Why All Women Should Take the DUTCH Complete Hormone Test

Back in 2016 when the DUTCH Complete Hormone test was newly out, I began to use it frequently. Hundreds of tests later…. I still rely on the Dutch test for my female patients with adrenal and sex hormone imbalances. Do you wonder if you have hormone imbalances? Take this assessment and get my free Smart Woman’s Guide to Hormone Balance.

What happens with your results?

These results are instrumental to:

  • Shed light on any hormone imbalances you have (adrenals, all sex hormones, and melatonin).
  • Gear a treatment plan tailored to you, based on your hormone levels and also how you metabolize or break down your hormones.

Your treatment plan is all-natural and customized to you. It can involve precise “lifestyle medicine” which are adjustments in sleep, food, exercise, and stress management. We may find that the use of supplements, herbs, and low-dose bio-identical hormones are right for you.

What does the DUTCH Complete Hormone test measure?

Precision Analytical labs developed this unique test. It measures your hormone metabolites from dried urine samples. The hormones include:

  • Cortisol
  • Cortisone
  • Estradiol
  • Estrone
  • Estriol
  • Progesterone
  • Testosterone
  • DHEA and DHEA-S
  • Melatonin

This test also measures your cortisol and cortisone rhythms and levels, and your estrogen metabolism pathways.

dutch hormone test

Why measure all these hormones?

There are lots of reasons!

  • If you have “adrenal fatigue,” sleep or stress issues, testing your adrenal hormones and their rhythms gives specific information about how to handle these problems. Read more about the adrenal part of this test. We are specifically looking at your adrenal-brain communication, known as your HPA axis (hypothalamus-pituitary-adrenal).
  • With fertility problems, polycystic ovarian syndrome (PCOS), fibroids, PMS, irregular periods, painful periods, anxiety and moodiness, and endometriosis, this test is highly beneficial. It gives a complete picture of how adrenal and reproductive hormone imbalances contribute to these problems.
  • If you use hormone replacement therapy, you want to monitor your levels. This test works uniquely well for oral progesterone, vaginal hormones, patches, pellets and injections. Note that this is only for hormone replacement therapy, not hormonal birth control pills!
  • With sleep problems, it’s important to check melatonin. Melatonin can be low and related to your sleep problems, or it can be normal. 
  • You may have low DHEA levels. This is a “feel-good” hormone produced by your adrenal glands. When it’s low, it can cause fatigue, a decrease in muscle mass or bone density, depression, aching joints, loss of libido, and lowered immunity.
  • You may have “estrogen dominance.” This is when the scales are tipped so that progesterone is low and estrogen is high. Estrogen dominance can be a factor in endometriosis, PMS, painful periods, fibrous breasts, fibroids, tender breasts, moodiness, and more. It can make perimenopause symptoms significantly worse.
  • This test shows how you metabolize estrogen through your liver. If you don’t metabolize estrogen well, your risks of estrogen-related cancers such as breast, cervical and uterine cancer can increase.

The DUTCH test add-ons

New markers are now included on the Dutch test (as of 2018). These include:

  • The three B vitamins that are most commonly low: B12, B6 and Folate.
  • A marker for oxidative stress (“rusting” in your body, which damages your cells, your DNA, and your mitochondria).
  • Neurotransmitters that show dopamine and first responder stress hormones (epinephrine and norepinephrine).
  • Your need for glutathione, which is THE master anti-oxidant that you make. You will not detox well or use omega 3 fats properly with low glutathione. It’s often tanked if you have a high level of environmental chemical exposures, such as living next to a golf course or agriculture.

What does this test involve?

It’s easy! It comes in an envelope with little strips to dip in your pee, in the comfort of your home. You dip the strips, let them dry, mail them off. The instructions are very clear.

What does it cost and does insurance cover it?

Insurance does NOT cover this test at this time because it is “investigative.” The retail price is $399. If you’re my patient you get a discounted price.

