My TSH is normal but I still feel awful. What now?

TSH alone is a screening test rather than the full picture. Free T4, free T3 and thyroid antibodies each answer a different question, and antibodies in particular can be raised for years before TSH moves. Your naturopath can arrange the wider panel and will also look at iron, B12 and vitamin D, which produce a very similar set of symptoms.

Can naturopathy replace thyroid medication?

No. If your thyroid isn't producing enough hormone, replacing it is what fixes that, and nobody here will suggest coming off it. Naturopathic care works on the nutrients thyroid function depends on, the conversion of T4 to T3, and the antibody picture in autoimmune thyroid disease.

Does iodine help an underactive thyroid?

Sometimes, and it can also make things considerably worse — particularly in Hashimoto's, where high-dose iodine can accelerate the process. It's not a supplement to take speculatively, and status is testable.

Thyroid Naturopath Melbourne | Hashimoto's & Hypothyroid

The thyroid sets the pace of a great deal of your metabolism, and when it’s off, the symptoms are broad enough to be blamed on almost anything else. Fatigue, weight change, cold or heat intolerance, hair thinning, constipation, low mood, brain fog and cycle changes all belong in the list.

Two directions and one common cause: underactive (hypothyroidism), overactive (hyperthyroidism), and Hashimoto’s thyroiditis, an autoimmune condition and the most common reason for an underactive thyroid in Australia.

Getting the full picture on paper

A great many people are told their thyroid is fine on the basis of one number. TSH is a good screening test and it isn’t the whole story.

Test	What it answers
TSH	How hard the pituitary is pushing the thyroid
Free T4	How much of the storage hormone is available
Free T3	How much of the active hormone you actually have
TPO and thyroglobulin antibodies	Whether the process is autoimmune
Reverse T3	Where conversion may be going, in specific pictures

Antibodies can be raised for years before TSH moves, which is why testing them changes what happens next.

Your naturopath can arrange the wider panel. Functional testing goes through a private laboratory and is paid directly to the lab, with no Medicare rebate — some of these are also available on a GP request, and it’s worth asking.

What your naturopath works on

The nutrients thyroid function depends on — iodine, selenium, zinc, iron and tyrosine — assessed rather than assumed, because iodine in particular can worsen Hashimoto’s.

Conversion. T4 becomes active T3 largely outside the thyroid, and that step is affected by stress, chronic dieting, inflammation and low selenium.

The autoimmune side, where antibodies are raised — gut health, vitamin D and the trigger load.

What mimics it. Iron deficiency, B12 deficiency, low vitamin D, sleep apnoea and depression produce a strikingly similar picture, and all are worth excluding.

Absorption of your medication, if you take thyroxine. Iron, calcium, magnesium and coffee all interfere with it, and timing alone sometimes explains a dose that never quite worked.

⚠ Thyroid care is shared care

Thyroid conditions are diagnosed and monitored medically. Don’t change or stop thyroid medication on the basis of anything on a website — dose changes are made with the prescriber, on repeat bloods.

A thyroid lump or a swelling in the neck, a rapid or irregular heartbeat, unexplained rapid weight loss, or thyroid symptoms during pregnancy need medical assessment now. Where specialist care is the next step, we’ll provide a detailed letter setting out the findings and recommendations.

Who you’d see

Jessica Pensa works across thyroid, autoimmune and hormonal conditions. Bachelor of Health Science in Naturopathy.

Thyroid health