This month I would like to bring the fabulous DUTCH test into focus. acronym for; Dry Urine Test For Comprehensive Hormones
If you think you have issues with chronic stress, that is affecting your hormones then this is the test for you to complete. Like most private LAB tests it can be done in the privacy of your home, taking only minutes to complete.
MARKERS CONSIDERED IN THE DUTCH TEST
Stress
The definition of STRESS is the down-regulation of the HPA axis. Down-regulating the para-sympathetic nervous system, creating a dominant sympathetic response.
What happens when we get stressed? We release cortisol, taking 10 minutes to release, but then between 1-2 hour to break down. This can vary however depending on the health of the individual since the liver is involved within the process of breaking down cortisol when liver issues are present it can take 3-4 hours or even all day to break down.
Cortisol is then affected by the balance of all other hormones in your body. The Dutch test is a highly sensitive test, bringing all hormones into focus when considering your stress hormones. See the sample report above.
Cortisol is bound up by cortisol binding globulin transcortin. Transcortin is very sensitive to estrogen. Actually, all binding globulins are sensitive to estrogen. Therefore, when a woman is on the contraceptive Pill, or has been on the Pill for some time, there is a very good chance she is low in FREE cortisol, simply because it is all bound up to the binding globulins.
Free cortisol is less than 5% circulating but in its active form.
SEX HORMONES
DHEA
- DHEA, 80% is made in the adrenal glands 20% in the ovaries.
- DHEAs is what is measured, however, this is not the active form. DHEA needs to un-S taking the S off to become the active form. This conversation is dependent on the SULT1A1 gene, therefore sulphonation plays a role.
- DHEA is your master hormone, breaking down to the three estrogens.
- If you’ve had your 23&Me interpreted, you can check to see the status of your SULT genes.
- DHEA made in the brain protects the hippocampus from cortisol, therefore DHEA in the brain is a good thing.
- Stress damages our hippocampus, affecting our short term memory, not good!
Cortisol
When we get too much free cortisol roaming the system, our receptor sensitivity stopping being so active. Adrenaline and cortisol end up circulating. In this way, chronic stress leads us into a rut, in which the wiring of our neural networks keeps us repeating the same dysfunctional behaviour. Yet hoping for a different outcome! This by definition, is a form of insanity.
Adrenal Medulla
Other genes which are relevant to our stress response, mood and thinking are the COMT and MAOA. When these are running slow, you will not be breaking down catecholamines easily, and therefore do not break adrenaline down easily either. Check these genes if you are feeling stressed all day! Running slow means a high amount of neurotransmitters are stored since you are not going to break down adrenaline or nora-adrenaline. Rather, it can carry on ALL day. Stressy, buzzy, tense.
All there needs to be present to impact this system significantly is an infection, inflammation, food intolerance or a pile of housework building up to tip someone with slow genes to be tipped into overwhelm.
Cerebral cortex > CRH > anterior pituitary > ACTH > cortisol release > adrenaline and noradrenaline.
Our protective, survival mechanism is to shut down the parasympathetic nervous system and upregulate the sympathetic, now we are chronically in fight and flight! At this stage, we are likely to get receptor sensitivity. We can liken this to ‘annoying kid syndrome’ which I use to call being ‘mummed’. Mum, mum, mum .. for hours. We then get hyper-sensitive, and cortisol goes up even further because we are not tolerating it.
On the other hand, if you are a super laid back person your COMT and/or MAOA may be running too quickly. Feed the furnace with additional protein plus Tyrosine.
How do we break the cycle?
Change the biochemistry through food and nutrient therapy and then also rewire your habits.
Two analogies work for me here: First, we need to dry up the riverbeds were ‘too much’ of a hormone/catecholamine/ transmitter has been allowed to flood the system. Secondly, it takes a while for a worn-down path to grow grass again, was ‘not enough’ of the right hormone/catecholamine/transmitter has been present.
Stress and Fasting
Clients like to bring in the option of fasting, believing that fasting will help to clear the system and take the stress of the system. Whilst this is true in cases where adrenal fatigue is NOT present, it is not true for those who do not have a robust HPA axis. Primarily cortisol manages blood sugar levels. Do not stress the system out even more by Fasting when adrenal dysregulation is present.
Auto-immunity
Cortisol is higher in the morning with the sun. When cortisol is high it suppresses melatonin and growth hormone production. Cortisol helps to fight infection via inflammation, think viruses, bacteria, etc. The pro-inflammatory cytokines stimulate the stress system releasing cortisol.
