Advanced Hormone Panel
The DUTCH Complete® with addition of saliva cortisol testing
The DUTCH Plus® adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.
This panel includes everything in the DUTCH Complete including analysis of all 35 different hormones: estrogen, progesterone, testosterone, DHEA-S, and diurnal pattern of free cortisol and distribution of cortisol metabolites.
What is the Cortisol Awakening Response?
When we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 30 minutes after waking, cortisol levels will still show this sharp increase. By 60 minutes after waking, cortisol levels have peaked and begin to decline.
Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range.
How Is Cortisol Tested?
A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.
What Can The Cortisol Awakening Response Tell Us?
Even though a patient may have “normal” free cortisol levels throughout the day, that doesn’t always mean everything is functioning properly.
A blunted or exaggerated Cortisol Awakening Response (CAR) can appear, even when single samples return “normal” results. The HPA axis might not be appropriately responding when faced with a stressor, even when cortisol levels are fluctuating nicely throughout the day.
The “stress” of waking allows us to test the HPA axis in a way that has been independently correlated to clinical outcomes and cannot be assessed by other cortisol tests on the market.
Sample Collection is simple and you can do right in your own home. 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.
HRT Monitoring to a whole new level. 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.