DUTCH

The DUTCH test is a urine steroid hormone test that measures hormones and hormone metabolites from a dried urine sample.

16-OH-E1

Optimal range: 0.7 - 2.6 ng/mg

16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.

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16-OH-E1 (male)

Optimal range: 0 - 1.2 ng/mg

16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. 

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16-OH-E1 Postmenopausal

Optimal range: 0.2 - 0.6 ng/mg

16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estriol. It is a potent estrogen similarly to estrone, and it has been suggested that the ratio of 16α-hydroxyestrone to 2-OH-E1, the latter being much less estrogenic in comparison and even antiestrogenic in the presence of more potent estrogens like estradiol, may be involved in the pathophysiology of breast cancer. Conversely, 16α-hydroxyestrone may help to protect against osteoporosis.

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2-Methoxy-E1

Optimal range: 2.5 - 6.5 ng/mg

The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.

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2-Methoxy-E1 (male)

Optimal range: 0 - 2.8 ng/mg

The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.

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2-Methoxy-E1 Postmenopausal

Optimal range: 0.3 - 1.4 ng/mg

The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.

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2-Methoxy-E2

Optimal range: 0 - 0.7 ng/mg

The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.

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2-Methoxy-E2 Postmenopausal

Optimal range: 0 - 0.4 ng/mg

The 2-Methoxy Estrogens are considered to be protective. Low levels are usually a reflection of overall low estrogens and may be improved with supplemental estrogen.

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2-OH-E1

Optimal range: 5.1 - 13.1 ng/mg

2-Hydroxyestrone is an endogenous biomarker and major urinary metabolite of estrone and estradiol. Along with 16α-Hydroxyestrone, 2-Hydroxyestrone is used as an indicator for increased risk of breast cancer. 

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2-OH-E1 (male)

Optimal range: 0 - 5.9 ng/mg

2-Hydroxyestrone is an endogenous biomarker and major urinary metabolite of estrone and estradiol. Along with 16α-Hydroxyestrone, 2-Hydroxyestrone is used as an indicator for increased risk of cancer.

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2-OH-E1 Postmenopausal

Optimal range: 0.3 - 2 ng/mg

2-Hydroxyestrone is an endogenous biomarker and major urinary metabolite of estrone and estradiol. Along with 16α-Hydroxyestrone, 2-Hydroxyestrone is used as an indicator for increased risk of breast cancer. 

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2-OH-E2

Optimal range: 0 - 1.2 ng/mg

Research and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated with increased breast cancer risk.

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2-OH-E2 Postmenopausal

Optimal range: 0 - 0.3 ng/mg

Research and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated with increased breast cancer risk.

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24hr Free Cortisol

Optimal range: 80 - 230 ug

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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24hr Free Cortisone

Optimal range: 220 - 450 ug

4-OH-E1

Optimal range: 0 - 1.8 ng/mg

A very carcinogenic estrogen metabolite, levels low in the reference range are desirable. Additional magnesium, liver support, and methylation support may help decrease 4-OH-E1 levels.

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4-OH-E1 (male)

Optimal range: 0 - 0.8 ng/mg

A very carcinogenic estrogen metabolite, levels low in the reference range are desirable. Additional magnesium, liver support, and methylation support may help decrease 4-OH-E1 levels.

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4-OH-E1 Postmenopausal

Optimal range: 0 - 0.3 ng/mg

A very carcinogenic estrogen metabolite, levels low in the reference range are desirable. Additional magnesium, liver support, and methylation support may help decrease 4-OH-E1 levels.

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4-OH-E2

Optimal range: 0 - 0.5 ng/mg

4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol, are very reactive estrogens and may increase risk of estrogen-sensitive cancers.

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4-OH-E2 Postmenopausal

Optimal range: 0 - 0.1 ng/mg

4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol, are very reactive estrogens and may increase risk of estrogen-sensitive cancers.

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5-Hydroxyindoleacetate (5HIAA)

Optimal range: 2.5 - 7.5 ug/mg

5-Hydroxyindoleacetic acid (5HIAA) is a breakdown product of serotonin that is excreted in the urine. Serotonin is a hormone found at high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors.

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5a-Androstanediol

Optimal range: 12 - 30 ng/mg

5a-Androstanediol is one of the four testosterone metabolites. The other ones are androsterone, etiocholanolone and 5b-androstanediol.

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5a-Androstanediol (male)

Optimal range: 30 - 250 ng/mg

5a-DHT

Optimal range: 0 - 6.6 ng/mg

5a-DHT is an endogenous androgen sex steroid and hormone. The enzyme 5α-reductase catalyzes the formation of DHT from testosterone in certain tissues including the prostate gland, seminal vesicles, epididymides, skin, hair follicles, liver, and brain.

