Ever failed to fix someone’s presenting complaint they came in with but they keep coming back? Me too. One especially that comes to mind, from over a decade ago, was someone with alopecia. She’s still in my care. And that’s despite the fact that she never grew thicker hair, as was her express objective at our initial appointment and she’s gone on to develop several other conditions. So who’s at fault? Me? Because I failed to find all the ‘fixes’ – firstly for her alopecia and then because I couldn’t abort everything else that followed? Or her? For rebooking? Which would then naturally fall back on me – for letting her – if indeed it was apparent, that the answers for her were elsewhere.
How we each, individually, think about ‘health’, informs how we set out to care for patients and set up our practice models.
Packages and programs make the case for ‘health’ as a series of discrete challenges. Offering us the option of focussed goal-oriented interventions to produce our desired end-objectives: fitness, weight loss, conception. Apothecaries by providing everyday access to healthcare and medicines with low buy-in barriers, could be said to be more of an acknowledgment of the inescapable and ongoing nature of this very humanising thing we call ‘health’. Shared medical appointments lean away from ‘health’ as something that happens to an individual, which can in turn amplify our sense of isolation, and instead, act to remind us that the struggle to be well is universal and our efforts to overcome our health issues can actually unite us. Practitioners still engaged in General Practice regard ‘health’ as a whole body undertaking and something they’re less able to make sense of when siphoned into disconnected systems. Those identifying as ‘Family focussed – recognise that ‘health’ also expresses itself & may benefit from being assessed & addressed at the level of the ‘household’. If instead, in the one family, ‘she’ sees a women’s health specialist, he, a men’s and their kids each consult with various clinicians, appropriate to their age, stage and particular presentation (skin, mental health etc) – how does the overall ‘health’ of that family fare? Health professionals delivering care in Corporate settings, highlight how our ‘health’ is impacted by the large portion of our lives spent at work and the incredible contribution our daily habits and workplace culture can make. All of these are important. All of these have their place.
All of these are rooted in our own beliefs & framing of ‘health’ combined with our own unique sense of how we can best help. Which part of the path we can accompany people on, which piece of the puzzle we might facilitate them to solve.
Early in my career I offered a lot of ‘packages’ and I think that was a good fit for me in my 20s when ‘health’ did seem like a series of ‘tests’. Can I make a baby? Can I make enough breastmilk for two?! 😵Can our immune systems cope with all the ‘intruders’ they bring into the home? Can I be well as a working mum? And like all things perhaps, my experiences, & therefore the way I individually conceptualise ‘health’ continued to undergo adjustments. So too my sense of what ‘health’ hand-holding we need and what kind contribution I can make to that. So back to the story of the patient who keeps seeing me even though I wasn’t able to solve the very thing she first came in for. For 15 years, she has valued me as a reliable source of information. She has seen me as part of her team, not operating independently of the other healthcare providers she’s supported by. I collaborate and refer for things beyond my scope. She understands I am here for the long game, for the unmasking that ageing does to all of us. I am here as long as she will have me, for as long as she sees herself as ‘better’ for me, just ‘healthier’ because I am here.
I’ve been seeing my long-standing (suffering😅) psychologist for about 8 years now and she’s yet to cure my primary concern. But myinternal (& therefore also external) life now, compared with before, is so different, vastly improved, by and large as a result of having her on my team.
Having had this experience as a patient helped me again to see the enormous value this practice model of continuity of care offers. And I hear that echoed by others. Some practitioners speak to now having supported 3-4 generations even within the one family! Accompanied often by, ‘What a privilege! What an honour!’. I feel the same way about my own enduring patient relationships. It turns out, I’ve sat on both sides of this therapeutic equation then. I wonder if you have too?
How did you do all that? Often coupled with a statement like ‘You were a machine!’ No, just a woman with no lamps and no life. If this makes you most concerned about my ongoing ambient lighting options – rest assured – I am lamped to the max now. But at my peak level of productivity I just couldn’t run the risk of getting sleepy after I put the kids to bed because I still had several hours of work to put in at the computer…true.
‘What are you doing now with all that extra time?’ Ok let’s be clear, ‘extra time’ is an illusion! But in addition to more time under lamplight, in short, when I wrapped up Group Mentoring I turned to my kids and said, “I want to be of service – that’s my next chapter’. After momentarily toying with an OS post with Medicins Sans Frontieres or similar, I instead found my vollie roles a little closer to home. I support several new mums with their babies (hardly selfless when cuddles are involved) and am an occasional extra-hand with my local Landcare. I also undertook training in Last Aid – yes think the opposite of First Aid (kinda) – it’s about being death-informed and able to support people through their palliative process & also beyond it. It was phenomenal. I intend to share about this in-depth in our upcoming conversations via The Curious Minds Club (CMC).
‘What’s next?’ Well the CMC is a new initiative I’m really inspired about and I hope you are too. I’ve already shared some reasons why I think we all need this right now- a place where we can think out loud together. Have the conversations that aren’t happening elsewhere – because others can’t or won’t. But what else is up next? Well I wish I knew! Because just as I didn’t anticipate or entirely plan my exit from running the ANS, or delivering education for several institutions, or Group Mentoring – I have instead listened very much to my gut about when it’s time to ‘make a move’ – and it seems this little corner of the internet is next 😉
The new season of ‘Alone’ is out & the contenders are all from our community: Nats, Nuts & Herbalists. Who’s likely to last longest?😅 I’ve been entertaining myself with this idea ever since I attended an inspiring interactive workshop at the recent NHAA Summit. Seated at a few round tables outside (bliss), we were asked to imagine we were on a deserted island & come up with the most uses for the single herb we’d been assigned. I was team ribwort. I had nothing to contribute. I was in awe, however, of the knowledge pouring out around me – about teas, compresses & all the consumable parts to boot! About various applications ranging from topical to internal, with many speaking from first hand experiences. It was clear in that moment, that if there ever was a survival contest, I was going to lose.
Which has given me a lot to think about...& just might for you too. Not because I suffer anyGina Chick* delusions but because I studied naturopathy because I am a lover, & child, of nature. * for those overseas readers that’s our Bear Grylls but better
A hippie at heart (anyone actually surprised?) – beingin the elements is essential to my sense of self, as well as my physical & mental wellbeing. I’m a huge fan of first-light, an electrifying ocean-immersion under a stormy sky (for which skinny dipping can’t be beat🏊♀️), the majestic light that filters through the bush, as I walk at twilight. It’s my connection with nature that has most often inspired me and offered my thinking direction. And about so many aspects of life, including how I eat, move, rest & sleep, and the rhythm of these across each day. And it’s done so, since I was an adolescent. So when I was living in Byron Bay at 18 & learned that there were people calling themselves ‘naturopaths’, regardless of the real meaning and origin of that word, it felt like a fit! I would lead patients down their ‘path’ to health, as laid out by ‘nature’. And certainly in my first thrilling year of study, I imagined my future-self spending most of my time in clinic doing just this. Then the medical sciences really ramped up in the coming years and, having also a very analytical mind, I adored these too.
