Lab Education
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November 4, 2024

Using The DUTCH Plus Test In Your Clinic

Medically Reviewed by
Updated On
December 11, 2024

In the evolving landscape of personalized medicine, understanding hormonal health is paramount for diagnosing and managing a myriad of conditions, from adrenal fatigue to reproductive disorders. 

The DUTCH Plus test by Precision Analytical (DUTCH) is a comprehensive test panel that provides detailed insights into a patient's hormonal milieu, providing answers to questions like: 

"Why am I tired all the time?"

"Why is my mood all over the place?"

"Why do I have menopausal symptoms?"

"Why am I having trouble losing weight?"

"How am I coping with stress?"

This guide aims to equip clinicians with the knowledge and confidence to effectively incorporate the DUTCH Plus test into their clinical practice, enhancing patient care through precise hormonal assessment.

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Understanding the DUTCH Plus Test

DUTCH is an acronym for "Dried Urine Test for Comprehensive Hormones." The DUTCH Plus test is one of many hormonal panels offered by Precision Analytical that uses dried urine samples to measure hormones and their metabolites. 

The DUTCH Plus combines the DUTCH Complete and Cortisol Awakening Response (CAR) tests to create a comprehensive hormonal overview of reproductive and adrenal function, nutritional status, intestinal dysbiosis, and oxidative stress.

DUTCH Plus Components

The DUTCH Plus includes measurements of the following biomarkers:

Sex Hormones

  • Estrogen Metabolites: estrone (E1), estradiol (E2), estriol (E3), 2-OH-E1, 4-OH-E1, 16-OH-E1, 2-Methoxy-E1, 2-OH-E2, 4-OH-E2, and total estrogen
  • Androgen Metabolites: testosterone, DHEA-S, androsterone, etiocholanolone, 5a-DHT, 5a-androstanediol, 5b-androstanediol, epitestosterone
  • Progesterone Metabolites: a-pregnanediol, b-pregnanediol 

Adrenal Hormones

  • Daily free cortisol pattern
  • Daily free cortisone pattern
  • Cortisol metabolites (a-THF, b-THF)
  • Cortisone metabolites (b-THE)
  • DHEA-S

Cortisol Awakening Response

  • Salivary CAR
  • Cortisol
  • Cortisone
  • Insomnia cortisol measurement (optional)

Organic Acids

Clinical Applications of the DUTCH Plus Test

The DUTCH Plus test provides clinically relevant information about hormone production and metabolism for patients who are experiencing a wide variety of health concerns, including:

Benefits of Using the DUTCH Plus Test in Your Clinic

Dried urine and salivary testing provide a comprehensive view of hormone metabolism and adrenal function. Scientific evidence supports the validity of urine and saliva testing for assessing sex hormones and cortisol. 

It highlights that the test provides a comprehensive view of hormone metabolism and allows for non-invasive, at-home sample collection that enhances patient convenience.

Urinary tests are particularly effective for measuring hormone metabolites, providing insights into how hormones are processed in the body. This level of detail is difficult to achieve with serum testing alone, which measures circulating hormone levels but offers limited information on how those hormones are metabolized. 

For instance, estrogen metabolites measured in urine can reveal the balance between potentially protective pathways and those associated with higher cancer risk, giving clinicians a deeper understanding of a patient's hormonal landscape.

Like sex hormones, research has validated urinary and salivary testing for accurately measuring cortisol and its inactive metabolite, cortisone. Salivary and urine cortisol tests offer several key advantages over traditional serum testing: 

  • Free cortisol is the fraction of hormone that is unbound to carrier proteins and is bioavailable to tissues and receptors in the body. It is generally a preferred measurement over total cortisol. Unlike blood tests, which measure total cortisol, urine and saliva tests are ideal for measuring free cortisol and its metabolites. 
  • The CAR, only measurable through salivary tests, is a sharp increase in cortisol levels within the first 30-60 minutes after waking. It is an important marker of adrenal health and stress adaptation.
  • Multi-sample collections throughout the day better capture the natural variations in cortisol secretion over 24 hours than a single-point blood test. 
  • Non-invasive and at-home sample collections make testing highly convenient for patients. 

