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Dr Neet Hormone Imbalance Test UK

Serum, saliva or urine? Why we choose DUTCH testing at The Bespoke Clinic

Clinical Insights · Hormone Testing

Serum, saliva or urine?
Why we choose DUTCH testing at
The Bespoke Clinic

If you have ever wondered whether blood, saliva or urine is the best way to submit a hormone imbalance test, you are not alone. At The Bespoke Clinic, we use DUTCH testing because it provides a far more complete picture of hormone levels, metabolism and cortisol patterns. This is a guide to the three main approaches to hormone testing and why the right choice depends on what question you’re actually asking.

Patients often arrive having done their own research, which we welcome. A common question we hear is: “I’ve heard of ZRT saliva testing. Why did you choose a urine test instead?” It’s a fair question, and it deserves a real answer rather than a dismissal.

The short answer is: there is no single “best” method. Each approach, be it serum (blood), saliva, or dried urine, has genuine strengths and limitations. What matters is matching the right tool to the right clinical question. Here at The Bespoke Clinic, we use DUTCH dried urine testing for most hormone assessments, and we want to explain why, including where it falls short and where saliva or serum may be more appropriate.

Dr Neet Hormone Imbalance Test UK
Dr Neet, Clinical Expert

First, what are we actually measuring?

All three methods measure steroid hormones (oestrogen, progesterone, testosterone, cortisol, DHEA), but they capture different things:

Serum (blood)
  • Measures total hormone (mostly protein-bound)
  • Snapshot at one moment in time
  • Requires a phlebotomy appointment
  • Gold standard for baseline diagnostics
  • Best for: diagnosing deficiency, TRT dosing
  • Weaker for: transdermal oestradiol monitoring
Saliva (ZRT etc.)
  • Measures free (unbound) hormone
  • Non-invasive, at-home collection
  • Can capture diurnal patterns
  • Best for: cortisol rhythm assessment
  • Problem: dramatically inflated readings after topical hormone application
  • No evidence these elevated values reflect tissue exposure
Dried Urine (DUTCH)
  • Measures hormone metabolites over time
  • 4-spot at-home collection across one day
  • Shows how hormones are processed by the body
  • Best for: metabolite patterns, transdermal oestradiol monitoring, HPA axis
  • Not optimal for: baseline TRT deficiency diagnosis

The saliva debate: what the research actually shows

Saliva testing has been taught within integrative medicine for over 25 years as the gold standard for monitoring topical hormone creams and gels. The logic was appealing: free hormones in saliva represent bioavailable, tissue-active hormone, the fraction “actually doing something” in the body. ZRT Laboratory, one of the most respected names in this space, built their reputation on this principle.

However, a landmark peer-reviewed paper published in 2026 in Frontiers in Reproductive Health, authored by Mark Newman and colleagues at Precision Analytical, the creators of DUTCH, has comprehensively challenged this view for sex hormone monitoring.

Key finding

After reviewing over 100 published studies, the authors could not find a single study where elevated salivary testosterone values after topical application corresponded to clinical outcomes: not bone density, lean mass, sexual function, or androgen symptoms. Every clinical change tracked with serum levels, not saliva levels.

However, a landmark peer-reviewed paper published in 2026 in Frontiers in Reproductive Health, authored by Mark Newman and colleagues at Precision Analytical, the creators of DUTCH, has comprehensively challenged this view for sex hormone monitoring.

This is clinically significant because while serum barely moves, when transdermal testosterone is applied, saliva readings spike dramatically and often into supraphysiological territory. If you’re using saliva to guide dosing, you may dramatically under-dose your patient, believing they’re already “flooded” with hormone when tissue levels are actually still low.

The paper also included new real-world data from hundreds of women on transdermal testosterone: those with supraphysiological saliva levels reported no more androgenic symptoms (acne, hair loss, irritability etc.) than women with normal saliva levels. The elevated saliva simply wasn’t telling us what we thought it was.

So does saliva have no value at all?

Not quite, and this nuance matters. Saliva remains a well-validated tool for cortisol rhythm assessment. For cortisol specifically, saliva provides an instantaneous snapshot that complements the averaged picture you get from urine.

The problem is specific to monitoring topically applied sex hormones. Here, the saliva signal appears to reflect a local skin/salivary gland artefact rather than systemic tissue exposure. It’s not that saliva testing is “wrong”, it’s that it’s the wrong tool for this particular question.

Dr Neet Hormone Imbalance Test UK

What about oestradiol and progesterone?

The 2026 paper focused primarily on testosterone, but the authors comment that oestradiol behaves similarly. Saliva values inflate well above serum and urine with transdermal application, and there is currently no published clinical evidence that those elevated values correspond to meaningful outcomes. This mirrors what DUTCH’s own data has shown for years.

Progesterone is the most complex case of all, and frankly, no method does it perfectly. Serum levels don’t scale predictably with transdermal doses. Urine captures metabolites but not the parent hormone. Saliva inflates dramatically; 100mg of transdermal progesterone can push salivary levels far beyond premenopausal norms, while urine levels may remain below the premenopausal range. For now, clinical judgement of symptoms, cycle patterns, and endometrial monitoring, where relevant, remains an essential part of the progesterone picture alongside any lab testing.

