What does a DUTCH hormone test show that regular bloodwork can’t?

A DUTCH test or other functional hormone test shows how your body uses hormones over time, not just the amounts in your blood at a single moment. It maps production and breakdown steps, including whether you are clearing hormones well. It also charts your daily stress hormone patterns. Bloodwork alone can look “normal,” yet you still feel off.

What a DUTCH reveals that blood tests alone miss

Blood tests are a snapshot. They tell you how much hormone is in your bloodstream at one moment. The DUTCH test, using dried urine and in some panels saliva, shows the journey of those hormones over a day or even an entire monthly cycle, including how your body activates them, breaks them down, and “tags and ships” them out (methylation). That deeper view can explain symptoms like fatigue, sleep trouble, PMS, acne, cycle changes, or midsection weight gain even when basic labs look “normal”.

“How” hormones are used, not just “how much”

Think of hormones like traffic in a city. Bloodwork counts the cars. A DUTCH test shows the routes, detours, toll booths, and exits. In practical terms, it reveals:

  • Whether your body is using protective or potentially harmful estrogen routes, plus the final tag-and-ship step, often called methylation, that helps used hormones leave safely.
  • Androgen patterns that explain oily skin, hair changes, or PCOS-type symptoms, even if a single blood number looks okay.
  • Your full daily stress pattern, including the morning spark plug, so we can see if you are wired at night or flat in the morning.

How many markers are we talking about

A typical conventional hormone check might include only estradiol (E2 or the “main” estrogen during cycling years) and testosterone, sometimes progesterone. By comparison, a DUTCH Complete or Plus looks at about 35 to 40 markers. That includes sex hormones and their byproducts, daily free and metabolized cortisol, melatonin, and a few nutrient and gut-related clues. More markers means more context, which can make your healing gameplan more precise.

When pairing DUTCH with bloodwork helps most

At Dr. Kenny’s clinic, we consider advanced functional testing alongside a good conventional workup. Blood is excellent for items like LH, FSH, SHBG, prolactin, and thyroid hormones. A DUTCH test shows how your body is handling those hormones and how stress hormones rise and fall through the day. Together they reduce guesswork and guide simple, doable steps for food, sleep timing, movement, and targeted supplements, or referral for conventional treatment options when needed.

Real-world examples where DUTCH adds clarity

  • Breast health context: Certain urine estrogen patterns in research are linked with higher or lower risk. If your DUTCH shows less friendly breakdown and sluggish clean up, we focus on fiber, crucifer veggies, and key nutrients, while coordinating with your medical team. A single blood estrogen would not show this nuance.
  • PCOS and acne or hair changes: Two people can have the same blood testosterone, yet very different urine androgen patterns. If your body favors a stronger pathway, we adjust nutrition, stress rhythm, and sometimes specific supplements differently than if clearance is simply slow.
  • Fertility goals or symptom-ridden cycles: “Normal” blood estrogen with poor clean up on DUTCH can explain PMS, heavy cycles, or luteal symptoms. We then support the upstream steps and timing, not just chase a number.
  • Burnout or wired-but-tired: A flat morning spark with high overall cortisol output tells a different story than a single low or high serum value. That points us toward sleep-wake cues, protein and mineral rhythm, and nervous-system work.

Additional Resources:

The official DUTCH biomarker chart lists what each panel measures, including sex hormones, metabolites, cortisol patterns, melatonin, and more.

If your bloodwork says “normal” but you do not feel normal?

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Answered by Dr. Kenny Mittelstadt, DACM, DC, IFMCP
Certified functional medicine practitioner specializing in advanced lab testing and personalized healing protocols to uncover root causes of health roadblocks.

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