Advanced Hormone Testing with the DUTCH Test

If your sex or adrenal hormones are out of whack, you’re not going to be at your optimal.

But if you wait until you feel like crap to do something about it (what 99% of people do), significant dysfunction and damage has already been occurring deeper down in your body for months and years.

I teach my clients to be proactive about their health. This is the key to long-lasting mental faculties and vitality. You want to identify hidden metabolic problems as soon as possible and balance them.

The analogy is: you don’t wait for your car to break down before you have it checked, do you? No! You get it inspected every year, without fail!

Isn’t it a sad state of affairs? Most people take better care of their cars than their bodies. Then they chalk up their health problems to genetics (“oh, it runs in my family”) or their age (“what do you expect, I’m X years old…”).

No, you just have not been taught a better way. Yet.

When Would You Test Your Hormones?

Your hormones affect every aspect of your life, and imbalances can cause you minor or major health issues. Getting them balanced is key to optimal health and mental performance.

Most often people have their hormones tested when they are experiencing some sort of complaint:

  • Fatigue
  • Stress
  • Insomnia
  • Low libido
  • Mood swings
  • PMS (women)
  • Erectile issues (men)
  • Fertility issues
  • Low motivation

In these instances, the information provided by hormone testing is, of course, invaluable. Other instances where sex and adrenal hormone testing is useful include:

  • Thyroid issues
  • Adrenal issues (HPA dysfunction)
  • Obesity/weight loss
  • When you are on hormone replacement therapy
  • Women’s concerns (irregular cycles, polycystic ovarian syndrome, perimenopause/menopause)

But as I already said, you shouldn’t necessarily wait until you have significant symptoms or complaints before you take positive actions to improve your health.

You may be entering a new phase of life, or simply may not be feeling at your best. Or you may want to go from good to great and are seeking ways to optimise your health.

Whatever your motivation is for looking deeper into your physiology, I’m about to show you the best way to go about it.

Testing Your Hormones with the DUTCH Test

The DUTCH Complete Test (Dried Urine Test For Comprehensive Hormones) is the most advanced hormone test on the market.

With it, we can glean insights into your androgens and estrogens (sex hormones), and stress hormones such as cortisol. There are even markers on the test for DNA damage, melatonin (the sleep-inducing hormone), vitamin B6 and B12, and a couple of neurotransmitters.

You take the test samples at home by urinating on a strip of paper four or five times in a 24-hour period, after which you send them to the lab for analysis. As convenient as it gets.

Let me take you on a quick tour of the most interesting parts of the test.

Adrenals – Cortisol and DHEA-S

Diurnal Cortisol Pattern

Let’s start with your adrenals. Your cortisol (one of your primary stress hormones) follows a daily pattern. It is highest in the morning (to “get you going”), peaking about an hour after you wake up. It then gradually tapers down during the day, with the lowest levels occurring between 3 to 5 hours after you fall asleep.

You want to maintain this rhythm as much as possible, but naturally, life stresses can disrupt it. The DUTCH test maps your daily free cortisol pattern (see picture) and shows where you are in the range for your age.

If your daily free cortisol pattern is irregular (too high or low at the wrong times), it’s worth investigating further because often times there are lifestyle tweaks we can use to improve it.

If your cortisol is too low in the morning, you will have trouble waking up and having a productive day. If it’s too high in the evening, you’ll have trouble falling asleep, or staying asleep. And we know how that can turn into a vicious cycle.

Metabolised Cortisol

Your metabolised cortisol amounts to about 80% of your total cortisol production. Why is this useful? Knowing your total cortisol output and correlating it to your current and past stress levels can tell us a lot about the state of your adrenal glands, as you’ll see below.

Some basic examples where this data is useful:

  1. If your free cortisol is elevated, it signals that you are under stress, of course. However, when your own perceived levels of stress are not very high, it could signal a hidden stressor (e.g. an infection or inflammation).
  2. If you’re under considerable stress but your total and free cortisol output are low – it could signal that you are burning out or have dysfunction with your Hypothalamus-Pituitary-Adrenal (HPA) axis.
  3. If your free cortisol is elevated in the evening, it could be due to a stressor (internal or external) which may also cause disrupted sleep. These stressors could include things like food sensitivities, gut pathogens, blood-sugar imbalances, chemical or heavy metal toxicity, or lifestyle factors such as work or relationship stresses.
  4. If your free cortisol rises during the night, it could signal a gut infection (e.g. parasites) or potential blood-sugar regulation issues.