Why we use DUTCH Testing at The Bespoke Clinic

The DUTCH test uses dried urine collected across four time points in a single day. This means it captures an average picture of hormone exposure rather than a single moment; particularly useful for hormones that fluctuate through the day, including cortisol and oestradiol. Crucially, it also maps hormone metabolites, which serum and saliva cannot do.

Clinical question Best method
Diagnosing testosterone deficiency / baseline TRT assessment Serum
Monitoring testosterone cream or gel dosing Serum (primary) + DUTCH (adjunct)
Monitoring transdermal oestradiol cream or gel DUTCH or serum, not saliva
Cortisol rhythm / HPA axis patterns DUTCH or saliva, both valid
Oestrogen metabolism (2-OH vs 16-OH pathway etc.) DUTCH only
Transdermal progesterone monitoring No method fully reliable, lean on symptoms
Comprehensive hormonal picture including HPA axis + metabolites DUTCH

Hormone metabolism matters deeply in functional medicine. Two patients can have identical serum oestradiol levels yet completely different risks depending on whether they’re metabolising oestrogen down the protective 2-OH pathway or the more problematic 16-OH route. Only urine testing reveals this. Similarly, understanding the HPA-cortisol-androgen axis as a whole (how stress affects sex hormones and vice versa) requires the breadth of markers that DUTCH provides.

What this means for you as our patient

When we order a DUTCH test, we are not following a trend or cutting corners, we are using the most information-rich tool currently available for the clinical questions we are asking. We have serum testing available and use it where it is clearly the right choice. We do not dismiss saliva testing; for cortisol rhythm, it remains a valuable modality.

What we do not do is use a method uncritically because it has been taught as standard for 25 years. The science in this field is evolving, and a 2026 peer-reviewed paper has substantially shifted our understanding of what saliva testing can and cannot tell us when patients are using topical hormone preparations.

We think you deserve to understand the reasoning behind every clinical decision we make. If you have questions about your specific test, your results, or why we chose one method over another, please ask. That conversation is always welcome.

A note on integrative medicine and evidence

One of the things we value most about functional and integrative medicine is its willingness to ask deeper questions about the body. But that same spirit of enquiry means we must be willing to update our practices when the evidence evolves, even when that challenges long-held assumptions. The current evidence supports DUTCH as the most clinically comprehensive at-home hormone test for most of our patients. We review this position as new research emerges.

Sources: Newman MS et al. (2026). Alternatives to serum testing for transdermal testosterone monitoring. Frontiers in Reproductive Health 8:1804311. DUTCH Test clinical articles, dutchtest.com. ZRT Laboratory clinical resources, zrtlab.com.

Am I in Perimenopause, Menopause or Postmenopause?

Am I in Perimenopause, Menopause or Postmenopause?

One of the most common things women say to me is:

“I don’t even know where I am in all of this.”

You may still be having periods but feel different.
You may have irregular cycles but “normal” blood tests.
You may have stopped bleeding and expected everything to settle, but it hasn’t.

The language around menopause can feel confusing. So let’s make it clearer.

Premenopause

Premenopause refers to the years before hormonal transition begins.
Cycles are generally regular. Ovulation happens consistently. Oestrogen and progesterone rise and fall in a predictable pattern.
That doesn’t mean everything feels perfect. PMS, heavy periods or mood changes can still occur. But the overall hormonal rhythm remains steady. If your cycles are consistent and you feel broadly well, you are likely still in this stage.

Perimenopause

Perimenopause is the transitional phase leading up to menopause. It often begins in the 40s, although some women notice changes in their late 30s. Others continue having periods well into their 50s.

Some women are still having periods at 50 or beyond and worry that something must be wrong. In many cases, this can still fall within the perimenopausal transition.

This is where things start to feel less predictable.

Ovulation becomes less consistent, which means progesterone often declines first. Oestrogen does not simply drop, it fluctuates. Some days it may be high, other days low. Testosterone gradually reduces over time.

That fluctuation is often what drives symptoms.

Sleep becomes lighter. Anxiety rises. Resilience drops. Brain fog appears. Periods change, sometimes heavier, sometimes lighter, sometimes closer together.

Early on, symptoms may feel cyclical. Later, they can become erratic, which in itself can feel stressful.

Blood tests may still sit within “normal” ranges because hormones are fluctuating rather than steadily declining. That is why perimenopause is primarily a clinical diagnosis.

Menopause

Menopause is defined as twelve consecutive months without a period. At this point, ovarian hormone production has declined significantly and oestrogen levels become consistently low.

The turbulence of fluctuation settles, but low hormone levels may bring their own symptoms. Hot flushes, vaginal dryness, sleep disturbance, reduced bone density and metabolic shifts can become more noticeable.

Postmenopause

Postmenopause refers to the years after menopause.

Hormone levels remain consistently low unless hormone therapy is used. Some women feel more stable once the hormonal turbulence of perimenopause ends. Others continue to experience symptoms that affect sleep, mood, cognition or physical health.

At this stage, attention often turns toward longer-term health, bone strength, cardiovascular health, muscle preservation and cognitive resilience.

It is not about chasing youth.
It is about supporting healthy ageing.

