DUTCH Research

Industry Leading, Peer-Reviewed, Validated Testing

The DUTCH Test® (Dried Urine Test for Comprehensive Hormones) helps practitioners answer complex clinical questions by providing the most comprehensive hormone monitoring results with simple patient collection. Our rigorous pursuit for the truth in hormone testing has produced multiple peer-reviewed studies proving the effectiveness of dried urine testing as an alternative to serum (blood) or saliva for monitoring a variety of hormone therapy applications. We use the most accurate method available (LC-MS/MS and GC-MS/MS) and our tests are used by thousands of healthcare providers and their patients all over the world.

The first specialty lab to present peer-reviewed research on
dried urine testing to the North American Menopause Society.

Precision Analytical Inc. became the first specialty lab to present peer-reviewed research on dried urine testing to the North American Menopause Society (NAMS) in September 2021. This validated research shows that dried urine testing is an effective alternative to serum (blood) or saliva for monitoring a variety of hormone therapy applications such as estradiol patches, transdermal gels, and creams.

E2 Patch Study: Estradiol (E2) patches are one of the most commonly used menopausal hormone therapy (MHT) formulations, and, as a result, are also one of the most studied. Many of these studies use serum testing; however, a great deal of intra and inter-subject variability exists in serum levels. This study set out to investigate whether urine could provide a representation of serum E2 levels over a 24-hour period because, in contrast to serum, urine sampling is non-invasive and easier to collect. Learn More >

E2 Gel Study: Transdermal (TD) estradiol (E2) gel is a commonly used menopausal hormone therapy (MHT). Serum is often used to measure E2 levels, but the results only represent a moment in time rather than a complete picture of hormone health. The aim of this study was to evaluate a dried urine sampling method to determine if it may be a viable option for monitoring MHT administered via TD gel. We set out to determine if urine could provide an alternative to serum E2 levels as it is non-invasive and easier to collect. Learn More >

Patches, Gels, and Creams Comparison: We set out to understand the comparative effects of transdermal (TD) estradiol (E2) patches, gels, and compounded creams given their complex and differing pharmacokinetics, while also considering the fact that there is essentially no published data supporting the efficacy of compounded E2 creams. E2 levels are most often measured in serum, but these values may not be the most accurate, especially since creams and gels show significant variation in E2 levels throughout the day, and serum only represents one moment in time. Our study sought to determine if urinary E2 levels could provide an accurate representation of serum E2 concentrations over a 24-hour period. Learn More >

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Peer-Reviewed Research

Scientific literature has much to say about the viability of measuring hormones in urine. In a newly released publication in the peer-reviewed journal, BMC Chemistry, a new study demonstrated that measurements of reproductive hormones in a collection of four dried-urine samples over a 15-hour span throughout the day would accurately reflect the measurement of these hormones in a 24-hour urine collection.

A journal published in 2020 featured DUTCH in a study to determine the utility of dried urine sampling in obtaining measures of cortisol and cortisol metabolites. Additional aims were to evaluate if a 4-spot urine collection is representative of a 24-hour urine collection and if expected diurnal cortisol patterns can be observed in samples from both urine and saliva.

DUTCH's first peer-reviewed journal submission was published in 2019 in BMC Chemistry. It was completed collaboratively with the University of Southern California Reproductive Endocrine Clinical Laboratory and shows that analysis of urine samples dried on filter paper provides results correlating with serum (blood) results. The research also shows a collection of four samples during the day (4-spot method) can be substituted for a 24-hour collection and the analysis of urine from dried samples is equivalent and is as adequately stable as liquid urine samples.

The DUTCH Test 4-spot dried collection method can be collected at home and is overwhelmingly preferred by patients over a traditional 24-hour urine collection or even serum (blood) tests. For providers, DUTCH is a useful clinical testing tool for hormone dysregulation and is becoming a desired method for determining hormone health. Precision’s research has continued to expand the DUTCH model of testing to include a comprehensive overview of male, female, and stress-related hormones along with markers for related vitamin deficiencies and neurotransmitter balance.

More peer-reviewed journal submissions featuring DUTCH are in process.

Research Collaborations and Clinical Trials

DUTCH testing was recently used in tandem with the Oura Ring to explore a potentially new method for predicting and defining the fertile window for women. This study was completed collaboratively with researchers from The Helen Wills Neuroscience Institute, University of California Berkley. Mark Newman, MS, president and founder of Precision Analytical Inc. was a coauthor of this paper which demonstrates how ultradian rhythms of distal body temperature and heart rate variation, measured using the Oura Ring, were able to anticipate the LH surge “at least two days prior to its onset in 100% of individuals.” This finding has the potential to lead to the full development of a novel fertility awareness tool that would be extremely useful for both women trying to conceive, as well as those seeking a natural contraception method.

DUTCH-Based Research

It is important to remember that many of the concepts used in the DUTCH test® are already established in the literature. The relevance, for example, of measuring estrogen metabolites in spot urine samples is found both in the scientific literature and is offered by other labs. For this test, we are simply using dried samples, which show excellent correlation to liquid urine and great stability for months at room temperature. One challenge to serum hormone testing is the fact that reproductive hormones change somewhat unpredictably throughout the day. Filicori, Butler and Crowley showed in the Journal of Clinical Investigation that serum progesterone values are highly variable throughout the day in premenopausal women. One advantage of the DUTCH collection and testing methodology is that the four urine samples used represent over half of the day, instead of just one moment in time.

Precision Analytical Inc. maintains a transparent approach to discussing the strengths and challenges of all testing modalities. Some competing labs and even a few healthcare practitioners have circulated questions about the DUTCH Test®. We asked ourselves many of the same questions when we began exploring the DUTCH concept. These papers give an overview of the challenges and questions to using dried, spot-urine samples for hormone analysis, and address some of the questions regarding DUTCH, hormone testing in general, and even hormone replacement therapy:

DUTCH Research Inquiries

We welcome collaborations with researchers, healthcare companies, and clinicians, including clinical trials which require a CLIA-certified testing laboratory. If you are interested in collaborating with DUTCH on a research project, click below and fill out the online form. A member of our staff will contact you shortly by phone or email.

Research-Inquiry