Implementing the DUTCH Plus Test in Your Practice

Doctors should set their patients with accurate expectations for what at-home testing entails to ensure testing accuracy. 

Test Timing

Men and postmenopausal women can collect samples at any time.

Premenopausal women with regular menstrual cycles should collect their samples 6-9 days before their cycle ends (between days 19 and 22 of a 28-day cycle). This handout will help patients determine what day during the month they should collect samples.

Test Preparation

72 Hours Before Sample Collection

  • Avoid taking oral estrogen, pregnenolone, or testosterone.
  • Consult your doctor if you take supplements containing tyrosine, L-Dopa, D,L-phenylalanine, mucuna, or quercetin, which can affect organic acid results.

48 Hours Before Sample Collection

  • Avoid eating avocados, bananas, and fava beans.
  • Avoid taking oral DHEA.

The Night Before Sample Collection

  • Avoid drinking alcohol and caffeine.
  • Limit total fluid intake to avoid diluting urine samples.
  • If you take oral progesterone, take it at bedtime.

Day of Sample Collection

  • Limit total fluid intake to no more than 64 ounces (spread evenly throughout the day).
  • Avoid drinking alcohol and caffeine.
  • Avoid exercising and flossing your teeth.
  • Do not eat or drink until after collecting sample #3.
  • Do not brush your teeth until after collecting sample #3 (in the morning) and sample #5 (in the evening).
  • Delay using hormone creams, gels, or suppositories until after collecting sample #4. 

Sample Collection

The DUTCH Plus requires patients to collect a total of 5-6 salivary samples and 4 urine samples over the course of a day:  

  • Sample #1: Collect saliva immediately upon waking and collect the first urine sample.
  • Sample #2: Collect saliva 30 minutes after waking.
  • Sample #3: Collect saliva 60 minutes after waking.
  • Sample #4: Collect urine 2-3 hours after waking.
  • Sample #5: Collect urine and saliva between 4 and 5 p.m. (before your evening meal). 
  • Sample #6: Collect urine and saliva at bedtime (no later than midnight). 
  • Sample #7 (Optional): Patients who struggle with staying asleep during the night should collect an extra saliva sample at the time of their sleep disturbance. Otherwise, collect this sample at noon. 

Saliva samples should be frozen within 12 hours of collection and should be kept frozen until ready to ship.

Urine collection devices should be fully saturated and left open to dry for at least 24 hours before being closed and placed in a resealable plastic bag.

Interpreting DUTCH Plus Test Results

DUTCH Plus results provide insights into clinical symptoms' hormonal and metabolic underpinnings. Results should always be interpreted within the context of the patient's health history and clinical concerns. 

Here is a brief summary of what general patterns in the DUTCH Plus panel can indicate:

Estrogens

High estrogen levels can lead to symptoms of estrogen dominance, including:

  • Heavy menstrual bleeding
  • Painful periods
  • Breast tenderness
  • Mood swings

Low estrogen levels, commonly seen in menopause, can result in: 

The DUTCH Plus test also assesses estrogen metabolism via the CYP450 enzyme pathways. 

  • Phase 1 Metabolism: 2-OH-E1 should be the favored estrogen metabolite. Elevated 4-OH or 16-OH metabolites are associated with DNA damage and cancer risk. (7) 
  • Phase 2 Metabolism: Methylation status is reflected in levels of 2-Methoxy-E1, which helps to deactivate estrogen metabolites. Impaired methylation could contribute to estrogen dominance and related risks. (7) 

Progesterone Metabolites

The DUTCH Plus test does not directly measure progesterone but evaluates its metabolites, alpha-pregnanediol and beta-pregnanediol, which correlate well with serum levels of progesterone. 

Low progesterone often accompanies estrogen dominance, leading to symptoms such as: 

  • Irregular periods
  • Headaches
  • Mood swings
  • Anxiety
  • Infertility

Androgens

High testosterone in women is associated with:

  • Acne
  • Weight gain
  • Mood swings
  • Increased body hair (hirsutism)
  • Menstrual irregularities
  • Fertility issues

Low testosterone in men and women may cause:

  • Fatigue
  • Low libido
  • Loss of muscle mass
  • Poor concentration
  • Depression

Cortisol and Adrenal Function

The DUTCH Plus test provides a detailed view of cortisol levels throughout the day, measuring both free cortisol and its metabolite, cortisone. 

