The DUTCH Adrenal from Precision Analytical is available at Toronto Centre for Naturopathic Medicine (“DUTCH” is an acronym for Dried Urine Test for Comprehensive Hormones).
DUTCH Adrenal is one of the most advanced tools for assessing adrenal hormone function, stress physiology, and hypothalamic‑pituitary‑adrenal (HPA) axis (dys)regulation.
This test can help you understand how stress and cortisol production, daily rhythm and routines, and your metabolism may be influencing energy, mood, sleep, immune resilience, and long‑term cardiometabolic health (blood sugar, blood pressure control, inflammation, etc.).
DUTCH Adrenal is widely used by naturopathic doctors and integrative and functional medicine practitioners to gain detailed information that standard blood tests cannot detect, in patients suffering from chronic fatigue, sleep issues, or persistent stress symptoms.
At Toronto Centre for Naturopathic Medicine, we use the DUTCH Adrenal test to translate complex hormone data into clear, personalized treatment strategies.
The DUTCH Adrenal measures:
The DUTCH Adrenal measures cortisol and cortisone production, metabolism and circadian rhythm across the day. Analytes assessed include:
- Free cortisone and cortisol (at four points over the day)
- Total free cortisol and free cortisone
- Cortisol metabolites
- 5α‑ and 5β‑reductase activity (cortisol metabolism pathways)
- DHEA-S
The DUTCH Adrenal may provide useful guidance if you experience:
- persistent fatigue or a sense of being “wired but tired”
- difficulty responding to stress or feeling easily overwhelmed
- non‑restorative sleep, early waking or insomnia
- low morning energy or afternoon energy crashes
- anxiety, low mood or stress‑related mood changes
- “brain fog” or difficulty concentrating
- sugar or caffeine dependence
- poor exercise recovery
It may also help your naturopathic doctor understand underlying causes of:
- chronic stress and burnout states
- hypothalamic‑pituitary‑adrenal (HPA) axis dysregulation
- insomnia and circadian rhythm disorders
- anxiety and depressive disorders associated with altered cortisol rhythms
- chronic inflammatory or immune‑related conditions
- metabolic dysfunction and cardiometabolic risk influenced by cortisol imbalance
How does the DUTCH Adrenal work?
The DUTCH Adrenal uses dried urine samples collected at specific times throughout the day to map cortisol and cortisone patterns across the circadian cycle. Dried urine testing allows for accurate reflection of free and metabolized hormones without the stress‑induced cortisol spikes that can occur with blood draws.
Samples are analyzed using high‑performance liquid chromatography with tandem mass spectrometry (LC‑MS/MS), a highly sensitive and specific analytical technology. This method enables precise measurement of hormone levels and their metabolites, providing insight not only into how much cortisol is produced, but also how efficiently it is metabolized and cleared.
DUTCH Adrenal Customization
DUTCH Adrenal may be ordered on its own, or as a component of:
- DUTCH Complete® (DUTCH Adrenal combined with sex hormone evaluation)
- DUTCH Plus® (DUTCH Adrenal combined with sex hormone evaluation; and cortisol awakening response [CAR])
We will help you navigate which combination is appropriate for you!
Learn more about DUTCH Adrenal.
Related Tests
Other tests available at Toronto Centre for Naturopathic Medicine that offer a deeper understanding of the underlying causes of persistent fatigue, difficulty concentrating, and symptoms of “being burned out” in general include:
Why work with a naturopathic doctor?
Interpreting DUTCH Adrenal results requires clinical context. Hormone metabolites must be evaluated alongside symptoms, medical history, lifestyle factors and other laboratory findings.
Our naturopathic doctors use DUTCH Adrenal results to design evidence-informed, individualized treatment plans, which may include dietary therapy, targeted nutritional supplementation, herbal (phyto) medicines and lifestyle interventions.
If you are considering testing using DUTCH Adrenal, we invite you to book a consultation to determine whether the DUTCH Adrenal can help you reach your health goals.
References
Precision Analytical Inc. DUTCH Adrenal Test Technical Guide and Clinical Overview. Precision Analytical; Beaverton, OR.
Precision Analytical Inc. Dried Urine Hormone Testing (DUTCH): Validation and Methodology. Precision Analytical; Beaverton, OR.
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