DUTCH Adrenal and Hormone Tests

I spent a whole day this week assessing the new DUTCH adrenal and hormone tests for us, so thought it might be useful for you if I put down my thoughts about them.

DUTCH stands for Dried Urine Test for Comprehensive Hormones and I’ve had them on the shop for quite a while for you – because you asked – but I always like to immerse myself in new tests to make sure we have the most up to date, valid and treatment-practical offering there for you. And so I can understand and help you with them, of course.

In actual fact, Victoria – our hormone guru – is ahead of me here and already has quite a bit of experience with these DUTCH tests. I’m rather glad about that because I simply hadn’t had time before today to look at them in depth. Besides, she will be the one I refer you to to go through the results – I’m not daft!

Anyway, my thoughts in case they are useful..this was the question I was really trying to answer for us:

If you want to test your adrenals or hormones, is it now better to use the DUTCH tests?

Well, yes and no.

In short, I think there is real value in the extra adrenal info you get (more of why below), but the hormone elements included in the DUTCH Complete, Sex & Metabolites and Cycle Mapping are pretty comparable to the ones we already do with Genova: the Complete Hormones and Rhythm respectively.

However, the DUTCH is much cheaper (when they do the combination tests), is dried urine so a bit more convenient than collecting 24 hours’ worth of urine and has a lot more guidance for people who are on meds and supplements like HRT to test effectively, and for those with irregular cycles – the bane of my life with the Rhythm!

On the down side, the reports are really complicated and even scared me until I ‘got’ them. You are more likely to need interp guidance from Victoria.

To clarify, there are several DUTCH tests:

The DUTCH Adrenal – which gives you the free cortisol in 4 measurements and total, the same as the Genova Adrenal Stress Test, but it also gives you the adrenal metabolites which can give you a much deeper picture if you need it.

DUTCH Sex & Metabolites – which gives you info on the sex hormones: oestrogen, progesterone and androgens (inc DHEAs and testosterone metabolites).

The DUTCH Complete – which gives you all of the adrenal and hormones as above. Sort of the new DUTCH Adrenal plus Genova’s Complete Hormones – much cheaper and the best all-round test for men and post menopause.

The DUTCH Cycle Mapping – this is the monthly cycle look at the hormones, much like the Genova Rhythm test we know and love.

The Dutch Complete with Cycle Mapping – all of the above! The most useful test in my view especially for women still having period cycles. And, of course, the most pricey – but far cheaper than the equivalent separate tests from Genova (which would be the Adrenal test, Complete Hormones and a Rhythm).

Phew. I am now going to be recommending the DUTCH Complete with or without Cycle Mapping because it gives you loads of the same and more info for less money than combined the Genova tests. And, I am recommending the DUTCH Adrenal test as a more complex look at those.


What’s the benefit of the adrenal metabolites?

The normal 4 sample saliva adrenal test is great at showing you the daily pattern of free cortisol – and you could only do that with saliva until DUTCH. Then, they discovered you could get comparable results from a dried urine sample too – although there hasn’t been anywhere near as much research to prove that and there has been a LOT of studies backing up the standard salivary test up to now, so both are probably valid.

The free cortisol and daily pattern gives you a good indication of what might be going wrong somewhere with your adrenals and, having done it for over a decade, I have found it very reliable. However, we have to acknowledge that free cortisol is a very small amount of what is actually available in the body so, in some cases, there might be something hidden going on.

In the DUTCH Adrenal, you also get the adrenal metabolites and an idea of inactive cortisone. Why is that important?

Well, say you had someone who looked on the normal adrenal test like their cortisol was low, you would think they had low production of cortisol. However, if you looked at the metabolised cortisol levels and they were high, that might suggest instead that their free cortisol – what’s measured in the normal adrenal test – was low but their overall total cortisol production was high. That could be important as someone might be actually making too much, or they might be not clearing it from the body well.

Of course the body doesn’t know the difference and high cortisol is high cortisol. High cortisol means inflammation, belly fat, stress etc.

Or, say someone was making a lot of the inactive cortisone. It might be that their free cortisol looks low but downstream their metabolites suggest the production looks OK in total. Then you see they are converting a lot of it to cortisone so that person is making enough cortisol itself but needs to stop converting so much of it.

I told you it was complicated!

Anyway, the upshot is that I think the extra metabolites info you get on DUTCH could prove very useful. It seems to me from reading what other US based practitioners are doing (it’s not quite so used in the UK yet – our Victoria is getting really good at it and was an early-adopter of it, I am pleased to say ) that they are using it for when people don’t respond to the normal adrenal protocols to dig a bit deeper. I think that is right, although I can see the usefulness of getting the extra info at the start too.

