Case Study: Understanding Thyroid Autoimmunity, Low Cortisol & Hormone Imbalance in a Woman in Her Early 40s
When Claire first came to see me, she was in her early 40s and felt completely defeated by her health. She had been gaining weight for years, felt tired all the time, and was becoming increasingly depressed.
The hardest part for her emotionally was that she no longer felt comfortable exercising - something she used to love.
She told me she felt ashamed of her weight, frustrated by the lack of progress, and confused about why nothing was working anymore. She felt stuck in a body that didn’t feel like hers.
Although she had been diagnosed with an underactive thyroid, her GP insisted her medication was “working fine.” But her symptoms clearly said otherwise.
I explained that if she wasn’t feeling well, we needed to understand why:
So we carried out two comprehensive tests:
Including antibodies, conversion markers and essential nutrients like B12, iron, folate, vitamin D and inflammatory marker.
Assessing oestrogen, progesterone, adrenal output (cortisol), and hormone metabolites.
This allowed us to look at the whole picture, not just one number on a blood test.
This meant her thyroid was autoimmune, not simply “underactive.”
Her immune system was attacking her thyroid tissue, which is why:
I recommended she seek referral to an endocrinologist familiar with autoimmune thyroid conditions, and in the meantime we began addressing the immune triggers nutritionally.
Cortisol is often misunderstood - people think of it as a “stress hormone,” but it is also:
Her cortisol was low all day, which explained:
This test result helped her feel validated - there was a real physiological reason she felt so low.
This is extremely common when:
Excess oestrogen can cause:
Her detoxification pathways also showed signs of being overloaded, meaning her body couldn’t clear hormones efficiently.
This combination - autoimmune thyroid + low cortisol + sluggish detox + high oestrogen gave us a clear roadmap on action plan.
But because she was exhausted and overwhelmed, we had to start gently.
We used:
This helped her body slowly rebuild its ability to produce cortisol when it was needed.
We focused on:
She noticed improvements quickly, especially in her mood.
To help her clear oestrogen more effectively, we used:
This also supported weight release, which had been stuck for years.
Her lifestyle was demanding - early mornings, long commutes into London, irregular eating patterns, and morning fasting.
Fasting can work for some people, but in cases of: underactive thyroid and imbalance of adrenals it can worsen symptoms dramatically and it is not recommended.
In her case, morning fasting was:
We needed to shifted towards:
This created an entirely new baseline for her body.
Over time, as her thyroid, cortisol, and hormonal pathways were supported:
She said at one point:
“This is the first time someone has explained what is actually happening in my body. I finally feel understood.”
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