I’ll be honest with you: this is probably the question I get asked most in initial consultations, usually right after “Will this actually help?” and before we’ve even looked at your health history. Someone will lean forward, eyes a bit uncertain, and say, “So… can you actually diagnose things, or…?”
It’s a fair question. And the answer is more nuanced than a simple yes or no.
Understanding what naturopaths can and can’t diagnose matters because it helps you make informed decisions about your care. It sets realistic expectations. And it helps you figure out whether naturopathy is the right fit for what you’re dealing with right now.
So let’s talk about it properly: what I actually do in clinical practice, where my scope begins and ends, and why those boundaries exist to protect you.
The Short Answer (But It’s More Nuanced Than You Think)
Here’s the legal reality: I don’t diagnose medical conditions in the way your GP does.
I can’t tell you that you have diabetes, coeliac disease, or hypothyroidism. I can’t confirm endometriosis, order an ultrasound, or write a prescription for antibiotics. That’s not my scope, and it’s not what my training qualifies me to do.
What I actually do is identify functional imbalances, nutritional deficiencies, and body system patterns that might be contributing to how you’re feeling. I look at the terrain, not just the label. I assess how your digestive system, hormones, nervous system, and immune function are working together (or not working together), and I build a plan to address what’s out of balance.
Why does the distinction matter? Because it shapes how we work together. If you come to me with undiagnosed chest pain, I’m sending you straight to your GP or emergency. But if you come with a confirmed IBS diagnosis and you’ve been told “there’s nothing more we can do,” that’s where I can step in and help you understand what’s driving those symptoms and what we can actually change.
What My Training Covers
I didn’t just read a few books on herbs and decide to call myself a naturopath. I completed a four-year Bachelor of Health Science degree that covered anatomy, physiology, biochemistry, pathology, pharmacology, and clinical nutrition in significant depth.
I learned how to read pathology, recognise red flags, understand drug-herb interactions, and assess clinical presentations. I studied the same disease processes medical students study. The difference is in how we’re trained to respond to them.
My clinical assessment tools include physical examination (tongue, nails, skin, posture), iris analysis, detailed health history taking, and functional questionnaires that help me understand patterns your GP might not have time to explore in a 10-minute appointment.
And my learning didn’t stop at graduation. I’m required to complete ongoing professional development every year to maintain my registration with ATMS and ANTA. That means staying current with research, refining clinical skills, and understanding when my scope ends and someone else’s begins.
What I Can Identify in Practice
Let me walk you through what actually happens in a naturopathic consultation, and what I’m looking for when I assess your case.
Nutritional Deficiencies & Imbalances
This is bread and butter naturopathic work, and it’s where I see some of the quickest shifts for clients.
I can identify clinical signs of:
- Iron deficiency (even when your bloods say “normal” but you’re exhausted, breathless, and craving ice)
- B vitamin depletion (brain fog, mouth ulcers, poor stress tolerance)
- Zinc insufficiency (white spots on nails, poor wound healing, frequent infections)
- Magnesium deficiency (muscle cramps, anxiety, sleep issues, chocolate cravings)
- Vitamin D inadequacy (low mood, immune issues, bone health concerns)
Here’s a real example: A client came to me after her GP said her iron levels were “fine” at 30 µg/L. Technically, that’s within the reference range (15-300 µg/L). But functionally? She was exhausted, her hair was falling out, and she had restless legs at night. Her ferritin was low-normal, and her clinical presentation screamed iron deficiency. We addressed it nutritionally and with supplementation, and within six weeks she felt like a different person.
I didn’t diagnose anaemia. But I identified a functional iron insufficiency that was impacting her quality of life, and we fixed it.
Digestive Function Patterns
I spend a lot of time with gut issues because they’re complex, often dismissed, and frequently mismanaged.
I can identify patterns consistent with:
- IBS (and whether it’s diarrhoea-predominant, constipation-predominant, or mixed)
- SIBO (small intestinal bacterial overgrowth)
- Dysbiosis (imbalanced gut bacteria)
- Food intolerances (not allergies, that’s different)
- Gut permeability issues (“leaky gut”)
- Digestive enzyme insufficiency
- Bile acid malabsorption
What I can’t do is diagnose IBD (Crohn’s or ulcerative colitis), coeliac disease, or bowel cancer. Those need medical investigation. But if you’ve already been tested for the serious stuff and you’re still bloated, irregular, and miserable? That’s where I come in.