High cortisol throughout the day is suggestive of maladaptive stress responses and circadian dysregulation, causing symptoms like: 

  • Sleep disturbances
  • Weight gain
  • High blood pressure
  • Menstrual irregularities

Conversely, low cortisol, especially in the morning, may indicate adrenal insufficiency or burnout:

  • Chronic fatigue
  • Weight loss
  • Low blood pressure and blood sugar
  • Muscle and joint pain

A blunted CAR may indicate chronic stress, PTSD, or depression, while an elevated CAR may be associated with anticipatory stress, glycemic dysregulation, or chronic pain (37). 

Organic Acids

The organic acids included in the DUTCH Plus provide information about the patient's metabolism but also have clinical relevance regarding hormone balance and function (37):

  • Imbalances in HVA and VMA can perpetuate estrogen imbalances. 
  • Deficiencies in B vitamins can negatively impact hormone metabolism.
  • Elevations in 8-OHdG, quinolinate, and indican are indicative of intestinal dysbiosis and inflammation, which can impair estrogen elimination and exacerbate symptoms of hormonal imbalance.

Integrating DUTCH Plus Test Results into Treatment Plans

For patients with high estrogen or imbalances in estrogen metabolites, a focus on supporting estrogen metabolism through lifestyle changes, diet, and supplements can be recommended: 

For low estrogen, progesterone, or testosterone, bioidentical hormone replacement therapy (HRT) or adaptogens may help restore balance. 

In cases of androgen excess (such as in PCOS), treatments may include: 

Addressing cortisol imbalances might involve stress management techniques like mind-body therapies, cognitive behavioral therapy, or supplemental adaptogens.

Challenges and Considerations

The DUTCH Plus test offers many benefits for hormone assessment, but there are several considerations that practitioners should keep in mind when using it in clinical practice. 

One of the primary challenges is the complexity of the test results' interpretation. The DUTCH Plus test provides a large volume of data, which can be overwhelming for clinicians unfamiliar with hormone pathways and metabolism. 

  • Providers new to DUTCH testing should be encouraged to use the clinical resources provided by DUTCH to help them learn how to interpret results and integrate them into comprehensive treatment plans.

While the DUTCH Plus test provides a comprehensive hormonal profile, it still reflects hormone levels at specific points in time. Hormonal fluctuations, which can occur due to various factors like diet, stress, or the menstrual cycle, may not always be fully captured, potentially leading to an incomplete picture of the patient's hormonal status.

  • Integrate and interpret DUTCH Plus results in the context of patient symptoms, medical history, and other clinical findings for a holistic approach to patient care. Follow up on abnormal results with additional tests as clinically indicated. 

The cost of the DUTCH Plus test may be prohibitive for some patients, as insurance coverage for such comprehensive hormone testing can be limited or unavailable.

  • Be transparent with patients about the out-of-pocket costs of the test. 
  • If insurance coverage is uncertain, provide patients with options to pay directly for the DUTCH Plus test. If insurance doesn't cover it, patients may be able to pay for it using their flexible spending account (FSA) or health savings account (HSA).

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Key Takeaways

  • The DUTCH Plus test by Precision Analytical represents a pivotal advancement in hormonal diagnostics, offering healthcare providers a nuanced and comprehensive tool for assessing adrenal and sex hormone health. 
  • By integrating this test into clinical practice, clinicians can achieve more precise diagnoses, tailor personalized treatment plans, and ultimately enhance patient outcomes. 
  • While challenges exist, informed implementation and continuous education can maximize the DUTCH Plus test's benefits, fostering a more holistic and effective approach to patient care.

Resources for Further Information

  • Ready to order the DUTCH Plus test by Precision Analytical (DUTCH) through Rupa Health? Click here!
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Lab Tests in This Article

DUTCH Plus by Precision Analytical (DUTCH)
Saliva
Urine
The DUTCH Plus™ offers an extensive assessment of sex and adrenal hormones and their metabolites. It also assesses the Cortisol Awakening Response (CAR) and includes the insomnia cortisol sample. This test cannot be ordered for patients under 12 years of age.

