Thyroid Dysfunction Explained: Symptoms, Testing & Holistic Support
Author: Jacqueline Lovett, Naturopath
Your thyroid is a small gland with a big job. When it's not functioning optimally, it can affect every aspect of your health, from your energy, mood, and digestion, to your metabolism, hormones, and mental clarity. While thyroid dysfunction is common, it’s often misunderstood, underdiagnosed, or mismanaged.
Thyroid dysfunction typically falls into two main categories -- hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Each presents differently in the body, but the root causes can vary widely – and in many cases, especially with autoimmunity, it’s not as black and white as the lab results might suggest
Hypothyroidism – When the body slows down
This is the most common form of thyroid dysfunction, often associated with Hashimoto’s thyroiditis, an autoimmune condition. Symptoms may include:
~ Fatigue and low energy
~ Tendency to constipation
~ Brain fog or slow memory
~ Weight gain or resistance to weight loss
~ Depression or low mood
~ Feeling cold all the time
~ Dry skin, thinning hair or brittle nails
Hyperthyroidism – When the body speeds up
Rarer, but still significant, hyperthyroidism is often linked to Graves’ disease, another autoimmune disorder. Symptoms may include:
~ Racing heart or palpitations
~ Anxiety, restlessness or irritability
~ Insomnia or difficulty staying asleep
~ Unexplained weight loss
~ More frequent bowel movements
~ Intolerance to heat or excessive sweating
~ Anxiety, restlessness or irritability
~ Insomnia or difficulty staying asleep
~ Unexplained weight loss
~ More frequent bowel movements
~ Intolerance to heat or excessive sweating
The grey area
I often see patients whose symptoms don’t line up with their lab results. They may feel more hyper (anxious, restless, losing weight) but their thyroid labs suggest hypothyroidism. Or vice versa. These cases require a deeper look at adrenal health (stress), inflammation, gut health, nutrients, and of course, autoimmunity.
Autoimmune thyroid conditions (Hashimotos and Graves) can cause swings between overactive and underactive states, especially in early or fluctuating stages of the disease. This is why a holistic, individualised approach is important.
Testing your Thyroid
Comprehensive thyroid testing is often overlooked in conventional medicine, which can lead to missed diagnoses or delayed treatment. Many patients are told their thyroid is "normal" based solely on their TSH levels - but TSH is not a direct marker of thyroid function.
To get the full picture, a complete thyroid panel should include:
- TSH (thyroid-stimulating hormone)
- Free T4 (inactive thyroid hormone)
- Free T3 (active thyroid hormone)
- Reverse T3 (inactive form that can block T3)
- Reverse T3 (inactive form that can block T3)
- And Thyroid Antibodies (to rule out Hashimotos or Graves)
Why medication alone is not enough
The conventional treatment for hypothyroidism is usually levothyroxine, a synthetic form of T4 (inactive thyroid hormone). While this can help normalise TSH levels, it doesn’t always support full thyroid function, and it certainly doesn’t address autoimmunity.
To reap the benefits of the medication, your body must convert it into its active form, T3. This conversion relies on healthy liver function and healthy gut function, as well as key nutrients like: Iron, vitamin D, iodine, selenium, zinc and magnesium to name a few. Without addressing these foundational areas, patients can remain symptomatic, even on medication.
When autoimmunity is involved, the question becomes — why is your immune system attacking your thyroid? The answer is never simple. It could be one thing, or it could be a combination of several things.
The Naturopathic Approach
As naturopaths, we always aim to treat holistically. That means, we don’t just look at thyroid pathology – we ask why the thyroid is struggling in the first place. Some common underlying drivers include:
~ Poor stress management (cortisol dysregulation often precedes thyroid issues)
~ Nutrient deficiencies or poor dietary intake
~ Inadequate protein consumption
~ Environmental toxin exposure
~ Nutrient deficiencies or poor dietary intake
~ Inadequate protein consumption
~ Environmental toxin exposure
~ Poor gut health
~ Blood sugar dysregulation
~ Chronic inflammation
~ Hormonal changes related to pregnancy or postpartum
~ Blood sugar dysregulation
~ Chronic inflammation
~ Hormonal changes related to pregnancy or postpartum
When starting treatment, monitoring your thyroid regularly is important and any natural intervention is always going to take time and patience. Our main goal as naturopaths is to educate you and empower you on your health journey so that you can take control and understand your symptom picture. If you suspect your thyroid isn’t working as it should, or if you’re on medication but still not feeling your best, know that there are answers. A holistic, root-cause approach can uncover what’s really going on and support your body’s natural ability to rebalance.
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