Dutch Testing

Many patients suffer from thyroid, adrenal, and hormone dysfunction at a subclinical levels, which lead to many symptoms such as weight gain, fatigue, depression, anxiety, panic, acne, sexual dysfunction, hair loss and a host of other life altering, subclinical symptoms that are often not addressed by conventional providers.

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This advanced functional hormone testing was developed to improve on available hormone testing options. DUTCH offers the most extensive profile of sex and adrenal hormones along with their metabolites. Additionally, the daily (diurnal) pattern of free cortisol is included, along with melatonin (6-OHMS), 8-OHdG, and six organic acids. This unique combination of clinical information is not available by any other method. Click here to view the female and male sample reports for the flagship test: DUTCH Complete. Other tests we offer through this lab are the DUTCH Plus, DUTCH car, DUTCH Cycle Mapping, and the DUTCH Cycle Mapping PLUS. Stand alone tests are also available including the Sex Hormone and Adrenal Only tests. 

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Precision Analytical’s testing methods go through a rigorous validation process to verify accuracy, recovery, and linearity to ensure the most accurate and precise techniques available for testing. Dutch testing is superior to serum/salivary/24-hour urine testing offered through Quest for the following reasons:

 

DUTCH vs. Saliva Testing

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While the free cortisol pattern in saliva has clinical value, there is a significant missing piece to surveying a patient’s HPA-Axis function with saliva testing – measuring cortisol metabolites. To properly characterize a patient’s cortisol status, free and metabolized cortisol should be measured to avoid misleading results when cortisol clearance is abnormally high or low. Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture for more precise clinical diagnosis of hormonal imbalances and HRT monitoring.

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DUTCH vs. Serum Testing

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While the most universally accepted testing method (due to the availability of FDA-cleared analyzers that are reliable and inexpensive), serum testing is lacking in some areas. Adrenal hormones cannot be effectively tested in serum because free cortisol cannot be tested throughout the day. There is also a lack of extensive metabolite testing (especially for cortisol and estrogens).

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DUTCH vs. 24-Hour Urine Testing

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There are two primary drawbacks to 24-hour urine testing of hormones. First, the collection is cumbersome, and as many as 40% of those who collect, do so in error (Tanaka, 2002). Secondly, dysfunction in the diurnal pattern of cortisol cannot be ascertained from a 24-hour collection. Some providers add saliva for daily free cortisol. DUTCH eliminates the need for two tests, saving you money.

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The DUTCH correlation to 24-hour collections is excellent. Because the dried samples span about 12-14 hours of the day (6-8 hours overnight plus 2 hours per day collection), they represent the entire day’s hormone production. A weighted average of the four samples is combined and measured for all hormones other than cortisol and cortisone. Values must be presented relative to creatinine (ng per mg of creatinine) to correct for hydration. This replaces the 24-hour value. The excellent correlation to 24-hour collections makes this model a very respectable alternative to 24-hour collections. With the addition of diurnal free cortisol, it becomes an improvement.

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Dried samples are accurate for hormone testing, and values correlate to liquid samples. Samples are stable once they are dried and easier to ship than liquid samples.

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Cortisol, cortisone, 8-OHdG, melatonin (6-OHMS), organic acid tests and metabolites related to cortisol are tested by LC-MS/MS. The remaining hormones are tested by GC-MS/MS. The most accurate methods available are used for all tests. These methods show increased accuracy over immunoassays used in typical serum and saliva testing.