Frequently Asked Questions

WHY USE DUTCH?

The Easiest Patient Collection: Patients collect just four or five dried urine samples over a 24-hour period. Dried samples are stable for several weeks making them convenient to ship worldwide.

Analytical and Clinical Validation: Precision Analytical’s testing methods go through a rigorous validation process to verify accuracy, recovery, and linearity. We pride ourselves in relentlessly pursuing the most accurate and precise techniques available for testing. See the data on the next page to support the analytical and clinical validation of this powerful new testing model.

Effective HRT Monitoring: DUTCH testing was designed to be optimally effective for most forms of hormone replacement therapy. Unique methods are used for improved monitoring of oral progesterone and vaginal hormones.

HOW DOES DUTCH COMPARE TO OTHER HORMONE TESTS?

DUTCH vs. Saliva Testing – 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.

DUTCH vs. Serum Testing – While the most universally accepted testing method (due to the availability of FDAcleared 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).

DUTCH vs. 24-Hour Urine Testing – 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.

How does the DUTCH Plus™ compare to the DUTCH Complete™?

The DUTCH Plus™ includes ALL of the markers included in the DUTCH Complete™, but the free cortisol measurements all come from saliva, not urine. The DUTCH Plus™ includes a 5th free cortisol measurement. Saliva collections at waking, 30 minutes after waking, and 60 minutes after waking allow for the assessment of the Cortisol Awakening Response. The collection is slightly more burdensome compared to the amazing ease of the DUTCH Complete™ due to the extra samples required. However, the DUTCH Plus™ is put together in a way that is very manageable for patients. In addition, our saliva collection devices are easier to use than traditional devices used by other labs. While the DUTCH Plus™ is still very cost-effective, the kit contents, shipping required (express return shipping paid for by Precision Analytical Inc.), and analytical methods make the cost higher.

What is the Cortisol Awakening Response and how do we test for it?

When we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 30 minutes after waking, cortisol levels will still show this sharp increase. By 60 minutes after waking, cortisol levels have peaked and begin to decline. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range. A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.

Can I do the DUTCH test if I am on birth control pills or have an IUD?

Women on birth control pills have suppressed estrogen and progesterone levels Synthetic estrogens and progestins will NOT show up on test You can use the DUTCH test if you are taking birth control, but testing the sex hormones will have diminished value.  Temporarily stopping the pill will still yield lower results. If you recently stopped taking the pill, wait three full cycles without the pill before testing Mirena IUD does not tend to supress estrogen like birth control pills. You may see estrogen dominance. Copper IUD should not affect results because it is nonhormonal.

Can I do the DUTCH test if I take hormones?

Yes, Precision Analytical gives a “Hormone Schedule” in the test instructions on how to time the sample collections with hormones.