DUTCH: Comprehensive hormone testing

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 under-diagnosed and under-treated for their very real (and very annoying) hormone imbalances.

The DUTCH 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 also looks at organic acids – markers for mood and nutritional balance in the body.

Why we may recommend the dutch test

1. 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?)

2. In depth hormone levels

If you have a question about your hormones, the answer is likely to be found in the DUTCH test. While your Naturopathic Doctor may still recommend blood testing for hormones like thyroid hormone, FSH or LH, the DUTCH test gives us a thorough assessment of ovarian and adrenal hormones.

3. Metabolism matters

The most likely reason I will recommend the DUTCH test, is that it measures metabolites. The absolute level of your hormones matter – 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.

4. 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, has 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.

5. 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.

6. Androgens, 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!

7. 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.

8. Organic acids

Organic acids are included in the DUTCH Complete test to give us a more complete understanding of your hormones, and the factors that influence them.

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.   As well as markers for inflammation, and neurotransmitters for nervous system health and assessment.  These tests round out the valuable information that can be gained from the DUTCH.

The 1 Reason I don’t love DUTCH Testing

1. The test results are ugly

I know. Such an aesthetic issue. But the test results are ugly – seriously. The results are clear. The information is valuable. But the results look a lot like an airplane dashboard, and some patients find this overwhelming. So take the time to talk through the results with your ND to understand what they mean for you.

Next Steps

If you are interested in DUTCH testing, I suggest booking a 10 minute complimentary meet and greet to discuss the details. 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.

~ Dr. Lisa

Further Reading

https://dutchtest.com

https://articles.mercola.com/sites/articles/archive/2016/05/08/dutch-hormone-test.aspx