Got any patients on Natural Thyroid Extracts (NTE)? Me too…and I am finding it’s on the increase. What’s the deal? What do we need to understand about this form of thyroid replacement therapy to best monitor and manage those patients already on it or contemplating taking it? Does it really offer advantages to all hypothyroid patients or just to a subset of those and how would we recognise these people who might benefit the most?
NTE are marketed as being superior to synthetic thyroxine primarily based on the fact that they provide the patient with some T3 as well as T4 and in addition to that, being extracts of pig thyroid glands, there are other thyroid and iodine based actives e.g. mono and diiodotyrosine, present in the extracts. So in essence this is giving us more iodine and more of the other ingredients we need to make our own thyroid hormones. Based on this, many proponents of NTE say this is a major advantage over synthetic thyroxine replacement because it is more ‘holistic’ and it supports the patient’s gland in its own hormonogenesis. (more…)
That’s the word on integrative medicine street. I had a sense this was coming, not just a tightening of our terminology but also a challenge of the very concept of ‘adrenal burnout’. Hear me out. (more…)
I just want to scream with joy…and then keep on screaming with utter frustration! Last week I presented the culmination of months of work looking into the extraordinary manifold relationships between thyroid health, fertility, pregnancy & post-partum health for mum and bub.
The findings are breathtaking: whether it’s about being able to put thyroid Abs firmly on the ‘Must Screen’ list for preconception care, given their ability to double-quadruple the rate of early miscarriage or their propensity for triggering post-partum thyroiditis in 50% of women who possess them or being able to state emphatically that maternal low iodine (prior to conception as well as during pregnancy) remains the number one risk for the thyroid’s healthy transition to pregnancy. The evidence is overwhelming that we need to pay very close attention to the thyroid. (more…)
I know you’re out there. Reading a recent news article I had instant flashbacks of being a young, big-eyed, rosy cheeked naturopathic student of 20+years ago. While my career since may have taken me in somewhat of a different direction, I know many of my colleagues have stayed true to their roots (both weedy and herbal) and love nothing more than a bit of urban foraging. Sometimes even sharing their bounty with me, much to my delight. I salute you! (more…)
This week I must have spent more than my daily time allocation (5mins) on Facebook and as a result I stumbled across an article I actually read from beginning to finish! The title called to me, “Bad Parent, Hey Bad Parent”…it works every time right? Anyway, once I started reading it I thought, no this is useful, we all need that manual that everybody talks about but nobody seems to own and I know this relates to not only the way I am bringing up my teens but I can pass on its pearls to my patients who are parents of teens as well.
My kids have been teens mathematically speaking for 3.5 years now, but I’m pretty certain, the metamorphosis happened just last Tuesday for one and a couple of months prior for the other. (more…)
I’ve managed to befriend a microbiologist. I know it wouldn’t excite everyone, but it’s my big good news story of the month and I can’t wipe the smile off my face when I announce this to friends and colleagues. Friends don’t get it. Yet another Rachel weirdism. But colleagues…every single praccie I’ve told says, “Oh wow!!!! Where can I get one of those??!!”
What’s even more special, is that my new BFF is not just any pathology lab scientist – she’s a passionate one, describing herself as, ‘the only one in the lab who would get excited about things, write down ideas and thoughts about how this patient might be presenting and remember to chase up doctors notes to see if I’d come close!’
