DUTCH Plus
Related tests
-
The DUTCH Plus
The DUTCH Plus® takes hormone testing to a whole new level. In addition to sex hormones and their metabolites, the DUTCH Complete™ looks at the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. The DUTCH Plus® adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.
What is the Cortisol Awakening Response and how does the DUTCH Plus test for it?
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. 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.
A low or blunted Cortisol Awakening Response
This can be a result of an underactive HPA Axis, excessive psychological burnout, seasonal affective disorder (SAD), sleep apnea or poor sleep in general, PTSD, chronic fatigue, and/or chronic pain. A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases.
An elevated Cortisol Awakening Response
This can be a result of an over-reactive HPA Axis, ongoing job-related stress (anticipatory stress for the day), glycemic dysregulation, pain (i.e. waking with painful joints or a migraine), and general depression (not SAD). A recent study showed that neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) did. This measurement of the response to waking has independent clinical value showing dysfunction that may be hidden by current testing options.
-
When I began working with Dr. Charny, she almost immediately recommended I try a GI-MAP test to see what might be causing my issues.
It’s pretty amazing how much Dr. Charny was able to read into my digestion from the results.The results of the MyPerio test astounded me. I never knew the bacteria in my mouth could affect my energy levels and even my high blood pressure! Thanks Dr. Charny for ordering this test and explaining my results.
My hormones tested normal on other blood tests, but with the DUTCH test we were able to see how my hormones are working and responding to stress in action. It’s so cool that the test is taken throughout the day.
Thanks Dr. Charny for helping me get a handle on things. -
At-home lab tests with Charny Healing
You have questions. We've got answers.
When you purchase an at-home lab test with Charny Healing, you're also getting a partner. We'll walk you through the process and send check-in emails with collection instructions & reminders. We're here for any questions, any time.
Read more about what to expect, from placing your order to receiving your results & everything in between.
Collection Instructions
Collection instructionsEverything you need to know to complete your test.
Review collection instructions thoroughly before taking your sample and shipping your test kit back to the lab.
Feel free to contact us if you have any questions.
Health Insights with Dr. Charny
Learn moreMake the most of your lab test by scheduling a results review with Dr. Charny.
Having worked with thousands of patients across a wide range of health issues, Dr. Charny has developed an expertise deriving powerful insights from her analysis of patient lab results.
Just add a consultation to your cart for each lab test you'd like to review with Dr. Charny.
What can the DUTCH Plus® tell us that the DUTCH Complete™ cannot?
Even though a patient may have “normal” free cortisol levels throughout the day, that doesn’t always mean everything is functioning properly. The graph below shows two good examples. 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.
Why aren’t true Cortisol Awakening Response tests readily available?
A true CAR assessment requires salivary samples to be collected at the moment of waking, and twice more, at 30 minutes after waking and 60 minutes after waking. These specifically timed collections are difficult and impractical with urine and traditional salivary options.
The DUTCH Plus® uses specialty, FDA-approved, and patented collection devices called Salivettes™. Salivettes™ are specifically made for testing cortisol when timing needs to be precise and are used in nearly all of the published CAR studies. The small synthetic cotton swab can be quickly saturated with saliva, providing a very fast and simple collection. Unfortunately for labs using saliva to test reproductive hormones, they are not a viable option as the swabs cannot be used when testing progesterone.
The DUTCH Plus® offers the most accurate salivary cortisol sampling with Salivette™ collection and analysis using LC-MS/ MS. An unparalleled clinical tool is created when combining salivary cortisol with the extensive urine metabolites from DUTCH.
What’s Included in the DUTCH Plus?
The DUTCH Plus® uses four dried urine samples and five saliva samples. These samples are collected over the course of one day, from waking to bed time.
The DUTCH Plus® report includes: Metabolites of Estrogens (10, including E1, E2, E3, 2-OHE1, 4-OH-E1, 2-OH-E2, 4-OH-E2, 16-OH-E1, 2-methoxy-E1, 2-methoxy-E2) , Androgens (8, including Testosterone, DHT and DHEA-S), Progesterone (2), Cortisol (3), Melatonin (6OHMS), 8-OHdG, and OATs (9). The diurnal pattern of Free Cortisol and Cortisone are also provided, including the Cortisol Awakening Response.
View a sample report
Hear what our patients have to say
about Lab Tests with Charny Healing
Josh R.
Santa Monica, CA
I’m a relatively healthy guy in my early sixties and I’ve always been in pretty good shape. Well a year ago or so I started to feel tired and even dizzy at random hours of the day. Never in my life had I experienced dizzy spells. I was unsuccessful with several doctors before Dr. Charny recommended something called the OAT test.
Well it turns out I had a bacteria called clostidria that somehow went undetected with other tests. After pinpointing the issue, Dr. Charny tailored my treatment and the progress has been amazing. I’m finally starting to feel back to my normal self.
Chelsea T.
Los Angeles, CA
Over the last few years I had been dealing with pretty regular constipation and general stomach uneasiness. When I began working with Dr. Charny, she almost immediately recommended I try a GI-MAP test to see what might be causing my issues. It’s pretty amazing how much Dr. Charny was able to read into my digestion from the results. We discovered I had crazy yeast overgrowth and I didn’t have enough enzymes to digest all the carbs I love to eat.
With Dr. Charny’s supplement recommendations, finally we are actually addressing the root cause. In the 3 months since taking the test I feel like I’m able to properly digest food. And I’ve even lost 10 pounds. Win win!
Richard M.
Los Angeles, CA
The results of the MyPerio test astounded me. I never knew the bacteria in my mouth could affect my energy levels and even my high blood pressure! Thanks Dr. Charny for ordering this test and explaining my results.
Kate T.
Los Angeles, CA
The last few years have been hard on a lot of us and for many reasons. On top of all the regular stressors I’ve just been feeling more stressed more regularly and experiencing hot flashes and gained weight for the first time. My hormones tested normal on other blood tests, but with the DUTCH test we were able to see how my hormones are working and responding to stress in action. It’s so cool that the test is taken throughout the day. And it makes sense too! I may wake up feeling fine, but can become stressed throughout the day, seemingly at random.
Thanks Dr. Charny for helping me get a handle on things.
Important lab test information
Please read the following prior to placing your lab test order.
- All sales are final and no refunds will be afforded and you waive any rights to charge-back your purchase with your credit card processor.
- Charny Healing does not participate in, take assignment, or accept any private insurance. We do not provide super bills and cannot assist with claim resolution for laboratory tests or consultations.
- Charny Healing is unable to ship lab kits to P.O. boxes. Please use a residential or business address.
- Some lab providers fill out requisition forms ahead of time with client information. To avoid confusion when processing orders, if you are ordering lab kits for multiple people, please place a separate order for each person.
- After you order a test kit, getting the lab draw and/or completing the test is your responsibility.
- Once Charny Healing has received your test results, the results will be uploaded to your HIPAA compliant client portal and you will receive an email instructing you how to access them.
- This test does NOT include a test interpretation consultation. If you are interested in having your test results interpreted please add a consultation with Dr. Charny.
- Test interpretations must take place within 3 months of placing the test order.
- Please contact us with questions.
* These statements have not been evaluated by the Food and Drug Administration.
This product is not intended to diagnose, treat, cure, or prevent any disease.
