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Dried Urine Test for Comprehensive Hormones - DUTCH test case study

The DUTCH test has been invaluable in establishing the root cause and helping one client move forward with her health goals in a targeted way. Here's the how and why.

After an initial consultation which established some good dietary practices, the client M.N. came to visit me for a follow up appointment several months later, still complaining of symptoms which all pointed to hormonal imbalance. The range of symptoms included fatigue, irritability, mood swings, night sweats, constipation, stress, anxiety and hair shedding.

Her main aims were to regain vitality and learn how to manage symptoms. Although not taking any prescribed medications she takes a wide variety of supplements and would like to streamline to target her specific symptoms.

M.N. took the oral contraceptive pill from 28-34 followed by fertility investigations she had several rounds of IVF before a successful pregnancy. Perimenopause symptoms of unusually heavy periods began at 45 and a Mirena coil was fitted. This lightened the bleeds, but further symptoms arose over the following years until her GP prescribed Oestrogel to balance the oestrogen/progesterone seesaw. Energy levels increased for some time but have now dipped.

This client has a full life with teenage children, ageing parents, demanding freelance work and a busy social life.

Her diet appears high in protein, low in fat and medium in carbohydrates fruits and vegetables. Alcohol and caffeine are high and water low.

My aims were to support firstly the digestive system to increase elimination, the liver to streamline hormone detoxification and the nervous system to promote relaxation.

With such an endocrine heavy picture it seemed an ideal use of the DUTCH test with the cortisol awakening response included.

Testing cortisol helps understand the circadian rhythm and answers questions such as “Why am I so tired?” “Why can I not sleep?” “Why do I crash in the afternoon?”.

Organic acid metabolites excreted in the urine help us understand symptoms such as anxiety, insomnia, depression, libido, oestrogen dominance, and stress.

Client’s need to be very much on board with the decision to use this test not only due to the high cost, but the commitment to following the complex sample collection procedure. Taken on day 21 of the cycle, halfway through the follicular phase when progesterone should be high and oestrogen should be low.

M.N. set alarms on her phone for the six different saliva and urine sample collection times. Samples were then stored in the freezer next to the peas and ice cream until being collected by courier the following day!

Three weeks later a 20 page document of information arrives in my inbox for interpretation. The results were fascinating to analyse in some cases confirming what we suspected to be the case from symptoms, such as oestrogen dominance but also highlighting red flag situations such as the testosterone level being dangerously low.

The subtleties of the three different liver detox pathways gave me plenty of direction on how to personalise the protocol and which supplements would be most useful to support this area.

This personalisation would not have been possible without the wealth of precise information provided by the test results.

M.N. now had a stream lined supplement programme and some specific nutrients rich foods to add into the diet plan. We have also been able to contact her GP to reconsider the HRT dosage.

If any of the symptoms mentioned resonate with you do not hesitate to arrange a call so we can discuss how nutritional therapy can help you overcome them.


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