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DUTCH stands for Dried Urine Test for Comprehensive Hormones. Developed by Precision Analytical, it analyzes four dried urine samples collected over a single day, plus saliva samples for cortisol timing. The combination produces a fuller picture of hormone production, metabolism, and rhythm than any single blood draw can capture.
DUTCH Plus is the most thorough version of the test — adding the cortisol awakening response (CAR) measurement, which is one of the most clinically meaningful HPA axis biomarkers available.
The test is done at home. We send the kit, you collect the samples, ship it back, and results return in roughly 2-3 weeks.
The full panel covers:
Four samples mapping how cortisol changes from waking through evening — the diurnal pattern that conventional testing misses entirely.
The 30-60 minute cortisol spike after waking, measured via saliva. Flattened CAR is one of the most consistent biomarkers in chronic stress, depression, complex trauma, and burnout.
Total cortisol production (not just what's circulating). The ratio reveals whether your adrenals are over- or under-producing.
The "anti-cortisol" adrenal hormone, often suppressed in chronic stress states.
Plus the metabolites that show how your body is processing them.
The 2-OH, 4-OH, and 16-OH pathways that affect cancer risk, hormonal symptoms, and methylation status.
A window into circadian rhythm and sleep architecture.
The DUTCH Plus organic acid section gives partial visibility into dopamine, serotonin, norepinephrine, and glutathione activity.
Hormones drive mental health symptoms through pathways that conventional psychiatry rarely investigates. The HPA axis sits at the center of depression, anxiety, PTSD, and chronic fatigue. Estrogen and progesterone fluctuations drive PMDD, perimenopausal mood symptoms, and post-pregnancy depression. Testosterone affects motivation, mood, and cognition in both men and women. Cortisol patterns affect sleep, focus, and emotional regulation throughout the day.
When these systems are dysregulated, no SSRI, mood stabilizer, or stimulant alone will fully restore function. The hormones have to be addressed too. DUTCH Plus is the test that makes that work possible — because it shows what’s actually happening, not just whether values fall within population reference ranges.
Your results inform every phase of your protocol. Phase one interventions — sleep architecture support, HPA axis stabilization, adaptogenic protocols — are sequenced based on what your cortisol pattern shows. Sex hormone optimization (where indicated and coordinated with prescribers) draws on the metabolite ratios. Estrogen detoxification pathways guide methylation and liver-support recommendations. The CAR pattern guides whether morning interventions need to focus on building cortisol or buffering it.
DUTCH Plus is one of seven tests in our standard mental health bundle. It works alongside comprehensive blood biomarkers, advanced nutrient analysis, gut microbiome assessment, food sensitivity testing, and genetic analysis to give the complete biological picture.
If you've already done DUTCH testing elsewhere, send us the results. We integrate prior labs into your clinical picture alongside the testing in our program — longitudinal hormone data often reveals patterns that a single timepoint can't.
DUTCH Plus is high-yield for nearly everyone seeking functional medicine support for mental health, but it's especially valuable for:
DUTCH Plus is included in our functional medicine assessment and consultation program. Full structure: