DUTCH Plus

Service Description

The DUTCH Plus® takes hormone testing to a whole new level. In addition to sex hormones and their metabolites, the DUTCH CompleteTM looks at the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. The DUTCH Plus® adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus. What’s Included in the DUTCH Plus®? The DUTCH Plus™ uses four dried urine samples and five saliva samples. These samples are collected over the course of one day, from waking to bed time. The results include: • Analysis of 35 different hormones: estrogen, progesterone, testosterone, DHEA-S, and cortisol along with their metabolites, plus the cortisol awakening response (CAR) • Graphical representation of results and embedded video tutorials to assist in the hormone assessment to share with your medical provider • DUTCH OATs: Melatonin (6OHMS), 8-Hydroxy-2-deoxyguanosine (8-OHdG), and six organic acid tests (OATs) including markers for vitamin B12 (methylmalonate), vitamin B6 (xanthurenate), kynurenate, glutathione (pyroglutamate), dopamine (homovanillate), norepinephrine/epinephrine (vanilmandelate). 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. *Not available in NY, NJ , RI or MD*

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