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).

Hormone Imbalance Investigation and Care

Mojo Klinik / Conditions / Hormones / Hormone Imbalance: Investigation and Care

DR MARIA MACKEY

Mojo Klinik · Neutral Bay Sydney

Hormone imbalance: investigation and care.

Hormones do not work in isolation. We do not test them that way.

Cycle changes. PMS that disrupts your life.

PCOS (polycystic ovarian syndrome), fertility, postpartum
picture not resolving.

Or you have been told your hormones are fine and they
clearly are not.

SOUND FAMILIAR?

You will recognise yourself in some of these.

Most patients arrive carrying one or more of these.

Your cycle has changed in some new way (timing, flow, symptoms)
You have PMS or PMDD that disrupts your life
You suspect PCOS or have a diagnosis but feel the standard care has not addressed the drivers
You are struggling with fertility and want a deeper investigation
You are post-baby and have not felt right since
You have mood, weight, or sleep changes that align with your cycle
Your hormones have been tested and you have been told they are fine
You are a man with low libido, low energy, or suspected andropause concerns

There is almost always a clinical explanation. Pulling on the thread is what we do

WHAT HORMONE IMBALANCE ACTUALLY IS

Hormones do not work in isolation.

The sex hormones interact with the thyroid, the adrenals, and the metabolic system. A symptom in one usually has fingerprints in the others.

A hormone testing Neutral Bay approach maps the relevant systems together. Sex hormones timed correctly to the cycle. Full thyroid panel. 4-point urinary hormone testing. Metabolic markers. The pattern across them tells the story that any single test misses.

This is also where the cross-link to perimenopause sits: if your symptoms are cycle-related and you are between 35 and 55, the perimenopausal transition is often part of the picture.

"A 2025 SHAW survey found that 21% of Australian women report being dismissed by a healthcare provider when raising hormonal concerns. The hormonal picture in women is genuinely complex. It deserves proper investigation, not reassurance."

Dr Maria Mackey, MBChB. FRACGP. FAARM. Mojo Klinik Founder

A PATTERN MAP

The five patterns we look for.

Hormones do not act in a vacuum. We do not test them that way.

OESTROGEN DOMINANCE

Frequently missed in standard care.

THYROID INVOLVEMENT

Often part of the cycle picture.

LOW PROGESTERONE

Common, treatable, often missed.

HPA-DRIVEN

Stress and HPA axis at the centre.

INSULIN-DRIVEN

Metabolic driver in PCOS and beyond.

Identifying the dominant pattern, plus its supporting patterns, sets the plan.

OUR THREE – PHASE APPROACH

Map the systems. Build the plan. Review against where you actually move.

Investigation, reset, restoration.

Phase 1

Investigate

Weeks 1 to 3

Detailed history. Cycle-timed hormonal testing. Full thyroid panel. 4-point urinary hormone testing. Metabolic markers. DUTCH testing where it adds clinical value.

Phase 2

Plan

Weeks 3 to 8

A plan built from what your testing actually shows. Lifestyle and nutritional support, targeted supplementation, hormone therapy where clinically appropriate, metabolic intervention where insulin resistance is part of the picture.

Phase 3

Review

Months 3 to 6

Cycle, mood, and energy often respond first within 6 to 12 weeks. Skin and weight changes typically take 3 to 6 months. Re-testing and review build a sustainable picture rather than a quick fix.

THE FIVE DRIVERS WE LOOK FOR

Hormone imbalance almost never has one cause.

Most patients have two or more of these patterns operating together.

Oestrogen dominance

Low progesterone

Insulin resistance with hormonal effects

HPA axis disrupting hormones

Thyroid involvement

PCOS has a new name. Polycystic Ovary Syndrome (PCOS) has officially been renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS). If you have been diagnosed with PCOS, the diagnosis still applies. The name has changed because the condition is a whole-body hormonal and metabolic picture that affects insulin, mood, skin and fertility, not a problem of cysts on the ovaries. That is how we have approached it at Mojo Klinik for years, and how we will continue to approach it. Consensus rename published in The Lancet. Supported by the Endocrine Society, RACGP, Diabetes Victoria, and the Monash WHIRL PCOS Centre.

IS MOJO KLINIK RIGHT FOR YOU?

Is this approach right for you?

IT'S A FIT IF

Your cycle, PMS, or hormonal symptoms have not been properly investigated
You have PCOS or suspect it, and want metabolic and hormonal investigation together
You are postpartum and your hormones have not reset
You are struggling with fertility and want a deeper investigation
You want cycle-timed hormone testing, not a single random blood draw
You are a man with low libido, low energy, or suspected andropause

NOT A FIT IF

HOW TO START

Two ways to start with us.

You have two booking options with Dr Maria Mackey. The right one depends on whether you want a focused hormone consultation or a deeper big-picture investigation.

OPTION 1

Hormone Assessment with Dr Maria Mackey

Medicare rebate available for in-person initial consultations

The fast-track. If your concerns are primarily hormonal: cycle, PMS, PCOS, fertility, or low testosterone in men. Targeted testing and a personalised plan.

OPTION 2

Mojo New Patient Appointment with Dr Maria Mackey

Medicare rebate available for in-person initial consultations

The deep dive. If hormones sit alongside thyroid, gut, fatigue, adrenal, or metabolic concerns that need investigating together.

