Written by: Dr Terrie Van Alstyne, ND
The Dutch dried urine hormone test is a comprehensive test that measures the levels of hormones in the body including sex hormones, and adrenal hormones. It is used to evaluate hormone imbalances that may be causing symptoms such as:
Menopausal symptoms
Irregular periods
Infertility
Acne
Weight gain
Mood swings
Fatigue
Sleep problems
The Dutch dried urine test measures the levels of the following hormones:
Estradiol
Progesterone
Testosterone
DHEA
Cortisol
The results of the Dutch dried urine test can help your doctor to determine if you have a hormonal imbalance, if the estrogen metabolic pathways indicate a health risk and how to correct this through diet, lifestyle, supplementation and if indicated, bioidentical hormone therapy.
For example, if the estrogen metabolite 4-hydroxyestrone (cell proliferative form of estrogen) is high, this puts a woman at risk for breast cancer.
If the liver is congested and not functioning well and/ or if a woman is constipated, estrogen will not be metabolized, detoxified and eliminated properly causing a re-circulation of excess estrogen (estrogen dominance) in the body causing estrogenic symptoms.
Estrogen dominance Symptoms:
Physical Symptoms: PMS, breast tenderness, irregular or heavy periods, painful periods, ovarian cysts, headaches, fluid retention, fatigue, insomnia, hot flashes, night sweats, acne, oily skin, hair loss, increased risk of blood clots, and gallbladder disease.
Emotional Symptoms: Mood swings, irritability, anxiety, depression, difficulty concentrating, and memory problems.
Cognitive Symptoms: Brain fog, difficulty making decisions, poor judgment.
Other Potential Symptoms: Increased risk of breast and endometrial cancer, infertility, miscarriage, endometriosis, and uterine fibroids.
Other causes of excess estrogen:
Obesity
PCOS (Poly cystic ovary syndrome)
Endometriosis
Hormone therapy – birth control pill, estrogen therapy
Exposure to environmental estrogens such as those in plastics and pesticides (concentrated in non-organic meat and dairy and non-organic fruits and vegetables)
Beer (hops are estrogenic)
There are 3 phases of estrogen metabolism and all three must be working well for us to eliminate estrogen in a healthy way. They involve specific phytonutrients, specific supplements, specific vitamins, specific diet, healthy intestine, minerals and correct insulin function.
Factors affecting Phase 1 estrogen metabolism:
Genetics: Variations in CYP (cytochrome P-450) enzyme genes can influence the rate and extent of estrogen metabolism
Age: Estrogen metabolism tends to decrease with age
Diet: certain dietary factors, such as cruciferous vegetables and grapefruit juice, can induce CYP enzymes and increase estrogen metabolism
Smoking: Smoking can induce CYP enzymes and increase estrogen metabolism
Medications: Some medications, such as antibiotics and antifungals can inhibit CYP enzymes and decrease estrogen metabolism
Phase 1 estrogen metabolism plays a crucial role in:
Estrogen clearance: Metabolites are more easily excreted from the body, reducing the overall exposure to estrogen.
Estrogen detoxification: Metabolites are often less biologically active than the parent estrogen, reducing the risk of estrogen-related adverse effects.
Formation of reactive metabolites: Some Phase 1 metabolites, such as 4-OHE1and 16-OHE1, can undergo further metabolism to form reactive intermediates that may contribute to carcinogenesis (cancer).
Understanding Phase 1 estrogen metabolism is important for assessing estrogen exposure and risk of estrogen-related diseases including cancer.
Phase 2 Estrogen metabolism involves conjugation of polar bodies (e.g. methylation, glucuronidation, acetylation and sulfation) which neutralizes the phase 1 metabolites and prepares them to be excreted out of the body instead of shuttling them back into circulation.
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