How I Healed from Auto Immune Disease, IBS & Estrogen Dominance
August 4, 2025
Rhya Pachin

From Healthy Childhood to College Crash


I grew up in the 80’s and 90’s eating the typical amount of ultra-processed foods popular during that time. I was rarely sick. I competed in multiple sports as well as dance and vocal performance. I was born Type A, and an obnoxious overachiever. Somehow this diet and lifestyle didn’t seem to affect me. I was healthy, energetic, and athletic. So far so good.


Then I went to college. That’s probably when health issues begin for many, although mine was pretty extreme especially in contrast to my seemingly invincible childhood. My freshman year was extremely stressful as I obsessed over straight A’s in my pre-med biology program, taught group classes at a gym, and waited tables part-time to help pay for my apartment and books. I had also adapted a vegetarian diet in an attempt to be “healthier”, and because I was now on my own and running 24/7, I was eating more processed soy in the form of shakes, bars, and magical tofu mixes. Alcohol intake also increased of course. Lo and behold,
I started having digestive issues after about a year of this. 


I tried my best to research and DIY a solution (remember this was at the very early stages of internet so I mostly had to read books). I tried various diets and fasts which maybe helped short-term, but constipation and bloating returned quickly after resuming a normal diet. I increased fiber, ate only fruits and vegetables (probably the worst ideas looking back), and all sorts of other food combos, potions, and supplements.


I went to a natural medicine doctor (not even sure his title!) and he suggested colonic hydrotherapy and some supplements. I slowly started to feel better, but I was afraid of regressing and still struggled to find balance in my diet. However, I was so intrigued that I got a job at a small natural food market in hopes to learn more about supplements and healthy eating. I was also spending a lot more on food than the average college kid and knew I needed to figure out a way to reduce my grocery bill!


I realized recently that maybe I haven’t published the full story of my own health journey, which was a primary inspiration for advancing my education and starting my own business to help others in finding answers about their health.


Feel free to scroll straight to the bottom if you just want my top tips for how I did it! But I know some of you will find hope in the story.


Learning from Rock Bottom


Three years later, my life changed forever. I slipped on black ice in the parking lot of my apartment complex (ironically on the way to the gym), and shattered my ankle. I was transported to the ER and got the worst news I could ever receive–because it was such a complex fracture I would need surgery and have plates screwed in to stabilize the joint. I knew this was bad-metal permanently inserted into my body?! I was devastated and terrified.


I got through the surgery, but gained about 15 lbs in the 3 months that followed. Sure I was laying in bed a lot, but my diet was still very clean and I wasn’t eating junk or even eating very much, just smoothies and bone-supportive foods to help heal, still a lot of soy protein which was popular at the time. But nothing else in my life had drastically changed. 


To make a very very long story a little shorter, I saw so many doctors, including a D.O. who I interned for during my pre-med school track. He was very kind but didn’t have any answers.
I finally found another D.O. who was also a homeopathic doctor who told me I had developed Hashimoto’s disease. She prescribed thyroid meds and told me to stop eating processed soy and reintroduce animal protein. I wasn’t ready to add animal foods back, but the medicine — and possibly cutting out processed soy — seemed to help reduce the puffiness in my face and my weight came down a little.


After several months of PT I was able to start lifting weights and running again. By the time I graduated college that year I felt pretty good but my weight was still not what I was used to and it didn’t seem to mirror the lifestyle I was living, especially as a 23-yr old when everyone else is still drinking excessively 5 nights a week and living on fast food. But I persisted,


There are many different types of food in the containers on the table.

There are many different types of herbs and plants on the table.

I suddenly realized just before med school began that I would receive little to no nutrition education, and I didn’t just want to learn how to match prescription medications to symptoms. So… I took the leap and dropped out. All that hard work down the drain. But I couldn’t do it.


So I got a random job in consulting sales and began a new life. I slowly lost more weight, but my digestion was still very finicky. I had resumed teaching group fitness, and finally decided to try adding animal protein back into my diet as fatigue caught up to me. The angel of a doctor I had originally seen for my thyroid suggested I wean off medication, so I did, and I actually continued to feel a little better. 


Motherhood and the Return of Symptoms


A few years passed and I got pregnant with my first daughter. I was one of those annoying people who had a totally uneventful, enjoyable pregnancy. It didn’t really phase me. I worked until 39 weeks, felt energetic, worked out the whole time, felt pretty great. I had an unmedicated birth with zero complications. It was beautiful. But then a few weeks later, my daughter became very colicky and my digestive issues had coincidentally ramped up again.


I assumed something I was eating wasn’t agreeing with both of us, so I removed gluten and dairy as a guess to see if that helped. And it did. Bloating and constipation improved, but I continued to feel extremely fatigued. Of course, my logical explanation, as well as the first 2 doctors I saw, was that I was a new mom and my daughter wasn’t sleeping through the night… blah blah… that’s all it was.


I still have those labs, and they were not good! I just hadn’t found someone who understood that “normal” is not the same as “optimal.” My thyroid was still struggling, and as I tried to go back to work with a baby who wasn’t sleeping (at least she wasn’t screaming anymore) and a high stress sales job, fatigue worsened. I did still lose my baby weight within about 7-8 months, and did slowly regain some energy so I agreed in my mind that I must’ve just been dealing with “mom brain” and stress related to having a new baby.



