If you can’t use DUTCH, since we can’t in New York, is it possible to use one, the 24-hour urine for total cortisol production of metabolites to the saliva test for diurnal variation? Is the 24-hour urine reference range for standard labs useful for functional assessment purposes, or would the range need to be refined?

Chris Kresser:  Great question. I actually was doing exactly what you mentioned and also combining serum cortisol and DHEA testing before DUTCH testing came around because I knew about some of the limitations for all of the methodologies prior to DUTCH being founded, so I was using these different methods, so it’s definitely possible to do that. I think the reference range for the standard labs, what you could probably do is just reduce it by 20 to 30 percent on each end. Don’t look at it as a hard and fast functional range, but look at the whole pattern. Look at the salivary levels. Look at the urine levels and possibly even the blood levels, and then look at the signs and symptoms and make a clinical decision based on that.