Dutch Plus Test
Complete Hormone, Adrenal and Cortisol Awakening Response (CAR)
1-day salvia and urine collection - Precision Analytical
The DUTCH Plus takes adrenal and hormone testing to a whole new level. In addition to sex hormones and their metabolites, the DUTCH Plus looks at the overall diurnal pattern of free cortisol, the total distribution of cortisol metabolites, the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.
What’s Included in the DUTCH Plus®
The DUTCH Plus® 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 Plus® report includes:
Metabolites of Estrogens
Androgens
DHEA
Progesterone
Cortisol
Melatonin
Organic Acids
The daily pattern of Free Cortisol and Cortisone
Cortisol Awakening Response - HPA Stress Response
What is the Cortisol Awakening Response and how do we test for it?
When we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 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. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range. A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.
A low or blunted Cortisol Awakening Response
This can be a result of an underactive HPA axis, excessive psychological burnout, seasonal affective disorder (SAD), sleep apnea or poor sleep in general, PTSD, chronic fatigue and/or chronic pain. A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases.
An elevated Cortisol Awakening Response
This can be a result of an over-reactive HPA axis, ongoing job-related stress (anticipatory stress for the day), glycemic dysregulation, pain (i.e. waking with painful joints or a migraine), and general depression (not SAD). A recent study1 showed that neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) did. This measurement of the response to waking has independent clinical value showing dysfunction that may be hidden by current testing options.
Dutch Cortisol Awakening Response (CAR) Adrenal Test
1-day salvia collection - Precision Analytical
The Cortisol Awakening Response Test only tests your adrenal system and your HPA stress response. There are no hormones or organic acids included this test.
This is a fantastic cheaper option to understand your stress and adrenal system.