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Better Than Blood Tests for Estrogen and Testosterone Hormonal Imbalance

Hormonal Imbalance? The Best Hormone Tests.

The Right Hormone Test is Your Hormone Balance Roadmap. Here’s What to Know… Guest article by Maria Claps, natural hormone balance expert.

Hormone testing options have flooded the market. Consumers in most US states can order their own hormone tests from direct to consumer labs, startups like EverlyWell and heck, even Amazon offers lab tests. But which test do you order? With so many options, it can be downright confusing and expensive (especially if you order the wrong test) when choosing a hormone test.

This article is for women and men who want to have a basic understanding of the different types of hormone tests available to them and how testing their hormones can lead to greater understanding of longevity, wellness and sexual satisfaction.

In this article, you will learn:

  • Why hormone testing matters to your overall health
  • The difference between saliva and urine testing for hormones
  • The hormone that balances estrogen for women
  • The hormone that balances estrogen for men
  • The importance of the different types of estrogen you produce
  • How your thyroid health affects your adrenal health
  • Issues to consider if your hormone therapy is not working

Why test hormones anyway though?

Hormones are chemical compounds in the blood that are so concentrated, they’re measured on the level of a few parts per trillion. Yet they are tremendously powerful in coordinating the actions of our organs and glands – and affecting our quality of life! Hormone imbalance can affect EVERY OTHER BODY SYSTEM and your specific lifestyle choices play a huge role in this outcome.

estrogen and testosterone
While it is possible to test hormones in blood or saliva and derive some useful data, these methods have drawbacks that limit their usefulness.

Dried urine testing is the newest methodology on the market and it’s a winner for women and men who want a clearer picture of their hormones, and more importantly, how their hormones are behaving in the body. The DUTCH test (by Precision Analytical Lab) is the test I use to help women and men connect their symptoms to their hormones and take control of their health. DUTCH  is an acronym that stands for “dried urine total complete hormones.”


Reason 1: It gives you a comprehensive look at cortisol production by your adrenal glands. Adrenal fatigue is a  term that is carelessly bandied around by anyone who has any fatigue related symptoms or has done a saliva test which came back with low cortisol. Saliva adrenal testing only measures the free fraction of cortisol, which is around 1% of your production. The DUTCH test will measure both free and total (also called metabolized) cortisol for a better look at overall production. Metabolized cortisol comprises 80% of your total production and is a more accurate way of determining adrenal gland health. For more information on this, see Maria Clap’s blog post

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Reason 2: The DUTCH test is easier to do than a saliva panel. Working up a tube full of spit can be a challenge, especially if you are over 50. With the DUTCH test, you just urinate on filter paper.

Reason 3: It is only slightly more expensive than a saliva test. A leading lab charges $219 for their salivary adrenal and sex hormone panel. When you work with a DUTCH-literate practitioner, you will likely pay about $250 for your hormone test.

Watch Susan’s Video Series All About Hormone Replacement, Including Natural Testosterone Production.

hormone replacement therapy videos
Reason 4: The DUTCH test can uncover a hidden thyroid problem. The DUTCH test is not a thyroid test but if you are hypothyroid, your adrenal function will be slowed down and you will accumulate a lot of free cortisol because the body can’t clear it quickly enough. A slow thyroid slows down everything and we can see this in your adrenals on the DUTCH test.

Reason 5: It tells you how you are processing your estrogen. Are you on estrogen therapy? If  you only test via blood (the choice of most physicians), you won’t see what your body is doing with that supplemental estrogen. 70% of your estrogen should be the protective estrogen (which is called 2-OH). The DUTCH test will show you exactly how much of this you make. Even if you aren’t on estrogen, depending on your age, you still may have plenty of your own estrogen and you still need to know how your body processes it.

Reason 6: The DUTCH test shows how much harmful estrogen you make. There are two types of estrogen which are measured on the DUTCH test (4-OH and 16-OH) that are proliferative and potentially cancer causing. We still need some of this estrogen, but not too much. The DUTCH test will show you precisely how much ‘bad’ estrogen you make.

