DUTCH Test for Hormones: What It Measures and When It's Worth It

The DUTCH test is a dried urine hormone test. You soak small filter-paper strips with urine four or five times over about a day, let them dry, and mail them to the lab. The lab reports your sex hormones, the metabolites your body breaks them down into, and the pattern of free cortisol across the day. It can answer a few questions a single blood draw can't. It's also a specialty test with a thin, mostly in-house evidence base, and for most people it isn't the right place to start.

That's the short version. The rest of this post covers what the test actually measures, how it compares with blood and saliva testing, what the research behind it does and doesn't show, and why, when cortisol needs a closer look, most adrenal workups (ours included) turn to a saliva cortisol test before DUTCH. It's general information, and it isn't a substitute for advice from your own provider.

What Is the DUTCH Test?

DUTCH is a brand name, not a medical category. It stands for "Dried Urine Test for Comprehensive Hormones," and it's made by Precision Analytical, a lab in McMinnville, Oregon. Nobody else runs a DUTCH test. Other labs sell dried urine hormone panels, but the name belongs to one company.

Collection happens at home. For the standard kit, the lab's own description is that you "collect four or five dried urine samples over a 24-hour period." Each sample goes on a strip of filter paper, dries flat, and goes back in the mail. No needle, no lab visit, no 24-hour jug in the fridge.

That convenience is a big part of its appeal. The other part is the promise of seeing more than a blood test shows. Both deserve a closer look.

What Does a DUTCH Test Measure?

The lab describes its main panel as looking at "sex hormones and their metabolites" and "the overall diurnal pattern of free cortisol." In practice that means a few groups:

• Estrogens, plus the metabolites estrogen is broken down into
• Progesterone metabolites
• Androgens such as testosterone and DHEA, and what they turn into
• Free cortisol and cortisone at several points across the day, plus the total of cortisol's breakdown products
• A handful of organic acids the lab includes as markers for some B vitamins and neurotransmitter breakdown, and melatonin

The metabolite part is what sets it apart. A blood test tells you how much estradiol is in your bloodstream at the moment of the draw. A urine metabolite panel shows what your body did with its hormones afterward, which pathways it used to break them down and clear them. Whether that changes treatment for a given person is a separate question, and an honest provider will tell you it often doesn't.

DUTCH Complete, DUTCH Plus and Cycle Mapping

The lab sells several versions. The three people search for most:

• DUTCH Complete. The standard dried urine panel described above.
• DUTCH Plus. The same panel with saliva added. The lab says it "adds an additional layer of analysis by measuring Cortisol Awakening Response (CAR)," which means cortisol right after you wake up. The kit includes six saliva tubes.
• Cycle Mapping. Built for a whole menstrual cycle. The lab lists "nine (9) targeted estrogen and progesterone measurements taken throughout the cycle" from first-morning urine samples. It's labeled female only and, per the lab, "not intended for women on hormonal birth control."

One thing none of them measure: thyroid hormones. A DUTCH report also won't show your blood sugar, cholesterol, iron stores or vitamin D. Those still come from blood.

DUTCH Test vs Blood Test vs Saliva Cortisol

Each sample type answers a different question. Side by side, they look like this.

Test	What it measures	What it shows well	Where it falls short
Blood draw	Hormones in the bloodstream at one moment, plus thyroid, metabolic, heart and nutrient markers	A wide picture from one visit, read against standard reference ranges	A single snapshot, so one morning cortisol can't show the day's rhythm
DUTCH dried urine	Sex hormones, their metabolites and free cortisol across about a day	How hormones are broken down, and the cortisol pattern in one kit	No thyroid or metabolic markers, and most validation work comes from the lab itself
Saliva cortisol	Cortisol at several set times of day	The shape of the daily cortisol curve	Cortisol only, so it answers one question rather than many

None of these replaces the others. A blood panel is the foundation because it covers far more ground. Saliva and dried urine come in when a specific question is left open.

Is the DUTCH Test Accurate?

The main validation studies are published and easy to read, and they're worth knowing about before you pay for the test.

A 2019 study in BMC Chemistry compared dried urine results with blood results for estradiol and progesterone. Its authors concluded the dried urine assay "is a good surrogate for serum testing" for those two hormones, and that four spot samples during the day agreed with a full 24-hour urine collection.

A 2021 follow-up in the same journal had 26 people collect both a 24-hour urine and four dried spot samples on the same day. For 14 of the 17 hormones and metabolites measured, agreement between the two methods was excellent, and it was good for the other three.

Read the author lines, though. Precision Analytical staff wrote or co-wrote both papers, and the 2021 paper is entirely in-house. The groups studied were small. That doesn't make the results wrong. It does mean the test hasn't had the independent, large-scale scrutiny that blood testing has had for decades, and you won't find DUTCH in mainstream clinical guidelines.

Our take, bluntly: a DUTCH report is a useful extra data point in the right hands and a poor stand-alone verdict. A colorful page of metabolite dials can look more certain than the science behind it.

