Here I describe why I use the Dutch Complete Hormone test as part of Phase 1 in my VIBRANT WOMEN OVER 40 Functional Medicine program. I also use this test for younger women. I explain what this test is and why I recommend it for all women.
What is the Dutch Complete Hormone test?
Precision Analytical labs developed this unique test. It measures your hormone metabolites from dried urine samples. The hormones include:
This test also measures your cortisol and cortisone rhythms and levels, and your estrogen metabolism pathways.
Why measure all these hormones?
There are lots of reasons!
For women over 40….
- If you use hormones, you want to monitor your levels. This test works uniquely well for oral progesterone, vaginal hormones, patches, pellets and injections.
- 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. I’ll explain this more in a separate post. Estrogen dominance can cause premenopause and menopause symptoms.
- 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.
Women of all ages….
- 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.
- With with fertility problems, polycystic ovarian syndrome (PCOS), fibroids, PMS, irregular periods, and endometriosis, this test is highly beneficial. It gives a complete picture of how adrenal and reproductive hormone imbalances contribute to these problems.
- This test is essential to check how you metabolize estrogen at any age. Even if you aren’t estrogen dominant (although many women are, especially in their late 30s and beyond), you want to reduce risks of estrogen-related cancer.
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 on the company’s website. In my practice the comprehensive test is $325, the adrenal-only portion is $225, and the sex hormone-only portion is $225. I recommend most women do the full test. 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. (By the way, I am in no way affiliated with this lab.)
What happens with the results?
We use the information to make adjustments to balance your hormones! Your results will be unique to you, so of course your protocol will be tailored. It may mean sleep or stress reduction is the top priority. Perhaps it is simple dietary changes that will shift your hormone balance. Or, the addition of missing nutrients that your hormones need to function. Sometimes herbs, supplements, or even bio-identical hormones are your best option.
Women who changed their lives with this test:
(names and photographs are fictitious to protect these patient’s identities)
Lisa, age 51:
Lisa felt exhausted for about four months, since a demanding overseas work trip. She had a history of chronic stress from her job. She used bio-identical hormones, had high cholesterol, low thyroid, and difficulty losing weight.
Results: Lisa’s test showed high cortisol. This correlates with abdominal weight, hypothyroid, and high cholesterol. Her high cortisol levels were most likely from chronic stress. She also had been on a calorie restricted diet, which can increase cortisol. Her test showed her estrogen, progesterone, DHEA, and melatonin levels were all good. It also showed her estrogen metabolism pathways were working well. It was safe for her to continue her bio-identical hormones.
Lisa needed to lower her stress and her cortisol. We made lifestyle modifications such as reducing stress, adding calories, and incorporating HeartMath. We also added supplements to regulate her adrenal (HPA axis) and lower cortisol. Her energy improved immediately.
Judy, age 63:
Judy was extremely fatigued all day long. She relied on strong coffee to get through the days. She slept poorly at night, and had a hard time getting up. Judy was retired and not aware of current stress. However, she did have past excessive stress from a divorce.
Results: Judy’s test showed high cortisol. Her cortisol and cortisone rhythms were off: very low in the day and elevated at night. This explains her poor sleep and “night owl” energy.
Her DHEA was very low. We only did the adrenal portion of the Dutch test, so we didn’t have information on sex hormones or melatonin.
Judy simply added supplements to support her serotonin production for sleep, raise her DHEA, and lower her cortisol. Within days she was able to go to sleep earlier and she slept significantly better. Her energy increased. She was able to go back to work (which she wanted to do), and add working out.
Susan, age 44:
Results: Susan’s test showed low female hormones, which was no surprise. It also showed high androgen hormones (testosterone and DHEA). Fortunately, her cortisol and cortisol rhythm were normal. This meant her symptoms were not related to her adrenals.
Since her androgens were high, I did Functional Medicine blood tests to search for signs of PCOS. This may sound like an odd path, as Susan was not going to have more children and PCOS is usually thought of as an infertility problem. However, PCOS can mean problems with metabolism that should be addressed regardless of reproduction. We did find out that she had markers of Metabolic Syndrome. These included high cholesterol and blood sugar.
We revamped Susan’s diet to control her early stage Metabolic Syndrome. We added a single supplement which allowed her to wean off Ativan. She then went off the supplement and used exercise and stress management techniques to successfully work with her anxiety and get good sleep.
Lucy, age 55
Lucy’s symptoms included chronic small intestine bacterial overgrowth, anxiety, low energy, and poor sleep. She was on hormone replacement therapy.
Results: Her test results showed extremely low cortisol. This means that we do not know whether symptoms like anxiety, poor sleep, or low energy are due to HIGH or LOW cortisol. Lucy had low daytime cortisol that drifted higher at night. This inverse curve is fairly common with sleep problems. Cortisol should be low at night. Her estrogen was very high, while her progesterone was low. This ratio is not good for any woman. Lucy metabolized her estrogen through an unfavorable pathway, one that increases risks of estrogen related cancer. Her phase 2 estrogen metabolism pathway, one that uses methylation, was also impaired.
These results are complicated. It’s likely her low cortisol caused her inability to resolve her small intestine bacterial overgrowth. Low cortisol lowers immunity. It can also cause anxiety. Her hormone replacement was imbalanced, with too much estrogen and too little protective progesterone. Her poor estrogen metabolism is of great concern.
These women demonstrate a range of Dutch hormone test results for women over 40. Each test result is unique. Each treatment or solution is also unique.
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