The Dentist Who Changed Everything


I moved jobs twice trying to figure out how to balance work and being a new mom. After the birth of my second daughter, I moved to Charlotte and was feeling the familiar fatigue I had with my first daughter. I saw 2 doctors who completely dismissed me. Then I randomly went to a biologic dentist to establish care, and he immediately asked me about my ankle surgery after reviewing my intake form and noticing mild swelling in my thyroid. He suggested the metal in my ankle may have triggered Hashimoto’s which would explain the swelling, and urged me to find another doctor who would run labs. A dentist!! That is who encouraged me not to give up in figuring out my thyroid issues! It takes a village sometimes, and I’m so thankful for him.


So… I saw another endocrinologist, and ended up crying in her office, begging her to do a full thyroid panel. She didn’t really know what I meant, my TSH was “normal,” but was kind enough to ask a few of the nurses in the practice, and one of them knew what to order. She said my T4 was actually pretty low and agreed to write me a prescription for a compounded natural thyroid medication vs synthetic T4-based meds that are most common. I had been doing my research and learned that some/many women don’t respond well to T4-only medications. Again, she clearly thought I was crazy but my kids were tearing apart her office and I was crying, so I think she just wanted me out of there!


This was really the beginning of my journey in healing from IBS and Hashimoto’s, are you exhausted already from reading this so far?? Me too! It’s such a long story, but the context is so important for understanding that I get it when you feel like you’ve been through a lot and no one hears you! I had the same story. It was a STRUGGLE for a long time. Traditional medicine is excellent for acute care, but not chronic disease. I felt like I was fighting and clawing my way back to health most of those years.



How I Finally Healed


I moved jobs twice trying to figure out how to balance work and being a new mom. After the birth of my second daughter, I moved to Charlotte and was feeling the familiar fatigue I had with my first daughter. I saw 2 doctors who completely dismissed me. Then I randomly went to a biologic dentist to establish care, and he immediately asked me about my ankle surgery after reviewing my intake form and noticing mild swelling in my thyroid.


He suggested the metal in my ankle may have triggered Hashimoto’s which would explain the swelling, and urged me to find another doctor who would run labs. A dentist!! That is who encouraged me not to give up in figuring out my thyroid issues! It takes a village sometimes, and I’m so thankful for him.


So… I saw another endocrinologist, and ended up crying in her office, begging her to do a full thyroid panel. She didn’t really know what I meant, my TSH was “normal,” but was kind enough to ask a few of the nurses in the practice, and one of them knew what to order. She said my T4 was actually pretty low and agreed to write me a prescription for a compounded natural thyroid medication vs synthetic T4-based meds that are most common. I had been doing my research and learned that some/many women don’t respond well to T4-only medications. Again, she clearly thought I was crazy but my kids were tearing apart her office and I was crying, so I think she just wanted me out of there!





What Worked:

Tips from My Healing Journey


So to jump to the good part, here’s what I’ve learned over those last 20 years from school, from life, and from various practitioners and professionals along the way:


  • Medicine is not a replacement for lifestyle support. Keep working on food and lifestyle to support what the medicine is doing.


  • A varied diet including animal products like collagen and pastured, humanely-processed meat drastically improved my joints (I also have RA in my family history), reduced injuries, and nourished my hormones and organs. I continue to eat lots of color and fiber from fruits and vegetables as well, but restricting my diet to only these foods made it difficult for me to balance hormones and support a high level of activity. (This may not be the case for everyone, but something to consider if deficiencies persist or labs/symptoms don’t improve).


  • No gluten, processed soy, or vegetable/canola/seed oils. I also avoid most corn, but do eat some organic popcorn or tortilla chips occasionally. I don’t waver on gluten at all, and I believe this has made the biggest difference for my thyroid labs. My antibodies have basically remained in remission for 7-8 years without medication (even though doctors have told me food cannot change your antibodies and they will remain elevated forever). These food products can trigger inflammation and damage to the thyroid. Sometimes dairy is a trigger, and you have to find what works for you. I eliminated dairy for 1-2 years, and then slowly reincorporated occasional cheese, ideally from goat and sheep sources which tend to be cleaner and easier to digest. This works for most of my clients, but again can take some trial and error to confirm.


  • Minimize alcohol. I have found 1-2 drinks per week is usually tolerable, but if weight loss, sleep, blood sugar or hormone balance are concerns, the less alcohol the better.


  • Work on the gut before anything else! If the gut isn’t digesting and absorbing properly, it is near impossible to repair other organs or hormones. Start here, save up to get proper testing and work with someone skilled in this area. Infection and digestion can be tackled first, but then don’t forget gut repair for 2-3 months at least to prevent future issues and optimize gut and metabolic health.


  • Focus on the adrenals. Many thyroid problems begin here (I believe mine did). Don’t ignore stress, or “power through” for months or years on end. It will catch up with you. Sleep and play are essential to healing autoimmune disease.


  • Eat the best food you can afford. Buy organic wherever you can. Buy local from regenerative farms. Meat is now one of the top sources of Omega-6 rich fats in our diet due to corn and soy-based animal feed, which can lead to excess inflammation. Chickens, pigs, and cows don’t naturally live on these foods, and it is affecting our health as well as theirs.


  • Prioritize supplements based on need. Buy quality products from reputable vendors, not big box stores, social influencers, or large online retailers who don’t third-party test or verify quality. If they don’t have a COA on file, they are not third-party testing so you don’t really know what you’re getting. Avoid folic acid in processed food and supplements! This inhibits methylation which is essential to hormone health. I have found a multivitamin/mineral, fish oil, Vitamin D, magnesium, and digestive enzymes with Betaine HCl to be the most important for my body.


  • Minimize medications including NSAID’s, birth control pills, reflux meds, and antibiotics. One or more doses of these meds can significantly change the gut microbiome, which in turn affects hormones and metabolism. If you are struggling to lose weight despite diet and exercise, consider the fact that these meds may have sabotaged your gut, metabolism and hormones and starting with the gut will need to be repaired.


