The long-awaited series on the DUTCH Test, something I’ve been threatening to do for probably about a year now! And so we begin...
As a Women’s Health Specialist, the DUTCH testing range has hands down become on of my favourite tests for clients over the years. I have ran various different types of DUTCH test both on myself and for my 1:1 clients, and it has proved invaluable in helping clients understand what is driving their symptoms to a level you simply wouldn't get with free GP testing (although this is always a good place to start).
So I’ll start by first explaining what exactly the DUTCH test is, what it is used for, different types of DUTCH test, and specific situations in which DUTCH is really powerful in helping to get to the root cause of specific hormone related conditions and symptoms.
Plus, I will be sharing real DUTCH test data (that would be mine!) from two repeat tests I have done to show you it is 100% possible to adjust your hormone levels through natural diet and lifestyle practices, once you know what you're dealing with.
So, let’s dive in!
What exactly is the DUTCH test, and what is it used for?
‘DUTCH’ stands for ‘Dried Urine Test for Comprehensive Hormones’. It is a type of hormone test that measures various hormones and their metabolites (what your hormones break down into after they have done their 'thing') in dried urine samples collected over a 24-hour period. It provides comprehensive insights into hormone levels and their metabolites, offering a more comprehensive view of hormonal balance compared to traditional blood or saliva tests.
The DUTCH test is used to assess hormonal imbalances and provide personalized insights into a wide range of health conditions, including:
1. Hormone Imbalances: It can identify imbalances in key hormones such as cortisol (the 'stress' hormone), oestrogen, progesterone, testosterone, and their metabolites. This information is valuable for diagnosing conditions such as adrenal fatigue, oestrogen dominance, and hormone-related symptoms such as irregular menstrual cycles, mood swings, PMS, PCOS, and low libido.
2. Adrenal Function: By measuring cortisol levels throughout the day, the DUTCH test can evaluate adrenal function and assess your body's stress response. It can detect abnormalities in cortisol patterns, such as elevated or depressed levels, which may indicate adrenal dysfunction or chronic stress.
3. Oestrogen Metabolism: The test provides insights into oestrogen metabolism by measuring oestrogen metabolites. This can help assess the risk of oestrogen-related conditions such as breast cancer, as well as guide personalized treatment strategies for hormone replacement therapy (HRT) or natural hormone balancing.
4. Testosterone and Androgen Metabolism: It can evaluate testosterone levels and androgen metabolism, which are essential for assessing fertility, libido, conditions such as polycystic ovary syndrome (PCOS) and androgen excess (acne, excess hair growth, weight issues).
5. Sleep Disorders: Cortisol and melatonin measurements provide insights into your sleep patterns and circadian rhythm disturbances, helping to identify underlying causes of sleep disorders such as insomnia or disrupted sleep-wake cycles.
6. Menopausal Transition: For women approaching menopause, the DUTCH test can assess hormone levels and provide guidance on hormone replacement therapy (HRT) or natural interventions to alleviate menopausal symptoms and support overall health during this transitional phase.
Types of DUTCH Test
The DUTCH offer a range of tests, each targeted at understanding specific hormone patterns. It is super important to make sure the right DUTCH test based on what it is you want to find out; I have explained below two of the most common DUTCH tests I use in clinic.
DUTCH Complete Sex & Adrenal
The DUTCH Complete Sex & Adrenal is my favourite, and most used, test with clients. It provides a snapshot of your hormones on a single day of your cycle and provides a full breakdown from initial production through to clearance so you can see exactly how much you're making and what how well your body is clearing them at the other end. It tells you:
How much of the key hormones you are producing (the three types of oestrogen, progesterone, testosterone and cortisol)
The metabolites of these hormones – which for me is THE most important aspect of this test. Even if your hormone production is "normal", your hormone metabolites can be imbalanced which is often a driver of symptoms, particularly in the case of oestrogen and testosterone.
Your cortisol and melatonin patterns – hugely helpful in situations where the client is struggling with sleep, feeling wired but burnt out/exhausted, and possibly in a cycle of caffeine/alcohol reliance to manage their day.
