Understanding Hormones and Health
Hormones are essential messengers that regulate nearly every physiological function, from metabolism and growth to immunity and mood. Optimal hormone levels enable proper function of the endocrine system, while imbalances can lead to a wide range of health issues affecting energy, mood, weight, and overall well-being.
What Is the DUTCH Plus Test?
The DUTCH Plus test is an advanced hormone assessment using both dried urine and saliva samples to measure the body's key sex and adrenal hormones along with their metabolites. By including the cortisol awakening response (CAR) in saliva, DUTCH Plus captures a more dynamic picture of daily hormonal changes, providing a clear view of diurnal free cortisol and cortisone levels and their metabolites.
The test also incorporates organic acid testing, allowing evaluation of factors like nutritional deficiencies, oxidative stress, gut health, melatonin, and neuroinflammation—insights that can reveal underlying health concerns and direct precise interventions.
Key Features:
- Advanced Cortisol Assessment: Measures cortisol and cortisone throughout the day, capturing the cortisol awakening response (CAR), a unique feature that reveals how cortisol spikes and falls within the first hour of waking.
- Organic Acid Testing: Adds insights into nutrition, oxidative stress, gut health, melatonin, and neuroinflammation.
- Extensive Hormone Profile: Tests for over 30 hormone markers, including estrogen, progesterone, testosterone, DHEA, and their metabolites.
How Is the DUTCH Plus Test Performed?
Patients can conveniently collect urine and saliva samples at home over the course of a single day. With filter paper and Salivettes®, samples are taken at specific intervals to capture both urine metabolites and saliva markers, particularly during the cortisol awakening period, where the natural rise and fall of cortisol within the first hour after waking is recorded.
Key Features:
- Sample Collection: Patients collect urine and saliva samples at specific times across one day.
- Transport: Dried samples on filter paper are stable for several weeks, making them convenient to ship.
Why Choose DUTCH Plus?
The DUTCH Plus test offers a uniquely comprehensive and practical approach to hormone testing, setting it apart from standard options. It offers a holistic view that empowers patients and providers alike to make more informed, personalized health decisions.
Key Features:
- Comprehensive Hormonal Assessment: DUTCH Plus includes an extensive profile of sex hormone metabolites, adrenal hormone patterns, organic acids, and the cortisol awakening response (CAR). This broader view helps in identifying and addressing imbalances with more tailored, effective treatment strategies.
- Enhanced Adrenal Function Insights: By incorporating the CAR through saliva samples, DUTCH Plus captures cortisol's natural rise upon waking. This initial spike is crucial for understanding stress response and adrenal health, providing a fuller picture of daily hormonal rhythms.
- Detailed Metabolite Analysis: With over 30 markers related to sex and adrenal hormones, DUTCH Plus enables precise intervention by highlighting hormonal production, metabolism, and detoxification pathways.
- User-Friendly and Stable Collection: Patients collect dried urine and saliva samples at home with ease. These dried samples remain stable for weeks, simplifying transportation and ensuring that results remain accurate and reliable upon arrival.
Who Should Consider DUTCH Plus Testing?
Testing can help pinpoint imbalances that may be contributing to these symptoms, guiding effective lifestyle, dietary, and supplement adjustments. The DUTCH Plus test benefits individuals experiencing symptoms linked to hormone imbalance or adrenal fatigue, including:
- Persistent fatigue or low energy
- Stress-related mood issues such as anxiety or depression
- Irregular menstrual cycles or fertility challenges
- Blood sugar swings and metabolic irregularities
- Reduced libido or hormonal changes
What Does the DUTCH Plus Test?
The DUTCH Plus test provides a comprehensive profile, offering insights into hormonal production, metabolism, detoxification pathways, and stress response, which supports targeted interventions to address underlying causes of hormonal imbalances. This bundled test includes all panels from the DUTCH Complete, assessing sex hormones, adrenal function, and organic acids, along with the Cortisol Awakening Response (CAR) panel.
This detailed hormonal profile allows for an in-depth understanding of endocrine function, metabolism, detoxification, and stress response, empowering patients and providers to implement effective, personalized health strategies.
Here’s what’s included in each area:
- Estrogen Metabolites: E1 (estrone), E2 (estradiol), E3 (estriol), as well as 2-OHE1, 4-OHE1, 16-OHE1, 2-MeOE1, 2-OHE2, and 4-OHE2, giving a detailed view of estrogen levels and metabolism.
