Get The Test For Adrenal Fatigue

Breakthrough Discoveries In Hormone Testing

When looking for the most comprehensive evaluation of how stress has been impacting your adrenals, and your hormones, the brand new DUTCH PLUS is the next game changer in the world of hormone testing.

“With Every Single Consult I Do For My Adrenal Fatigue Practice, The Dutch Plus Is Essential, Because All The Information It Provides Allows Me to Have The Most Accurate Diagnosis, and Precise Treatment Plan” - Dr. R Joel Rosen

Why I love the DUTCH PLUS TEST So Much & How It Stacks Up to All Other Adrenal Hormone Testing

Dutch Plus Gives The Full Picture


The DUTCH Plus™ adds salivary measurements of the Cortisol Awakening Response (CAR) to the DUTCH Complete to bring another important piece of the HPA axis into focus.

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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 HRT monitoring.

Likewise with sex hormones, measuring estrogen and androgen metabolites gives a fuller picture

Saliva Doesn’t Measure These Metabolites, DUTCH COMPLETE PLUS DOES

DUTCH vs. Serum Testing

Blood 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.

There is also a lack of extensive metabolite testing.

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, You Cannot look at the circadian rhythm. Some providers add saliva for daily free cortisol. DUTCH eliminates the need for two tests.

So What’s Included With the DUTCH COMPLETE PLUS?

Starting with the DUTCH COMPLETE:

The Dutch Complete™ was already an industry leader.

This test is a comprehensive assessment of sex and adrenal hormones and their metabolites.

It also includes the daily, free cortisol pattern, 8 Estrogen metabolites, metabolites of Progesterone, Total DHEAs, Androgens like Testosterone and it’s metabolites, Organic acids such as Dopamine, Serotonin, and Adrenaline Metabolites, Melatonin (6-OHMS), and 8-OHdG.

But That’s Not All….

It’s the “PLUS” PART IN

The DUTCH Complete “Plus” that takes hormone testing to a whole new level.

In addition to sex hormones and their metabolites, that you get with the DUTCH Complete

The DUTCH PlusTM adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.

What Exactly is the Cortisol Awakening Response? And Why Should You Care?

When you open your eyes upon waking, your cortisol levels should naturally begin to rise by an average of 50%

Emphasis on “should”

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.

This is called the Cortisol Awakening Response (CAR)

Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range.

By measuring your own rise and fall of cortisol levels at waking it can be used as a “mini stress test”

Most Saliva Tests do NOT measure your CAR Cortisol Awakening Response, And Make You Take the Sample At Dedicated Times

Times That May Or May Not Overlap With Your Own Cortisol Awakening Response

But The Dutch Complete Plus Does As Well As Everything Else Included In The Dutch Complete

More Information = More Customization = More Success

What’s Included in the DUTCH PlusTM?

The DUTCH PlusTM 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 PlusTM report includes: Metabolites of Estrogens (10, including E1, E2, E3, 2-OHE1, 4-OH-E1, 2-OHE2, 4-OH-E2, 16-OH-E1, 2-methoxy-E1, 2-methoxy-E2)

The DUTCH PlusTM report includes: Metabolites of Androgens (8, including Testosterone, DHT and DHEA-S), Progesterone (2), Cortisol (3), Melatonin (6OHMS), 8-OHdG, and OATs (6). The diurnal pattern of Free Cortisol and Cortisone are also provided, including the Cortisol Awakening Response.

The diurnal pattern of Free Cortisol and Cortisone are also provided, including the Cortisol Awakening Response.

What can the DUTCH PlusTM tell us that the DUTCH CompleteTM and other adrenal tests cannot?

A blunted or exaggerated 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.

The DUTCH PlusTM uses specialty, FDA-approved, and patented collection devices called SalivettesTM

SalivettesTM are specifically made for testing cortisol when timing needs to be precise and are used in nearly all of the published CAR studies.

The DUTCH PlusTM offers the most accurate salivary cortisol sampling with SalivetteTM collection and analysis

The DUTCH PlusTM offers an evaluation of the Cortisol Awakening Response (CAR) by measuring salivary cortisol upon waking and then again 30 and 60 minutes later (additional measurements are made around dinner and bedtime). Research has shown that this post-waking increase in cortisol (the CAR) is the best way to assess an individual’s stress response and HPA-axis function.

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