The DUTCH Complete Test is a comprehensive hormone test that offers a wealth of information about a person’s hormonal balance. In this guide, we’ll explain what the DUTCH Complete Test is, what it can tell you about your hormones and how it can be used to improve your health. We’ll also answer some common questions about the test and provide tips for interpreting the results.

DUTCH Complete Test

Introduction to the DUTCH Complete Test

The popular DUTCH Complete test by Precision Analytical has become one of the leading hormone analysis testing options on the market. DUTCH® stands for Dried Urine Test for Comprehensive Hormones which uses an innovative and easy at-home sampling of sex and adrenal hormones to uncover imbalances. There are a few types of DUTCH testing available, the most comprehensive urine test is the DUTCH Complete.

Hormones, the messengers of the body, are small proteins or steroids that are made in one part of the body, travel through blood and interstitial fluid, and set off a response in another part of the body. The study of hormones, endocrinology, is a complicated field as many hormones interact with one another causing multiple primary and secondary responses. The delicate balance between hormone production, transportation, utilization, metabolization and excretion can be tricky to determine based on symptoms or simple blood tests alone. The DUTCH Complete test measures over 30 hormones and markers in urine to enable a more complete hormone picture to be revealed. Hormone imbalances can lead to fatigue, weight gain, change of menstrual cycles, hair loss, infertility, mood swings, depression, body temperature extremes and conditions such as PCOS, hypothyroidism, BPH, diabetes and more.

The DUTCH Complete test is unique although several other companies have similar tests. Extra markers in the urine are measured such as melatonin, vitamins, anti-oxidants, neurotransmitters and markers of inflammation. This helps to provide a more complete picture of hormonal health and can lead to individual and comprehensive treatment plans. Results may indicate benefits to be had with the use of herbs, hormones, nutrition and lifestyle changes and also can point to persons with a higher risk of hormone-related conditions or diseases.

How the DUTCH Complete Test Works

The DUTCH Complete hormone test can be performed by both men and women. It is important to carefully choose the right day to test so that accurate hormone levels are reported. For men and women without a period, any average day can be chosen. This means a day in which sleep patterns are representative to you and your lifestyle and the amount of stress/activity is also pretty normal for you. Additional intense exercise is usually avoided when testing so that cortisol levels are not elevated from your baseline. Excess caffeine should be avoided (no caffeine is better!) as it can stimulate cortisol as well.

Women with a menstrual cycle will be instructed as to the best day of the cycle to test on. In general, those with a 28 day cycle will test on Day 19, 20 or 21 of their cycle, with Day 1 being the first day of flow. The testing window is adjusted depending on cycle length. Women with irregular cycles can also test and are advised to choose dates that fall in the second half of the cycle.

The DUTCH tests use several samples of urine to extract hormone levels from. The DUTCH Complete includes a cortisol curve which requires 4 or 5 samples within the same 24 hours. The test comes with comprehensive instructions and videos to make completing the test a relatively easy task. An absorbent paper is used to extract hormones from the dried urine and is calibrated based on the dilution of urine.

Hormones can be evaluated by urine, saliva and blood. Depending on the type of hormone tested, different samples may not give the same information. For example, the best way to evaluate thyroid hormone levels is by blood and experts believe that saliva is the best way to look at a 4 point cortisol curve. When an understanding of the used hormones, or metabolic byproducts of hormones is desired, urine analysis prevails. From a urine test, we can learn about the amounts of the 3 types of estrogen and how the body breaks down the highest risk form. Knowledge is power! Liver metabolism of estrogen can be influenced by supplementation and thus higher risk forms of estrogen can be lowered.


Multiple samples of urine throughout the day and night enable a much more accurate analysis of actual hormones and their metabolites. Hormones are released in differing levels throughout the day and night, if only one sample is used to look at hormones, it could be less accurate. Blood testing for some hormones has fluctuating results within the day and is consistent at a particular level for only seconds. Cortisol, for example, changes vastly. If an individual is afraid of needles or is running late to their blood draw appointment, cortisol levels will be higher than normal which would be reflected in the results. Urine levels are pooled values meaning the hormones gather over hours before being released and thus are more representative of the bigger picture.

What the DUTCH Complete Test Can Tell You

When testing hormones, the question is once imbalances are detected, what can we do about it? Importantly, the results of testing can indicate if BHRT or bioidentical hormone replacement therapy is safe and advised. Many cycling women suffer from estrogen dominance, the situation where more estrogen is present relative to the amount of progesterone. This can results in heavy periods, shorter cycles, stronger PMS and sometimes difficulties getting pregnant. This situation can be identified clearly on the DUTCH reports and can be remedied with options such as herbs, BHRT, liver detox and dietary advice.

The estrogen metabolism part of the report shows the proportions of the main estrogen metabolites. Research has helped our understanding of the significance of each one and has linked genetic properties to their production. Every man and woman creates all 3 of the main estrone metabolites. Optimal ratios are compared to the sample ratios and can be interpreted for risk of estrogen-related disorders. Knowing these risks can lead to treatment options which minimize and actually change the proportions to a healthier balance. How amazing is that? We can work to prevent hormonal diseases.

