Functional Adrenal Testing
DUTCH Adrenal
DUTCH Adrenal
Panel
You have been told your cortisol is normal. But one morning blood draw cannot tell the full story. The DUTCH Adrenal test maps your cortisol rhythm across four time points throughout the day, revealing patterns of HPA axis dysfunction and adrenal imbalance that standard testing misses entirely.
Home Collection Kit
No Blood Draw
Four Time Points
Cortisol Rhythm
DHEA Assessment
Adrenal Fatigue Patterns
Telehealth Available
Book Your Functional Intake
What It Measures
About DUTCH Adrenal
Your stress response
Your stress response
leaves a pattern.
The DUTCH Adrenal is a focused dried urine test that measures cortisol and DHEA at four specific time points throughout the day. Unlike a standard morning cortisol blood draw, which captures a single moment, the DUTCH Adrenal maps your full cortisol curve from waking through bedtime, revealing exactly how your adrenal and stress response system is functioning over the course of a normal day.
Cortisol is your primary stress hormone, produced by the adrenal glands in response to the demands of your day. In a healthy pattern, cortisol peaks within 30 to 45 minutes of waking, declines steadily through the afternoon, and reaches its lowest point at bedtime. When that rhythm is disrupted, the result is a pattern of symptoms that are often dismissed or misattributed, including chronic fatigue, anxiety, insomnia, poor stress recovery, brain fog, and burnout.
At Orchid Wellness, the DUTCH Adrenal is ordered during your functional wellness intake based on your symptom picture. The $275 intake fee covers your consultation. The DUTCH Adrenal test is billed separately. Available in Carrollton, Texas and via telehealth in Texas, New York, Virginia, and Washington DC.
Book Your Functional Intake How It WorksDUTCH Adrenal Panel
Focused Adrenal and
Cortisol Assessment
Cortisol Assessment
Home collection at four specific time points throughout the day
Maps the full cortisol curve from waking through bedtime
Measures cortisol metabolites reflecting true adrenal output
Includes DHEA and DHEA-S for adrenal reserve assessment
Results reviewed by Chelsea Asante, FNP-C in a dedicated appointment
Requires a Functional Wellness Intake
$275
Consultation fee only. The DUTCH Adrenal test is billed separately. Cherry financing available at pay.withcherry.com/orchid-wellness
Why DUTCH Adrenal
What a morning cortisol
What a morning cortisol
blood draw cannot tell you.
Standard cortisol testing captures a single moment. The DUTCH Adrenal captures an entire day. Here is the difference in what each approach reveals.
| What is being assessed | Standard Blood Test | DUTCH Adrenal |
|---|---|---|
| Cortisol level | Single morning snapshot | ✓ Four time points across the full day |
| Cortisol awakening response | Not captured | ✓ Waking peak measured and assessed |
| Afternoon cortisol decline | Not captured | ✓ Rate and pattern of decline tracked |
| Evening cortisol | Not captured | ✓ Bedtime level measured for high evening cortisol patterns |
| Cortisol metabolites | Not measured | ✓ Total cortisol production and clearance rate |
| DHEA and DHEA-S | Serum only, single draw | ✓ DHEA metabolites reflecting adrenal reserve |
| Flat cortisol curve | Invisible on blood test | ✓ Clearly identified as a burnout pattern |
| Inverted cortisol curve | Invisible on blood test | ✓ Low morning, high evening pattern identified |
| HPA axis dysfunction | Often missed entirely | ✓ Full axis function assessed across the day |
Cortisol Patterns DUTCH Adrenal Identifies
Your cortisol has a story.
Your cortisol has a story.
This is how we read it.
Most patients with adrenal and HPA axis dysfunction fall into one of these recognizable patterns. Standard blood testing cannot identify any of them. DUTCH Adrenal can.
Flat Cortisol Curve
Cortisol is low and relatively flat throughout the entire day with no clear morning peak. This is the classic burnout pattern, often seen after prolonged chronic stress where the adrenal system can no longer mount a normal response.
Associated symptoms
Inverted Cortisol Curve
Cortisol is low in the morning when it should be high and elevated at night when it should be low. This pattern disrupts sleep architecture, makes mornings brutal, and contributes to the wired-but-tired feeling that many patients describe.
Associated symptoms
Elevated Cortisol
Cortisol is consistently high throughout the day, reflecting a system in a chronic state of activation. Often seen in early-stage chronic stress, anxiety disorders, and certain metabolic conditions. Can masquerade as normal on a single morning draw.
Associated symptoms
High Morning, Rapid Drop
Cortisol peaks normally in the morning but drops too quickly, leaving patients energized early but crashing by midday. The afternoon energy slump that coffee barely touches is often this pattern.
