When “Normal” Isn’t Optimal: A Thyroid Case Study
May 25 was World Thyroid Day, and what better time to shed light on a story I see all too often in clinic?
If you’ve ever felt exhausted, foggy, or just off - only to be told your thyroid blood tests are “normal” - you’re not alone. Many women experience classic symptoms of thyroid dysfunction, like weight gain, fatigue, mood swings, and hair loss, without ever getting a proper diagnosis.
In this case study, I walk you through how functional thyroid testing and a naturopathic lens helped uncover Hashimoto’s thyroiditis and nutrient deficiencies that were missed in standard labs. Whether you’re navigating hypothyroidism, suboptimal thyroid function, or an autoimmune thyroid condition, this story sheds light on what your symptoms may really be telling you and how you can start feeling like yourself again.
Let me introduce you to Angela*, 42. She came to me frustrated and tired - literally and figuratively. Despite eating well, exercising regularly, and trying her best to look after herself, she was experiencing:
✔︎ Persistent fatigue
✔︎ Brain fog
✔︎ Weight gain (especially around the middle)
✔︎ Heavy, painful periods
✔︎ Hair loss
✔︎ Mood swings
Her GP had run basic bloods, including TSH, and reassured her that everything was “normal.”
But if you’ve ever been told you’re “fine” when you feel anything but — you’ll understand her frustration.
Digging Deeper: The Functional Approach
I ordered a comprehensive thyroid panel — not just TSH, but free T3, free T4, thyroid antibodies (TPO and TGAb), and reverse T3. I also checked key nutritional markers that are foundational to thyroid function.
Here’s what we found:
Thyroid Pathology
TSH: 3.8 mIU/L (High-normal, but not optimal)
Free T4: 13 pmol/L (Low-normal)
Free T3: 3.2 pmol/L (Low)
TPO Antibodies: 152 IU/mL (Elevated — confirming Hashimoto’s thyroiditis)
Reverse T3: 450 pmol/L (Elevated — indicating stress or impaired conversion)
Nutrient Testing
Ferritin: 65 µg/L (Low — ideal is 70–100 for thyroid health)
Vitamin D: 56 nmol/L (Suboptimal — immune-modulating and anti-inflammatory)
Zinc: 9.2 µmol/L (Low-normal)
Iodine (urinary): 60 µg/L (Low — requires cautious repletion in Hashimoto’s)
Iron Saturation: 12% (Low — impacting energy and T3 conversion)
So What Did We Do?
Instead of guessing, we built a targeted treatment plan around the data.
We focused on:
✔︎ Restoring key nutrients through food and gentle supplementation
✔︎ Supporting thyroid conversion and reducing inflammation
✔︎ Regulating the nervous system (goodbye, constant cortisol spikes)
✔︎ Creating sustainable nutrition and movement strategies that honoured her energy
Within 12 weeks:
✔︎ Her energy improved
✔︎ Brain fog lifted
✔︎ Hair loss reduced
✔︎ Her TPO antibodies dropped by 30%
✔︎ She felt like herself again
The Takeaway?
“Normal” doesn’t always mean optimal.
If you’ve been told everything looks fine but you still feel off, it may be time to look deeper.
This is why I’m passionate about thorough testing, real answers, and evidence-informed naturopathic support — because every woman deserves to feel energised, empowered, and heard.
Want to Learn More?
If you’re curious about what your blood tests could be telling you (or what they might be missing), I’ve created a helpful resource for you. Contact me for a copy of my Blood Test Overview, which is a guide to the key markers that provide key markers when it comes to thyroid health.