Why Does Knowing the Stage Matter?

Understanding where you are helps guide decisions.

Perimenopause may require flexibility. Progesterone support can be particularly relevant. HRT in perimenopause often needs more careful adjustment because hormones are fluctuating rather than consistently low.

Menopause and postmenopause may benefit from steadier oestrogen replacement and a broader focus on long-term health strategy.

The approach is not identical across all stages.

When Should You Seek Support?

If you feel different from yourself, more anxious, more tired, less resilient or less clear-headed, it is reasonable to seek assessment, even if you are still having periods.

You do not need to wait for things to become severe.

Many women seek a private menopause consultation when they feel their symptoms have been minimised or when appointment time has been too limited to explore the full picture.

Hormonal transition rarely follows a textbook timeline.

Personalised Menopause Care

At The Bespoke Clinic, we support women through premenopause, perimenopause, menopause and postmenopause with structured, doctor-led assessment.

If you are looking for a menopause doctor in Newcastle or would prefer an online menopause consultation elsewhere in the UK, appointments are available in clinic and remotely. Investigations can be arranged locally where required, and follow-up is individualised.

If you are unsure which stage you are in, or feel that something has shifted but cannot quite explain it, we would be pleased to support you.

Book a Consultation

Bioidentical vs Body-Identical HRT

Bioidentical vs Body-Identical HRT

A Balanced View

If you’ve spent time researching menopause treatment online, you will have noticed how divided the conversation can be.
Some clinics dismiss compounded bioidentical hormones entirely. Others promote them as the only safe or “natural” option.
When opinions are that polarised, the truth usually sits somewhere in the middle.
Let’s clarify it properly.

What Do These Terms Actually Mean?

Both body-identical and bioidentical hormones are structurally identical to the hormones your body produces naturally.

The difference is not the molecule. It is the manufacturing and licensing pathway.

Licensed body-identical HRT refers to preparations such as transdermal oestradiol and micronised progesterone that are produced by pharmaceutical manufacturers and hold formal marketing authorisation.

Compounded bioidentical HRT refers to prescriptions prepared individually by specialist compounding pharmacies. These may allow flexibility in dose or combination when clinically required.

Both use pharmaceutical-grade hormones identical to endogenous hormones.

The distinction lies in authorisation and standardisation, not in whether one is “natural” and the other “synthetic.”

What Do Professional Guidelines Say

The British Menopause Society advises that compounded bioidentical HRT is not routinely recommended. Their position reflects:

  • Greater published outcome data for licensed preparations
  • The availability of regulated alternatives
  • Limited evidence supporting routine saliva-based dose adjustment

These are reasonable population-level safety principles. However, guidelines are written for broad application. Clinical medicine is practised with individuals.

Are Compounded Hormones Unregulated?

You may have read that compounded hormones are “unregulated.” That is not accurate.

In the UK, specialist compounding pharmacies are registered with the General Pharmaceutical Council and operate within the Human Medicines Regulations framework. They are inspected and must comply with defined professional and manufacturing standards. The hormones used are pharmaceutical-grade and produced under Good Manufacturing Practice standards.

The key difference is this:

Licensed products undergo large commercial trial programmes tied to marketing authorisation.

Compounded prescriptions are prepared for individual patients and therefore do not follow that commercial licensing pathway.

That distinction matters in terms of evidence hierarchy. It does not mean absence of oversight.

What Does the Evidence Show?

Licensed body-identical oestradiol and micronised progesterone have reassuring safety data and are appropriate for many women.

For compounded formulations, large-scale outcome trials are more limited. That reflects differences in commercial licensing rather than differences in molecular structure.

The pharmacology of oestradiol, progesterone and testosterone is well established. What determines safety in practice is appropriate indication, careful dosing and ongoing review.

Medicine rarely operates in absolutes

When Might Compounding Be Considered?

For many women, licensed body-identical HRT works extremely well and should be first-line.

However, some women:

  • Do not tolerate standard progesterone regimens
  • Require dose adjustments outside available strengths
  • Have persistent symptoms despite optimisation
  • Need combinations not commercially available

In such cases, carefully supervised compounded therapy may be considered.
The key word is supervised.
Compounding should be clinically justified, not trend-driven.

What About Hormone Testing?

A single blood test taken in isolation, such as FSH, taken in isolation, is not a reliable way to decide on hormone replacement requirements
However, broader hormone assessment, when integrated with full clinical evaluation, may offer additional insight in complex cases.
Testing should inform judgement, not replace it.

My Position

I practise within established menopause guidance, including that of the British Menopause Society.

Licensed body-identical preparations are often entirely appropriate and effective.

Where individual circumstances require flexibility, intolerance management or bespoke dosing, compounded bioidentical therapy may be considered within a structured medical framework.

This is not about rejecting pharmaceutical medicine. Nor is it about embracing hype. It is about applying evidence thoughtfully to the individual woman in front of you. Menopause care should be balanced, proportionate and personalised.

If you would like to discuss which approach may be appropriate for you, consultations are available in clinic and remotely across the UK.

