Test Details
Lab Company: Precision Analytical
Sample Type: Urine and Saliva
Collection Location: At Home
The DUTCH Plus® measures a patient's sex hormones and metabolites, the diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites, to assess hormone health. The Insomnia Cortisol add-on analyzes cortisol's role in sleep disturbances.
Key Details
Avoid avocados, bananas, and fava beans 48 hours before collection.
Avoid alcohol, caffeine, large fluid intake, and exercise the night before collection and on the collection day.
Do not floss the day of collection.
Do not brush your teeth or consume morning food and drink until after collection 3.
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 (see below).
Freeze the saliva samples within 12 hours of collection. Keep them frozen until shipping.
Collect your Insomnia Cortisol add-on immediately at the time of your sleep disturbance.
Ensure the urine samples are fully dried before shipping them back.
Samples should be shipped back as soon as possible after collection.
Preparation & Timing
72 hours prior to collection
Do not take oral estrogen, testosterone, or pregnenolone.
Do not skip doses of birth control unless instructed by your healthcare provider.
48 hours prior to collection
Avoid avocados, bananas, and fava beans.
Do not take oral DHEA.
Night before collection
Avoid alcohol, caffeine, and large fluid intake.
Take any oral progesterone at bedtime.
Day of collection
Avoid alcohol, caffeine, and large fluid intake.
Avoid exercise.
Avoid morning food and drink until after collection 3.
After morning food and drink, keep fluids to no more than 40 oz total (spread evenly throughout the day).
Avoid food and drink for an hour before collections 5 and 6.
Do not brush your teeth until after collection 3 (morning) and collection 6 (evening).
Do not floss the day of collection.
The first sample should be collected before you get out of bed.
Other Medications
Consult your healthcare provider if you take any of these supplements: Tyrosine, L-Dopa, D,L-Phenylalanine (DLPA), Mucuna, and Quercetin.
Hormones taken at night should be taken after the bedtime sample.
Hormones taken in the morning should be taken after sample 4.
If you are using patches, pellets, or injections, collect samples midway between doses.
Hormone creams and gels can be taken as usual.
If you take glucocorticoids, check with your healthcare provider.
If you take oral hydrocortisone, see video instructions here.
If you take sublingual hormones, see video instructions here.
Cycling Women
Cycling women should take the test according to the following schedule.
For more information on the timing of your test, see the handout HERE.
Irregular cycles: Watch this video to determine when to collect.
Regular cycles: Use the table below to determine when to collect your sample. Begin collecting your sample 6-9 days before your cycle ends.
Length of your cycle (days) | Collect during these days of your cycle |
20 | 11-14 |
21 | 12-15 |
22 | 13-16 |
23 | 14-17 |
24 | 15-18 |
25 | 16-19 |
26 | 17-20 |
27 | 18-21 |
28 | 19-22 |
29 | 20-23 |
30 | 21-24 |
31 | 22-25 |
32 | 23-26 |
33 | 24-27 |
Collection Instructions
Collection Schedule
Collection 1 (Saliva, Urine): Upon waking
Collect saliva immediately upon waking.
Complete within 5 minutes of waking.
Set a timer for collections 2 and 3.
Collect the first urine sample.
Do NOT brush, floss, eat, or participate in vigorous activity.
Collection 2 (Saliva): 30 minutes after waking
Collect saliva only.
Do NOT brush, floss, eat, or participate in vigorous activity.
Collection 3 (Saliva): 60 minutes after waking
Collect saliva only.
You can now brush your teeth and eat.
Collection 4 (Urine): 2-3 hours after waking
Collect urine only.
Limit fluid intake for the rest of the day.
Collection 5 (Saliva, Urine): 4-5 pm (before your evening meal)
Avoid food and fluids for one hour before collecting samples.
Rinse your mouth with water 10 min before collecting saliva.
Collect saliva and urine.
Collection 6 (Saliva, Urine): 10 pm-12 am (or at your bedtime if prior to 10 pm)
Avoid food and fluids for one hour before collecting samples.
Rinse your mouth with water 10 min before collecting saliva.
Collect saliva and urine.
INSOMNIA OVERNIGHT CORTISOL ADD-ON: Collect saliva immediately at the time of your sleep disturbance.
Saliva Collection
Set the saliva collection device, requisition form, and pen next to your bed the night prior to your collection.
Collect the first sample immediately upon waking, before getting out of bed.
Remove the tube cap.
Place the cotton swab from the collection device in your mouth.
Touch the swab as little as possible with your hands.
Leave the swab in your mouth until fully saturated. Do not leave it in longer than 5 minutes.
Lightly chewing on the swab may help stimulate saliva flow.
Once the swab is saturated, place the swab back into the same tube as you found it.
Do not remove the inner tube.
Do not spit into the tube.
Complete all information on the tube label.
Freeze the saliva sample until ready to ship.
Set a timer for the second and third collections after you have completed the first.
Move to a well-lit location after the first saliva collection.
Repeat steps 3-8 for each collection.
Urine Collection
Complete all information on the collection device.
Saturate the filter paper completely by urinating directly on it OR by using a clean cup and dipping the filter paper for 5 seconds.
Leave the collection device open to dry for at least 24 hours.
Repeat steps 1-3 for each collection.
Once dry, close and fold each collection device.
Complete the test requisition form.
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.
Shipping
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 of the urine collection devices in the included resealable plastic bag.
Place the plastic bag containing the urine collection devices and the frozen saliva tubes in the test kit box.
Place the completed requisition form and the test kit box in the provided envelope to mail.
Affix the prepaid label to the envelope, if applicable.
Please ship ALL tests as soon as possible after completion.
If you have to wait to ship your samples, please place the plastic bag containing the samples in the freezer after they have dried.
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. We 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.
Your provider may choose to release your results to you. Rupa cannot release your results without provider authorization.
More Resources from Precision Analytical
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.