  • Prioritize rest. This means sleep but also “active rest,” which are calming activities that take us out of fight or flight mode which seems to be modern society’s default mode. I have purposely pursued gardening, cooking, hiking in the woods, and playing with my family and pets as hobbies to help give my nervous system small daily breaks from life’s demands.


  • Over time, switch to clean, non-toxic makeup, skincare, and household cleaning products. Use filtered water and air purifiers as needed.


  • Get sunshine daily and move your body 5-6 days per week in a way that is stimulating and energizing, not exhausting. This sometimes also requires trial and error, but usually there’s an achievable sweet spot for women trying to balance hormones and/or autoimmune disease. 



Final Thoughts: Don’t Give Up


The bottom line is show up every day, take small steps, and don’t give up. There are answers, and there are people who can help you. The journey can feel discouraging and hopeless, but coming out on the other side, I can tell you I’m in a better place having gone through the challenging times because of what I learned and how it’s changed my life. There was no other way for me to learn what I did, and now I get to share it with others which is even more rewarding.


If you’ve been on an autoimmune journey, especially Hashimoto’s, what other foods, supplements, therapies, or lifestyle changes have made the most difference in helping you heal? I’d love to hear from you!

A woman reaches for her neck, where her thyroid is highlighted
By Rhya Pachin • October 7, 2026
Thyroid problems can affect many parts of the body, and symptoms can look different depending on whether the thyroid is underactive or overactive . With an underactive thyroid (hypothyroidism) , common symptoms include fatigue, feeling cold, weight changes, constipation, dry skin, hair thinning, changes in mood or concentration, and menstrual changes. An overactive thyroid (hyperthyroidism) can cause symptoms such as feeling unusually hot, sweating, a racing or irregular heartbeat, trouble sleeping, anxiety, weight loss, tremors, or more frequent bowel movements. These symptoms can be important clues that your thyroid may need a closer look . But symptoms alone can't tell us whether you have a thyroid condition or what's contributing to the way you're feeling. That's why it's helpful to look at symptoms alongside appropriate thyroid testing, health history, medications, nutrition, and other relevant factors. - - - - - - Your Thyroid: Key Points Thyroid symptoms can show up in many ways: Hypothyroidism and hyperthyroidism can affect energy, temperature regulation, digestion, weight, mood, sleep, hair and skin, heart rate, and menstrual cycles. Symptoms can be clues: Symptoms such as fatigue, brain fog, feeling cold, constipation, hair thinning, or unexplained weight changes may be worth discussing with your healthcare provider when they persist or occur together. Testing helps clarify the picture: Thyroid symptoms can't diagnose a thyroid condition on their own. Appropriate blood testing, interpreted alongside your symptoms and health history, can provide important information about thyroid function. The type of thyroid condition matters: Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can affect thyroid function in different ways. The bigger picture still matters: Even when thyroid dysfunction is present, it's worth considering nutrition, medications, sleep, stress, hormonal health, and other relevant factors that may be contributing to symptoms or affecting overall health. Nutrition can support thyroid health: A balanced, nutrient-dense diet can be part of a comprehensive approach to thyroid health, but nutrition support does not replace appropriate medical evaluation or thyroid medication when medication is indicated. - - - - - - Understanding Thyroid Symptoms The thyroid is a small gland in the front of your neck that produces hormones involved in how your body uses energy. Thyroid hormones influence many body systems, including metabolism, temperature regulation, heart function, digestion, and brain function. When the thyroid is underactive, or hypothyroid , body processes can slow down. Common symptoms include fatigue, feeling cold, constipation, dry skin, dry or thinning hair, weight gain, muscle or joint discomfort, changes in menstrual periods, low mood, and difficulty concentrating. When the thyroid is overactive, or hyperthyroid, body processes can speed up. Someone may experience feeling hot or sweaty, a racing or irregular heartbeat, anxiety or irritability, difficulty sleeping, tremors, weight loss, increased bowel movements or diarrhea, or changes in menstrual periods. Autoimmune thyroid conditions are also part of this picture. Hashimoto’s thyroiditis is an autoimmune condition that commonly leads to hypothyroidism, while Graves’ disease is the most common cause of hyperthyroidism. The important thing to remember is that these symptoms can occur for many reasons. The same fatigue, brain fog, hair changes, or weight changes that make someone wonder about their thyroid can also be associated with other factors. That is why symptoms are a starting point for asking better questions, not a way to make a diagnosis. - - - - - - How Thyroid Testing Works If your symptoms suggest that your thyroid may need a closer look, testing can provide important information about how your thyroid is functioning. TSH is commonly used as an initial thyroid test , and depending on your symptoms, health history, and the clinical question, additional testing may include free T4, free T3, thyroid antibodies, and, in some cases, reverse T3. The specific tests that make sense depend on the individual. Thyroid results are best interpreted alongside symptoms, health history, medications, supplements, and other relevant factors rather than looking at a single number in isolation. Thyroid antibody testing may also be helpful when an autoimmune thyroid condition such as Hashimoto's thyroiditis or Graves' disease is being considered. From a functional nutrition perspective, testing is one piece of the bigger picture. The goal isn't simply to order more tests, but to understand what information would actually be useful and how it may help guide the next step. - - - - - - Who May Benefit From an Organic Acids Test It can be reasonable to talk with your healthcare provider about thyroid evaluation if you have persistent or unexplained symptoms that could fit with thyroid dysfunction , especially when several symptoms occur together or represent a noticeable change from your usual baseline. This can include ongoing fatigue, changes in weight, feeling unusually cold or hot, constipation or more frequent bowel movements, changes in hair or skin, changes in menstrual cycles, sleep disruption, heart palpitations, or changes in mood or concentration. It is also worth bringing up thyroid concerns if you have a personal or family history of thyroid disease or an autoimmune condition . Thyroid conditions can occur alongside other health concerns, so your broader history matters. At the same time, not every person with these symptoms needs an extensive thyroid workup. Symptoms alone