Nature & science had materialised as an overlapping Venn diagram in my mind.. And as long as my approach to health sat within this intersection between them I felt ideologically aligned with these 2 great loves of mine. But of course ‘those lines’ moved. Both objectively, once EBM took a seat at naturopathy’s table, as the overlap between them ballooned, and alsopersonally. My position increasingly shifted further toward the science, which, at times, neglected the balance of ‘nature’.
By student clinic, I had mostlystayed the course , but also strayed a little.
Still keeping ‘food first’ & health-related behaviour at the core of my patient recommendations – but of course, supps, and pills and potions and lotions also had their undeniable appeal. In part, because it became patently clear, they were a far simpler sell to the patients.
A decade in to my own clinical practice and just asking someone about the micro-details of their diet, let alone, working up a sweat trying to talk them into substantial course-corrections, suddenly seemed like VERY heavy-lifting. And most patients preferred the pills. ‘Swallow these supps’ is a comparatively tiny ask, of course, almost always given the alternative. ‘Shop differently, learn new ways to prepare foods, unlearn everything you’ve learned online, cut down on things you’re propping yourself up with (sugary cabs, caffeine, couch time & cocktails!) and, oh that’ll be $300’. Ouch. And while the purists in our profession play an essential role, and will suit some, many patients with reduced capacity or health literacy need us to meet them exactly where they are. And if we ignore this, instead maintaining our own rigid ideals, well we leave them out on the margins and our ‘purism’ risks tipping over into puritanism, which does a lot of damage – to individual patients and the whole profession. However, equally, once we as naturopaths & herbalists, start ignoring the power (both positive and negative) of ‘the path laid out by nature’, or, the ‘everything else’ beneath the ‘bottles’, we are forced into overdelivering – more complicated (and much more expensive) products and protocols. Tell me I’m wrong.
Now I’m only speaking as myself & describing my own full circle. It’s a total trope that we’re all hemp-wearing hippies – what an under-estimation of our diverse community! We come in every imaginable flavour. That’s one of our strengths.
But back at the workshop, I was aware that just behind ouroutside tables, adorned by real living herbs at the centre of each, was an exhibitors room. Packed to the rafters with products, associated packaging and marketing. And while I had nothing on ribwort – I could talk to these – U N D E R W A T E R. Because these are what have formed the biggest portion of my prescribing across my career. And I felt suddenly, not so much, a values misalignment, as a compound fracture of them. Of who I thought I was and what inspires me to work in this space. Yet another moment of recognition I’ve had recently, I sense of my own need to refind the path, not away from the wilderness but into it!
I know nature-care is simply not enough for everyone, certainly not everyone I see, but I fear it’s increasingly becoming a signpost on the path, rather than ‘the path’ itself. Anyone else?
…right here👇… this is the spot where you’ll be able to answer that question, add your own ideas & read those of others. And I can’t wait. For now, I’m simply putting a match to kindling to see what conversations ‘catch’ for you, for us. What lights us up as a professional community – whether that be with passion or rage or insight or inspiration. Together, we can build a whole series of campfires & talk through the nights (especially any long dark ones 😉) – maybe with an occasional Kumbaya for good measure 😊
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Sounds were emanating not just from me, but from everyone around me, at my table. Admittedly, I was sitting with some very seasoned practitioners, no doubt skewing how representative the sample was of our entire profession, however, at least one thing was clear. Allowing each sponsor the mic for 90 seconds to hard-pitch at us prior to each session of the conference – and sometimes that meant 4 sponsors back to back in a row! – didn’t feel, to experienced practitioners, ‘right’, ‘good’, ‘appropriate’ nor, conference organisers & sponsors please take note, therefore, ultimately effective. Now, of course, I don’t have data to base this on – I’m just going off the low-level groans – along with under-the-breath comments such as, ‘Let’s be sure to put this at the top of our feedback forms!’ Done.
Now recently, I wrote about not wanting to blog from atop a mountain 🌄 Because of course it’s an incredibly privileged position & one that offers potentially, a lot of protection from the realities of life actually on the ground.
Also, that’s a particularly risky take for someone with matching fingerprints! Having run a national naturopathic conference (& precisely 2.7 times -the 3rd all systems go until a nasty virus took us out), that received sponsorship $ from industry, I am all too familiar with the harsh financial realities of running these events. Actual ticket sales cover very little of the actual bill. Especially when we all enjoy the spoils of beautiful venues, edible offerings from caterers, along with all the bells & whistles, e.g. yoga at sunrise & networking drinks at sundown. Transforming what could feel like, yet more work, into something occupying the space between research & a reset. I mean, I’ve pitched pitching our own tents in some bush for a conference where we each cook our own meals over a campfire & entertainment ends with a bit of Kumbaya at 8 but only the most hardcore hippies among us seemed keen. Thanks Jason & Dawn for your unbridled enthusiasm 😂
But whenever industry is involved it immediately takes a range of topics off the table.
I knowthis all too well. Great abstracts addressing some of the most important issues will never see the light of day. Certain people will never get a speaking spot. And even in the instance someone manages to get something onto a program that promises to explore issues on the edge of, or even out-of-reach, of what sponsors are prepared to financially support – perhaps that’s questions about the quality of their products & services, or the health & integrity of the relationship we, as a profession, have with our associated industry – the politics that then plays out is deeply disheartening. Either beforehand, via excessive editorial oversight, e.g. remove slides 4,5 & 6, or after the fact. This was the jarring & scarring experience we had first hand with the industry-sponsored, yet entirely independent, Australian Naturopathic Summit. After getting our audience in the mood, via some on-stage bad dancing to ‘Money’ by Pink Floyd, Jason, Nirala and me dared to present concrete de-identified evidence of some unethical behaviour by practitioner-only supplement companies. The first aftershock we all felt was right there in the room. As it became clear that many practitioners had swallowed the story whole sold to them: that these commercial interests were there to merely ‘support’ us, not ‘sell’ us anything (laughable considering practitioner-only brands supposedly only have one customer : practitioners) & certainly not ‘swindle’ us…ever! The second after-shock came later.
The backlash from some sponsors was fast & furious. For others it was a long slow burn & grudge that meant that all future sponsorship of the ANS was in severe jeopardy. And the 3 of us, as the presenters of this evidence, were independently targeted.
