Discover the power of understanding your body’s hormonal balance from the comfort of your home! Join us for an enlightening session with Dr. Donna Dubois, a board-certified integrative physician who specializes in a holistic approach to health. This class focuses on utilizing the DUTCH test, a comprehensive at-home hormone testing method, to identify stress and hormone imbalances that could be affecting your overall well-being. Whether you're dealing with fatigue, weight issues, or just looking to optimize your health, this session will provide you with the insights and tools needed to effectively monitor and manage your hormonal health. Explore natural and gentle detoxification strategies, tailored treatment plans, and receive expert guidance on how to interpret your test results to better support your journey towards a healthier, more vibrant life.

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Dr. Donna Dubois, a Doctor of Osteopathic Medicine with two decades of experience in hormone replacement therapy, shared valuable insights on the DUTCH test. This innovative diagnostic tool provides a more comprehensive look at hormone levels by analyzing both saliva and urine samples. Unlike traditional serum testing, the DUTCH test offers a detailed breakdown of hormone metabolism, providing critical information for optimizing patient care.

What Makes the DUTCH Test Unique?

The DUTCH test stands out because it measures hormones at multiple points throughout the day, offering a dynamic view of hormonal fluctuations. Patients collect saliva samples five times daily—upon waking, 30 minutes later, another 30 minutes after that, in the late afternoon, and at bedtime. Urine samples are taken at similar intervals, giving providers a clearer picture of how hormones are processed and metabolized.

Case Study: A 54-Year-Old Postmenopausal Woman

Dr. Dubois discussed the case of a 54-year-old woman experiencing sleep difficulties, dry skin, vaginal dryness, anxiety, and a declining libido. While she did not report symptoms like hot flashes, brain fog, or weight gain, her hormonal imbalances were affecting her quality of life.

To address her concerns, Dr. Dubois prescribed a bioidentical estrogen (bi-est 80/20) at 1 mg. However, after experiencing nipple tenderness, the dose was adjusted to 0.75 mg. The patient also received 0.5 mg of testosterone, applied to the labia for better absorption, and progesterone, which was increased from 150 mg to 200 mg due to her high anxiety levels.

Analyzing Hormonal Pathways

The DUTCH test evaluates hormone metabolism, highlighting key pathways:

• Progesterone Metabolism: The test measures two breakdown enzymes—5-alpha and 5-beta. The 5-alpha pathway is crucial as it crosses the blood-brain barrier and has a calming effect.
• Estrogen Breakdown: Estradiol (E2) converts into estrone (E1) before breaking down into three different pathways. The DUTCH test uses a color-coded system to indicate the preferred pathway (green), a less favorable one (blue), and a problematic one (red). Dr. Dubois noted that her patient had an elevated estrone level, prompting her to consider strategies to bring it down, such as reducing estrogen dosage or using natural interventions like peppermint oil or grapefruit extract.
• Methylation and Excretion: Estrogen metabolism includes phase one (oxidation) and phase two (methylation). Proper methylation ensures hormone breakdown products are effectively excreted. The patient showed a balanced methylation pattern, but Dr. Dubois explained that for those with imbalances, supplementation with SAMe, B12, or folate could be considered.

Cortisol and Stress Response

Cortisol, a stress hormone, was another focus of the discussion. Ideally, cortisol peaks shortly after waking and gradually declines throughout the day. However, many patients, including this one, show irregular patterns, often due to chronic stress. While the patient was not actively concerned about her cortisol levels, Dr. Dubois suggested monitoring her intake of green tea, as it can influence cortisol metabolism.

Gut Health and Hormone Recycling

The DUTCH test also evaluates organic acids, which indicate how well the body is eliminating hormones. A high indole level, for example, suggests that estrogen metabolites are being reabsorbed rather than excreted, often due to gut microbiome imbalances. In such cases, dietary changes and probiotics may help improve hormone clearance.

Who Should Consider the DUTCH Test?

Dr. Dubois recommends the DUTCH test for individuals using transdermal or transvaginal hormone therapies, as these do not circulate in the bloodstream in the same way as oral medications. Standard blood tests may not accurately reflect their hormonal status, making saliva and urine testing a more reliable alternative.

Cost and Availability

The full DUTCH test, including hormone levels, cortisol patterns, and organic acids, costs around $400. There are also partial test options available at lower prices. While the test is not yet integrated into GoldCare services, Dr. Dubois expressed optimism that providers could facilitate its use for their patients in the future.

Final Thoughts

The DUTCH test offers a cutting-edge approach to hormone assessment, providing a detailed understanding of hormone metabolism, stress response, and gut health. Dr. Dubois emphasized its value in fine-tuning hormone replacement therapy and addressing symptoms that may not be fully explained by traditional tests. As awareness of hormone health grows, tools like the DUTCH test are proving to be invaluable in personalized medicine.