Hormonal Overview of DUTCH Complete

Estrogen has 3 active forms, estrone (E1), estradiol (E2) and estriol (E3). Each has different functions and different risks associated. Estriol is the safe and protective estrogen. It helps to support vaginal tissue integrity and ability to secrete fluids, while also indirectly influencing a healthy bladder. Estradiol is the most active form of estrogen, when menopause hits, the lack of this hormone can cause insomnia, hot flashes and other typical menopausal symptoms. Estrone is made in the liver and increases during menopause and postmenopausal. Estrone breaks down into 3 forms of metabolites that can be measured to indicate health benefits and risk factors. Some supplements may be advised as part of hormone balancing to lower the high-risk forms of estrone.

Progesterone itself is difficult to evaluate in the urine. The 2 main metabolites of progesterone are instead measured to give the level of progesterone. This hormone is typically the first to decline heading into perimenopause and is important for fertility, mood, sleep and normal, regular cycles. Progesterone is considered a safe and protective hormone thus many women (and sometimes men) can benefit from supplementing with bioidentical progesterone therapy or herbs.

Testosterone and DHEA are androgenic hormones that both men and women produce. They help muscles become strong, support confidence, drive and determination as well as libido and healthy moods. These hormones and their metabolites are measured to enable a detailed analysis of androgens. Women with PCOS can have elevated androgens and men with baldness or prostate conditions may also have an increase of certain metabolites of testosterone. When details are uncovered of androgen levels, treatments can help to change the metabolism, increase levels or decrease levels of DHEA and testosterone.

Cortisol, our stress hormone, is involved in many processes in the body. It aids in glucose metabolism, blood pressure control, the ability to recover from exercise, mental clarity, weight changes and immune health. This important hormone is analyzed on many levels in the DUTCH test. Values are tested for with each sample along with the precursor hormones and metabolites. Adrenal fatigue or overproduction of cortisol may be uncovered. Details about cortisol production and utilization are revealed and thus individualized treatment plans with supplements, diet, nutrition, lifestyle and stress can be incorporated.

Melatonin is our circadian rhythm hormone and is important for deep sleep. The pineal gland in the brain produced melatonin in conditions of darkness. The DUTCH Complete test measures melatonin output and results will help determine if supplementation may aid in sleep and energy improvements.

Interpreting the Results of the DUTCH Complete Test

The comprehensive laboratory report that is sent to the ordering practitioner contains 15-20 pages of information. Both absolute values and diagrammatic representations of results are provided to make the complicated analysis easier to understand. The first page of the report reveals the legend and how to read your results. It is always advised to have a hormone health practitioner review results with you for full understanding. An odometer-looking icon represents your individual results within the range and shows if levels are above or below expected. Cortisol levels are transferred to a graph in order to understand your curve shape relative to the reference range.

The first page of diagrams lays out results in a flow chart according to how the hormones are produced. Endocrinology is a fascinating and complicated web of hormone production and transformation. Did you know that testosterone can convert into estrogen? This page shows details between sex hormones and their metabolites. Estrogen, testosterone, progesterone and DHEA are detailed both with individual levels and the amounts of their breakdown byproducts.

The next analysis shows melatonin and adrenal health. Cortisol and its precursor hormone cortisone are graphically represented in a 4-point curve. This can be interpreted for adrenal fatigue, overproduction, impacts of stress, energy dips in the day, determining the best time to exercise and if difficulties producing the active form are present. Decisions about adrenal health can be made to influence lifestyle and nutrition as well as the impact of stress on health.

The final page of analysis looks at multiple individual health markers. Vitamins B12, B6 and biotin levels are reported. The important antioxidant glutathione is measured and can thus be advised to supplement. In cases of over production of high risk estrogen forms, we often see deficiency in glutathione as it is used to change those metabolites into a low-risk estrogen metabolite. There are also 3 markers of inflammation reported – one for the gut, one for the neurological system and another for DNA. This may result in looking deeper to the causes like digestive dysfunction and overloads of toxins such as mold toxins, heavy metals or chronic infections. The last markers noted on this page are the neurotransmitters dopamine, epinephrine and norepinephrine. What a comprehensive test!

Working with a practitioner that has strong skills in endocrinology is key to using the DUTCH Complete results to guide a treatment plan. It is so important to review symptoms, past medical history, current medications, diet, stress levels and sleep patterns along with test results to understand the whole health picture. Even doctors seek out healthcare from other doctors, it is impossible to be objective with one’s self, putting trust into your provider is important. Your naturopathic physician should be a good listener and have years of experience treating hormones.

How to Use the DUTCH Complete Test to Improve Your Health

Developing a comprehensive treatment plan to relieve hormonal symptoms and to re-balance levels starts with comparing DUTCH test results and symptoms. For women in perimenopause or menopause, analyzing the safety of hormonal interventions and the use of BHRT is possible prior to prescribing and treatments can be initiated. Herbal medicine can provide relief of symptoms and promote a healthier balance with hormones such as lowering or increasing testosterone naturally, promoting progesterone production and either lowering or increasing cortisol levels.