It also identifies certain vitamin deficiencies and inflammation markers.
DUTCH Cycle Mapping
The DUTCH Cycle Mapping test is a little more time/effort intensive, but well worth it if you are struggling with fertility challenges, irregular cycles, long/short cycles, PMDD symptoms or severe PMS.
For some women, testing reproductive hormones (progesterone, oestrogen, etc.) on a single day is enough to get the insights we need. In other scenarios, the clinical picture cannot be properly captured without “mapping” out the hormonal pattern throughout their menstrual cycle.
The expected pattern of your hormones over a typical cycle is below:
We expect to see low oestrogen levels early in the cycle, a surge around ovulation and another little rise just after ovulation. Oestrogen levels then slowly drop off during the luteal phase and should be at their lowest whilst you menstruate.
Progesterone levels follow a very different pattern; progesterone levels should be relatively low until you ovulate, after which they rise and peak around 7 days after ovulation. They then drop slowly until menstruation begins.
Any disruption in this rise and fall of these two key sex hormones can lead to fertility challenges, PMS, PCOS and other hormonal imbalances.
This test requires you to take samples throughout a full cycle; so it requires a little more forward planning. This test maps your oestrogen and progesterone throughout an entire cycle, so it is incredibly helpful in understanding if you are over/under producing one of these hormones, or if your hormone peaks are happening earlier/later than a typical cycle, which is in turn is driving your symptoms.
This test can identify issues with ovulation, a short/long luteal phase and help to understand drivers of severe PMS or possible PMDD (pre-menstrual dysphoric disorder).
Tailoring Your DUTCH Test
If you need a combination of different test data, the beauty with DUTCH is that you can customise your test based on what you need. You can do the DUTCH Cycle Mapping and DUTCH Complete together, or you can just test your sex hormones alone if you aren’t interested in the adrenal markers. So you can make sure the data you get with your DUTCH will give you the exact insights you need.
How do I Know if a DUTCH Test Can Help Me?
If you are struggling with any of the following, it could be worth exploring DUTCH testing to understand what could be at the root of your issues:
· You have irregular cycles (cycles that are less than 21 days or longer than 38 days).
· You have abnormally heavy/long periods.
· You are struggling to conceive.
· You have high androgen symptoms (excess hair growth, acne, weight gain).
· You are battling a range of perimenopause symptoms (particularly weight gain/weight loss struggles, migraines, heavy/long periods, anxiety).
· You feel persistently exhausted, depressed or wired.
It is very important to know which DUTCH test is right for you based on your specific health challenges and symptoms. For example, DUTCH Cycle Mapping in perimenopause is less helpful as we expect to see greater fluctuations and unpredictable hormone levels during this time. So before you spend your money, please speak to a healthcare professional who understands DUTCH testing who can help guide you on the best test for you.
How much does a DUTCH Test cost?
DUTCH tests range from £190 to just over £400 – so it is an investment for sure, but in my view an extremely worthy one if you are really struggling with unexplained and persistent symptoms relating to your cycle and your hormones.
A practitioner can guide you to ensure you opt for the most cost-effective test that will provide all the information needed based on your own individual circumstances and goals.
DUTCH Testing in Summary
The DUTCH test range offers a comprehensive and fully personalized approach to hormone testing, and allows me to tailor treatment plans which are super-specific to my client’s needs. It allows me to optimize their hormonal balance over time (and it does take time!) and move them positively towards their main goals.
In the next part of this DUTCH series, we will take a deep-dive into cortisol, looking at optimal cortisol patterns, what cortisol metabolites can show us regarding where you are on the “stress spectrum” and look into specific strategies that can help support a normal, healthy cortisol response. I will also share my own cortisol data taken 18 months apart – even I was shocked at the difference!
If you have any questions about DUTCH testing, and want to explore whether this would be helpful for you, feel free to email me at info@lucypatelnutrition.co.uk or book in for a quick call, and I'll gladly offer my help.