Reason 7: The DUTCH test tells you how well you are methylating your estrogen. Methylation of estrogen is a step in the process of how our body processes estrogen. It is a protective step that takes place in the liver, making this test an indirect measurement of liver health as well. Many people fall a little short in this area….it seems that our methylation is collectively lacking. Perhaps this is reflective of the toxic environment that living in the 21st century presents us with.

Reason 8: The DUTCH test tells you what type of testosterone you make. Testosterone can break down into 5a-DHT or 5b-DHT. 5a-DHT is more “androgenic” form of testosterone and is responsible for things like acne, thinning head hair and excess body hair. If you have this, there are specific things that can be done to reduce this type of testosterone, but you need to test in urine, such as the DUTCH test because salivary testing will not give you this data.

Reason 9: The DUTCH test can tell you if you are estrogen dominant. Estrogen dominance is one of the most damaging and rampant hormone imbalances that we face today. Although estrogen dominance is more common in our premenopausal years, it can happen even to post menopausal women and men too.  Symptoms of estrogen dominance include PMS, migraines, heavy periods, low libido, weight gain and moodiness. For men, estrogen dominance can present as man boobs and inability to get or maintain an erection.

Estrogen dominance can sound a little misleading because it implies that you have too much estrogen. This is usually the case, but not always. You can actually be low in estrogen and estrogen dominant which means that you have low estrogen and even lower progesterone.  For women, their estrogen is balanced by progesterone. For men, their estrogen is balanced by testosterone. The DUTCH test will show this crucial info. These values are important in recovering from hormone imbalance.

estrogen hornome level
Reason 10: You’re on hormone therapy but not seeing the benefits. The DUTCH test is great for all women and men who want to truly lean into their wellness instead of just relying on someone to tell them what to do. Too often, I have clients come to me who are on hormones and are still struggling. Their doctor uses blood labs to help guide dosing of supplemental hormones yet they are still suffering. When someone is on hormones and not deriving benefit, I often find that they are not doing the other things which are critical to ensuring that their hormone therapy lands correctly in the body. Those other things include a fastidious level of nutrition, a B-complex vitamin, stress management, appropriate exercise, adrenal support,  detoxification and connection with nature. When you work with a DUTCH-literate practitioner, you will see what your body is doing with your hormones (your own and any you take) and you will likely also be working on the aforementioned items that make your hormone therapy work better.

Now that you know about hormone testing, what can you do?

Science has advanced, you realize this now. That saliva test that you might have been considering is not an option for you anymore. Blood testing is better than saliva testing, but it too has its limits and you want the best test there is. You want a DUTCH test.

In most states, consumers can order a DUTCH test directly from the lab, but I don’t recommend this because you won’t have the support you need. The test is complex and unless you have a comprehensive understanding of hormone physiology, you’ll be left struggling to understand the generic lab comments that come with the test and implement necessary changes. It is best to work directly with someone who can help you interpret the test, choose the right supplements and implement lifestyle changes based on your unique symptoms, health goals and lab findings.

Download Maria’s 1-page hormone cheat sheet to understanding the pros and cons of all 

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Watch Susan’s Video Series All About Hormone Replacement, Including Natural Testosterone Production.

Maria Claps
Maria Claps is a certified health coach, Functional Diagnostic Nutrition practitioner and natural hormone balance expert.

After receiving inadequate healthcare that did nothing to address her perimenopause problems, Maria enrolled in the Institute for Integrative Nutrition (IIN) in order to help herself. After that, Maria pursued several hormone-centric trainings including Dr. Sara Gottfried’s practitioner hormone training program, the Functional Diagnostic Nutrition program and training with hormone scholar and scientist Dr. Lindsey Berkson.

Maria helps women all over the world with DUTCH testing, gut health improvement and lifestyle coaching.

When she’s not facilitating her online community, Maria continues to be found at farmer’s markets or in the kitchen creating recipes.

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3 Responses

  1. You have explained “hormonal imbalances” so perfectly. I got a lot of information regarding to the Hormonal Imbalance

  2. It appears that men would benefit from the DUTCH test as well. However, this article and the link to Maria Claps only refers to women. How can I go about getting both the test and assistance in its interpretation?

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