I know…I’ve met my match 🙂 …we could talk for days without drawing breath! And wouldn’t you know it, the more I learn, the more questions I have, which is always a good sign. (more…)
Have you still got some thyroid patients that don’t fit any sort of traditional thyroid disease model and are difficult to get results with? Oh yes me too… and watch out…I’ve been spending the last few weeks with my nose firmly embedded in hundreds of articles digging around for more answers. As I am presenting on thyroid conditions for ACNEM in Adelaide March 18-19th, I couldn’t resist going back to the literature to see if by delving a little deeper again I could come up with some more answers to these weird, wacky and hard to treat thyroid presentations that we’re increasingly seeing and guess what…I think I’ve found a few gems. (more…)
We all try and surround ourselves with fabulous people in our workplace and I have been luckier than most. I’ll talk more another time about how to attract the right people to work for your business but right now I just want to share a gem from the fabulous Freya who currently fills the role of my 2IC. You see Freya is a straight talking, millenial, naturopathic graduate (Dux might I add ;)) who happens to work for the dark side as well. Yes, it’s true, long before she started working for me, she was working for a coffee company. Now much to Freya’s amusement this gives her a front row seat to see the foible of this addiction up close….and being a straight shooter, she thinks we humans are a bit slow 🙂 (more…)
This year has kicked off with lots of time spent re-calibrating my own and other practitioners’ businesses models via business mentoring and it’s such a privilege. One symptom that seems to creep into almost every practitioner’s business model though, is one of over-delivery. (Curse that empathy and all those good hearts hey!) Over-delivering comes in many forms, it might sound or look like this…
“I always run over”
Rather than responding to this with further self-criticism and , pledging better allegiance to the clock – we could hear this as a reflection that our appointment structure is out-dated or unsuitable. We need to restructure to allow for the time we really do spend and need to spend with our clients and then adjust the appointment fees appropriately. Having said that be aware of the other golden oldie: (more…)
I’ve been digging around in the scientific literature all about appendicitis and I’ve ended up here. Long gone are the days when medicine foolishly considered the appendix without purpose – a dispensable ‘extra’ of the GIT and now, thanks to genetic PCR bacterial identification, gone also is its more recent portrayal as something sinister – a potential harbourer of ‘bad bugs’. The current consensus about this apparently complex little sac is that it constitutes a ‘safe house’ for the microbiota within the GIT, making one of its key roles the healthy recolonisation of the gut following diarrhoeal episodes and even oral antibiotics. Amazingly, antibiotics that can quickly sterilise the rest of the digestive tract, fail to clean out the appendix, due in part to its specialised and exaggerated biofilm as well as its more diverse and environmentally tough species. Wouldn’t you know it, the strange little sac has a critical role in keeping us well?!
Given this radical rethink of the healthy appendix I wondered whether medicine’s understanding of appendicitis and in particular what causes it, had also undergone a revolution. This condition, which was first described over 100 years ago has confounded scientists and clinicians ever since – I love this quote from a 1972 paper in the Medical Journal of Australia (Williams):
“It is interesting and humiliating that a small organ which in man performs no useful function can so frequently give rise to problems which, if not treated, may have fatal complications, and of which we
still do not fully know the cause.” (more…)
Yep, I’ve had them…and made them. I often hear practitioners say they cringe when they think back about the patients they saw in the first year because of the vastly greater knowledge they have now. I do too. But my mistakes are more recent than that!
I know more this week than I did last, and that is a good thing…right?! For me and most practitioners, there is acknowledgement that our learning is infinite, ongoing, without end. This is a source of excitement for me, not a negative. The light-bulb moments are deeply satisfying – those moments when I become enlightened about a mistake I’ve been making, or a misunderstanding I have had. (more…)
Make the most of this special offer! If you become a 12 month subscriber before the end of January (that’s tomorrow!) you receive 10% off ALL individual mentoring sessions in 2017!
And just so you know what we have in store for you as an Update in Under 30 Subscriber this month: Rachel’s kicking off the year with ‘Melatonin – Misunderstandings and Mistakes’ – an amazing clinical update about what we are getting right and wrong with Melatonin. This podcast answers in particular, one of the most common sources of fascination & frustration for clinicians, the reasons behind the Melatonin non-responder. We’ve all encountered patients who have taken Melatonin for sleep problems and reported no benefit, or initially responded and then lost efficacy quickly, or even patients who experienced insomnia after taking. What does this tell you about your patient and what should you do to resolve this and better still, prevent it? Now we know. (more…)
Have you heard what everyone is saying about the “Update in Under 30 Podcasts”? But more importantly, have you heard about “Update in Under 30 Podcasts”… fullstop?! If you’ve somehow missed out on being a subscriber & receiving these monthly gems over the last few years, you MUST read on … These dynamic podcasts will help you keep abreast of the latest must-knows in integrative medicine. Focused on one key issue at a time, Rachel details all the salient points so that you don’t have to trawl through all the primary evidence yourself. In Under 30! Each podcast represents unbiased education that can contribute to your CPE points and is delivered to your inbox every month for under $13 a month… how easy is that! (more…)
Sheeeeeshkebab I squirm at the whole premise of new year’s resolutions. If you understand a little about the process of behavioural change, you’ll appreciate that there’s no magic dust (or firework pollutants!) you are going to get sprinkled with between pre and post midnight on any one day of the year, not even NYE, that will create a ‘new you’. Therefore to set ourselves or our patients up with such an expectation just leads to another big red rubber stamped ‘FAIL’ and guess what impact that has on your next serious attempt…yes…you guessed it…it diminishes your chances of future success because it provides evidence of our inability to change.
