What Is a DUTCH Test, and What Does It Measure?

How the collection works

You collect four or five small urine samples on filter paper over about a day: typically in the early evening, at bedtime, on waking and a couple of hours after waking. The strips dry and are mailed back to the lab.

The timing is the point. A single blood draw gives one reading at one moment. Several timed samples show how a hormone such as cortisol moves across the day, which one reading cannot.

Collection days matter for anyone who cycles. The lab gives instructions on which days to collect, and a sample taken on the wrong day can make a result look unusual when it is simply mistimed. Some medications and supplements also affect the reading, so the lab’s preparation instructions are worth following closely.

What a DUTCH test measures

The most commonly ordered version, DUTCH Complete, reports several groups of markers.

Sex hormones and their metabolites: estrogens and testosterone are measured along with the compounds the body breaks them down into. Progesterone is reported through its metabolites, because urine does not carry progesterone itself in a useful amount.

Estrogen metabolism: the report shows which breakdown pathways estrogen is taking and in what proportion.

Cortisol and cortisone: the timed samples produce a daily curve, alongside a figure for total cortisol metabolites.

DHEA-S and a melatonin metabolite measured in the waking sample.

A small set of organic acids, which are markers related to certain B vitamins and to neurotransmitter breakdown.

Why metabolites are part of the report

A blood test tells you how much of a hormone is circulating when the blood was drawn. A urine metabolite test adds what the body has been doing with that hormone over the collection period.

That is different information, and it is useful for different questions. Two people can have a similar hormone level in blood and process it quite differently. It does not make one test better than the other. Blood remains the standard for many decisions a physician makes, and the two are often read side by side.

What a DUTCH test cannot tell you

It does not diagnose anything. A pattern on a DUTCH report is not a diagnosis of a hormone condition, and it is not a reason to start, stop or change a medication. Those decisions belong with your physician.

It is a snapshot. Hormones respond to sleep, stress, illness, travel and where you are in a cycle, and one collection reflects that day.

It is not the right test for every question. Thyroid hormones are not on it, and for some people a standard blood panel answers the question more directly and for less money.

As health coaches, we use a DUTCH report as one input among several: your history, your symptoms, other labs you hold and how your days actually run. If a result suggests something that needs medical attention, we say so and encourage you to take it to your physician.

When we consider it

We do not run a fixed set of tests. Whether a DUTCH test is worth ordering depends on your symptoms, history and goals, and on what you already have. If you have recent hormone bloodwork, that is often where we start.

The complimentary consult is where we talk that through. If the test would not change what we would suggest, we will tell you.