Dutch Hormone Test -Everything You Need to Know

In my work with women’s health and hormones, one of the biggest areas of debate is hormone testing. Women are confused about when and how to test their hormones, and if I’m honest, a lot of doctors are confused as well. Which is leaving women underdiagnosed and under-treated for their very real (and very annoying) hormone imbalances.

But no more. Science has come a long way and right now we have the ability to test for hormones in ways that we never have been able to before. And women everywhere can benefit. So if you’ve ever wondered, “Do I have a hormone imbalance?”, now we can easily answer that question.

THE DUTCH HORMONE TEST

DUTCH is an acronym that stands for Dried Urine Test for Comprehensive Hormones. It is a simple, but sophisticated test that looks not just at your hormones, but how your body processes and metabolizes them.

The DUTCH test looks not just at your reproductive hormones (although it does look at those quite thoroughly), but it also looks at your stress hormones, your androgens (male pattern hormones), your melatonin and the new Dutch HormoneTest also looks at organic acids – markers for mood and nutritional balance in the body.

WHY DRIED URINE VERSUS BLOOD? ⠀

DRIED URINE:⠀
• gives the diurnal rhythm of cortisol/total production (necessary for a full picture of adrenal health)⠀

• easy to collect, no needles/blood draw⠀

• shows metabolites of hormones

• gives you a full overview of your hormones

BLOOD:⠀
• requires blood draw/needles and can cause stress for some ⠀

• doesn’t show the pattern of cortisol/total cortisol

•doesn’t show hormone metabolites ⠀
*not saying blood labs aren’t beneficial in fact I use both with my clients especially to look at thyroid health, iron, B12 etc.

WHAT DUTCH COMPLETE HORMONE TEST ACTUALLY TESTS?⠀

• Sex hormones (estrogen, progesterone, testosterone)

• Progesterone metabolites (a-pregnanediol, b-pregnanediol)

• Androgens (DHEA-S, etiocholanolone, androsterone, testosterone, 5a-DHT, 5a-androstanediol, 5b-androstanediol, epi-testosterone)

• Adrenal hormones (DHEA, free cortisol, metabolized cortisol, cortisone, melatonin)⠀

• Breaks down of estrogen metabolites (2-OH, protective; 4-OH, more carcinogenic; 16-OH, proliferative/can make tumors/cysts grow)⠀

• Assesses methylation (phase 2 detox, if you have poor methylation, 4-OH can bind to and damage DNA)⠀

• Nutritional organic acids (B12, B6, glutathione)

8 REASONS THE DUTCH TEST IS THE GOLD STANDARD FOR HORMONE TESTING

SIMPLE COLLECTION

Nothing is easier than peeing on a piece of filter paper. (Ok… some people might get a little pee on themselves, but still… is that the worst thing that can happen to you today?)

IN-DEPTH HORMONE LEVELS

If you have a question about your hormones, the answer is likely to be found in Dutch Hormone Test. While your Naturopathic Doctor may still recommend blood testing for hormones like thyroid hormone, FSH or LH, just about every other hormone is covered in the DUTCH test.

METABOLISM MATTERS

Hands down, the reason the DUTCH test is the best, is that it measures metabolites. The absolute level of your hormones matters – but what can matter more is what your body does with those hormones. This is metabolism – does your body turn testosterone into nasty acne-promoting 5a-DHT?? Does your body turn estradiol into DNA damaging 4-OH estrone? Are you healthfully metabolizing and eliminating estrogen from your body? The DUTCH test can tell you.

IT’S ALL ABOUT THOSE CURVES

Not every hormone has stable levels over the entire day. In particular, our primary stress hormone, cortisol, and its metabolite cortisone have a curve that changes over the course of the day. Blood tests only give us a single snapshot of your cortisol levels, but the dried urine test gives us not only the total levels of cortisol and cortisone but also the curve – how those levels change over the day. This is some VALUABLE information for people who are struggling with stress, fatigue, anxiety, decreased libido, trouble sleeping, and insomnia.

BALANCED ESTROGEN

Estrogen is one of the most important hormones in our bodies, and it has so many benefits for our health, but it can also have negative impacts if it is not in balance.

Typical hormone testing for estrogen looks just at estradiol, the dominant estrogen in the body. But that only tells us such a small bit of information. If we want to balance our estrogen, and prevent complications of estrogen dominance, then we want to understand how our body copes with our burden of estrogen. What metabolism pathways does our body use? Are those the best pathways?

If you are considering bioidentical hormones (BHRT) for perimenopause or menopause symptoms, then the DUTCH test is highly recommended at the initial visit to understand how you will metabolize the hormones.

ANDROGENS AND ACNE AND HAIR HEALTH

In my work with women, no one condition is more loathed or baffling than acne. WTF, am I right ladies? How did we reach our 30s and still have to deal with acne?? Often it’s an issue of androgen metabolism. But typical hormone testing just looks at the amount of testosterone being made, and not what your body is doing with it. If your body is sending more testosterone towards the DHT metabolites, you will have more acne and possibly hair loss (and chin/ upper lip hair growth!) The DUTCH test will tell you if this is happening – and then we can talk about what to do about it!

MELATONIN

If you are having difficulty sleeping, knowing your melatonin levels is amazing information to have. But not only those with insomnia or sleep challenges should know their melatonin levels. Melatonin is also a powerful antioxidant in our bodies, and optimal levels of melatonin have been found to reduce the incidence of hormonal cancers (including breast cancer). No other hormone test looks at melatonin, but the DUTCH test does.

ORGANIC ACIDS

A new addition in 2018 to the DUTCH test is the 6 OAT (organic acid tests). I’m so excited for this new information!

Three new markers for neurotransmitters – to help us understand your mood. If you struggle with depression, anxiety or insomnia, this information can be very significant. If you have tried antidepressants without benefit, your organic acid markers for specific neurotransmitters, like serotonin, may tell you why.

Additionally, there are three new markers for nutritional levels – looking at your B6 and B12 metabolism as well as your glutathione status. If you are concerned about weight gain or inflammation as part of your hormone imbalance, now we may be able to identify why.

LOOKING TO GET DUTCH TESTING DONE

If you are interested in one-on-one support and testing you can learn more here. It is an amazing, useful, sophisticated test. But it’s not the right test for everyone. So let’s talk and see if it is the right test for you.

Ashleigh Norris, CNP, NNCP

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