Hormone blood tests are useful too, but they are not the same as this comprehensive test. Blood tests won’t measure your cortisol rhythms and estrogen metabolism. Blood tests will not track hormone replacement as thoroughly. They will not shed light on adrenal, cortisol, and sleep problems. Hands down, this test is THE most cutting edge, comprehensive, functional medicine hormone test.

Women who changed their lives with the DUTCH test:

Names and photographs are fictitious to protect these patient’s identities.

Postpartum and No Periods

Dutch hormone test

Melanie (age 36) had not felt herself since the birth of her second child one and a half years ago. Her periods had not returned and she suffered from insomnia, fatigue, anxiety, and depression. She had no interest in sex, and symptoms of low thyroid (cold, tired, dry skin) even though her thyroid hormones were normal.

Dutch Test Results:

  • Menopausal ranges for progesterone, low cortisol and testosterone, elevated stress hormones.

What Happened: We also discovered Melanie had blood sugar dysregulation and nutrient deficiencies, so we addressed these as well. We used dietary changes, herbs, and supplements.

Within three months Melanie got her period and her energy back, and her moods became much more stable and uplifted. Her skin got healthier and she felt warmer.


Estrogen Dominance and Toxic Load

Dutch hormone test

Jasmine (age 29) had a myriad of hormone imbalance symptoms including anxiety, PMS, painful periods, breast tenderness, fatigue, irritability, and frequent migraines. The worst symptom was very frequent and heavy periods.

Dutch Test Results:

  • Perfect adrenal hormones, low progesterone, high estrogen, and impaired detox.

What Happened: Jasmine’s primary root cause was estrogen dominance, and we also discovered nutrient deficiencies, anemia, and low beneficial bacteria in her gut. We used herbs, supplements, foods, cyclical progesterone, acupuncture, and focused detox.

Her first cycle on this protocol was significantly better! Each cycle improved, and after a year she had normal, pain-free periods, and migraine incidence dropped down to very rare.


PCOS and Infertility

Dutch Hormone Test, PCOS

Gemma (age 31) knew she had PCOS and had tried to heal it, but had not been successful going off the pill and getting regular periods. It was next to impossible to know if and when she was ovulating, and she really wanted to have several children, which was frustrating and upsetting.

Dutch Test Results: 

  • High testosterone, low progesterone, high estrogen, and high cortisol (we never know what the PCOS hormone picture is without testing).

What Happened: We knew Gemma had insulin resistance as well. We used herbs, supplements, diet and exercise hacks, and stress management training to adjust her hormone imbalances and to promote ovulation and regular cycles.

Within only three months, Gemma dropped 11 pounds and got pregnant!


Adrenal Fatigue and High Cortisol

Dutch hormone test

Lisa (age 51) felt exhausted for about four months, since a demanding overseas work trip. She had a history of chronic stress from her job. She had high cholesterol and difficulty losing weight in spite of being on a low-calorie diet and doing spin class daily. And although she was on bio-identical hormone replacement therapy, she suffered from hot flashes, which were worse if she had her beloved glass (or 2) of wine at night.

Dutch Test Results: 

  • High cortisol. Estrogen and progesterone levels good, with good estrogen metabolism, so her hormone therapy was at the right levels and safe to continue.

What Happened: We made lifestyle modifications such as adding calories, incorporating meditation and acupuncture, reducing exercise, and keeping wine to the weekend nights. We also added herbs and supplements to regulate her adrenal (HPA axis) and lower cortisol.

Lisa’s energy improved immediately, she began to lose weight, and really enjoyed spinning less, eating more, relaxing more often, and feeling calmer.


Adrenal Fatigue with Infertility (Poor Egg Quality)

Dutch Hormone test

Judy (age 27) was extremely fatigued all day long and relied on strong coffee to get through the days. She felt that she never recovered after “burning the candle at both ends” during graduate school. She was ready to start a family but had not fallen pregnant yet. And she was worried about her ability to conceive as doctors had told her she had “poor egg quality.”