So, conclusion overall is that I will continue to offer the usual Genova salivary adrenal test which I think can give you a good snapshot – and all the protocols I’ve used in-clinic successfully for over a decade are in the corresponding Adrenal Plan for you – but offer the DUTCH for those who want a deeper look either at the beginning or later on.

There is, of course, quite a large difference in price too: £82 versus £179 (the DUTCH has just come down happily from £199).

With the sex hormones though, I will swap to DUTCH as you get the same info for much less money. Reports aren’t quite as good or useful but as long as we can interpret them, that’s fine!

As such, I’ve updated the shop pages. See here for Adrenal Tests and here for Hormone Tests.

My head hurts – hormones always do that to me, in more ways than one since I had flat adrenals, insulin resistance and PCOS😉



Mental Health Guru Deborah Joins Us

DeborahColson-speaking  Phew, hot on the heels of Julie (clinical hypno), Victoria (nutrition: metabolic, gut and hormones) and Anne (nutrition: genetics), let me introduce you to Deborah (nutrition: mental health) who joins us now too on the clinical referral team. Oh, and there’s me – I keep leaving myself out! Micki (director, chronic disease, gluten and ACE disorders).

You can see everyone here so far on the Support page.

Anyway, back to the lovely Deborah..

Deborah and I met a few years ago when I attempted to do an MSc in Nutritional Therapy at Westminster, sadly before I was well enough. I had to be in London two days running every month and just couldn’t get up to do the second day, so had to give up. Never mind: I wrote the TGF stuff instead so it all turned out for the best – and  met Deborah and some other nutritiony friends to chat with, so it wasn’t all bad!

Nutrition for mental health 

I always thought that Patrick Holford’s work on nutrition for mental health was pretty on the ball and read everything he wrote voraciously. Then, he was involved, from memory, in setting up the Brain Bio Centre in London where I tended over the years to refer the more complex cases.

Deborah and I chatted over coffee one day in Westminster and I discovered she was one of the main therapists there so, ever since, I have given her name out specifically to people who need mental health, cognitive and child behavioural support.

Lately, I have been finding people with pyroluria and histamine issues, imbalanced neurotransmitters, magnesium deficiency, brain ‘allergies’ and the like causing anxiety, depression and mental health struggles quite a lot, which is a shame.

So, I sought Deborah out again and asked her to join the clinical referral team for this kind of specialist biochemical help. Happily, despite being yet another busy bee, she agreed:)

I think her biochemical approach dovetailed with Julie’s ‘working on the subconscious’ approach to anxiety and depression will be a really strong combo therapy. I often refer for both as the two tend to go in tandem.

Deborah Colson, Functional Medicine, Brain, Neuro & Mental Health  You can see Deborah’s page on the shop here. She works best on phone, email and face to face in London. She really knows her stuff on this and cognitive, brain and neurological conditions and is a lovely, caring person too. She’ll help, I’m sure.

The clinical referral team is almost complete, I think, now! I’m just trying to find a homotoxicologist/complex remedies homeopath and a herbalist to join us now. I’ve a few feelers out, so working on it for us.

Meantime, welcome Deborah from all of us x

4 Steps to ‘Proper’ Genetic Testing

23andMe DNA Test KitOver the last year or so, I have studiously buried my head in the sand and avoided genetic testing like 23andme like the plague!

If anyone asked me for help, I sent them straight over to Anne Pemberton, the UK’s foremost Nutrigenomics practitioner (more on her joining our team below, oh yes..) and left them to it!

I did introduce proper gluten gene testing to the UK in 2011, I thank you, and do some thyroid, methylation and detox gene testing, but in general I have stayed clear of the kind of ‘overview tests’ like 23andme which gives such a lot of info I don’t have the expertise to pick through for you. Hence the need for Anne!

And, to be quite honest, I always wait and see what will happen with something when a ‘trend’ calms down. I am not an early-adopter of such things as I’ve seen too many ‘wonder’ tests, supplements, meds etc etc prove not to be so wonderful at all in the end.

I’ve learned to let things settle before I jump on the bandwagon! It loses me money as I could make a fortune servicing people’s requests, but I hope you know by now Purehealth is here for the long haul (17 years so far..) and I don’t jump on any bandwagons – unless I am creating or driving them like TrulyGlutenFree and now ACE Disorders!

Conflicting and confusing information

Anyway, as it stands today, I get asked about gene test results very often still. There is a lot of expertise about, but much of it is confusing and leading people down wrong treatment paths or causing unnecessary worry to my mind – so I feel the time is right to give a bit more guidance.

Genetic testing, it seems, is here to stay, so Christine, Victoria and I have pooled our knowledge and come up with the best way forward for people wanting to test properly.

