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Fatigue & Hypothyroidism Case Study with Martin Budd ND

Martin Budd ND is a renowned authority on fatigue, blood sugar and thyroid disorders.  Martin’s clinical journey began in 1963 when he graduated as a naturopathic consultant.  After many years of clinical experience and having written several books on the subject, Martin is now considered an authority on fatigue, thyroid health and blood sugar disorders.  We are grateful to Martin for his time and thrilled to be able to share with you here, his thoughts on hypothyroidism and fatigue, and a brief case study too:

Fatigue is our commonest symptom after pain and aside from the cancers, heart conditions and various anaemias, the chief cause of fatigue is an underactive thyroid (hypothyroidism).

Unfortunately, the medical diagnosis and treatment for thyroid disorders is unsatisfactory in most of Europe, with diagnosis being based on the patients’ blood level of the pituitary hormone known as T.S.H. or Thyroid Stimulating Hormone. The level of T.S.H. will rise in response to a thyroid deficiency. However borderline thyroid problems are not always reflected in such an increase.

For this reason, the most valuable diagnostic test is the blood thyroxine (Free T4). Many countries including America see the Free T4 as the most important indicator of thyroid malfunction.

Although fatigue is a symptom of hypothyroidism there are also many other symptoms that are diagnostically useful.

A further flaw in medical diagnosis is the great variation in the “normal range” for Free T4 offered by various laboratories in the U.K. I have seen “normal” ranging from 7.5-18pmol/L up to 12-22pmol/L.  As blood thyroxine reduces with age, the normal ranges should be based on patients’ age.

The testing of patients taking thyroxine also presents problems. Interpretation of a patient’s thyroid status needs to be based on their thyroxine dosage, in addition to their age and symptoms.  American test results usually offer different “normal ranges” based on the patient’s thyroxine dosage, i.e. a higher range for a higher dosage.  Possibly half of my patients with an underactive thyroid are taking thyroxine when they consult me, yet they are invariably fatigued and have been reassured by their G.P. or endocrinologist that “all is normal”.  Blood test results need to be matched to their symptoms. An example being a person with Free T4 of 16pmol/L on 50mcgms of thyroxine may be judged normal yet still suffer with chronic fatigue. If the patient is under 40 years of age their “normal” Free T4 may need to be 25pmol/L + before symptom relief is achieved.

Case study – Hypothyroidism & fatigue


Female patient aged 53 years.
Treatment 50mcgms thyroxine daily over 2 years with symptoms of fatigue, “brain-fog” and overweight.


Free T4 level in 2015 – 16pmol/L
Free T4 level in 2016 – 22pmol/L


I recommended a comprehensive supplement specifically designed to fine tune thyroid function & containing a range of essential vitamins and minerals including:

 • Tyrosine - Amino acid needed to make thyroid hormone
 • Kelp – Concentrated source of bioavailable iodine, which is an essential component of thyroid hormones
 • B vitamins and copper - Essential co-factors in the metabolism of tyrosine (an amino acid which is needed to make thyroid hormones)
 • Liquorice root and B vitamins - Support adrenal function which in turn supports thyroid function

NB: This blend of nutrients is of particular value for patients on thyroxine.


This client’s symptoms over a 6-month period have all improved and the patient hopes in the future to maintain good health without relying on thyroxine.

About Martin Budd ND, MRN, CNHC

Martin Budd has been a Naturopathic Consultant and a member of the register of naturopaths since 1963.  Over the years Martin has developed a special interest in thyroid, blood sugar disorders and fatigue.  His first book, Low Blood Sugar, was published in 1981 and has since been followed by several more on Diabetes, Migraine, Hypothyroidism, Fatigue and Obesity.   His latest book, ‘Why am I so exhausted?’ was published by Hammersmith health Books in 2013.

With the publication of these books and his vast clinical experience, Martin Budd has become an authority on the diagnosis and treatment of blood sugar disorders, hypothyroidism, chronic fatigue, overweight, stress and allied health problems and is regularly asked to lecture on these subjects.   

Patients travel from many parts of the UK, Europe and America to his practices in Bournemouth (Dorset) and London (Harley Street).  Although he now lives in South West France, he travels to the UK to see patients every other month.  For more information visit