Thyroid & Metabolism

Gaining weight, losing hair, and told your thyroid is “fine”?

Functional medicine looks beyond basic TSH to uncover the conversion issues, nutrient deficiencies, and immune triggers keeping your metabolism locked in slow motion.

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Sound Familiar?

Signs your thyroid needs a deeper look

If you’ve been told your thyroid is “within range” but you feel anything but normal — these patterns suggest your metabolic system needs a more thorough investigation.

Unexplained weight gain

You’re eating well and exercising but the weight won’t shift. Your metabolism feels like it’s stopped responding.

Persistent fatigue & sluggishness

A heavy, bone-deep tiredness that sleep doesn’t fix. Everything feels like it takes twice the effort.

Hair thinning & dry skin

Your hair is falling out in clumps, your skin is dry and flaky, and your nails are brittle and ridged.

Feeling cold all the time

Cold hands, cold feet, needing layers when everyone else is comfortable. Your internal thermostat is off.

Brain fog & slow thinking

Difficulty concentrating, poor memory, feeling mentally sluggish — like your brain is running on half power.

Constipation & fluid retention

Sluggish digestion, puffy face in the morning, and bloating that doesn’t respond to dietary changes.

The Gap in Standard Care

Why your GP only tested TSH

Standard thyroid testing checks TSH — and sometimes free T4. If those are “in range,” you’re told your thyroid is fine. But the reference ranges are broad, and TSH alone misses most of the picture.

Functional medicine tests the full thyroid cascade and the nutrients, hormones, and immune factors that influence how your thyroid actually performs.

T4 to T3 conversion failure — your body makes thyroid hormone but can’t activate it
Elevated reverse T3 — stress and inflammation blocking thyroid hormone at the receptor
Hashimoto’s autoimmunity — immune attack on the thyroid that standard TSH tests don’t reveal
Nutrient deficiencies — low selenium, zinc, iodine, or iron impairing thyroid function
Gut dysfunction — around 20% of active T3 is produced in the gut, so dysbiosis and poor digestion directly impair thyroid activation

“Rohan was the first practitioner to target my complex condition from a different angle which has ended up working remarkably. I appreciate his knowledge of the interconnectedness of bodily processes.”

— Xandir, Adelaide

Understanding Your Diagnosis

What’s the Difference Between Hashimoto’s and Hypothyroidism?

These two terms are often used interchangeably — but they’re not the same thing. Hypothyroidism describes an underactive thyroid gland (a symptom pattern). Hashimoto’s thyroiditis is an autoimmune disease (a root cause) that frequently leads to hypothyroidism over time. You can have Hashimoto’s with a completely normal TSH, which is why antibody testing matters beyond the standard thyroid panel.

Comparison table: Hashimoto’s thyroiditis vs Hypothyroidism
Feature	Hashimoto’s Thyroiditis	Hypothyroidism
What it is	An autoimmune disease — the immune system produces antibodies that attack thyroid tissue	A clinical state in which the thyroid gland does not produce sufficient thyroid hormone
Cause	Immune dysregulation, often with genetic predisposition and environmental triggers (e.g. gut permeability, iodine excess, infections)	Most commonly caused by Hashimoto’s; other causes include iodine deficiency, thyroid surgery, radioactive iodine treatment, certain medications
Relationship	Hashimoto’s is a cause — it damages the gland over time, eventually impairing hormone output	Hypothyroidism is an outcome — it describes what happens when thyroid function declines, regardless of cause
Key tests	TPO antibodies (anti-thyroid peroxidase), anti-thyroglobulin antibodies, TSH, Free T3, Free T4	TSH, Free T3, Free T4 — antibodies often not ordered in standard care
Can TSH appear normal?	Yes — in early or fluctuating Hashimoto’s, TSH may appear normal while antibodies are already elevated and symptoms are present	By definition, hypothyroidism involves an elevated TSH (or low T3/T4) — a normal TSH suggests the thyroid is still compensating
Standard care	Thyroid hormone replacement if TSH is elevated; no conventional treatment for the autoimmune process itself	Thyroid hormone replacement (levothyroxine); dose adjusted to normalise TSH
Functional approach	Investigate immune triggers — gut permeability, nutrient co-factors (selenium, iodine balance, zinc, vitamin D), stress, and dietary drivers of immune activation	Identify the root cause; support conversion of T4 to active T3; address nutrient deficiencies impacting thyroid function

What this means for you

If your TSH comes back “normal” but you still feel hypothyroid — fatigue, cold intolerance, hair thinning, brain fog — Hashimoto’s antibodies may be elevated and the autoimmune process already underway. A full thyroid panel including TPO and anti-thyroglobulin antibodies paints a very different picture than TSH alone.

