Over the next few blog posts, we are going to shine a light on some of the key clinical insights we can get from the tests we offer. DUTCH testing for example, can be invaluable in getting to the root cause of symptoms and in helping to put the most appropriate support protocol in place. Even during the covi19 pandemic these tests are still available, and we are very much still available via remote consultation. We can help you interpret the results and put a plan in place.
DUTCH testing is nothing to do with the Netherlands, but an acronym for Dried Urinary Testing of Comprehensive Hormones. And comprehensive is it, so much so that this post will focus on just one very small part of it. We will go into other parts in later posts. Quite frankly, every woman (and man) should do this test.
The DUTCH test is a comprehensive look at your hormone levels and systems. It uses a dried urine collection method which is a convenient and accurate way to test. An imbalance in sex hormones may be present in PMS, irregular or absent cycles, anovulation, infertility, recurrent miscarriage, endometriosis, skin problems and fibroids amongst others.
Detoxification of oestrogen is also an important consideration where there is an increased risk (or history of ) breast cancer, prostate cancer or for protection of your future health.
The DUTCH test measures oestrogen and how it is metabolised. Oestrogen is metabolized (primarily by the liver) down three phase I pathways – 16-OH, 4-OH, and 2-OH. The 2-OH pathway is the safest because of the anti-cancer properties of 2-OH metabolites. Conversely, the 4-OH pathway is the most toxic as its metabolites can create reactive products that damage DNA. The third pathway, 16-OH creates the most oestrogenic of the metabolites – 16-OH-E1.
The pie chart then assists in comparing the three pathway options of phase I metabolism compared to what is healthy. As you can see from the diagram, this patient’s ratios are not ideal. There is a preference for the 16-OH pathway and the 4-OH also being higher than we would like to see.
Thankfully, there are nutritional, nutraceutical and lifestyle interventions that can support safe oestrogen metabolism and these can be tailored depending on your individual results. For example, cruciferous vegetables such as kale, broccoli, cauliflower, Brussels sprouts, and cabbage contain a compound called Indole-3-carbinole which may help to alter the ratio of weak to strong oestrogens (2-OH/16-OH) favourably. This is something most people can safely incorporate into their daily diet. However, hormonal or liver support supplements can be quite strong and should not be taken without supervision or prior testing.
If you would like to talk to us about testing, call us on 01 4020777 or book online now.