We all have thick skin (plumped by good nutrition😉) so that’s not the point but rather where do these conversations happen now? Not so long ago I had an off-the-record 4 way conversation with 2 leading naturopathic educators and 1 integrative GP who also offers training. It was prompted by a mentoring session a practitioner, who had only recently undertaken training with several of them, had with me. I was stunned because this well meaning and clearly well-educated praccie presented a case with a whole swathe of testing performed by a particular very dubious pathology provider. I went back to each educator and asked, ‘Are you recommending these guys?” and ‘Heck no!’ was the answer all round. With each adding something to the effect of, ‘Their results are entirely unreliable. I can’t openly say that for fear of litigation or at the very least backlash but we all know this, right?! [wrong 😥] …I share images of results from other providers in my training – trusting practitioners pick up on the fact that I never use them – that’s the best I can do!’ 😶
So now, a word from my Sponsors. 🦗🦗🦗
Yep crickets. I ain’t got none which is a good thing because I believe we desperately need a place to speak openly about the issues that matter. I am not anti-industry. And the conversations I want all of us to share in are much bigger and go way beyond this. But if we find ourselves in this place, where all the big names in naturopathic education know something that none of them can say out loud, such that practitioners continue to incorrectly place their trust, & spend their patients’ money, with companies underserving of that trust – well we need to find a better way 🙄
I am leaving the blogosphere.
Well not entirely but almost. At the EOFY all my weekly blogs will be accessible only to those signed-up to The Curious Minds Club. Every event, practitioners tell me how they love these blogs. I’ve heard ‘learning while laughing (lmao)’ more than once and it never fails to delight! And I love this small kind of community that we’ve created here between you and me. I so appreciate being able to talk to you. To have the ‘other conversations’, the ones others can’t or won’t. The bigger ones, the tougher ones, the more involved, complicated ones, than most mediums and messaging allows. But I also have had a rapidly growing sense that I want to say more and I really want to hear from you.
So we’re switching on comments.
Because I want this to be an actual conversation between us – not me monologing from atop the mountain! too removed from the realities of our very real clinical lives. I want it to be a co-creation. So we get to address the questions that might remain for you about an issue, the weeds we need to walk through together, in order to come out the other side with real clarity. Whether that’s in relation to ethics, practice models, education, prescribing, diagnostics, industry, politics etc
I’m genuinely excited about this next chapter. More depth. More honesty. More conversation.
We’ll be in touch with the details soon. Because you’re on our mailing list you’ll be first to know.
But chances are you know very little. This is especially true of the parasocial relationships we experience with lots of different people – not just those we’ve never met. You might have been in the same room as them, talked to them, and on more than one occasion. Might have even been taught by them, read their blogs, followed their feed. And because of all those interactions, that for us, have been very impacting, we autofill all the other information about these individuals, using our imagination, lead by our own cognitive biases, to create our own version of ‘them’. Often making them increasingly one-dimensional, ‘They’re Perfect! Lives it – breathes it’, or alternatively, ‘Here’s a naturopath that still knows how to party!” Our assumptions & autofill could be about any aspect of that individual, their privilege, up-bringing, background, previous life & career, pivot points, their diet, their lifestyle, their own health journey.
Kirabecame profoundly unwell each time she attempted to complete her Masters in Research which, taken together with her Californian upbringing & the legacy of summer camps full of tie-dying anything not tied down, told her to return to her ‘woo woo’.
Phil had an established international career in anti-nuclear activism& is ultimately motivated by the need for improved social equity.
Lesley, the daughter of an energetic healer, studied naturopathy alongside pharmacy but found the emotional load of 1:1 practice the most difficult to navigateso chose a better suited application of everything she knew.
Sescame to Australia at the time of our AIDS crisis in the 80swhich motivated her to reach out & build a bridge with ACON prior to her Hep C research & work.
Sueworked in youth justice in her mid 20s, which she was passionate about but burdened with excessive responsibility by, so she fled to London & found herself working in a health food store – because they loved employed articulate ‘girls from the colonies’!
Liza was exposed to a childhood of nothing more than a dehydrated apricot for dessert, once her mother discovered naturopathy as a necessary course-correction for their ‘toxic farming’ lifestyle.
Hearing myselfacross the weekend’s program referred to as, ‘The Queen of Mentoring’, along with, ‘Needs no introduction’, was the other side of this same phenomenon. It’s a surreal experience. I imagine that if I wasn’t me, I too would think things about ‘me’. Make some assumptions, autofill the rest. I wondered who ‘she’ is – in the minds of all of these people – and what fraction of my whole that represents. I am sure I am both much less and also much more. I’m aware of a particular role I’ve played in parasocial relationships practitioners have formed with me. I intensely compartmentalised my life, segregated & split-off work from anything personal, for the most part of my career. I don’t post pictures of my kids, speak about my family in any firm terms, I’ve probably sounded sketchy on the details about lots of aspects of my life. It was driven by both my desire to present as the professional I am (& back in the day when that was absolutely mutually exclusive from the current ‘authenticity’ piece) and a desire to protect both mine & my little flock’s privacy.But when I hear some versions of ‘Rachel Arthur’ I think it maybe was a little to my detriment. Perhaps it’s fostered an impression of me more robot than real flesh and blood human, who has all the struggles, the uncertainties, the challenges, the love & the load that you would expect of any middle aged, divorced, single mother of two, solo practitioner, who had their first paid work at 12 (oh yes the work ethic was alive and kicking in my neck of the woods) but transitioned to working for myself from the time my twins turned 2!
I still find myself asking, what’s the value in you knowing this & more of the personal stuff about me?
I guess just so that you don’t ‘other’ me. Such that you can see yourself in me, both in my strengths, but equally my follies. But also so I don’t feel so alone. The summit program this weekend was all about our community & how we each individually need our community to be well – ’tis so true – and Kira, in her closing speech, gave us the evocative analogy of the mother tree of a sequoia grove. To have had the honour of influencing how we educate ourselves in this community but to simultaneously have often felt on the ‘outer’ (because I am not part of an institution, I decline to absolutely align with any aspect of industry, I am not even part of a praccie chic-click – more of a chic-flitter between several 😅) has been a confusing combination over my career. The Australian Naturopathic Summit circa 2016 & 2018 (& 2020 which was put to a stop only by a pandemic!), co-created with Nirala Jacobi, Kathryn Simpson and via all the input of our incredible speakers, vollies and attendees was, I guess, an attempt at creating the community that I until then, I hadn’t experienced myself. And I know to this day, it holds that place in many hearts forever for that reason. But in the absence of the ANS, I ‘gotta’ say NHAA, You did a good job – offering us a big warm hug, an opportunity for reconnection & to see all of ourselves as real people with so much more to each of our stories…
I am leaving the blogosphere.
