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Advanced Adrenal Metabolism – DUTCH HOR 34

Advanced Adrenal Metabolism – DUTCH HOR 34

About the DUTCH Advanced Adrenal metabolism Profile

DUTCH stands for, Dried Urine Test for Comprehensive Hormones. Urine samples are taken using filter paper making the test easy to do at home as there is no need for a blood draw or 24-hour total urine collection. You need to collect just four or five dried urine samples over a 24-hour period.

This profile is a comprehensive assessment of adrenal hormones and their metabolites. The profile includes measures of both ‘free’ cortisol as well as in it’s inactive form called cortisone.

The Advanced Adrenal Metabolism Profile provides:

  1. Assessment of the daily pattern of free cortisol throughout the day
  2. The total level of cortisol metabolites providing insight into total cortisol production
  3. Assessment of the body’s preference for cortisol (active form) or cortisone (inactive form).

Who is the Dutch Adrenal Metabolism Profile Urine Test for?

 This test is suitable for any one that is looking for a comprehensive way to measure and assess the impact of stress levels on their health. This profile provides insight in to the body’s ability to manage stress by assessing the hormones cortisol and DHEA. Imbalances in these hormones can result in a wide range of symptoms from fatigue to loss of motivation, depression and hormonal problems.

What do the adrenals do?

The HPA-Axis is responsible for the stress response and gut brain communication. When a physical or psychological stressor occurs, the brain sends a message to stimulate the adrenal glands to make the stress hormone, cortisol and to a lesser extent DHEA and DHEA-S. This is part of a series of steps that start with the HPA – Axis made up of the hypothalamus (H) and pituitary (P) in the brain down to the adrenal glands (A) that sit on top of the kidneys.

Normally, the HPA-axis production follows a daily pattern in which cortisol rises rather rapidly in the first 10-30 minutes after waking in order to help with energy, then gradually decreases throughout the day so that it is low at night for sleep. The cycle starts over the next morning.

There can be problems with the signalling and communication between the brain and the adrenal glands, and /or with the production of our stress hormones, resulting in many different symptoms or conditions of adrenal dysfunction.

These may include:

  • Fatigue or low energy
  • Depression
  • Insomnia
  • Anxiety
  • Loss of libido or sex drive
  • Loss of motivation and focus
  • Weight gain
  • Mood swings
  • Poor concentration and memory

What is being measured

 The DUTCH Advanced Adrenal metabolism is a urine test that provides data that parallels saliva testing.

• Daily free cortisol pattern (4)
• Daily free cortisone pattern (4)
• Cortisol metabolites (a-THF, b-THF)
• Cortisone metabolites (b-THE)

Type of specimen required for the test


Why test adrenal hormones via Urine?

When testing hormones, we have the option of three different sample types which provides different information. To better understand this you need to know the cortisol is the active hormone whilst cortisone is the inactive hormone.

1. Testing hormones in blood provides an assessment of both the active hormone and the binding protein. The binding proteins help to transport the hormones around the body.

2.  Testing Hormones in saliva we are measuring the ‘free,’ unbound fraction of the hormone which is bioavailable to act on cell receptors , but it usually represents only about 1-3% of total production leaving the bound part of the hormone unassessed. A 4-point Salivary unbound cortisol profile provides insight into the pattern of free cortisol throughout the day.

3.  Testing hormones in urine, the free unbound cortisol is represented in the same way as the unbound saliva, but it also assesses the total cortisol production, and a comparison between the active form of cortisol and the inactive form of cortisol (cortisone).

We can use the analogy of money to help explain this:

Testing hormones in blood is akin to having your money tied up in investments. It is present but not available to be spent (blood). When we draw down the investment and release the cash, we now have it available to spend (saliva, and also reflected by urine). Once we have spent it, all we have left after the purchase is the cash receipt (urine).

Important information

This test is suitable for adults only; the minimum age for testing is 12 years old.

Returning your sample

Samples are posted back to the lab in the US via normal postage and need to arrive within 3 weeks of taking the samples.

How long does it take to get my results?

Test results take 10 working days

Test specific Q&A

What if I miss a collection?
Simply collect the sample as instructed the following day. All samples do not need to be collected in one 24-hour period.

Do I have to take the samples in the order listed?
No, they can be collected in a different order. If you wish you may start with sample #3, followed by #4, #1 & #2. If you begin with #3, collect the extra sample if you wake and urinate in the night.

How long can I keep the dried samples before sending them in?
While hormone levels are very stable in dried samples, they should be sent back as soon as possible. If you have to wait to send them in, place in freezer (in plastic bag) after drying.

Do I need to stop taking my hormones for this test?
This test is built to test patients “on” their hormones. Our suggestion is to follow the Hormone Schedule (listed previously), and any specific instructions given by your provider.

What if my sleep schedule is abnormal (night workers, etc.)?
Collect the bedtime sample (#2) before your longest stretch of sleep, the waking sample (#3) after this sleeping period, and sample #4 two hours later. The dinnertime sample (#1) should be collected 4-7 hours before bed.

What if I am unable to urinate at the specific time?
Simply drink some fluids and go as soon as you are able.

Please see sample report below
Advanced Adrenal metabolites DUTCH Sample Report