I’m trained to differentiate between functional digestive issues and red flags that need urgent medical attention. Blood in stool, unexplained weight loss, new onset symptoms over 50, severe pain… these get referred immediately.
You can read more about why people choose to see a naturopath for these kinds of ongoing issues.
Hormonal Imbalances
Hormones are another area where functional assessment really shines, particularly when standard pathology comes back “normal” but you feel anything but normal.
I can identify clinical patterns of:
- Oestrogen dominance (heavy periods, PMS, breast tenderness, fibroids)
- Progesterone insufficiency (short luteal phase, anxiety, insomnia)
- Thyroid dysfunction (even when TSH is “fine” but you’re cold, tired, gaining weight, and losing hair)
- Adrenal stress patterns (wired and tired, blood sugar crashes, salt cravings)
- PCOS presentations (irregular cycles, acne, excess hair growth, insulin resistance)
- Perimenopause shifts (cycle changes, hot flushes, mood swings, sleep disruption)
Let me be clear: I cannot diagnose hypothyroidism or hyperthyroidism. That requires pathology and medical oversight. But I can read your thyroid panel, identify subclinical patterns, assess thyroid antibodies, and work with you to support thyroid function while you’re under the care of your endocrinologist or GP.
One of my clients had a TSH of 3.8 mIU/L (reference range 0.5-5.0). Her GP said it was fine. But she was exhausted, constipated, cold all the time, and her hair was thinning. Her Free T4 was low-normal, her reverse T3 was elevated, and she had positive thyroid antibodies. We worked on reducing inflammation, supporting conversion, optimising nutrients (selenium, zinc, iodine), and addressing gut health. Her energy improved, her hair stopped falling out, and her next pathology showed better Free T4 levels.
I didn’t treat a thyroid condition. I supported thyroid function within my scope.
Stress & Nervous System Patterns
This is where naturopathy really comes into its own, because conventional medicine often doesn’t have great tools for chronic stress beyond “try to relax” or antidepressants.
I can identify:
- HPA axis dysfunction (the stress response system)
- Chronic stress vs acute stress presentations
- Sleep architecture issues (trouble falling asleep vs staying asleep vs non-restorative sleep)
- Nervous system dysregulation (stuck in sympathetic overdrive)
- Burnout presentations (and when to differentiate from clinical depression)
Here’s where I’m careful: I cannot diagnose depression, anxiety disorders, PTSD, or any mental health condition. That’s outside my scope. But I can recognise when someone’s stress response is overactive, their cortisol rhythm is flat, and their nervous system needs support. And I can recognise when symptoms suggest something more serious that needs psychological or psychiatric assessment.
If someone tells me they’ve lost interest in everything, they’re having intrusive thoughts, or they can’t get out of bed, I’m referring them to their GP or a psychologist that same day. Naturopathy can support mental health, but it doesn’t replace proper mental health care.
Key Point
Naturopaths identify functional patterns and imbalances. We don’t diagnose medical conditions, but we can recognise when body systems aren’t working optimally and address the underlying drivers.
What I Absolutely Cannot (and Should Not) Diagnose
Let’s be really clear about this, because it matters.
I cannot diagnose:
- Medical conditions that require pathology confirmation (diabetes, coeliac disease, thyroid disorders, autoimmune conditions)
- Serious pathology requiring imaging or specialist investigation (cancers, structural abnormalities, cardiovascular disease)
- Mental health diagnoses (depression, anxiety disorders, bipolar disorder, ADHD, autism)
- Infections requiring medical treatment (though I can support immune function and recovery)
- Anything requiring prescription medication to manage safely
When I refer: If your symptoms suggest something outside my scope, I refer. Always. If you need imaging, specialist review, or urgent medical attention, I’ll tell you. It’s my professional and ethical responsibility.
Real example: A woman came to me complaining of bloating, irregular bowel habits, and abdominal discomfort. She’d been told it was IBS. During the consultation, I asked about red flag symptoms. She mentioned she’d noticed some blood in her stool “a few times” but hadn’t mentioned it to her GP because she thought it was just haemorrhoids. I stopped the consultation and told her to book with her GP that week for a referral to gastroenterology. She was frustrated at first, but six weeks later she called to thank me. She’d had an endoscopy and colonoscopy, they’d found and removed polyps, and caught early-stage pathology that needed monitoring. That’s why scope of practice matters.