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5a-DHT (male)

Optimal range: 5 - 25 ng/mg

5a-DHT is an endogenous androgen sex steroid and hormone. The enzyme 5α-reductase catalyzes the formation of DHT from testosterone in certain tissues including the prostate gland, seminal vesicles, epididymides, skin, hair follicles, liver, and brain.

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5b-Androstanediol

Optimal range: 20 - 75 ng/mg

5b-Androstanediol (male)

Optimal range: 40 - 250 ng/mg

8-OHdG (Waking)

Optimal range: 0 - 5.2 ng/mg

8-OHdG measures the effect of endogenous oxidative damage to DNA. The marker is used to estimate the risk for various cancers and degenerative diseases. Adjusting treatments and lifestyle to minimize the presence of 8-OHdG is a productive step toward health and longevity.

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a-Pregnanediol (luteal range)

Optimal range: 200 - 740 ng/mg

This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.

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a-Pregnanediol (male)

Optimal range: 20 - 130 ng/mg

Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.

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a-Pregnanediol (oral progesterone range)

Optimal range: 580 - 3000 ng/mg

This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.

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a-Pregnanediol (postmenopausal range)

Optimal range: 15 - 50 ng/mg

This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.

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a-Tetrahydrocortisol (a-THF)

Optimal range: 75 - 370 ng/mg

Metabolized cortisol is the sum of a-tetrahydrocortisol (a-THF), b-tetrahydrocortisol (b-THF), and b-tetrahydrocortisone (b-THE). They are a good indication of the total cortisol output from the adrenal gland or clearance out the body.

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Androsterone

Optimal range: 200 - 1650 ng/mg

Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.

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Androsterone (male)

Optimal range: 500 - 3000 ng/mg

Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways.

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b-Pregnanediol (luteal range)

Optimal range: 600 - 2000 ng/mg

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

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b-Pregnanediol (male)

Optimal range: 75 - 400 ng/mg

Progesterone itself is not readily found in the urine. Instead, this test measures pregnanediol (a progesterone metabolite). Pregnanediol is well-established in research literature as a reliable marker for progesterone levels.

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b-Pregnanediol (oral progesterone range)

Optimal range: 2000 - 9000 ng/mg

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

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b-Pregnanediol (postmenopausal range)

Optimal range: 60 - 200 ng/mg

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.

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b-Tetrahydrocortisol (b-THF)

Optimal range: 1050 - 2500 ng/mg

B-Tetrahydrocortisol [aka 5-beta-Tetrahydrocortisol (5b-THF)] is a metabolite of cortisol.

Tetrahydrocortisone, Tetrahydrocortisol and Allo-Tetrahydrocortisol are cortisol metabolites that reflect approximately 50% of daily cortisone synthesis. These will often reflect a chronic adrenal picture if levels are out of normal limits.

Urine contains free cortisol, but it also contains many cortisol metabolites, like cortisone or 5-alpha- tetrahydrocortisol, 5-beta-tetrahydrocortisol, tetrahydrocortisone, etc.

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b-Tetrahydrocortisol (b-THF) (male)

Optimal range: 1750 - 4000 ng/mg

B-Tetrahydrocortisol [aka 5-beta-Tetrahydrocortisol (5b-THF)] is a metabolite of cortisol.

Tetrahydrocortisone, Tetrahydrocortisol and Allo-Tetrahydrocortisol are cortisol metabolites that reflect approximately 50% of daily cortisone synthesis. These will often reflect a chronic adrenal picture if levels are out of normal limits.

Urine contains free cortisol, but it also contains many cortisol metabolites, like cortisone or 5-alpha- tetrahydrocortisol, 5-beta-tetrahydrocortisol, tetrahydrocortisone, etc.

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b-Tetrahydrocortisone (b-THE)

Optimal range: 1550 - 3800 ng/mg

b-Tetrahydrocortisone (b-THE) is an adrenal steroid and a cortisol metabolite.

Tetrahydrocortison (THE) is a down-stream metabolite of cortisol and cortisone. It can often reflect a chronic adrenal picture if levels are out of normal limits.

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b-Tetrahydrocortisone (b-THE) (male)

Optimal range: 2350 - 5800 ng/mg

b-Tetrahydrocortisone (b-THE) is an adrenal steroid and a cortisol metabolite.

Tetrahydrocortison (THE) is a down-stream metabolite of cortisol and cortisone. It can often reflect a chronic adrenal picture if levels are out of normal limits.

