By Jandra Mueller, DPT, MS, PHRC Encinitas
The DUTCH test is a newer technology created by Mark Newman, MS. He has spent many years with various labs specifically on developing and testing hormones until he created his own lab, Precision Analytical Inc. and the DUTCH test is his flagship product. The name stands for Dried Urine Test for Comprehensive Hormones. Hormone testing is most commonly performed by blood tests (known as serum tests) and occasionally by saliva or urine tests.
To date, the DUTCH test is the most comprehensive test to evaluate your sex and stress hormones. In addition to measuring hormone levels, this test also takes into consideration metabolites (metabolites are breakdown products of these hormones) and specific nutrients (which are necessary for our body to use the hormones). The importance of these groups of hormones are that they play a vital role in many aspects of our life that if left unbalanced, they can wreak havoc in our bodies and leave us feeling anxious, tired, moody, and fatigued among many other things.
This blog explains the DUTCH test and the information it can provide you.
What does the DUTCH test measure?
- Estrogen (Estradiol, Estriol, and Estrone)
- Nutritional organic acids
- Neurotransmitter metabolites
- Hormone metabolites (the breakdown products of hormones which can tell us how your body is effectively, or ineffectively using the hormone – this may be the cause of one’s hormone imbalance).
Various environmental factors, medical treatments and age-related changes affect hormones in men and women. The DUTCH test is beneficial for both sexes, not just women as many people assume!
There are a few different types of DUTCH testing. Depending on which test you take, you will either collect 4-5 strips of urine and/or 4-5 tubes of saliva that get sent into a lab. The results will be analyzed and then you will have a comprehensive picture of what is going on in all those little cells inside your body.
The full picture
In addition to your sex hormones (the three primary estrogens, progesterone, and testosterone) and adrenal hormones (cortisol), the DUTCH test looks analyzes hormonal metabolites which can be just as important as your hormone levels. But, there are also other key players in how your body can use its hormone. People need key nutrients for optimal function, therefore this test also measures nutritional organic acids, which are markers to show how much B6, B12, and glutathione your body has (or is lacking). Nutritional organic acids are not typically evaluated in standard medical hormone assessments. In order to have a comprehensive knowledge of your hormones, you need to know these other key factors. The additional benefit of these markers is that they show your risk of oxidative stress (or your potential for DNA damage) as well as your risk of estrogen related cancers and other estrogen related issues.
People are understandably concerned about hormones and cancer risk. There is a tremendous amount of misinformation about hormones and generalized confusion, both in patients and amongst medical professionals. This is an additional topic we will address in another post, but in short, how your body metabolizes estrogen plays just as much of a role as the amount of estrogen itself and this test helps to identify this information. The DUTCH test helps identify patterns and risk factors, it helps guide safe lifestyle and medical treatments to restore balance. For example, if you show higher or lower numbers in your organic acids that may be affecting your hormone breakdown and treatment may be as simple as saying, you need more B12 in your diet, versus you need hormone therapy. Or, if your cortisol levels are very high, mindfulness and meditation may be more important for someone’s treatment than compared to someone without high cortisol.
How does this test compare to other ways of evaluating your hormones?
Serum blood test
Most people are used to getting a blood draw to assess hormones, this is the standard of care to measure hormones, this is called a serum test. There are many benefits of this test including convenience and it is inexpensive. However, the drawbacks are that it will only show you what is circulating in your blood at that moment in time. Hormones fluctuate throughout the month and throughout the day, so it may not capture as precisely as the DUTCH test would, especially for cortisol. A blood test cannot accurately determine what is going on with your cortisol levels. The DUTCH test has been studied and is comparable and as accurate as performing a blood test.
Saliva testing does have clinical value for cortisol especially if you do it over the course of a day, this is called a diurnal pattern which is the best way to measure cortisol but doesn’t necessarily give the full picture of what is going on in the body in regards to cortisol. Additionally, saliva testing is not the most accurate measure for sex hormones. The benefit of the DUTCH test is that it is one test that will measure both your cortisol and sex hormones accurately.
Standard 24-hour urine test
This test is another type of urine test for hormones and cortisol. Sex hormones and cortisol can be measured well in urine which is why the DUTCH test uses urine, but for cortisol, without a saliva comparison it cannot be as accurately measured in that diurnal pattern. This test has a high error rate (40%) and can be messy (it is collected in containers throughout the day). The DUTCH test uses dried urine, not wet urine, and studies have shown that the accuracy is very comparable and just as accurate, but this is an easier method of collection and again, takes out the need for multiple tests.
Who would benefit from this test?
This test is useful to help anyone wanting to get a better picture of overall hormone and metabolite balance. It helps people identify if there are lifestyle and diet changes to better balance hormones. We all have stress, and we are all predisposed to dietary and environmental stressors that can affect our hormone levels. But beyond this, anyone that is dealing with symptoms of hormonal imbalance or chronic stress or disease – insomnia, obesity, weight gain, fatigue, pelvic pain, endometriosis, vulvodynia, erectile dysfunction, PCOS, infertility, mood changes, brain fog, etc can benefit from taking a closer look with the DUTCH test. This is a great test also for those that are experiencing symptoms of hormonal changes but their blood tests are coming back pretty normal. For more info on hormones check out our previous blog post Hormones: Your Body’s Frenemies.
Benefits and drawbacks
The benefit of the DUTCH is that it gives you a more complete picture and overview of the key components your body needs to both produce and utilize your hormones. It is a great compliment to that blood test your doctor ordered for you, and it is good for both men and women as the results can help identify the root cause of issues you may be having.
The DUTCH test is not currently covered by insurance. Running the test requires restrictions during testing, certain supplements and medications are recommended to be out of the system and for some women, it is necessary to take it at a specific time during your cycle.
If you are suffering from any of the issues mentioned in this blog, the DUTCH test could be right for you. We live in a country where there are culprits everywhere responsible for throwing off our hormones – pesticides and hormones in our food and chemicals in our cleaning and beauty products, to just name a few.
Precision Analytical Inc., shares educational blogs and videos about the DUTCH test on their website, which you can find here. We are now offering the DUTCH test through PHRC! If you are an existing PHRC patient and interested in the test please ask your physical therapist for more information. If you are not a PHRC patient and are interested in the test please call us at 760 – 487- 5118 or send us an inquiry via this link.
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. The cost for this service is $85.00 per 30 minutes. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at (510) 922-9836