Naturopathy works best when it’s part of a healthcare team, not a replacement for it.
How I Work With Your Existing Diagnoses
Most of my clients come to me with a diagnosis already. They’ve been to their GP, they’ve had the tests, and they’ve been told “you have IBS” or “it’s just stress” or “your bloods are normal, there’s nothing wrong.”
That’s where I step in.
I can:
- Read and interpret pathology within my scope (I’m trained in pathology interpretation, just not in ordering medical imaging or making medical diagnoses)
- Use functional reference ranges alongside conventional ranges to identify subclinical issues
- Work alongside your GP or specialist to support your treatment plan with nutrition, herbal medicine, and lifestyle strategies
- Address the underlying drivers that conventional treatment might not have time to explore
Case study: I worked with a client who had been diagnosed with Hashimoto’s thyroiditis by her endocrinologist. She was on levothyroxine, her TSH was stable, but she still felt exhausted and struggled with weight gain. Her endocrinologist managed her thyroid medication, and I focused on reducing inflammation, healing her gut (many Hashimoto’s patients have gut permeability issues), balancing blood sugar, and supporting her adrenal function. We worked as a team. Her thyroid antibodies dropped, her energy improved, and she finally felt like herself again.
I didn’t treat her thyroid condition. I supported her body’s ability to function optimally while she was being medically managed.
If you’re curious about the types of conditions naturopathy can help with, I’ve written more about that here.
The Functional Medicine Approach
Here’s what makes naturopathic assessment different: I’m not just looking for a diagnosis to match a prescription. I’m looking at why your body is struggling and what we can do to restore balance.
Functional assessment means:
- Looking at patterns across multiple body systems, not just isolated symptoms
- Identifying root causes, not just managing symptoms
- Understanding that “normal” pathology doesn’t always mean optimal function
- Recognising that your gut health affects your hormones, your stress levels affect your digestion, and your sleep quality affects everything
Example: A client came to me with chronic hives. She’d been to dermatologists, allergists, immunologists. She’d tried every antihistamine. Nothing worked. Her conventional doctors were looking at her skin and her immune system in isolation. I took a step back and looked at her gut health, her stress levels, her diet, her toxic load. We ran a comprehensive stool analysis and found gut dysbiosis and inflammation. We healed her gut, removed food triggers, supported detoxification pathways, and within three months her hives were gone. Not because I diagnosed her hives (the dermatologist did that), but because I identified the underlying pattern driving them.
That’s functional medicine in action.
Functional Testing I May Recommend
Sometimes standard pathology doesn’t give us the full picture. That’s when I might suggest functional testing.
Tests I commonly recommend:
- Comprehensive stool analysis (for gut microbiome, inflammation, digestive function)
- DUTCH hormone testing (detailed sex hormone and cortisol mapping)
- Food sensitivity panels (IgG testing for delayed reactions, though I’m selective about when this is useful)
- Organic acids testing (metabolic function, nutrient status, neurotransmitter markers)
- Nutritional panels (vitamins, minerals, fatty acids)
When these are worth it: If we’ve done the basics and you’re still stuck. If your symptoms are complex and we need more detail. If you want specific data to guide targeted intervention.
When they’re not worth it: If you haven’t tried foundational changes yet. If you’re not ready to act on the results. If cost is prohibitive and we can make progress without them.
I interpret these results in context. A single marker doesn’t tell the whole story. I’m looking at patterns, trends, and how everything fits together with your clinical presentation.
Red Flags I’m Trained to Spot
Part of my job is knowing when to step back and refer. I’m trained to recognise symptoms that need urgent medical attention.
Red flags include:
- Unexplained weight loss
- Blood in stool or vomit
- Severe or sudden onset pain
- Chest pain or shortness of breath
- New neurological symptoms (numbness, weakness, vision changes, severe headaches)
- Suicidal ideation or severe mental health crisis
- Symptoms in children or pregnant women that need medical assessment
- Any presentation that doesn’t fit a clear functional pattern
My duty of care means that if I suspect something serious, I tell you. Sometimes that means saying “stop, we need to get you to a doctor today” before we even start talking about treatment.
The collaborative care model that actually works is one where everyone stays in their lane, communicates well, and puts your health first.