Why Saliva Cortisol Usually Comes Before DUTCH

Cortisol isn't meant to be flat. In most people it peaks shortly after waking and falls through the day, reaching its low point at night. That daily rhythm is the thing worth measuring when someone says "I'm exhausted all morning and wired at bedtime." A single blood cortisol drawn at 8 a.m. sees one point on that curve and can look perfectly normal even when the shape is off.

A saliva test fixes that with several samples at set times. It's a simpler collection than a full DUTCH kit, and it answers the cortisol question directly. Saliva also has a recognized place in conventional medicine: the Endocrine Society's guideline on diagnosing Cushing's syndrome lists late-night salivary cortisol among its first-line screening tests. That's a different job from mapping everyday stress, but it shows the sample type is taken seriously.

Our own order of operations follows that logic. Cortisol is part of the blood panel every new patient gets. When the history and the numbers point to a cortisol problem, the next step is a 12-hour salivary cortisol test. We do order DUTCH, but rarely, and it isn't our standard adrenal workup.

About the word "adrenal": your adrenal glands don't get tired. But HPA axis dysfunction (the technical term) is real, measurable, and well-documented in the research. It describes the signaling loop between the brain and the adrenal glands, and the daily cortisol curve is one of the clearest windows into it. Our post on adrenal fatigue goes further into that, and cortisol belly covers what a cortisol test can and can't explain about weight around the middle.

When a DUTCH Test Can Be Worth It

The test earns its place when the question is specifically about patterns or breakdown pathways that blood doesn't show. A few situations where it tends to come up:

• A full blood panel is done, symptoms still don't add up, and the provider wants to see how sex hormones are being metabolized
• Someone needs the day's cortisol pattern and a sex hormone picture from one collection
• A woman with irregular cycles needs hormones tracked across a whole cycle rather than on one day, which is what Cycle Mapping was built for
• A provider wants a second view of a result that doesn't fit the person in front of them

Notice what all four have in common. A provider is asking a specific question, and a blood panel came first.

When It Probably Isn't Worth It

Skip it, or at least wait, if it would be your first and only hormone test. A DUTCH kit can't tell you about your thyroid, your blood sugar or your cholesterol, and those are often where the answer to fatigue, weight gain or brain fog turns up.

Be wary of buying it direct and reading it alone, too. Metabolite reports are dense, and the same result can mean different things depending on your age, your cycle, your medications and your symptoms. A report you can't interpret is an expensive pile of charts.

Timing matters as well. For anyone with a menstrual cycle, the day of collection changes the result, and the lab sets a collection window by cycle day. If you take hormones, supplements or other medications, ask the provider who ordered the test what to do before you collect. Don't stop a prescribed medication on your own to make a test "cleaner."

How Much Does a DUTCH Test Cost?

There's no single price. The lab, the kit version and the clinic ordering it all set the total, and insurance coverage depends on your plan. Ask for the full cost, including any interpretation visit, before you collect a single sample.

At Med Matrix, a DUTCH test isn't part of the standard new-patient panel. That panel is the 80+ biomarker blood test, and it already covers the ground most people need first: total and free testosterone, SHBG, estradiol, progesterone, FSH, LH, DHEA-sulfate and cortisol, along with a full thyroid panel, fasting insulin and HbA1c. New patient onboarding is $1,500 and includes that panel, an InBody 770 body composition scan and a 60-minute provider consultation. Labs can be drawn in our office, or at a partner lab near you. If something is still unanswered after that, your provider will tell you which follow-up test fits, and why.

Frequently Asked Questions

Is the DUTCH test legitimate?

It's a real lab test with published validation studies showing dried urine results track blood results for estradiol and progesterone. Those studies are small and mostly written by the lab's own staff, and the test isn't part of mainstream clinical guidelines. Legitimate, then, but specialized, and best read alongside a blood panel.

Is a DUTCH test better than a blood test?

Neither is better across the board. Blood covers far more, including thyroid, metabolic, heart and nutrient markers, and it's the standard most guidelines use. DUTCH adds hormone metabolites and a daily cortisol pattern. For most people, blood comes first.

Does the DUTCH test show hormone levels?

Yes. It reports sex hormones and cortisol as measured in dried urine, adjusted for creatinine, along with their metabolites. Those numbers aren't the same units or reference ranges as a blood test, so they can't be compared line by line.

Does insurance cover the DUTCH test?

It depends on your plan and how the lab bills it. Check with both the lab and your insurer before you collect, and ask what you'll owe if the claim is denied.

Can men take the DUTCH test?

Yes. The standard and Plus kits are used by men and women. Only Cycle Mapping is female only, because it tracks a menstrual cycle.

Start Feeling Like Yourself Again

If you've been told your labs are "normal" and you still don't feel normal, start with the full picture before any specialty kit. It begins with a Free Discovery Call, then an 80+ Biomarker Test & Full Body Scan. Our Medical Team Reviews Everything, and a 60-Minute Provider Consultation goes through every result with you, read against ranges set for you rather than a one-size card. Ongoing Support & Progress means we retest and compare against your own baseline. See what's included in our advanced testing, and how we approach hormone balance and thyroid and adrenal care.

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Med Matrix is a functional medicine clinic in South Portland, Maine, serving patients across Greater Portland and southern New Hampshire.