References

  1. Anderson, S. (2022, July 18). What Is Adrenal Fatigue? Is It A Real Condition? Rupa Health. https://www.rupahealth.com/post/wired-but-tired-this-isnt-a-normal-part-of-aging
  2. Arslan, A. A., Koenig, K. L., Lenner, P., et al. (2014). Circulating Estrogen Metabolites and Risk of Breast Cancer in Postmenopausal Women. Cancer Epidemiology, Biomarkers & Prevention, 23(7), 1290–1297. https://doi.org/10.1158/1055-9965.epi-14-0009
  3. Choi, M. H. (2022). Clinical and Technical Aspects in Free Cortisol Measurement. Endocrinology and Metabolism, 37(4), 599–607. https://doi.org/10.3803/enm.2022.1549
  4. Christie, J. (2022, March 25). The Most Common Causes Of Infertility In Men and Women. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-infertility
  5. Christie, J. (2022, April 7). 5 Common Root Causes Of Endometriosis And How To Treat Them. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-endometriosis
  6. Christie, J. (2022, April 22). A Functional Medicine Approach to PMS. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-pms
  7. Christie, J. (2022, August 23). Signs You Aren't Metabolizing Estrogen Properly. Rupa Health. https://www.rupahealth.com/post/how-to-know-if-your-body-is-metabolizing-estrogen-properly
  8. Christie, J. (2023, February 28). Why You Should Incorporate Melatonin Testing Into Your Practice? Rupa Health. https://www.rupahealth.com/post/testing-melatonin-levels-101
  9. Christie, J. (2024, April 1). A Root Cause Medicine Protocol for PCOS. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-protocol-for-pcos
  10. Cloyd, J. (2023, February 16). A functional medicine protocol for estrogen dominance. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-protocol-for-estrogen-dominance
  11. Cloyd, J. (2023, March 7). An integrative medicine approach to fatigue. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-fatigue
  12. Cloyd, J. (2023, August 9). A Root Cause Medicine Protocol for Patients With Depression: Comprehensive Lab Testing, Therapeutic Diet, and Supplements. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-protocol-for-patients-with-depression-comprehensive-lab-testing-therapeutic-diet-and-supplements
  13. Cloyd, J. (2023, October 2). A Functional Medicine Approach to Stress Management. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-stress-management
  14. Cloyd, J. (2023, October 26). How To Interpret Your DHEAS Test Results. Rupa Health. https://www.rupahealth.com/post/how-to-interpret-your-dheas-test-results
  15. Cloyd, J. (2023, October 30). How To Interpret Your Cortisol Urine Test Results. Rupa Health. https://www.rupahealth.com/post/how-to-interpret-your-cortisol-urine-test-results
  16. Cloyd, J. (2023, November 21). Do You Know About Inositol? Learn the 6 Evidence-Based Uses for This Powerful Nutrient. Rupa Health. https://www.rupahealth.com/post/do-you-know-about-inositol-learn-the-6-evidence-based-uses-for-this-powerful-nutrient
  17. Cloyd, J. (2023, December 1). The Functional Medicine Protocol For Beating Burnout with Adrenal Support. Rupa Health. https://www.rupahealth.com/post/the-functional-medicine-protocol-for-beating-burnout-with-adrenal-support
  18. Cloyd, J. (2023, December 29). Is There An Adrenal Fatigue Test? Rupa Health. https://www.rupahealth.com/post/is-there-an-adrenal-fatigue-test
  19. Cloyd, J. (2024, January 3). Saliva Testing: Cortisol and Hormone Test Result Interpretation Guide. Rupa Health. https://www.rupahealth.com/post/saliva-testing-cortisol-and-hormone-test-result-interpretation-guide
  20. Cloyd, J. (2024, March 15). 4 Decisive Signs You Need Hormone Replacement Therapy. Rupa Health. https://www.rupahealth.com/post/signs-you-need-hormone-replacement-therapy
  21. Cloyd, J. (2024, April 15). Cortisol and Weight Gain: Understanding the Connection. Rupa Health. https://www.rupahealth.com/post/cortisol-and-weight-gain-understanding-the-connection