do not tell us what testing is appropriate, and a thyroid-focused evaluation should not distract from other potential explanations. If you are pregnant, trying to conceive, recently postpartum, or taking thyroid medication, thyroid evaluation and monitoring can require additional attention. Your physician or other appropriate medical provider should guide diagnosis and medication management in these situations. At Carolina Functional Nutrition in Charlotte, I work with both hypothyroid and hyperthyroid concerns, including autoimmune thyroid conditions such as Hashimoto’s and Graves’ disease. My role is to provide nutrition and lifestyle support alongside appropriate medical care, not to replace it. - - - - - - Risks, Limitations & What to Monitor There is no single downside to having thyroid symptoms, but there are a few important limitations to keep in mind when trying to interpret them. First, symptoms are nonspecific . Fatigue, weight changes, hair thinning, brain fog, constipation, and sleep changes can occur with many different conditions. Assuming that every symptom is caused by the thyroid can lead you away from other factors that may need attention. Second, thyroid testing has to be interpreted carefully . TSH is an important test, but the right combination of tests depends on the clinical situation. Different thyroid conditions can produce different patterns, and test results can be affected by certain medications, supplements, health conditions, and life stages. Biotin is one example. This common supplement can interfere with some thyroid blood tests, so it is important to tell your healthcare provider about supplements you take before testing. Do not stop a prescribed medication on your own; instead, ask your healthcare provider whether any preparation is needed before testing. Third, thyroid medication requires monitoring . Too little thyroid hormone can leave symptoms such as fatigue or feeling cold unresolved, while too much thyroid hormone can contribute to symptoms such as feeling nervous, feeling hot, having a fast heartbeat, or losing weight. Medication doses should be adjusted with the prescribing clinician rather than based on symptoms alone. Finally, nutrition support should be individualized . There is no single “thyroid diet” that is appropriate for everyone, and adding large amounts of individual nutrients or supplements is not automatically helpful. The goal is to identify nutritional gaps and practical dietary factors that are relevant to the individual while keeping medical treatment and monitoring in place. If symptoms persist , worsen, or change significantly, follow up with your healthcare provider rather than assuming you simply need more supplements or another dietary change. - - - - - - When To Seek Care Most thyroid symptoms can be evaluated through routine medical care, but some symptoms need more immediate attention . Seek urgent medical care for severe or rapidly worsening symptoms such as chest pain, significant difficulty breathing, fainting, or a very fast or irregular heartbeat. Severe symptoms accompanied by confusion, marked agitation, or a high fever also warrant urgent evaluation. If you have a known thyroid condition and develop a significant change in symptoms, contact your healthcare provider promptly. This is particularly important if you are taking thyroid medication and notice new or worsening symptoms that could suggest your dose needs to be reassessed. - - - - - - Next Steps  If you’ve been wondering whether your symptoms could be related to your thyroid, you don’t have to figure it out on your own. A good place to start is a conversation about what you’ve been experiencing, your health history, and what questions may be worth exploring. A free 15-minute Jumpstart Call gives us a chance to talk through what’s been going on and help you understand what the next step could look like. - - - - - - Sources & Citations Hypothyroidism – American Thyroid Association Hyperthyroidism – American Thyroid Association Thyroid Tests – National Institute of Diabetes and Digestive and Kidney Diseases TSH (Thyroid-Stimulating Hormone) Test – MedlinePlus Medically reviewed by Rhya Pachin, MS, RDN, LDN, CLT Last updated: October 7, 2026 This content is for educational purposes and does not substitute personalized medical advice.
By Rhya Pachin • October 6, 2026
An Organic Acids Test (OAT) is a urine-based laboratory test that measures a range of organic-acid metabolites , which are byproducts of normal metabolism. Depending on the specific OAT used, the markers can provide information about areas such as energy production, nutrient-related metabolism, oxidative stress, and microbial activity. Vibrant Wellness and MosaicDX both offer OATs, although the exact markers and reporting vary between laboratories. An OAT can be a useful piece of information for some people, but it is not a test that everyone needs. At Carolina Functional Nutrition, testing is selected based on the individual, their symptoms and history, and the clinical question we are trying to answer. - - - - - - Organic Acid Testing: Key Points OAT is a urine test: An Organic Acids Test measures organic-acid metabolites in a urine sample. These compounds are produced through metabolic processes and are excreted in urine. It looks at multiple pathways: Depending on the laboratory, an OAT may include markers related to energy and mitochondrial metabolism, nutrient-related pathways, microbial activity, neurotransmitter metabolism, and oxidative stress. The exact panel varies, so two OATs should not automatically be treated as identical. It is not a standalone diagnosis: An abnormal marker does not automatically tell you what condition you have or what treatment you need. Results need to be considered alongside symptoms, medical history, medications, nutrition, and other relevant testing. Testing should have a purpose: An OAT is most useful when the results could add meaningful information to a specific clinical question. More testing is not necessarily better testing. Preparation matters: Diet, medications, supplements, hydration, timing, and other factors can influence organic-acid results. Your provider or laboratory should give you specific collection instructions. The test is only one piece of the picture: An OAT does not replace appropriate medical evaluation or standard laboratory testing when those are indicated. In some situations, other or more targeted testing may be more appropriate. - - - - - - Understanding Organic Acids Testing The term “organic acids” refers to a broad group of compounds produced during normal metabolism. Your body creates and breaks down these compounds as it processes carbohydrates, fats, amino acids, nutrients, and other substances. Many are ultimately excreted in urine. A commercial OAT brings a number of these markers together into one urine panel. For example, the current Vibrant Wellness OAT includes markers related to metabolic and mitochondrial function, microbial and gut health, neurotransmitter and brain function, and detoxification, nutritional, and oxidative-stress pathways. MosaicDX describes its OAT as measuring 76 organic acids from a urine sample across several metabolic categories. That