Book a Discovery Call

SHBG, Testosterone, and Why “Normal” Blood Tests Don’t Always Tell the Full Story

SHBG, Testosterone, and Why “Normal” Blood Tests Don’t Always Tell the Full Story

It is not uncommon for men to be told that their testosterone levels are “normal”, yet they continue to experience symptoms such as low energy, reduced libido, poor motivation, brain fog, loss of muscle tone, or difficulty recovering from exercise. One of the most common reasons for this disconnect is a hormone-binding protein called SHBG.

SHBG stands for Sex Hormone Binding Globulin. It plays a central role in how much testosterone is truly available for the body to use.

What is SHBG and why does it matter?

Testosterone in the bloodstream exists in three forms:

  • Bound tightly to SHBG
  • Bound loosely to albumin
  • Free testosterone, the small fraction that is biologically active

When SHBG levels are high, more testosterone becomes tightly bound and unavailable to tissues. This means total testosterone can appear normal on a blood test, while free or bioavailable testosterone is low. In many cases, it is the free testosterone level that best reflects how someone feels.

This is why two men with the same total testosterone level can have very different symptoms.

Why might SHBG be high?

SHBG is produced mainly by the liver and is influenced by a wide range of factors. Common contributors to higher SHBG include:

  • Ageing
  • Chronic stress and elevated cortisol
  • Undereating, excessive dieting, or prolonged low-carbohydrate intake
  • Overtraining and inadequate recovery
  • Thyroid overactivity or thyroid hormone over-replacement
  • Liver factors and alcohol intake
  • Higher oestrogen exposure
  • Certain medications
  • Genetic tendency

Importantly, SHBG is rarely the “problem” itself. It is usually a signal that something upstream needs attention.

A functional medicine perspective

Functional Medicine clinicians, including Dr Neet, often highlight that hormones do not operate in isolation. Testosterone, SHBG, cortisol, insulin, thyroid hormones, and oestrogen are all part of an interconnected system.

Therefore, persistently high SHBG could be a marker of broader physiological stress:

  • Chronic stress and poor sleep can raise cortisol, which in turn can increase SHBG
  • Low energy availability from dieting or over-exercise can push SHBG higher
  • Metabolic and liver health influence how hormones are produced, bound, and cleared

Rather than immediately focusing on replacing testosterone, the functional approach asks a more fundamental question: why is the body binding testosterone so tightly in the first place?

SHBG, metabolism, and long-term health

SHBG is also increasingly recognised as a metabolic marker. Large population studies have shown associations between SHBG levels and future risk of type 2 diabetes, highlighting that hormone binding reflects wider metabolic health rather than just reproductive hormones.

This reinforces the importance of viewing testosterone symptoms within the broader context of lifestyle, insulin sensitivity, inflammation, and liver function.

How SHBG should be assessed

When testosterone is being investigated, SHBG should almost always be measured alongside:

  • Total testosterone
  • Albumin
  • Calculated free testosterone (or high-quality free testosterone testing where available)

Blood tests should ideally be taken in the morning and repeated if results do not match symptoms. A single “normal” result is rarely enough to draw meaningful conclusions.

What can be done if SHBG is high and free testosterone is low?

Management depends on symptoms, underlying drivers, and individual goals, including fertility. In practice, this is often approached in stages.

1
Address upstream drivers

This may include:
• Improving sleep and stress regulation
• Adjusting training load and recovery
• Ensuring adequate protein, calories, and healthy fats
• Reviewing alcohol intake
• Checking thyroid function and metabolic markers

2
Optimise lifestyle foundations

Resistance training, adequate nutrition, and stress reduction often improve symptoms even if hormone numbers change modestly.

3
Correct deficiencies where appropriate

Vitamin D, zinc, and magnesium may be helpful when low, but supplementation should be targeted rather than automatic.

4
Consider medical options when appropriate

If symptoms persist despite optimisation and results are consistent over time, testosterone therapy or other medical options may be considered under specialist supervision. In this context, treatment is not about “chasing a number” but restoring function while maintaining long-term health and safety.

Functional medicine frameworks, including those discussed by Dr Mark Hyman, emphasise that hormone therapy should sit within a wider strategy that supports metabolic health, stress resilience, and sustainable wellbeing, rather than being used as a standalone fix.

The key takeaway

SHBG is one of the most important, and most overlooked, markers in male hormone health. When symptoms and blood tests do not align, it often provides the missing context.

Understanding SHBG allows for more personalised, nuanced decision-making, and helps move the conversation away from “your testosterone is normal” towards a more meaningful discussion about how the body is functioning as a whole.

References and further reading

  1. Bhasin S et al. Testosterone Therapy in Men with Hypogonadism: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism.
  2. Goldman AL, Bhasin S. Testosterone replacement therapy: what we know and what we don’t know. Current Opinion in Endocrinology, Diabetes and Obesity.
  3. Ding EL et al. Sex hormone–binding globulin and risk of type 2 diabetes in men and women. New England Journal of Medicine.
  4. Rosner W et al. Utility, limitations, and pitfalls in measuring testosterone. Journal of Clinical Endocrinology & Metabolism.
  5. Hyman M. The Doctor’s Farmacy Podcast and writings on functional hormone health and metabolic optimisation.

GI-MAP vs GI360 vs Microba: Which Gut Test Do You Actually Need?

