Dutch Test 101: All You Need to Know

Are your hormones healthy? Consider taking the DUTCH test to find out…

DUTCH Test 101

The DUTCH test is a hormone test that measures the levels of steroid hormones (sex hormones) and adrenal hormones (cortisol & cortisone) in your body— along with several other markers responsible for hormone balance, brain function, and overall health.  

The DUTCH Test is used primarily to detect hormone health—particularly looking for imbalances, signs of stress (“HPA-Axis Dysfunction” or “adrenal fatigue”) and neurotransmitter function (brain chemicals affected by hormones) in your body.  

DUTCH Test Benefits

DUTCH Test results can help you and your healthcare practitioner further assess your personal hormone balance and the role of stress in your body and total health. 

From PMS and amenorrhea (loss of period), to PCOS, hypothyroidism, metabolic dysfunction, blood sugar imbalances, IBS, constipation, gut “issues,” autoimmune disease, inflammation, chronic infections and more—the DUTCH Test is a great tool for helping you see a clear picture of whether or not your hormones are “in tune” (balanced) and how cortisol levels may be affecting a number of health conditions and symptoms. 

Hormones 101

As a refresher: Hormones are “messengers” in the body that send signals to every organ, cell and tissue about “what to do.”

Think of hormones like the conductor of our body’s musical orchestra—responsible for keeping hundreds of processes and organ “in tune.” 

From emotions and mood, to energy, appetite, digestion, growth, fertility and metabolism, you have more than 50 different hormones that serve as chemical messengers, controlling and coordinating activities throughout your body. 

When our hormones are balanced, our body’s orchestra feels balanced and “in tune.” When our hormones are “imbalanced,” or “off,” then our body’s “musical orchestra” sounds more like a noisy garage band than a classical orchestra. 

Hormone imbalances are often a byproduct of “imbalanced” cortisol (your stress hormone). 

How Cortisol Impacts Hormone Balance

One word: Stress.

Cortisol is a hormone created by your adrenal glands, responsible for your “stress response”—and any hormone imbalances you may experience. 

Cortisol is necessary for helping us fight various stressors throughout our lives—from running a marathon; to popping out of bed at 6 a.m. to get to work early; staying alert and aware when walking down a dark ally at night; dealing with the harsh words of “mean girls” in middle school; and making a public speech. Cortisol keeps us on our toes.

However, while cortisol is a GOOD thing for helping us combat and deal with stress, too much cortisol is NOT a good thing. 

Too much cortisol can send your body’s balance for all other health process into “stressed out mode” 24/7 if not given time to “cool off.”

When we are in a chronic state of stress—both physically and/or mentally—our health takes a hit, often leading to hormone imbalances and/or “HPA Axis Dysfunction” (adrenal fatigue), and a host of other signs and symptoms. 

Hormone Imbalances: Signs & Symptoms

Hormone imbalance is exactly what it sounds like: Hormones that are out of balance—or “out of tune.”

Both high and low cortisol hormone levels, in particular, are associated with a host of hormone imbalances that affect the balance of other parts of your health. Common symptoms of “hormone imbalances” include:

• Feeling wired and tired at night
• Digestive distress (constipation, bloating, IBS)
• Pelvic pain
• Insomnia or difficulty falling asleep
• Afternoon yawning
• Get drowsy easily
• Slow starter in the morning
• Not “feeling like yourself”
• Easily tired (despite sleeping)
• Afternoon headaches
• Easily keyed up or trouble calming down
• Needing caffeine/coffee to function
• Cravings for carbs, sugar or sweets
• Feeling wired or jittery after coffee
• Shortness of breath
• Weakness
• Dizzy upon standing
• Arthritic tendencies
• Environmental or food allergies
• Sweat easily
• Salt foods before tasting/crave salt

• Unexplained anxiousness
• Calm on the outside, troubled on the inside
• Blood pressure above 120/80 OR low blood pressure
• Chronic low back pain, worse with fatigue
• Chronic constipation or bloating
• Difficulty maintaining manipulative corrections (chiropractic)
• Slow metabolism
• Muscle wasting 
• Poor fitness performance/gains
• Blood sugar imbalances
• Hormone imbalances (sex hormones)
• Abnormal body hair growth or hair loss
• Skin conditions (acne, rashes, psoriasis) 
• Low immunity (easily sick)
• Easily forget things/brain fog
• Panic attacks
• Low mood or mood swings
• Feeling weepy for no reason
• High cholesterol markers
• Diagnoses of autoimmune disease
• Thyroid imbalances

 

If more than 3-5 of these symptoms sound familiar, the role of your hormone health may be worth considering. 

Enter: The DUTCH Test—one clinical method for assessing the balance of your hormones. 

How the DUTCH Test Works

The DUTCH Test stands for “Dried Urine Test (for) Comprehensive Hormones.”

The at-home test kit involves taking 4 different samples of urine (“dried urine”) on test strips, along with 4 different samples of saliva swabs. You simply pee on a test strip at 4 specific times throughout the day, and chew on a cotton swab at 4 specific times during the day.

Once collection is complete, you then send the kit off to a lab where it is processed and generates your personal hormone and neurotransmitter report. 

