Why DUTCH hormone testing is considered the ‘Gold Standard’.

I see a lot of women (and men) with hormone symptoms - sex, stress and thyroid hormones. Some have been struggling for years and repeatedly asking, if not begging,

their doc to run hormone testing. Many won’t. And when they do, the testing is so sparse it says next to nothing. In Germany (and in much of the U.S. too) even integrative and

naturopathic clinicians typically rely on serum (blood) or sometimes saliva tests for evaluating hormones. You may have heard the criticism that lab data is a ‘snapshot’ of your body

function (in this case hormones) based on that day only, which is largely true. BUT not true with DUTCH hormone testing, which I have been offering in my Functional Nutrition

practice.

Blood tests your doc runs can be useful for certain clinical questions that meet strict disease or disorder criteria, they usually fail to capture enough data to look for more

subtle imbalances that keep you up at night. Hormone serum testing fails to look at hormone production, metabolism, and circadian patterns which drive your symptoms. The DUTCH

test (Dried Urine Test for Comprehensive Hormones) does that. I wish I would have discovered this 25 years ago when I was suffering through endometriosis and getting zero answers

from my conventional docs. It would have saved me decades of suffering. There is a reason DUTCH is considered the ‘GOLD STANDARD.’

Here is how it is different and why I, and my clients, got answers typical labs would never show.

Conventional serum labs measure parent hormones only (e.g., estradiol, progesterone, testosterone, cortisol). DUTCH measures these too, but also looks at hormone metabolism (estrogens progesterone and androgens like testosterone and DHEA). METABOLISM IS WHAT IS DRIVING YOUR SYMPTOMS so this matters if you want to feel better . Two people with the same estradiol level in blood (which is what conventional docs look at) can behave completely differently depending on whether they push estrogen down protective vs. problematic pathways.

Got wonky sleep cycles or weird energy you can’t figure out? Standard labs would usually measure cortisol in blood, which is a snapshot of your stress hormones at that exact moment in time. If you are lucky, they may look at urine, which mixes your overall cortisol for the day and lumps it into one value. DUTCH shows the exact cortisol curve for the day - when you wake (including if you awake in the middle of the night), after breakfast, midday and in evening so you can tell your circadian patterns.

From this, you can figure out if you are waking up in the middle of the night, why? If you feel low energy throughout the day, is that due to lower than optimal cortisol during the times you need it (remember, cortisol is also the ‘day hormone’ and the counter to melatonin)? Feeling tired but wired when you want to be in bed sleeping? DUTCH could show your cortisol is too high at that time of the day and your circadian rhythm is off.

A single morning cortisol reading from your doctor misses ALL of this.

Suspect you may have some kind of burnout or adrenal depletion picture? DUTCH gives a much deeper read into your adrenal output - i.e. how long you have been burning the candle at both ends by measuring both Free and Metabolized Cortisol AND DHEA (the counterbalance to cortisol).

Saliva tests from conventional medicine show free cortisol only. Blood largely reflects total cortisol. DUTCH shows free cortisol (your available cortisol) AND metabolized cortisol (your total cortisol production). This allows me to see to distinguish between a few common problems with totally different treatments - whether you make a lot but use very little or a normal amount (poor conversion), whether you make and use very little (aka ‘adrenal fatigue) or high output with low free (true high cortisol picture).

Neither blood nor saliva alone can differentiate these patterns. And how you treat each of these scenarios with exercise, supplementation, nutrition interventions and lifestyle changes is very different!

In perimenopause or menopause and suffering and told there is no point in testing your hormones because they are just too wacky? DUTCH is helpful even for perimenopause and menopause. A lot of symptoms that women experience in perimenopause are because their hormone metabolism is pushing down problematic (symptom driving) estrogen or progesterone pathways. Cortisol also plays a huge part in womens’ perimenopause symptoms as the adrenal glands play a deeper role in making our sex hormones as we age. If our adrenals are tanked, our perimenopause symptoms will likely be way worse. DUTCH shows this (see above) and conventional serum tests do not. This makes it especially valuable for women 35–55 if that is you.. :)

DUTCH also digs into nutrients and nutrient depletions that affect hormone metabolism and make you feel crappy. Maybe you are low on nutrients needed for hormone metabolism and conversion (like B vitamin metabolites, oxidative stress markers, neurotransmitter metabolites and methylation markers). Conventional labs don’t look at these cross-relationships.

Whenever I walk clients through these tests they are amazed and what data on their own bodies and hormone function it offers - whether they are missing periods, on birth control, trying to have a baby or transitioning out of cycling. It doesn't capture everything, but it offers quite a lot for not that much money, in my opinion (It is under 500e). Click on lab testing to read more and schedule a talk with me