Hormone Imbalance
Hormones tell a story — if you measure them properly.
Standard serum tests show a single moment. Hormone metabolite testing shows the whole pathway: what your body makes, how it processes it, and where the system is breaking down.
Open to the public · No referral required · Functional medicine evaluation
Why standard testing falls short
A blood draw is a snapshot. Hormones are a movie.
THE TIMING PROBLEM
Hormones swing wildly within a day.
Cortisol can vary 3- to 4-fold from morning to evening. Estrogen and progesterone shift weekly. A 9 AM draw catches one moment; the dysfunction often shows up elsewhere.
THE METABOLITE PROBLEM
It’s not the hormone — it’s how you process it.
Estrogen can route through three pathways — one of them protective, two carcinogenic. Serum testing doesn’t tell you which path your body uses.
THE HPA PROBLEM
Cortisol dysfunction comes in shapes, not levels.
High in the morning, crashed by lunch, spiking at night — the pattern matters more than the total. A single draw misses the shape entirely.
The DUTCH test — what we actually measure
Urinary metabolites tell the whole story.
The DUTCH test (Dried Urine Test for Comprehensive Hormones) measures hormones AND their breakdown products across a full day. It’s the closest thing we have to watching the system run.
SEX HORMONES
Estrogen, progesterone, testosterone
Total levels plus the three estrogen metabolism pathways (2-OH, 4-OH, 16-OH), DHT conversion, and the protective vs. proliferative balance. Critical for evaluating cycle disorders, perimenopause, andropause, PCOS, and hormone-related cancer risk.
HPA AXIS
Cortisol pattern + DHEA
Four cortisol measurements across the day mapping the daily curve, plus total cortisol output, free cortisol, cortisone, and DHEA. Reveals adrenal dysfunction patterns that single-draw testing routinely misses.
METHYLATION + DETOX
8-OHdG, organic acids, B-vitamin markers
Oxidative stress, neurotransmitter metabolites, methylation status, B6/B12/folate function. Tells us whether hormones are being cleared properly — or accumulating where they shouldn’t.
CIRCADIAN + MELATONIN
Melatonin metabolite
6-sulfatoxymelatonin (6-OHMS) shows whether your circadian system is producing the protective hormone needed for sleep, immune regulation, and antioxidant defense.
The DUTCH is the diagnostic foundation under almost every hormone-driven case we see. It catches what serum testing fundamentally cannot.
Phase 1 estrogen metabolism
Estrogen routes through three pathways.
One of them is protective. The other two carry real cancer risk if your detox isn’t handling them well. Serum testing can’t see this. DUTCH urinary metabolite analysis does.
A serum estrogen test gives you a single number. DUTCH metabolite analysis shows you where that estrogen is actually going — and whether your body is detoxifying the riskier metabolites or letting them accumulate.
The cascade view
Where hormone imbalance actually starts.
Hormone dysfunction is almost never just about hormones. It’s about the signals upstream, the conversion machinery midstream, and the symptoms patients feel downstream.
Chronic stress + HPA
Cortisol pathways “steal” from sex hormone production. Pregnenolone diverts to cortisol.
Insulin + thyroid drift
Insulin resistance and undertreated thyroid both distort sex hormone production and clearance.
Gut & estrobolome
Gut microbes regulate how estrogen is recirculated vs. cleared. Dysbiosis = hormone recycling.
Nutrient + detox status
Without B-vitamins, magnesium, and proper detox capacity, hormones can’t be cleared safely.
Hormone production drifts
Estrogen, progesterone, testosterone shift out of optimal ranges and out of healthy ratios.
Cortisol pattern distorts
Daily curve flattens, inverts, or spikes — visible only on DUTCH-style timed sampling.
Detox pathways stall
Estrogen routes through 4-OH (carcinogenic) instead of 2-OH (protective); 4-OH stays unmethylated.
Cycle disorders + PMS
Anxiety + mood swings
Fatigue + sleep loss
Low libido + ED
Belly weight gain
Acne + hair changes
Brain fog + memory
Bone density loss
Same symptom set can come from very different upstream drivers. Two patients with identical complaints often need opposite protocols. The DUTCH is how we tell them apart.
Where to go from here< HSA/FSA eligible · Telehealth nationwide · No referral required/p>
The DUTCH is part of the Blueprint.
START HERE
Free 30-min consultation
Free · 30 min · no pressure
Talk through your symptoms on a free 30-min call. Figure out whether the Blueprint is the right next step or if there’s a smaller starting point.
FULL HORMONE WORKUP
Metabolic Blueprint
~$1,250 · DUTCH + chemistry + gut · written report
DUTCH urinary metabolites + full chemistry + GI-MAP. The complete picture of your hormone system + the drivers underneath it.
Open to the public. No referral required. HSA/FSA typically accepted for clinical components. Located at 1700 Hwy 36 W, Suite 400, Roseville, MN 55113 · (651) 636-0055.
Medical disclaimer. The content on this page is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Twin Cities Metabolism delivers functional medicine evaluation and clinical protocols; results vary by individual and depend on adherence and underlying physiology. Always consult a licensed clinician about your specific situation. Reviewed by Dr. Jared Larsen, LN, CNS, DC, MS. Last reviewed: May 2026.
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