To clarify: when I say ‘properly’ I mean knowing if the SNiPs that turn up are actually having any impact on a functional level (ie. on your actual health) and need to be considered in treatment or not. Most often, it is not or, more accurately, not maybe in the ways you might have thought from the obvious headlines in your results. Ooh controversial..!

Between us, we actually have quite a bit of knowledge on the team – well, Christine and Victoria do anyway😉 – so I am really pleased about that.

Welcome Anne Pemberton

That said, I’m pleased to say that our knowledge will be backed up by the much stronger expertise of Anne, who has agreed to join us on our clinical team. She couldn’t really not after I wailed , moaned and stamped my feet until she agreed…:)

OK, to start: here’s my 4 steps to proper gene testing for you then. I just made that up as I realised there are in fact 4 key steps in my new Purehealth Gene Tests factsheet:

Genetic Tests & What To Do With Your Gene Results

As you’ll see that guides you through

  • how to do a 23andme test
  • which online software service to run the results through
  • points you to good resources to start learning what they may mean and
  • recommends you talk to Anne on the team, or someone like her (she’s training people up as fast as she can, bless her!).

Here is Anne’s page on the shop, where you can book a free initial chat with her and take it forward if you need to.

Anne Pemberton, Functional Medicine and Genetics Anne Pemberton

My biggest piece of advice on gene testing, which comes from the zillions of ‘panicked’ or simply confused callers asking me what this or that genetic problem means and what to do about it – is that it is all in the interpretation.

The golden rule is:

If a gene is ‘expressing’, you have the problem but just seeing SNPs on a list does not mean you have an issue and should go off and treat it.

OK, I hope that all helps get you through the maze of SNP testing! And welcome to Anne from all of us. Maybe I’ll test my own now then and see what mine say, eek!


Nuts: Natural Anti-Inflammatories and Not Fattening!

I am always asked if it is ‘OK’ to eats nuts if you’re trying to lose weight because they are ‘fattening’. Er, yes it is and no they are not. In fact, the opposite is often found in studies, see here, for example:

Nuts Whole Hazelnuts

13 Healthy Reasons to Eat More Walnuts

Eat Almonds For Breakfast

Crumble rhubarb Français : Crumble à la rhubarbe The latter also includes my nutty crumble breakfast recipe, which I have happily started making again now I’ve got nuts back into my diet:)

Anyway, nuts generally help keep you fuller for longer, are nutrient-dense and help control blood sugar, so stop the ‘fat-hormone’ insulin from going too mad and sticking fat on your belly! For more on this, see my Belly Fat book.

So, today, I was also pleased to see a report on nuts being linked to lower inflammation levels:

Nuts are natural anti-inflammatories

People who eat nuts five or more times a week have lower markers of inflammation compared to people who never eat nuts—and inflammation levels dropped dramatically among people who substitute three servings a week of red meat, processed meat, eggs or refined grains for nuts.

Ok, so it’s not fabulous science but my clinical experience backs this up. The good fats and nutrients such as magnesium and B vits are probably the reason why – and also because if you substitute rubbish food with good food, of course your inflammation will come down.

I also recalled the other day that you can get a whopping 50mcg of the very important selenium from just one large brazil nut! Make sure any men are having a couple a day for prostate health at least and if your thyroid is not quite firing on all four cylinders, selenium is crucial. I am finding a lot of people are having hidden thyroid hormone conversion problems from simply a lack of the selenium required in that pathway. Similarly with iodine, but I digress. See the Thyroid Problems factsheet for more on that

Anyway, the upshot is: get some nuts! as the advert says – your insulin, cravings, glands and inflammation will thank you!


What Is an ACE Disorder? Is Your Chronic Illness The Result of a High ACE Score?

Brain iconHas your childhood – or adult experience even – subconsciously triggered your chronic illness, or could deeply-buried beliefs you built then be stopping you from getting well now, maybe? I was asked this question many times over the past few years.

I thought it was a crock, quite honestly.

But then I had no choice in the end but to look at my chronic fatigue, multiple food and chemical sensitivity from a brain, emotional and trauma point of view. And found the answer or at least most of it!

So, when I am talking to you all on emails and the Support Calls etc, nowadays I make a point of asking if there was any so-called ‘trauma’ in your childhood or as an adult before the onset of your illness. It is stunning me actually how many times the answer is yes.

Trauma means different things and everyone has some!

Ok, let’s get this out there right now: ‘Trauma’ does not just mean the severe abuse and violence stuff, although sadly, there seems to be a lot of that about, but other forms of trauma also count such as not feeling loved or wanted, feeling unsafe or alone, humiliated or bullied, put down, ignored, neglected physically or emotionally, and more besides. If it felt traumatic to you, then it was traumatic.

And, yes, everyone has some trauma at some point; that’s life. The point though is when and how did it occur and were you in a position to build resilience against it? Many do, of course, but it seems to me that a lot of the chronic illness cases I am dealing with nowadays did not.

