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Evaluation
We help identify the factors contributing to your symptoms and build a plan that fits your life.
Have you ever been told your thyroid labs are “normal,” even though you are losing hair, exhausted, foggy, cold, struggling with weight changes, or simply not feeling like yourself? It is an incredibly frustrating experience — especially when you know something feels off but are told everything looks fine. Normal does not always mean optimized. In many standard settings, thyroid screening starts and stops with TSH. TSH is important, but it does not always tell the full story. At Alpenaura Holistic Health in Bend, Oregon, we take a more comprehensive approach: a full thyroid panel, including how your body is producing and converting thyroid hormones, and whether there may be signs of autoimmunity such as Hashimoto’s thyroiditis. We also look at the bigger picture — inflammation, nutrient status, stress, hormone shifts, metabolism, and the symptoms you are actually experiencing. We proudly serve patients in Bend, Redmond, Sisters, Sunriver, and throughout Central Oregon. We also offer telehealth services for Oregon, Washington, Alaska, and California clients.
A complete thyroid picture requires more than one number. We evaluate production, conversion, and autoimmunity together, then interpret those results against your symptoms rather than in isolation.
Hashimoto’s is the most common cause of hypothyroidism, and antibodies are often present long before TSH moves out of range. Identifying autoimmunity early changes both the explanation for your symptoms and the approach to managing them.
Thyroid symptoms overlap heavily with perimenopause, iron deficiency, and metabolic changes — which is precisely why they are so often misattributed. We evaluate the whole picture rather than assuming a single cause.
Treatment is individualized. Some patients do well on standard levothyroxine; others need adjustment, combination therapy, or attention to the nutrient and inflammatory factors affecting conversion. Monitoring matters as much as the initial prescription.
From the Nurse Practitioner
We help identify the factors contributing to your symptoms and build a plan that fits your life.
We offer individualized support around nutrition, movement, sleep, stress, blood sugar balance, and lifestyle habits without shame, crash dieting, or unrealistic expectations.
Hormonal shifts, thyroid dysfunction, PCOS, insulin resistance, perimenopause, menopause, medications, poor sleep, chronic stress, and under-fueling can all affect metabolism.
While GLP-1s can be an effective tool for some patients, we also explore lifestyle foundations, hormone and thyroid optimization, supplements, and other pharmaceutical interventions depending on the patient's history, goals, risks, and clinical needs.
Every woman’s health journey is unique. Here are answers to some of the most common questions about our approach to women’s health, hormone care, treatment options, and personalized care at Alpenaura.
TSH is a screening test, not a complete evaluation. Free T4, Free T3, and thyroid antibodies can reveal problems with hormone production, conversion, or autoimmunity that TSH alone does not capture. Symptoms can also stem from iron deficiency, perimenopause, or metabolic changes, which is why we evaluate them together.
Laboratory reference ranges reflect a broad population, not necessarily what is optimal for an individual. A result inside the range can still be inconsistent with how a particular patient feels and functions. We interpret labs alongside symptoms and treat the patient rather than the number alone.
Often not. Most thyroid conditions can be evaluated and managed in our practice. We refer to endocrinology for nodules requiring biopsy, complex or unstable cases, thyroid cancer concerns, and other situations where specialty care is warranted.
Yes, though thyroid dysfunction is rarely the sole factor. We evaluate thyroid function alongside insulin resistance, hormones, nutrition, sleep, and stress to understand the full metabolic picture.
Explore simple medication support or a more guided membership with monthly check-ins, provider visits, supplies, and included labs on select tiers.
Best for patients who want medication access and pharmacy coordination with visits/labs handled separately.
Best for patients who want structure, accountability, supplies, labs on select tiers, and follow-up built in.
| Pathway | Semaglutide | Tirzepatide | Best Fit |
|---|---|---|---|
| Basic GLP Support | $225-$325/mo | $275-$499/mo | Lower-touch support; visits and labs handled separately. |
| Comprehensive Reset | $325-$475/mo | $375-$625/mo | More structure: supplies, monthly MA check-ins, quarterly provider visits, labs on Standard/Advanced tiers. |
Comprehensive Standard and Advanced Reset memberships include an Expanded Metabolic Panel at initiation and a Basic Weight Loss Safety Panel at 6 months; both annually thereafter. Microdose Reset and Basic GLP Support patients may choose cash-pay labs a la carte, if they opt out of billing through insurance.
Medication is prescribed only when clinically appropriate.
Titration is based on tolerability, goals, and response.
Standard/Advanced Reset tiers include baseline and 6-month labs.
Monthly check-ins help you stay supported between visits.
| Start-Up | Commitment | Good To Know |
|---|---|---|
| $149 one-time enrollment/setup fee | 3-month initial commitment for medication-inclusive plans | Medication is not guaranteed. Eligibility, medication choice, and dose are determined after clinical review. |
Symptoms rarely have a single cause. Explore the other areas of Jade’s practice — hormone therapy, women’s health, medical weight loss, and comprehensive evaluation.
"Comprehensive women’s health care for every stage of life, from preventive care to hormone and cycle support."
"Bioidentical hormone therapy for perimenopause, menopause, and the symptoms you've been told to live with."
"An ongoing partnership in your health: comprehensive testing, personalized protocols, and a provider who knows your story."
YOUR CARE STARTS HERE
Stop guessing about your symptoms. Comprehensive testing, honest answers, and a plan built around
you — with Jade Carboy, NP