DUTCH Test Results: When NHS testing stops and a £150 clinician option
Your DUTCH report summarises sex hormones, your daily cortisol pattern, and a set of metabolites and organic acids that together build a picture of hormonal health. Start with the summary page, known as the DUTCH Dozen, to spot your priority markers at a glance. Match whatever stands out there against your symptoms, and if the picture still feels unclear, get a professional to walk through it with you.
TL;DR:
- Most markers outside the population range or aligning with your main symptoms warrant priority, especially if several are elevated or decreased simultaneously.
- Elevated androgen metabolites may signal symptoms like acne or hair thinning, while low levels often relate to fatigue or low libido, requiring different approaches.
- Cortisol patterns track your circadian rhythm, with metabolised cortisol offering a more complete picture of overall adrenal output influenced by factors like inflammation or liver function.
- Results can be affected by cycle timing, recent hormone use, or missed sample collections, so accurate timing and full medication disclosure are essential.
- Interpreting the report with a healthcare professional helps translate the data into a personalized plan, especially when indicators suggest urgent medical review.
Table of Contents
- How to read the summary page: the DUTCH Dozen and the sliders
- What each hormone group means: estrogens, progesterone and androgens
- Understanding cortisol on your DUTCH report: daily pattern, 24-hour total and metabolised cortisol
- Accuracy, sampling method and timing: what affects DUTCH results
- What to do next: clinical context, red flags and preparing for an appointment
- How Food Connection uses DUTCH results in practice
- Getting your DUTCH report interpreted and turned into a plan
- FAQ
- Sources
How to read the summary page: the DUTCH Dozen and the sliders
The DUTCH Dozen is a 12-assessment framework built into the summary page of your report, grouping estrogens and progesterone, androgens and cortisol into the markers clinicians check first. The twelve assessments cover four estrogen and progesterone markers, four androgen markers and four cortisol markers, so rather than scanning dozens of individual values, you get a curated shortlist designed to flag where to look next.
Each marker on the summary page is shown as a slider against a population percentile scale, with your result marked by a black arrow. The DUTCH interpretive guide explains that most sliders carry a green band representing the typical “in range” population zone for that marker, which helps identify results that are unusual or out of range.
When several markers are off, prioritise by pairing them with your actual symptoms:
- Markers far outside the typical range deserve attention before those just outside it.
- Markers that align with your most troubling symptoms should be addressed first.
- Patterns across related markers often matter more than single isolated readings.
What each hormone group means: estrogens, progesterone and androgens
Estrogen results on a DUTCH report include the three main forms, estrone (E1), estradiol (E2) and estriol (E3), alongside their detox pathway metabolites: 2-OH, 4-OH and 16-OH. The ratio between these pathways matters as much as the absolute estrogen level, since it reflects how your body is processing and clearing estrogen rather than simply how much is circulating.
Progesterone is assessed through its urinary metabolites, including alpha and beta pregnanediol. Low levels often reflect anovulation in that cycle or a sample taken outside the luteal phase rather than a fixed deficiency, so the timing of the cycle during sampling is important for interpretation.
Androgens cover DHEA and its metabolites alongside testosterone breakdown products:
- Elevated androgen metabolites often accompany symptoms like acne, scalp hair thinning or irregular cycles.
- Low androgen output can show up as low energy, reduced muscle recovery or low libido.
- DHEA metabolites specifically reflect adrenal androgen production, which can run separately from ovarian or testicular output.
Understanding cortisol on your DUTCH report: daily pattern, 24-hour total and metabolised cortisol
Your cortisol section includes the daily free cortisol pattern, showing collection points throughout the day. These values indicate whether your circadian rhythm follows the expected pattern or is altered.
Two further figures sit alongside that graph:
- 24-hour free cortisol adds up what has been released across the day, reflecting overall output rather than its timing.
- Metabolised cortisol, calculated from cortisol metabolites a-THF, b-THF and b-THE, indicates total adrenal cortisol production for the day according to the DUTCH interpretive guide, and can be shifted by thyroid function, inflammation, body weight and liver function.
Metabolised cortisol equals the sum of THF and THE metabolites, a DUTCH-specific calculation that captures daily adrenal output in a way free cortisol alone cannot. The same guide also describes Cortisol Clearance Rate and systemic cortisol-to-cortisone preference, two derived metrics that matter when free and metabolised cortisol disagree, since that mismatch often points to how quickly your body is clearing cortisol rather than how much it is producing.
