Do I still need to see my regular GP?

Yes. We work alongside your GP. Functional and integrative medicine is complementary — we don't replace your primary care relationship.

My results keep coming back normal. Can you actually help?

Yes. Standard blood tests typically look for overt disease. We run broader panels — reverse T3, fasting insulin, inflammatory markers, microbiome analysis, provoked urine testing for heavy metals — that pick up patterns standard testing misses.

Will I need a lot of testing?

It depends on your case. Your first appointment includes a thorough history. Testing is ordered based on what we find — never a panel-for-the-sake-of-a-panel approach.

How long until I feel better?

Complex chronic illness takes time to unpack. Most patients notice measurable shifts within 8-12 weeks of starting their individualised plan, with deeper changes over 6-12 months.

Where is Mojo Klinik located?

Suite 11, 40 Yeo Street, Neutral Bay NSW 2089, Sydney, Australia.

What are the clinic hours?

Monday to Friday, 9:00am to 5:00pm. Bookings are by appointment only.

Is parking available?

Yes. There is 2-hour free parking on Yeo Street and surrounding streets, plus public transport options including the Neutral Bay ferry wharf a 5-minute walk away.

Do you offer telehealth?

Yes. Telehealth follow-ups are available Australia-wide. The first appointment is strongly recommended in-person at our Neutral Bay clinic.

What kinds of conditions do you treat?

Chronic, complex, multi-system, often unexplained conditions — including hormonal, digestive, metabolic, fatigue, immune and toxicity-related presentations. We do not provide acute or emergency care.

Do you treat cancer, Alzheimer's or dementia?

No. We do not advertise treatment for cancer, Alzheimer's, dementia or serious neurodegenerative conditions per TGA prohibited representations.

How do I know which condition page to start with?

Most patients begin with the Mojo New Patient Appointment (one hour) which covers the full clinical picture. From there we identify which condition-specific testing is needed.

Can I see both doctors?

Yes. Many patients see both Dr Mackey and Dr Varipatis — typically Dr Mackey for hormonal, digestive and metabolic presentations and Dr Varipatis for environmental, heavy metal and chronic infection work.

Small Intestinal Bacterial Overgrowth (SIBO) is a condition where bacteria that normally live in the large intestine overgrow in the small intestine, causing bloating, gas, abdominal pain and altered bowel habits.

How is SIBO diagnosed?

We use a lactulose or glucose breath test that measures hydrogen and methane gas over 2-3 hours. This identifies bacterial overgrowth and the dominant gas pattern (hydrogen-dominant, methane-dominant, or hydrogen sulfide).

Is IBS the same as SIBO?

No, but they overlap. IBS is a functional diagnosis of digestive symptoms without identifiable disease. SIBO is one identifiable cause of IBS-like symptoms. Many IBS patients have underlying SIBO, but not all.

How long does treatment take?

Treatment duration depends on the case. A typical SIBO protocol involves 2-4 weeks of antimicrobial therapy followed by gut repair and prevention of recurrence. Underlying motility and digestive function must also be addressed.

Yes, SIBO has a moderate recurrence rate. We focus on identifying and treating the underlying causes (motility, structural issues, MMC function, diet) to reduce recurrence risk.

Do I need to stop my medications before testing?

Some medications (particularly antibiotics and probiotics) need to be stopped before breath testing. Your practitioner will advise specific preparation instructions at booking.

Will Medicare or private health insurance cover this?

The Mojo New Patient Appointment carries a Medicare rebate. Breath testing is privately billed. Private health fund rebates depend on your policy — check with your insurer.

What is perimenopause?

Perimenopause is the transition period leading up to menopause, typically lasting 4-10 years. Hormone levels fluctuate, causing symptoms that often begin years before periods stop.

At what age does perimenopause start?

Most women begin perimenopause in their mid-40s, but it can start earlier. Symptoms before age 40 may indicate primary ovarian insufficiency and warrant investigation.

Menopausal Hormone Therapy (formerly HRT) replaces the hormones that decline during perimenopause and menopause. Modern body-identical MHT is far safer than older synthetic versions.

Current evidence shows body-identical MHT is safe for most women when started within 10 years of menopause onset. Individual risk assessment is essential — your family history, personal history and current symptoms all inform the decision.

What is DUTCH testing?

DUTCH (Dried Urine Test for Comprehensive Hormones) measures hormones and their metabolites over 24 hours, giving a fuller picture than a single blood draw. It's particularly useful for perimenopause where hormone levels fluctuate.

Do I need blood tests or urine tests?

Both. We typically run a full blood panel (thyroid, sex hormones, metabolic markers, vitamins) plus DUTCH for detailed hormone metabolite analysis. The combination gives the clearest clinical picture.

Can I take MHT if I've had breast cancer?

This requires careful specialist input. Non-hormonal options are usually preferred. Decisions are made in consultation with your oncology team.

What is heavy metal toxicity?

Accumulation of toxic metals (mercury, lead, arsenic, cadmium, aluminium) in body tissues beyond levels the body can safely excrete. Sources include dental amalgams, contaminated fish, occupational exposure, old plumbing and some traditional medicines.

