Dutch Plus
An at-home saliva & urine panel that maps your daily cortisol rhythm and key sex hormones to explain what's really behind your energy, mood, and sleep.
Member Price
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Non-Member Price
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What is this Test?
The DUTCH Plus® combines the flagship dried urine test with a saliva test to maximize the available information on sex and adrenal hormone production and metabolism. This extensive profile provides insights into the overall diurnal pattern of free cortisol and cortisone, the total distribution of cortisol metabolites, and the cortisol awakening response (CAR). Organic acid tests provide further insight into potential nutritional deficiencies, oxidative stress, gut dysbiosis, and more.
Who is this Test For?
The DUTCH Plus test is primarily used by people experiencing complex, chronic symptoms related to hormonal imbalances or prolonged stress that standard blood tests haven't fully explained.
Common Symptoms of Users
Practitioners typically recommend this test for individuals struggling with:
Chronic Fatigue: People who feel constantly exhausted, experience "burnout," or feel "tired but wired" at night.
Sleep Disorders: Individuals facing insomnia, frequent nighttime waking, or difficulty falling asleep.
Severe PMS or PMDD: Women dealing with intense mood swings, painful periods, heavy bleeding, or irregular cycles.
Weight Alterations: People dealing with unexplained weight gain, especially around the abdomen, that resists diet and exercise.
Mood Disturbances: Individuals experiencing generalized anxiety, brain fog, panic attacks, or depressive episodes.
Low Libido: Men and women experiencing a sudden, unexplained drop in sex drive.
What Does it Measure?
The DUTCH Plus test measures 35 distinct hormones and their metabolites, alongside several nutritional and neurotransmitter markers, across four major areas:
1. Sex Hormones and Metabolites
Instead of just measuring static hormone levels, the test tracks how your body breaks down and clears these hormones:
Estrogens: Estrone (E1), Estradiol (E2), and Estriol (E3). It looks heavily at estrogen metabolism pathways (2-OH, 4-OH, and 16-OH estrogens) to check if your liver is filtering estrogen safely.
Progesterone: Measured via its primary metabolites (a-pregnanediol and b-pregnanediol) to evaluate overall progesterone production.
Androgens: DHEA-S, Testosterone, and 5a/5b metabolites (like Androsterone and Etiocholanolone). Tracking the 5a-reductase pathway helps pinpoint why someone might have high-androgen symptoms like cystic acne or hair loss.
2. Adrenal Hormones and Stress Patterns
The test evaluates both total production and the active, daily rhythm of your stress hormones:
Free Cortisol & Cortisone: Tracked at 5 distinct points throughout the day using saliva to map your exact diurnal (daily) rhythm.
Metabolized Cortisol: Measured via urine to show the total amount of cortisol your adrenal glands produced over the whole day.
Cortisol Awakening Response (CAR): Evaluates the specific, sharp rise in cortisol that occurs within the first 60 minutes of waking up. This is a crucial metric for evaluating brain-to-adrenal communication (the HPA axis).
3. Nutritional and Organic Acid Markers (OATs)
The test includes baseline organic acids in the urine to evaluate specific cellular functions:
Vitamin B12 & B6: Measured via methylmalonate (MMA) and xanthurenate.
Glutathione: An indicator of liver detoxification capacity and cellular antioxidant status.
Melotonin: Measured via 6-OH-melatonin-sulfate to evaluate sleep architecture.
4. Neurotransmitter Metabolites
While it does not measure brain chemistry directly, it tracks the organic waste products of nervous system chemicals:
Dopamine: Measured via homovanillate (HVA).
Norepinephrine / Epinephrine: Measured via vanilmanderate (VMA).
To help put this into perspective, tell me:
Are there specific hormones (like estrogen or cortisol) you are most concerned about?
Are you trying to investigate a specific condition, like PCOS, menopause, or chronic fatigue?
Why Evergreen?
Testing is only valuable when it leads to clarity and action. At Evergreen, your hormone results are reviewed by a practitioner who takes the time to explain what they mean for you specifically.
We connect the dots between your cortisol rhythm, your symptoms, and your daily life, then work with you to build a practical, personalized plan to support your hormone balance.
Our goal is education and partnership, not one-size-fits-all recommendations, so you leave every conversation understanding your body a little better.
Frequently Asked Questions
Is this test covered by insurance?
How is the sample collected?
How long does it take to get results?
Will I meet with someone to review my results?
Can this test diagnose a specific condition?
Why saliva instead of a blood test?
Still unsure if this test is right for you?
Book a free 15-minute consultation with one of our providers to discuss your health goals.