Are you tired of battling the disruptive symptoms of hormonal imbalance?
Irregular menstruation
Heavy or painful periods
PMS
Headaches
Reduced libido
Anxiety
Depression
Mood swings
Breast tenderness
Endometriosis
Fibroids
Acne
Insomnia
Weight Gain
Have you been told that your blood tests are all 'normal'?
This discrepancy between how you feel and what your conventional medicine tests show is a common frustration, especially in perimenopause, with or without Hormone Replacement Therapy (HRT).
Hormonal issues can wreak havoc on your daily life and overall well-being.
I use an assortment of 'functional' tests, which provide 'ah ha' moments that we can then use to help support and, in most cases, ameliorate the hideous issues.
So, if you're tired of feeling out of sync with your body, consider the DUTCH test.
Why Consider the DUTCH Test?
Hormones are pivotal in our well-being, influencing everything from metabolism to mood. Understanding how our bodies handle hormones is crucial for maintaining optimal health and addressing any imbalances that may arise, especially as one hormone rarely gets out of sync.
Unlike conventional hormone tests, which rely on blood or saliva samples, the DUTCH test utilises a unique combination of dried urine and saliva samples to provide a comprehensive snapshot of the balance between different hormone levels and their various metabolites.
Steroid hormones like oestrogen, progesterone, testosterone, and cortisol are not water-soluble. They are broken down in the liver and kidneys, forming smaller, water-soluble particles called metabolites, which are then excreted.
Excess production of specific metabolites can be harmful, underscoring the importance of testing.
Widely recognised for its accuracy, the DUTCH test offers a comprehensive solution to unravelling hormonal health's complexities.
While I don't always recommend it—we are all individuals—I do believe that it offers a more nuanced understanding of hormonal health, enabling healthcare providers to tailor interventions to each person's specific needs.
What does the DUTCH test do?
This is a complicated test, and it would be too much to discuss everything in one blog. I will discuss just a few of the main issues that you may be more aware of here.
Oestrogens, Progesterone, and Androgens
The DUTCH Test evaluates metabolites and biomarkers derived from oestrogens, progesterone, and androgens.
Oestrogen
There are three different forms of oestrogen: Estrone (E1), estradiol (E2), and estriol (E3). All three need to be detoxified, primarily in the liver, in three phases.
Knowing what is happening to your oestrogen allows us to understand why you may be getting symptoms of what is often termed 'oestrogen dominance' – heavy periods, mood swings, weight gain, and endometriosis.
Phase 1 involves hydroxylation (adding an OH group). Where this OH group is attached matters, and there are three choices. The OH compounds produced from this process are unstable and more potent, so they need to be removed as soon as possible.
This next step—phase 2 (!)—makes the compounds fully water soluble through a process called conjugation. This process relies on an assortment of different enzymes. The one that the DUTCH test assesses is COMT, which involves adding a methyl group (CH3). If this process is slow (the enzyme can be slow), then oestrogen is recirculated in the body. This recycling can often create symptoms that we would rather not have.
The test above shown is me. I have a slow COMT enzyme and so need to support this, otherwise my oestrogen ends up in a bottle neck and goes round and round in circles.
Phase 3 happens in the gut. After phases 1 and 2, oestrogen is excreted either through urine or bile and then into the colon. This is where the microbiome and digestive process are crucial. Certain bacteria will allow the neat package created in phases 1 and 2 to be pulled apart, so oestrogen can recirculate. That is not good.
The DUTCH test doesn't look at phase 3 detoxification, but it can easily be assessed through a stool test.
Progesterone
Progesterone is more straightforward in some ways. It can be pushed down two pathways, and we all have a preference for one.
This pathway is analogous to that for testosterone: an alpha and a beta pathway. Women with PCOS, male pattern baldness, and cystic acne tend to utilise the alpha pathway more, and women who are hypothyroid tend to use the beta pathway.
Adrenal Assessment
The DUTCH Test includes eight adrenal analytes so providers can evaluate the health of their patients' HPA axis.
Free cortisol is the active form of the hormone which binds to receptors and turns them on. Testing free cortisol helps understand the circadian rhythm and answers questions about a patient's low energy and sleep trouble.
Metabolised cortisol is an indication of total cortisol production and metabolised through the liver in one day.
The DUTCH Test includes metabolised cortisol because cases of hypothyroidism, hyperthyroidism, long-term stress, inflammation, insulin resistance, infection, poor liver function, anorexia, critical illness can greatly influence it.
Adrenal health is key in menopause, as the adrenal glands are the source of hormones. Checking in on the HPA axis during perimenopause and menopause can help guide appropriate treatment to support this system.
Organic Acids Tests (OATS)
Organic acid tests (OATS) comprise the last portion of the DUTCH Test. They include nutritional and neurotransmitter metabolites and markers for neuroinflammation, oxidative stress, gut health, and melatonin.
OATs can round out hormone testing in a way that provides additional information about a patient's nutritional status, gut and brain health.
Reasons why a DUTCH test can be a go-to tool during perimenopause and menopause
The DUTCH test isn't just about identifying problems but finding solutions.
Whether you're struggling with perimenopause symptoms or seeking hormone replacement therapy guidance, the DUTCH test offers personalised insights tailored to your unique needs.
Understanding hormone levels and metabolism can be game-changing during perimenopause and menopause. By assessing oestrogen dominance, androgen levels, and adrenal function, the DUTCH test empowers you to take control of your hormonal health.
Although the levels assessed by the DUTCH test are not absolute, the dials can show the relative levels of progesterone to oestrogen, which can help to determine where you may be in the process and what may be driving your symptoms more.
The insights gained from an individual test, coupled with a detailed diet and lifestyle assessment, can significantly assist women navigating perimenopause, menopause, or any life stage.
These findings enable us to offer tailored recommendations for diet and lifestyle adjustments, supplementation, or hormone replacement therapy, providing comprehensive support for optimal well-being.
Despite some scepticism from conventional medical practitioners, as a pharmacist, I rely on evidence-based practices. The scientific data from Precision Analytical, the creators of the DUTCH test, has convinced me of its efficacy.
Having personally utilised the test and witnessed significant improvements in my symptoms and those of my clients, I am confident in its value.
I will share my results and experiences on IG in the coming weeks. If you have any inquiries or wish to discuss your concerns further, please don't hesitate to contact me or schedule a call.
The complimentary conversation is an opportunity to explore your symptoms and the possible ways to manage them with absolutely no obligation. Remember, understanding and then addressing your symptoms is vital to finding relief and improving your daily life.
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