Key Point
Good naturopaths know their limits. If your symptoms suggest something outside our scope, we refer. Every time. Your safety comes first.
What This Means for Your Care
So what does all this look like in practice?
You might see both me and your GP because that’s often the ideal scenario. Your GP manages medical diagnoses, prescriptions, and serious pathology. I focus on optimising function, addressing root causes, and supporting your body with nutrition, herbal medicine, and lifestyle strategies.
In an initial consultation, I’ll spend 60-90 minutes with you. I’ll ask detailed questions about your health history, your current symptoms, your diet, your stress levels, your sleep, your digestion, your menstrual cycle (if relevant), and your life circumstances. I’ll look at your tongue, your nails, your skin. I’ll review any recent pathology you’ve had done. And I’ll start to piece together the patterns that might be contributing to how you’re feeling.
I won’t diagnose you with a medical condition. But I will identify what’s out of balance, explain why you might be experiencing these symptoms, and build a practical, personalised plan to address it.
If you’re wondering whether naturopathy is right for you, my article on does naturopathy really work might help clarify things.
Common Misconceptions
Let’s clear up a few things I hear regularly.
“Naturopaths just guess based on symptoms.”
Not if we’re trained properly. Clinical assessment, health history, physical examination, and functional testing (when needed) guide my recommendations. I’m not guessing. I’m using the same diagnostic reasoning process I was taught in my degree, just within a different scope.
“You can replace proper medical diagnosis with natural therapies.”
Absolutely not. If you have a serious medical condition, you need medical care. Naturopathy can complement that care, but it doesn’t replace it. Anyone telling you otherwise is either uninformed or unethical.
“Naturopaths diagnose everything as adrenal fatigue.”
Some practitioners might overuse that term, sure. But “adrenal fatigue” isn’t a medical diagnosis, it’s a functional pattern of HPA axis dysfunction. And yes, chronic stress does impact cortisol rhythms, energy, and resilience. The term might be imprecise, but the pattern is real. I prefer to say “stress-related fatigue” or “HPA axis dysregulation” because it’s more accurate.
Setting realistic expectations is part of my job. I’m not going to cure your autoimmune condition, reverse your diabetes without medical oversight, or fix your chronic pain overnight. But I can help you feel better, function better, and address the underlying patterns that conventional medicine might not have time to explore.
Working Within Professional Boundaries
Here’s why scope of practice matters: it protects you.
Professional regulation through ATMS (Australian Traditional Medicine Society) and ANTA (Australian Natural Therapists Association) ensures that registered naturopaths meet minimum education standards, maintain insurance, and adhere to a code of conduct.
If a naturopath tells you to stop your thyroid medication, claims they can cure cancer, or diagnoses you with a serious medical condition without proper medical training, they’re overstepping their scope. And you have the right to report them.
What happens if a naturopath oversteps? They can lose their registration, their insurance, and their right to practice. These boundaries exist for a reason.
Finding a qualified, ethical practitioner means looking for someone who:
- Has a recognised degree qualification (Bachelor of Health Science in Naturopathy)
- Is registered with ATMS or ANTA
- Is transparent about their scope and limitations
- Works collaboratively with other healthcare providers
- Refers when appropriate
If you’re not sure whether naturopathy is legal or regulated in Australia, I’ve written about that here.
The Collaborative Care Sweet Spot
I’m genuinely comfortable with my scope. I know what I can do well, and I know where my expertise ends and someone else’s begins.
The best outcomes happen when everyone stays in their lane and works together.
Your GP is brilliant at diagnosing disease, managing acute illness, and prescribing medication when needed. Your specialist has deep expertise in their specific area. Your psychologist supports your mental health. And I focus on optimising function, addressing root causes, and helping you feel better in your body.
None of us can do it all. But together? We can give you really comprehensive, personalised care.
If you’re unsure whether naturopathy is right for your situation, I offer clarity calls where we can talk through your case, discuss whether I’m the right fit, and figure out the best path forward for you.
Final thought: You deserve healthcare providers who are honest about what they can and can’t do. You deserve transparency, collaboration, and care that puts your wellbeing first. That’s what I aim to provide, every single time.
And if you’re curious about potential limitations, I’ve also written about the disadvantages of naturopathy because informed decisions matter.
Sarah Mitchell, BHSc (Naturopathy)
Providing personalised naturopathic care Australia-wide via online consultations
