Understanding the Secrets of Your Hormonal Blueprint
- Jul 27
- 5 min read
Updated: Jul 29
Labs That Listen Part 1 of 3 - A Deep Dive into the DUTCH Plus Test
Are you feeling out of balance, struggling with fatigue, mood swings, or stubborn weight changes? Your hormones might be trying to tell you something. In the world of functional medicine, the DUTCH Plus test stands out as a comprehensive tool for gaining a detailed understanding of your hormonal health. But what exactly is it, and how can it help you on your health journey?
What is the DUTCH Plus Test?
The DUTCH Plus (Dried Urine Test for Comprehensive Hormones) is an advanced hormone test that uses dried urine and saliva samples to provide a complete picture of your hormone levels and their metabolism. It's designed to go beyond basic hormone measurements, offering insights into how your body produces, processes, and eliminates hormones. This test is particularly favoured by practitioners for its ability to combine several key aspects of hormone assessment that other single tests might miss.
What Does the DUTCH Plus Measure?
The DUTCH Plus is incredibly comprehensive, assessing a wide range of markers crucial for understanding your endocrine system. Here’s a breakdown of what it covers:
Sex Hormones and Their Metabolites:
Description |
It measures estrone (E1), estradiol (E2), and estriol (E3), as well as their breakdown products, which indicate how your body is detoxifying estrogen. |
For women, it provides progesterone metabolites (alpha-pregnanediol and beta-pregnanediol). |
For both men and women, it assesses androgens like DHEA-S and testosterone, along with their metabolites such as androsterone and etiocholanolone. |
These androgen metabolites can indicate if you have a "5-alpha preference," which is linked to symptoms like hair loss and cystic acne. |
Cortisol and Cortisone Metabolites:
The test provides a detailed look at your adrenal function, measuring both free (active) cortisol and cortisone throughout the day, as well as their total metabolized levels. This helps to understand your overall cortisol production and how efficiently your body is clearing it.
Cortisol Awakening Response (CAR):
This is a unique and critical component of the DUTCH Plus. It measures the sharp increase in cortisol levels that naturally occurs within 60 minutes of waking. The CAR acts as a "mini stress test" and provides valuable information about HPA axis (hypothalamic-pituitary-adrenal axis) function, even if daily free cortisol levels appear normal. A blunted or exaggerated CAR can indicate underlying issues like psychological burnout, chronic fatigue, or ongoing stress
Melatonin:
The DUTCH Plus measures 6-OH-melatonin sulfate, the main urinary metabolite of melatonin, providing insight into your natural melatonin production. This is crucial for evaluating sleep patterns and circadian rhythm.
Organic Acids:
While not a full organic acid test, DUTCH Plus includes several key organic acid markers that relate to hormone function, nutrient deficiencies, and oxidative stress. These include markers for; B12, B6, glutathione and Oxidative stress (8-OHdG). It also includes markers related to neurotransmitters like dopamine and norepinephrine & gut dysbiosis markers.
Why DUTCH Plus?
The DUTCH Plus offers several advantages over traditional blood or single-sample saliva tests:
Comprehensive Insight:
Unlike blood tests that often provide only basic hormone levels, DUTCH Plus gives you detailed information on hormone metabolites and how they are processed. This is vital because high total cortisol in blood might not tell you if it's bioavailable or being cleared properly.
Adrenal Function Beyond "Fatigue":
It moves beyond the outdated concept of "adrenal fatigue" to instead assess HPA axis dysfunction. It helps differentiate between patterns of high cortisol, low cortisol, or issues with cortisol metabolism (clearance), which are influenced by factors like thyroid function, inflammation, and body composition.
Cortisol Awakening Response (CAR):
This unique feature provides an early indicator of stress response and HPA axis resilience that other tests may miss, even when daily cortisol levels appear "normal". A healthy CAR is essential for daytime energy, recall memory, and even has implications for autoimmune risk and mortality in certain cancers.
Convenient Collection:
As a dried urine test, it's generally easier for patients to collect samples at home multiple times throughout the day, without the need for blood draws.
Actionable Data:
The detailed insights allow practitioners to create highly personalized treatment plans, addressing root causes rather than just symptoms. For example, understanding estrogen metabolism can guide specific nutritional or supplemental support to promote healthier detoxification pathways.
Collecting Your DUTCH Plus Sample: What You Need to Know
Cycling women should collect samples 5–7 days post-ovulation, typically days 19–21 of a 28-day cycle. Irregular cycles may require a DUTCH Cycle Mapping test. Post-menopausal women and men can collect samples any day.
Practitioners analyse DUTCH Plus reports for patterns and correlations.
Condition | Description | Symptoms | Potential Support |
|---|---|---|---|
Oestrogen Dominance | High oestrogen relative to progesterone | PMS, heavy periods, anxiety | Support detox pathways with DIM or sulforaphane (e.g., "bad" 4-hydroxy vs. "good" 2-hydroxy) |
Progesterone Insufficiency | Low progesterone, often linked to perimenopause or stress | Anxiety, poor sleep, severe PMS | Address calming brain effects with targeted support |
Androgen Imbalances: | High androgens and 5-alpha reductase | Cystic acne, hair loss, and hirsutism, often linked to PCOS, inflammation, or high insulin. |
Cortisol Patterns | |
|---|---|
Description | Implications |
High Free & Metabolized Cortisol | Indicates high overall cortisol production, often seen in acute stress or inflammation. |
Low Free & Metabolized Cortisol | Suggests low cortisol production, often a result of chronic stress leading to HPA axis downregulation. |
High Free Cortisol & Low Metabolized Cortisol | Points to sluggish cortisol clearance by the liver, commonly associated with hypothyroidism or poor liver function. |
Low Free Cortisol & High Metabolized Cortisol | Means the body is making and clearing cortisol very rapidly, often seen in obesity or hyperthyroidism. |
Comprehensive Insights | |
|---|---|
Insight Category | Description |
CAR Insights | Low CAR signals chronic stress and burnout; high CAR indicates anticipatory stress or glycaemic issues. Address stress, sleep, and brain health. |
Melatonin Levels | Low melatonin may stem from insufficient darkness exposure, caffeine, or nutrient deficiencies. |
Organic Acid Markers | High methylmalonate suggests adenosyl B12 needs; pyroglutamate signals potential glutathione issues. |
Is DUTCH Plus Right for You?
The DUTCH Plus is an invaluable tool for anyone experiencing symptoms related to hormonal imbalance, chronic stress, or unexplained fatigue, particularly those who haven't found answers with conventional testing. It provides a blueprint of your unique hormonal landscape, allowing for precision in diagnosis and treatment.
However, it's crucial to remember that a test is only as good as its interpretation. Working with a qualified functional medicine practitioner is key to translating these complex results into an actionable plan that addresses your unique needs and lifestyle. They will help you understand the "why" behind your symptoms and guide you toward personalized interventions, whether through diet, lifestyle modifications, or targeted supplementation.
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All Functional Medicine Tests include a 45 min consultation with Jenny Hague to explain your results and a suggested way foreword.
Disclaimer: This blog post
does not constitute medical advice. Please consult with a qualified healthcare professional for personalized guidance on hormone testing and health management.
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