Thyroid Dysfunction: Symptoms, Testing & Support

Thyroid dysfunction affects millions of people worldwide and is particularly common in women. Whether you're experiencing fatigue, weight changes, brain fog, anxiety, digestive issues or hormonal imbalances, your thyroid may be playing a role. Understanding the signs of hypothyroidism, hyperthyroidism and autoimmune thyroid disease is the first step towards getting the right support.

Why Thyroid Health Matters for Women.

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

Why Thyroid Symptoms Don't Always Match Blood Test Results

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)
- And Thyroid Antibodies (to rule out Hashimoto’s thyroiditis or Graves disease)

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
~ Poor gut health
~ Blood sugar dysregulation
~ Chronic inflammation
~ Hormonal changes related to pregnancy or postpartum

As a naturopath, I often see women experiencing thyroid symptoms such as fatigue, brain fog, weight changes, digestive issues and hormonal imbalances, even after being told their thyroid results are "normal". While thyroid medication can be an important part of treatment, addressing the broader picture is often essential for improving long-term health and wellbeing.

By exploring factors such as nutrition, stress, gut health, inflammation and nutrient status, a holistic approach can help uncover some of the underlying drivers affecting thyroid function and overall health.

If you suspect your thyroid isn't functioning optimally, or you're still experiencing symptoms despite treatment, know that there are options available. With the right support, it is possible to better understand your symptoms and take meaningful steps towards improving your health and wellbeing.

Based in Leichhardt, Sydney, I work with clients both in person and online across Australia to provide personalised, evidence-based support for thyroid health.

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Frequently asked questions

Yes. This is something I see regularly in clinical practice. While many standard thyroid assessments focus primarily on TSH (thyroid-stimulating hormone), TSH alone does not always provide a complete picture of thyroid function.
When symptoms such as fatigue, brain fog, constipation, weight changes, low mood or feeling cold persist despite "normal" test results, it may be worth investigating further. A more comprehensive thyroid assessment can include markers such as Free T4, Free T3 and thyroid antibodies, alongside consideration of factors such as stress, nutrient status, gut health and inflammation.
It's also important to remember that symptoms can arise from multiple underlying factors, not just the thyroid itself. Looking at the broader picture can help identify what may be contributing to ongoing symptoms and guide a more personalised approach to care.
Hypothyroidism refers to an underactive thyroid, where the gland does not produce enough thyroid hormones to meet the body’s needs. This can result in a slowing of many metabolic processes and symptoms such as fatigue, weight gain, constipation, and low mood.
Hashimoto’s thyroiditis is an autoimmune condition and is one of the most common causes of hypothyroidism. In Hashimoto’s, the immune system mistakenly attacks the thyroid gland, leading to inflammation and gradual reduction in thyroid function over time.
In other words, hypothyroidism describes the state of low thyroid function, while Hashimoto’s describes the underlying autoimmune cause that may be driving it.
Some people may have Hashimoto’s before their thyroid hormone levels become abnormal, which is why testing thyroid antibodies can be an important part of assessment.
Hashimoto’s is especially common in women, in particular after pregnancy, and is often seen alongside other hormonal or immune-related conditions.
Yes. Stress can have a significant impact on thyroid function.
The thyroid is highly sensitive to both physical and emotional stress, as well as factors such as nutrient deficiencies and inadequate protein intake. Chronic stress can influence the hypothalamic-pituitary-adrenal (HPA) axis, which in turn can affect thyroid hormone production, conversion, and utilisation in the body.
In some cases, symptoms that resemble thyroid dysfunction may actually be driven or amplified by stress-related changes in the body, rather than a primary thyroid disorder. This is why comprehensive thyroid testing, along with a broader assessment of stress levels, nutrient status, and overall health, is important.
The key question is not only whether the thyroid is underactive or overactive, but also what factors may be influencing how well it is functioning.
This is particularly relevant for women experiencing chronic stress, burnout, or hormonal changes.
Several nutrients are essential for healthy thyroid function, as they play a role in thyroid hormone production, conversion, and regulation within the body.
Key nutrients that support thyroid health include iodine, selenium, zinc, iron, vitamin D, magnesium, and B vitamins. These nutrients are involved in processes such as thyroid hormone synthesis, the conversion of T4 (inactive thyroid hormone) to T3 (active thyroid hormone), and supporting immune and metabolic function.
Protein intake is also important, as adequate protein is required for the transport and utilisation of thyroid hormones in the body.
Rather than focusing on individual nutrients in isolation, it is often more effective to assess overall diet quality, digestive health, stress levels, and absorption, as these factors influence how well the body can use these nutrients.
Nutrient needs can vary between individuals, particularly in cases of hypothyroidism or Hashimoto’s thyroiditis, so personalised assessment is important.