I just keep on diving into the controversial topics, but I won’t stop. It makes me very angry to see people being taken advantage of, and hormones are the latest grift.
Like, ‘balancing’ hormones.
And of course, hormone testing. As in, the DUTCH test.
I’ve been asked a huge number of times to do a DUTCH test review, and when I started doing research about it, I was stunned to see that there was really no unbiased information online about it.
The company the sells the DUTCH test, Precision Analytics, seems to have bought up all of the SEO around this topic, so the first couple of pages in Google lead right to their website. The other ‘reviews’ and information on the DUTCH test are by people who actually sell it.
How useful is that? Not so much.
As with all of my other posts, I wanted to give you the most up-to-date and reliable information in this DUTCH test review. I know that I’m going to get major blowback from this post, from people who either offer the test or who have taken it. But I did my due diligence here, as I do with all of my reviews, to get the real story.
Hormones are a touchy subject, y’all, especially when someone finds out that they’ve spent a ton of money on a test that’s basically worthless. Oh no! Did I give away the plot of this review?
Because I couldn’t get the answers I wanted online, I decided to interview a gynaecologist and two endocrinologists about DUTCH testing. After all, these people are actual **hormone experts.**
What is the DUTCH test?
The DUTCH test allegedly measures hormone levels to determine which ones need to be ‘fixed.’ It’s used as a diagnostic test not by medical doctors, but by alternative health providers and sadly, some registered dietitians.
DUTCH is an acronym for Dried Urine Test for Comprehensive Hormones.
Precision Analytics claims that “Millions of women suffer from hormonal imbalances. Whether it is menopause, weight gain, fatigue, low libido, premenstrual symptoms (PMS), mood swings, or depression, these symptoms can lead to more serious problems if misdiagnosed. Identifying the root cause of chronic health issues is certainly correctable, but only if properly identified.”
Every time I see the words ‘root cause,’ it’s a red flag.
This is a popular phrase used by a lot of alternative providers to suggest that unlike conventional providers, they find what’s causing symptoms, instead of just treating them with medication.
Nothing could be further from the truth. Sure, there are some bad conventional docs out there, just like there are in every profession. But to suggest that conventional medicine is only interested in prescribing drugs and not treating the cause of illness, is completely egregious.
Doing the DUTCH test involves the collection of four urine samples over the course of two days.
The urine is then dried, sent to the lab, and analyzed for hormone metabolites.
Pretty much all of the providers I looked at offered the DUTCH as a way to measure sex and adrenal hormones.
Adrenal hormones (eg: cortisol and DHEA)
Estrogens and metabolites (eg: estradiol)
Progesterones and metabolites
Androgens and metabolites (eg: testosterone and DHEA)
Is the DUTCH test accurate?
Precision Analytics claims that DUTCH is superior in comparison to serum and saliva hormone tests, because DUTCH is more accurate in measuring cortisol and cortisol metabolites.
But is it?
Not according to Disha Narang, MD, a board certified endocinologist.
She told me this:
Not a single one of these tests is useful for a legitimate practitioner. First of all, there’s been zero validation via randomized controlled trials to prove that the DUTCH test is accurate.
Also, metabolites are never used in clinical practice. It’s very rare for any of the metabolites to be low – that would mean you have dysfunctional enzymes that convert estrogen.
In my experience, the DUTCH is used by providers like naturopaths to say ‘your metabolites are low’ and sell you a supplement.
Karl Nadolsky, DO FACE, and board certified in endocrinology, diabetes & metabolism, agrees.
While the variety of tests in DUTCH may ultimately become validated methods of testing some hormones, there is no currently validated clinical indication for using it. We must have a keen clinical consideration for why, how and when to check any specific hormone lab when evaluating patients for endocrine diseases (excess, deficiency, etc). Having a random slew of hormones checked in the Dutch method does not help diagnose any endocrinopathy at this time that I am aware of.
There is also no benefit to testing four times in a day. Cortisol, for example, follows a circadian rhythm – so it’s naturally low in the morning and higher at night. The DUTCH test will show this, but that doesn’t mean there’s anything wrong with you.
Cortisol is a stress hormone that can cause us to gain weight. But the answer to elevated cortisol isn’t diet; it’s decreasing stress as much as possible. Some practitioners will also recommend cutting out coffee, and if you’re drinking a lot, cutting down may help.
But if you typically have one coffee a day, and your body is accustomed to it, research says that cutting out your daily cup won’t do a lot of good for lowering your cortisol.
Even if your cortisol is high, there are no herbs or supplements that can fix that, according to Narang.
And the multiple collections in a day don’t give more or better information.
Narang adds, “even with a multiple collections in a 24-hour period, the DUTCH test won’t give me any extra information that current validated testing doesn’t give me already.”
DUTCH testing and diet
The diet recommendations that come along with DUTCH results will probably be the same as anyone would give: regular meals, more fibre, lots of plants, moderate protein, healthy fats. Don’t overdo the coffee and sugar. As many whole foods as possible.
Those recommendations, not the DUTCH testing, may be responsible for your symptom resolution. But you can get them without spending $600 on a DUTCH test.
There’s no secret here.
And taking unregulated supplements not only lines the pocket of whoever has sold them to you, it can also be super dangerous.
It’s pretty safe to assume that actual endocrinologists, like the ones quoted above, have all of the facts. They aren’t lying, or somehow complicit in some scheme with ‘Big Pharma’ to hide some fabulous treatment that only your naturopath knows about.
The DUTCH test is clinically meaningless for menopause and should not be used to evaluate menopausal status or to guide menopausal hormone therapy. In fact, no hormone testing is needed to guide menopausal hormone therapy. This is not just my opinion, but the recommendation of the major medical societies.
I’ve heard from women who say that the DUTCH test solved all of their hormone issues. I am not going to minimize their experiences. Hormones are complicated, and of course there’s a chance that something that provider recommended ended up working. But again, the diet part – if that’s what made symptoms better – isn’t dependent on DUTCH results.
According to Narang, “Some resolution of symptoms may honestly be psychological. Other therapies can have short-term benefit – but a lot of these therapies have no studies on long-term effects or benefits.
There is no guarantee that any of these therapies will make people feel perfect. And unfortunately sometimes that’s what people want to feel, and it’s a set up for failure.”
What I’ve found is that a lot of women who resort to alternative providers and DUTCH testing, have been unable to get answers to their questions and symptoms from conventional medicine.
That’s because sometimes, there are no answers. And just because someone makes answers up or doesn’t follow current evidence-based practice, doesn’t make them a better provider.
Let’s face it – there are also some doctors who aren’t great. I’ve heard plenty of stories about those, too. But again, resorting to woo woo because your doc isn’t up to par is a pretty big jump in the wrong direction.
Honestly, I feel like it’s a red flag when a practitioner sells unvalidated, unsupported tests like IgG or LEAP food sensitivity, MTHFR, stool microbiome and DUTCH. It’s even more of a red flag when they use your results from those tests to sell their own brand of supplements or special diet to ‘correct’ your ‘condition.’
If DUTCH testing was so insightful, it would be used by all practitioners. But it’s not, and contrary to what you may have been told, the North American Menopause Society does NOT recommend DUTCH testing for hormones.
What if you still want to get a DUTCH test after reading this DUTCH test review? DUTCH tests aren’t harmful (except to your wallet), so if you want to try it, go right ahead. But it’s not necessary to diagnose or treat hormone issues.