ACE triggers physical brain change, a lowered lifespan and the autoimmune disease risk is HUGE!

The plain fact is that if a vulnerable person (such as a child under 10 or a low-self-esteem adult) suffers regular events that are traumatic to them, the brain undergoes actual epigenetic changes which then make us much more susceptible to stresses. The whole stress and hormonal cascade drip, drip, drips over time to create a chronic inflammatory state – and BANG – illnesses start in later life – late 30s/40s onwards, most often.

Most experts believe all illnesses are inflammatory to some extent so it is no wonder that a person with a high ACE score has a likelihood of living 20 years less than someone who doesn’t! And get this one: a person with 2 or more ACEs has an average 75% increased chance of developing some form of autoimmune disease.

That is a huge and stunningly important statistic given the ‘epidemic’ we are currently experiencing in autoimmune disease.

Have you got a high ACE score?

If you have a chronic health disorder, especially one relating to fear (ie. phobias), loss of safety (eg. agoraphobia), reactivity (multiple sensitivity, light, noise etc), pain (especially fibromylagia types), anxiety, depression, fatigue, cardiovascular or autoimmunity, please don’t do what I did for 3 years and ignore this aspect of illness because you’re convinced your problem is entirely physical.

It IS physical – blimey, I’ve felt the pain, trust me! – it IS a measureable brain and hormonal change issue, it IS hypersensitivity in many different ways and it IS solvable!

Basically, your pain, sensitivity, stress and inflammation switches are turned on too high and we need to turn them down again. The rest of your symptoms are most likely down to the consequences of those eg. adrenals and thyroid out due to hormone changes and autoimmunity, pain due to inflammation and reaction to things, nutrient deficiency as you need so much because of a constant inflamed state – that means fatigue and nothing much working very well.

You see how it all fits together?

Anyway, when I’ve been trying to chat to people about whether they may have an ACE disorder or trauma-triggered illness – and they have been looking at me gone-out! – I have found it hard to explain it. Effectively, you need to identify if there is an ACE disorder likely and work on that to turn yourself down and change your brain – literally – as well as work on the symptomatic consequences of it. That’s tough to get across, trust me!

So, I have written a new factsheet on ACE for you so I can at least say ‘read this!’. I’ve included resources such as the ACE questionnaire so you can find out your own ACE score, plus videos, ebooks and articles for you to watch and read to start turning your illness around as part of the ‘knowledge therapy’ you need to do for this type of illness.

My next job is to add my own healing plan to it so that you can see precisely what I did to get from chronic fatigue, fibromyalgia and multiple food and chemical sensitivity to chocolate, eggs, wine and spuds again!

Don’t dismiss it for ages like I did – do the questionnaire and see what your score is.

Go here to read the new ACE Factsheet. I truly hope it helps.


Parasites Trigger Histamine Reactions

A good reminder for us today from Yasmina not to forget parasites as a cause of an over-enthusiastic allergy or immune response:


“Pretty much any invader can cause this mast cell activation…

There are many causes of a high overall IgE level, but parasite infection is definitely one of them.

Good point.

In fact, just recently, I seem to be finding more parasites and ‘invaders’ of all types on your gut and virus screens. Parasites are tricky little beggars to find; they hide and we have to do three day stool samples just to have a shot at seeing them in the gut.

They do crop up though, especially helicobacter pylori, which people think of mainly as the ‘ulcer’ and acid reflux baddie, but I am finding it quite a bit, even in people with no gastric symptoms. I wonder if this may be more prevalent than we think and not helping the mast cell/allergy situation in some people? Maybe getting rid of those ‘invaders’ might help stop triggering the over-active immune response? Very likely.

I do have quite a few colleagues who swear that any health issues come down to infections of all types and certainly we are finding links between certain parasites, bacteria and viruses in specific autoimmune diseases more and more. Just this morning, I found a high LPS marker (signifying a probable endotoxin from a bacterial infection) as the likely cause of a leaky gut – on a Cyrex 2 test if you’re interested. Fascinating stuff.

Anyway, a good reminder as I say. However, one word of caution with treatment. Don’t just start taking a killing herb or whatever preferably without giving your liver some preparation otherwise often people can feel really quite poorly killing off stuff they didn’t have a clue was even there! Not always, but pretty commonly.

Often, when we see results on a test that show an ‘invader’ of some type, the lab suggests something that has killed it in vitro. We then say do the Candida Plan stage 1 for preparation, then adapt stage 2 using some of the suggested treatments in the ‘killing’ stage. Works a treat and is managed rather than willy-nilly, if you see what I mean.

Anyway, see gut tests inc H pylori here, viruses and -again seemingly becoming ubiquitous in chronic illness: Lyme disease tests here.