Neurotransmitter Metabolites (Urine) - DUTCH

The Neurotransmitter Metabolites section of the DUTCH test measures organic acids that are the breakdown products (metabolites) of important brain chemicals.
These markers provide insight into how your body is producing and processing dopamine, norepinephrine, and serotonin-related pathways.

The DUTCH test reports three main urinary metabolites:

1. Homovanillate (HVA) – The primary metabolite of dopamine.

   • Dopamine supports motivation, focus, mood stability, and motor control.

   • Low HVA may suggest reduced dopamine production or turnover.

   • High HVA may be linked to increased dopamine metabolism, stress, or certain metabolic states.

2. Vanilmandelate (VMA) – The main metabolite of norepinephrine and epinephrine.

   • These neurotransmitters regulate alertness, energy, blood pressure, and the body’s stress response.

   • Low VMA may indicate low catecholamine output.

   • High VMA can occur with chronic stress or in certain adrenal conditions.

3. Quinolinate – A metabolite from the kynurenine pathway of tryptophan metabolism.

   • Elevated levels are considered neurotoxic and may reflect inflammation, oxidative stress, or overactivation of immune pathways.

   • High quinolinate can disrupt normal brain signaling and has been linked to mood disorders and neurodegeneration risk.

Why DUTCH Includes Neurotransmitter Metabolites

Neurotransmitter balance is closely tied to hormone health. Cortisol, estrogen, and other hormones can directly influence dopamine, norepinephrine, and serotonin metabolism.
By measuring these metabolites alongside hormone patterns, the DUTCH test gives a more complete picture of how stress, hormones, and brain chemistry interact.

How to Interpret These Results

While urinary neurotransmitter metabolites are not a perfect reflection of brain neurotransmitter levels, research supports their use as a reliable marker of whole-body neurotransmitter activity.
They help practitioners:

• Identify whether low or high neurotransmitter activity may be contributing to symptoms

• Understand whether hormone imbalances are affecting brain chemistry

• Guide targeted nutritional, lifestyle, and therapeutic support for both hormonal and neurological health