Associated symptoms
Low DHEA with Normal Cortisol
DHEA is the anabolic counterpart to cortisol. When DHEA is depleted even with normal cortisol levels, the result is a hormonal imbalance that drives fatigue, low libido, muscle loss, and accelerated aging that cortisol testing alone misses.
Associated symptoms
Variable or Chaotic Pattern
Some patients show erratic cortisol with no consistent rhythm, often associated with highly irregular sleep schedules, shift work, chronic anxiety, or poorly managed chronic conditions. DUTCH Adrenal captures this variability in a way no blood test can.
Associated symptoms
Panel Breakdown
Everything DUTCH Adrenal
Everything DUTCH Adrenal
measures.
The DUTCH Adrenal is a focused panel. It measures fewer markers than DUTCH Complete but goes deeper into the adrenal and stress physiology picture than any other available test.
DUTCH Adrenal vs DUTCH Complete
If your primary concerns are hormone-related, including PMS, perimenopause, HRT monitoring, or sex hormone imbalances, Chelsea may recommend DUTCH Complete instead. If your primary concerns are fatigue, burnout, stress response, and cortisol rhythm, DUTCH Adrenal is often the right starting point. In some cases both are ordered together.
Free Cortisol at Four Time Points
Urine free cortisol measured at waking, morning, afternoon, and bedtime. Maps the full diurnal rhythm and identifies deviation from the healthy cortisol curve pattern.
Cortisol Metabolites (Total)
Total cortisol metabolites reflect actual cortisol production by the adrenal glands, separate from how quickly the liver clears it. Provides a true picture of adrenal output.
Cortisone Metabolites
Cortisone is the inactive form of cortisol. The ratio of cortisol to cortisone metabolites reflects 11-beta-HSD enzyme activity, relevant to metabolic syndrome and inflammation.
DHEA-S
DHEA-S is the sulfated form of DHEA and the most abundant steroid hormone in the body. It reflects adrenal reserve, androgenic function, and the balance between stress and repair hormones.
DHEA Metabolites
Androsterone and etiocholanolone are DHEA downstream metabolites. Together with DHEA-S they provide a complete picture of adrenal androgen output and adrenal aging.
Who Should Consider DUTCH Adrenal
For patients whose energy
For patients whose energy
never fully recovered.
DUTCH Adrenal is for patients whose cortisol and stress response have been affected by chronic stress, burnout, illness, or years of pushing through. These are the most common presentations Chelsea sees.
Chronic Fatigue and Burnout
Exhaustion that does not improve with rest, sleep, or vacation. The kind of tired that feels systemic. Often a flat cortisol curve pattern where the adrenal system can no longer mount a normal stress response.
Anxiety and Poor Stress Recovery
Disproportionate stress reactions, difficulty recovering after stressful events, persistent worry, and a sense of being constantly on edge even when circumstances do not warrant it.
Insomnia and Sleep Disruption
Difficulty falling asleep, waking at 2 or 3am and being unable to return to sleep, or feeling wired at bedtime. These patterns are often driven by elevated evening cortisol.
Wired but Tired
Exhausted during the day but unable to wind down at night. Cannot nap even when tired. Crashes on weekends when stress is removed. A classic sign of cortisol rhythm dysregulation.
Blood Sugar and Craving Patterns
Mid-afternoon energy crashes, intense carbohydrate cravings, lightheadedness when meals are missed, and hypoglycemic-type symptoms often track with cortisol rhythm dysfunction.
Long-Term Stress or Illness History
Patients recovering from prolonged illness, grief, caregiver burnout, workplace stress, or years of sleep deprivation often present with measurable HPA axis changes that DUTCH Adrenal can document.
The Process
Simple collection.
Simple collection.
A full day of data.
The DUTCH Adrenal collection is done entirely at home on a typical day. No needles, no fasting, no clinic visit required for the test itself.
01
Book Your Functional Intake
Schedule your $275 functional wellness intake with Chelsea. Available in-person in Carrollton, Texas and via telehealth across Texas including Dallas Fort Worth, Houston, and Austin, as well as New York, Virginia, and Washington DC.
02
Receive Your Kit
A DUTCH Adrenal collection kit is mailed directly to you. The kit includes filter paper strips, collection instructions, and a prepaid return mailer to the lab.
03
Collect at Four Time Points
You urinate on the filter paper strips at four specific times throughout the day. Strips air dry and are mailed to the lab. Chelsea confirms the exact timing and any preparation instructions at your intake.
