The Most Informative Hormone Test Available
Understanding what your hormones are doing is highly useful information. The challenge lies in accurately measuring your hormone levels and interpreting the test results.
The DUTCH test, which stands for Dried Urine test for Comprehensive Hormones, is innovative in a number of respects. It offers several benefits over older hormone tests – all of which have their drawbacks and limitations.
The DUTCH test is the simplest, most elegant and informative go-test hormone test for anyone considering assessing and regulating their hormone levels.
DUTCH Captures More Information in One Simple Test
One of the biggest problems is that some hormones fluctuate throughout the day. Cortisol, for example, rises as soon as you get out of bed and then declines as the day wears on.
If your levels are low in the morning and high at night, you have a serious problem. But, a 24-hour urine test can’t show you this.
That’s really the advantage of a saliva test, which is done several times over the course of a day. The drawback is the collection method, which can be time consuming and tedious.
The DUTCH test, on the other hand, captures all of that information and more in one simple test. Simply urinate on the filter paper on the collection device and let it dry.
Those test strips are then used to give you a complete hormone panel, including metabolites (which can’t be measured in blood or saliva), effectively replacing multiple testing methods.
Limitations of Standard Hormone Tests
Blood testing falls short when testing adrenal hormones like cortisol, as it can only show you total cortisol. Using DUTCH you can check the free cortisol, which is a better marker.
An additional advantage of the urine test is that it can measure both parent hormones and metabolites. Metabolites can help us understand what the underlying pathology is.
For example, one of the primary metabolites of testosterone is dihydrotestosterone (DHT), which is one of the primary risk factors for prostate cancer.
You want high levels of natural testosterone, but you don’t want to have too much conversion to DHT, so you don’t have excessive amounts of that metabolite.
A blood, urine or saliva test can tell you if you’re making too much testosterone; however if those levels are normal and you’re still experiencing symptoms of high testosterone, such as PCOS (polycystic ovarian syndrome), it suggests testosterone is being metabolized into DHT, resulting in adrogenic facial hair, thinning scalp hair and acne.
In order to evaluate where the testosterone is going we need to check the metabolites.
The diagram below shows an example of the importance of being able to assess metabolites. In this patient we were able to give her supplements to speed up her clearance of estrogen. That’s information we only knew because we were able to look at all the metabolites – the whole family of estrogen (not just total estrogen) – to get a more precise picture of exactly what’s going on.
Patient Case Study: Depression From Sluggish Clearance of Cortisol
Let’s take a particular example of someone who struggled with depression and anxiety. We tested her cortisol levels.
What did we find?
Her free cortisol levels were high. We know there’s more depression in people who have elevated free cortisol.
Then we looked downstream at her metabolites and noticed that they’re actually low.
So the reason for the high cortisol is largely because she had sluggish clearance of free cortisol. She’s making cortisol, but not getting rid of it. The liver is not processing it properly to get rid of the cortisol so the free cortisol is high.
It’s not because her adrenals are pumping out too much cortisol. In fact, they weren’t pumping out that much at all.
And that specific pattern can happen when your thyroid is low. So we needed to support her thyroid… which led to a response on the cortisol side.
With an older test we may have incorrectly chased that high cortisol and given her something to lower her adrenal output. But that’s wasn’t her issue. Her issue was more nuanced and complex.
That’s the value in using the DUTCH test – we look at all three dimensions of the cortisol, we get the full picture.