DUTCH

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

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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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-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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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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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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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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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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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

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

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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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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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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

This is the 2nd cortisol sample of the day. Usually measured 30 to 60 minutes after waking. 

Cortisol is a hormone produced by the adrenal glands, which are located on top of the kidneys. It is normally released in response to events and circumstances such as waking up in the morning, exercising, and acute stress.

In the Dutch test there are 4 individual free cortisol readings that were measured at different times throughout one day:

- Cortisol A (Waking)

- Cortisol B (Morning)

- Cortisol C (Afternoon)

- Cortisol D (Night)

When you are looking at Cortisol B (Morning) it is essential to also look at Cortisol A (Waking). The difference between those 2 cortisol samples is called the cortisol awakening response (or CAR). 

An elevated CAR would mean that the difference between those 2 markers is really big.

Different possible reasons for an elevated CAR:

- an overactive HPA axis (=plays an important role in the stress response), ongoing job-related stress (anticipatory stress for the day)

- blood sugar dysregulation

- pain (i.e. waking with painful joints or a migraine), 

- and general depression (not Seasonal affective disorder/”winter depression”)

Neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) does. So this means that if your morning free cortisol reading spikes up high first thing in the morning, there is something to look at. Is there an overactivity to stress? Are you anticipating a stressful day at work? If your morning free cortisol levels are high, this can be due to stress or anticipating stress. 

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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

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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