dutch

Question 1

What ages is the dutch test made for? females and males.

Answer 1

females: 20 years +
Males: 18 +

Question 2

do andogrens decline or increase with age

Answer 2

decrease

Question 3

Progesterone metabolite that modulates gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS) and can lead to improvements in mood
and sleep.

Answer 3

a-pregnanediol

Question 4

Most prominent progesterone metabolite, however, doesn’t modulate GABA receptors.

Answer 4

b-pregnanediol

Question 5

moderate strength estrogen

Answer 5

estrone E1

Question 6

most potent, biologically active estrogen

Answer 6

estradiol E2

Question 7

least potent, weak estrogen derived from estradiol and 16-OH-E1

Answer 7

Estradiol (E3)/16-OH-E2

Question 8

Phase 1 estrone (E1) metabolite; 2-OH metabolites are the most stable phase 1 metabolites.

Answer 8

2-Hydroxy-Estone (2-OH-E1)

Question 9

phase 1 estradiol (E2) metabolite; 2-OH metabolites are the most stable phase 1 metabolites.

Answer 9

2-Hydroxy-Estradiol (2-OH-E2)

Question 10

Phase 1 estrone (E1) metabolite; 4-OH metabolites are the most carcinogenic phase 1 metabolites.

Answer 10

4-Hydroxy-Estone (4-OH-E1)

Question 11

Phase 1 estradiol (E2) metabolite; 4-OH metabolites are the most carcinogenic phase 1 metabolites.

Answer 11

4-Hydroxy-Estradiol (4-OH-E2)

Question 12

Phase 1 estrone (E1) metabolite; proliferative estrogen that may contribute to breast tenderness and heavy bleeding, etc.

Answer 12

16-Hydroxy-Estone (16-OH-E1)

Question 13

Phase 2 metabolite that is much more stable than its precursor 2-OH-E1.

Answer 13

2-Methoxy-E1 (also known as 2-Me-E1)

Question 14

Represents the sum of all estrogen markers.

Answer 14

total estrogen

Question 15

sulfated and circulating form of DHEA

Answer 15

DHEA-S

Question 16

Alpha DHEA metabolite that is roughly seven times weaker than testosterone; can be used to estimate androgen activity in the tissues.

Answer 16

aldosterone

Question 17

weak beta DHEA metabolite

Answer 17

Etiocholanolone

Question 18

major circulating androgen

Answer 18

testosterone

Question 19

Alpha metabolite of testosterone and the most potent androgen; roughly three to four times more androgenic than testosterone.

Answer 19

5a-DHT

Question 20

The best marker of 5a-DHT formation and activity in the tissues; can be used to estimate androgen activity in the tissues.

Answer 20

5a-Androstanediol

Question 21

Weak beta androgen metabolite of testosterone that does not contribute to symptoms of androgen excess.

Answer 21

5b-Androstanediol

Question 22

Not an androgenic hormone but produced in approximately the same amount as testosterone by the testes. Can be used to distinguish a truly low testosterone from a falsely low measurement due to the UGT genetic variant, see “UGT Deletion” on page 23 for more information.

Answer 22

Epi-testosterone

Question 23

A compound that is produced from the metabolism of creatine from the kidneys and excreted in the urine. In order to provide the most accurate results, the DUTCH Test uses creatinine excretion to control for hydration status.

Answer 23

creatinine

Question 24

Daily diurnal (circadian) rhythm of active cortisol that is normally highest in the morning and lowest at night.

Answer 24

free cortisol diurnal pattern

Question 25

An HPA axis resiliency marker, an anticipatory marker of upcoming daily events, and a surrogate marker for HPA axis plasticity/reactivity.

Answer 25

Cortisol Awakening Response (CAR)

Question 26

Alpha cortisol metabolite.

Answer 26

a-Tetrahydrocortisol (a-THF)

Question 27

Beta cortisol metabolite.

Answer 27

b-Tetrahydrocortisol (b-THF)

Question 28

Beta cortisone metabolite.