Test Results: 

  • Low cortisol, and low sex hormones, especially for her age!

Treatment: Herbs, supplements, and foods to nurture hormone production and get her adrenals back on track.

Within six months Judy no longer felt tired all day long. She had enough energy to work out again. And, 8 months later, she got pregnant!


Peri-menopause with Estrogen Dominance

Dutch hormone test

Aparna (age 44) was a breast cancer survivor and was now experiencing early menopause symptoms because of the medications. She took Ativan for sleep and anxiety and wanted to get off it.

Dutch Test Results:

  • Low estrogen with poor metabolism, high stress hormones, oxidative stress, need for glutathione.

What Happened: Aparna had estrogen dominance previously, but now estrogen was blocked. She had nutrient deficiencies, toxic burden, and immune dysregulation (usually the case with cancer). We used nutrition, supplements, focused detox, and herbs – all to support her immune system, build her vitality, and help her detox function.

Over the course of the next year, Aparna was able to wean slowly off Ativan, restore deep sleep, lessen her hot flashes, and reduce her anxiety. A year later she felt that she had recovered, and her vitality had returned.

Get Your DUTCH Test

These women demonstrate the vast differences in hormonal symptoms and in DUTCH test results. Each test result is unique. Each treatment or solution is also unique. Wonder what your hormone picture is? You can first order a DUTCH test, and then book a single consult with me for analysis and a treatment plan. Many women, including other medical and health practitioners, choose this option.


Have you taken the DUTCH test before and interested in retesting? Read about retesting here.

paris healing arts, doctor laura paris, dr. laura paris, dr laura paris

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56 Comments

  1. You GP can provide a blood test for these steriod hormone levels. Depending on when you live, this may be covered by your healthcare provider ( e.g free in the UK, 50 euros in Belgium, and free in the Netherlands. US depending on your health insurance ).

    You don’t need the dutchtest web site. This site is an advertisment for the Dutchtest,

    Cortisol
    Cortisone
    Estradiol
    Estrone
    Estriol
    Progesterone
    Testosterone
    DHEA
    Melatonin

    Kind regards.

    1. I appreciate your input, and testing some of these hormones via serum (blood) is useful, particularly the sex hormones and DHEA. However, the Dutch test measures hormone metabolites, not actual hormones. The 5 samples are averaged over 24 hours. This is very different than serum, which measures actual hormones in the blood at the given moment of the draw, but not hormone metabolism. Hormone metabolism is extremely important, especially for estrogen. In addition, Dutch measures how cortisol is metabolizing into cortisone and vice versa. It also measures the 24 hour cortisol and cortisone curve, and averages all hormone metabolites over 24 hours (with 4-5 samples) – serum will not give any of this information. Melatonin is not measured well by serum. A random blood draw for cortisol or melatonin is not useful, as it does not take into account the diurnal production or rhythm. I have no affiliation with Precision Analytical, the lab that provides the Dutch test. Rather, I use it for clinical information not available via conventional serum tests.
      Best,
      Laura

      1. Hi Laura,

        I agree measuring some levels via saliva is useful, but using this for estrogen testosterone or progesterone is unhelpful when trying to monitor levels caused by exogenous sources ( e.g via transdermal patches ). The levels will be distorts to some degree, and thus patients should discontinue exogenous sources a day before taking samples: But, for example, E2 will have been flushed from the system with 20 hours and dropped significantly withing 12 hours. Progesterone also has a short half life.
        ” Blood tests will not track hormone replacement as thoroughly. ” How does the Dutch saliva test get around this?

        in your example above of LISA: aged 51 ” She used bio-identical hormones,” her results could be distoted.
        Susan, age 44: “Susan had a hysterectomy” . Then should already be on HRT. Her E2/E1 levels would be stable and low. A blood test would show this. No need for saliva snapshots because she is not menstrating.

