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Hormones and Why I Use the DUTCH Test

Hormones are the messengers made in different glands that tell our tissue to perform specific functions. There are many different types of hormones, but typically, ‘hormone imbalance’ refers to SEX (estrogen, progesterone, testosterone), ADRENAL (DHEA, cortisol), and THYROID gland function.


After menopause, traditional HRT (Hormone Replacement Therapy) uses an evidence-based approach for treatment recommendations. Using science to direct therapy that helps a majority of the population makes sense, is cost-effective, and many women get relief with standardized hormone replacement.

Studies that provide the ‘evidence’ for clinical guidelines, however, are often funded by the pharmaceutical companies who benefit from selling their drugs. Also, current options for HRT focus only on estrogen and progesterone.  Unfortunately, many women are disillusioned and frustrated by this limited approach or are not getting adequate relief from all their symptoms.


The sex, adrenal, and thyroid hormones interact and affect each other. When in balance, they perform like a beautifully orchestrated symphony. Balancing hormones requires the skill of a conductor who understands hormones and keeps them in tune and in unison with each other.


A Functional Medicine approach to hormone balancing uses symptoms, hormone levels, lifestyle, and individual circumstances to improve the safety and effectiveness of bioidentical hormone therapy. Hormone levels can be tested in blood, saliva, or urine.

Blood Test

Blood is the most common type of testing available but has limitations when measuring sex and adrenal hormones. Because hormones need to be attached to a carrier protein in the blood, levels are affected by the amount of binding proteins present.  Also, hormones vary by time of day and throughout a menstrual cycle, so a single poorly timed blood draw can give misleading results.  Blood levels can usually detect if hormones are very high or very low, but are less helpful in detecting subtle changes which may explain symptoms. It is frustrating to hear that your hormone levels are ‘normal’ when you don’t feel right.

Saliva Test

Hormones become active when released from the carrier protein into the target tissue. Saliva testing measures free hormones and is collected 3-4 times throughout the day. Averaging multiple values and excluding inactive protein-bound hormones is a closer representation of what is happening in the tissue. Adrenal and sex hormones can be measured in saliva. Testing cortisol at certain times throughout the day is used to measure adrenal function and the body’s response to stress. Traditional hormone therapy does not typically rely on saliva testing.

Urine Test

After a hormone’s message is completed, it is deactivated and excreted. Urine testing is used to measure hormone metabolites. There are several metabolic pathways used to deactivate estrogen and some metabolites can increase risk of diseases like cancer or lead to increased side effects of hormone therapy. Urine samples are also collected 4-5 times per day to improve accuracy, and measuring metabolites helps determine how well the body is functioning.


When evaluating hormones, I find that the DUTCH (Dried Urine Test for Complete Hormones) is the most affordable, easy to collect, and a comprehensive test for hormonal health.  By comparing individual hormones,  their metabolites, and organic acids, the DUTCH test uses a broad and science-based approach to help guide individual treatment options and keep hormone use safe.


If you are interested in the DUTCH test or bioidentical hormone replacement, a consultation with us at Wisconsin Vein Center & Medispa. You can get in touch by calling us at 262-236-5179 or by filling out an online form.