  22. Cloyd, K. (2023, September 7). Unlocking Hormonal Health: A Comprehensive Guide to Understanding and Choosing the Right Hormonal Testing for Your Patients. Rupa Health. https://www.rupahealth.com/post/unlocking-hormonal-health-a-comprehensive-guide-to-understanding-and-choosing-the-right-hormonal-testing-for-your-patients
  23. Cloyd, K. (2023, November 10). Erectile Health and the Gut: Surprising Connections Unveiled. Rupa Health. https://www.rupahealth.com/post/erectile-health-and-the-gut-surprising-connections-unveiled
  24. Cloyd, K. (2023, December 20). Interpreting Oxidative Stress Markers. Rupa Health. https://www.rupahealth.com/post/interpreting-oxidative-stress-markers
  25. Cloyd, K. (2024, January 10). CCalcium-D-Glucarate'sEffectiveness in Estrogen Balance: An Integrative Endocrine View. Rupa Health. https://www.rupahealth.com/post/calcium-d-glucarates-effectiveness-in-estrogen-balance-an-integrative-endocrine-view
  26. Coleman, E. (2024, April 16). Indoles for Cancer Prevention: Understanding the Protective Role of Cruciferous Vegetables. Rupa Health. https://www.rupahealth.com/post/indoles-for-cancer-prevention-understanding-the-protective-role-of-cruciferous-vegetables
  27. Coleman, E. (2024, May 31). 6 Natural Ways to Enhance Insulin Sensitivity. Rupa Health. https://www.rupahealth.com/post/improve-insulin-sensitivity
  28. Conner, V. (2022, August 2). Nutrition and Lifestyle Tips to Help Reduce Hot Flashes. Rupa Health. https://www.rupahealth.com/post/natural-treatments-for-menopause
  29. Cox, A. D. (2022, December 2). Adaptogen Herbs: Evidence, Medicinal Benefits, & More. Rupa Health. https://www.rupahealth.com/post/adaptogens
  30. Creedon, K. (2022, March 18). 8 Ways To Prevent Osteoporosis As You Age. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-osteoporosis
  31. Creedon, K. (2022, August 4). 6 speciality labs that get to the root cause of insomnia. Rupa Health. https://www.rupahealth.com/post/6-speciality-labs-that-get-to-the-root-cause-of-insomnia
  32. Daglis, S. (2024, February 1). Heart Health in Menopause: Understanding and Managing Cardiovascular Risks. Rupa Health. https://www.rupahealth.com/post/heart-health-in-menopause-understanding-and-managing-cardiovascular-risks
  33. DeCesaris, L. (2023, May 16). Complementary and Integrative Medicine Approaches to Treating PMDD: Specialty Testing, Supplements, and Nutrition. Rupa Health. https://www.rupahealth.com/post/complementary-and-integrative-medicine-approaches-to-treating-pmdd
  34. DePorto, T. (2023, January 31). Glutathione Health Benefits: The Master Antioxidant. Rupa Health. https://www.rupahealth.com/post/glutathione-health-benefits-the-master-antioxidant
  35. Diorio, B. (2022, September 23). How to Regulate Your Dopamine Levels Naturally. Rupa Health. https://www.rupahealth.com/post/how-to-regulate-your-dopamine-levels-naturally
  36. Diorio, B. (2022, October 25). How to Balance Adrenaline Levels Naturally. Rupa Health. https://www.rupahealth.com/post/adrenaline
  37. DUTCH Plus by Precision Analytical (DUTCH). Rupa Health. https://www.rupahealth.com/lab-tests/dutch-dutch-plus
  38. Easthope, A. (2022, April 26). 11 Common Causes Of Low Male Testosterone (And How To Fix Them). Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-low-male-testosterone-hypogonadism
  39. Gerow, S. (2024, May 31). Cortisol Test: Understanding Your Stress Hormone Levels. Rupa Health. https://www.rupahealth.com/post/cortisol-test-understanding-your-stress-hormone-levels
  40. Jackson, K. (2024, October 4). Is The DUTCH Test Legitimate? Rupa Health. https://www.rupahealth.com/post/is-the-dutch-test-legitimate
  41. Low Estrogen. (2022, February 8). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22354-low-estrogen