Well not entirely but almost. At the EOFY all my weekly blogs will be accessible only to our Curious Minds Club subscribers. Every event, practitioners tell me how they love these blogs. I’ve heard ‘learning while laughing (lmao)’ more than once and it never fails to delight! And I love this small kind of community that we’ve created here between you and me. I so appreciate being able to talk to you. To have the ‘other conversations’, the ones others can’t or won’t. The bigger ones, the tougher ones, the more involved, complicated ones, than most mediums and messaging allows. But I also have had a rapidly growing sense that I want to say more and I really want to hear from you.
So we’re switching on comments.
Because I want this to be an actual conversation between us – not me monologing from atop the mountain! too removed from the realities of our very real clinical lives. I want it to be a co-creation. So we get to address the questions that might remain for you about an issue, the weeds we need to walk through together, in order to come out the other side with real clarity. Whether that’s in relation to ethics, practice models, education, prescribing, diagnostics, industry, politics etc
I’m genuinely excited about this next chapter. More depth. More honesty. More conversation.
We’ll be in touch with the details soon. If you’re on our mailing list you’ll be first to know.
Overly responsible for everyone else from a young age. Parentified even. Dependable to the point of invisibility. If you’re a Swifty, you know where this is headed, but for the rest of us: welcome to Eldest-daughter Syndrome and, strangely enough, to the story of Thiamine. It’s the number 1 in B1, right, that unambiguously announces the arrival of nutrition’s firstborn to the world. Isolated & identified as essential to humans in 1926, she’s undeniably our eldest and yes, she’s turning 100! But before we get her to blow out the candles, just like Tay Tay, she has a few spicy words she’d like to share on what being the often-ignored eldest has entailed, especially in the context of our long-standing carb culture wars!
But, first she’d like to set the record straight regarding her siblings.
“We’re not related – you know– me & all those that came afterwards, like B2, 3, 5, 6 etc.?! Our names make it sound like each new ‘B’ baby was just a small shift in chemical structure from the last! But nothing could be further from the truth! Have you seen any snaps of us all side by side?! We look nothing alike! [ignore the artist’s impression above!] Other than occasionally crossing paths on a job, there’s nothing more meaty or meaningful that connects us!”
And it’s true of course, the numbers merely reflect the chronology of their discovery. And what about all the missing ones like B4 & B8? These were micronutrient miscarriages, of a kind. For example, we thought they were essential, but then we identified endogenous production, only much later to acknowledge not enough, as was the case with choline (B4). But by this time, Nutritional Science had conceded the complete folly of such a simplified naming system, acknowledging that the ‘B vitamin family’ was in reality more of a biochemical ‘junk drawer’ rather than a coherent collective but misunderstandings about this persist! ‘Why is she so keen to separate herself from her siblings?‘, you might be wondering, well listen in…
“Because I mostly work alone. Well except for my one true metabolic mate: Magnesium. Whom without, I can’t get a thing done! And what’s most crazy about us two is twofold! We’re both central to energy supply – especially in the form of carbohydrates – yet diets at either end of the carbohydrate intake spectrum (LCDs, grain-free, Keto, Carnivore OR SAD) are equally at risk of our inadequate intake! So if you know who’s behind these carb culture wars – I’d like to have a word!”
But if this was the case, wouldn’t you be seeing B1 deficiencies in your patients? Look again. Our whole understanding of its deficiency picture has undergone a complete rethink. One of my favourite articles on this, that has stayed with since I first read it in 2021, calls this out from the kick-off: Hiding in Plain Sight – Modern Thiamine Deficiency. But there’s SO much more that has emerged even since then! Have you met the new baby of the Beri Beri family? Remember the wet (CVS) and the dry (Neuro) presentations & forms? Well now there’s a third, plus a whole subclinical syndrome that we’re absolutely seeing! And sometimes in our so-called ‘healthiest’. Should we just dose everyone with the ‘biochemical junk drawer’…ummm, no. Yeah…our ideas on how to support B1 status are also in need of an entire overhaul! While I’m sure you’d love to hear about this from our eldest herself, it’s been another big day in a big birthday year, and never one to say no to carbs and especially cake when it’s full of B1 fortified flour(!) she’s a bit sleepy now…so you might just need to listen to my 30 min summary of all the absolute must-knows instead!
B1 Caught in the Crosshairs of Our Carb Culture Wars
For a vitamin discovered through catastrophic deficiency disease, thiamine (Vitamin B1) has become strangely invisible in modern health conversations. And yet, quietly and relentlessly, it sits at the gateway of carbohydrate metabolism itself. In this episode, Rachel revisits one of nutrition science’s oldest discoveries through an unmistakably contemporary lens – exploring how modern eating patterns may simultaneously increase our dependency on B1 while reducing the likelihood of obtaining enough of it.
From ultra-processed diets and alcohol intake to grain-free eating patterns, obesity, bariatric surgery, and the rise of GLP-1 medications, this episode examines why thiamine may be uniquely vulnerable in the modern metabolic landscape.
This is not an episode about demonising carbohydrates, glorifying low-carb diets, or promoting simplistic supplement narratives. It’s an exploration of metabolic context, nutritional trade-offs, and the hidden micronutrient costs embedded within contemporary food culture. Or, put more simply: the story of a tiny vitamin carrying a disproportionately heavy load.
You can purchase B1 Caught in the Crosshairs of Our Carb Culture Warshere. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
Tenacity (adj.) the quality of being very determined, persistent, and unwilling to give up, even when facing difficult challenges, setbacks, or opposition.
Sounds admirable right? You might think unworthy of a ‘toxic’ title. Might even think, here we go, here’s her ‘humblebrag’ bit. But it’s both. I mean, my super-power & my kryptonite. I have an almost pathological inability to stop pulling at loose threads once something doesn’t make sense. And SO many things in nutrition, naturopathy, mainstream medicine et al don’t make sense!
I can’t leave inconsistencies alone. Can’t ignore the gap between what’s confidently repeated and what’s actually evidenced. Can’t keep quiet when our profession starts mistaking certainty for understanding, trends for progress, or louder voices for truths.
It’s exhausting! Potentially annoying. Definitely not always ‘brand-friendly’. Think for a moment about all the ramifications – the full fallout- of never being able to let the things that matter (in medicine, in nutrition, in health) slide. And while you’re humouring me with that I’ll just scattergun some headline-highlights that may help to illustrate my point. Speaking out about questionable business ethics, mis & disinformation about products & services has had me blacklisted by numerous companies across my career. Side note, I had to laugh when one ran a whole conference in my area of expertise but didn’t invite me to speak, however, according to several accounts, many of their speakers openly referenced me! 😆 And recently I heard about a particular governance role related to supplements sold in Australia and when I mentioned I might be interested, the individual sharing this with me replied, ‘That’ll never happen! Your reputation proceeds you! They think you’re anti-them!’Um…. ouch & wow! 😶
But of course, outside of my early career when I worked for a couple of companies, I’m not doing this for them. I am doing it for me.
