DUTCH PLUS (US + Canada)


Sex Hormone Metabolites, Adrenal, Organic Acid Tests, Cortisol Awakening Response, Insomnia Cortisol


The DUTCH PLUS tests sex hormones and their metabolites, the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. This comprehensive test also includes Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.

Sample Female Test Report

Sample Male Test Report


  • Sex Hormone Metabolites (Progesterone, Androgen, Estrogen Metabolites)
  • Adrenal (Cortisol, Cortisone, Cortisol Metabolites, Creatinine, DHEA-S)
  • Cortisol Awakening Response (CAR)

Turnaround time for results is 5-10 days from when the test specimen is received.

All Orders Receive:

  • Test kit shipped directly to the address provided.
  • Step-by-step test collection instructions.
  • Email support from IOE Program within 24 hours to confirm shipping address.
  • Prepaid FedEx shipping label for the submission of a sample.
  • Written report that summarizes all test findings emailed to you as a PDF file.
  • The option to receive additional insight into these findings by Dr. Lawenda. **Requires additional purchase of a lab review. Not automatically included. 

**NEW YORK, RHODE ISLAND, AND MARYLAND RESIDENTS: Restrictions apply. If you are interested in this test, please reach out to us by emailing admin@ioeprogram.com before ordering.

**INTERNATIONAL ORDERS:  Restrictions apply. Please contact us to confirm availability by emailing admin@ioeprogram.com. Testing not available in all areas outside of U.S.**

Why Is This Test Important?

The DUTCH PLUS captures an extensive profile of sex and adrenal hormones and melatonin, along with their metabolites, to identify symptoms of hormonal imbalances. In addition, it adds salivary measurements of the Cortisol awakening response, which is another important piece of information about overall health. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test” and reveal a number of mental disorders too.

What can the DUTCH PLUS tell us that the DUTCH Complete cannot?

The DUTCH PLUS includes everything in the DUTCH Complete, plus it includes the Cortisol Awakening Response (CAR).

Even though a patient may have “normal” free cortisol levels throughout the day, that doesn’t always mean everything is functioning properly. A blunted or exaggerated Cortisol Awakening Response (CAR) can appear, even when single samples return “normal” results. The HPA axis might not be appropriately responding when faced with a stressor, even when cortisol levels are fluctuating nicely throughout the day. The “stress” of waking allows us to test the HPA axis in a way that has been independently correlated to clinical outcomes and cannot be assessed by other cortisol tests on the market.