does not mean an OAT can tell you exactly why you have a particular symptom. Instead, the results may p rovide additional information that can be considered alongside the rest of your health picture . For example, someone dealing with persistent fatigue may have several possible contributors worth considering, including sleep, nutrition, blood sugar regulation, thyroid function, medications, digestive health, or other medical conditions. An OAT may be useful in some cases, but it would not automatically be the next step for every person with fatigue. This is why personalized testing matters. The same symptom can have very different contributors from one person to another. - - - - - - How OAT Results Are Evaluated IAn OAT generally requires a urine sample. Both Vibrant Wellness and MosaicDX describe their OATs as urine-based tests, with collection instructions provided for the specific laboratory's kit. The exact preparation instructions can vary. For example, Vibrant Wellness recommends a first-morning urine collection and provides guidance around fasting, hydration, medications, supplements, certain foods, and other factors that may affect the sample. The laboratory specifically advises patients to follow their provider's instructions rather than independently stopping prescribed medications. Once the sample is processed, the report provides results for the markers included in that particular panel. The next step is interpretation. This is an important part of the process. A result should not be viewed in isolation and turned into a supplement recommendation simply because one marker falls outside a reference range. Organic-acid profiles can be influenced by diet, medications, clinical state, and other factors, and interpretation depends on the overall pattern and clinical context. At Carolina Functional Nutrition, we use testing to help answer questions —not to create a longer list of things to “fix.” The goal is to understand whether the information from an OAT adds something useful to the rest of the evaluation. - - - - - - Who May Benefit From an Organic Acids Test An OAT may be considered for an adult or child when the symptoms, history, and clinical question make the information potentially useful. It may be particularly relevant when someone has a more complex or multi-system symptom picture and a practitioner is trying to better understand certain metabolic or nutritional patterns. That does not mean an OAT is automatically appropriate for fatigue, digestive problems, brain fog, mood changes, or other common symptoms. Those symptoms have many possible explanations, and testing should be selected based on the individual rather than the symptom alone. You should also be cautious about ordering an OAT simply because you saw a list of symptoms online and recognized yourself in it. A test result without appropriate interpretation can create confusion, unnecessary worry, or an overly restrictive treatment plan. People with significant medical conditions, complex medication regimens, or concerning symptoms may also need evaluation through their physician or an appropriate medical specialist. Functional nutrition can complement conventional medical care; it should not replace necessary diagnosis or treatment. For someone in Charlotte, NC—or working with a provider virtually—the important question is not simply, “Can I get an OAT?” It is, “Would this test add useful information for my situation?” - - - - - - Risks, Limitations & What to Monitor An OAT is generally noninvasive because it involves urine collection rather than a blood draw. The bigger considerations are usually related to preparation, interpretation, cost, and what you do with the information afterward. Preparation requirements: Depending on the laboratory, you may receive instructions about fasting, hydration, foods, supplements, medications, exercise, or the timing of your urine collection. Following the laboratory's instructions matters because diet, medications, supplements, and other factors can affect organic-acid results. Results can be nonspecific: An elevated or decreased marker does not necessarily point to one single cause. Organic-acid profiles can be affected by nutritional, medication-related, physiologic, and other factors, which is one reason results should be interpreted in context. Different labs measure different things: Vibrant Wellness and MosaicDX do not report exactly the same panel. The number and type of markers can vary between laboratories, so it is important to know which test was ordered and what its specific markers are. More information can sometimes mean more confusion: If testing is ordered without a clear clinical question, an unexpected result may lead to unnecessary supplements, dietary restrictions, or additional testing. The purpose of testing should be to clarify the plan, not simply to generate more data. Follow-up matters: If an OAT is used as part of your evaluation, the results should be considered alongside your symptoms and other relevant information. Depending on what is found, your practitioner may recommend no additional testing, a more targeted test, coordination with your physician, or a nutrition and lifestyle plan. - - - - - - When To Seek Care An OAT is not designed to replace evaluation for urgent or potentially serious symptoms. Seek prompt medical attention for symptoms such as severe or worsening abdominal pain, significant or persistent vomiting, blood in the stool, fainting, severe dehydration, new confusion, chest pain, difficulty breathing, or sudden weakness or numbness. If you have persistent symptoms that are affecting your daily life but are not an emergency, bring them to the attention of your primary-care clinician or another qualified healthcare professional. An OAT may or may not be appropriate depending on what is happening and what other evaluation has already been completed. - - - - - - Next Steps If you are wondering whether an Organic Acids Test could be useful for you, the best place to start is with your individual symptoms, history, and goals rather than ordering a test based on a general recommendation. At Carolina Functional Nutrition, we use personalized testing when it can help clarify the bigger picture and guide next steps. If you’re in Charlotte, NC, or working with us virtually, you can Book a discovery call to talk through whether our approach is a good fit. You can also learn more about our functional nutrition services . Testing is only one part of the process; the goal is to understand what information is actually useful for you. - - - - - - Sources & Citations GOrganic Acids Test – Vibrant Wellness How Should Patients Prepare for the Organic Acids Test? – Vibrant Wellness Organic Acids Test (OAT) – MosaicDX Laboratory analysis of organic acids, 2018 update: a technical standard of the American College of Medical Genetics and Genomics – Genetics in Medicine Organic Acids Screen, Urine Spot – Mayo Clinic Laboratories Medically reviewed by Rhya Pachin, MS, RDN, LDN, CLT Last updated: October 6, 2026 This content is for educational purposes and does not substitute personalized medical advice.
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About the Author

