The DUTCH Plus™ takes hormone testing to a new level. In addition to sex hormones and their metabolites, the DUTCH Complete™ looks at the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. The DUTCH Plus™ adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA axis into focus.

The results include:

• Analysis of 35 different hormones: estrogen, progesterone, testosterone, DHEA-S, and cortisol along with their metabolites, plus the cortisol awakening response (CAR)

• Graphical representation of results and embedded video tutorials to assist in the hormone assessment to share with your medical provider

• DUTCH OATs: Melatonin (6OHMS), 8-Hydroxy-2-deoxyguanosine (8-OHdG), and six organic acid tests (OATs) including markers for vitamin B12 (methylmalonate), vitamin B6 (xanthurenate), kynurenate, glutathione (pyroglutamate), dopamine (homovanillate), norepinephrine/epinephrine (vanilmandelate).

SUITABLE TIME TO COLLECT

1. Regular Cycles / Premenopausal Women Begin collection between days 19 and 22 of a 28-day cycle.
2. Men & Non-Cycling or Postmenopausal Women Collect any day.
3. Longer Cycles or Shorter Cycles 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).
4. Irregular Cycles or Not Bleeding (ablation or hysterectomy) Contact Anti-Fragility Health at (714) 864-3730 or pe@anti-fragilityhealth.com for assistance in finding the optimal time to collect.

ARE YOU TAKING ANY HORMONES?

• Oral Estrogen, Testosterone or Pregnenolone
  • Do not take for 72 hours before your first collection (does not apply to birth control).
• Oral DHEA
  • Do not take for 48 hours before your first collection.
• Oral Progesterone
  • Should be taken at bedtime the night before the test.
• Hormone Creams and Gels
  • Can be taken as usual during the test.
• Patches, Pellets and Injections
  • Collect midway between doses.
• Any and All Hormones Taken in the Morning
  • Do not take until after the 2nd urine collection (sample #4).
• Sublingual Hormones (absorbed in the mouth)
  • Please visit dutchtest.com for specific video instructions.
• Oral Hydrocortisone (cortisol)
  • Please visit dutchtest.com for specific video instructions or contact Anti-Fragility Health at (714) 864-3730 or pe@anti-fragilityhealth.com.
• Glucocorticoids (Prednisone, Dexamethasone, etc.)
  • Check with your provider.

RESTRICTION

• 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.

HOW TO COLLECT

SALIVA

1. Remove the blue cap and place the cotton swab from the collection device in mouth
2. Leave in mouth until fully saturated but not longer than 5 minutes. Lightly chewing on the swab may help stimulate saliva flow
3. Once done, place swab back in the same tube, just as you found it. Do not remove the inner tube. You do not need to spit into the tube. Touch the swab as little as possible with your hands. Label each device completely
4. Freeze all saliva samples until they are ready to ship

URINE

1. Complete all the information on each collection device
2. Saturate the filter paper by urinating directly on it OR urinating into a clean cup and dip the filter paper for 5 seconds
3. Leave the sample open to dry for at least 24 hours
4. Once dry, close each collection device and place them all in the resealable plastic bag provided

For more information on Dutch Plus Instructions, click here