The Process

A structured path from confusion to clarity

No guesswork. Every step is guided by testing, clinical experience, and a deep understanding of how your body’s systems interconnect.

Map Your Pattern

A comprehensive 90-minute initial consultation to understand your full history, symptoms, lifestyle, and what’s been missed. We identify the patterns that matter.

Test What Matters

In-depth pathology interpretation that catches what others miss — plus targeted functional testing when deeper answers are needed.

Build Your Plan

A personalised treatment protocol targeting root causes — nutritional support, gut restoration, nervous system regulation, and lifestyle recalibration.

Video coming soon

From Rohan

Understanding thyroid health from a functional perspective

In this short video, Rohan explains why a “normal” TSH result doesn’t mean your thyroid is functioning well — and what a comprehensive thyroid investigation actually looks like.

If you’ve been symptomatic for years with “normal” results, this is the explanation that’s been missing.

Functional Testing

What we investigate

The specific tests and pathways we examine to uncover the root causes of your thyroid dysfunction.

Full Thyroid Panel

TSH, free T3, free T4, reverse T3, and thyroid antibodies (TPO, TgAb) — the complete picture, not just TSH.

Thyroid Nutrient Cofactors

Iodine, selenium, zinc, iron, and vitamin D — the essential building blocks your thyroid needs.

Adrenal & Cortisol Assessment

Cortisol rhythm and DHEA — chronic stress directly suppresses thyroid conversion and raises reverse T3.

Sex Hormone & Estrogen Panel

Estrogen, progesterone, and testosterone balance — estrogen dominance is a major hidden driver of thyroid suppression.

Inflammatory Markers

hs-CRP, homocysteine, and immune activation markers that indicate systemic inflammation affecting thyroid function.

Genetic Assessment (MTHFR)

Methylation variants affecting detoxification, hormone metabolism, and nutrient conversion pathways.

Common Questions

Thyroid & Metabolism — Frequently Asked Questions

What’s the difference between a normal TSH result and an optimal thyroid result?

TSH is the main test GPs use, and the “normal” range is broad — typically 0.5 to 4.5 mIU/L. The problem is that many people feel terrible at the high end of that range. Functionally, most practitioners consider an optimal TSH to sit between 1.0 and 2.0. Beyond TSH, a complete thyroid picture needs Free T3, Free T4, and thyroid antibodies — tests that aren’t always ordered but tell us far more about how your thyroid is actually performing.

Why do I still feel exhausted and cold if my thyroid results are “in range”?

“In range” and “optimal” aren’t the same thing. You can have a TSH of 3.8 — technically normal — and still have sluggish thyroid function affecting your energy, temperature regulation, mood, and metabolism. We also commonly see Hashimoto’s thyroiditis, where TSH looks normal while the immune system is actively attacking thyroid tissue. Standard testing misses this unless antibodies are specifically checked.

What thyroid tests does functional medicine use that my GP doesn’t order?

A complete functional thyroid assessment includes TSH, Free T3, Free T4, Reverse T3, TPO antibodies, and TgAb antibodies. We also look at nutrients critical for thyroid hormone conversion — iodine, selenium, zinc, and iron — because a thyroid can produce hormones but still fail to convert them into the active form your cells actually use. We arrange all testing through local labs when required.

Can nutrition and lifestyle actually make a difference to thyroid function?

Absolutely — particularly for autoimmune thyroid conditions like Hashimoto’s. Removing dietary triggers, addressing nutrient deficiencies, managing cortisol, and supporting gut health can significantly reduce antibody levels and improve symptoms. For non-autoimmune thyroid dysfunction, targeted nutritional support and lifestyle changes often restore normal function without medication. We always start with the least interventive approach that the evidence supports.

How long does it take to notice improvement?

Thyroid-related changes tend to be gradual. Most people notice improved energy and temperature tolerance within 6–10 weeks of starting a protocol. Reducing elevated antibodies in Hashimoto’s typically takes 3–6 months of consistent dietary and supplement intervention, although some cases can take longer. We retest at appropriate intervals so you can see the numbers shifting, which can happen before you can actually feel it.

Do I need a referral to see a clinical nutritionist for thyroid issues?

No referral needed — book directly online. If you’ve had recent blood tests, bring them even if they were reported as normal. Telehealth is available for interstate clients. See the Services & Fees page for what to expect from your first consultation.

Patient Experience

“I’ve been working with Rohan for 7 years, I am so thankful to find such a competent practitioner. I have discovered the causes and strategies to manage my health conditions.”

— Amy, Adelaide

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