The Hormone Test Every Woman Needs To Do
What’s the deal with hormones?
Hormone imbalances are rife in this day and age. Leading a busy life, not sleeping enough, feeling tired and wired, and at times properly burnt out? A clear sign of your hormones (and your digestive & nervous systems) screaming for help. Every single woman I work with has some work to do in this area.
Problem is, when it comes to hormones and gut health, similar symptoms can be driven by very different dynamics in the body. Testing, rather than guessing, shortcuts the journey to better health considerably.
This where the DUTCH test comes in. DUTCH – Dry Urine Test for Comprehensive Hormones by Precision Analytical lab. It truly is the MOST comprehensive hormone test on the market, the Rolls- Royce of hormone tests if you like.
It gives you a complete picture of your adrenal and sex hormones via urine metabolites (a good indicator for total hormone production) + you also see the free (bioactive) hormone levels, alongside other markers – see below.
THE TEST OFFERS A BRILLIANT OPPORTUNITY FOR MAKING SPECIFIC CHANGES THROUGH FOOD, LIFESTYLE AND TARGETED SUPPLEMENTATION.
1. Levels of the 3 main estrogens – Estrone (E1), Estradiol (E2), Estriol (E3) – and the estrogen metabolites – aka what your body does with the hormones and how it synthesizes them. These metabolites must be in a particular proportion for us to be healthy.
Estrogen breaks down into 3 different types of metabolites.
2-OH is protective and beneficial. We want to make at least 70% of this.
4-OH is mostly not beneficial. The test offers an important insight into potential DNA damage and potential increased risk of hormone-sensitive cancers (breast, ovarian and uterine/endometrial).
We want to make 10% or less of this.
16-OH is mostly not beneficial. It is a proliferation pathway (encourages growths like cysts).
We want to make no more than 20% of this.
An example below of less than optimal proportions of the estrogen metabolites.
2. Testosterone metabolites – androgens can go down 2 different pathways – 5a & 5b. 5a dominant people are prone to acne, facial hair, hair loss on the scalp, mood swings like anger. Applies to both, men and women.
3. Progesterone metabolites x 2 – skewing in the ratio can promote insomnia and anxiety.
4. Total cortisol, total cortisone, free 24 hours cortisone + free 24-hour cortisol, and the daily free cortisol and cortisone patterns. This gives us a complete adrenal health overview.
An example below with very low free cortisol, which will correlate with symptoms of fatigue throughout the day. However, from the total metabolites, we can see that this is not a cortisol production issue. In other words, the body is making enough, what needs to be determined here is why the free (bioavailable) cortisol is so low.
This is why we need all this info – metabolised cortisol, free cortisol (and cortisone) and the cortisol pattern so we can make a proper assessment. If any of these markers are missing, we don’t have the complete picture and the assumptions we make can be wrong.
5. Methylation (Phase 2 liver detoxification process) – It shows how well the liver is detoxing the estrogen out of the body (very important for hormone balance). The picture below shows an issue with this phase.
“When optimal methylation occurs, it has a significant positive impact on many biochemical reactions in the body that regulate the activity of the cardiovascular, neurological, reproductive, and detoxification systems, including those relating to: DNA production, neurotransmitter production, detoxification, histamine metabolism, estrogen metabolism, eye health, fat metabolism, cellular energy, liver health.” | thorne.com
6. Markers for B12, B6 and folate – all very important for hormone health and methylation.
7. Marker for oxidative stress – an indication of how much of a toxic burden the body is under and how well it is coping.
8-OHdG measures the effect of internal oxidative damage to DNA. “The marker is used to estimate risk factor for various cancers (including breast cancer and prostate cancer), and degenerative diseases including high blood pressure, diabetes, cystic fibrosis, atopic dermatitis, rheumatoid arthritis, Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, pancreatitis, and chronic hepatitis.” “Reducing oxidative stress is a key component to overall health.” ~ Precision Analytical
8. Neurotransmitters – dopamine (critical for mood) and the first responder stress hormones adrenaline / epinephrine and noradrenaline / norepinephrine.
9. Levels of glutathione – THE master antioxidant in our bodies. When it is low, it indicates a toxic burden on the body.
10. Melatonin metabolite – a super important hormone for good sleep. Also an important antioxidant, and involved in immune system health.
Why you may want to know what’s happening with your hormones? Imbalanced hormones are not fun, to put it mildly, and if yours are not happy, you may experience some of the below symptoms. Testing can be very helpful in narrowing down issues and dynamics for your specific body, situation and lifestyle.
Hair Growth (body, face)
Types of hormones testing + why the DUTCH is far superior to anything else on the market
The screenshot was taken from a presentation by Precision Analytical lab.
DUTCH vs Saliva Testing
- Missing cortisol metabolites so we don’t see the total cortisol production. We need both pieces of info to be able to assess what’s happening in the body.
Free cortisol represents 1-3% of the total cortisol production. It is important as this is what’s circulating, but it doesn’t tell us much about how much we produce. If the free is low, and we don’t measure the total, we can falsely assume the person needs a cortisol production boost and thus, suggest ways to boost, which can be inaccurate.
I.e. Obesity increases cortisol production and cortisol clearance, so someone who is obese is likely to show low free cortisol, not because they are not making enough, but because there are dynamics helping it to clear out of the body quickly, which effectively need addressing in order to see a rise in the free cortisol.
- Estrogen testing is not accurate – the testing method is not sensitive enough for estradiol.
- Saliva testing methods are prone to cross-reactivity problems, meaning results for certain hormones can be inaccurately skewed.
DUTCH vs Serum Testing
- Free (bioavailable) cortisol cannot be tested throughout the day.
I.e. Birth control supplementation increases the hormone-binding proteins and thus the total cortisol, however, the free part remains relatively unchanged.
- Does not include metabolites. Testosterone and estrogen are fine to test in serum, what we don’t get are the metabolites, meaning we don’t know what the body does with the hormones. We only get a basic baseline level.
- Serum only represents a moment in time.
- The methods for testing matter. For estrogen and testosterone, particularly for lower levels, we want a better testing method, like the DUTCH as it’s more accurate. For a man, total testosterone is ok to measure in blood, for women not so much.
- Supplemental hormones can be problematic to test in serum (sublingual, vaginal, transdermal and oral). The Dutch gives a much more accurate picture.
DUTCH vs 24-Hour Urine Testing
- “The collection is cumbersome, and as many as 40% of those who collect, do so in error (Tanaka, 2002). Every single drop of urine needs to be collected in a 24 h period.” Precision Analytical
- “Dysfunction in the diurnal pattern of cortisol cannot be ascertained from a 24-hour collection. Some providers add saliva for daily free cortisol. DUTCH eliminates the need for two tests.” Precision Analytical
When is the DUTCH test not appropriate?
If a person has kidney disease, the levels of creatinine – what the test relies on to measure hormones, will be skewed. In such situations, the lab advises people to use a 24-hour urine collection test in conjunction with serum testing.
Also, do not do the DUTCH test in the middle of a detox as this can compromise the results.
You just pee on a strip of paper and let it dry.
It’s advisable to send the test back as soon as possible, however dry urine is stable for up to 2 weeks.