If you are a female and feel like something is “off”, then you are in the right place! Many times women feel like they have tried everything and are doing all the right things for their health and they still feel like something is not right. Whether your goal is weight loss, conceiving a child, working through menopause symptoms, struggling with PCOS, etc. the DUTCH could be your answer.
DUTCH stands for Dried Urine Test for Comprehensive Hormones. This test was created to bring the results of saliva, blood and 24-hour urine testing together to not miss any of the pieces. These other tests are great and I actually like to look at them together if you have already completed them, but there could be missing information. You will have 4 dried urine test strips and done in the comfort of your own home. The individual samples will be measured for “free” cortisol and this is important to look at the HPA-axis for cortisol production. This information is not offered in traditional urine testing. We are measuring the free cortisol throughout the day and combine them to look at the metabolites of estrogens, androgens, progesterone and cortisol. All of these together gives you a very unique and comprehensive look at your hormones.
The DUTCH is used to assess female health in an overall health prospective. Blood work could show hormone levels are in a healthy range, but metabolites are strongly favoring a pathway that could be oxidative or correlated to estrogen dominant cancers for an example. How hormones are moving throughout the body and being metabolized is as important as overall levels.
The DUTCH now offers markers for neurotransmitters (HVA, VMA, 5HIAA), oxidative stress, B6 and B12 deficiency (which is needed for estrogen methylation), and glutathione deficiency.
Below are the different types of tests and when to use them:
DUTCH Complete
This test is the easiest patient collection with just four or five dried urine samples over a 24-hour period. This test offers the most extensive profile of sex and adrenal hormones along with their metabolites (breakdown products of these hormones). Also included is the daily pattern of free cortisol, melatonin and six organic acids. This test is needed to identify symptoms of hormonal imbalance.
This is a great test for women who want a baseline of hormonal health and gives us a picture of any hormonal imbalances.
DUTCH Plus
This test takes hormone testing to a new level. In additional to all of your sex hormones and their metabolites. Metabolites are what we look at for the pathways the hormones are traveling through. The DUTCH Plus adds in the Cortisol Awakening Response (CAR). This is going to show us how our HPA-axis is functioning. This is a complex system of neuroendocrine pathways and feedback loops. This axis controls reactions to stress and helps regulate digestion, mood, sexuality, energy and more. The rise and the fall of the cortisol is what we will be looking at instead of only overall levels.
Measuring the rise and fall of cortisol levels at waking can be used as a “mini stress test”. Even if a patient has “normal” free cortisol levels, that does not mean everything is functioning properly. The Plus Test shows us exact levels throughout our day that the Complete Test does not.
This test is for you if you are experiencing poor sleep, chronic pain and/or fatigue, GI is eases, postpartum depression or general depression, waking migraines and painful joints.
DUTCH Cycle Mapping
The Cycle Mapping Test maps the progesterone and estrogen pattern through the menstrual cycle. This test gives the full picture of a woman’s cycle. Hormone levels will be measured throughout the cycle to characterize the follicular, ovulatory and luteal phases. Single day hormone testing could not properly capture the full picture.
This test is for you if you are struggling with month-long symptoms, infertility, partial hysterectomy, have cycling hormones without regular bleeding, ablations, irregular cycles, migraines, mid-cycle spotting and PCOS.
This test is not for you if you are a postmenopausal women, women on birth control, or women with regular cycle patterns.
DUTCH Cycle Mapping Plus
The Cycle Mapping Plus combines the full picture of a woman’s cycle and adds salivary measurements of the Cortisol Awakening Response (CAR) which is our “mini stress test”. The Plus Test maps the monthly patterns of estrogen and progesterone but also adds the comprehensiveness of all the hormone metabolites with CAR.
This test is for you if you are struggling with month-long symptoms, infertility, partial hysterectomy, have cycling hormones without regular bleeding, ablations, irregular cycles, migraines, mid-cycle spotting and PCOS.
This test is not for you if you are a postmenopausal women, women on birth control, or women with regular cycle patterns.
All of this information can be found on my website under “FUNCTIONAL TESTING” but any further questions please fill out a contact form!
I truly believe that the greatest passion I have as a dietitian is helping women overcome hormone imbalance. Your symptoms are valid and living a hormonally symptom free life is achievable!