{"product_id":"dutch-plus","title":"DUTCH Plus","description":"\u003cp\u003e\u003cstrong\u003eA low or blunted Cortisol Awakening Response\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003ecan be a result of an underactive HPA axis, excessive psychological burnout, seasonal affective disorder (SAD), sleep apnea or poor sleep in general, PTSD, chronic fatigue and\/or chronic pain. A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eAn elevated Cortisol Awakening Response\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003ecan be a result of an over-reactive HPA axis, ongoing job-related stress (anticipatory stress for the day), glycemic dysregulation, pain (i.e. waking with painful joints or a migraine), and general depression (not SAD). A recent study1 showed that neither the waking nor post-waking cortisol results correlated to Major Depressive Disorder, but the CAR calculation (the change between the first two samples) did. This measurement of the response to waking has independent clinical value showing dysfunction that may be hidden by current testing options.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat’s Included in the DUTCH Plus\u003c\/strong\u003e®\u003cstrong\u003e?\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eThe DUTCH Plus™ uses four dried urine samples and five saliva samples. These samples are collected over the course of one day, from waking to bed time.\u003c\/p\u003e\n\u003cp\u003eThe\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eDUTCH Plus\u003c\/strong\u003e® takes hormone testing to a whole new level. In addition to sex hormones and their metabolites, the\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eDUTCH Complete\u003c\/strong\u003eTM looks at the overall diurnal pattern of free cortisol, and the total and distribution of cortisol metabolites. The\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eDUTCH Plus\u003c\/strong\u003e® adds the Cortisol Awakening Response (CAR) to bring another important piece of the HPA-axis into focus.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat is the Cortisol Awakening Response and how do we test for it?\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eWhen we open our eyes upon waking, cortisol levels naturally begin to rise by an average of 50%. 30 minutes after waking, cortisol levels will still show this sharp increase. By 60 minutes after waking, cortisol levels have peaked and begin to decline. Measuring this rise and fall of cortisol levels at waking can be used as a “mini stress test”. Research shows that the size of this increase correlates with HPA-axis function, even if the sample measurements are all within range. A quick saturation of saliva swabs upon waking, and at 30 and 60 minutes after waking, provide what is required to assess a patient’s Cortisol Awakening Response.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eHow to Collect Saliva\u003c\/strong\u003e\u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003eBe sure to\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003ecomplete all information on each collection device.\u003c\/strong\u003e\n\u003c\/li\u003e\n\u003cli\u003eBegin collecting right when you wake up, before getting out of bed. Remove the blue cap and place the cotton swab from the collection device in mouth.\u003c\/li\u003e\n\u003cli\u003eLeave in mouth until fully saturated but not longer than 5 minutes. Lightly chewing on the swab may help stimulate saliva flow.\u003c\/li\u003e\n\u003cli\u003eOnce done, place swab back in the same tube, just as you found it. Do not remove the inner tube.\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003eYou do not need to spit into the tube.\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eTouch the swab as little as possible with your hands.\u003c\/li\u003e\n\u003cli\u003eYou may\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003efreeze all saliva samples\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003euntil they are ready to ship.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003eImportant Note:\u003cspan\u003e \u003c\/span\u003e\u003c\/strong\u003eFor the waking sample, set the saliva collection device, the requisition form, and a pen next to your bed. It is helpful to have a timer nearby to set for 30 and 60 minutes after you have begun your first collection. After collecting the first sample, it is best for you to be in a well-lit place.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eHow to Collect Dried Urine\u003c\/strong\u003e\u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eComplete all information on each collection device.\u003c\/strong\u003e\u003c\/li\u003e\n\u003cli\u003eSaturate the filter paper by urinating directly on it OR urinating into a clean cup and dip the filter paper for 5 seconds.\u003c\/li\u003e\n\u003cli\u003eLeave the sample open to\u003cspan\u003e \u003c\/span\u003e\u003cstrong\u003edry for at least 24 hours.\u003c\/strong\u003e\n\u003c\/li\u003e\n\u003cli\u003eOnce dry, close each collection device and place them all in the resealable plastic bag provided.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003eHow to Return\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eUpon Completion\u003c\/strong\u003e\u003c\/p\u003e\n\u003col\u003e\n\u003cli\u003eAfter drying the urine collection devices, make sure each sample is clearly labeled and dry.\u003c\/li\u003e\n\u003cli\u003ePlace the dried urine collection devices in the resealable plastic bag and back in the test kit box, along with the frozen saliva tubes.\u003c\/li\u003e\n\u003cli\u003eComplete the requisition form.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e\u003cstrong\u003eShipping Information\u003c\/strong\u003e\u003c\/p\u003e\n\u003col start=\"4\"\u003e\n\u003cli\u003ePlace the entire test kit box and the completed requisition form inside the return mailer.\u003c\/li\u003e\n\u003cli\u003eAffix the prepaid label or postage, if applicable.\u003c\/li\u003e\n\u003cli\u003eReturn using the appropriate carrier.\u003c\/li\u003e\n\u003c\/ol\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003e*Not available in NY, NJ , and RI*\u003c\/strong\u003e\u003c\/p\u003e","brand":"Precision Analytical","offers":[{"title":"Default Title","offer_id":53308130820393,"sku":null,"price":649.0,"currency_code":"USD","in_stock":true}],"url":"https:\/\/brighterlifelabs.com\/products\/dutch-plus","provider":"Brighter Life Labs","version":"1.0","type":"link"}