  42. Maholy, N. (2023, February 17). A functional medicine approach to anxiety: Testing, nutrition, & supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-anxiety
  43. Maholy, N. (2023, February 27). An Integrative Medicine Approach to Menorrhagia. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-menorrhagia
  44. Maholy, N. (2023, March 2). A Functional Medicine Protocol for Dysmenorrhea. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-protocol-for-dysmenorrhea
  45. Maholy, N. (2023, March 8). A Functional Medicine Protocol for Amenorrhea. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-protocol-for-amenorrhea
  46. Maholy, N. (2023, April 24). A Functional Medicine Protocol for Hypo-Responsiveness Adrenal Dysregulation. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-protocol-for-hypo-responsiveness-adrenal-dysregulation
  47. Newman, M. S. Clinical Validation of DUTCH Test (pp. 1–35). Precision Analytical Inc. https://dutchtest.com/wp-content/uploads/2018/09/Clinical-Validity.pdf
  48. Newman, M., & Curran, D. A. (2021). Reliability of a dried urine test for comprehensive assessment of urine hormones and metabolites. BMC Chemistry, 15(1). https://doi.org/10.1186/s13065-021-00744-3
  49. Newman, M., Curran, D. A., & Mayfield, B. P. (2020). Dried urine and salivary profiling for complete assessment of cortisol and cortisol metabolites. Journal of Clinical & Translational Endocrinology, 22, 100243. https://doi.org/10.1016/j.jcte.2020.100243
  50. Newman, M., Pratt, S. M., Curran, D. A., et al. (2019). Evaluating urinary estrogen and progesterone metabolites using dried filter paper samples and gas chromatography with tandem mass spectrometry (GC–MS/MS). BMC Chemistry, 13(1). https://doi.org/10.1186/s13065-019-0539-1
  51. Preston, J. (2023, March 9). 7 most common female reproductive health issues. Rupa Health. https://www.rupahealth.com/post/7-most-common-female-reproductive-health-issues
  52. Preston, J. (2023, March 15). An Integrative Medicine Approach to Managing Menopause Symptoms. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-managing-menopause-symptoms
  53. Sweetnich, J. (2023, February 7). A Non Pharmaceutical Approach to PCOS. Rupa Health. https://www.rupahealth.com/post/a-non-pharmaceutical-approach-to-pcos
  54. Sweetnich, J. (2023, February 15). How to Support Optimal Liver Estrogen Detoxification. Rupa Health. https://www.rupahealth.com/post/how-the-liver-affects-female-hormones
  55. Sweetnich, J. (2023, February 22). An Integrative Medicine Approach to Estradiol Imbalance. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-estradiol-imbalance
  56. Sweetnich, J. (2023, February 23). 4 Functional Medicine Labs to Test for Root Cause of Estrone Imbalance. Rupa Health. https://www.rupahealth.com/post/4-functional-medicine-labs-to-test-for-root-cause-of-estrone-imbalance
  57. Sweetnich, J. (2023, February 23). How to Test for The Root Cause of Progesterone Imbalance. Rupa Health. https://www.rupahealth.com/post/a-integrative-medicine-approach-to-progesterone-imbalance
  58. Sweetnich, J. (2023, February 28). Testosterone Testing 101. Rupa Health. https://www.rupahealth.com/post/testosterone-testing-101
  59. Sweetnich, J. (2023, February 28). Using The DUTCH Cortisol Awakening Response (CAR) Test in Clinic: 101. Rupa Health. https://www.rupahealth.com/post/dutch-cortisol-awakening-response-car-test-101
  60. Sweetnich, J. (2023, April 13). How To Get Rid of Hormonal Acne Naturally. Rupa Health. https://www.rupahealth.com/post/how-to-get-rid-of-hormonal-acne-naturally
  61. Sweetnich, J. (2023, April 14). Functional Medicine Protocol for Low Libido in Women. Rupa Health. https://www.rupahealth.com/post/functional-medicine-protocol-for-low-libido-in-women
  62. Sweetnich, J. (2023, April 20). Which DUTCH Test Is Best For Your Patients? Rupa Health. https://www.rupahealth.com/post/dutch-complete-vs-dutch-plus-vs-dutch-cycle-map-a-guide
