Understanding the DUTCH test – why it is useful?

You might have heard of the DUTCH (dried urine test for comprehensive hormones) test, or a healthcare professional might have suggested it. Still, maybe you are not familiar with why it is a fantastic diagnostic tool and worth the hype.

It is one of my favourite functional tests as it provides an in-depth look at hormone levels (sex hormones, adrenal hormones, melatonin and nutritional markers), offering guidance for highly personalised therapeutic plans. I suggest this test to patients suffering from hormonal imbalances, suspected PCOS, irregular menstrual cycles, sleep disturbances, mood swings and high levels of stress to understand the root cause of it.

What is the DUTCH test, and why is it different from a hormone blood test?

The DUTCH test is a dried urine test using samples taken over a 24-hour period to evaluate hormonal fluctuations over the day. This differs from a blood sample, giving insights into hormonal levels only at the specific time the sample was taken.

The DUTCH is specifically designed to assess sex hormones (androgens, estrogen metabolites and progesterone) levels, cortisol and cortisone patterns, melatonin and specific neurotransmitter metabolites. It also offers much more in-depth analysis of sex hormones than the average blood test, as it addresses not just testosterone, estrogen and progesterone but all their metabolites and pathways.

How does the DUTCH test work?

It is a straightforward test to perform, as it is a dried urine test. The patient is required to collect four urine samples at a specific time of the day (upon waking, before lunch, before dinner and before bed). Those samples are then taken to specially designed paper strips provided with the test and dried to be shipped to the lab.

The samples should be taken on day 21 (mid-luteal phase, 5/7 days after ovulation) of your period if you are a menstruating woman with an average 28-day cycle. If your period is irregular, it could be useful to use an ovulation stick to understand when you are ovulating and plan the sample collection for 5/7 days after. Menopausal women and men (yes, the DUTCH is helpful for men too!) can take their sample anytime.

What can you learn from the DUTCH test?

Being such a comprehensive diagnostic tool, you can learn many insights from this test; that’s why it is a practitioner’s favourite!

Hormonal health

The DUTCH can shed light on hormonal irregularities and imbalances, as well as show which stage of your perimenopause and menopause journey you are at. It can help identify PCOS if you ovulate during your cycle, which estrogenic pathway you prefer and how you detoxify hormones.

Understanding hormonal levels can also help to address PMS and irregular cycles. In men, it can be helpful to assess andropause (similarly to women's menopause, men experience a hormonal decline during mid-life) and hormonal unbalances, such as the excessive transformation of testosterone into estrogen.

Stress and cortisol/cortisone patterns

Understanding fluctuating levels of stress hormones and overall DHEA levels can give an excellent indication of stress and how it affects the individual. Cortisone and its relation with cortisol can indicate if the stress is chronic or acute and help the practitioner provide adequate lifestyle, supplementation and dietary changes to support the individual. Understanding and addressing melatonin, the sleep hormone, production can also help in stress management.

Mood swings and fatigue

Joining the dots between hormonal fluctuations and cortisol day patterns can help understand the root cause of mood swings and fatigue. The DUTCH test also includes an analysis of organic acids, which shines light on neurotransmitter metabolites which can contribute to low mood, fatigue, and energy crashes.

The DUTCH is far more than just a hormone test! It is a favourite of mine as it provides the data to create highly personalised plans fully to support my patient's health. While you can order it privately, it is always better to order this test via a practitioner who will be able to provide a comprehensive test interpretation and a personalised plan to address the test findings.