About Test

About DUTCH Complete™

Key Details

• Review your kit - When you receive the test kit in the mail, review its contents, and read through the information provided with the kit.
• This is a urine collection kit that you will collect for at home.

What Days of the Month Do I Collect?

• Cycling Premenopausal Women
  • Begin collection between days 19 and 22 of a 28-day cycle. For longer cycles, add the number of days you usually go beyond 28 days. In a similar manner, subtract if your cycles are shorter (example: collect days 17-20 for a 26 day cycle)
  • For irregular cycles or non-cycling (ablation or uterus removed), watch the irregular cycle collection video in the video library at dutchtest.com/videos for suggestions on collecting.
• Men & Non-Cycling or Postmenopausal Women
  • Collect any day.

Restrictions

• Watch Your Fluid Consumption
  • No Alcohol, Caffeine or Large Fluid Intake after lunch before collecting the dinner sample. No more than one cup of fluids between Samples #3 and #4.
  • Do not drink any fluids for two hours before collecting each sample. We suggest you keep fluids to < 32oz on day 1, and < 8oz between waking (Sample #3) and 2-hrs after waking (Sample #4).
• Using Hormones?
  • DO NOT TAKE oral DHEA 48 hours before, or any oral estrogen* or pregnenolone 72 hours before your first collection.
  • Do not skip doses of birth control for this test unless instructed by your practitioner.
  • Any other hormones taken at NIGHT (including oral progesterone) should be taken after the bedtime sample. Generally, hormone creams or gels can be taken as usual during the test. All hormones taken in the MORNING should not be taken until after sample #4.
    If you take glucocorticoids (Prednisone, Dexamethasone, etc.) check with your practitioner. For patches, pellets and injections, collect midway between doses. If you take sublingual hormones (absorbed in the mouth or under the tongue) or if you take oral hydrocortisone (cortisol), visit dutchtest.com for specific video instructions.
• Foods
  • Avoid avocado, bananas and fava beans for 48 hours before collecting as they may elevate the HVA organic acid result; if you do consume, please make a note on your requisition form.
• Supplements
  • Some supplements may impact the HVA organic acid result. If you take any of the following, please consult your provider: Tyrosine, L-Dopa, D,L-Phenylalanine (DLPA), Mucuna and Quercetin.

When to Collect

While adhering to your most common wake/sleep schedule, collect as close as possible to the below timeline.

Collection Day 1

• Sample #1: Dinnertime
  • Approximately 5pm. Do not drink fluids for two hours before collecting.
• Sample #2: Bedtime
  • Approximate 10pm. Do not drink fluids for two hours before collecting.

Collection Day 2

• Extra Overnight Sample
  • Collect at your first waking sleep disturbance with urination*
  • *If you wake and urinate a second time during the night, do not collect.
• Sample #3: Wake/Rising
  • Within 10 minutes; Do not lay awake in bed before Sample #3.
• Sample #4: 2-hrs After Waking
  • Tip: Set a timer after Sample #3

How to Collect

• Complete all information on each collection device.
• Saturate the filter paper by urinating directly on it OR use a clean cup and dip the filter paper.
• Leave the collection device open to dry for at least 24 hours.
• Once dry, close each collection device. Place all devices in the resealable plastic bag and return in the provided envelope. Be sure to include the completed requisition form (required) and the payment card (if needed).

Why Use DUTCH?

The Easiest Patient Collection

Patients collect just four or five dried urine samples over a 24-hour period. Dried samples are stable for several weeks making them convenient to ship worldwide.

Analytical and Clinical Validation

Precision Analytical’s testing methods go through a rigorous validation process to verify accuracy, recovery, and linearity. We pride ourselves in relentlessly pursuing the most accurate and precise techniques available for testing. See the data on the next page to support the analytical and clinical validation of this powerful new testing model.

Effective HRT Monitoring

DUTCH testing was designed to be optimally effective for most forms of hormone replacement therapy. Unique methods are used for improved monitoring of oral progesterone and vaginal hormones.

How does DUTCH Compare to Other Hormone Tests?

DUTCH vs. Saliva Testing

While the free cortisol pattern in saliva has clinical value, there is a significant missing piece to surveying a patient’s HPA-Axis function with saliva testing – measuring cortisol metabolites. To properly characterize a patient’s cortisol status, free and metabolized cortisol should be measured to avoid misleading results when cortisol clearance is abnormally high or low. Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture for more precise clinical diagnosis of hormonal imbalances and HRT monitoring.

DUTCH vs. Serum Testing

While the most universally accepted testing method (due to the availability of FDA-cleared analyzers that are reliable and inexpensive), serum testing is lacking in some areas. Adrenal hormones cannot be effectively tested in serum because free cortisol cannot be tested throughout the day. There is also a lack of extensive metabolite testing (especially for cortisol and estrogens).

DUTCH vs. 24-Hour Urine Testing

There are two primary drawbacks to 24-hour urine testing of hormones. First, the collection is cumbersome, and as many as 40% of those who collect, do so in error (Tanaka, 2002). Secondly, dysfunction in the diurnal pattern of cortisol cannot be ascertained from a 24-hour collection. Some providers add saliva for daily free cortisol. DUTCH eliminates the need for two tests.