Because I am passionate about naturopathy, nutrition, integrative health & all the potential these hold when practiced well and untruths, partial truths, myths & misunderstandings lie across our path, obstructing us from attaining that. Oh and I am a total science-nerd!!! These are the real reasons I’ve spent decades asking questions others didn’t/couldn’t/wouldn’t/’shouldn’t’ – about whether ‘new’ always means ‘improved’ (forms, delivery technology, protocols etc), about whether the doses recommended deliver results or just more sales, about what amounts to truly integrative pathology interpretation, and especially the incredibly tricky task of trying to assess nutrient status of individuals, via any medium (blood, urine, hair, skin – take your pick!) I have unpicked assumptions about aetiology (Gilbert’s Syndrome being not-so-benign after all, up to 50% IBS being B.A.D. & the high histamine hysteria that feels like it could be here to stay etc) And I have made plenty of mistakes and missteps when I thought I understood something – only later to know better! But I have always tried to be open about those and own that – I’m thinking pyrroles & Zn dosing for a start! Always asking myself, as much as anyone else, about all the quiet little leaps of logic hiding inside the increasingly unwell ‘wellness culture’.
But, however, and (one of my favourite little sayings) I get push-back from practitioners who just want it all to be easier. Who desperately want to subscribe instead to someone selling certainty over the inherent complexity that is all things holistic health! And to those who don’t & won’t make us all feel uncomfortable in the unknowns of it all.
I get it. Really I do. I’d leave (and leave it alone) if I could! And you know, the irony is, something that’s only literally just occurred to me in this moment (!!), my dad had a series of sayings that he repeated over and over again to me & it totally gave me the S H 1 T s’s (that’s one of his 😂) and probably his top pick was this: “Persistency – do you hear that Rachel Jane? Persist and see!” Oh boy I miss his maddening catchcries…turns out, he got me good – and yes I mean that both ways 😥
Anyway, what I’m trying to say is, I’m not trying to be difficult – it just is difficult. And my goal isn’t to make things more complicated – it’s simply to make us all, and our medicines, more successful, more often.
Just in case you were worried I’d forgotten our April episode…never!!! I’ve been busy, and for some time now, mulling over the medicine we offer our patients that is beyond the bottle…in the form of our capacity to communicate their Mattering, increase their Expectancy for better health & encourage and cultivate Active Hope – three psychological constructs that every practitioner needs to know more about, in order to vastly improve patient outcomes. I’ve talked about Mattering before…and as per usual it started with a story…
After not seeing her for some time I messaged my longstanding (or should that be long suffering? 😂) psychologist chasing up a contact. Much to my astonishment she rang & left a voice message along the lines of, “Great to hear from you, I often think of you and would love an update if you want to call me back.” So I did.
I mean this was an unmistakable demonstration of care.
More than that, it potently evoked a sense in me of mattering. And in this instance, mattering in the mind & crazy-busy world of this exquisite professional with decades of experience & oodles of clients. And well it made my day, my week, my month… & reminded me all over again why I choose her.
Cut to today’s story… given the gift of time and space for more reflection, including a long sustained stare into the rear-view at the road I’ve travelled with patients across all these years, I’ve come to see that sometimes the most technically correct naturopathic medicine I’ve practiced hasn’t always been the most therapeutic, or even effective at all. And that’s where this month’s Update in Under 30 begins: both an acknowledgement of, and an attempt to rebalance, the uneven attention currently afforded to our so-called “unifying” naturopathic principles.
Because while the bell of Tolle causam — treat the cause — tolls loudest, we risk forgetting that naturopathic medicine was never intended to be a perfectionistic exercise in pathologising, but a system equally anchored in Vis medicatrix naturae: the cultivation of the conditions through which healing becomes possible.
The Medicine Beyond the Bottle
What if the most powerful part of your treatment plan isn’t what you prescribe—but what the patient leaves believing? In this episode, we challenge the idea that better outcomes come solely from more precise diagnoses, more detailed testing, or more targeted interventions. Instead, we explore how the therapeutic interaction itself shapes patient physiology, behaviour, and engagement through three core drivers: mattering, expectancy, and active hope. Grounded in behavioural science and clinical insight, this episode unpacks how these forces influence outcomes—and how clinicians can intentionally design for them in practice. If you’ve ever wondered why technically “perfect” care doesn’t always translate into results, this conversation will change how you think about what actually makes treatment work.
You can purchase The Medicine Beyond the Bottle here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resourceshere.
We’re in the grip of a podcast plague. I’m serious – everyone has one. Have you checked the children?! Not to ensure they’re safe in bed but to be certain they’re not broadcasting from there 🙃😆 And podcasts have now gone AV! We’re able to watch people speak!! It’s almost like IRL but better because they’re wearing massive headphones. Being able to watch, what was previously, an audio-only offering, caters to our microattention span issues & is also the only assurance (though not for long of course!) that this is an actual conversation between two or more real humans, rather than an AI bot exchange 😥 But when they’re good they’re great!
Recently I’ve been interviewed by athletes & performance coaches, a nutritionist who’s an expert in weight management, along with some great GPNs (general practice nats).
And what a delight it’s been to dine out on these kind of conversations! When two minds meet in the middle- our shared curiosity for critical thinking in nutrition – & the hosts, themselves, bring so much to the table, by way of their own expertise.
Given my slowed pace & ipso facto increased sense of space I’m now able to accept these invites & I am eager to unflinchingly unpack the evidence with other experts and spread the word! Not of the New Testament or any other holy text but rather of the extraordinary lessons I’ve learned, particularly in the last few years. Because, generally speaking, the longer anyone works in nutrition, the less interested they become in simplistic answers. Not because simplicity is bad but because the innumerable exchanges between our bodies & the nutrients that fuel them, rarely behave as neatly as entry-level education suggests. After 20+ years in practice, I spent an entire year revisiting the latest research (the actual research not the premasticated and often adulterated AI abridged version of it).
I expected updates. What I found instead fundamentally changed how I interpret assessment, prescribing and almost every aspect of clinical decision-making regarding nutrition.
I’ve spoken many times about my foundational undergrad nutrition as being phenomenal and also incomplete & incorrect. Two issues are at play here – firstly science doesn’t stand still (thankfully) so what may have been correct at the time the content was created (no matter how many years ago that was for each of us…) is often no longer and secondly, because, entry-level education has to be simplified. That’s normal. simplification is a pedagogical necessity but dangerous when mistaken for the full picture. An organisation contacted me recently asking if I would deliver nutrition training to their new intake of heath professionals, as I’ve done many times before but it became clear they wanted to stay with the ‘old songbook’ & an overly simplified and outdated script.
I can do simple. But I can’t & won’t make the mistake of making out that Nutrition is simple. There’s a difference.
So I had to say no but how many of us already out there working with nutrition, still sing from the old songbook? Plagued by questions about why our nutritional prescriptions don’t always work? Or work in some and not in others? Or left feeling a little lost because the markers we’re using to measure individual nutrients aren’t responding to repletion the way we’d anticipated. Or even, ask ourselves, ‘Is this the best way to address my patients needs using these sources and supplements?’ Entry-level education enables us to name the nutrients needed. A significantly more advanced understanding, however, is essential to answering all the other questions embodied in any prescription: What form? How much? How often & when? &, for how long for? Being across critical details, that have only emerged in the evidence more recently, changes all of these decisions and ultimately our patient outcomes.
Maybe you’re ready to join our Nutrient Prescriber’s Program Alumni? A group of practitioners who tell us repeatedly, they have undergone an extraordinary (& uncomfortable!) transformation. If that’s you, why wait? Because optimal outcomes begin where entry-level education ends.
The Nutrient Prescriber’s Program is a structured process for creating prescriptions that’s systematic, scientific and more likely to produce successful outcomes. You’ll gain a reliable and robust framework to answer key questions such as: Which form? How much? How often? And, for how long? Dive into the pharmacokinetics of micronutrients, their various uptake pathways in different scenarios, how they work in networks & how co-prescribing in the right ratios is essential for efficacy and safety, rather than as ‘single nutrient solutions’. Are you ready to reexamine the science when it comes to nutritional prescribing?
What unites you as a family? For me, my kids & their partners, it’s humour & the more absurd & unexpected the better. Know the type? You spend most of the show asking yourself, ‘Is this the show?!’ Confused as to whether you should laugh because you’re also a little scared you’ve stumbled into something so loose it could fall apart at any moment! Making our annual pilgrimage to Melbourne Comedy Festival, you’ll find us front row for the fringe-dwellers. The ones too fringe to make money, so they settle for exposure. No budget for polish. No safety net. Just raw, slightly unhinged creativity. So there’s no money for extras & the comedy kicks off early as they stand, often in sight, but just off to the side, appropriating the role of the ‘announcer’ & hilarious self-hype-person.
Which is ironic, because as a professional speaker, sitting somewhere in a room full of delegates, dissociating, while someone reads out the bio I wrote but I hate, has to be my least favourite thing.
Penning your own bio is a bit bent right? Referring to yourself in the 3rd person while letting your ‘id’ introduce you, is not a natural social phenomenon &, in fact, it’s the very opposite of what balanced folk aspire to. So what exactly are you meant to do? Tell the truth the whole truth and nothing but the truth? Most would fall asleep a few hours in and for those still with us, they’re thinking, ‘Sheesh, that was a lot of main character energy with some unexpected plot twists that someone shoulda taken a chainsaw to!’ But if you’ve got to the point of presenting education en masse, your story is always going to be long because you didn’t become an authority overnight. Or do the opposite & downplay it (which I have absolutely done) and then, as you listen to the other ‘id’ intros of the speakers before you, you think, ‘Ok, well Ms Humble how’s that feeling in the midst of all that Hype?!’
We have a lot of newbies, here & on socials & I notice you’re supposed to re-introduce yourself ala – ‘on previous episodes’...but tbh this is triggering my bio trauma big time!
So, instead, I thought, maybe I’ve found the perfect job at last, to give AI? Given it never tires of telling us ALL how UNIQUELY EXTRAORDINARY we are…as INDIVIDUALS (of course) 😆 Telling me how especially AWESOME I am, any chance it gets: “You’ve articulated something important there” “That’s a powerful observation!” “You’re thinking about this in a very nuanced way”“The fact you’re questioning this shows real awareness” “Most people don’t think about this, but you are” You too?! Maybe AI is how I distance myself from getting bogged down in the significant details of my expansive CV, get some perspective about what really should be shared, outsource my ‘id’, avoid downplaying my achievements and feel better about my bio?
Hilariously, it offered me options – straight or subversive (Even suggesting the latter fits better with my style😲 Settle down Romeo!) I’ll let you guess which one I am going with 😂
Rachel Arthur has spent over two decades in clinic, long enough to know that more information doesn’t make better practitioners—better thinking does.
A nutritionist, naturopath and educator, she now works primarily with healthcare professionals, teaching them how to interpret what others miss and question what’s routinely accepted. Through her CPD programs and longstanding role in ACNEM’s GP training, she’s known for pulling apart the gaps between research, pathology and real-world practice—and making clinicians far more precise in how they work.
Her background spans academia (including teaching electives in medicine at Monash University), authorship and editorial roles in leading Elsevier texts, and large-scale industry work analysing health data across corporate populations.
Rachel is an Advisory Board Member and Founding Fellow of the Association of Accredited Clinical Nutritionists, and a Fellow of the NHAA.
She is not known for being a hype person. She is known for changing how practitioners think.
It then promised, as it always does, to do better 😅 To ‘push it further—making it almost uncomfortable, in its simplicity.’ Well, when have I ever said no to making people uncomfortable?!! Go! I could play this game all day but it’s never going to cure me of my bio-baggage! If you really want to know where I’ve been & what I’ve done that might, in any way shape or form, justify why you find yourself here – dare I say – look at my Linked In LOL
It’s 2004 & I’m practicing from South Melbournewhen one of my patients comes in with a few pages of test results she wonders if I want to take a look at. I’d love to of course but the ‘language of labs’ was not taught in naturopathy back then, so it all just looks like scribble to me. But I need all the help I can get. She’s got a complex medical history, including a serious condition I don’t think I’d ever encountered even in our pathology lectures. That’s not necessarily a deal-breaker for naturopaths of course. And as I had been taught to do, I put that aside in an effort to see her health as a ‘whole’. Identify & then follow all the individual threads, so that I can see how her key vulnerabilities or imbalances intersect & therefore know how and what to actually treat, rather than any diagnoses & labels she’s been given. But I look at these pieces of paper full of impenetrable information in my hand &instinctively think, ‘Ineed to follow this thread too & see where it takes me.’
The universe was clearly in a conspiratorial frame of mind in that moment, because I went to the books (see above reference to the year) to learn about some of her out of range results – one was Cu, I remember that clearly!- and it provided me with immediate insight that I hadn’t arrived at by any other method.
And so I began building.
Within 12 months with my preschool twins & partner in tow, I had relocated to Northern NSW to undertake research on this at SCU. Yep this sense of something building was quite the force! I wanted to add to my emerging understanding of the role of pathology interpretation but also create a conversation with my whole profession about how this could be of enormous additional value to all of us. And my bilingualism was building & I had come to believe this was the only option for us as a profession: to understand mainstream markers enough to be completely competent medically with our interpretation of them and by adding our deeper and more detailed knowledge of biochemistry & nutrition, radically optimise those insights & understanding about each individual we could glean from these.
The universe conspired again, this time in the human-form of Dr. Tini Gruner, who became my SCU thesis supervisor.
A woman equally passionate about this being part of naturopathic practice and already doing it. A biochemist by trade (then a naturopath) she was renowned for her sleuthing skills & her superpower was including pathology results in the work up of her own patients. She taught her undergrads not just how to incorporate but also integrate these into their practices. While she constantly sought out further CPD in this space for herself. Pushing us all forward on this front as a result – until she wasn’t. However, Tini had already well & truly passed me a baton before she tragically passed away & was emphatic that I should Keep. On. Building.
So I did.
In addition, seeing its enormous potential to improve the way we practice, my thesis had given me a glimpse into how problematic pathology testing could be. We make assumptions that if a test is available commercially (& esp mainstream) it must have good evidence behind it. Uh…no. And then the very idea that reference ranges represent what’s healthy. Also a no. I was now insatiable in my appetite for anything that could help me better understand & extract the full value from the biggest dataset we have on every patient – routine screen results. I undertook any vaguely related CPD including courses with the association of pathologists, that were so dry they bordered on crumbly! And I applied every new bit of information. In my own private practice, through my role as a clinic supervisor and lecturer, via all the cases I was exposed to across over a decade of mentoring huge numbers of practitioners. I kept reading research & applying it in real time. Not only in the initial work up but all the way through individuals’ treatment – to see what was still standing at the end, as solid, sensible, reliable, reproducible, interpretation of these mainstream markers. At every stage I learned & adjusted my lens. And my instructions about how to improve their accuracy also because I’d seen first-hand results go rogue in response to every type of collection condition confounder us crazy humans can conjure up!
Over time isolated ideas I’d had about individual results & what they reflected became intricate patterns, such that I was able to formalise frameworks, shaped in practice.
When the plague came in 2020 I turned to my team and said, this is our opportunity. It was the culmination of something that started that day in South Melbourne. We built the MasterCourse in Comprehensive Diagnostics & ‘comprehensive’ was not an adjective used lightly. From reading enormous amounts of primary research we were able to actually redefine the ‘reference ranges’ for all routine screens . Transforming these from what we see on our patients’ reports, which are simply statistical ‘norms’ of the population (or even worse, an inconceivably small sample of users from one pathology provider!) – into ranges that actually reflect ‘healthy’, even in some instances ‘optimal’. And not satisfied with simply applying this to every adult, we went further, stratifying by sex, by age, by reproductive stage wherever possible. Then we added another layer, emerging mathematical ratios reflecting meaningful relationships between markers. It was of course no longer 2004 and we were no longer beholden to borrowing books and making photocopies, but it was an enormous undertaking and one I will always be proud of.
But it was never about creating just a new set of numbers and a narrower threshold for triggering ‘Hs & Ls’ but about fostering a paradigm shift in pathology interpretation & equipping clinicians with an entirely new skillset.
It’s 2026 and pathology interpretation has never been more important & relied upon in our practices. I’m thrilled and Tini would be too. Accordingly, references range cheat sheets, software apps etc are popping up everywhere. I love a shortcut as much as the next person if it takes me to the same destination, but these are not designed to do that. The ranges and models I teach, as hopefully you might now have an inkling of, are part of a comprehensive system developed over many years and are not reproducible without that training and context. Oh and if you’re assuming the praccies behind these products (who often reference me but off the record) have undertaken my MasterCourse…uh, again. no. But one individual did reach out. Refreshingly retro and professional & perhaps even, sensible. Has the universe once again acted conspiratorially to write this next part of the story? We’ll see🤔
Sorry for such a long rave but we have a lot of new people here & the practice landscape including all the options for pathology interpretation are seemingly changing on a daily basis and I just thought sharing the story of how it all started might be timely.
“You absolutely delivered! I knew that there would be some clinical pearls at least, but I did not expect to get such a comprehensive exploration of the theory behind basic pathology tests. I am so impressed with not only your analytical mind and ability to explain how things connect and where they fit into a vast pathology mural, and your ability to convey the concepts clearly and create presentations that facilitate absorption of the information.”
ALYSSA TAIT | Naturopath & Physiotherapist
“I thought my pathology skills were pretty up there until I did Rachel’s Diagnostic Masterclass course! Nothing like being knocked off my perch by a literal avalanche of new information, especially when it comes from the most commonly tests that we all use so often. The course has been a fantastic learning opportunity for me, and has since helped me pick out many intricacies in cases that have previously been missed. The course structure was great, the level of detail was right up my alley, and the case studies were entertaining (in true RA fashion). Once again Rachel has increased my knowledge base, and help me provide way better service to my patients.”
Anyone else? Or should that be…’Everyone else?‘ 🙄Because if I had a dollar for every cracking encounter I’ve had with people that included this line, I wouldn’t be writing this line – so too, if I’d been persuaded by the push-back against this lovely little legume. It just happened again the other night, out to dinner with relatives. But my all-time favourite Soy Scream Scene was when I was invited to meet a ‘wellness celebrity’. We caught up in a cafe & when I ordered my beverage of choice, she just about leapt across the table (entirely unnecessary given her elevated volume) to shout, “I can’t believe you drink soy?!” I think she felt it was her civic duty that the entire balcony benefitted from her wisdom – or at least just a way to ensure more individuals had clocked her presence 😎
And these encounters, of course,are not limited to those without qualifications.
That’s not to say that I expect, or ever desire, those of us that do to be unified on all issues. That sounds far from ideal. We’re free thinkers after all and each of us has been privy to different information & our own experiences. Me siding with soy (& not in all individuals or instances ofc!) is both personal and professional. On the n=1 front, I was 18, living my best life in Byron Bay (which often did not include shoes) when I was introduced to soy milk in lieu of cow’s. I loved it. Never having been a big fan of the old moo juice and less & less as a teenager, I preferred the taste, the texture, the principle. I was a vego. (Side-note: ‘plant-based’ was not invented until long after the 80s!) So, I also got right into plant proteins – namely tofu & tempeh. Miso was our main go-to as a way to add flavour to our cooking, even lacquering toast with it as a tasty spread! Ahhhh my glory days & mine were swimming in soy!
Go forward a few years &, having readjusted to the rigors of footwear, I am sitting in a lecture room listening to my herbal medicine teacher talking us through the chemical structure, physiological functions & potential applications of isoflavones.