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Cortisol A (Waking)

Optimal range: 12 - 55 ng/mg

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Cortisol B (Morning)

Optimal range: 38 - 155 ng/mg

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Cortisol C (Afternoon)

Optimal range: 7.3 - 30 ng/mg

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Cortisol D (Night)

Optimal range: 0 - 14 ng/mg

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Cortisone A (Waking)

Optimal range: 40 - 120 ng/mg

Cortisone B (Morning)

Optimal range: 90 - 230 ng/mg

Cortisone C (Afternoon)

Optimal range: 32 - 95 ng/mg

Cortisone D (Night)

Optimal range: 0 - 55 ng/mg

Creatinine A (Waking)

Optimal range: 0.2 - 2 mg/ml

A creatinine test reveals important information about your kidneys.

Creatinine is a chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Creatinine is the result of normal muscle metabolism. The chemical enters your bloodstream after it’s broken down. Your kidneys remove it from your blood. The creatinine then exits the body through urination.

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Creatinine B (Morning)

Optimal range: 0.2 - 2 mg/ml

A creatinine test reveals important information about your kidneys.

Creatinine is a chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Creatinine is the result of normal muscle metabolism. The chemical enters your bloodstream after it’s broken down. Your kidneys remove it from your blood. The creatinine then exits the body through urination.

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Creatinine C (Afternoon)

Optimal range: 0.2 - 2 mg/ml

A creatinine test reveals important information about your kidneys.

Creatinine is a chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Creatinine is the result of normal muscle metabolism. The chemical enters your bloodstream after it’s broken down. Your kidneys remove it from your blood. The creatinine then exits the body through urination.

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Creatinine D (Night)

Optimal range: 0.2 - 2 mg/ml

A creatinine test reveals important information about your kidneys.

Creatinine is a chemical waste product of creatine, an amino acid made by the liver and stored in the liver. Creatinine is the result of normal muscle metabolism. The chemical enters your bloodstream after it’s broken down. Your kidneys remove it from your blood. The creatinine then exits the body through urination.

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DHEA-S (Urine)

Optimal range: 20 - 750 ng/mg

Dehydroepiandrosterone (DHEA) is an androgen precursor and excitability neurosteroid.

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DHEA-S (Urine) (male)

Optimal range: 30 - 1500 ng/mg

DHEA is produced in the adrenal glands and is a precursor to both testosterone and estrogen.

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Epi-Testosterone

Optimal range: 2.3 - 14 ng/mg

Epi-Testosterone is one of several naturally-occurring testosterone compounds in the body that act as steroids. Athletes using anabolic steroids may be questioned about anabolic steroid use if testosterone increases while Epi-Testosterone levels stay low.

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Epi-Testosterone (male)

Optimal range: 25 - 115 ng/mg

Epi-Testosterone is one of several naturally-occurring testosterone compounds in the body that act as steroids. Athletes using anabolic steroids may be questioned about anabolic steroid use if testosterone increases while Epi-Testosterone levels stay low.

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Estradiol (E2)

Optimal range: 1.8 - 4.5 ng/mg

The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.

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Estradiol (E2) (male)

Optimal range: 0.5 - 2.2 ng/mg

Estradiol is the main "female" hormone. The full name is 17-beta-Estradiol.

Current research indicates that, in some people, this hormone may play a role in the loss of bone density, prevents male bodies from clearing DHT out of the prostate gland, and can stimulate estrogen-sensitive tumor growth (if estrogen-sensitive cancer cells are already present).

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Estradiol (E2) Postmenopausal

Optimal range: 0.2 - 0.7 ng/mg

The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.

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Estriol (E3)

Optimal range: 5 - 18 ng/mg

Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.

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Estriol (E3) (male)

Optimal range: 2 - 8 ng/mg

Has weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.

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Estriol (E3) Postmenopausal

Optimal range: 0.6 - 4 ng/mg

Estrone (E1)

Optimal range: 12 - 26 ng/mg

Estrogen metabolite

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Estrone (E1) Postmenopausal

Optimal range: 3 - 7 ng/mg

Estrogen metabolite

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Estrone(E1) (male)

Optimal range: 4 - 16 ng/mg

There are three types of estrogen: estradiol, estriol, and estrone. Estradiol is the primary female sex hormone. Estriol and estrone are minor female sex hormones. Estriol is nearly undetectable in women who aren’t pregnant.

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Etiocholanolone

Optimal range: 200 - 1000 ng/mg

Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.

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Etiocholanolone (male)

Optimal range: 400 - 1500 ng/mg

Etiocholanolone is an androstenedione and testosterone metabolite that is excreted in the urine. It is produced from androstenedione and the 5-alpha and 5-beta-reductase metabolic pathways. It is helpful in evaluating adrenal and androgen function.

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Homovanillate (HVA) (DUTCH)

Optimal range: 4 - 13 ug/mg

Homovanillate (aka Homovanillic Acid) is a dopamine metabolite.

Homovanillate and Vanilmandelate are breakdown products from neurotransmitters involved in hormone and nerve impulse transmission, called catecholamines.

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Kynurenate

Optimal range: 0 - 7.3 ug/mg

Kynurenate is product of the metabolism of L-Tryptophan and appears in urine in Vitamin B6 deficiencies. Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein.

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Melatonin (Waking)

Optimal range: 10 - 85 ng/mg

Melatonin is a hormone produced in the pineal gland in response to light therefore, among many things, it regulates the sleep-wake cycle or circadian rhythm and is also a very powerful antioxidant.

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Metabolized Cortisol (THF+THE)

Optimal range: 2750 - 6500 ng/mg

Metabolized cortisol best reflects total cortisol production.

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Metabolized Cortisol (THF+THE) (male)

Optimal range: 4550 - 10000 ng/mg

Metabolized cortisol best reflects total cortisol production.

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Methylmalonate (MMA) (DUTCH)

Optimal range: 0 - 2.2 ug/mg

The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.

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Progesterone

Optimal range: 6 - 20 ng/mL

Although progesterone is found in both males and females, it is primarily known for its role in conception, pregnancy, and the regulation of a woman’s menstrual cycle.

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Pyroglutamate

Optimal range: 32 - 60 ug/mg

Pyroglutamate (or Pyroglutamic acid) is an intermediate in the glutathione metabolism and a marker of glutathione deficiency.

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Saliva Cortisol - Afternoon

Optimal range: 0.4 - 1.5 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisol - Night

Optimal range: 0 - 0.9 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisol - W+30 min.

Optimal range: 3.7 - 8.2 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisol - W+60 min.

Optimal range: 2.3 - 5.3 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisol - Waking

Optimal range: 1.6 - 4.6 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisol Total

Optimal range: 9.6 - 19.3 ng/mL

Cortisol is a stress hormone produced by the adrenal glands and is the primary agent used in our body’s flight or fight response to threatening stimuli.

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Saliva Cortisone - Afternoon

Optimal range: 2 - 7.1 ng/mL

Saliva Cortisone - Night

Optimal range: 0 - 4.8 ng/mL

Saliva Cortisone - W+30 min

Optimal range: 12.4 - 19.4 ng/mL

Saliva Cortisone - W+60 min.

Optimal range: 9.4 - 15.3 ng/mL

Saliva Cortisone - Waking

Optimal range: 6.8 - 14.5 ng/mL

Saliva Cortisone Total

Optimal range: 36 - 55 ng/mL

Testosterone (DUTCH)

Optimal range: 2.3 - 14 ng/mg

Testosterone is the major androgen in the body. It is converted to dihydrotestosterone by 5-alphareductase, and to estradiol by aromatase.

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Testosterone (DUTCH) (male)

Optimal range: 25 - 115 ng/mg

Testosterone is the primary male sex hormone in humans. Testosterone blood tests can assess testosterone that is bound to a protein, testosterone that is free in the blood, or both. A healthcare professional may order any of these tests if you’re experiencing sexual or hormonal problems.

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Total DHEA Production

Optimal range: 400 - 3000 ng/mg

DHEA is often called the anti-aging hormone. It’s made in the adrenal glands naturally and levels hit their peak in your 20s. They start to dwindle after you hit 30. Estrogen and testosterone are created from DHEA.

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Total Estrogen

Optimal range: 35 - 70 ng/mg

Total estrogen is a reliable test for estrogen status and is used to detect hormone imbalances.

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Total Estrogen (male)

Optimal range: 10 - 34 ng/mg

Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4).

Although estrogen is identified with a females, it is also found in men.

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Total Estrogen Postmenopausal

Optimal range: 4 - 15 ng/mg

Total estrogen is a reliable test for estrogen status and is used to detect hormone imbalances.

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Vanilmandelate (VMA)

Optimal range: 2.4 - 6.4 ug/mg

Vanilmandelate is a metabolite of epinephrine and norepinephrine (also known as adrenaline and noradrenaline).

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Xanthurenate

Optimal range: 0 - 1.4 ug/mg

Your body needs vitamin B6 (pyridoxine) to utilize amino acids derived from dietary protein. Inadequate vitamin B6 is one factor that leads to increased concentrations of kynurenate and xanthurenate in urine.

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