Diagnostic guide
DUTCH Hormone Test
Hormones, their metabolites and the daily cortisol curve from dried urine
Your request opens ready in Gabriel. Details are verified and nothing is booked or ordered without your approval. Gabriel Care membership is optional.
Evidence status: mixed evidence. Not a guideline standard test. The Menopause Society calls urine and saliva testing to set hormone therapy doses unreliable. Review results with a licensed clinician.
Cost
$434
Turnaround
7 to 10 business days
Ordering path
Precision Analytical (DUTCH)
Results flow
Upload + interpret in Gabriel
Local access
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What this test reports
What this test reports
The Dried Urine Test for Comprehensive Hormones (DUTCH) measures cortisol patterns, sex hormones, their metabolites, and melatonin from dried urine samples collected at home.
Unlike a single blood draw, DUTCH tracks your cortisol curve through the day and shows how your body breaks hormones down, which is why many integrative practitioners use it to look at estrogen metabolism, stress patterns and androgens. It is not a guideline standard. The Menopause Society's 2022 position statement says urine and saliva hormone testing to set hormone therapy doses is unreliable and not recommended, because levels vary through the day and from person to person, and that blood hormone testing is rarely needed. Read results alongside symptoms and other labs with a licensed clinician.
People usually reach for this kind of diagnostic when they want a clearer read on full cortisol curve (free and metabolized), estrogen metabolites (2-oh, 4-oh, 16-oh pathways), progesterone and its metabolites, especially when symptoms or prior testing still leave blind spots.
Once results are back, you can upload them into Gabriel to connect the findings to symptoms, protocols, and next-step testing instead of leaving them as a static report.
Commonly relevant for: Pcos Hormonal Imbalance, Menopause Perimenopause, Adrenal Fatigue, Fertility.
Gabriel difference
Why this becomes more useful inside Gabriel
A standard blood hormone panel is like a photograph of a river: you see the water level at one moment. DUTCH adds how you're metabolizing hormones, not just how much estrogen you have. The 4-OH estrogen pathway, for example, has been associated with cancer risk in research, and standard blood panels don't measure it. Upload your results and Gabriel explains them in plain words, next to your symptoms and other labs. Decisions about hormone therapy belong with a licensed clinician.
Gabriel interprets results through a functional, root-cause lens: optimal ranges, pattern recognition across multiple diagnostics, and what the findings actually mean for action rather than just classification.
That means this test can feed directly into protocols, practitioner matching, food strategy, and follow-up testing instead of ending as a one-off PDF or lab portal result.
What to expect
What to expect from ordering to results
01
Order
Order directly through Precision Analytical (DUTCH) or ask Gabriel whether there is a better path first.
02
Complete
You'll collect dried urine samples on filter paper at four specific times throughout one day (and one first-morning void the next day). Simply saturate the paper, let it dry, and mail it in the prepaid envelope.
03
Interpret
Upload the results to Gabriel for pattern recognition, protocol suggestions, and next-step guidance.
Frequently asked questions
Questions people usually ask before ordering
DUTCH measures hormone metabolites and a daily cortisol pattern, not just circulating levels. Blood tests show what's in your bloodstream at one moment. Practitioners use DUTCH to look at how hormones are processed and cleared. Different isn't the same as better: The Menopause Society says urine and saliva testing to set hormone therapy doses is unreliable and not recommended.
You collect 4-5 urine samples on filter paper strips throughout one day, from evening through the next morning. The strips dry at room temperature and are mailed to the lab. No blood draw, no clinic visit needed.
For cycling women, collection is typically done on days 19-22 of your cycle (luteal phase) when progesterone should be at its peak. Post-menopausal women and men can test any time. Your practitioner will guide timing based on your specific situation.
Typically 7-10 business days from when the lab receives your samples. Results are sent to your ordering practitioner, who will schedule a consultation to review findings and create a treatment plan.
Generally no. The DUTCH Complete test costs approximately $300 to $400. HSA or FSA funds may be eligible; check with your plan administrator. Some practitioners consider it worth the out-of-pocket cost; ask how the result would change your plan before you order it.
Practitioners order it when looking into hormonal acne, irregular periods, fertility issues, PMS/PMDD, perimenopause symptoms, fatigue, low libido, unexplained weight gain, mood and sleep problems, often when standard blood work comes back 'normal' but symptoms persist. It doesn't diagnose these on its own; a licensed clinician reads it with your symptoms and other tests.
Not sure which test belongs in your workup?
Tell Gabriel your symptoms, goals, and what you have already tried. You will get a more useful answer than a generic test catalog can give you.