  63. Sweetnich, J. (2023, April 24). Vitamin B6 101. Rupa Health. https://www.rupahealth.com/post/vitamin-b6-101-testing-nutrition-and-supplements
  64. Sweetnich, J. (2023, April 26). Unlocking the Benefits of Vitamin B12: The Importance of Maintaining Optimal Levels. Rupa Health. https://www.rupahealth.com/post/vitamin-b12-101
  65. Sweetnich, J. (2023, May 1). Testing Your Patient’s Biotin Levels: The Essential Vitamin for Hair, Skin, and Nails. Rupa Health. https://www.rupahealth.com/post/biotin-101
  66. Taylor, R. L., Machacek, D., & Singh, R. J. (2017). Validation of a high-throughput liquid chromatography-tandem mass spectrometry method for urinary cortisol and cortisone. Clinical Chemistry, 48(9), 1511–1519. https://pubmed.ncbi.nlm.nih.gov/12194928/
  67. Wang, T., Nichols, H. B., Nyante, S. J., et al. (2020). Urinary Estrogen Metabolites and Long-Term Mortality Following Breast Cancer. JNCI Cancer Spectrum, 4(3). https://doi.org/10.1093/jncics/pkaa014
  68. Weinberg, J. L. (2022, March 31). How to tell if you have an estrogen imbalance. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-estrogen-imbalance
  69. Weinberg, J. L. (2023, May 9). What are Xenoestrogens and How To Test for Exposure. Rupa Health. https://www.rupahealth.com/post/what-are-xenoestrogens-and-how-you-can-avoid-them
  70. Yoshimura, H. (2023, August 7). Top labs to run bi-annually on your irregular menstrual cycle patients. Rupa Health. https://www.rupahealth.com/post/top-labs-to-run-bi-annually-on-your-irregular-menstrual-cycle-patients
  71. Yoshimura, H. (2023, October 11). An Integrative Medicine Approach to Circadian Rhythm Disorders. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-circadian-rhythm-disorders
  72. Yoshimura, H. (2023, October 23). What is Neuroinflammation, and How Can Functional Medicine Help to Identify and Reduce it? Rupa Health. https://www.rupahealth.com/post/what-is-neuroinflammation-and-how-can-functional-medicine-help-to-identify-and-reduce-it
  73. Yoshimura, H. (2024, January 26). Nutritional Support for Optimal Methylation: A Guide for Functional Medicine. Rupa Health. https://www.rupahealth.com/post/nutritional-support-for-optimal-methylation-a-guide-for-functional-medicine
Jaime Cloyd
Author
Dr. Jaime Cloyd ND
Naturopathic Physician based in the greater Seattle area
Medically Reviewed by
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Coronary Calcium Scoring: What is This Important Test, What Does it Tell Us About Our Heart, and What Does it Hide?Coronary Calcium Scoring: What is This Important Test, What Does it Tell Us About Our Heart, and What Does it Hide?
Coronary Calcium Scoring: What is This Important Test, What Does it Tell Us About Our Heart, and What Does it Hide?
,
December 18, 2024
Jessica Christie
Jessica Christie, ND, CNS
December 18, 2024
Red Blood Cells and Inflammation: Leveraging CBC and Metabolic Biomarkers for Early Disease InsightsRed Blood Cells and Inflammation: Leveraging CBC and Metabolic Biomarkers for Early Disease Insights
Red Blood Cells and Inflammation: Leveraging CBC and Metabolic Biomarkers for Early Disease Insights
Dr. Chris Magryta, MD
December 13, 2024
Dr. ,
December 13, 2024
The Predictive Power of Micronutrient Cofactor Testing in Disease Prevention and ManagementThe Predictive Power of Micronutrient Cofactor Testing in Disease Prevention and Management
The Predictive Power of Micronutrient Cofactor Testing in Disease Prevention and Management
Dr. Chris Magryta, MD
December 13, 2024
Dr. ,
December 13, 2024
Is TSH the Only Lab Value That Evaluates Thyroid Dysfunction and Disease?Is TSH the Only Lab Value That Evaluates Thyroid Dysfunction and Disease?
Is TSH the Only Lab Value That Evaluates Thyroid Dysfunction and Disease?
Dr. Chris Magryta, MD
December 13, 2024
Dr. ,
December 13, 2024
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