How do you test for heavy metal burden?

We use provoked urine testing — a chelating agent is administered to mobilise stored metals, then urine is collected over 6 hours. This reveals what's actually stored in tissues, not just recent exposure. Blood tests only show recent exposure.

Is chelation therapy safe?

When medically supervised, chelation is safe and well-tolerated. The Heavy Metal Initial Appointment assesses kidney function, mineral status and overall suitability before any chelation is undertaken. Treatment is individualised.

Do I need to see a specific doctor?

Both Dr Mackey and Dr Varipatis offer Heavy Metal Initial Appointments. For chelation therapy specifically, both doctors prescribe — Dr Varipatis has the longer clinical history with chelation, Dr Mackey integrates it with broader hormonal and metabolic work.

Will my insurance cover this?

The Heavy Metal Initial Appointment does not carry a Medicare rebate. Private health fund coverage depends on your policy. Itemised receipts are provided for you to submit.

How long does treatment take?

A typical chelation programme runs 6-12 months depending on the metal burden identified. Repeat provoked urine testing guides treatment duration.

What's the difference between you and a naturopath?

Dr Mackey and Dr Varipatis are AHPRA-registered medical doctors. Provoked urine testing, chelation therapy and pharmaceutical prescribing are medical acts not available to naturopaths. Your treatment is medically supervised throughout.

Clinically termed 'increased intestinal permeability' — the gut lining becomes more porous than it should, allowing partially digested food particles, bacterial fragments and toxins to enter the bloodstream, driving systemic inflammation.

What causes bloating?

Common drivers: SIBO, food intolerances (FODMAP sensitivity, histamine, lactose), microbiome imbalance, low stomach acid, sluggish motility, and increased intestinal permeability.

How do you diagnose it?

We use a combination of detailed symptom analysis, breath testing (SIBO), stool microbiome analysis, intestinal permeability markers (zonulin, lactulose/mannitol test), and food intolerance panels where indicated.

Is bloating always related to food?

Not always. Bloating can also be driven by HPA axis dysfunction, hormonal fluctuations, stress, structural issues, and microbiome imbalance independent of specific foods.

How long does treatment take?

Most patients see significant improvement within 8-12 weeks. Full gut repair typically takes 6-12 months depending on the underlying cause and how long the issue has been present.

Should I do an elimination diet?

Elimination diets can help identify triggers short-term, but they're not a long-term solution. We use targeted testing where possible to identify specific drivers, then individualise dietary advice.

Sometimes, but not always. The wrong probiotic for your specific microbiome imbalance can worsen symptoms. We test first, then prescribe specific strains based on your results.

Can stress cause bloating?

Yes. Chronic stress alters gut motility, microbiome composition, digestive enzyme secretion, and intestinal permeability. We address the stress component alongside the physical drivers.

Hashimoto's thyroiditis is an autoimmune condition where the immune system attacks the thyroid gland, gradually reducing its function. It's the most common cause of hypothyroidism in Australia.

Why is my TSH 'normal' but I still have symptoms?

Standard TSH testing misses many thyroid issues. We test the full panel — TSH, free T3, free T4, reverse T3, and thyroid antibodies (TPO and TG). Patterns of suboptimal T3 conversion, elevated reverse T3, or positive antibodies explain persistent symptoms.

Do you prescribe thyroid medication?

Yes. As AHPRA-registered medical doctors, we prescribe all forms of thyroid medication including T4 (Oroxine), T3 (Cytomel/Tertroxin), and combination T4/T3 therapy. Decisions are based on the full panel and your symptoms.

What's reverse T3 and why does it matter?

Reverse T3 is an inactive form of T3 that blocks thyroid receptors. Elevated reverse T3 (from chronic stress, calorie restriction, illness, or low iron) causes hypothyroid symptoms even when TSH and free T4 look 'normal'.

How long until I feel better on thyroid treatment?

Most patients notice meaningful improvement within 4-8 weeks of starting treatment, with full stabilisation over 3-6 months. Repeat testing at 6-8 weeks guides dose adjustment.

Will my GP continue to manage my thyroid?

We work alongside your GP. Once stable, we can transition thyroid monitoring back to your GP with a clear management plan. Many GPs prefer this collaborative approach for complex thyroid cases.

How do you test hormones?

We use a combination of blood tests (for thyroid, sex hormones, metabolic markers) and DUTCH (Dried Urine Test for Comprehensive Hormones) for detailed hormone metabolite analysis. The combination reveals patterns a single blood draw misses.

Do I need to test on a specific day of my cycle?

Yes for blood tests — typically day 21 for progesterone, day 2-3 for baseline hormones. DUTCH can be done any day and is more forgiving.

Can hormones cause weight gain?

Hormonal drivers of weight gain include thyroid dysfunction, cortisol dysregulation, insulin resistance, oestrogen dominance, and perimenopausal changes. We test for these before any weight management advice.

What about testosterone in women?

Testosterone in women is essential for energy, libido, muscle mass and motivation. We test and address both deficiency and excess (PCOS-related).

Uncategorized Archives - Mojo Klinik | Functional & Integrative Medicine Neutral Bay

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