The world of stool testing can feel overwhelming. With so many options — GI-MAP, GI360, MetaXplore, microbiome sequencing — it’s natural to wonder which one is “best”.

The truth is: there is no single best test for everyone.

Each one answers a different question, which is why at The Bespoke Clinic I choose the right test based on your symptoms, history and goals.
Here’s a simple breakdown to help you understand the differences.

do I need supplements

GI-MAP: precision testing for symptoms

GI-MAP uses quantitative PCR, one of the most accurate tools we have for identifying the exact levels of bacteria, parasites, viruses and fungi in the gut.

It’s exceptionally useful when symptoms are active, such as:

  • Bloating, IBS-type symptoms, diarrhoea or constipation
  • Acne, rosacea or eczema
  • Candida or “dysbiosis” patterns
  • Hormone imbalance (oestrogen, cortisol, androgens)
  • Autoimmune conditions
  • Low immunity
  • Suspected H. pylori

Because GI-MAP gives numerical values, it allows for highly targeted treatment plans. This is why I often favour it when we need clarity on what’s driving your symptoms.

GI360: a blended ecological overview

GI360 combines 16S sequencing, PCR, culture and microscopy. This can be useful for:
• A general overview of microbiome balance
• Diversity assessment
• Yeast, parasite and digestion screening
It’s not as quantitative as GI-MAP, but offers a broader ecological picture of the gut.

do I need supplements

MetaXplore (Microba): whole-genome microbiome sequencing

This is the deepest level of testing available. MetaXplore uses shotgun metagenomics, analysing all microbial DNA — bacteria, fungi, viruses — along with functional genes.
It uncovers:
• Butyrate and SCFA pathways
• LPS and inflammatory signatures
• Histamine, sulphur and bile metabolism
• Vitamin synthesis capacity
• Strain-level detail
• Diversity and richness scores
This is particularly helpful in complex cases such as long-standing gut issues, metabolic problems, autoimmunity, histamine intolerance or unexplained chronic symptoms.

So which test is right for you?

That depends entirely on you.
Some patients need the precision of GI-MAP.
Some benefit more from metabolic and functional insights via MetaXplore.
Sometimes combining a quantitative test with a sequencing test gives the clearest picture.
At The Bespoke Clinic, I guide you to the option that answers the questions your body is asking — so your treatment plan is both targeted and meaningful.

supplements and healthy diet

If you’d like to explore your gut health further, book a consultation and we’ll decide which test will give you the most useful insight.

Sign up to our newsletter for more tips.

Get in touch for a free discovery call.

It is important to remember, you are one whole person, not just a condition, label or set of bloods
Let’s look at the whole of you and see if we can move the dial. Get in touch for a free discovery call.

Contact Us
supplements

Do I Really Need Supplements if I Eat Healthy?

(Why even the best diet might not be enough in 2025!)

“If I Eat Healthy, Why Would I Need Supplements?”

It’s one of the most common questions we hear at The Bespoke Clinic — and it’s a very reasonable one.

In an ideal world, you shouldn’t need supplements. Real food would provide every vitamin, mineral, and antioxidant your body needs to thrive. But in modern life, that’s rarely the case.

From soil depletion and long transport times to daily stress and environmental toxins, even the most nutritious diets often leave subtle nutrient gaps that can quietly impact your energy, mood, hormones, and overall resilience.

do I need supplements

The Modern Nutrient Gap: Why Food Alone Isn’t What It Used to Be

Research consistently shows that the vitamin and mineral content of our food has dropped dramatically over the past century. Modern agricultural practices — especially intensive tilling, pesticides, and synthetic fertilisers — have stripped the soil of key trace minerals like magnesium, zinc, and selenium.

Recent UK data confirms this. Analyses comparing 1940, 1991 and 2019 food composition tables reveal significant declines in mineral content across fruits and vegetables (Tandfonline, 2021). At the same time, UK dietary intake studies show a 21–22 % reduction in vitamins A and D, and roughly a 10 % decline in riboflavin, folate and calcium between 1996 and 2016 (Gavin Publishers, 2022). Even wheat — a core staple — now contains 20–30 % less iron, zinc, copper and magnesium than in the 1960s (Rothamsted Research, 2020).

So even if you’re eating plenty of plants, the raw materials your body relies on simply aren’t as richly supplied as they once were.

Subclinical Deficiency: The Hidden Cause of “Feeling Flat”

When most people think of deficiency, they imagine scurvy or rickets — but that’s the extreme end of the spectrum. Far more common are subclinical deficiencies — where your levels are “within range,” but not high enough to support optimal function.

These hidden shortfalls often show up as:
• Persistent fatigue or brain fog
• Poor sleep quality
• Low mood or anxiety
• Hormonal imbalance or PMS
• Slow recovery or reduced exercise performance

Functional medicine focuses on optimising, not just normalising, nutrient status — because there’s a big difference between surviving and thriving.

I believe you when you say you feel unwell, but the GP told you ‘your bloods were normal’. I believe we need to dig deeper and work out why!

do I need supplements

Testing, Not Guessing: The Smarter Way to Supplement

Before we talk about what to take, it’s worth addressing a common critique. Professor Tim Spector has famously said that many people are “wasting money” on supplements that simply end up as expensive urine (The Times, 2023). He’s right — to a point. Randomly taking high-dose vitamins without a clear reason or need is unlikely to deliver meaningful benefit. The fact so many people are taking random supplements is no surprise either!

