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Your hormones and the DUTCH test

Hormones and hormonal imbalance are always hot topics, and with good reason. Your body is constantly being affected by your body’s mini messengers, and if they’re out of whack, you’re probably not feeling on top of your game. Fatigue, insomnia, depression, anxiety, low libido, and irregular menstrual cycles are just a few of the common symptoms of hormone imbalance. They may be symptoms you’ve suffered with for years, or they could have recently started popping up. The simplest way to understand what’s up (or down) with your hormones, is by testing them.

But, first…

What are hormones?

Hormones are chemical messengers that are secreted by specific glands in your body. These glands, called endocrine glands, release hormones into the blood where they travel to their target tissues and organs exerting a specific effect. Hormones are important because they are necessary to our survival! Their effects are systemic, and control essential functions such as heart rate, blood pressure, metabolism, mood, reproduction, growth, appetite, and sleep. Some of these bigger hitters include cortisol, estrogen, progesterone, testosterone, DHEA, and melatonin.

What are symptoms of a hormone imbalance?

Hormonal imbalance can cause a wide range of signs and symptoms depending on which hormones are affected, and in which way the scale is tilted. Some of these include:



-Trouble concentrating




-Memory loss

-Weight gain

-Chronic allergies

-Bone loss

-Irregular periods

-Breast tenderness

-Hot flashes

-Vaginal dryness

-Low libido

-Heart disease risk

-Breast cancer risk

Ok, so some of those symptoms sound familiar… What do I do now?

Insert the DUTCH test.

What is the DUTCH test?

The DUTCH test, or the Dried Urine Test for Comprehensive Hormones, is a simple dried urine test capable of gathering an extensive amount of information on hormones and how they are metabolized in the body. Measuring both hormones and their metabolites can give a better overall picture of hormone production.

The test is compact, concise and user friendly. It is set-up so that patients can take it home and collect samples without disrupting their usual schedule. The kit consists of an envelope containing instructions, a requisition form, and 5 paper strips for sample collection. 4 dried urine samples are collected throughout a 24-hour period:


-2 hours after waking

-Dinner time (~5:00pm)

-Bed time

-Extra overnight sample if needed

After collecting your samples, they are sent into the lab via air mail. Results can take approximately 2-4 weeks to be returned. You will then receive a detailed and straightforward report from the lab. This will include an overview of hormone levels (total estrogens, progesterone, testosterone, total DHEA production, 24-hour free circulating cortisol, and metabolized cortisol). It also includes a breakdown of the hormones and their metabolites, as well as a list of hormones with their normal ranges.

What exactly is tested?

-8 estrogen metabolites (E1, E2, E3, 2-OH- E1, 4-OH-E1, 16-OH-E1, 2-methoxy-E1)

-8 androgens (including Testosterone, DHT and DHEA-S)

-Progesterone (2)

-Cortisol (3)

-Melatonin (6OHMS)


-The diurnal pattern of Free Cortisol and Cortisone are also provided, including the Cortisol Awakening Response.

DUTCH vs. other testing methods

Dried urine testing has become a very sought after form of hormone testing as it is a good reflection of not only hormone levels, but hormone metabolites. Metabolites are the downstream breakdown products of hormones and are excreted in the urine. Some of these metabolites can be harmful, so testing their levels can be useful in determining the root cause of symptoms.

Saliva testing: Useful for testing free cortisol, but does not measure cortisol metabolites. To properly characterize a patient’s cortisol status, free and metabolized cortisol should be measured to avoid misleading results when cortisol clearance is abnormally high or low. Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture for more precise clinical diagnosis.

Serum testing: Adrenal hormones cannot be effectively tested in serum because free cortisol cannot be tested throughout the day. There is also a lack of extensive metabolite testing (especially for cortisol and estrogens).

If you’re interested in the DUTCH test, talk to your naturopathic doctor or visit for more information.

Dr. Michelle Hislop ND


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