depression and weakened immunity. The DUTCH Plus Test additionally measures melatonin, which is important for healthy sleep. DUTCH is an excellent tool for establishing a baseline for patients taking hormone replacement therapy or determining the efficacy of a new compounded hormone regimen.
Adrenal Hormones
Hormones are small molecules that act as messengers and set off a response in another part of the body. They travel through the blood and interstitial fluid, bind to receptors and are either used or excreted in the urine. Problems with hormone production, transportation, use, metabolization or excretion lead to imbalances that are hard to find based on symptoms or standard labs.
The DUTCH test provides a detailed look at the hormonal system in both men and women. It assesses sex hormones, adrenal hormones and their metabolites, as well as organic acids and melatonin. It also measures how the estrogens are metabolized (via 2-hydroxy or 4-hydroxy pathways). This is especially important in cases of estrogen dominance that can cause heavy periods, PMS, fibroids and endometriosis.
The DUTCH Plus adds a daily free cortisol pattern and metabolites as well as a marker of oxidative stress called 8-Hydroxy-2-deoxyguanosine. It is a great option for patients with fatigue who have had a DUTCH panel and have found that their cortisol levels are normal but they still feel tired.
Organic Acids
The DUTCH test measures hormones and their metabolites to bring the whole picture of hormones into focus. It is a valuable tool for practitioners of functional medicine, who seek to identify and treat the root cause rather than just manage symptoms.
The sex hormone results give insight into estrogen dominance, which can manifest as PMS, heavy bleeding, fibroids, and endometriosis. A healthy progesterone metabolism helps bind excess estrogens and clear them from the body, which can help reduce or eliminate these symptoms.
The DUTCH Cycle Mapping analyzes the full range of progesterone and estrogen measurements over nine days of a menstrual cycle to plot out the follicular, ovulatory, and luteal peaks of a woman’s menstrual cycle. This can be a helpful way for practitioners to assess whether a patient’s current treatment plan is working or not. The DUTCH Plus adds a salivary cortisol awakening response measurement to further evaluate the HPA axis, which can provide insights into stress and adrenal function.
Melatonin
The DUTCH test performs a thorough assessment of hormones and their metabolites by collecting urine samples at several times throughout the day, drying them and sending them to a lab for analysis. It offers a more detailed view of the body’s hormonal rhythms than blood or saliva tests, making it an excellent choice for evaluating hormone imbalances and helping to create treatment plans that improve overall health.
The test assesses 35 different sex hormone and adrenal hormone metabolites, as well as six organic acid markers, an oxidative stress marker, and melatonin metabolites. It also measures a daily diurnal pattern of cortisol and includes an insomnia cortisol sample, which is particularly useful for managing adrenal dysfunction and sleep disorders.
The DUTCH test is popular among practitioners of functional medicine, which emphasizes hormone balance as a key component to wellness. It also aligns with the principles of personalized and holistic medicine, which promotes the use of testing to identify root causes rather than simply treating symptoms.