Answer 28

b-Tetrahydrocortisone (b-THE)

Question 29

Sum of all cortisol and cortisone metabolites.

Answer 29

Metabolized Cortisol (THE + THF)

Question 30

Metabolic byproduct of the citric acid cycle that elevates with vitamin B12 deficiency.

Answer 30

Methylmalonate (MMA)

Question 31

Metabolic byproduct of tryptophan metabolism that elevates with vitamin B6 deficiency.

Answer 31

Xanthurenate

Question 32

Metabolic byproduct of tryptophan metabolism that elevates with vitamin B6 deficiency and inflammation.

Answer 32

Kynurenate

Question 33

An intermediate in glutathione recycling and production that elevates with glutathione deficiency.

Answer 33

Pyroglutamate

Question 34

Marker associated with biotin deficiency.

Answer 34

b-Hydroxyisovalerate

Question 35

Metabolic byproduct of tryptophan metabolism in the gut that elevates with intestinal dysbiosis.

Answer 35

indican

Question 36

Primary dopamine metabolite.

Answer 36

Homovanillate (HVA)

Question 37

Primary norepinephrine and epinephrine metabolite.

Answer 37

Vanilmandelate (VMA)

Question 38

Metabolic byproduct of tryptophan metabolism and neurotoxin that elevates with neuroinflammation and general inflammation.

Answer 38

Quinolinate

Question 39

Marker associated with oxidative stress and DNA damage.

Answer 39

8-Hydroxy-2-Deoxyguanosine (8-OHdG)

Question 40

steroid medications can suppress what activity?

Answer 40

HPA-axis *thus can affect adrenals for 4-12 weeks while they're recovering. *steroid meds can affect androgen levels such as DHEA and testosterone

Question 41

Cycling females may consider collecting in their midluteal phase, between days ___ and ___ of a 28-day cycle, If the cycle is different than 28 days in length, simply subtract ___-___ from the cycle length. For example: collect on days 17-20 for a 26-day cycle. If there are irregular cycles, consider collecting 5-7 days after ovulation. Ovulation can be determined by following BBT and with an OPK, see Figure 1.11 as well as “Basal Body Temperature (BBT)” and “Ovulation Predictor Kits (OPKs)” below, to learn how to use BBT and OPKs. It may be helpful to collect in the luteal phase to understand if ovulation has occurred, if the corpus luteum is making adequate progesterone, and if estrogen is well balanced with progesterone.

Answer 41

19 and 22 , 6-9

Question 42

Preovulatory BBTs range from about ___-___ degrees Fahrenheit. After ovulation, BBT rises to about 97.8 degrees or higher. This is because after a female ovulates, the follicle that released the egg turns into the corpus ____ and begins making progesterone. Progesterone is thermogenic meaning it increases body temperature.

Answer 42

97.0 to 97.7 , luteum

Question 43

which pathway is carcinogenic for estrogen

Answer 43

4-OH-estrogen

Question 44

studies, which have found that ___-___ mg of oral or 45-90 mg of vaginal progesterone, nightly, protects the endometrium.

Answer 44

100-200

Question 45

The alpha androgen metabolites (5a-DHT, 5a-androstanediol and androsterone) best reflect androgen activity at the _____ level, whereas the beta androgen metabolites (5b-androstanediol and ______) have little to no androgen activity

Answer 45

tissue, etiocholanolone

Question 46

If excessive testosterone replacement therapy (TRT) is used, symptoms of androgen excess (facial hair growth, body hair growth, scalp hair ____, acne, mood changes, etc.) will often manifest.

Answer 46

loss,

Question 47

What are the 5 androgens

Answer 47

1- 5a-DHT 2- 5a-androstanediol 3- andosterone 4- etiochalone 5- testosterone

Question 48

what are the 5 estrogens

Answer 48

estrone, estradiol, phase 1 estrogen metabolites, and 2-methoxy-E1

Question 49

DHEA-S may be increased by: Spironolactone, dexamethasone, ___ _____St. John’s Wort, forskolin. DHEA-S may be decreased by: Low cysteine, _____ LPS, ketoconazole, progestin, _____

Answer 49

bile acid, inflammation,licorice.