There is so much misinformation out there from TikTok and Instagram and celebrities endorsing brands and products, because they get paid!! Come on, let’s be real everyone.

But that’s not the same as saying supplements don’t work. The problem isn’t that people take supplements — it’s how they take them.

In functional medicine, we take a different approach: testing, not guessing. Rather than one-size-fits-all products, we use targeted, clinically guided supplementation based on real data — blood tests, micronutrient panels, and functional assessments that reveal what your body truly needs.

This distinction matters. It’s the difference between buying a multivitamin “just in case” and correcting a measurable magnesium or vitamin D deficiency that’s affecting energy, hormones, or mood. When supplements are chosen carefully — in bioavailable forms, at appropriate doses, and alongside a nutrient-dense diet — they become a powerful bridge between good health and optimal health, not “expensive urine.”

Quality Over Quantity: Why Supplement Choice Matters

Not all supplements are created equal. The form of a nutrient (for example, magnesium glycinate vs oxide) dramatically affects absorption and tolerance. We only recommend medical-grade or practitioner-tested brands that guarantee purity, potency, and clean formulations without unnecessary fillers or additives.

When used correctly, supplements don’t replace food — they bridge the gap between a good diet and optimal function.

supplements and healthy diet

The Functional Medicine Perspective

From a functional medicine viewpoint, supplementation isn’t about quick fixes or endless pills. It’s about giving your cells the raw materials they need to repair, energise, and protect you — so your body can do what it’s designed to do: heal and thrive.

The Takeaway

Whole, colourful food remains the foundation of health. But in 2025, supplements are no longer a luxury — they’re a practical tool to help your body keep pace with modern life.

If you’re curious whether your diet is truly meeting your needs, we can help you test, not guess. Book a Doctor Consultation at The Bespoke Clinic to explore advanced nutrient testing and create a plan tailored to your biology, lifestyle, and goals.

supplements and healthy diet

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References

    1. UK Food Composition Database Analysis (1940–2019). Tandfonline Journal of Nutritional Science (2021).

 

    1. Rothamsted Research. Fact or Fake News: Is Our Food Becoming Less Nutritious? (2020).

 

    1. Gavin Publishers. UK Dietary Changes Over the Last Two Decades: A Focus on Vitamin and Mineral Intakes. (2022).

 

  1. The Times. Tim Spector: Half the Population Takes Supplements with No Evidence They Work. (2023).

Get in touch for a free discovery call.

It is important to remember, you are one whole person, not just a condition, label or set of bloods
Let’s look at the whole of you and see if we can move the dial. Get in touch for a free discovery call.

Contact Us

Supporting Your Thyroid: Nutrients, Toxins, and What You Can Do

When it comes to thyroid health, many people think only of iodine. But in my experience working with women over the years, I’ve seen time and again that a range of nutrients, environmental exposures, and even food choices can all play a significant role in how well the thyroid is functioning.

It’s not uncommon for patients to feel like something is off, even when their blood tests are technically within range. And sometimes, by identifying and correcting simple deficiencies, like selenium, iron, or vitamin D, we’ve been able to improve thyroid function naturally and even reduce reliance on high-dose levothyroxine. Here’s what you need to know.

Selenium
Selenium is a trace mineral that the thyroid relies on for two key functions: producing active thyroid hormone (T3) and protecting itself from inflammation. Low selenium is common and can be a trigger for autoimmune thyroid issues like Hashimoto’s.

Selenium is found in foods like Brazil nuts (1–2 per day is usually plenty), eggs, seafood, chicken, and sunflower seeds. In some people, supplementation is needed, but it must be done carefully, as too much can be harmful. This is something we review on a case-by-case basis.

Iodine
Iodine is essential for thyroid hormone production. Most people in the UK get enough through a varied diet, though dairy-free or vegan diets may reduce intake. Seaweed, white fish, shellfish, and eggs are good sources.

However, it’s not just about getting enough iodine, too much of certain other compounds (like fluoride, bromine, or raw cruciferous vegetables) can block iodine’s effect in the thyroid. We sometimes see this in people who have good iodine levels but still have symptoms.

Bromine
Bromine is in the same chemical family as iodine and can compete with it in the thyroid gland. It’s found in some soft drinks, baked goods, fire retardants, and pool chemicals. If your iodine intake is optimal, bromine likely won’t be an issue, but if iodine is low, excess bromine may affect hormone production.

Reducing processed foods and using non-toxic household and personal care products can help lower your exposure.

Filtered Water (Why This Matters in the UK)
In some countries, arsenic exposure from private well water is a real concern. In the UK, this is rare, but that doesn’t mean our tap water is perfect. Chlorine, microplastics, and trace contaminants can add to your overall toxic load.

Many of my patients choose to use a high-quality water filter at home, to reduce everyday exposures that can subtly affect thyroid and hormone health.

Iron
Your body needs iron to convert T4 (inactive thyroid hormone) into T3 (the active form). We often check ferritin (your iron storage marker), and if it’s below 80 µg/L, it may affect how well your thyroid is working.

