Comprehensive hormone read
DUTCH Complete.
Dried urine across 24 hours. Cortisol curve, full sex hormones, metabolites, melatonin. The hormone panel that reads the network instead of the snapshot.
By Precision Analytical · Dried urine, 4-point 24-hour collection
Why it matters
Standard hormone blood draws give you one number at one moment in time. The DUTCH (Dried Urine Test for Comprehensive Hormones) reads the cortisol curve across the whole day, the sex hormone network, and the downstream metabolites that tell you what your body is actually doing with what it makes. For perimenopausal women, men with cortisol-pattern fatigue, anyone with hormone symptoms whose blood draws came back "normal," this is the read that explains why.
Estrogen metabolism is where the DUTCH stands apart. The same total estradiol can be metabolized down a protective pathway (2-OH) or down riskier ones (4-OH, 16-OH). Blood does not show this. Urine does. The same is true for cortisol: a flat-line low curve is a different clinical picture than a high-peaked early curve, even if the daily total is the same.
Mock interpretation fee placeholder. The standalone price will be confirmed before this panel ships with a live checkout URL.
What I read for
I read the DUTCH the way I read every panel: as a network, in clinical context, against optimal physiology. The cortisol curve is the most actionable single read on a single sheet of paper in adult medicine. The sex hormone metabolites tell me whether the patient is making the steroid hormones their biology needs and whether they are getting metabolized safely.
- The cortisol curve across the day. Flat, spiked, inverted, or appropriately diurnal.
- Estrogen metabolism (2-OH vs 4-OH vs 16-OH ratios). The estrogen safety read.
- Androgen metabolism (5α-reductase activity, DHT load). The hair-loss and acne pattern.
- Progesterone in luteal-phase women, baseline in men. The calming side of the sex-hormone network.
- Melatonin overnight. The sleep handoff to morning cortisol.
- Organic acid markers (B6, B12, glutathione status, oxidative stress). The nutrient floor underneath the hormone story.
What it measures
DUTCH Complete reads the hormone network across a single 24-hour window in dried urine, plus an organic acid add-on that frames the nutrient and methylation context.
See all 26 biomarkers
Cortisol and the diurnal curve
- Free cortisol (4 timepoints: waking, +30 min, +5 hr, bedtime)
- Free cortisone (4 timepoints, parallel to cortisol)
- Metabolized cortisol (a-THF, b-THF)
- Metabolized cortisone (a-THE)
- DHEA-S
Estrogens and metabolites
- Estradiol (E2)
- Estrone (E1)
- Estriol (E3)
- 2-OH estrogen metabolites
- 4-OH estrogen metabolites
- 16-OH estrogen metabolites
- 2-methoxy estradiol (methylation product)
Androgens and metabolites
- Total testosterone
- 5α-DHT (dihydrotestosterone)
- Androsterone
- Etiocholanolone
- 5α-androstanediol
- 5β-androstanediol
Progesterone
- Pregnanediol (progesterone metabolite)
- α-pregnanediol
- β-pregnanediol
Melatonin
- 6-OHMS (overnight melatonin metabolite)
Organic acid context
- Methylmalonic acid (B12 status)
- Xanthurenic acid (B6 status)
- Pyroglutamate (glutathione status)
- 8-OHdG (oxidative DNA damage)
Who this is for
The DUTCH earns its place when the question is the hormone NETWORK, not a single marker.
Common reasons I order it
- Perimenopausal women whose blood-draw hormones look "normal" but whose symptoms tell a different story.
- Men with cortisol-pattern fatigue, low motivation, sleep that does not restore.
- Anyone with estrogen-driven symptoms (heavy cycles, fibroids, breast tenderness, family history of estrogen-sensitive cancer) where estrogen metabolism is the question.
- Hair loss in either sex when the androgen-to-DHT conversion ratio matters more than total testosterone.
- Patients optimizing peri-bedtime light, glucose, and melatonin who want to see the overnight handoff to morning cortisol.
Not for everyone. When a standard blood draw answers the question, that is the panel that earns its place.
How collection works
- 1
Kit ships to your home
Precision Analytical sends a small kit with collection strips, instructions, and a prepaid return mailer.
- 2
Four collections across 24 hours
Waking, 30 minutes after waking, around 5 hours after waking, and just before bed. The overnight melatonin metabolite is collected the next morning on the same strip stack.
- 3
Strips air-dry, get mailed back
No refrigeration. No spinning. The dried-urine method preserves the markers for shipping at ambient temperature.
- 4
Results in about 21 days
From the day the lab receives the kit. You get the raw Precision Analytical report plus a written interpretation specific to your case.
How to prepare
DUTCH timing matters. The collection day is when you read the cortisol curve, so it has to be a representative day, not a hard exercise day or a high-stress event day.
Diet and timing
Pick a normal day: Same sleep, same wake time, same caffeine schedule you usually keep. Avoid red-eye flights, all-nighters, or the day after a hard workout.
Hydrate normally: Do not over-hydrate to dilute the sample. Drink as you usually would.
Avoid alcohol the night before: Alcohol shifts cortisol and disrupts melatonin. Even a glass of wine the night before can change the overnight handoff.
Supplements and medications
Discontinue bioidentical hormones 24-48 hours before: Topical estradiol, progesterone cream, and testosterone all show up in the urine. Stop them 24 hours (creams) to 48 hours (injections) before the collection day. Pellets are not pausable; the interpretation accounts for the implant timeline.
Hold biotin for 48 hours before: Biotin (often in hair and nail supplements) interferes with some metabolite assays. Hold it the day before and the day of.
Pause cortisol-modulating supplements 24 hours before: Ashwagandha, rhodiola, phosphatidylserine, licorice root. These can mask the curve the DUTCH is built to read.
Coffee is OK: Your normal coffee schedule is part of your physiology. Keep it. Do not double it.
Women cycling: collect days 19-22 of the cycle (mid-luteal). Women on cycle-disrupting birth control or in perimenopause: any day, noted on the requisition.
Men: any day on a normal schedule.
If you take oral hydrocortisone or prednisone, do not collect without first reviewing with me. The result is not interpretable without that context.
What you get
The full Precision Analytical DUTCH Complete report (cortisol curve, sex hormones + metabolites, melatonin, organic acid context).
A written interpretation from Dr. Tagge, specific to your case, with the cortisol-curve shape called out and the estrogen safety pathway explained.
A 30-minute video review to walk through what the panel says and the next move.
Questions
Dried urine captures both the free (bioactive) hormones and the metabolites the liver has already processed. Blood gives you one number at one moment. Saliva gives you the free hormones but not the metabolite story. Dried urine gives you both, across the whole day, with a sample method that ships at ambient temperature.
A blood panel is a snapshot at the moment of the draw. The DUTCH gives you a 24-hour cortisol curve plus the estrogen and androgen metabolites that tell you what your body is doing with what it makes. If the blood draw answers the question, that is the right panel. If the symptoms are a mismatch with the blood numbers, the DUTCH usually explains why.
Typically cash-pay through the practice. Precision Analytical provides CPT codes for possible reimbursement; coverage varies by plan and is rarely complete. Plan to budget for the lab cost as out-of-pocket.
About 21 days from when Precision Analytical receives the kit. The kit usually ships within 3 business days of order; collection day is your choice within the next two weeks.
Available standalone
Kit ships within 3 business days. Your written interpretation arrives within 7 business days of the lab releasing results.
From the writing