Diagnostic testing
DUTCH Complete Hormone Test (DUTCH)
When you need to see not only what your hormones are doing, but what your body does with them afterwards.
DUTCH stands for Dried Urine Test for Comprehensive Hormones. It measures sex hormones, adrenal hormones and, unlike most panels, the metabolites your body produces as it breaks those hormones down. Samples are collected on filter paper at four or five points across a day and dry before you post them back.
The distinction matters more than it sounds. Two people can show the same estrogen level and be in very different situations, because one clears it down a pathway associated with a favourable profile and the other does not. A level tells you how much is present. A metabolite tells you where it went.
PhotographyDUTCH Complete Hormone Test collection kit, laid out on a clean surface.
What it measures
Inside the DUTCH
Estrogens and their metabolites
Estradiol, estrone and estriol, plus the 2-OH, 4-OH and 16-OH pathways that show how estrogen is being cleared.
Progesterone metabolites
Beta and alpha pregnanediol, which reflect progesterone production across the collection window.
Androgens
Testosterone, DHEA-S and the 5-alpha metabolites associated with acne, hair thinning and prostate symptoms.
Free and metabolized cortisol
The daily rhythm alongside total cortisol production, which separates low output from rapid clearance.
Cortisol awakening response
The rise in the first 30 to 60 minutes after waking, an early signal of how the stress axis is coping.
Organic acids and melatonin
Markers for B12, B6, glutathione and neurotransmitter turnover, plus overnight melatonin production.
This is the widest panel we offer. It is usually chosen when a saliva panel has already shown something worth looking into properly, or when symptoms have persisted through more than one round of treatment.
Who this test is for
It may be a fit if you are experiencing
- Perimenopause or menopause symptoms that have not responded to a first round of support
- Cycle problems, heavy bleeding, PMS or PMDD
- Persistent fatigue where an adrenal panel alone did not explain it
- Acne, unwanted hair growth, or hair thinning with a hormonal pattern
- A family history that makes estrogen clearance worth understanding
- Anyone on hormone therapy who wants to see how it is being processed
- Sleep that does not improve despite good sleep habits
It is the most detailed option rather than the automatic first step. For many people a targeted saliva panel answers the question at lower cost.
Why dried urine
What metabolites show that a hormone level on its own does not
Dried urine captures what has passed through the body rather than what is circulating at one instant. That is what makes the metabolite pathways visible, and those pathways are frequently where the useful answer sits when levels themselves look unremarkable.
Collecting on filter paper also means the samples dry, post safely, and need no refrigeration, so a panel of this depth can still be done at home. Multiple collections across the day preserve the cortisol rhythm that a single sample would flatten.
The lab we use has been trusted for decades by our pharmacist and master of holistic medicine, particularly for complex hormone cases. The methodology is well established, reproducible, and clinically actionable.
How results are used at LivBTR
Your results are never read in isolation
They are interpreted alongside your intake, symptoms, lifestyle, nutrition, movement, and any other findings. From there we build a personalized support plan.
- Targeted support for estrogen clearance pathways
- Nutrition and supplement protocols matched to the metabolite picture
- Nervous system and sleep work guided by the cortisol pattern
- Discussion of hormone therapy options with the prescribing team when appropriate
- Liver and gut support where clearance appears to be the limiting step
- A repeat panel to confirm a change has actually landed
A panel this detailed is only worth running if it changes what you do next. The review is built around which one or two pathways to act on first.
DUTCH Complete Hormone Test questions
How is this different from the saliva hormone panels?
Saliva measures the free, bioavailable fraction at the moment of collection, which is the right tool for cycle timing and cortisol rhythm. DUTCH adds the metabolites, showing how hormones are being processed and cleared rather than only how much is present.
Do I have to collect urine in a container?
No. You saturate a filter paper strip at four or five set times and let it dry. The dried strips are what you post back.
When in my cycle should I collect?
If you are still cycling, usually days 19 to 22 of a 28 day cycle. Your instructions adjust that if your cycle runs longer or shorter. If you are post-menopausal or not cycling, timing is flexible.
Can I do this while on hormone therapy?
Yes, and it is one of the more useful reasons to run it. It shows how the hormones you are taking are being metabolized. Tell us what you are taking and at what time so collection can be timed around it.
Is this a medical diagnosis?
No. It is a functional wellness assessment interpreted within an integrative framework. It does not diagnose disease. Where results suggest medical evaluation, you are encouraged to take them to your primary care provider.
If you have already tested once and still do not have an answer, this is usually the panel that finds it.
It is the most detailed option we offer, so it is worth a conversation first to confirm it is the right one for your question.