Rhya Pachin is a licensed dietitian nutritionist who employs an "integrative" approach to support overall health rather than addressing just one symptom. As a certified LEAP therapist, she designs and supervises custom elimination diets. Her focus areas include gastrointestinal conditions like IBS and IBD, autoimmune diseases such as rheumatoid arthritis and Hashimoto's, persistent weight issues, food sensitivities, and chronic inflammatory conditions in both adults and children.

A woman reaches for her neck, where her thyroid is highlighted
By Rhya Pachin • October 7, 2026
Thyroid problems can affect many parts of the body, and symptoms can look different depending on whether the thyroid is underactive or overactive . With an underactive thyroid (hypothyroidism) , common symptoms include fatigue, feeling cold, weight changes, constipation, dry skin, hair thinning, changes in mood or concentration, and menstrual changes. An overactive thyroid (hyperthyroidism) can cause symptoms such as feeling unusually hot, sweating, a racing or irregular heartbeat, trouble sleeping, anxiety, weight loss, tremors, or more frequent bowel movements. These symptoms can be important clues that your thyroid may need a closer look . But symptoms alone can't tell us whether you have a thyroid condition or what's contributing to the way you're feeling. That's why it's helpful to look at symptoms alongside appropriate thyroid testing, health history, medications, nutrition, and other relevant factors. - - - - - - Your Thyroid: Key Points Thyroid symptoms can show up in many ways: Hypothyroidism and hyperthyroidism can affect energy, temperature regulation, digestion, weight, mood, sleep, hair and skin, heart rate, and menstrual cycles. Symptoms can be clues: Symptoms such as fatigue, brain fog, feeling cold, constipation, hair thinning, or unexplained weight changes may be worth discussing with your healthcare provider when they persist or occur together. Testing helps clarify the picture: Thyroid symptoms can't diagnose a thyroid condition on their own. Appropriate blood testing, interpreted alongside your symptoms and health history, can provide important information about thyroid function. The type of thyroid condition matters: Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can affect thyroid function in different ways. The bigger picture still matters: Even when thyroid dysfunction is present, it's worth considering nutrition, medications, sleep, stress, hormonal health, and other relevant factors that may be contributing to symptoms or affecting overall health. Nutrition can support thyroid health: A balanced, nutrient-dense diet can be part of a comprehensive approach to thyroid health, but nutrition support does not replace appropriate medical evaluation or thyroid medication when medication is indicated. - - - - - - Understanding Thyroid Symptoms The thyroid is a small gland in the front of your neck that produces hormones involved in how your body uses energy. Thyroid hormones influence many body systems, including metabolism, temperature regulation, heart function, digestion, and brain function. When the thyroid is underactive, or hypothyroid , body processes can slow down. Common symptoms include fatigue, feeling cold, constipation, dry skin, dry or thinning hair, weight gain, muscle or joint discomfort, changes in menstrual periods, low mood, and difficulty concentrating. When the thyroid is overactive, or hyperthyroid, body processes can speed up. Someone may experience feeling hot or sweaty, a racing or irregular heartbeat, anxiety or irritability, difficulty sleeping, tremors, weight loss, increased bowel movements or diarrhea, or changes in menstrual periods. Autoimmune thyroid conditions are also part of this picture. Hashimoto’s thyroiditis is an autoimmune condition that commonly leads to hypothyroidism, while Graves’ disease is the most common cause of hyperthyroidism. The important thing to remember is that these symptoms can occur for many reasons. The same fatigue, brain fog, hair changes, or weight changes that make someone wonder about their thyroid can also be associated with other factors. That is why symptoms are a starting point for asking better questions, not a way to make a diagnosis. - - - - - - How Thyroid Testing Works If your symptoms suggest that your thyroid may need a closer look, testing can provide important information about how your thyroid is functioning. TSH is commonly used as an initial thyroid test , and depending on your symptoms, health history, and the clinical question, additional testing may include free T4, free T3, thyroid antibodies, and, in some cases, reverse T3. The specific tests that make sense depend on the individual. Thyroid results are best interpreted alongside symptoms, health history, medications, supplements, and other relevant factors rather than looking at a single number in isolation. Thyroid antibody testing may also be helpful when an autoimmune thyroid condition such as Hashimoto's thyroiditis or Graves' disease is being considered. From a functional nutrition perspective, testing is one piece of the bigger picture. The goal isn't simply to order more tests, but to understand what information would actually be useful and how it may help guide the next step. - - - - - - Who May Benefit From an Organic Acids Test It can be reasonable to talk with your healthcare provider about thyroid evaluation if you have persistent or unexplained symptoms that could fit with thyroid dysfunction , especially when several symptoms occur together or represent a noticeable change from your usual baseline. This can include ongoing fatigue, changes in weight, feeling unusually cold or hot, constipation or more frequent bowel movements, changes in hair or skin, changes in menstrual cycles, sleep disruption, heart palpitations, or changes in mood or concentration. It is also worth bringing up thyroid concerns if you have a personal or family history of thyroid disease or an autoimmune condition . Thyroid conditions can occur alongside other health concerns, so your broader history matters. At the same time, not every person with these symptoms needs an extensive thyroid workup. Symptoms alone do not tell us what testing is appropriate, and a thyroid-focused evaluation should not distract from other potential explanations. If you are pregnant, trying to conceive, recently postpartum, or taking thyroid medication, thyroid evaluation and monitoring can require additional attention. Your physician or other appropriate medical provider should guide diagnosis and medication management in these situations. At Carolina Functional Nutrition in Charlotte, I work with both hypothyroid and hyperthyroid concerns, including autoimmune thyroid conditions such as Hashimoto’s and Graves’ disease. My role is to provide nutrition and lifestyle support alongside appropriate medical care, not to