There is real importance in this morning cortisol spike. When auto-immune symptoms are presented then understanding your cortisol patterns is super important. Low cortisol in the morning means that the auto-immune regulator does not happen. Morning cortisol triggers those cells in the thymus who failed central tolerance to get destroyed. What that means is, before immune cells get let out into the body, the thymus checks whether immune cells are auto-immune. If cells are auto-immune, then the thymus pushes the cells off to the side and the thymes kill those cells. Without the morning spike THIS DOES NOT HAPPEN!, and auto-immune cells get let out into the system.
Therefore, if we are consuming foods which create a cortisol spike at night, or we are fighting an infection at night, this suppresses melatonin, which in turn stops us from sleeping. Leads to a low cortisol spike in the morning with auto-immune flare-ups. For this reason, gluten and HHV6 will play more than one roll in creating auto-immune flare-ups.
GET YOURSELF TESTED
When is it best time to test?
- 5-7 days after ovulation on days 19, 20, 21
- If your cycles are long, then shift up. If your cycles are short, then shift down.
- First, track your ovulation through temperature gauging or other symptoms. Then count forward by 5-7 days and collect your urine.
Look at your Estrogens
Dutch tests for Estrogens E1 E2 E3, which then go through the liver and get converted to Hydroxy 2, Hydroxy 4 or Hydroxy 16.
Each esterogen dominant pathway has key characteristics. Estrogen 4 hydroxy for instance goes down the quinone pathway, correcting to estrogen-related cancers.
16 Hydroxy, the 2/16 ratio 2:16 can implicate estrogen proliferative symptoms such as moody, PMS, tender breasts and weight gain.
2 Hydroxy is The Happy Healthy Way.
Estrogen in the right amount
Good for > bone health
Good for > brain cognition
Good for > temperature regulation
Good for > collagen, tissue skin
Good for > fertility
When it’s decreased, we can face menopausal symptoms, skipping of cycles, low cholesterol even anorexia!
Too much estrogen, pre-disposed from either being on the contraceptive pill, environmental estrogens such as cling wrap, tap water (re-cycling of the hormone pill within the water system:
We can experience being over-weight, diabetes, increased risk of Alzheimer, PCOS.
Reduced hormones, on the other hand, can be a direct result from cholesterol-reducing medication for instance. People seem to over-look that cholesterol makes up all our hormones. When we lower cholesterol we also lower our testosterone, DHEA and Estrogens.
Other estrogen lowering activities
- Extreme exercise, marathon running, cross-fit.
- Frequent flying
- Under appropriate body weight.
- Head injuries.
- Surgery decreases the blood flow to the area as capillaries are damaged.
- Sugar, gums up the works, diabetes, and smoking.
- Birth control pill reduces estrogen in the long term.
Consider Progesterone
Progesterone helps with anxiety and insomnia as well as the lining of the uterus, as women losing progesterone report anxiety and insomnia.
Alpha-pregnanediol goes down, usually goes up to GABA, supporting the glymphatic system during sleep.
A-pregnanediol typically converts into neuro-steroid ALLO, that crosses BBB (blood brain barrier) and can activate GABA a-receptors.
Progesterone in the brain is calming, supporting neurons, and is even used after traumatic brain surgery or after Stroke.
Progesterone enhances serotonin receptors in the brain and reduces gall bladder activity. Conversely, higher estrogen increases the risk of gall bladder disease and stones.
Those on lots of NSAIDS will typically have low progesterone activity when used for more than 10 days.
Consider Androgens
DHEA: facial hair, acne
Consider FREE cortisol, verses stored cortisol
- Consider infections
- Consider allergies
- Consider food intolerances
- Consider weight gain
Marker 8-hydroxy-2-deoguanosine (8OHdG)
Marker correlating to chronic inflammation, high stress, high cortisol, insomnia, hypertension, kidney disease, IBD, depression.
What do we do now with this information?
Note where on the dials we are, which is dominant. Are we triple estrogen dominant?
Depending on where your markers are, we may wish to support Phase 1 liver with P450 enzymes and DIM. Or Phase 2 Liver with SamE precursor or SamE if you wish to order it in from the US. P%P, Mg, Choline, Methionine, Methyl groups TMG are all useful here.
Foods can be influential, but ONLY if stomach acid is good. This will not be the case where P5P and/or TMG is warranted. Kale, broccoli, Brussel Sprouts, Broccoli Sprouts, artichoke, onions, foods high in FOS and fibre.
Support Glymphatic system for catecholamine clearance at night.
Support MAOA with SamE donations and methyl donors.
Support COMT with Mg chloride.
Support the serotonin pathway.
Support the dopamine pathway.
Harness the benefits of apoptogenic herbs.
Combat infections.
Temper exercise according to the dominant hormone, verses hormone insufficiency.
Support HPA axis with key nutrients; C, B5, Zn, Fe, Mg, Sel
Weight management.
Given the results of your DUTCH test, there are plentiful options to improve your health. So, if you are interested in ordering this test with result interpretation you can email Anna directly.