For full pricing, see Consultation Fees. Telehealth available Australia-wide for followups. Medicare rebates apply for in-person initial consultations (except Heavy Metal Initial Appointment). For your first appointment, in-person at our Neutral Bay clinic is strongly recommended.

FAQ

Frequently Asked Questions.

How much does a chronic bloating or leaky gut consultation cost at Mojo Klinik?

The fastest path is the Gut Assessment with Dr Maria Mackey: 45 minutes,
$390 in-person or $410 by Zoom, with a Medicare rebate available for inperson initial consultations. The deeper investigation is the Mojo New
Patient Appointment: 1 hour, $490 with Dr Mackey or $480 with Dr Varipatis.
Functional pathology (microbiome, intestinal permeability, food sensitivity
testing) is billed separately by the lab.

"For most hormonal presentations the 45-minute Hormone Assessment is the right entry point. The full hour is appropriate when hormones sit alongside multi-system concerns that need to be looked at together."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

I have been told my hormones are normal. Why do I feel like something is wrong?

A single test on the wrong day can look normal in someone with significant
symptoms. Hormones fluctuate. The test needs to be timed correctly to your
cycle, the right hormones tested, and the full picture looked at, including
thyroid, adrenal, and metabolic markers.

"The hormonal picture is not a single number. It is a pattern across the cycle, read against thyroid, adrenal, and metabolic context. Testing the wrong hormone on the wrong day is the most common reason a patient is told her results are normal when she is clearly not."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

A 2024 review in the Journal of Clinical Endocrinology and Metabolism confirmed that singletimepoint hormonal testing has limited sensitivity for cycle-related and perimenopausal
hormonal disorders.

Can integrative care help PCOS (recently renamed PMOS)?

Yes. PCOS, recently renamed Polyendocrine Metabolic Ovarian Syndrome
(PMOS) by international consensus, is fundamentally a metabolic and
hormonal condition. The standard approach often involves the oral
contraceptive pill, which manages symptoms but does not address the
underlying drivers (insulin resistance, inflammation, gut, stress). We address
the drivers. If you were diagnosed with PCOS, that diagnosis still applies.
The name has changed because the condition is a whole-body picture, not
an ovarian one.

"PCOS is fundamentally an insulin resistance picture with hormonal consequences. Mechanism before label. Address the metabolic driver, the gut, and the inflammatory load, and the cycle, the skin, the fertility prospects, and the overall picture usually move together. The oral contraceptive pill manages symptoms. It does not treat the underlying condition."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

A 2024 Lancet Diabetes and Endocrinology review confirmed that insulin resistance is the
dominant metabolic driver in approximately 70 to 80% of PCOS cases.

Do you treat male hormones?

Yes. We assess testosterone (total, free, SHBG), DHEA, oestradiol, and the
related metabolic and adrenal markers in male patients with relevant
concerns: low libido, low energy, low mood, weight changes, suspected
andropause, or fertility-related issues.

"Male hormonal assessment is one of the most underdiagnosed areas in primary care. A man whose testosterone has dropped 30% from his personal baseline can still sit inside a population reference range. We assess your specific picture, not just whether the result clears the population threshold."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

A 2023 review in the Asian Journal of Andrology documented suboptimal testosterone levels in
approximately 30% of Australian men over 40, with a substantial proportion unrecognised.

Do you do bioidentical hormone therapy?

Where clinically appropriate, yes. Body-identical refers to hormones
structurally identical to those your body produces. We discuss all MHT
(menopausal hormone therapy) options in the context of your individual
situation, history, and current Australasian Menopause Society guidance.
The specific regimen is discussed in detail at consultation.

"Bioidentical and conventional MHT terminology overlap considerably in current practice. The body-identical regimen recommended in current AMS guidance is first-line for most women. We tailor the choice to your specific picture."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

For the Australasian Menopause Society’s own patient information on bioidentical and bodyidentical hormone therapy, see menopause.org.au/hp/information-sheets/bioidenticalhormones-for-menopausal-symptoms.

I am post-baby and still do not feel right. Could that be hormonal?

Yes, often. The postpartum period is one of the most significant hormonal
transitions in a woman’s life. Symptoms persisting beyond 6 to 12 months
postpartum may include postpartum thyroiditis, persistent HPA axis
dysregulation, sex hormone shifts, or persistent micronutrient depletion
from pregnancy and breastfeeding.

"Postpartum hormonal recovery is more variable than is often acknowledged. Some women settle within months. Others have hormonal patterns that have not reset 18 months in. Postpartum thyroiditis specifically is significantly more common than standard screening picks up."

Dr Maria Mackey, MBChB FRACGP Dip Hom FAARM

Approximately 5 to 10% of postpartum women develop postpartum thyroiditis, with significant
under-recognition in routine postnatal care. American Thyroid Association, 2023 statement.

What testing will I need?

A comprehensive hormonal assessment may include sex hormones (timed
correctly to your cycle), full thyroid panel, 4-point urinary hormone
testing and DHEA, HbA1c and metabolic markers, and DUTCH testing
where indicated. The specific panel is decided at consultation based on
your presentation.

AN INVITATION

Ready to be properly investigated?

One hour. Your full history. The right tests. A real plan. Book your
first appointment online, or call reception on 02 9133 8500.

WHERE
Suite 11, 40 Yeo Street
Neutral Bay NSW 2089

HOURS
Mon – Fri 8:30am – 5:00pm
Selected Saturdays by arrangement