replace it. - - - - - - Risks, Limitations & What to Monitor There is no single downside to having thyroid symptoms, but there are a few important limitations to keep in mind when trying to interpret them. First, symptoms are nonspecific . Fatigue, weight changes, hair thinning, brain fog, constipation, and sleep changes can occur with many different conditions. Assuming that every symptom is caused by the thyroid can lead you away from other factors that may need attention. Second, thyroid testing has to be interpreted carefully . TSH is an important test, but the right combination of tests depends on the clinical situation. Different thyroid conditions can produce different patterns, and test results can be affected by certain medications, supplements, health conditions, and life stages. Biotin is one example. This common supplement can interfere with some thyroid blood tests, so it is important to tell your healthcare provider about supplements you take before testing. Do not stop a prescribed medication on your own; instead, ask your healthcare provider whether any preparation is needed before testing. Third, thyroid medication requires monitoring . Too little thyroid hormone can leave symptoms such as fatigue or feeling cold unresolved, while too much thyroid hormone can contribute to symptoms such as feeling nervous, feeling hot, having a fast heartbeat, or losing weight. Medication doses should be adjusted with the prescribing clinician rather than based on symptoms alone. Finally, nutrition support should be individualized . There is no single “thyroid diet” that is appropriate for everyone, and adding large amounts of individual nutrients or supplements is not automatically helpful. The goal is to identify nutritional gaps and practical dietary factors that are relevant to the individual while keeping medical treatment and monitoring in place. If symptoms persist , worsen, or change significantly, follow up with your healthcare provider rather than assuming you simply need more supplements or another dietary change. - - - - - - When To Seek Care Most thyroid symptoms can be evaluated through routine medical care, but some symptoms need more immediate attention . Seek urgent medical care for severe or rapidly worsening symptoms such as chest pain, significant difficulty breathing, fainting, or a very fast or irregular heartbeat. Severe symptoms accompanied by confusion, marked agitation, or a high fever also warrant urgent evaluation. If you have a known thyroid condition and develop a significant change in symptoms, contact your healthcare provider promptly. This is particularly important if you are taking thyroid medication and notice new or worsening symptoms that could suggest your dose needs to be reassessed. - - - - - - Next Steps  If you’ve been wondering whether your symptoms could be related to your thyroid, you don’t have to figure it out on your own. A good place to start is a conversation about what you’ve been experiencing, your health history, and what questions may be worth exploring. A free 15-minute Jumpstart Call gives us a chance to talk through what’s been going on and help you understand what the next step could look like. - - - - - - Sources & Citations Hypothyroidism – American Thyroid Association Hyperthyroidism – American Thyroid Association Thyroid Tests – National Institute of Diabetes and Digestive and Kidney Diseases TSH (Thyroid-Stimulating Hormone) Test – MedlinePlus Medically reviewed by Rhya Pachin, MS, RDN, LDN, CLT Last updated: October 7, 2026 This content is for educational purposes and does not substitute personalized medical advice.
By Rhya Pachin • October 6, 2026
An Organic Acids Test (OAT) is a urine-based laboratory test that measures a range of organic-acid metabolites , which are byproducts of normal metabolism. Depending on the specific OAT used, the markers can provide information about areas such as energy production, nutrient-related metabolism, oxidative stress, and microbial activity. Vibrant Wellness and MosaicDX both offer OATs, although the exact markers and reporting vary between laboratories. An OAT can be a useful piece of information for some people, but it is not a test that everyone needs. At Carolina Functional Nutrition, testing is selected based on the individual, their symptoms and history, and the clinical question we are trying to answer. - - - - - - Organic Acid Testing: Key Points OAT is a urine test: An Organic Acids Test measures organic-acid metabolites in a urine sample. These compounds are produced through metabolic processes and are excreted in urine. It looks at multiple pathways: Depending on the laboratory, an OAT may include markers related to energy and mitochondrial metabolism, nutrient-related pathways, microbial activity, neurotransmitter metabolism, and oxidative stress. The exact panel varies, so two OATs should not automatically be treated as identical. It is not a standalone diagnosis: An abnormal marker does not automatically tell you what condition you have or what treatment you need. Results need to be considered alongside symptoms, medical history, medications, nutrition, and other relevant testing. Testing should have a purpose: An OAT is most useful when the results could add meaningful information to a specific clinical question. More testing is not necessarily better testing. Preparation matters: Diet, medications, supplements, hydration, timing, and other factors can influence organic-acid results. Your provider or laboratory should give you specific collection instructions. The test is only one piece of the picture: An OAT does not replace appropriate medical evaluation or standard laboratory testing when those are indicated. In some situations, other or more targeted testing may be more appropriate. - - - - - - Understanding Organic Acids Testing The term “organic acids” refers to a broad group of compounds produced during normal metabolism. Your body creates and breaks down these compounds as it processes carbohydrates, fats, amino acids, nutrients, and other substances. Many are ultimately excreted in urine. A commercial OAT brings a number of these markers together into one urine panel. For example, the current Vibrant Wellness OAT includes markers related to metabolic and mitochondrial function, microbial and gut health, neurotransmitter and brain function, and detoxification, nutritional, and oxidative-stress pathways. MosaicDX describes its OAT as measuring 76 organic acids from a urine sample across several metabolic categories. That does not mean an OAT can tell you exactly why you have a particular symptom. Instead, the results may p rovide additional information that can be considered alongside the rest of your health picture . For example, someone dealing with persistent fatigue may have several possible contributors worth considering, including sleep, nutrition, blood sugar regulation, thyroid