DHEA (dehydroepiandrosterone) is the most abundant anabolic hormone in your body and is mainly produced in your adrenal glands. It is a counter-regulatory hormone of sorts to cortisol, which is catabolic in nature (it breaks down tissue including muscle to raise blood sugar). Low levels of DHEA-S are an early warning of HPA axis/adrenal dysfunction (which leads to or contributes to many, if not most, disorders and diseases). It’s often very low in people with chronic stress and may lead to further chronic stress-related disorders if left unchecked.

Sex Hormones and Metabolites

Your androgens are your anabolic hormones – they signal your body to build tissue and stimulate growth. While they are much higher in men, both sexes need to maintain adequate levels of androgenic hormones.

The 5α/5ß-Reductase Pathways and their Preference in Your Body

The DUTCH Complete shows you whether there is a preference for the “5α-reductase” or “5ß-reductase” pathway in your body. The 5α pathway is known to be more androgenic.

Why is that important?

In women, a 5α-reductase preference can cause side effects such as hair loss, hirsutism (hair growth in places you don’t want e.g. chin or chest), acne, mood swings, and PCOS.

In men, too much preference for the 5α pathway in the body can cause male pattern baldness, mood swings, and prostate issues.

The key is balance. Knowing which side of the pendulum your body is in can be helpful for your practitioner to guide you in balancing your androgens.

Estrogens and their Metabolism

Testosterone gets aromatised into the estrogens, the primary ones being:

  • Estrone (E1)
  • Estradiol (E2)
  • Estriol (E3)

Your normal hormone metabolism requires estrogens to be metabolised and detoxified through certain pathways, some of which are considered healthy. Other pathways are not-so-healthy, therefore knowing how you’re metabolising your hormones will allow you to take preemptive action when you see significant imbalances in their metabolism.

The DUTCH Complete report shows you your estrogen levels, as well as which pathways are used to detoxify them.

E1 and E2 both go through Phase 1 detoxification. Phase 1 detoxification has three pathways it can go through (2-OH-E1, 4-OH-E1, 16-OH-E1). You can see them mapped out below.

The 4-OH-E1 pathway (red arrows), if over-used and not properly detoxified, can lead to DNA damage (which can be carcinogenic). This is something we want to avoid if we can help it.

Phase 2 detoxification goes through the 2-Methoxy-E1 pathway where the COMT enzyme plays a role. If your COMT gene is slowed down due to genetic variations or other environmental factors, your ability to complete the detoxification pathway may be impaired. Again, having this information is helpful for your practitioner, as it will allow them to address any imbalances like this.

Other Valuable Data from the DUTCH Complete

The data provided by the DUTCH Complete so far is already incredible, especially for a test you can do at home. But the folks at Precision Analytical didn’t stop there. The also decided to include some organic acids which can give you information about some of your neurotransmitters, status of certain vitamins, and more.

Briefly, these markers are for:

  • Methylmalonate (MMA) – A vitamin B12 marker. When elevated, it signals a vitamin B12 deficiency.
  • Xanthurenate – A vitamin B6 marker. When elevated, it signals a vitamin B6 deficiency.
  • Pyroglutamate – A marker for your Glutathione status. Glutathione is your primary cellular antioxidant, involved detoxification, immunity and keeping you alive and healthy. Extremely important, to say the least.
  • Homovanillate (HVA) / Vanilmandelate (VMA) – These are metabolites of the neurotransmitters dopamine and adrenaline/noradrenaline respectively.
  • Melatonin – Your primary sleep hormone, as you probably know. Low levels will often correlate with sleep problems and/or gut dysfunction.
  • 8OHdG – This is a marker for oxidative stress and DNA damage. Naturally, you’d want this to be low. When it is elevated, it warrants further investigation with your practitioner.


This concludes our relatively brief overview of the DUTCH Complete. I’m sure that you’re starting to see the incredible value this test can provide in assessing your adrenal and sex hormone systems.

Let me say it again, because it must stressed repeatedly:

By the time you experience noticeable symptoms, significant dysfunction and damage has been occurring deeper down in your body.

Take a proactive approach to your health today. Your future “you” will thank you.

If you would like to run this test, or are interested learning more about others, get in touch with me. Click the button below to book your free 15-minute discovery session so that we can discuss your health goals and needs.