DUTCH Complete

Description

What is included in DUTCH Complete test, its director is explaining in this video

DUTCH Complete Overview

https://youtu.be/y5eVHW3k-To

The kit includes:

• Easy directions and filter paper collection strips
• Requisition form for patient information, pertinent supplements, medications, hormone replacement and a health questionnaire
• Sealable return envelope

What is a hormone metabolite and what is hormone metabolism?

When looking at a DUTCH test or through this website, you may notice the word “metabolites” or “metabolized” used fairly often. When you make a hormone such as progesterone or cortisol, or when someone takes a hormone (such as in HRT), it must be processed by the body in the liver through the process of phase 1 and phase 2 detoxification before it can be excreted. This is known as hormone metabolism. As a hormone is undergoing that process, it gets changed into other forms known as metabolites. For example, during estrogen metabolism, the potent estrogen known as Estradiol (E2) goes through phase 1 detoxification in the liver where it can be changed into the estrogen metabolites known as 2OH-Estrone, 4OH-Estrone, or 16OH-Estrone. In the dried urine test, progesterone itself is not found in urine so we test the progesterone metabolites known as a-pregnendiol and b-pregnenediol that correlates well with the progesterone that is floating around in your system. The wording of these concepts can be confusing. 16-OH-E1 is a metabolite of estrone (E1). We also measure E1 itself, BUT as it appears in urine, E1 is actually in the form of E1-glucuronide or E1-sulfate. Those are commonly called “conjugates” of estrone, but some might call that a metabolite since conjugation is part of phase II metabolism. For the purpose of simplicity, we call things like 16-OH-E1, 5a-androstanediol and tetrahydrocortisol “metabolites” (of estrogens, testosterone and cortisol respectively).

What is the difference between pre-menopausal, peri-menopausal, and post-menopausal?

Pre-menopausal describes the time in a woman’s life when she still cycles on a regular basis. This occurs most commonly between her teen years up into her 40’s and sometimes 50’s.

Peri-menopausal describes the time prior to menopause where her hormones are starting to shift due to the ovaries beginning the process of shutting down and not cycling every month. She may experience a change in her cycle (no cycles, short cycles, long cycles, and irregular cycles) that had not been normal to her. She may also experience common symptoms such as insomnia, hot flashes, night sweats, brain fog, weight gain, joint pain, and vaginal dryness. This occurs most commonly between the 40’s and 50’s.

Once a woman has not had a period in 12 consecutive months, she is considered post-menopausal. She may still continue to have unpleasant hormonal symptoms, but she does not cycle anymore.

What if I am on HRT or hormone replacement?

You are still able to use DUTCH testing when on HRT. We strongly encourage you to visit our free video library, find the route of administration you are taking (ie. oral, topical, vaginal) and watch the video in order to determine your specifics. DUTCH testing can provide useful information on hormone metabolism for any form of HRT. To get highly useful information regarding proper dosing of hormones, be careful using DUTCH testing for the following forms of HRT:

• Oral estrogens (estradiol, estriol) – values can be artificially inflated from 1st-pass metabolites that end up in urine from gut metabolism having never been in circulation as a bioavailable hormone.

• Sublingual progesterone, estrogens, testosterone – If these hormones are swallowed when you take them (which is difficult to avoid) a lot of the concentration in the urine will be from 1st-pass metabolism (a hormone that gets metabolized in the gut and excreted in urine without making into circulation as a bioavailable hormone). It is not possible to differentiate between hormones that get into circulation and end up in urine and those that are there due to 1st-pass. This makes the interpretation difficult.

• Transdermal progesterone, testosterone – Monitoring transdermal creams are controversial and not entirely clear (especially with progesterone and to some degree testosterone). For more information on this topic, see our video library.

What if I use the birth control pill/patch/ring/implants (not IUD)?

The birth control pill (patch, ring, and implants) stops the FSH and LH surge from the pituitary to prevent an estrogen rise and ovulation (thus progesterone production) from the ovary. If you hormone test while on the pill, your estrogen and progesterone should be predictably low. That means the pill is doing its job and you are not likely to become pregnant.

If you are on hormonal birth control to prevent or decrease symptoms of certain conditions such as endometriosis or heavy bleeding, talk with your healthcare provider first before just stopping your birth control. If you stop your birth control your symptoms will likely return immediately. It is the healthcare provider’s role (not the labs) to decide what treatment options should be followed, but we want to make sure the lab testing provides maximum information. In some cases where birth control has been taken, reproductive hormone values have diminished value (as they are relatively predictable).

Remember the DUTCH testing is very specific (accurate) so synthetic estrogens and progestins found in birth control are NOT seen by our testing methods.

What if I am on a steroid medication such as prednisone, steroid inhaler, steroid allergy nasal spray or topical hydrocortisone/Cortaid cream?

Cortisol is also known as hydrocortisone and is a corticosteroid (meaning it comes from the cortex of the adrenal glands). Prednisone is a synthetic corticosteroid. Prednisone and other synthetic steroids (dexamethasone, triamcinolone) are much more potent and remain circulating in the body a lot longer than cortisol. They can cause a lot of side effects such as adrenal suppression, thinning skin, and weight gain however they may be necessary in an emergency or autoimmune situation. If someone is taking a steroid medication regularly, it may disrupt and suppress the adrenal gland output of cortisol resulting in very low cortisol markers on the DUTCH test.

Be aware that a “steroid hormone” and someone taking synthetic steroids such as for body building are different. “Steroid hormone” is an umbrella term for those hormones made in the cortex of the adrenal glands (ie. cortisol) or the gonads (ie. testosterone or progesterone). Remember the DUTCH testing is very specific (accurate) so synthetic glucocorticoids like Prednisone are NOT seen by our testing methods.

What about metabolized cortisol?

On the adrenal page of our test, we measure metabolized cortisol. Just like above, cortisol has to be processed in the body and is then excreted as metabolized cortisol. On our test these markers are known individually as a-tetrahydrocortisol (aTHF), b-tetrahydrocortisol (bTHF), and b-tetrahydrocortisone (bTHE). They are the best marker of the total cortisol output from the adrenal gland (see the cortisol section for more information).