DUTCH stands for Dried Urine Test for Comprehensive Hormones, and it's one of the most requested panels in our functional medicine testing. It's also one of the most misunderstood, so here's the plain-English version.
How it works
You collect four or five small dried urine samples at home over about a day, at set times. The kit ships to the lab, and a few weeks later we sit down together, over video, and walk through the results marker by marker.
That collection pattern is the first advantage: instead of one blood draw capturing one moment, DUTCH sees your hormone output across a full daily cycle.
What it measures that blood work doesn't
That distinction sounds technical, but it changes decisions:
- Estrogen processing. DUTCH shows which pathways your body uses to break estrogen down. Some pathways are preferable to others, and knowing yours matters, especially before starting hormone therapy.
- The full cortisol curve. Instead of one morning cortisol number, you see your stress hormone's rhythm across the day: the morning rise, the daytime slope, the nighttime drop. Fatigue with normal blood cortisol often looks very different on a curve.
- Androgen pathways. How your body handles testosterone and its downstream metabolites, relevant for both women and men.
Who it's for
We reach for DUTCH most often with perimenopausal and menopausal symptoms that standard labs called normal, cycle irregularities, stubborn fatigue with a stress-shaped pattern, and anyone starting or fine-tuning hormone therapy where knowing the processing pathways changes the plan.
What it costs you to skip
Nothing, if you feel fine. But if you've cycled through "normal labs" more than once while feeling worse each year, the pattern usually isn't going to break on the third identical blood panel. Different question, different test.
DUTCH is one tool among several we use, alongside GI-MAP for gut health, OAT for metabolic markers, and conventional labs. The right panel depends on your symptoms, which is why testing at Aspire starts with a conversation instead of a shopping cart.