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Functional Testing: Adrenal, HPA Axis & Stress

DUTCH Advanced Adrenal Metabolism Profile


This profile is a comprehensive assessment of adrenal hormones and their metabolites. The profile includes measures of both ‘free’ cortisol as well as in it’s inactive form called cortisone.

DUTCH stands for, Dried Urine Test for Comprehensive Hormones. Urine samples are taken using filter paper making the test easy to do at home as there is no need for a blood draw or 24-hour total urine collection. You need to collect just four or five dried urine samples over a 24-hour period.


The Advanced Adrenal Metabolism Profile provides:

Assessment of the daily pattern of free cortisol throughout the day

The total level of cortisol metabolites providing insight into total cortisol production

Assessment of the body’s preference for cortisol (active form) or cortisone (inactive form).


Who is the Dutch Adrenal Metabolism Profile Urine Test for?

This test is suitable for any one that is looking for a comprehensive way to measure and assess the impact of stress levels on their health. This profile provides insight in to the body’s ability to manage stress by assessing the hormones cortisol and DHEA. Imbalances in these hormones can result in a wide range of symptoms from fatigue to loss of motivation, depression and hormonal problems.



© Sandra James 2020

dutch adrenal 2
DUTCH TEST adrenal

What do our adrenals do?

The HPA-Axis is responsible for the stress response and gut brain communication. When a physical or psychological stressor occurs, the brain sends a message to stimulate the adrenal glands to make the stress hormone, cortisol and to a lesser extent DHEA and DHEA-S. This is part of a series of steps that start with the HPA – Axis made up of the hypothalamus (H) and pituitary (P) in the brain down to the adrenal glands (A) that sit on top of the kidneys.


Normally, the HPA-axis production follows a daily pattern in which cortisol rises rather rapidly in the first 10-30 minutes after waking in order to help with energy, then gradually decreases throughout the day so that it is low at night for sleep. The cycle starts over the next morning.


There can be problems with the signalling and communication between the brain and the adrenal glands, and /or with the production of our stress hormones, resulting in many different symptoms or conditions of adrenal dysfunction.


These may include:

Fatigue or low energy




Loss of libido or sex drive

Loss of motivation and focus

Weight gain

Mood swings

Poor concentration and memory

It is worth considering the following tests for a full picture:


DUTCH Complete  - to also include sex hormones, their metabolites and key organic acids for a full hormonal piture. Note female sample report below - male also avaialble

DUTCH Plus (includes Cortisol Awakening Response)

The addition of the cortisol awakening response (CAR), a transient, immediate rise in cortisol upon awakening (distinct from the diurnal rhythm), provides a fuller assessment of hormone fluctuations, baseline stress response, and reflects a person's ability to cope with anticipated challenges. CAR also shows someone's perception of control around chronic stress, providing insight into HPA resiliency.


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