If you have heard of the DUTCH hormone test then you are probably aware that it is the most detailed test available to assess sex hormones and adrenal function.
But the DUTCH test can give us many other insights into your health. In this article, I will go over the 5 surprising benefits of the DUTCH hormone test that many people are not aware of.
Just in case you have not heard of the DUTCH test it stands for Dried Urine Test for Comprehensive Hormones and is the go-to test for Functional Medicine practitioners to get a deeper understanding of your hormone health.
The DUTCH test is a hormone test that you do at home, so no need to visit a lab or get blood testing done. Also because the test is done at home you can conveniently collect the samples throughout the day and night to track the changes in cortisol throughout the day.
Compared to blood testing, and saliva testing the DUTCH hormone test gives us a lot more information. This benefits you as we can fully understand the cause of your hormone imbalance - and not just know your hormones are out of balance.
So let’s look at the 5 surprising benefits of the DUTCH hormone test.
Number One - DUTCH Hormone Test Shows How Your Body Is Detoxifying Estrogen
The DUTCH hormone test, blood testing, and saliva testing all show the levels of estrogen, progesterone, and testosterone that you have, and this is important information as it can show whether your hormone levels are optimal or not.
However, only the DUTCH test can show how your body is metabolizing these hormones.
Why is this important?
Well if you have high estrogen levels which is quite common for many women (and men), the DUTCH hormone test can help to show why the hormones are high.
You will be able to know if it is an issue with making too much estrogen, or is it an issue with phase one of liver detoxification, or a problem with the methylation of estrogen by the COMT gene.
DUTCH Test - Estrogen Detoxification Phase One
Estrogen is detoxified down the three pathways. There is a healthy pathway known as the 2-OH Hydroxy Pathway and we want to increase the detoxification of estrogen down this pathway.
Another pathway is the 4-OH Hydroxy pathway, this is an unstable pathway that increases the risk of cancer. We want these levels to be low for both women and men, especially if there is a family history of breast, ovarian, or prostate cancer.
The third pathway is the 16-OH Hydroxy pathway. It is involved in the detoxification of estriol which is a weaker form of estrogen. This pathway can also be associated with proliferation so can make things grow, so can be worse for endometriosis and cancer.
This information is only in the DUTCH hormone test and not assessed in blood or saliva tests.
Knowing this information can help to guide us on whether we need to improve phase one detox through diet, supplements like DIM, and assessing other environmental toxin exposures that may be causing the problem.
Genetics, environment, weight can all lead to poor phase one detoxification.
Excess body fat not only increases estrogen production but insulin resistance and high leptin levels can affect how your body metabolizes estrogen, leading to an increase in the unwanted 4-OH detox pathway.
How To Improve Phase One Detox?
Diindolylmethane, commonly known as DIM is the number one supplement to improve phase one detoxification of estrogen. DIM is made from broccoli sprouts but it is a lot more potent. So while eating a healthy diet with cruciferous vegetables is important, this may not be enough to significantly improve your phase one pathways.
The DUTCH test assesses glutathione levels by measuring pyroglutamate. Glutathione is an important detox pathway for toxins and hormones. If the DUTCH test shows low levels of glutathione then supplementation of N-acetyl-cysteine (NAC) and sulforaphane can help to improve glutathione levels.
DUTCH Test - Estrogen Detoxification Phase Two
Why is phase 2 detox important, it makes the phase one metabolites (which are harmful reactive oxygen species) water-soluble so they can easily be eliminated from the body.
Phase two detoxification is the methylation pathway. Most people think of MTHFR when they see methylation but it is the COMT gene that is important for the detoxification of estrogen.
The DUTCH hormone test measures methylation activity, if this is low it needs to be addressed to help lower estrogen levels.
COMT requires methyl donors like magnesium, SAM-e, TMG, choline, and b vitamins.
Gut infections can affect COMT, also BPA and PCB exposure, COMT mutations, and high serotonin (possibly SSRI’s).
High leptin can reduce COMT activity, high leptin can also downregulate thyroid function which can impact the sex hormones and adrenal hormones. During the assessment of your DUTCH test results, we can help you identify if leptin is a problem for you and how to address this.
It can become a vicious circle, high estrogen levels can lead to weight gain, but the excess weight can make it difficult to get estrogen levels down, this is why testing can help to identify what areas are a priority.
Phase Three Detoxification
Phase three detoxification eliminates estrogen out of your body through the intestines and there are a number of things that can disrupt this, leading estrogen to get reabsorbed back into your bloodstream.
Inflammation, gut bacteria, medications can all affect phase 3 detoxification.
This is where doing a stool test like the GI Map test can help to identify imbalances in gut bacteria, plus b-glucuronidase levels which can affect estrogen detoxification.
High levels of b-glucuronidase lead to estrogen getting absorbed back into the body. The supplement calcium d-glucarate can help with this, but you still need to address the underlying cause and not just rely on supplements.
DUTCH Test Estrogen Metabolism Summary
Number Two - DUTCH Hormone Test Shows Free Cortisol and Total Cortisol Levels
Your adrenal glands produce cortisol which is your main stress hormone, you don’t want too much, and you don’t want too little - the body needs just the right amount of cortisol.
Cortisol levels change throughout the day so it is important to assess cortisol at 4-5 different times so that you can understand the cortisol rhythm.
There are also free cortisol levels as well as total cortisol production. Both of these are important when it comes to understanding the adrenal function and the best way to improve your adrenals.
Why Blood Testing Is Not Accurate?
When you test cortisol levels in the blood, this only assesses cortisol at one particular time of the day, usually the morning, as it is not practical to get a blood draw throughout the day and night. A blood test for cortisol also will show the total cortisol levels at the time of testing.
