In ADDITION to your lab report we provide the following options which are INCLUDED in the package prices:

A) Follow up personalised written report produced by our clinical team highlighting dietary and lifestyle advice plus links to supplement protocols, specific doses and any further testing requirements included. We use the patient information you provide us at checkout along with your results to compile personalised action points for you.

OR

B) Follow up 30-minute video call to discuss your results and answer any questions you have. Once the lab has completed your results you will be sent these via email with a link to book a time and day online. You will also then be given the option to upgrade your 30-minute call to a 45-minute call for an additional £30 if you wish. During the call your practitioner will explain the results in more detail and what they mean for you. After your call you are sent a personalised list of supplements & the dose your practitioner advises with links to purchase from our supplements store. This is for your convenience. You are of course welcome to purchase supplements elsewhere. You will also be provided with a list of follow up tests should this be required plus a copy of your recorded zoom call which you can download and keep.

OR

C) Both Zoom call and written report with personalised next steps (Zoom call is first and written report follows).

Cortisol, cortisone and metabolites related to cortisol are tested by LC-MS/MS

DUTCH Adrenal can help identify the root causes of adrenal imbalances in both women and men. It gives more information than just testing the free cortisol patterns alone. While the free cortisol pattern in saliva has clinical value, there is a significant missing piece to surveying a patient's HPA-Axis function with saliva testing, the measurement of cortisol metabolites.

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• 24 hour free cortisol
• 24 hour free cortisone
• a-Tetrahydrocortisol (a-THF)
• b-Tetrahydrocortisone (b-THE)
• b-Tetrahyrodcortisol (b-THF)
• Cortisol (free) x 4
• Cortisone (free) x 4
• DHEA-S
• Metabolized cortisol (THF+THE)

This dried urine screen kit is posted to you within 48 hours from the UK so you should receive your test kit within a few days via DHL. You can then arrange DHL to collect your sample using the freepost returns. If you are ordering from outside the UK we will ship via DHL or Fedex with return labels.

When we receive your results back from Precision Analytical Laboratory in the USA (approx 2-3 weeks) we will email you your PDF report and provide support depending on which package you select at checkout.

A single cortisol blood test taken at the GP gives one snapshot of cortisol at one moment in time. Cortisol naturally rises and falls in a daily rhythm, so a single value cannot show whether that rhythm is intact, flattened, or out of phase. The DUTCH Adrenal Stress Test collects samples across a full day, which is what allows us to see the daily pattern. It also measures cortisol metabolites (the broken-down forms of cortisol that the body produces and excretes) alongside free cortisol. Free cortisol on its own represents only a small fraction of total cortisol production, so combining both gives a much more complete picture. This is why a comprehensive cortisol testing approach is the norm in functional medicine for adrenal and HPA axis investigation, rather than a one-off blood draw.

The HPA axis, short for hypothalamic-pituitary-adrenal axis, is the communication loop between three areas of your body that coordinate your stress response. The hypothalamus and pituitary in the brain signal to the adrenal glands (which sit on top of your kidneys) to release cortisol and DHEA when needed. When this loop is working well, cortisol rises sharply on waking, gives you the energy to start the day, then gradually falls towards evening to allow sleep. When it becomes dysfunctional, often through prolonged stress, illness, or disrupted sleep, the rhythm can become flattened, reversed, or out of step with daily life. This is when symptoms such as persistent tiredness, poor sleep, low mood, or stress sensitivity tend to appear. The DUTCH Adrenal Stress Test maps the daily cortisol pattern and the body's overall cortisol production, which together let us see whether your HPA axis is working with you or against you.

People typically come to us for the DUTCH Adrenal Stress Test when they recognise themselves in one or more of the following patterns:

• Persistent fatigue or low energy that does not improve with rest
• Difficulty getting going in the morning, or feeling "wired but tired" at night
• Poor or unrefreshing sleep, frequent waking, or trouble falling asleep
• Anxiety, low mood, or feeling unable to cope with everyday stress
• Long periods of demanding work, caregiving, illness, or grief
• Hormonal symptoms that have not been fully explained by other testing
• Wanting objective data on your daily cortisol pattern and adrenal function before deciding on next steps

The test results give context to these symptoms and help us, alongside you, plan the right kind of support.

Yes, and this is one of the key advantages of the DUTCH Adrenal Stress Test. Because it measures cortisol, cortisone, their metabolites and DHEA-S rather than sex hormones, the contraceptive pill and most forms of hormone replacement therapy do not interfere with the markers being tested.

The DUTCH Adrenal Stress Test focuses specifically on adrenal function and the daily cortisol rhythm. It measures cortisol, cortisone, their metabolites (a-THF, b-THF, b-THE, and total metabolised cortisol) and DHEA-S, and is a natural choice if your symptoms point primarily to stress, fatigue, sleep, or HPA axis issues.

The DUTCH Complete is a broader panel that also includes sex hormone metabolites and organic acids alongside the adrenal markers. Choose the Complete if you want a fuller picture of hormone balance in addition to adrenal function. For women on oral contraception or those without ovaries, the Adrenal Stress Test on its own is often the more appropriate option. If you're not sure which is right for you, our team can advise based on your symptoms and what you're hoping to learn.

Each sample type has trade-offs. A blood test gives only a single point-in-time reading and cannot show the daily cortisol rhythm. Saliva testing can show the rhythm but only measures the free, bioactive fraction of cortisol, which is roughly one to three per cent of what your body actually produces. Dried urine on filter paper combines a multi-sample daily-rhythm collection with the ability to measure cortisol metabolites alongside free cortisol, which together represent a much greater proportion of total cortisol output. The dried-paper format also keeps samples stable in transit, which is what makes a private adrenal profile practical to ship internationally.