        1. Soph,
          I am not sure you actually read this post, or familiarized yourself with this test, because the Dutch test is not saliva. Also, the test has very specific instructions as to when to stop taking exogenous hormones for a clear dried urine metabolite sample. Thirdly, in Susan’s case above, estrogen metabolism was/is critical to determine, as it is for all women. Respectfully, if you’d like to educate yourself about exactly what you are commenting on, you can contact Precision Analytical, and get thorough information exactly what this test entails, and all the caveats you bring up.
          Best,
          Laura

        1. I’ve also suffered with a lot of anxiety, terrible periods and worst of all terrible insomnia since stopped nursing 2nd child in January . I have been to cognitive behavioral therapist, I have been to several biofeedback appts, a hypnotist and now working on meditation but sleep is such an issue. I’ve been taking ashwaganda root and just started serotonin supplement and bedtime and progesterone cream and DIM but honestly just doing this off of my symptoms but not sure what my hormone levels are so want to figure this out and do what my body needs. Suggestions? Thank you

          1. I am sorry to hear of your suffering, and you’re doing great work!

            I think it’s best to be under the care of a trusted medical provider rather than guesswork and self-treatment. Do some labs and get a sound treatment plan, from a gynecologist or functional doctor, or someone who is both.

            Best to you!

  2. Will this help me and my Dr figure out how to better balance the bhrt I am on now since it’s been such an issue using only blood tests ? She wants me to use this test too now. Will it help see what’s going on so we can adjust better ??? I pray so

    1. Definitely! Especially because if adrenal hormones are dysregulated, then BHRT is less likely to work. And it’s also important to know about hormone metabolism.

  3. Since the birth of my 2 kids I have not felt “right”. Extremely tired, full of anxiety, major mood swings, easily frustrated and now really heavy and painful periods. I know there is regular fatigue and stress that comes with becoming a mother, but I was never like this prior to the children. I’m seriously wondering if it could be a hormonal imbalance? I’m still nursing (morning and night) my youngest, and I know that affects hormones as well. I know producing oxytocin is supposed to make you feel warm and fuzzy happy feelings…but it seems to have done the opposite for me. I’ve never felt that and actually felt worse breastfeeding, but continued to do it for the benefit of the children. However I’m now realzing that it may have been the cause of some of my issues. Would it be better to wait until after the breastfeesing to test? I have no idea how long it takes for hormones to adjust back to “normal” after stopping.

    1. Cheryl,

      It’s fine (and sounds appropriate) for you to test hormones now instead of waiting until after breastfeeding ends.

  4. I am 59 post menopausal for over a decade, had no menopausal symptoms until years after, have been working with my GYN who does not advocate bio identical hormone replacement so I have been self supplementing with adrenal supplements, progesterone and estriol cream for hair loss, facial hair and hypo-thyroid symptoms, blood serum tests consistently show below normal DHT and high Testosterone, would this test benefit me ?

    1. I always recommend testing rather than guessing, and using hormones judiciously under the care of a medical provider knowledgable about them.

  5. Hi, Laura–

    Which medical practitioner/specialist is best qualified to interpret the DUTCH test results and create a personalized approach to balancing the hormones? My OB/GYN or an Endocrinologist?

    My OBGYN only uses the blood hormone tests; but from those results + my physical symptoms, she was able to identify my PCOS and Insulin Resistance. (My GP of 20yrs had no idea that my many textbook symptoms for those conditions were even indicators, so she never referred me to see a hormone specialist. I found an OBGYN on my own.)

    At present, me and my OB are utilizing Rx, supplements, herbs, acupuncture, & organic/gluten-free/sugar-free nutrition. I’m thankful she’s open to all forms of treatment. However, she’s never once mentioned the Dutch test, and I 100% want to take it since I’ve done research on it and am still having sleep issues (even on Melatonin) and can’t seem to break a weight plateau that’s lasted 2-mos since initially losing 25lbs. It’s like my body does not want to stay asleep for the entire night OR go below the 25lbs I’ve lost under my existing regimen. I don’t want to ask my doctors to assess metabolite results they’ve not been specifically trained to assess or medicate.

