DUTCH Complete Test

What this test actually measures

A blood hormone test answers one question: how much of this hormone is circulating at the moment the needle went in.

That is a good question and it is not the only one worth asking. Two others matter, and this test is built around them.

The first is what happened next. Hormones do not simply circulate and vanish, they get processed down specific pathways, and the products of that processing are metabolites. Two people with identical oestrogen levels can be metabolising it down noticeably different routes, and a blood level cannot see that at all.

The second is the shape across a day. Cortisol swings enormously between waking and midnight, so a single measurement is one point on a steep curve. Collecting at several points describes the curve instead.

The collection method follows from that. You urinate onto a filter strip at set times through the day, the strips dry, and you post them. Dried urine is stable enough to travel, which is what makes a multi-point at-home collection practical at all.

What the metabolites add, and where I would hold it loosely

The strongest case for this test is the oestrogen metabolism picture, so let me explain what it is actually showing.

Oestrogen gets processed down more than one hydroxylation pathway, and the proportions differ between people. Those proportions are influenced by things you can act on, including cruciferous vegetable intake, alcohol, body composition and gut function.

A blood oestradiol tells you the level. The metabolite pattern tells you the route. Those are genuinely different pieces of information, and the second one is not obtainable from a standard blood panel.

The androgen metabolites are similarly informative, showing how testosterone is being processed, which is relevant to acne and hair loss patterns in a way a total testosterone alone is not.

Now where I would hold this more loosely, because you deserve the honest version.

The cortisol pattern is the part most heavily marketed and the part I would lean on least hard. A 2016 systematic review in BMC Endocrine Disorders searched 3,470 articles and analysed 58 studies of the cortisol testing used to support adrenal fatigue, including direct awakening cortisol, the cortisol awakening response and salivary cortisol rhythm, and found conflicting results almost systematically, concluding there was no substantiation for the condition.

The DUTCH cortisol measurement is a different collection method from those studies, and the underlying interpretive problem is the same one: reading a daily cortisol pattern as a diagnosis is not well supported.

That does not make cortisol meaningless. A 2021 randomised crossover study found that clamping cortisol during four nights of short sleep cut the resulting insulin resistance roughly in half, so cortisol changes have real metabolic consequences. It means the pattern is context rather than a verdict.

So my honest read: order this for the metabolite information, which is genuinely unavailable elsewhere, and treat the cortisol curve as one input among many rather than as the finding that drives your plan.

Test details

What is measured: sex hormones and cortisol with their downstream metabolites, from dried urine collected at several points across a day.

Sample: urine.

Provider: Precision Analytical, ordered through Jess's practitioner dispensary.

Fasting: not required. Collection timing across the day matters, and for those still cycling the collection day should be timed to the cycle, so read the kit instructions before you start.

Turnaround: results typically within a few business days of the sample reaching the lab.

Order this test.

How the pricing works

I want to be straightforward about this, because lab pricing in the wellness industry frequently is not.

Jess takes no markup on the test itself. The lab cost is passed through exactly as it comes. What you pay is the test cost, the dispensary's service fee, the authorization fee, the collection fee where one applies, a flat handling fee for placing and managing the order, and the card processing cost. The handling fee is the part that is Jess's, and it is flat regardless of how expensive the test is.

That structure is deliberate. A percentage markup on labs creates an incentive to recommend expensive tests, and this way there is not one.

The full lab menu shows everything available, and the order page itemises every fee before you pay.

Who this test is worth running for

Anyone with a hormonal question where the metabolism matters rather than only the level. That includes oestrogen-related symptoms, cyclical breast tenderness, heavy or difficult periods, and androgen-driven acne or hair loss patterns.

It is best used as a second-line test rather than a first one. If you have never had a thyroid panel, ferritin with hs-CRP or fasting insulin, those answer more common causes for considerably less, and they answer them from one blood draw.

It is also worth having a practitioner lined up before you order it. This report is long and dense, and its value comes almost entirely from being read alongside your symptoms and your other results. Ordered and interpreted alone, it tends to produce a supplement list rather than a direction.

Ordering restrictions

The lab network cannot issue orders to residents of New York, New Jersey, Rhode Island, or Hawaii. New York, New Jersey, and Rhode Island prohibit direct-to-consumer lab testing outright, requiring a treating provider's signature on every requisition. Hawaii is excluded by the network. This is tied to where you live, not where the sample is collected, so it applies to kits as well as draws.

If you live in one of those four states, your doctor can order the same test.

What to do with the result

Start with the metabolite pathways rather than the cortisol curve. That is where the information you cannot get from a blood panel actually lives.

Read the cortisol pattern as context, not as a diagnosis. The evidence does not support building a treatment plan on a daily cortisol shape.

Check the collection was correctly timed. For anyone still cycling, the day matters, and a mistimed collection affects the sex hormone results the same way it would a blood draw.

Rule out the cheaper explanations if you have not already. Thyroid, iron and insulin cause a great deal of what people bring to a hormone panel, and they are far less expensive to check.

Take the report to someone who reads it with the rest of you. A good functional medicine doctor, alongside your blood work and your symptoms. That is what turns a dense document into a plan.