You Deserve Better
Unfortunately, many women are lead to believe that their hormones are “fine” or “normal” because of a serum (blood) test done at their doctor’s. However, serum testing is woefully lacking in giving you a comprehensive or sometimes accurate representation of your hormones. This leaves many women thinking there is nothing wrong until they have fertility issues or struggle with ongoing symptoms like acne, PMS, depression, anxiety, fatigue, migraines, and irregular or heavy periods that they can’t get to the bottom of.
In this article I am going to discuss the problems with standard hormone testing, introduce you to the most advanced hormone test available, and talk about why every women (even those not struggling with hormone issues) can benefit from this easy-to-collect, hormone test that can be done in the comfort of your own home.
Hormone Testing 101
The biggest problem with standard hormone testing is that many times a woman is given a script to go get their blood drawn for hormone testing but not told WHEN to go. This is a huge issue! Your hormones are drastically different from one part of your cycle to another! So first off, it you have been told your hormones are “normal” but no attention was paid to the timing of this collection, well, that’s not doing you any favors. For example: if blood was drawn from days 1-14 of your cycle and you were told you had low progesterone, that’s actually normal! Progesterone is supposed to be low in this half of your cycle. Additionally, it blood was drawn on days 15-30 of your cycle and low estrogen was said to be the issue, again, that is what’s supposed to happen! Plus, there is no way to correlate this one value with how it should be changing throughout the month since it is only a snapshot into that monthly cycle period.
In addition, serum labs can only tell you so much. These labs usually assess one level of the main hormone levels estrogen, progesterone, testosterone, and (maybe) cortisol. This information is helpful as a starting point, but, there is a much more comprehensive approach that every women should take advantage of.
What is the DUTCH Test?
First off, let’s address the elephant in the room here: the DUTCH test is not a test to see if you have any Dutch heritage in your genetics. DUTCH stands for Dried Urinary Test for Comprehensive Hormones and is the most advanced hormone test available to functional medicine practitioners. The information provided by the DUTCH test is invaluable when helping you get to the root-causes of hormone issues.
The DUTCH test is the number one testing method I use in my practice for a number of reasons:
In the DUTCH Cycle Mapping progesterone and estrogen are mapped out over the course of 30 days to see exactly how these two hormones are harmonizing, or not, throughout your monthly cycle. On top of this the DUTCH provides hormone detoxification markers, neurotransmitters, oxidative stress makers, and organic acids which no serum draw can ever provide.
- The collection is super easy and done in the comfort of your own home.
- Collecting this test is done between days 19 and 22 of a 28-day cycle in order to provide the correct information needed for proper assessment. If a woman does not have a regular cycle, that’s where we would have a conversation and make sure she collects on the right day for her, not just any old day of the month.
- Hormones are so much more than just the standard three that normally get tested (estrogen, progesterone, and testosterone). In addition to these hormones, the DUTCH test also evaluates: cortisol, organic acids, oxidative stress markers, neurotransmitters, and hormone metabolites.
What These Hormones Mean For You
Cortisol is the major stress hormone that could be impacting your energy and fertility. If you feel like you aren’t human until you have three cups of coffee in the morning, or you’re “tired and wired” at night and can’t fall asleep, or anxiety is a constant struggle… this guy may be the culprit. The DUTCH test collects four points throughout the day to map out what is really going on. If you look at the photo below, you can see the four cortisol points collected which is the red line. This woman was experiencing morning anxiety and trouble sleeping which you can see on DUTCH Collection #1 (high morning cortisol and the peak in night cortisol). After a blend of adaptogens and morning mindfulness were implemented, this cortisol pattern adjusted perfectly to DUTCH Collection #2. This change was a factor in improving ovulation in this woman.