- Androgen Metabolites: Includes testosterone, DHEAS, and DHT, offering insights into male hormone balance.
- Progesterone Metabolites: α-pregnanediol and β-pregnanediol support precise monitoring of progesterone.
- HRT Monitoring: Provides accurate tracking of hormone levels for individuals on hormone replacement therapy, including vaginal hormones and oral progesterone.
- Daily Free Cortisol and Cortisone Patterns: Monitors cortisol and cortisone fluctuations across the day.
- Cortisol Metabolites: Tracks α-THF and β-THF for cortisol, and β-THE for cortisone, to better understand cortisol production and breakdown.
- DHEA-S: A key adrenal hormone that plays a role in stress response and energy levels.
A critical adrenal measure, CAR captures the cortisol spike in the first hour after waking, providing crucial insights into the body’s stress response and resilience.
- Melatonin (6-OHMS): Assesses circadian rhythm and sleep-wake cycle regulation.
- Oxidative Stress (8-OHdG): Measures cellular health impact from oxidative stress.
- Neurotransmitter Metabolites: VMA (vanilmandelate) for norepinephrine/epinephrine and HVA (homovanillate) for dopamine provide insights into mood and neuroinflammation.
- Vitamin and Nutritional Markers: Includes MMA (methylmalonate) for vitamin B12, xanthurenate and kynurenate for vitamin B6, and β-hydroxyisovalerate for biotin.
- Gut Health Indicators: Indican reflects protein digestion and gut health, while pyroglutamate serves as a glutathione marker for detoxification.
Symptoms and Risk Factors for Hormone Imbalance
Hormonal imbalances can result in diverse symptoms, including:
- Common Symptoms: Low energy, mood fluctuations, cognitive fog, muscle loss, digestive issues, and poor stress resilience.
- Women: Irregular or painful menstrual cycles, fertility issues, vaginal dryness, and symptoms of menopause.
- Men: Loss of muscle mass, mood swings, and sexual health concerns.
Risk factors include:
- High stress levels or recent trauma
- Thyroid dysfunction
- Chronic health issues or adrenal fatigue
- Poor sleep quality or circadian rhythm disturbances
Understanding Your DUTCH Plus Results
DUTCH Plus results provide an in-depth view of hormone levels and metabolite patterns. Our clinical team offers personalized interpretations, identifying areas of imbalance and creating targeted plans that include lifestyle adjustments, dietary recommendations, and supplement guidance. Each plan is tailored to support optimal hormonal balance and address underlying issues for sustained health improvements.
Preparing for DUTCH Plus Testing
The DUTCH Plus kit includes all necessary components and instructions for sample collection. Patients should avoid high-sodium foods, caffeine, alcohol, and hormone creams near the time of collection to prevent skewed results. Documenting supplement and medication use ensures accurate interpretation.
Frequently Asked Questions
Yes, but avoid large, sodium-rich meals, caffeine, and alcohol near collection times to ensure accuracy.
Continue medications as normal unless instructed otherwise as certain exogenous hormones or steroid medications can obscure the natural hormone production we aim to quantify.
Stick to your normal intake but try not to drink excessively to prevent diluted samples.
The non-invasive process involves collecting small samples at 4 set intervals: morning wake-up, before lunch, before dinner and before bedtime. This tracks circadian shifts.
Key indicators of possible imbalance include chronic exhaustion, mood issues or sexual health shifts, unexplained weight gain, menstrual irregularity, infertility, hot flashes, night sweats, changing hair texture or thinning, persistent brain fog and new onset migraines.
Yes, follow your normal caffeine routine. If you typically have caffeine, it’s best to wait until after the second morning urine or saliva collection to avoid any spikes in cortisol. If you don’t usually drink caffeine, avoid starting on test day, as it may increase cortisol levels.
If you can wait two hours before each sample collection, results should be accurate. If you need to urinate during the night, use the provided “insomnia” strip.
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During your first 60-minute functional televisit, we will try to figure out what’s causing your current health problems. Contact us today at Internal Healing and Wellness MD in the Houston area and The Woodlands, we will make sure to provide you with a personalized functional medicine-based treatment plan so that you can begin working towards your goal of a better, healthier life.
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