Why is it so many of us women (and men!) in their mid-late 30’s, 40’s (and beyond..) are so lacking in energy? It’s pretty unfair as we used to be able to so easily burn the candle at both ends....but now- even just getting up out of bed and facing whatever responsibilities we have to deal with- whether it’s that morning commute to work in the city, work part time and study or being a stay at home mum – it’s all such a struggle!

I was faced with this very predicament in my mid thirties when I was working in a stressful teaching role that was leaving me exhausted by the end of the week with little energy to socialise or do any of the fun things I used to be able to do. I didn’t realise it at the time but at that point, I had pretty much burnt myself out with my excessive lifestyle, struggling and overwhelmed with stress and pressures at work (it was a trigger that lead to a diagnosis of ‘chronic fatigue syndrome’ several years later.) These feelings of depletion, which soon included head fog, aching limbs, food sensitivities and ironically, insomnia forced me to quit my job and dig a bit deeper. It led me on a journey to eventually becoming a nutrition practitioner so I could help others struggling with complex health issues of their own. I discovered there’s no ‘root cause’ to chronic fatigue, rather it’s multi-factorial and, like an onion, I’ve slowly been ‘peeling back’ the layers. However, lifestyle and dietary change and supporting emotional health have made a huge difference in my recovery (I’m still getting there!).


So where to begin? What tests should you ask for? A test you can ask your GP for is a thyroid function test. The thyroid is a butterfly-shaped gland that straddles the windpipe and it governs the metabolic rate of every cellular and bodily function- it has been called the ‘thermostat’ of our body, as it maintains our temperature. The thyroid will manufacture and secrete the hormones T3 and T4. Hypothyroidism (or slow thyroid) results from a deficiency of thyroid hormone. Hyperthyroid is over-activity of the thyroid gland which results in excessive thyroid hormone production and can also result in fatigue.

Recognise any of these? Here are some common symptoms of hypothyroidism:

  • Fatigue, loss of energy, lethargy
  • Weight gain
  • Decreased appetite
  • Intolerance to cold
  • Dry Skin
  • Hair loss
  • Muscle pain, joint pain,
  • Depression
  • Head fog
  • Constipation

Your GP will first check your levels of thyroid stimulating hormone (TSH). If TSH levels are above the reference range, (TSH should not be above 4.5 and optimal level is between 1 and 2) the next step is to measure thyroxine (T4) if levels are low, the usual conventional medical treatment involves giving the person synthetic thyroid hormone of T4 (levothyroxine). However- T4 is not the active thyroid hormone; it must be converted into T3 in the body in order to exert its effects. The problem for many lies in the conversion and most doctors don’t check T3 levels.

Several imbalances in the body prevents this conversion of T4 to T3.

  • Mineral deficiencies. Firstly we need iodine and the amino acid tyrosine to manufacture T4 and T3. Selenium and zinc play an important role in the conversion of T4 to T3. This doesn’t mean that you should begin supplementing with these minerals, but ideally you should get tested to see if you have a deficiency.
  • Sluggish liver. About 20% of conversion happens in the liver, so gentle liver support with food such as cruciferous veg- cabbage, broccoli, and cauliflower help with enzyme production, radish and garlic are rich in sulphur which aid detoxification pathways, bitter vegetables and herbs such as mustard greens, chicory, dandelion root and artichoke get the bile flowing and toxins shifting and is a good starting point.
  • Gut health: inflammation and imbalance in gut flora can cause problems with the absorption of the minerals needed for conversion- so even if you are not deficient in selenium or zinc, if you have problems with digestion then this can affect the ability to convert T4 to T3.
  • Stress. Having high cortisol levels can affect the conversion of T4 to T3. This leads me back to the havoc of chronic stress- (it’s so important for us to address!) Certain adaptogenic herbs can be used modulate the cortisol levels, such as Ashwaganda or rhodiola. I will cover this more in another post.

Commonly, blood thyroid tests do come back normal but a thyroid imbalance is present. Over the years, my blood results have always been within range. I recommend all my clients to ask for a copy of your results!

If your results do return within ‘normal’ range, I would recommend an additional full thyroid screen that will test for T3, reverse T3 (which inhibits T3 function and keeps T3 in check- too much also indicates thyroid dysfunction) and anti-TG and anti-TPO antibodies (antibodies assess for thyroid autoimmunity). This is something a nutritional therapy practitioner can arrange.

But what if this screening test still comes back in normal range?

In my case, my full thyroid screen did come back ‘normal’ but I certainly didn’t feel normal. So what was going on?

There is another scenario- what if your T4 is being converted to T3, but not able to get inside the cell where it’s needed? Elevated free T3 on your blood test is a good indication- blood can reveal only what is circulating in the blood stream and not what is being efficiently absorbed into the cell, where it is actually utilised. The most common imbalances in low thyroid effect are due to impaired cell permeability– meaning the thyroid hormones can’t get into the cells to do their job! Years later, I discovered that this was one of my issues after I had my first Hair tissue mineral analysis (HTMA).

In his book “The Calcium Lie II” Dr. Thompson identified what he terms ‘Type 2 hypothyroidism’. This is when adequate levels of the hormones are being produced, but the body is simply not able to recognise or use them. This resistance is caused by a calcium/potassium imbalance in all the cells of the body, caused by far too much calcium and far too little potassium inside these cells, neutralising the effects of the thyroid hormones. High calcium on a HTMA is not caused by too much calcium in the diet- it is a sign of biounavailable calcium– meaning our cells and soft tissue are slowly becoming calcified. Chronic stress and over supplementation of vitamin D can cause biounavailable calcium. You can read more about what causes high calcium or “calcium shell” on a HTMA here.

This form of hypothyroidism is reversible over time by following a mineral balancing program that will correct the intra-cellular calcium and potassium levels and the ratio. Biounavailable calcium and magnesium (as indicated on a HTMA) causes reduced cell membrane permeability that decreases thyroid hormone uptake into the cells. This produces a cellular thyroid hormone deficiency. Find out more about how HTMA and mineral balancing can help you here.

So this for me, was one missing piece (of several!) of the jigsaw puzzle in my investigation into why I was feeling so depleted. Part 2 in this series will be about stress and the adrenals.



Thompson, R (2013) “What your doctor still doesn’t know- The Calcium Lie II”