DUTCH Cycle Mapping + Complete

HOW DOES DUTCH COMPARE TO OTHER HORMONE TESTS?

DUTCH vs. Saliva Testing – While the free cortisol pattern in saliva has clinical value, there is a significant missing piece to surveying a patient’s HPA-Axis function with saliva testing – measuring cortisol metabolites. To properly characterize a patient’s cortisol status, free and metabolized cortisol should be measured to avoid misleading results when cortisol clearance is abnormally high or low. Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture for more precise clinical diagnosis of hormonal imbalances and HRT monitoring.

DUTCH vs. Serum Testing – While the most universally accepted testing method (due to the availability of FDA-cleared analyzers that are reliable and inexpensive), serum testing is lacking in some areas. Adrenal hormones cannot be effectively tested in serum because free cortisol cannot be tested throughout the day. There is also a lack of extensive metabolite testing (especially for cortisol and estrogens).

DUTCH vs. 24-Hour Urine Testing – There are two primary drawbacks to 24-hour urine testing of hormones. First, the collection is cumbersome, and as many as 40% of those who collect, do so in error (Tanaka, 2002). Secondly, dysfunction in the diurnal pattern of cortisol cannot be ascertained from a 24-hour collection. Some providers add saliva for daily free cortisol. DUTCH eliminates the need for two tests.

WHY USE DUTCH? The Easiest Patient Collection: 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. Analytical and Clinical Validation: Precision Analytical’s testing methods go through a rigorous validation process to verify accuracy, recovery, and linearity. We pride ourselves in relentlessly pursuing the most accurate and precise techniques available for testing.

Effective HRT Monitoring: 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.

WHAT DAYS OF THE MONTH DO I COLLECT?

Cycling Premenopausal Women Begin collection between days 19 and 22 of a 28-day cycle. For longer cycles, add the number of days you usually go beyond 28 days. In a similar manner, subtract if your cycles are shorter (example: collect days 17-20 for a 26 day cycle). You may collect any day if only ordering the DUTCH Adrenal or DUTCH OATs.

For irregular cycles or non-cycling (ablation or uterus removed), watch the irregular cycle collection video in the video library at dutchtest.com/videos for suggestions on collecting.

Men & Non-Cycling or Postmenopausal Women Collect any day.

For some women, testing reproductive hormones (progesterone, estrogen, etc.) on a single day is sufficient. In other scenarios, the clinical picture cannot be properly captured without “mapping” out the hormonal pattern throughout their menstrual cycle.

The expected pattern of hormones shows relatively low estrogen levels early in the cycle, a surge around ovulation and modest levels in the latter third of the cycle (the luteal phase). Progesterone levels, on the other hand, stay relatively low until after ovulation. After ovulation, levels ideally increase (>10-fold) and then drop back down at the end of the cycle. A disruption in this cycle can lead to infertility or hormonal imbalance.

DUTCH Cycle Mapping

WHEN IS DUTCH CYCLE MAPPING™ RECOMMENDED?

• Women struggling with infertility

• Women with cycling hormones and no menses

• Partial hysterectomy (ovaries intact but no uterus)

• Ablations

• Mirena IUD (no actual menstrual bleeding due to IUD but still has hormonal symptoms)

• Women with irregular cycles

• PCOS

• If the luteal phase shifts from month-to-month

• Not sure when to test due to long or short cycles

• Women whose hormonal symptoms tend to fluctuate throughout the cycle

• PMS, mid-cycle spotting, migraines, etc.

WHEN IS DUTCH CYCLE MAPPING™ NOT NEEDED? (DUTCH COMPLETE™ IS SUFFICIENT)

• Postmenopausal women

• Women on birth control

• Women with cycles that follow the expected pattern

How to Collect-DUTCH Complete

• Complete all information on each collection device.

• Saturate the filter paper by urinating directly on it OR use a clean cup and dip the filter paper.

Leave the collection device open to dry for at least 24 hours.

• Once dry, close each collection device. Place all devices in the resealable plastic bag and return in the provided envelope. Be sure to include the completed requisition form (required) and the payment card (if needed).

How to Collect Urine-Cycle Mapping

1. Complete all information on each urine collection device. Fill in the day of cycle and date of collection with pen (not a gel pen).

2. Collect your samples with your first morning void/urination. Saturate the filter paper by urinating directly on it OR urinating into a clean cup and dip the filter paper for 5 seconds.

3. Leave each sample open to dry for at least 24 hours.

4. Once dry, close each collection device and conveniently store in the kit box until you are done collecting all samples.

5. Continue collecting according to your cycle schedule. Once ALL samples are completely dry, place them in the enclosed plastic bag and seal.

How to Return

UPON COMPLETION

1. After drying the urine collection devices, make sure each sample is clearly labeled.

2. Place the urine collection devices in the resealable plastic bag and store in the test kit box.

3. Cut out the completed collection schedule from pages 6, 8, or 10.

SHIPPING INFORMATION

1. Place the entire test kit box, the completed collection schedule, and requisition form inside the return envelope.

2. Affix the prepaid label or postage, if applicable. Return using the appropriate carrier.