Description

A complete picture of your hormonal health, stress response, and sleep cycle—all in one advanced test.

The DUTCH Plus™ (Dried Urine Test for Comprehensive Hormones) offers an in-depth look at sex hormones, adrenal hormones, cortisol rhythms, and organic acids, giving a powerful insight into your endocrine and metabolic function.

What sets this panel apart is its inclusion of the Cortisol Awakening Response (CAR)—a critical marker for evaluating the health of your HPA axis and how your body responds to stress. This panel also includes an insomnia cortisol sample to assess nighttime stress hormone output that could impact sleep.

Sample Type: Saliva + Dried Urine

Fasting: Not required, but follow instructions for sample timing

Estrogens & Estrogen Metabolites

  • E1 (Estrone), E2 (Estradiol), E3 (Estriol): Primary female sex hormones; imbalances may relate to PMS, menopause symptoms, fertility issues, or estrogen dominance.
  • 2-OH-E1, 2-OH-E2, 4-OH-E1, 4-OH-E2, 16-OH-E1: Estrogen detox pathways. Imbalance can raise risk for hormone-sensitive conditions like breast cancer or fibroids.
  • 2-Methoxy-E1: A protective methylated estrogen metabolite. Low levels may reflect poor estrogen detox or methylation issues.

Progesterone Metabolites

  • a-Pregnanediol & b-Pregnanediol: Reflect progesterone production. Low levels may relate to infertility, irregular cycles, or anxiety.

Androgens & Their Metabolites

  • Testosterone: Primary male sex hormone (also vital in females); linked to libido, energy, mood, and muscle mass.
  • 5a-DHT (Dihydrotestosterone): Potent androgen; high levels may relate to hair loss, acne, or PCOS.
  • 5a-Androstanediol & 5b-Androstanediol: Testosterone breakdown products—help identify how your body processes androgens.
  • Androsterone & Etiocholanolone: Important for evaluating androgen clearance and liver detox.
  • Epi-Testosterone: An inactive form of testosterone—can help assess balance in testosterone metabolism.

Adrenal Hormones (Cortisol & Cortisone Patterns)

  • Cortisol (Waking, Morning AM30/AM60, Noon, Evening, Night): Shows your daily stress response rhythm. Disruptions are linked to fatigue, poor sleep, burnout, or adrenal fatigue.
  • Cortisone (Same time points): Inactive form of cortisol. Helps assess enzyme activity (11β-HSD) and overall adrenal metabolism.
  • THF, THE, a-THF, b-THF: Metabolites of cortisol and cortisone—provide insight into adrenal output and detoxification pathways.

Cortisol Awakening Response (CAR)

  • Measures the rise in cortisol within the first hour of waking.
  • Why it matters: A strong CAR is linked to resilience, motivation, and energy. A blunted CAR is associated with chronic stress, burnout, and depression.

🔸 Melatonin

  • Melatonin (measured via 6-OHMS): The primary sleep hormone. Low levels can lead to poor sleep quality, insomnia, and mood imbalance.

Oxidative Stress & DNA Damage

  • 8-OHdG (8-hydroxy-2'-deoxyguanosine): A marker of DNA damage and oxidative stress. Elevated levels suggest increased cellular wear and tear—often from stress, toxins, or poor sleep.

Neurotransmitter & Nutrient-Linked Organic Acids

  • MMA (Methylmalonic Acid): Reflects B12 status. Elevated levels = B12 deficiency.
  • Xanthurenic Acid & Quinolinic Acid: Linked to vitamin B6 and brain inflammation. Imbalances may affect mood and cognition.
  • Kynurenic Acid: Neuroprotective pathway of tryptophan metabolism. High levels can signal inflammation or detox stress.
  • Pyroglutamic Acid: Marker for glutathione depletion (major antioxidant).
  • 3-Hydroxyisovaleric Acid: Indicates biotin (B7) deficiency.
  • Indican: Gut dysbiosis marker. Elevated levels suggest poor gut flora and tryptophan breakdown.

Other Key Markers

  • Creatinine: Normalizes urine hormone levels and checks kidney function.
  • Total Estrogen: Summarizes E1, E2, E3—used to assess overall estrogenic activity.
  • VMA (Vanillylmandelic Acid): A breakdown product of epinephrine/norepinephrine—used to assess adrenal medulla output.
  • HVA (Homovanillic Acid): Dopamine metabolite—used to assess mood, focus, and neurochemical health.

Why Choose DUTCH Plus™?

  • Comprehensive analysis of estrogen metabolism, testosterone balance, and adrenal fatigue
  • CAR testing offers deeper insight into stress resilience and burnout
  • Includes organic acid markers for sleep, neurotransmitters, detox pathways, and nutrient status
  • Ideal for those with symptoms related to:
  • Hormone imbalance (PMS, menopause, low libido, PCOS)
  • Chronic fatigue, stress, or adrenal dysfunction
  • Mood disorders, poor sleep, or burnout
  • Detoxification issues or oxidative stress