04
Results Review and Plan
Results return in 2 to 3 weeks. Chelsea reviews your cortisol curve and adrenal pattern with you and builds a targeted intervention plan covering lifestyle, nutrition, supplementation, and any clinical referrals needed.
Collection Timing
Four collections.
Four collections.
One typical day.
The DUTCH Adrenal should be collected on a representative day, not during illness, unusual stress, or travel. Detailed instructions are included with your kit.
Waking
Immediately on waking, before eating, drinking, or any activity. Captures the cortisol awakening response which is clinically significant on its own.
Morning
Approximately 2 to 3 hours after waking. Captures cortisol as it descends from its morning peak.
Afternoon
Approximately 4 to 5 hours after the morning collection. Captures the midday cortisol level.
Bedtime
After lights are out and you are ready to sleep. Captures evening cortisol and confirms whether your cortisol has appropriately declined.
Before You Collect
Collect on a typical day that represents your normal routine and stress level.
Avoid vigorous exercise, alcohol, and excessive caffeine on collection day as these affect cortisol levels.
Biotin supplements should be stopped 72 hours before collection as they can interfere with assays.
Certain medications and supplements can affect cortisol readings. Chelsea will provide a specific list at your intake.
Do not collect during acute illness, travel across time zones, or within a week of a major stressful event.
If you work night shifts or have an unusual sleep schedule, Chelsea will provide modified collection timing instructions.
Results typically return 2 to 3 weeks from when the lab receives your sample.
Explore All Functional Tests
Other testing available
Other testing available
at Orchid Wellness
DUTCH Adrenal is one of several advanced functional tests available through your intake consultation. Explore the full range below.
HTMA
Hair Tissue Mineral Analysis
Mineral and heavy metal assessment via hair sample
DUTCH Complete
DUTCH Complete Hormone Panel
Comprehensive sex hormone and adrenal assessment
DUTCH Adrenal
DUTCH Adrenal Panel
Cortisol rhythm and adrenal function across the day
GI-MAP
GI-MAP Stool Analysis
DNA-based comprehensive gut microbiome assessment
IgG / IgA
Food Sensitivity Panel
Delayed food reactivity driving chronic inflammation
OAT
Organic Acids Test
Cellular metabolism, mitochondria, and neurotransmitters
Micronutrient
Intracellular Micronutrient Panel
Vitamins, minerals, and antioxidants at the cellular level
MTHFR
MTHFR and Methylation Panel
Genetic variants affecting detox, mood, and cardiovascular risk
Frequently Asked Questions
DUTCH Adrenal FAQ
The DUTCH Adrenal test is a focused dried urine assessment that measures cortisol and DHEA at four specific time points throughout the day. It maps your full cortisol rhythm from waking through bedtime, revealing patterns of HPA axis dysfunction, adrenal fatigue, and stress hormone imbalance that a single morning blood draw cannot detect.
DUTCH Adrenal focuses specifically on cortisol rhythm, cortisol metabolites, and DHEA. It is the right choice when fatigue, burnout, anxiety, and stress response are the primary concerns. DUTCH Complete includes all of that plus a full sex hormone panel, hormone metabolites, melatonin, and oxidative stress markers. Chelsea will recommend the right test at your intake. In some cases both are ordered together.
Adrenal fatigue is not an official medical diagnosis in the conventional sense, but the underlying pattern, HPA axis dysregulation, is real and measurable. It describes a functional disruption of the stress response system where cortisol rhythm becomes abnormal. DUTCH Adrenal measures this pattern directly rather than relying on a label. Chelsea interprets your results in the context of your full clinical picture.
Yes. The functional wellness intake and results review are available via telehealth in Texas, New York, Virginia, and Washington DC. The DUTCH Adrenal is a home collection kit. You collect urine samples on filter paper strips at four specific time points, let them dry overnight, and mail them to the lab in the prepaid return envelope included with the kit.
Results typically return within 2 to 3 weeks after the lab receives your sample. Chelsea schedules your results review appointment at your intake so you have a time already on the calendar when your results come in.
The DUTCH Adrenal test is not covered by insurance and is direct-pay. The $275 intake consultation fee and the test fee are billed separately. HSA and FSA cards are accepted for both. Cherry financing is available at pay.withcherry.com/orchid-wellness.
Ready to Understand Your Stress Response
Your body has been keeping
score of every stressor.
Let's see what it says.
The DUTCH Adrenal test is ordered during your $275 functional wellness intake with Chelsea Asante, FNP-C. The test is billed separately. In-person in Carrollton, Texas or via telehealth across Texas, New York, Virginia, and Washington DC.
Book Your Functional Intake Free Discovery Call