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Mar 8, 2016

The Underlying Foundation And The Practical Application Of The Dutch (Dried Urine Test For Comprehensive Hormones) Test With Mark Newman

by Dr. Dan Kalish

Mark Newman discusses below the importance of the DUTCH test with Dr. Kalish: “When you look at urine testing, you’re missing that cortisol pattern but getting all these great metabolites. We wanted to create a test where we could look at all that in one test. It ended up being a nice easy collection. We just did a study ourselves where we looked at 3 salivary points over a 2-hour period. We empty our bladder and at the end of that 2-hour period, we’re collecting. We’re looking at the 3 saliva tests as an average or a sum. It’s 3 saliva tests versus one urine sample, so nice correlation in terms of giving you the same information on free cortisol. We’re going to add to it, and that’s where this becomes unique is that you get more information. When we take a weighted average of those 4 samples, we get 24 hour correlations for all this other stuff, most of which you can’t measure in saliva. That’s the real benefit, a good correlation between what we’re doing and a traditional 24-hour urine. There are 3 huge benefits. The most important is that it’s more comprehensive for cortisol. Saliva testing gives you the cortisol pattern, but it doesn’t give you a good marker for production. 24-hour urine gives you better cortisol production. Serum testing is not without its use but it’s not great for cortisol. The point of developing this was to give something that gives you all this information in one test. We already established that the pattern of free cortisol is the same in both. When I look at the patient like this, my pattern is a little bit different because I have a waking sample. Remember waking saliva is waking cortisol. Waking urine is a picture of what you’ve done while you’re sleeping, so this patient is low here. 2 hours later you collect the next sample, the range is up here because it should go up over those 2 hours, and this patient is low. We look at free cortisone, which basically is confirming what’s going on with that pattern, that’s the inactive form of cortisol. You look at this patient and you start talking about stage 3 adrenal fatigue because they don’t make any cortisol, but in this case we’re looking at free cortisol and its metabolites. This is where most of it ends up. The way I describe this is that the metabolites of cortisol are the bucket at the end of the day. The tetra-hydro cortisone doesn’t really do anything, but it reflects how much cortisol you’ve made. On this scale if I get a 100 on free cortisol, I’m high. These are the same units, I’m pushing 9000 here. The point is one, this represents a much larger fraction of the whole but in this case it’s a dichotomy. Here I’m low and I say you don’t make any cortisol, and here I say it’s all in the toilet. This person is hyper-cortisol in terms of their production, but you’re not going to know it unless you look at all this information. This is what led to this test, looking at a fat, stressed out patient whose free cortisol and saliva is low but then you ramp up their production and they don’t do very well.” KALISH COMMUNITY MEMBERS: To watch the complete interview Dr. Kalish and Mark Newman go HERE or to learn more about DUTCH testing visit their website. (http://dutchtest.com/)
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Dr. Dan Kalish

Dr. Dan Kalish

Founder of the Kalish Institute
Dan Kalish, DC, IFMCP, is founder of the Kalish Institute, an online practice implementation training program dedicated to building Integrative and Functional Medicine practices through clinical and business courses.