Accuracy, sampling method and timing: what affects DUTCH results
A 2021 validation study published in BMC Chemistry compared the 4-spot dried urine method against traditional 24-hour liquid urine collection. Fourteen of seventeen steroid metabolites showed excellent agreement between the two methods, with the remaining three still showing good agreement, which supports dried urine as a reliable, more convenient alternative within clinical practice.
Several factors can still shift your results on the day:
- Menstrual cycle timing changes expected progesterone and estrogen values considerably, so sex hormone samples are usually timed deliberately.
- Hormonal contraception or recent HRT and steroid use alters baseline levels and needs to be disclosed, not guessed around.
- Missed or late collection points distort the daily cortisol curve more than almost any other error.
Results typically return within a couple of weeks of your sample reaching the lab, and sample reports with full slider visuals are available directly from the DUTCH Dozen resource page before you test, which is worth reviewing so you know what to expect.
What to do next: clinical context, red flags and preparing for an appointment
Before any appointment to discuss your results, pull together a short checklist:
- Note your exact sample collection times and cycle day, or menopause stage, when you tested.
- List current medications, supplements, HRT or contraception, since these shift baseline values.
- Write down your three most troubling symptoms and the three most abnormal summary markers, so the conversation starts where it matters.
Certain findings warrant urgent medical review rather than nutrition planning alone: Cushingoid features (rapid central weight gain, facial rounding, skin thinning), rapid virilisation, or severe unexplained weight change all need a GP or endocrinologist first.
Pro Tip: Bring your summary page printout, not just the full report, to your first conversation. It keeps the discussion focused on your priority markers.
For most readers, an interpreted report feeding into a structured plan, an initial consultation, a written set of recommendations and scheduled follow-up, turns scattered data points into a plan you can actually follow.
How Food Connection uses DUTCH results in practice
We find that lab data only becomes useful once it is tied to a plan someone can sustain. Clients who gain the most from a paid interpretation tend to have complex symptom pictures, perimenopause, chronic fatigue or stubborn weight issues, where a single summary slider will not tell the whole story. We treat each report as a starting point for honest, evidence-led conversation, not a verdict.
— Irina
Getting your DUTCH report interpreted and turned into a plan
Reading your own sliders gets you partway there, but turning twelve summary markers into a food and lifestyle plan you can stick to is a different task. We offer laboratory test analysis and interpretation alongside structured nutrition support, so your DUTCH results feed directly into recommendations rather than sitting in a PDF.
What this looks like in practice:
- A one and a half hour initial consultation plus written personalised recommendations, priced at £150.
- A follow-up consultation within weeks of your initial session to track how your plan is working; current prices are on the pricing page.
- Twelve weeks of dedicated support for anyone who wants ongoing guidance rather than a single session.
If your DUTCH results point towards perimenopause-related shifts, our perimenopause and nutrition guide is worth reading alongside your report. Booking details and current pricing sit on our prices page.
This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.
FAQ
What do my DUTCH test results mean?
Your results show where your estrogens, progesterone, androgens and cortisol pattern sit against population percentiles on the summary page. Outlier markers point towards areas worth discussing with a practitioner, ideally matched against your actual symptoms rather than read in isolation.
How accurate is the DUTCH test for hormones?
A 2021 BMC Chemistry validation study found that 14 of 17 steroid metabolites showed excellent agreement between the 4-spot dried urine method and traditional 24-hour urine collection, with the remaining three showing good agreement. That supports dried urine testing as a reliable method within its intended clinical context.
How long does it take to get results back from a DUTCH test?
Results typically take around two weeks to return once your sample reaches the lab, though exact timing can vary by provider. Sample reports showing the full slider format are available to preview before you test through the DUTCH Dozen resource.
Does the DUTCH test look at thyroid?
The DUTCH test focuses on sex hormones, adrenal cortisol patterns and related organic acids rather than thyroid hormones directly. UK clinical guidance notes that menopause in women over 45 is usually diagnosed on symptoms, with hormone tests reserved for specific or atypical cases, so thyroid concerns are generally investigated separately through standard blood testing.
Sources
- Introducing the DUTCH Dozen
- Validation of 4‑spot dried urine vs 24‑hour urine for steroid metabolites (BMC Chemistry 2021)
- NHS-aligned guidance on biochemical investigation of suspected endocrine problems in females