Question 50

5a-Reductase is best known because it makes androgens like _____ more potent. It is also responsible for metabolizing progesterone and cortisol. If up- regulated, it may cause high _____ symptoms in men (thinning hair, prostate) and women (as in PCOS, thinning hair, acne, facial hair growth). 5b-Metabolites are less androgenic (weaker).

Answer 50

testosterone . androgen

Question 51

5a may be increased by: Insulin resistance, obesity, ____ supplementation, PCOS. 5a may be decreased by: Saw palmetto and beta-sitosterol, reishi, ___ root, pygeum africanum, polyunsaturated fats (PUFAs), and EGCG. 5b may be increased by: Insulin resistance, ____ , PCOS. 5b may be decreased by: .

Answer 51

DHEA, nettle high triglyceride, Licorice

Question 52

Cortisol is metabolized by 5a/5b-reductase (and 3a-HSD) to a/b-THF & THE for excretion. Metabolism may be increased in obesity, high ____ and hyperthyroid. It may be slowed in cases of hypothyroidism, _____, cholestasis, or poor liver function.

Answer 52

insulin. anorexia,

Question 53

DHEA converts to DHEA-S with hydroxysteroid sulfotransferase while DHEA-S converts to DHEA with steroid sulfatase; these interconvert in different locations within the body. DHEA-S may be increased by: Spironolactone, dexamethasone, bile acid, ___ ___ ____, forskolin. DHEA-S may be decreased by: Low cysteine, inflammation, LPS, ketoconazole, ____ licorice.

Answer 53

St. John’s Wort, progestin,

Question 54

CYP-1b1 May be increased by: ______, smoking, PAHs. May be decreased by: Flavonoids, resveratrol.

Answer 54

Inflammation,

Question 55

May be increased by: Cruciferous vegetables, DIM/IC3, ______,____ fish oil, rosemary extract, thyroxine, flaxseed. May be decreased by: High sugar diet, moderate alcohol consumption, ______, pterostilbene.

Answer 55

caffeine, soy resveratrol

Question 56

Day one of the menstrual cycle (and day one of the follicular phase) is marked by the onset of menses. During the follicular phase, follicle stimulating hormone (FSH) stimulates multiple follicles to grow within the _____. While this is happening, _____ ______ stimulates ovarian theca cells to make androgens and FSH stimulates the aromatase enzyme to convert these androgens to estrogens in the ovarian granulosa cells. A single, dominant follicle is selected around cycle days ___-____ This selected follicle will go on to release an egg later in the cycle. The other follicles that were not selected degenerate.

Answer 56

ovary. luteinizing hormone (LH) 5-7.

Question 57

The follicular phase is followed by the ovulatory phase. During the ovulatory phase, surging estradiol released by the dominant follicle signals the pituitary to release a large amount of LH. About ____-____ hours after LH peaks, ovulation occurs, and an egg is released from the follicle. The remaining part of the follicle becomes the corpus _____ a temporary endocrine structure that produces progesterone through the end of the menstrual cycle. If pregnancy occurs, the corpus luteum will continue to make progesterone until the placenta takes over at the end of the 1st trimester. If there is no pregnancy, then _____ and _____ levels decrease, triggering menstrual bleeding and starting the next cycle.

Answer 57

10-12. luteum, estradiol and progesterone

Question 58

what builds the endometrium for possible pregnancy

Answer 58

estradiol (E2)

Question 59

which is beneficial for bone health, insulin sensitivity, healthy weight-management, neurotransmitter balance, sleep, mood, concentration, memory, hair, skin, vaginal pH, vaginal lubrication, and cardiovascular health.

Answer 59

estradiol (E2)