Similar to getting bloodwork completed at your doctor to assess for Vitamin D levels or thyroid function, the DUTCH test is a specific, detailed method to see your hormone balance—on paper. 

DUTCH Test Results

Here are some sample reports from the DUTCH Test. (click HERE)

As you can see, unlike blood tests or many other hormone tests, the DUTCH test covers a wide range of markers including:

• free cortisol
• free cortisone
• cortisol metabolites
• DHEA & DHEA Sulfate
• androgens such as etiocholanolone and androsterone
• melatonin (your sleep hormone)
• sex hormones: progesterone, estrogen, estrogen metabolites, testosterone, and 5α-DHT
• Neurotransmitters: MMA, pyruvate acid, serotonin, norepinephrine, dopamine,, 8-OHdG
• Nutrient markers: glutathione, Vitamin B6, Vitamin B12

In short: The DUTCH test goes deep. 

DUTCH 101: Video

Here’s a short video that gives an overview of the test:

 

DUTCH Test: 4 Key Cortisol Patterns

There are 4 primary cortisol patterns the DUTCH Test results can help you detect:

1. High free cortisol & high metabolized cortisol. (i.e. Cushing’s disease or pseudo-Cushing’s syndrome, high perceived stress, and inflammatory conditions like PCOS, IBD, depression, etc.)
2. Low free cortisol & metabolized cortisol. (i.e. Addison’s, medication-induced adrenal fatigue, trauma, PTSD, chronic fatigue or adrenal fatigue syndrome)
3. Low free cortisol & high total/metabolized cortisol. (i.e. obesity, insulin resistance and other metabolic dysfunction, hyperthyroidism, chronic stress, glucocorticoid use, and chronic fatigue syndrome)
4. High free cortisol & low metabolized cortisol. (hypothyroidism, licorice supplementation, inflammation, some cases: “normal”)

Translation: “Adrenal fatigue” does NOT always mean you have super low—or super high—cortisol.

Additionally, other possible patterns on the DUTCH test include things such as:

• High estrogen or low estrogen—pointing to hormone imbalances (PMS, amenorrhea, menopause symptoms)
• Disrupted circadian rhythm 
• DHEA imbalances—responsible for inflammation 
• High testosterone or low testosterone—linked to conditions like PCOS or low libido 
• Low or high melatonin—explaining sleep disturbances 
• Methylmalonate levels—responsible for B12 sufficiency 
• And more

What this means for you?

No two hormone “imbalances” are necessarily alike!

It’s important to realize that your hormone balance is 100% unique to you and your body. 

TONS of supplements, medications and programs are marketed to people for “Boosting Libido,” “Curing PMS,” or “Adrenal Fatigue”—however these may make things worse (not better) if you don’t understand your hormone’s unique presentation. 

DUTCH Test vs. Blood Test Hormones

Can’t I just check my hormones on my bloodwork from my doctor?

Nope. 

Unlike laboratory blood tests, the DUTCH tests and other 24-hour hormone tests capture a “bigger picture” and the patterns of what your hormones do throughout the day. Hormones are NOT the same at any given point in time—and can be greatly affected by your body’s own circadian rhythms and various stressors throughout the day. 

For instance, if you struggle with getting out of bed every morning—despite sleeping 7-9 hours—your cortisol levels may be pretty low. Then by 11 am, after you’ve had 2-3 cups of coffee, your cortisol levels may be higher. Only to dip again around 3 p.m. when you feel a crash and cravings for a snack or something sweet. Then spike up again by 10 p.m. when you feel “wired and tired” at night. 

Unfortunately, blood tests ONLY capture a stick in time—unless you were to measure your hormone blood levels at several times throughout the day. 

DUTCH Test vs. Other Hormone Tests

Can’t I just do another hormone test—just a saliva test, hair test or urine test? 

While other hormone tests that use the same 24-hour screening period with saliva, hair or urine samples, the DUTCH shines is in 3 key areas that most tests do not:

1. The DUTCH Test differentiates between free cortisol & metabolized cortisol levels. Metabolized cortisol is the form cortisol ACTUALLY processed and used in your body that affects total health (1).
2. The DUTCH Test captures the salivary CAR (cortisol awakening response) (2) first thing in the morning—a key marker that determines your “baseline” cortisol throughout the day
   
3. The DUTCH Test includes other health assessment markers—including organic acids that show neurotransmitters and nutrient markers, as well as an in-depth look at sex hormones and DHEA—NOT just cortisol levels

While no lab test is 100% perfect—just like no supplement or other assessment tool is 100% perfect—the DUTCH Test  is primarily great for identifying overall cortisol and hormone patterns in order to help you better understand what is going on “under the hood” with your hormones. 

Getting a DUTCH Test

Lastly, connect with a practitioner today like Dr. Lauryn to understand your unique hormone and adrenal health profile, and get an action plan for taking your health back into your own hands. 

1. Boonen, E., Vervenne, H., Meersseman, P., Andrew, R., Mortier, L., Declercq, P. E., … Van den Berghe, G. (2013). Reduced Cortisol Metabolism during Critical Illness. The New England Journal of Medicine, 368(16), 1477–1488.

2. Elder et al. 2015. Assessing the daily stability of the cortisol awakening response in a controlled environment. BMC Psychology.

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