What is The DUTCH Test?
The DUTCH test (Dried Urine Test for Comprehensive Hormones) is a comprehensive hormone panel used to assess hormone imbalance in women of all ages. It involves collecting a small amount of urine on filtered paper and returning the dried strips to the lab. The tests measures adrenal and sex hormones and their metabolites in the urine.
What can a DUTCH test tell you about your hormonal health?
The DUTCH complete test is by far the most advanced hormonal test available. It provides information about the following:
- Your oestrogen and progesterone levels
- Your testosterone level
- Your preferred metabolic pathway for each of these hormones
- Your methylation index, i.e. your ability to clear potential cancer-inducing oestrogen metabolites from your system
- Your total daily cortisol production, as well as your cortisone and cortisol metabolite levels
- Your daily free cortisol pattern
What are the limitations of the DUTCH test?
- It is expensive.
- There are no randomised controlled studies (the gold standard of evidence) to validate the benefit of doing this test. More research is therefore needed.
What are the benefits of a DUTCH test?
- All steroid hormones start as cholesterol, which is then metabolised along various metabolic pathways to progesterone, cortisol, testosterone and oestrogen. Knowing what happens along these pathways help us identify potential root causes of your symptoms. For example, testosterone is turned into oestrogen with the help of an enzyme called aromatase. Aromatase can be dialled up or down by a variety of lifestyle and dietary factors. This matters, for example, if you present with symptoms in keeping with oestrogen dominance.
- Testosterone gets metabolised via two different metabolic pathways. The 5-alpha pathway produces a far more androgenic metabolite than the 5-beta pathway. Knowing which is your body’s preferred pathway can help explain symptoms like acne and excessive hair growth, even if your testosterone levels are normal.
- Oestrogen is metabolised via three different pathways. The 4-OH pathway is potentially problematic as it produces interim metabolites which can bind to and damage DNA, increasing your risk of cancer. If this is your body’s preferred pathway, you need to ensure that your detoxification pathways in your liver is functioning optimally so that these interim metabolites can be rendered inactive and cleared from your body.
- Methylation is another important mechanism for clearing the damaging 4-OH oestrogen metabolites from your body. It relies on a functioning MTHFR gene. However, 60% of the population have mutations in this gene, reducing your body’s ability to adequately methylate and inactivate damaging metabolites. The DUTCH report provides an indication of your methylation activity.
Should you get a complete Dutch Test?
The DUTCH test provides valuable information as discussed above. It shines the spotlight on potentially serious health risks that can be mitigated with lifestyle and nutritional interventions. It also explains the drivers behind your symptoms. But it is an expensive test and a comprehensive lifestyle and nutritional treatment plan should address most of the issues without needing proof that they exist. So, similarly to the gut microbiome mapping test, this is a ‘good to know’ test but probably not essential.
Not sure what to do?
Book an exploratory hormonal health consultation with Dr Nelda Swart to discuss the pros and cons before you make the investment.