
DUTCH Plus™ with Insomnia
The DUTCH Plus™ takes hormone testing to a whole new level. In addition to sex hormones and their metabolites, the DUTCH Complete™ looks at the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. The DUTCH Plus™ adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA axis into focus.
Insomnia
When patients suffer from insomnia, the 5 salivary cortisol measurements on the DUTCH Plus may not be enough to assess cortisol’s potential role in the sleep disturbances. Salivary measurements typically begin when the patient wakes and rises in the morning. It would be very helpful to also provide cortisol levels in the middle of the night when the patient is struggling to sleep, why this test includes one extra salivary cortisol measurement, to bee taken if awakening in the middle of the night.
What is the Cortisol Awakening Response and how do we test for it?
When we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 30 minutes after waking, cortisol levels will still show this sharp increase. By 60 minutes after waking, cortisol levels have peaked and begin to decline. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range. A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.
A low or blunted Cortisol Awakening Response can be a result of an underactive HPA axis, excessive psychological burnout, seasonal affective disorder (SAD), sleep apnea or poor sleep in general, PTSD, chronic fatigue and/or chronic pain. A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases.
An elevated Cortisol Awakening Response can be a result of an over-reactive HPA axis, ongoing jobrelated stress (anticipatory stress for the day), glycemic dysregulation, pain (i.e. waking with painful joints or a migraine), and general depression (not SAD). A recent study* showed that neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) did. This measurement of the response to waking has independent clinical value showing dysfunction that may be hidden by current testing options.
Women
- Depression
- Fatigue
- Low libido
- Menopause
- Mood swings
- Premenstrual symptoms (PMS)
- Weight gain
Men
- Depression
- Fatigue
- Hair loss
- Increased prostate cancer risk
- Lower sex drive
- Sleeping troubles
- Weight gain
Use functional testing to set yourself on the right path
Your questions answered
Certain tests may ask you to remove certain foods from your diet for a short period, or discontinue some supplements before taking your sample. All details of any adjustments required can be found on the individual test pages under ‘Collection Instructions’. These will also be sent to you in full with your test kit.
If the test you are taking would be impacted by medication then this will be noted on the sample form when you receive the test kit. You would just need to state the medication you are taking, the dose and when you take it. Not all tests will require this information. You must not discontinue any medication without consulting your prescribing physician.
Yes, all tests include international shipping and return by courier in the stated price.
Yes, all tests can be shipped worldwide. You will be asked for your shipping details at checkout.
Please email us at info@lieblinghealth.com if you have any issues.