Assessing Hormone Levels with the DUTCH Test

The DUTCH Test, or the Dried Urine Test for Comprehensive Hormones, is a helpful tool to assess hormone levels in the body. The DUTCH Test assesses adrenal hormones, such as cortisol, as well as sex hormones and organic acids. Assessing these different hormones and their metabolites gives insight into hormone production as well as hormone utilization or breakdown. We use this investigative tool to help guide targeted nutrition and lifestyle strategies for the best management and treatment for hormone-related conditions. 

What is Tested?

Adrenal Hormones on the DUTCH Test

Source: News-Medical

The adrenal glands are located just above the kidneys and are responsible for hormones like: stress hormones and partially for androgen hormones like testosterone. The DUTCH Test measures cortisol production, the daily free cortisol pattern, and cortisol metabolites. These measures reflect the health of our HPA (hypothalamic-pituitary-adrenal) axis. The HPA axis is the body’s main stress response system. Along this axis, chemical signals (aka hormones) are sent from the brain and pituitary gland to our adrenal glands, triggering the release of other hormones, such as cortisol. Cortisol is our primary stress hormone that also plays a role in female sex hormones and thyroid hormone balance. It helps to regulate the sleep cycle and the body’s metabolism of sugar. Because cortisol fluctuates throughout the day with our circadian rhythm, it is beneficial to see the daily free cortisol pattern provided by the DUTCH Test. The pattern of cortisol’s rise and fall throughout the day gives insight into how we can best support the adrenal glands, and symptoms of chronic stress. This is reflected in the diurnal cortisol profile as shown below. 

Source: British Psychological Society

The adrenal glands are also responsible for other hormones like testosterone, DHEA and androstenedione (see image below). Understanding the levels of these hormones is important in treating symptoms like: acne, hirsutism (male pattern hair growth), hair loss, abdominal weight gain. Nutritional support for the adrenal glands differs depending on whether someone has high or low levels of cortisol. In the case of high cortisol, we may implement a variety of cortisol lowering foods and/or supplements. Adaptogenic herbs, such as ashwagandha and maca, are a class of supplements that can help regulate stress and adrenal cortisol levels. Stress management practices also play an important role in supporting the adrenal glands. Many of our clients experience improvements in symptoms such as fatigue, poor sleep, low mood, and even skin issues from simply making nutrition and lifestyle adjustments as it relates to their individual cortisol pattern.

Overview of Where Androgens are Made:

Source: Dutch Test

Sex Hormones and Estrogen Metabolism on the DUTCH Test

The DUTCH Test also assesses reproductive hormones such as estrogens, androgens, progesterone, and their metabolites. Testing reproductive hormones can be beneficial for those experiencing symptoms of hormonal imbalance. These symptoms may include acne, irregular menstrual cycles, PMS, painful periods, fibroids, endometriosis, mood changes, breast tenderness, sleep challenges, and more. This testing can also help determine the main drivers of conditions such as PCOS, from which we can determine the most appropriate nutrition treatment plan.

There are three forms of estrogen in the body: estrone (E1), estradiol (E2), and estriol (E3). All three forms of estrogen are measured by the DUTCH Test, as well as their phase 1 and phase 2 metabolites. The rate of estrogen metabolism, as well as the respective metabolite ratios, can help elucidate potential estrogen-driven cancer risk, and inform best practices from a nutrition perspective. This information also illustrates activity in the liver. The liver is responsible for detoxifying, or breaking down, hormones as well as toxins for them to be eliminated by the body. We can support liver health through nutrition by the incorporation of bitter foods, green tea, and more. The liver can also be supported through lifestyle changes and supplementation.

Organic Acids on the DUTCH Test

Organic acids are also assessed by the DUTCH Test. Organic acids are byproducts of metabolism, or the breakdown of nutrients in the body. The organic acids assessed by the DUTCH Test are helpful markers of nutritional status, inflammation, gut dysbiosis, and oxidative stress. Markers of B vitamin status point to suboptimal levels or deficiency. An imbalance in the gut microbiome (known as gut dysbiosis) and protein malabsorption are two main causes that can affect vitamin B status and are directly influenced by nutrition. Pyroglutamate is a marker of glutathione status, the major antioxidant utilized by the liver for everyday detoxification. By testing organic acids, we are able to dive deeper in understanding potential nutrient deficiencies and underlying causes of symptoms related to digestion, metabolism, gut microbiome balance, energy levels, and more. 

Who is the DUTCH Test for?

The DUTCH Test can serve as a helpful investigative tool for both men and women of all ages suffering from a wide variety of hormone-related challenges. We work especially with women who are experiencing…

• Hormone-related symptoms, including those whose hormones may come back “normal” on a blood test
• Thyroid conditions, for example hypothyroid or Hashimoto’s
• Irregular or absent menstrual cycles after discontinuing hormonal birth control
• Symptoms of peri-menopausal hormone fluctuations
• Frustrating symptoms such as chronic fatigue, sleep challenges, weight gain, weight loss resistance, PCOS, fertility challenges, mood changes, brain fog, premenstrual dysphoric disorder (PMDD)

At Functional Fueling, it is our mission to uncover your root causes and provide personalized, evidence-based solutions for hormonal imbalances. The DUTCH Test is a helpful investigative tool and just one piece of the puzzle. By utilizing advanced functional testing like the DUTCH Test, and designing an individualized treatment plan, our goal is to support you in achieving vibrant health. Learn more about our personalized program that includes testing like the DUTCH test here.