So my message to people during this annual transition is: Don’t Change. (more…)
Want to start 2017 with some good news? Sometimes working with patients challenged by mental health I get scared. A well-known colleague of mine introduced me to the notion of the ‘clinician in crisis’. The practitioner who, in the face of their patient’s extraordinary pain & distress feels overcome by the need to Do Something…Anything. Over time I have learned to spot, what we call a ‘desperation prescription’, the patient who is on 3+ psych medications all from different drug classes and still remains tragically symptomatic. It is potentially frightening stuff. I’ve had the same experience with patients using herbs and nutrients. The patient’s biological drivers may seem straight forward on paper, but they fail to respond as predicted. Nobody has a 100% success rate…not me, not Ben Lynch, not Kelly Brogan…as much as their marketing machines might make you think otherwise. (more…)
The standout gift I got this year for Christmas without a doubt was my very own copy of Sarah Lantz & Tabitha McIntosh’s, One Bite at a Time – Reduce Toxic Exposure & Eat the World You Want. Every time I walk past it on the table a strange force compels me to run my fingers over the cover, reach for it to pour over some more pages whenever I have moments to myself and show it to everyone who crosses our doorstep. This strange force…I think is called pride. I experienced a tsunami of this at the Australian Naturopathic Summit and now here is another wave. (more…)
I’ve decided to resign, to quit, to call it a day. It’s a big decision and it may come as a surprise to some of you but it’s a timely one. You see, it’s actually good business practice to figuratively or literally quit your job at the same time each year. Schedule it in, pop it into google calendar with a big flashing reminder that shouts “RESIGN TODAY”. For me, it’s an annual event and it coincides with the festive season so while others are unwrapping pressies, I’m unwrapping the finer details of my new career. The call to quit should prompt you to spend time – perhaps a full dedicated day or several focused installments over a week – asking yourself, “What do I want to do…now?” (more…)
It’s officially official! The Rachel Arthur Mentorship Program for 2017 is in the loading dock ready to launch & we kick off with our first session on January 30. We are soooooooooooo excited & we have just a few spots left. If you haven’t heard as yet we have embraced … ok I admit I was pushed! 😉 … an amazingly user-friendly cloud based group platform…(it’s like a new language isn’t it?! Who knew all those words went together!)
Let’s break this down into terms the rest of us understand… this new fancy platform we have, called ‘Basecamp’, is an incredible way you and me and all the other practitioners in your group can share resources, communicate between sessions, keep tabs on ongoing patient updates and results etc…ultimately, this means the ongoing practical support, skill development and network building you receive is BIGGER & BETTER THAN EVER BEFORE!
Right, now I have that off my chest 🙂 I have to tell you that all our groups are full…except for a few spots in one! (more…)
I think of you most mornings. You see I’m totally in the habit of checking abc online news when I wake and frequently expel several ‘Oh my goodnesses’, before even getting out of bed. Here’s one that made me want to jump out of bed and instantly share them with you…better late than never 😉
In case you haven’t heard about it yet, Gary Fettke is an orthopaedic surgeon in Tasmania and an advocate of a low carbohydrate diet. He got that way after dedicating a fair chunk of his surgery hours to amputating the limbs of diabetic patients and is now famous for virtually telling some of his patients ‘cut out carbs or die’! That catch-cry has made the headlines of course but Gary Fettke’s less punchy take on diet goes something like this: “It’s just eating lots of vegetables, pasture-fed meat and the right amount of oil in the form of things like nuts, avocado, cheese, olive oil and fish.” Sound familiar to anyone?
Can you guess what happened next? Well an anonymous complaint was made against him (note not by a patient but by one of the dietitians at the hospital!) which prompted a 2 1/2 year investigation by the Australian Health Practitioner Regulation Agency (AHPRA). They recently concluded that he was “working outside his scope of practise and was not qualified to give specific nutritional advice, and he was ordered to stop speaking about the low carbohydrate, high fat diet.” They have issued him with a caution. (more…)
Often we assume our patients know at least the basics about health – especially about things soooo seemingly basic…that we fear mentioning them would offend and make us look like someone trying to teach grandma anything! But there are some instances where I’ve found I have simply assumed too much.
I think the issue of what I affectionately call ‘Vag Care’, is right up there as an example.
Soapy water? Female deodorisers, daily panty liners, re-enacting bad movie scenes with soapy suds sex…what the??? It’s been my astonishing discovery that women of all ages, but especially a frightening majority of younger females (<30 yo), in this time of increasingly unreal ideas about sex and sexuality, feel inclined or pressured to adopt these practices in order to erase all trace of natural odour and healthy discharge. The abnormal has become normalised. (more…)