Functional Diagnostic Assessments

DUTCH® Complete Hormone Testing: Get The Complete Picture With Hormone Imbalance Lab Testing In Toronto

Get To Know Your Hormone Levels with the DUTCH test

Hormones are chemical messengers that are secreted by specific glands in your body. These glands, called endocrine glands, release hormones into the blood where they travel to their target tissues and organs exerting a specific effect. Sometimes when hormones are out of balance we can experience a number of concerns.

Getting to the Root of Symptoms of Hormone Imbalance with DUTCH Complete Hormone Testing Services

If you are experiencing any of the following symptoms, hormone imbalances may be at the root.  The DUTCH test is a functional diagnostic test that may help to uncover what is happening at the root of hormonal concerns.

  • Weight gain or inability to lose weight
  • Fatigue
  • Migraines and headaches
  • Decreased sex drive
  • Muscle or joint aches
  • Depression, anxiety, or irritability
  • Infertility
  • Weight loss or decreased appetite
  • Salt cravings
  • Brain fog
  • Mood swings or loss of emotional control
  • Fluid retention
  • Cramping pains, back pains
  • Heavy periods, or very light periods
  • Breast tenderness, lumps, or cysts
  • Light-headedness or fainting
  • Muscle weakness
  • Abdominal pain, nausea, diarrhea or vomiting
  • Hot Flashes
  • PCOS

What is the DUTCH test? Is it simply a urine test?

The DUTCH test, or the Dried Urine Test for Comprehensive Hormones, is a simple dried urine test capable of gathering an extensive amount of information on hormones and how they are metabolized in the body. Measuring both hormones and their metabolites can give a better overall picture of hormone production. The test is compact, concise and user friendly. It is set-up so that patients can take it home and collect samples without disrupting their usual schedule. The kit consists of an envelope containing instructions, a requisition form, and 5 paper strips for sample collection. 4 dried urine samples are collected throughout a 24-hour period:

  • Waking
  • 2 hours after waking
  • Dinner time
  • Bed time
  • Extra Overnight sample if needed

The DUTCH test uses functional medicine testing to measure these hormones and metabolites:

Sex Hormones & Metabolites:

Estrogens – The balance between estrogen and progesterone is important for fertility, PMS and menopausal symptoms.

Estrogen metabolites – These metabolites show how your body is detoxifying estrogen. If not optimized, it can increase your risk of breast cancer, prostate cancer, cysts and fibroids.

Testosterone – there is an optimal range for men and women which is associated with vitality and wellbeing, low levels can affect mood, fertility, libido and athletic performance.

Progesterone metabolites – (a-pregnanediol, b-pregnanediol) will indicate your total progesterone levels, these are also precursors to make the neurotransmitter GABA. Low progesterone levels can lead to PMS symptoms and infertility.

Androgen metabolites of DHEAS and Testosterone – this is important to assess how well your body is processing testosterone, if it is metabolized down the 5a-DHT pathway this can cause hair loss, skin problems, aggression and even increase prostate cancer risk in men.

Adrenal Hormones & Metabolites:

Total metabolized cortisol – this shows you how much cortisol your body is making over the entire day and can be very different to the free cortisol level. The amount of cortisol you are producing will help to guide your treatment plan.

Total cortisone – tells us how quickly your body is deactivating cortisol to cortisone.

Free cortisol – this shows you the active levels of cortisol in your body, the level and rhythm of free cortisol will help to guide your treatment plan.

Free cortisone – plus the metabolites of cortisone to show how quickly cortisol is getting deactivated to cortisone, this will help to guide us on the best treatment strategy for you.

  • Tetrahyrdocortisone – this is a metabolite of cortisone;
  • a-tetrahydrocortisol – this is a metabolite of cortisol;
  • b-tetrahydrocortisol – this is a metabolite of cortisol.
  • DHEAs – is a precursor to testosterone and estrogen, a high level can indicate PCOS and inflammation, a low level can indicate adrenal insufficiency.

Organic Acids:

Just added to the DUTCH test are markers for neurotransmitters, B12, B6 and glutathione.


6-OH-melatonin-sulfate – which assesses melatonin production, low melatonin can affect sleep quality making it difficult to fall asleep or stay asleep. Melatonin also has antioxidant affects which can help to protect the brain and improve mood.

DUTCH vs. other testing methods

Dried urine testing has become a very sought after form of hormone testing as it is a good reflection of not only hormone levels, but hormone metabolites. Metabolites are the downstream breakdown products of hormones and are excreted in the urine. Some of these metabolites can be harmful, so testing their levels can be useful in determining the root cause of symptoms.

Saliva testing: Useful for testing free cortisol, but does not measure cortisol metabolites. To properly characterize a patient’s cortisol status, free and metabolized cortisol should be measured to avoid misleading results when cortisol clearance is abnormally high or low. Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture for more precise clinical diagnosis.

Serum testing: Adrenal hormones cannot be effectively tested in serum because free cortisol cannot be tested throughout the day. There is also a lack of extensive metabolite testing (especially for cortisol and estrogens).