Interestingly, the sex hormones are strongly affected by cortisol levels. Often a gradual introduction of supplements and medications benefits in the long run, and the first step can be supporting adrenal health and cortisol balance. Insulin, thyroid and cortisol hormones have a strong influence on estrogen, progesterone, testosterone and DHEA. Taking the time to normalize the daily cortisol rhythm can make BHRT more effective once initiated. 

Lifestyle modifications such as improving sleep quantity and quality, using stress reduction techniques and changing the stressors that can be changed have major impacts on balancing cortisol. Addressing other causes for low or high cortisol may lead to treating blood sugar, inflammation or auto-immune diseases. Dietary modifications with healthy macronutrient ratios, low sugar and regular eating routines can also help with healthy hormones.

Supplements have powerful effects and should be used under the guidance and prescribing of a medical professional. Commonly used supplements when dealing with hormones include B vitamins, magnesium, vitamin D, anti-oxidants, amino acids and herbal extracts. Eventual tapering down of doses and frequency and transitioning to more food-based nutrient consumption should be the goal. Naturopathic Physicians are experts when it comes to lifestyle, nutrition, supplementation and the use of herbal medicine Many NDs are also educated in and practice prescribing bioidentical hormones which can round out the most individualized treatment plans.

Is the DUTCH Complete Test Right for You?

Most often, the answer is yes! Truly, every woman should complete this test at least once in their life to, at minimum, know their estrogen-related risks. Because hormones change throughout the stages of life, re-testing hormones either through a second DUTCH Complete or saliva evaluation would be ideal. Knowing your hormone levels and balance helps to have a deeper understanding of overall health, symptoms and the best diet and lifestyle patterns for you.

The DUTCH Complete test can be performed by almost all men and women. It is best to discuss with your provider if you are currently a good candidate to use information received from testing to evaluate health. Women using hormonal birth control are generally not advised to test until after cessation and at least 3 cycles have gone by. Inaccurate hormone levels which show the influence of external hormones (oral birth control, IUD) instead of natural hormones would be observed on results.

Women who want to understand their hormones would have a fantastic, complete analysis of all sex and adrenal hormones. Underlying reasons for irregular cycles, acne, PMS, pain, heavy bleeding, menopausal symptoms, infertility, hormonal risk factors and simply prevention and longevity health are all valid reasons to test urine hormones. Men may look to hormone testing when hair loss, erectile dysfunction, weight gain and mood changes are present. Determining the reason behind symptoms leads to treatment options!

DUTCH Complete tests should be ordered by an expert in hormones. A doctor that takes time to learn your full health history, current symptoms and concerns and your future outlook and goals with respect to health. This valuable information along with DUTCH results will guide treatment protocols and health plans. Dr. Jennifer Luis has more than 10 years of experience working with hormones. Click the link below to book your test today!

DUTCH Complete Test FAQs

What are the common symptoms of hormonal imbalances?

Hormonal imbalance can present in so many different symptoms. Fatigue, low energy and motivation, insomnia, anxiety, weight gain or loss, abnormal menstrual cycles or flow, hair loss, hair growth in unwanted places, acne, mood disturbances, aches and pains, heat, feeling cold and brain fog to name a few!

How is the DUTCH Complete Test different from other hormone tests?

The Dried Urine Test of Comprehensive Hormones measures over 30 markers in urine over 4-5 times in the day. Hormone levels and their metabolites are measured and compared to a reference range specific to age and stage of life. This test also includes important nutrients, neurotransmitters and markers of inflammation that can give even more depth to interpretation of hormone balance. Using saliva hormones is also helpful but doesn’t provide the metabolic picture to help understand how the body uses hormones.

Is the DUTCH Complete Test invasive or painful?

No, simply collecting urine in a plastic cup and dipping an absorbent paper into the urine is all you have to do. There is no needle, swab or other invasive or painful technique required for this test. It is performed at home and shipped by courier back to the lab.

How long does it take to get the results of the DUTCH Complete Test?

Once Precision Analytical receives your samples, it takes 7-10 days to process and send results back to the prescribing practitioner. Other companies that perform urine hormone analysis can sometimes take up to 6 weeks to turn around results.

Can I take the DUTCH Complete Test if I'm on hormonal birth control or other medications?

Good question. The ideal timing to perform the DUTCH test is when no hormonal birth control is being used and a few cycles have gone by since cessation. There can be exceptions to this, speak to your health care provider for more details about your current health goals and type of hormonal birth control.

How can I prepare for the DUTCH Complete Test?

To get the most accurate results, performing the test on a specific day of your menstrual cycle will be advised. Recording your cycles for several months leading up to the test is ideal to determine the best testing day. Additionally and for men or non-cycling women, choosing a day that is average in stress and activity level will provide more accurate information about cortisol levels. Ideally no caffeine should be consumed before or during the test.