function, medications, digestive health, or other medical conditions. An OAT may be useful in some cases, but it would not automatically be the next step for every person with fatigue. This is why personalized testing matters. The same symptom can have very different contributors from one person to another. - - - - - - How OAT Results Are Evaluated IAn OAT generally requires a urine sample. Both Vibrant Wellness and MosaicDX describe their OATs as urine-based tests, with collection instructions provided for the specific laboratory's kit. The exact preparation instructions can vary. For example, Vibrant Wellness recommends a first-morning urine collection and provides guidance around fasting, hydration, medications, supplements, certain foods, and other factors that may affect the sample. The laboratory specifically advises patients to follow their provider's instructions rather than independently stopping prescribed medications. Once the sample is processed, the report provides results for the markers included in that particular panel. The next step is interpretation. This is an important part of the process. A result should not be viewed in isolation and turned into a supplement recommendation simply because one marker falls outside a reference range. Organic-acid profiles can be influenced by diet, medications, clinical state, and other factors, and interpretation depends on the overall pattern and clinical context. At Carolina Functional Nutrition, we use testing to help answer questions —not to create a longer list of things to “fix.” The goal is to understand whether the information from an OAT adds something useful to the rest of the evaluation. - - - - - - Who May Benefit From an Organic Acids Test An OAT may be considered for an adult or child when the symptoms, history, and clinical question make the information potentially useful. It may be particularly relevant when someone has a more complex or multi-system symptom picture and a practitioner is trying to better understand certain metabolic or nutritional patterns. That does not mean an OAT is automatically appropriate for fatigue, digestive problems, brain fog, mood changes, or other common symptoms. Those symptoms have many possible explanations, and testing should be selected based on the individual rather than the symptom alone. You should also be cautious about ordering an OAT simply because you saw a list of symptoms online and recognized yourself in it. A test result without appropriate interpretation can create confusion, unnecessary worry, or an overly restrictive treatment plan. People with significant medical conditions, complex medication regimens, or concerning symptoms may also need evaluation through their physician or an appropriate medical specialist. Functional nutrition can complement conventional medical care; it should not replace necessary diagnosis or treatment. For someone in Charlotte, NC—or working with a provider virtually—the important question is not simply, “Can I get an OAT?” It is, “Would this test add useful information for my situation?” - - - - - - Risks, Limitations & What to Monitor An OAT is generally noninvasive because it involves urine collection rather than a blood draw. The bigger considerations are usually related to preparation, interpretation, cost, and what you do with the information afterward. Preparation requirements: Depending on the laboratory, you may receive instructions about fasting, hydration, foods, supplements, medications, exercise, or the timing of your urine collection. Following the laboratory's instructions matters because diet, medications, supplements, and other factors can affect organic-acid results. Results can be nonspecific: An elevated or decreased marker does not necessarily point to one single cause. Organic-acid profiles can be affected by nutritional, medication-related, physiologic, and other factors, which is one reason results should be interpreted in context. Different labs measure different things: Vibrant Wellness and MosaicDX do not report exactly the same panel. The number and type of markers can vary between laboratories, so it is important to know which test was ordered and what its specific markers are. More information can sometimes mean more confusion: If testing is ordered without a clear clinical question, an unexpected result may lead to unnecessary supplements, dietary restrictions, or additional testing. The purpose of testing should be to clarify the plan, not simply to generate more data. Follow-up matters: If an OAT is used as part of your evaluation, the results should be considered alongside your symptoms and other relevant information. Depending on what is found, your practitioner may recommend no additional testing, a more targeted test, coordination with your physician, or a nutrition and lifestyle plan. - - - - - - When To Seek Care An OAT is not designed to replace evaluation for urgent or potentially serious symptoms. Seek prompt medical attention for symptoms such as severe or worsening abdominal pain, significant or persistent vomiting, blood in the stool, fainting, severe dehydration, new confusion, chest pain, difficulty breathing, or sudden weakness or numbness. If you have persistent symptoms that are affecting your daily life but are not an emergency, bring them to the attention of your primary-care clinician or another qualified healthcare professional. An OAT may or may not be appropriate depending on what is happening and what other evaluation has already been completed. - - - - - - Next Steps If you are wondering whether an Organic Acids Test could be useful for you, the best place to start is with your individual symptoms, history, and goals rather than ordering a test based on a general recommendation. At Carolina Functional Nutrition, we use personalized testing when it can help clarify the bigger picture and guide next steps. If you’re in Charlotte, NC, or working with us virtually, you can Book a discovery call to talk through whether our approach is a good fit. You can also learn more about our functional nutrition services . Testing is only one part of the process; the goal is to understand what information is actually useful for you. - - - - - - Sources & Citations GOrganic Acids Test – Vibrant Wellness How Should Patients Prepare for the Organic Acids Test? – Vibrant Wellness Organic Acids Test (OAT) – MosaicDX Laboratory analysis of organic acids, 2018 update: a technical standard of the American College of Medical Genetics and Genomics – Genetics in Medicine Organic Acids Screen, Urine Spot – Mayo Clinic Laboratories Medically reviewed by Rhya Pachin, MS, RDN, LDN, CLT Last updated: October 6, 2026 This content is for educational purposes and does not substitute personalized medical advice.
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By Rhya Pachin • September 7, 2026
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