I have many patients that come into the clinic having found me while searching for “skin clinic Kingston” in google and pausing to reconsider their goals. Most of these patients have done it all – diet changes, topical treatment, antibiotics, etc. The list is long and they are left frustrated and confused. They are looking for a root cause treatment that will resolve their acne once and for all. The powerful tool that’s getting me and my patients answers? It’s the DUTCH test!


The DUTCH test stands for Dried Urine Test for Comprehensive Hormones and is the gold standard in hormone testing. It tests hormone production, adrenal function, melatonin production, oxidative stress markers and a full breakdown of hormone metabolites. As many of my patients have heard me say in clinic – “test, don’t guess!”


It’s important to realize the limitations of any test method before employing them and while blood and salivary testing are quick and convenient they too have their own limitations.
Serum (blood) testing: 
Pro: Can be used to assess both free and total hormones
Cons: Doesn’t provide an accurate reflection hormones at work in the tissues (we call these bioavailable hormones).
Salivary (spit) hormone testing: 
Pro: Assesses hormones (cortisol, DHEA, estrogen, progesterone and testosterone) available at the cellular level
Cons: Fails to give any information about how those hormones are processed and metabolized by the body.
Cortisol Production + Adrenal Health
The DUTCH test provides a comprehensive look at “stress hormone” production by the adrenal glands. The DUTCH test measures both free and total/metabolized cortisol. Looking at metabolized cortisol values gives us the most accurate, objective look at what’s going on with your adrenals.
Hormone Metabolites
As a Naturopathic skin clinic doctor, one of the most valuable measurements from the DUTCH test to me is an assessment of how estrogen is being processed and the ratio of protective (2-OH) and harmful estrogens (4-OH and 16-OH). This means we get a peak into not only how hormones are PRODUCED but how they are METABOLIZED and DETOXED from the body which is important when we are looking to treat one of your 5 organs of elimination (the skin)!
DUTCH also provides insights into testosterone is metabolism. When Testosterone is broken down it becomes either 5α-DHT or 5b-DHT. 5a-DHT is more “androgenic” form of testosterone and can cause: acne, thinning head hair and excess body hair. Blood testing doesn’t provide this levels of details which is why I used the DUTCH test.


  • Free cortisol
  • Free cortisone
  • Cortisol metabolites (stress hormones)
  • DHEA & DHEA Sulfate
  • Androgens such as etiocholanolone and androsterone
  • Melatonin (your sleep hormone)
  • Sex hormones: progesterone, estrogen, estrogen metabolites, testosterone, and 5α-DHT
  • Neurotransmitters: MMA, pyruvate acid, serotonin, norepinephrine, dopamine,, 8-OHdG
  • Nutrient markers: glutathione, Vitamin B6, Vitamin B12
Treating hormones isn’t just a matter of hormones being too low vs. too high. Together, we have to determine: Is there a production issue, a processing/metabolism issue and/or a detoxification/elimination issue? The DUTCH test gives me a complete picture of hormone production, metabolism and detoxification routes and helps direct treatment so you get full, lasting resolution of your skin concerns once and for all!
September 5th, 2019|Skin|