How do I read the DUTCH™ cortisol curve?

The cortisol curve plots free cortisol at four points across the day. A healthy pattern peaks in the morning (highest within ~30–45 minutes of waking, the Cortisol Awakening Response) and tapers to its lowest at night. A flat, reversed, or low curve can reflect dysregulation of the HPA (stress) axis. The DUTCH™ report plots your values against population reference ranges so you and your practitioner can see the shape, not just single numbers.

What do the estrogen metabolites (2-OH, 4-OH, 16-OH) mean on a DUTCH™ report?

After estrogen does its job, the body breaks it down through three phase-I pathways: 2-OH (generally considered the more favourable route), 4-OH, and 16-OH. The DUTCH™ report shows how your estrogen is distributed across these pathways and how well it is then methylated (cleared), information a standard blood estrogen level cannot show.

What is the difference between free and metabolized cortisol?

Free cortisol is the active, unbound hormone available to your tissues and reflects your daily rhythm. Metabolized cortisol measures total cortisol production after the body has processed it. Looking at both together helps distinguish, for example, slow clearance from genuinely low output — a distinction the DUTCH™ test is designed to reveal.

Will someone help me interpret my DUTCH™ results?

Yes. Your report is reviewed in the context of your intake, and an independently contracted Functional Diagnostic Nutrition Practitioner (FDN-P) can walk you through the findings. The DUTCH™ report is educational and supports a practitioner relationship; it is not a diagnosis.

DUTCH™ Test Sample Report (Example) | See What Your Results Look Like

Every DUTCH™ test includes a comprehensive report analyzing 35+ hormones and metabolites. Below is a preview of what your results will look like. The actual report you receive will be personalized to your unique hormone profile.

⚠️ Illustrative example only. The values shown below are sample figures created to demonstrate the report format — they are not a real patient's results and are not medical advice.

Example DUTCH™ Complete hormone report — estrogen, progesterone, androgens and the daily free-cortisol pattern graphed against optimal ranges

DUTCH™ Test Results

Dried Urine Test for Comprehensive Hormones

Confidential Laboratory Results

Sample ID: DUTCH™-2025-XXXXX Date: January 2025

Sex Hormones

Your levels of estrogens, progesterone, and androgens compared to optimal reference ranges.

Estradiol (E2)

1.8 ng/mg

Estrone (E1)

6.2 ng/mg

Estriol (E3)

4.1 ng/mg

Progesterone (Pg)

42 ng/mg

Testosterone

18 ng/mg

DHEA-S

142 µg/g

Cortisol Pattern (Diurnal)

Your cortisol levels throughout the day compared to the expected healthy pattern.

High Mid Low

Waking +2 hrs Afternoon Evening

Waking 18.2 ng/mg Normal

+2 Hours 8.4 ng/mg Normal

Afternoon 3.2 ng/mg Normal

Evening 1.1 ng/mg Normal

Estrogen Metabolism Pathways

How your body processes and eliminates estrogen through the 2-OH, 4-OH, and 16-OH pathways.

2-OH Pathway Protective

62%

4-OH Pathway Monitor

18%

16-OH Pathway Normal

20%

Methylation Activity

2-Methoxy-E1: Normal - Your body is effectively methylating estrogen metabolites.

Additional Markers

Melatonin and other important metabolic markers.

Melatonin (6-OH-MS)

32 ng/mg Normal

8-OHdG (Oxidative Stress)

3.2 ng/mg Low (Good)

Report Summary

Cortisol Pattern

Healthy diurnal rhythm with appropriate morning peak and evening decline.

Progesterone

Below optimal range. Consider discussing with your healthcare provider.

Estrogen Metabolism

Favorable 2-OH pathway predominance with good methylation activity.

Understanding Your Report

DUTCH™ reports are comprehensive and can be complex. Here's what makes them valuable:

Metabolite pathways: See how your body processes hormones, not just levels
Cortisol patterns: Understand your stress response throughout the day
Estrogen metabolism: Identify which pathways dominate (important for breast health)
Actionable insights: Results that can guide targeted interventions

We highly recommend adding practitioner analysis to help interpret your results and create a personalized plan.

How to read your DUTCH™ report

Tap each section for a plain-language explanation of what it shows. Educational only — your practitioner interprets your results in full context.

The curve plots free cortisol at four points across the day. A healthy rhythm peaks in the morning — highest within ~30–45 minutes of waking (the Cortisol Awakening Response) — then tapers to its lowest at bedtime. A flat, reversed, or blunted curve can point to HPA-axis (stress-response) dysregulation. Because it's a pattern, a single blood draw can't capture it.

Estradiol, progesterone, testosterone, DHEA-S and related markers are each shown against a population reference range. The goal isn't a single "perfect" number — it's seeing where you sit relative to the optimal range and how your hormones relate to one another (for example, the progesterone-to-estrogen relationship).

After estrogen does its work, your body clears it through three phase-I routes — 2-OH (generally considered the more favourable pathway), 4-OH, and 16-OH — and then methylates them for elimination. The report shows how your estrogen is distributed across these pathways and how efficiently it's being cleared, which a standard blood estrogen level cannot reveal.

Free cortisol is the active hormone available to your tissues (it drives the daily rhythm). Metabolized cortisol reflects your total production after processing. Reading them together helps distinguish slow clearance from genuinely low output — a key strength of the DUTCH™ method.

An independently contracted Functional Diagnostic Nutrition Practitioner (FDN-P) reviews your report alongside your intake form and can walk you through the findings. The report supports a practitioner relationship — it is educational and is not a diagnosis. Meet our practitioners →

Reviewed by Madison Ordway, FDN-P · about our practitioner · Last reviewed June 2026

Sample DUTCH™ Report