This means that a blood test is not the best way to assess cortisol as it does not give different cortisol readings throughout the day, or show the free cortisol levels.
Why Saliva Testing For Adrenal Function Is Not Enough?
Saliva testing for cortisol is better than a blood test as it measures the changing rhythm of cortisol throughout the day, and depending on the company doing the testing will check 4-5 different saliva readings.
But the standard saliva testing does not assess total cortisol levels, and it does not measure cortisone levels so we can see how the cortisol is getting metabolized.
Free saliva cortisol levels have their limitations as you could have low free saliva cortisol levels but still be making a lot of cortisol, or you may have high levels of free cortisol but total cortisol production is low.
This is important to understand as it is going to impact the treatment.
The DUTCH Test And Adrenal Function
The DUTCH test measures free cortisol levels at 4-5 times throughout the day, plus it measures cortisone levels so we can see how quickly cortisol is getting metabolized.
The DUTCH test also assesses total cortisol production, this is how much total cortisol your body is producing in a 24-hour period. Free cortisol is usually less than 5% of your total cortisol levels so understanding all of these markers is important before implementing a treatment program.
When assessing adrenal function we need to assess the cortisol rhythm, free cortisol levels, total cortisol production, cortisone, and DHEA levels - the DUTCH hormone test is the only test that does this.
Number Three - DUTCH Hormone Test Assesses Melatonin And Overnight Cortisol Levels
Do you have problems with insomnia?
There are a number of reasons for insomnia but there are two hormones that can influence the quality of your sleep, they are melatonin and cortisol.
The DUTCH test measures overnight melatonin levels as well as cortisol and this can help to determine whether we need to help to improve your melatonin levels or focus on reducing cortisol levels.
Sleep is crucial to good health, and if you have trouble falling asleep or staying asleep then the DUTCH hormone test is a good option to determine the cause of your insomnia.
If you have low melatonin levels you can always supplement with melatonin, but you also want to make sure that you have the key nutrients to make melatonin - this includes Vitamin D, magnesium, and Vitamin B6 (which is also tested in the DUTCH test).
If you have high nighttime cortisol you are going to wake up in the night and feel like you are wide awake and ready to go, and that is because cortisol is an important hormone to wake you up in the morning.
But you don’t want your cortisol levels to be rising at 2 am and waking you up!
Poor sleep can make your hormones worse in a number of ways, it can lead to weight gain which has been shown to disrupt hormones, affect thyroid function, and increase insulin resistance.
So even if you are eating well and exercising it is possible to gain weight because of poor sleep and high cortisol levels.
Once we get the results of your DUTCH hormone test I can help guide you on the best way to treat the hormones so that you can sleep better.
Number Four - DUTCH Hormone Test Assesses Methylmalonic Acid
First, what is methylmalonic acid?
Methylmalonic acid is recognized as the most accurate way to test for vitamin B12 levels, and while B12 is important for energy production, it is also important for hormone health.
Vitamin B12 helps the nervous system and the methylation process, it is this role in methylation that Vitamin B12 has been shown to help with fertility and reduce the risk of breast cancer.
There are different forms of Vitamin B12 and I have written about this in detail in the Vitamin B12 guide, and if your methylmalonic acid levels are high this indicates that you are lacking in adenosylcobalamin, this is an active form of vitamin B12.
A lot of supplements contain cyanocobalamin which is a poorly absorbed form of B12, especially if you have digestion issues.
Also, with the popularity of vegetarian and vegan diets, there is an increase in people who are Vitamin B12 deficient as B12 is only found in animal protein.
Symptoms of B12 deficiency include fatigue, brain fog, memory problems, muscle weakness, numbness, tingling, depression, and headaches. Of course, these symptoms can be caused by many other things. That's why testing is important.
Number Five - DUTCH Hormone Test And Your Flight Or Fight Hormone
Norepinephrine, also known as noradrenaline, is our flight or fight hormone, it is a great hormone to have but like all hormones, we don’t want it too much or too little.
When your body feels like it is under stress it will release norepinephrine. In the old days this would be when we were getting chased by a tiger, the release in norepinephrine would trigger us into action so that we can escape. After that levels would return to normal and life would continue (that’s if you escaped from the tiger!)
However, these days we are constantly under low-grade stress, not as severe as getting chased by a tiger, but enough to keep our flight and fight hormone elevated for long periods of time.
DUTCH Test And High Norepinephrine
High levels of norepinephrine can lead to symptoms like:
Elevated levels of norepinephrine make it hard to relax and wind down, and while there are supplements that can help with this, the best things to do are breathing exercises that can help to balance the sympathetic and parasympathetic nervous systems.
Meditation has also been shown to help, especially when practiced regularly.
DUTCH Test And Low Norepinephrine
Low levels of norepinephrine can lead to symptoms like:
Low levels of norepinephrine leave you feeling exhausted, people often look to caffeine and sugary foods to help give them a “pick me up”.
Once again breathing exercises and meditation can be helpful to improve norepinephrine levels, in particular, the Wim Hof breathing method is a good option when you are feeling exhausted.
Other Benefits Of The DUTCH Hormone Test
Besides these 5 surprising benefits of the DUTCH hormone test, there are many other reasons for testing your sex hormones, adrenal hormones, and the additional organic acid markers on the DUTCH test.
If you are experiencing a number of these issues then the DUTCH hormone test can help to identify the underlying cause:
The DUTCH hormone test can be shipped worldwide, it requires no blood draw and the urine samples are collected at home so there is no need to go to a pathology lab.
The urine samples are collected on a special litmus paper which is allowed to dry, this makes it super convenient to be able to ship the samples back to the lab in the provided envelope.