Dried urine hormone panel (DUTCH Complete / DUTCH Adrenal / DUTCH Plus)

ND-recommended test reviewed: dried urine hormone panel (DUTCH-type).
Indications reviewed: Cushing's syndrome, adrenal insufficiency, hormone imbalance; no validated indication for this panel identified.
Not ordered. Rationale discussed: panel reference ranges and pattern are not validated against a recognized diagnosis. Ref: Endocrine Society; Cadegiani and Kater 2016.
Patient informed test available privately via ND. Patient given info page: https://labs.ajaxharwoodclinic.com/dried-urine-hormone-panel/patient
Revisit if: symptoms suggest a specific, testable condition (Cushing's features, adrenal insufficiency features, or a specific hormone deficiency) — order the targeted test instead.

Indicated when

None recorded.

Not indicated when

• —Any use as a diagnostic test for Cushing's syndrome, adrenal insufficiency, or 'adrenal fatigue': the panel is not among the guideline-recommended tests for any of these diagnoses [2, 3, 4]
• —Investigating fatigue, burnout, hormone 'balance,' or perimenopausal symptoms as a stand-alone diagnostic panel [5]

Why not

The panel reports multiple urinary cortisol and cortisone metabolites plus sex-hormone metabolites against reference ranges that have not been validated against any recognized adrenal or endocrine diagnosis, and it is not among the guideline-recommended first-line tests for Cushing's syndrome or adrenal insufficiency [2, 3]. Reporting many results at once can generate multiple borderline or out-of-range findings that prompt further testing, supplementation, or anxiety with no validated clinical pathway to act on them.

Better first step

If Cushing's syndrome or adrenal insufficiency is genuinely suspected, use the guideline-recommended tests instead: late-night salivary cortisol, 24-hour urine free cortisol, or a 1 mg dexamethasone suppression test for Cushing's; 8 AM cortisol plus corticotropin stimulation for adrenal insufficiency [2, 3]. If sex-hormone symptoms are the concern, order the standard, validated blood assay for the specific hormone in question.

Typical ND rationale

An ND may order a dried urine panel to get one comprehensive picture of cortisol pattern and sex-hormone metabolism at once, reasoning that it is more convenient than several separate tests and reports information — cortisol metabolites and hormone breakdown products — that standard blood tests don't provide; it is explicitly marketed as an alternative to standard blood hormone panels [1].

Ontario coverage & CONO orderability

OHIP status

unverified

This is a proprietary, branded send-out panel, not a line item in the 2026 OHIP Schedule of Benefits for Laboratory Services; it is sold and collected directly through naturopathic and specialty-lab channels rather than billed to OHIP. ND-ordered testing of this kind is patient-paid [6, 7, 1].

CONO orderable

Yes — CONO list #148, #151, #152, #153, #154, #155, #161, #163

Not listed as a panel. Its component analytes are on the CONO urine list (cortisol/cortisone 148, DHEAS 151, estradiol 152, estriol 153, estrogen 154, estrone 155, progesterone 161, testosterone 163), and Ontario ND clinics offer it [1]. CONO doesn't specify the dried-urine format.

Linked conditions

• "Adrenal fatigue" ↗
• menopause ↗

Counselling script

“This dried urine panel measures a lot of hormone breakdown products at once, but that pattern hasn't been validated against a real diagnosis, so I can't reliably interpret it or act on an abnormal result. Let's use the specific, well-studied blood tests that match what you're actually experiencing instead.”

Revisit if

• —Discriminating features of Cushing's syndrome appear
• —Features of adrenal insufficiency appear
• —A specific, targeted hormone deficiency is suspected

References

1. [1]naturopathtoronto.ca (2026). Lab Tests | Hormones | Thyroid | Food Allergies | Naturopath. linkExample of an Ontario ND clinic marketing the DUTCH test as an alternative to standard blood hormone panels
2. [2]Endocrine Society (2008). The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline. linkolder guidelineRecommended first-line tests for Cushing's syndrome do not include a dried urine metabolite panel
3. [3]Endocrine Society (2016). Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. linkRecommended tests for primary adrenal insufficiency do not include a dried urine metabolite panel
4. [4]BMC Endocrine Disorders (2016). Adrenal fatigue does not exist: a systematic review. linkolder guidelineNo urinary or salivary cortisol pattern reviewed in this systematic review was validated against fatigue or 'adrenal fatigue'
5. [5]Endocrine Society (patient education) (2026). Adrenal Fatigue. linkThere is no test that can detect 'adrenal fatigue,' the concern this panel is often ordered to investigate
6. [6]Government of Ontario (e-Laws) (2026). Health Insurance Act, R.R.O. 1990, Reg. 552: General, s. 22 (insured laboratory services). linkA lab test is insured only when ordered by a physician, midwife, or NP who has clinically assessed the patient
7. [7]Ontario Ministry of Health (2026). Ontario Health Insurance Plan: Schedule of Benefits for Laboratory Services (effective April 1, 2026). linkTests ordered by anyone other than an authorized provider, including NDs, are not insured services