Understanding Cortisol vs. Cortisone — What Your DUTCH Test Really Reveals

When it comes to understanding stress, fatigue, and hormone balance, the body’s cortisol rhythm tells a powerful story. Yet, there’s another key player often overlooked — cortisone, the inactive partner to cortisol. Together, these two hormones show how well your body adapts, restores, and recovers from daily stress.

Cortisol: Your Body’s Natural Stress Hormone

Cortisol is produced by the adrenal glands and acts as your body’s internal alarm system. It helps you wake up in the morning, regulate blood sugar, fight inflammation, and respond to physical or emotional stress.

When cortisol rises and falls in healthy rhythm, you feel energized in the morning, focused through the day, and relaxed at night.

When it stays elevated too long, you may feel anxious, wired, or unable to sleep. When it drops too low, you can feel flat, fatigued, or mentally foggy.

Cortisone: The Rest and Repair Counterpart

Cortisone is the inactive form of cortisol — like a “standby” mode for your stress response. Your body can convert cortisone back into cortisol when needed, or deactivate cortisol into cortisone to protect tissues from overload.

If cortisol is the accelerator, cortisone is the brake pedal that helps your system cool down after stress.

What the DUTCH Test Measures

The DUTCH (Dried Urine Test for Comprehensive Hormones) is one of the most insightful tools for assessing adrenal health because it measures:

• Free Cortisol (active)

• Free Cortisone (inactive)

• Metabolized forms (how you process and clear stress hormones)

• Daily rhythm (how levels rise and fall from morning to evening)

By looking at both cortisol and cortisone, we can see if your body is:

• Overactivated — high cortisol, low cortisone (wired, anxious, inflamed)

• Over-deactivating — low cortisol, high cortisone (burnout, exhaustion, brain fog)

• Flatlined — both low (chronic depletion, adrenal fatigue pattern)

• Balanced — healthy peaks and valleys with smooth recovery

Why This Matters for Healing

Understanding your cortisol–cortisone balance helps tailor your treatment plan precisely:

• If cortisol is high, calming adaptogens like Ashwagandha, Holy Basil, and Lemon Balm help regulate stress response.

• If cortisone is high and cortisol low, stimulating adaptogens like Rhodiola or Licorice root can gently restore energy and resilience.

• Lifestyle therapy — breathwork, grounding, mindful rest, and balanced nutrition — further reset the HPA axis (hypothalamic-pituitary-adrenal connection).

The Takeaway

Cortisol tells us how much stress your body is under. Cortisone tells us how well you’re recovering.

By interpreting both through the DUTCH Test, we can see not just how you react to stress — but how well you heal from it.

If you’ve been feeling wired but tired, anxious yet exhausted, or if sleep and energy never seem to align, understanding your cortisol-cortisone pattern could be the key to restoring true balance.