DUTCH Plus
Updated over a week ago

Test Details

Lab Company: Precision Analytical
Sample Type: Urine and Saliva
Collection Location: At Home

The DUTCH Plus™ is a comprehensive test that assesses your sex and adrenal hormones and their metabolites. It also looks at your Cortisol Awakening Response (CAR). This test can help you and your healthcare provider understand how your hormones are functioning and how they may be impacting your overall health.

Key Details

  • You must avoid certain foods, beverages, and activities before and during the collection period.

  • If you are taking hormones or supplements, consult the information below and your healthcare provider to discuss collection timing.

  • If you are a cycling woman, you must collect the samples on specific days of your cycle.

  • Keep your saliva samples frozen until you ship them.

  • Ensure the urine samples are fully dried before shipping them back.

  • Samples should be shipped to the lab as soon as possible after sample collection.

  • You MUST send the completed test requisition form and waiver (NY & RI patients only) back to the lab with your samples. Failure to send these forms with your samples may result in a recollection.

Preparation & Timing

  • Some supplements may affect your organic acid results. Please consult your healthcare provider regarding collection preparation and timing if you take any of the following supplements:

    • Tyrosine

    • L-Dopa

    • D,L-Phenylalanine (DLPA)

    • Mucuna

    • Quercetin

  • DO NOT skip doses of birth control unless instructed by your healthcare provider.

  • DO NOT collect your sample while traveling for short periods of time.

  • If you are taking

    • Patch, Pellet, or Injectable Hormones: Collect your sample midway between doses.

    • Sublingual Hormones: Please review the video instructions HERE.

    • Oral Hydrocortisone: Please review the video instructions HERE.

    • Glucocorticoids: Check with your healthcare provider regarding when you should collect your samples.

  • Men and menopausal women can collect their samples at any time.

  • Cycling women should take the test according to the following schedule:

    • Irregular cycles: Watch THIS video to determine when to collect.

    • Regular cycles: Use the table below to determine when to collect your sample.

      • You should begin collecting your sample 6-9 days before your cycle ends.


72 hours prior to sample collection

  • Avoid taking the following oral hormones:

    • Estrogen

    • Pregnenolone

    • Testosterone


48 hours prior to sample collection

  • Avoid the following foods before sample collection.

    • Avocados

    • Bananas

    • Fava beans

  • Avoid taking oral DHEA.


Night before Collection Day

  • Avoid the following beverages.

    • Alcohol

    • Caffeine

  • Limit your fluid intake.

  • If you take oral progesterone, take it at bedtime.


Sample Collection Day

  • Limit your fluid intake.

    • Keep fluids to no more than 40 oz total (spread evenly throughout the day).

  • Avoid the following beverages.

    • Alcohol

    • Caffeine

  • Avoid the following activities.

    • Exercise

    • Flossing your teeth

  • DO NOT eat or drink until after collection 3.

  • DO NOT brush your teeth in the morning until after collection 3.

  • DO NOT brush your teeth in the evening until after collection 6.

Collection Instructions

Collection Schedule

Collect at your first waking sleep disturbance.

Collection Number

Sample Type

Collection
Time

Collection
Notes

1

Saliva

Immediately upon waking

MUST be completed within 5 minutes of waking.

1

Urine

Immediately upon waking

Set a timer for 30 minutes and 60 minutes.

2

Saliva

30 min after waking

-

3

Saliva

60 min after waking

You can now brush your teeth and eat.

4

Urine

2-3 hours after waking

-

5

Saliva

Before dinner
(~4 - 5 pm)

-

5

Urine

Before dinner
(~4 - 5 pm)

-

6

Saliva

At bedtime
(~10 pm - 12 am)

-

6

Urine

At bedtime
(~10 pm - 12 am)

You can now brush your teeth.

Overnight Sample

Saliva

Collect at your first waking sleep disturbance.

-

Saliva Collection

  1. Set the following items next to your bed the night prior to your collection.

    1. Saliva collection device

    2. Requisition form

    3. Pen

  2. Collect the first sample immediately upon waking, before getting out of bed.

  3. Remove the tube cap.

  4. Place the cotton swab from the collection device in your mouth.

    1. Touch the swab as little as possible with your hands.

  5. Leave the swab in your mouth until fully saturated.

    1. DO NOT leave it in longer than 5 minutes.

    2. Lightly chewing on the swab may help stimulate saliva flow.

  6. Once the swab is saturated, place the swab back into the same tube as you found it.

    1. DO NOT remove the inner tube.

    2. DO NOT spit into the tube.

  7. Complete all information on the tube label.

  8. Freeze the saliva sample until ready to ship.

  9. Set a timer for the second and third collections after you have completed the first.

  10. Move to a well-lit location after the first saliva collection.

  11. Repeat steps 3-8 for each collection.

Urine Collection

  1. Write the following information on the collection device.

    1. Your full name

    2. Date of collection

    3. Time of collection

    4. Day of your cycle (if applicable)

    5. Sample number (following the schedule above)

  2. Collect your urine by either:

    1. Urinating directly on the filter paper

    2. Collecting your urine in a clean cup

  3. If you collected your urine in a clean cup, dip the filter paper in the urine.

  4. Ensure the filter paper is fully saturated.

  5. Leave the collection device open to dry for at least 24 hours.

    1. DO NOT touch the filter paper with your fingers.

  6. Repeat steps 1-5 for each collection.

  7. Once dry, close and fold each collection device.

  8. COMPLETE THE TEST REQUISITION FORM.

    1. Instructions on how to fill out your requisition can be found HERE.

    2. If you live in New York or Rhode Island, please also complete the included waiver (instructions HERE).

    3. Failure to complete and send the test requisition form may result in a sample recollection.

  9. Place all devices in the resealable plastic bag.

Requisition & Payment

  • Your kit has been prepaid. You DO NOT need to pay anything extra.

  • Instructions on how to fill out your requisition can be found HERE.

    • Since you pre-paid for your tests, you do not need to fill in the payment information on any of these forms.

  • If you live in New York or Rhode Island, please also complete the included waiver (instructions HERE) and send it to the lab with your samples.

Shipping

  • Please ship your samples as soon as possible after collection.

    • If you have to wait to ship your samples, please keep the samples in the freezer until you are ready to ship.

  • To prepare your samples for shipping,

    • Once the urine collection devices are dry, close and fold each device.

    • Ensure all collection devices and tubes are clearly and properly labeled.

    • Place all sample collection devices into the resealable plastic bag.

    • Place the plastic bag into the test kit box.

    • Place the frozen saliva tubes into the test kit box.

    • Place the test kit box into the provided UPS envelope.

    • Place the completed requisition form into the provided UPS envelope.

    • Place the completed waiver (NY & RI patients only) into the provided UPS envelope.

    • Seal the envelope.

  • Make a note of the tracking number so that you can track your sample back to the lab.

Results

  • Results should be released to your provider 7-10 business days after samples are received at the lab. Rupa cannot guarantee processing time.

  • Your provider will notify you when your results are in and schedule a follow-up appointment for you to review them together.

More Resources

Questions?

For general questions, email Rupa Health at support@rupahealth.com. For test-specific questions, contact Precision Analytical by calling 1-503-687-2050 or chatting with support.

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