Red meat, lentils, and leafy greens are good sources, and combining these with vitamin C (like lemon juice or red pepper) improves absorption.

Zinc
Zinc supports thyroid hormone production and immune balance. It also helps with wound healing, skin, and energy. If you’ve been under stress or have skin/hair issues, this could be relevant.

Pumpkin seeds, meat, shellfish, and legumes like chickpeas are great food sources.

Tyrosine
Tyrosine is an amino acid and a building block for thyroid hormones. Low protein diets or high stress may reduce its availability. Turkey, eggs, dairy, almonds, and tofu all provide tyrosine.

Vitamin D
Vitamin D helps regulate the immune system, which is particularly important in autoimmune thyroid conditions. In the UK, many people are deficient, especially in winter.

We test and supplement if needed, aiming for optimal, not just “normal”, levels.

Toxic Metals: Arsenic, Mercury, and Cadmium
Some environmental toxins can bind to nutrients like selenium and interfere with thyroid function. Arsenic (found in rice, seafood, wine), mercury (in large fish like tuna), and cadmium (from cigarettes or certain grains) all contribute.

These are things we test for when relevant, especially in patients with unexplained fatigue, hormone issues, or autoimmune thyroid disease.

Finally…
Optimising thyroid health isn’t just about chasing a diagnosis or increasing medication. It’s about understanding the wider picture: what you eat, how your body absorbs and uses nutrients, your environment, and your individual symptoms.

In clinic, we use testing where needed, but also look at your diet, stress levels, and supplement use. For some women, addressing these root causes has made a huge difference in how they feel, and has even reduced the need for high-dose thyroid medication.

If you’re curious about your own thyroid health or suspect something is being missed, it’s worth exploring. Supporting the thyroid is as much about what you take out (toxins) as what you put in (nutrients). And small changes can make a big difference!

Case Study

36y female, tired, weight gain, hair loss
Bloods with GP – normal!
TSH (thyroid stimulating hormone) checked and normal!
Full blood count checked but not a ferritin level

We checked a full female hormone profile, Thyroid panel, including T4, T3 and autoantibodies, ferritin. In addition we checked selenium, iodine, zinc, toxins by doing a simple functional medicine test to look at urinary excretion of these amongst others! This showed a low normal T4 and T3 level, low ferritin (although in ‘normal range’), very low level of selenium and slightly high mercury levels. We took a holistic, root cause approach, and without treating with Levothyroxine, we were able to normalise this lady’s bloods and more importantly, improve her symptoms.

Get in touch for a free discovery call.

It is important to remember, you are one whole person, not just a condition, label or set of bloods
Let’s look at the whole of you and see if we can move the dial. Get in touch for a free discovery call.

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Mounjaro, Metabolic Health and Functional Medicine

Mounjaro (tirzepatide) is gaining attention for its role in weight loss and blood sugar control, but it’s far more than just a quick fix. At The Bespoke Clinic, we use Mounjaro only when it supports your full health journey, combining it with functional testing, nutrition, and personalised care to achieve real, lasting results.

In my practice, I use this medication with care, only after deep assessment, appropriate blood testing, and clear discussions around safety and long-term goals. This is not about quick fixes. It’s about restoring balance and supporting your body’s natural capacity to heal.

What is Mounjaro?

Mounjaro is a GLP-1 and GIP dual agonist, licensed for type 2 diabetes and for weight management under certain clinical criteria (such as a BMI over 30, or over 27 with related health issues like insulin resistance or high blood pressure).

It can:

  • Support significant weight loss (15–22% on average)
  • Improve HbA1c (a marker of long-term blood sugar)
  • Help lower cholesterol and triglycerides
  • Regulate appetite, reduce food noise, and improve satiety

But that’s only part of the story.
In my clinic, I look at the whole picture, your gut health, hormones, sleep, stress response, and metabolic function, before ever considering a medication like tirzepatide.

Is Mounjaro Safe? Understanding Pancreatitis Risk

There’s growing conversation around GLP-1 drug side effects, particularly the risk of pancreatitis. As of 2025, the MHRA (UK regulator) has recorded hundreds of reports of pancreatic inflammation in people using medications like Mounjaro and Ozempic. While this is still rare, it reinforces why supervision and testing are non-negotiable.

In my care model, we:

  • Always start with baseline bloods (liver, kidney, thyroid, inflammation, HbA1c, cholesterol, nutrients)
  • Review your digestive and gallbladder history
  • Monitor for symptoms like upper abdominal pain, nausea, or bloating

The goal is not just to avoid side effects, it’s to use this tool safely and in alignment with your body’s real needs.

Case Study: More Than Weight Loss

One man I’ve worked with had been stuck in a pre-diabetic state for years. His blood sugars were borderline, cholesterol climbing, and self-confidence low. He wasn’t just looking for weight loss, he was looking for hope.

With proper testing, we identified:

  • Gut inflammation and sluggish liver function
  • High triglycerides and poor insulin sensitivity
  • Low confidence and avoidance of the gym or social movement

We used a tailored approach:

  • Therapeutic nutrition and gut support
  • Supplements for blood sugar, liver, and energy
  • Nervous system regulation tools
  • Mounjaro, as one part of the plan

The outcome?