    My research indicates an Endocrinologist is the right medical specialist to see. What’s your opinion on this?

    Sienna
    [My stats: 44yo, 1yr post-op open-myomectomy, no new fibroids, hormone blood tests show improved/balanced/normal levels as of 2wks ago, want to ttc next yr, I suspect my cortisol and adrenals are still off.]

    1. I don’t think an Endocrinologist would interpret the Dutch test unless they are a Functional Medicine doctor. This is a Functional Medicine test. The company can tell you which of us Functional prax runs a lot of Dutch tests. I hope you know about the PCOS Solution program – getting awesome results!
      https://myhormoneanswers.com/

    1. Deborah, either choice is valid. Check with your practitioner to see what she/he has in mind.

  6. I finally decided to see a Naturopath after years of feeling unwell and suffering panic attacks. I am 59 and had a total hysterectomy at 49.
    My GP and the specialists were useless at helping me.
    My Naturopath found me very low on Vit B12 and D and one of my thyroid tests was abnormal.
    I just finished doing the DUTCH test and am looking forward to the results. The two vitamin supplements have already helped me and I suspect my adrenals are way off.
    I am also going to do the SIBO( May as well go all the way) as I have had gut issues for years that mysteriously( my gastro’s exact words) disappear whenever I took antibiotics for something else ?
    My extended health coverage will cover some things but even if nothing was covered it’s very worth it to have a thorough check of my systems done and maybe help me feel better.
    I feel the traditional medical system is uninterested and has let me down big time.
    I am thankful to have access to do this testing through alternative medical practitioners.
    It’s the way of the future and the system needs to get on board with it!

  7. I always prefer testing rather than using and getting addicted to painkillers medicines without getting into the root cause. The most impressive part of your article is the real example women who changed themselves after hormone testing.

  8. I have peripheral neuropathy, and will try stem cell therapy. I have reseRched, and one doctor who was thorough said I shoul also have the Dutch test.
    I would like to order this test.

  9. Hi Laura.

    I’m wondering if the DUTCH test is the next step in my search. I’m 39 years old and for years have been feeling “off”. I’ve seen an endocrinologist, gyn and gp and not one has been able to help. Blood serum tests have come back in the “normal” range. Recently I took the GI map test which indicated sibo and have been undergoing treatment for a month. While I feel better, I still don’t feel well. Weight gain and low libido are primary concerns. My question is if the blood serum tests are normal, can the DUTCH identify anything further that may help these two issues? Thank you.

    1. Hi,
      Certainly the Dutch test can provide info about libido and weight loss resistance. With the latter, there can be many many root causes. The GI Map is not diagnostic of SIBO, unfortunately.

  10. I am 59 years old and post menopausal for almost 10 years. If I am on bio-identical hormones (Pellets Progesterone & NP Thyroid from a compounding pharmacy), when is the best time to take the Dutch test to get the most useful results? Before I re-pellet or after? Thx

  11. Hi,

    Can you take the Dutch test if you are already on supplementation and herbs for adrenal issues and to improve immunity? Will it still give an accurate reading?

    1. It could shed light, but I highly recommend getting guidance from a doctor and possibly a pelvic physical therapist.

  12. If you don’t know when or if you ovulate then when would you test using the Dutch complete? My cycles are fairly regular every 28-30 days, but have extremely heavy bleeding the first 4 days and then taper off and spot for 3-5 days more. I have fibroids. It has been very difficult to determine when I ovulate or if I do ovulate. So, what day would I test? Do you recommend ovulation strips? Thanku!

  13. I was on a hormonal (levonorgestrel) iud for heavy bleeding for three years. I had it removed due to a serious adverse reaction. That synthetic steroid accumulates and is known to linger in the body long after the removal of the iud. How long after removal of the iud should I wait to do the Dutch test? Thank you.

