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Advanced DUTCH Check

Type

Blood Testing

Biomarkers

56

Duration

30 min

Results

14 days

Comprehensive hormone analysis using dried urine to assess hormone balance and identify potential imbalances.

Adrenal and stress hormone profiling tests — including the DUTCH (Dried Urine Test for Comprehensive Hormones) — provide a detailed picture of how your body produces, metabolizes, and eliminates stress hormones and sex hormones throughout the day. Unlike a single blood draw that captures one moment in time, these tests typically collect multiple samples over 24 hours to map your cortisol curve — the natural rise and fall of cortisol that should peak in the morning and decline through the day. The DUTCH test goes further by measuring hormone metabolites, revealing how your body processes hormones through specific enzymatic pathways. This information is invaluable for functional medicine practitioners investigating chronic fatigue, sleep issues, weight resistance, and hormonal imbalances.

Key Details

Sample Type
Dried urine (DUTCH) or saliva
Collection
Multiple samples over 24 hours
Turnaround
1–3 weeks
Fasting Required
No, but timed collection required
Common Use
Stress hormone profiling, HPA axis assessment

Who Is This For?

People with chronic fatigue, burnout, or suspected adrenal dysfunction. Those with sleep issues — particularly difficulty waking or evening energy spikes. Women with hormonal imbalances including PCOS, endometriosis, or difficult perimenopause. Anyone working with a functional medicine practitioner who wants detailed hormone metabolism data.

What's Included

Cortisol pattern throughout the day
DHEA-S and cortisol/DHEA ratio
Hormone metabolites (DUTCH test)
Specific markers vary by test type

Preparation Required

Follow the specific collection instructions included with your test kit. Most adrenal profiles require multiple samples throughout the day (morning, afternoon, evening, night). DUTCH tests use dried urine on filter paper. Saliva cortisol tests require timed samples. Avoid eating, drinking (other than water), or brushing teeth 30 minutes before saliva collection.

Biomarkers Tested

56
Estradiol (E2) pg/mL

The most potent and prevalent form of estrogen. In women, estradiol regulates the menstrual cycle, fertility, and bone density. In men, it's produced from testosterone and plays roles in bone health and libido. Levels vary significantly with age and menstrual cycle.

Oestrone (E1) pg/mL

Oestrogen produced in ovaries and other tissues; levels change with age and menopause.

Oestriol (E3) pg/mL

Weakest oestrogen, produced in the placenta during pregnancy; has oestrogenic and anti-oestrogenic effects.

Oestrogen Quotient Ratio

Calculation of Oestriol/(Oestradiol + Oestrone).

2-OH Oestradiol ng/mL

Metabolite of estradiol.

2-OH Oestrone ng/mL

Metabolite of estrone.

4-OH Oestradiol ng/mL

Metabolite of estradiol.

4-OH Oestrone ng/mL

Metabolite of estrone.

16α-OH Oestrone ng/mL

Metabolite of estrone.

2-OH (E1 + E2)/16-α-OH E1 Ratio

Ratio of estrogen metabolites.

2-MeO Oestradiol ng/mL

Metabolite of estradiol.

2-MeO Oestrone ng/mL

Metabolite of estrone.

2-MeO E1/2-OH E1 Ratio

Ratio of estrogen metabolites.

4-MeO Oestradiol ng/mL

Metabolite of estradiol.

4-MeO Oestrone ng/mL

Metabolite of estrone.

4-MeO E1/4-OH E1 Ratio

Ratio of estrogen metabolites.

4-MeO E2/4-OH E2 Ratio

Ratio of estrogen metabolites.

Pregnanediol mg/day

Metabolite of progesterone.

Allopregnanolone mg/day

Neuroactive steroid metabolite of progesterone.

Allopregnanediol mg/day

Metabolite of progesterone.

3α-Dihydroprogesterone mg/day

Metabolite of progesterone.

20α-Dihydroprogesterone mg/day

Metabolite of progesterone.

Deoxycorticosterone mg/day

A steroid hormone produced by the adrenal glands.

Corticosterone mg/day

A steroid hormone produced by the adrenal glands.

Pgdiol/E2 Ratio

Ratio of pregnanediol to estradiol.

DHEA µg/dL

A hormone produced by the adrenal glands, serving as a precursor to testosterone and estrogen. DHEA peaks in early adulthood and declines steadily with age. It's one of the most studied biomarkers in anti-aging research.

Androstenedione ng/dL

Androstenedione is a steroid hormone and a precursor to testosterone and estrogen. Abnormal levels can indicate adrenal or reproductive disorders.

Androsterone mg/day

A metabolite of testosterone.

Etiocholanolone mg/day

A metabolite of testosterone.

Testosterone (Total) ng/dL

The primary male sex hormone, also important in women at lower levels. Testosterone regulates muscle mass, bone density, fat distribution, libido, and mood. Levels decline naturally with age in both sexes.

Epi-Testosterone mg/day

Metabolite of testosterone.

T/Epi-T Ratio

Ratio of testosterone to epitestosterone.

5α-DHT mg/day

5α-Dihydrotestosterone, a potent androgen.

5α,3α-Androstanediol mg/day

Metabolite of testosterone.

Total Cortisol mg/day

Total cortisol levels in urine.

Total Cortisone mg/day

Total cortisone levels in urine.

Cortisol/Cortisone Ratio

Ratio of cortisol to cortisone.

Tetrahydrocortisol mg/day

Metabolite of cortisol.

Tetrahydrocortisone mg/day

Metabolite of cortisone.

Free Cortisol - 1st Morning µg/day

Free cortisol levels in the first morning urine sample.

Free Cortisol - 1st Morning µg/day

Free cortisol levels in the first morning urine sample.

Free Cortisol - Evening µg/day

Free cortisol levels in the evening urine sample.

Free Cortisol - Night µg/day

Free cortisol levels in the night urine sample.

Free Cortisol - 1st Morning µg/day

Free cortisol levels in the first morning urine sample.

Free Cortisol - 1st Morning µg/day

Free cortisol levels in the first morning urine sample.

Free Cortisol - Evening µg/day

Free cortisol levels in the evening urine sample.

Free Cortisol - Night µg/day

Free cortisol levels in the night urine sample.

Melatonin - 1st Morning pg/mL

Melatonin levels in the first morning urine sample.

Melatonin - 2nd Morning pg/mL

Melatonin levels in the second morning urine sample.

Melatonin - Evening pg/mL

Melatonin levels in the evening urine sample.

Melatonin - Night pg/mL

Melatonin levels in the night urine sample.

Creatinine (pooled) mg/day

Creatinine levels in the pooled urine sample.

Creatinine - 1st Morning mg/day

Creatinine levels in the first morning urine sample.

Creatinine - 2nd Morning mg/day

Creatinine levels in the second morning urine sample.

Creatinine - Evening mg/day

Creatinine levels in the evening urine sample.

Creatinine - Night mg/day

Creatinine levels in the night urine sample.

Frequently Asked Questions