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MediBalans›Thyroid & Hormonal Balance
Investigation · Stockholm

Your results look normal.
But you still do not feel well.

Physician-led assessment of hypothyroidism, Hashimoto’s and persistent symptoms. Fatigue, feeling cold and difficulty concentrating can affect everyday life. We review your symptoms, previous results and treatment to assess whether your thyroid or another issue needs follow-up.

Free first consultation · 45 minutes · No referral needed

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Your symptoms deserve attention, even when results fall within the reference range.
This does not automatically mean you need more thyroid hormone. We consider the results alongside how you feel and what has already been investigated.

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What happens at your first consultation?

Bring previous TSH and free T4 results, a current medicine list and details of supplements. We review your symptom timeline, how you take any levothyroxine and what treatment has changed. Further steps may include tests, assessment of other possible causes or contact with your treating clinician. Further appointments and tests depend on the plan; we explain costs before you decide.

Changes to thyroid treatment need to be made with your treating clinician. Do not change your dose or stop levothyroxine on your own.

Care areaRead about persistent fatigue and autoimmunity when other symptoms are part of your situation.
Tests and clinical assessment

How we interpret thyroid results

01

TSH and free T4 in context

TSH is the pituitary signal to the thyroid and a central first-line test for suspected primary hypothyroidism. Free T4 adds information when indicated. If pituitary disease is suspected, TSH and free T4 need to be assessed together; TSH alone is insufficient.

02

Hashimoto’s and TPO antibodies

Hashimoto’s is autoimmune inflammation of the thyroid. TPO antibodies can support the diagnosis when testing is indicated. Positive antibodies alone do not establish a need for hormone treatment; thyroid function and the clinical picture guide assessment.

03

T4, T3 and reverse T3

The body converts T4 into active T3 and inactive reverse T3 (rT3). Routine rT3 testing is not recommended to diagnose hypothyroidism or guide levothyroxine dosing. A high result does not establish clinical T3 receptor blockade.

04

Persistent symptoms need a broader assessment

We review dosing, medicine interactions and how treatment is taken. Sleep problems, anaemia, other conditions or medicines can also contribute. Tests and actions follow the symptoms rather than a fixed list of add-on tests.

The Hashimoto's protocol

Hashimoto’s: treatment and follow-up

In hypothyroidism, levothyroxine replaces hormone the thyroid is not producing in sufficient amounts. Treatment is monitored using relevant results and symptoms. Hashimoto’s with preserved thyroid function may instead need monitoring.

Selenium is part of enzymes including deiodinases involved in thyroid hormone metabolism, but routine supplementation is not an established substitute for treatment. High doses of selenium or iodine can be harmful. Suspected coeliac disease warrants targeted assessment; a gluten-free diet is not routinely recommended for everyone with Hashimoto’s.

GCR — prioritising clinical questions

GCR is our clinical working model for prioritising questions and reviewing outcomes. It does not replace established thyroid diagnostics or mean everyone needs gut, saliva or genetic tests.

Genova Diagnostics

Thyroid profile — select tests for the question

TSH and, where indicated, free T4 are central in suspected hypothyroidism. Antibodies and other tests depend on the clinical question. A broader commercial panel is not automatically more useful; rT3 is not routinely needed.

Genova Diagnostics

Adrenocortex Stress Profile (ASP)

A saliva profile for cortisol and DHEA is not mandatory for persistent thyroid symptoms. It does not establish why levothyroxine treatment is not helping. Suspected adrenal disease requires targeted medical investigation.

Cell Science Systems

ALCAT — cellular reactivity

Measures cellular reactions in the laboratory. It does not diagnose Hashimoto’s or establish which foods cause TPO antibodies. It is not part of established routine assessment of hypothyroidism.

Cell Science Systems

CMA — cellular nutrient response

Examines white blood cell responses to nutrients under laboratory conditions. It does not directly measure selenium or iodine in the thyroid. Suspected deficiency is assessed through diet, symptoms and relevant tests.

FAQ

Questions about thyroid investigation

Fatigue, feeling cold and difficulty concentrating can have several causes. Normal TSH usually argues against primary hypothyroidism, but needs to be interpreted alongside symptoms, treatment and other findings. We assess whether additional tests or investigation of other causes are needed.
No. Hashimoto’s with normal thyroid function often needs monitoring over time. When hormone deficiency is established, levothyroxine may be needed. Dietary changes or supplements do not replace necessary hormone treatment, and dose changes should be made with your treating clinician.
Reverse T3 (rT3) is an inactive breakdown product of T4. It is not recommended as a routine test for suspected hypothyroidism or to guide levothyroxine dosing. An abnormal result does not prove that active T3 is blocked in tissues.
Related tests

Explore test contents and limitations

Diagnostics
Thyroid profile — select tests for the question
TSH and, where indicated, free T4 are central in suspected hypothyroidism. Antibodies and other tests depend on the clinical question. A broader commercial panel is not automatically more useful; rT3 is not routinely needed.
Diagnostics
Adrenocortex Stress Profile (ASP)
A saliva profile for cortisol and DHEA is not mandatory for persistent thyroid symptoms. It does not establish why levothyroxine treatment is not helping. Suspected adrenal disease requires targeted medical investigation.
Diagnostics
ALCAT — cellular reactivity
Measures cellular reactions in the laboratory. It does not diagnose Hashimoto’s or establish which foods cause TPO antibodies. It is not part of established routine assessment of hypothyroidism.
Diagnostics
CMA — cellular nutrient response
Examines white blood cell responses to nutrients under laboratory conditions. It does not directly measure selenium or iodine in the thyroid. Suspected deficiency is assessed through diet, symptoms and relevant tests.

Medical background and sources

Guidelines and patient information on testing, hypothyroidism and Hashimoto’s. Assessment follows the clinical question and established diagnostics.

Next step

Start with how you feel

Your first consultation is free and lasts 45 minutes. No referral is needed, and you do not need to choose a test beforehand.

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Keep reading. Explore symptom guides, clinical notes, assessments and diagnostics in our knowledge base.

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MediBalans + Meet Mario

Your plan continues between visits

For patients following a MediBalans protocol, Meet Mario can make the plan easier to follow between visits, with a meal plan, educational explanations and a separate channel to the care team.

See how Meet Mario supports your plan
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