  • HbA1c dropped from borderline to fully normal
  • Cholesterol and lipids improved so much that statin discussions stopped
  • He lost over 15% of his weight
  • Most importantly, he felt reconnected to himself, and started exercising again, not from shame, but from strength

This is what root-cause medicine can look like.

Functional Medicine + Mounjaro: Why My Approach Is Different

If you’re researching weight loss clinics near me or considering GLP-1 medications, you may be overwhelmed with options, many of which offer little to no real support beyond a prescription.

Here’s what I offer instead:

  • Full metabolic blood panel
  • Gut health review (including microbiome testing if appropriate)
  • Personalised food and supplement plan
  • Nervous system and stress-resilience tools
  • Ongoing reviews, not one-and-done

We may use Mounjaro, but only as part of a bigger picture, and never as the only strategy.

What Else Is Mounjaro Being Studied For?

Emerging research suggests tirzepatide may offer support beyond blood sugar and weight, including:

  • Heart failure (improved outcomes in HFpEF)
  • Alzheimer’s and cognitive protection (through improved insulin signalling)
  • Kidney health and inflammation reduction
  • Potential effects on liver fat, mood, and even fertility, though these are not licensed uses

This reflects what functional medicine teaches us: when you improve metabolic flexibility, you often improve everything else too.

Final Word: It’s About You, Not Just a Pen

You don’t need another generic programme. You need a plan that sees your body as a system, not a series of symptoms to suppress.

Whether you’re exploring support for:

  • Insulin resistance
  • Hormonal weight gain
  • Post-menopausal metabolic shifts
  • Chronic fatigue or inflammation
  • Or just a sense that “things aren’t working like they used to”…

…there’s a deeper path available.

I work with patients who are ready for a partnership, not a transaction. Who want to feel better, not just look smaller.

If that sounds like you, let’s talk.

Want to Learn More?

Book a discovery call or sign up to my newsletter below for updates on root-cause health, personalised medicine, and how functional support can help you feel like yourself again, with or without medication.

EMFACE: Needle-Free Facial Treatment at The Bespoke Clinic

Everything You Need to Know About EMFACE – Featuring Dr Neet in Luxe Magazine

EMFACE is a needle-free facial treatment designed to tone muscles and smooth the skin, all without surgery or injections. Available at The Bespoke Clinic, this technology is ideal for anyone seeking natural, noticeable results with minimal disruption to their day.

In a recent Luxe Magazine feature, Dr Neet Dang answers common questions about how it works, what to expect, and why this non-invasive treatment fits perfectly with the clinic’s patient-focused approach.

How it works

This treatment uses a combination of radio frequency and HIFES™ (High-Intensity Facial Electrical Stimulation) to target both the skin and the underlying facial muscles. This dual action helps to lift and refresh the face while encouraging natural collagen production.

“It’s like a workout for your face – but calming,” says Dr Neet.

Why patients choose The Bespoke Clinic

Backed by clinical studies and strong patient feedback, this approach is about subtle, natural results. Sessions are short, relaxing, and designed to slot easily into your day – with no needles, downtime or discomfort.

Dr Neet explains why this treatment stands out in today’s aesthetics world: it works with the body, not against it, and helps patients feel like the best version of themselves.

Read the full EMFACE article on Luxe Magazine

The making of The Bespoke Clinic

The Bespoke Clinic Jesmond, led by Dr Neet Dang, is redefining healthcare through a more personal and holistic lens.

In a recent feature by Luxe Magazine, Dr Neet shared her deeply personal story, from navigating her own health challenges to launching a space where patients are treated as whole people – not just symptoms.

With years of experience as a GP and a passion for functional medicine, Dr Neet founded The Bespoke Clinic Jesmond to give patients something often missing from conventional care – time, empathy, and a broader understanding of wellbeing. The clinic opened its doors in 2023 and quickly became a leading name in personalised, evidence-based care in the North East.

In the Luxe Magazine article, Dr Neet reflects on the limitations of standard NHS appointments, how her own experience with hormonal imbalance and autoimmune issues highlighted key gaps in the system, and what finally pushed her to create something new. At The Bespoke Clinic Jesmond, no two appointments are the same. Patients are guided through a bespoke health journey that could include hormone testing, gut health analysis, mental wellbeing support, and even aesthetic treatments such as EMFACE and the EMSELLA chair – all under one roof.

What makes the story especially powerful is Dr Neet’s openness. She speaks candidly about misdiagnosis, feeling dismissed, and the toll it took on her physical and emotional wellbeing. But it was that experience that shaped the clinic’s approach: warm, thorough, and focused on the bigger picture.

Today, The Bespoke Clinic Jesmond is a doctor-led space where medical expertise and holistic treatments come together. From gut health to sleep, from pelvic floor therapy to emotional wellbeing, the team focuses on treating root causes – not just surface symptoms.

In a recent Luxe Magazine feature, Dr Neet Dang opens up about the real story behind Bespoke Clinic Jesmond. From navigating the frustrations of conventional healthcare to launching a CQC-registered, doctor-led space focused on gut health, hormones, mental wellbeing and more – it’s a powerful look into what makes this clinic so different.

Read the full article on Luxe Magazine
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