  14. We are trying to figure out why my daughters hair has been thinning for the last 13 months. I’ve been to 9 doctors and specialists. I’m I terested in using the dutch testing. She takes a lot of supplements. So when would she need to stop taking the supplements amd what day of her cycle would she do the test? She is almost 16 years old. Thank you

  15. Ive been on bio identical Estrogen (cream), Test(cream), Preg (Capsule) and Prog(Capsule) for a year and half. In December I found a cyst in my left breast and my DO told me to stop all BHRT with no alternatives. Hot flashes and no libido came right back. Ive been researching this urine hormone test (dutch test) in the hopes I can feel comfortable going back on after ruling out any estrogen metabolism issues. A few questions 1. Do you do phone consultations? I am in California. 2. Your feelings on pellet therapy 3. My mom died of post menopausal breast cancer in 2000 (they say it was from estrogen injections in the 70’s), i have developed a cyst after my estrogen was increased – am I still a candidate for BHRT? or is it something I should avoid?

    1. Hi!
      1. Yes I do remote consultations by phone, although I prefer video.
      2. It depends.
      3. You need to consult your provider for this question.
      Best,
      Laura

  16. How do I go about finding an MD to guide my treatment? My GP has been trying to find the source of my insomnia for two years with no success. I’m 37, mother of two. I’ve had insomnia since I stopped breastfeeding my youngest. I truly think it’s hormone induced but no one has been able to help me! Help!

  17. Hi, I’m interested in the Dutch test. But my problem is I’ve done saliva testing and blood work, I know these are not the same but it showed estrogen dominance but recently showed through serum low estrogen along with low testosterone.
    I’ve tried bioidentical cream for replacement of low progesterone which causes severe migraines and I’ve also tried replacing estrogen & testosterone with increased migraines. Have you came across someone who can’t take bioidenticals? I’m 42 hysterectomy with 1 ovary left.

  18. I have read about the use of bio-identical hormones for hormone replacement. What is your take on that?

  19. Hi Laura. In Judy’s example above with low cortisol and low sex hormones, treatment was with herbs, supplements and foods. Is it possible to bring hormones back to balance without needing bio identical hormones? I suffer from extreme fatigue all day long and I have estrogen dominance with uterine fibroids.

    Also, I cannot find the cost of consultations on your website.

    1. The fee is for the test and does include some lab notes. Further interpretation and treatment can be from your doctor.

  20. I am currently seeing a hormone specialist and have been on bio-identical hormone replacement for several years. I’m 70 ( feel 50) however I’ve gained lots of weight around the mid line waist and nothing is helping. My doctor has had me do the blood spot test several times along with the saliva cortisol test. My cortisol was off balance and my estrogen is high. I’d like to take the DUTCH test and have my hormone specialist look at the results. How would he know what to adjust and what supplements to administer? Does the test give all this information to get me back on track? I eat gluten free, dairy free and whole foods 95% of the time. Appreciate any suggestions!

    1. Hi Jan,
      Most people have their practitioner interpret the DUTCH test for them and make recommendations.

  21. Hello! I’m 48 and I am post menopausal. I am a personal trainer, I eat right and exercise daily and I am gaining weight. I’m tired all the time and I feel overwhelmed and foggy very often. The quiz said I am peri menopausal but I am most definitely post.
    (I went through menopause at 43)

    Can you help me understand the process?
    Do I send this test back to you or how does this work?

    Thank you!
    Shana Mullaney

    1. Shana I think there was confusion about this question on the quiz: Are you over age 40 and feel like you’re in puberty again with cycles changing, hot flashes, poor sleep, mood swings, or anxiety? … It should be Are you over age 40 and feel like you’re in puberty again with cycles changing PLUS hot flashes, poor sleep, mood swings, or anxiety? Meaning, still having cycles. I will fix this to make it more clear.

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