DUTCH Collection #1
DUTCH Collection #2
Nutritional Organic Acids
Organic acids are functional markers for vitamin deficiency. These compounds essentially back up in human biochemistry when a key nutrient is missing. When these are high, it indicates a deficiency in B12, B6, and/or glutathione. This marker is considered superior to measuring serum B12 levels. A 2012 publication showed that 20% of those tested had a genetic defect in the protein that transports B12 into cells so a deficiency does not show in serum levels. Glutathione is considered “the master antioxidant” and low levels may indicate low egg quality in women. B6 is a critical nutrient in women’s health with emphasis on the following areas:
- Hormone balance
- Pregnancy nausea support
- Reduce PMS
- Better sleep
- Brain health optimization
- Mood support
- Reduce inflammation
- Autoimmunity support
Oxidative Stress Marker
8-OHdG is a marker for estimating DNA damage due to oxidative stress. This marker is considered a biomarker for various cancer and degenerative disease initiation and progress. This marker can be a wonderful way to see if certain nutrients may be helpful to prevent premature chromosomal abnormalities in egg and sperm.
Neurotransmitter markers provide insight into mood and energy issues such as food cravings, fatigue, low motivation, depression, and poor gut health.
Nutritional Organic Acids, Oxidative Stress Markers, Neurotransmitter Metabolites.
This may be my favorite part of the DUTCH test. After hormones are produced and complete their functions, they must be packaged up and shipped out of the body. When this doesn’t happen symptoms like acne, heavy and painful periods, tender breasts, and PMS become an issue. Additionally, as seen in the DUTCH Collection #1 picture below (the red arrow pathway), if estrogen is not detoxified properly it can increase risk for DNA damage. This section of the test allows for individualized detox, lifestyle, and nutrition recommendations.
DUTCH Collection #1
DUTCH Collection #2
This one easy-to-collect test can show if your hormones are being produced in necessary amounts and if they are being detoxed from your body properly to see if your body is managing your hormonal orchestra.
Who Should Take the DUTCH Test?
Honestly, I don’t think there is anyone who wouldn’t benefit from the DUTCH test. Case in point: my personal experience with the test. I took this test only because I had an opportunity to through my work. I remember thinking, “sure – I’ll take this. I have absolutely no hormone issues and I can’t wait to get this back to see just how freaking awesome my hormonal health is.”
I was in complete shock and denial when I got the results back because my DUTCH results showed:
- I was not ovulating (even though I had regular periods with NO issues and had never been on birth control)
- My progesterone was non-existent (the most important hormone for conception)
- I was estrogen dominant and not detoxing this extra estrogen well so it was going down a pathway that damages DNA (hello strong family of breast cancer!)
- I had PCOS
So here I am, finding out that I have PCOS from a test that I didn’t even think was necessary in the first place! After months of denial about my new diagnosis, I finally decided to do something about it. Now, I have DUTCH to thank for launching Let’s Get Real RD where I help women just like you get control of their hormones, even if they didn’t realize they were out of control to begin with, just like I did!
Hormonal Imbalances (PCOS, Endometriosis, PBCS)
In women who have pre-existent hormone imbalances such as PCOS and endometriosis or who have symptoms such as:
- PMS or PMDD
- Insulin resistance
- Painful periods, missing periods, irregular periods
The DUTCH Complete and DUTCH Cycle Mapping are two tests that I use on every single of my TTC (trying to conceive) couples. Take for example a client of mine who didn’t expect to have any problems with fertility. After collecting the DUTCH Cycle Mapping test we were able to see that she simply wasn’t producing enough of her main sex hormones, estrogen, and progesterone to support conception. At the time of writing this we are working together to support this naturally through diet and lifestyle changes, but, without knowing where to start, it would be difficult to understand why she was even struggling. Men can also take the DUTCH Complete, as one-third of fertility problems stem from the male partner, it’s important to not leave them out.
Women Who Have Experienced Miscarriage(s)
A miscarriage is something that no woman or couple wants to go through. There are many things that are simply out of our control here, however, understanding the hormonal role in miscarriage, especially repeated miscarriages can provide hope and clarity through this tough time. Progesterone, the main hormones needed to sustain a fertilized embryo through the initial blastocyte phase and into a developing baby. Without enough progesterone, this process will not happen fully and miscarriage can occur. While there are various medical causes of recurrent miscarriage, including blood clotting and immune disorders, nearly half of all early miscarriages are caused by chromosomal errors in the egg. By improving egg and sperm quality, you and your partner may be able to reduce the chance of miscarriage.
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