I have a vivid visual memory of the whiteboard and her words. These were none of the reasons I loved this legume but I was enthralled by the revelation about its potential role as a health intervention. I still am. Because despite the sequential Soy Scream Scenes that have punctuated my life – I think the body of evidence demonstrating its beneficial effects is too large to ignore and why would we? Either it’s because of evidence that is well out of date (feeding babies infant formula made from soy flour!), a hypothetical that has since been disproven (clinically meaningful goitrogen) or mis and dis information. But look I get it! Check out soy’s wrap sheet – it’s not for the faint (food) hearted !
Potentially allergenic, as well as interacting with our immune cells in other myriad ways!
Agriculturally it’s one of the biggest mono-crops & a major contributor to deforestation, heavy on the pesticides, and often GMO
So, if we were cops profiling for potential culprits in a case of: farting, digestive discomfort, unexplained nutritional deficiencies, hypothyroidism, immune issues, food allergy, reproductive disorders or gout – certainly bring the guy in for questioning! (among a LONG list of other food and also non-food items included in the line-up!) And ensure you’ve read the research & understood all of the evidence enough to know what is plausible (theoretical but without in vivo real world confirmation), possible (it has been shown to happen but not commonly) & probable (it’s deserving of its place on your list of differentials but is still just a suspect, not a certainty). If all this sounds sizeable (and it is) then get the cheat notes. We just recorded an Update in Under 30 episode on the very latest evidence for SIFs in perimenopause including an update on adverse effects 🤓
Oh & if you’re qualified in nutrition I don’t need to tell you to choose: locally grown, organic, non GMO, whole forms, which you ferment frequently & include as part of a balanced diet, right? But is that any different from your advice generally about good eating principles? 🙄
This episode explores how one of nutrition’s most debated foods has moved from early promise, through backlash, into a far more nuanced clinical role. This episode unpacks receptor selectivity, equol, bone preservation, vasomotor symptoms, and why SERMS such as isoflavones may matter most during a phase defined by instability. This is a fresh look at where soy genuinely earns its place in modern peri/menopause care.
You can purchase Soy’s Second Act in Perimenopause here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
I’ve been talking lately about my own perimenopause experience & I’ve been listening to others do the same when suddenly it occurred to me that when these conversations happen – women all around lean in. Physically, mentally, emotionally, biologically. While for many of us, this kind of deep communing doesn’t happen often (enough), I feel the other occasion it reliably shows up is when we the share our birth stories. You know what I am saying? Like the second a woman opens that file & finds those words, all other noise in the room stops. And almost trance-like, we’re all drawn toward the teller. An impromptu circle of women appears around her that could not have been better coordinated had it been choreographed & rehearsed! Powerful stuff.
Women’s circles we know, have a long history & tradition.
And though I decidedly spend less time in the woods with womenfolk these days, as both a naturopath & resident of the Northern Rivers for most of my adult life – you can trust I gave it a good nudge in my younger years.
But here we are. Come full circle…if you’ll pardon the pun. Others have spoken to this phenomenon far more eloquently than I’m able to but in simple terms, when women begin sharing stories, whether it’s birth, bleeding, breastfeeding, miscarriage, perimenopause, or any other deeply embodied experience, what often looks like simple conversation is actually something perhaps much more primal, it’s pattern recognition in real time. We’re listening for ourselves inside someone else’s story – asking ourselves along the way things like
What happened next?
Has that happened to me?
Could that explain what I’ve been feeling…Why I am feeling..?
Is this normal?
…Am I normal?
I don’t have to tell you guys why these have had to be the places women seek answers rather than medicine & medical authorities 😠🤬🤯🤐 And even now, when it feels perimenopause is finally now ‘a thing’ in primary care be warned sisters 🧙♀️that’s mostly because when symptoms get loud enough, sales soar and the ‘peri/menopause market’ is one of the biggest money makers right now for many 🥺 …so go cautiously & let’s keep these more honest conversations between us going.
Soy’s Second Act in Perimenopause
Explores how one of nutrition’s most debated foods has moved from early promise, through backlash, into a far more nuanced clinical role. This episode unpacks receptor selectivity, equol, bone preservation, vasomotor symptoms, and why SERMS such as isoflavones may matter most during a phase defined by instability. This is a fresh look at where soy genuinely earns its place in modern peri/menopause care.
You can purchase Soy’s Second Act in Perimenopausehere. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
It always does! Turns out I rely heavily on those last few days of every month to get my homework done in time 😦 as many of my 11th hour Update and Under 30 timestamps will attest to! And this month (as is the case every other month tbh) I felt the topic was so important that I just couldn’t cut any corners. Yes folks we’re wrapping up our whole Supplement Boom Series applying all that we’ve learned to Iron – and this episode is overflowing with aha moments 🧐
🎤Brand spanking newly discovered uptake mechanisms for more diverse dietary forms
⚡How even endocytosis uptake of the entirely engineered forms – don’t escape regulation
💥The precise pocket that each of the new forms (Pea ferritin, Iron polymaltose, FPP nanoparticles) would be the perfect fit for in terms of your patients and their presentations!
💡The option for daily dosing back, and even combining with iron’s key competitors could be back on the table with certain forms!
Ok that’s the extent of the words I have left right now…February ate all them too!!
One of our most popular past episodes explored the relative efficacy of the many iron supplements on the market. Since then, the landscape has changed dramatically. New and novel forms have emerged each claiming to solve long-standing issues with iron interventions. In this second part of our iron investigation, we take the following forms to task: haem, plant ferritins, iron polymaltose & nanoparticles of ferric pyrophosphate. Discussing in detail each of their unique dynamics regarding digestion, absorption and regulation of iron. Ultimately it answers the questions when to use each form and why.
Listen in as we revisit some of our long-held assumptions about what makes a “good” iron form and hold them up against emerging evidence that is reshaping our understanding of digestion, absorption, regulation etc. It’s time to rethink iron — and update old ideas in light of new science.
You can purchase New Iron Offerings – Novel or Nonsense? here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resourceshere.
Hey wait what? What are you still doing here? The average time we look at anything online is 3-8 seconds. Poof! There’s another big portion of followers gone just with stating that stat! But, you see, if we are so quick to think we have all that we need from something, that we’ve deduced its true meaning & reached solid conclusions, all based on a glance at a curated Canva or AI-generated image & accompanied by not more than 125 characters (for maximal “scannability” on socials according to AI) what are we missing? Substance.
In this last week I have literally had people express genuine surprise that a) contrary to my word I have not retired from group mentoring b) but gee I really should given how much it’s accelerated my ageing process
And if you’re still reading this dear-wonderfully-off-trend-outlier-friend I hope you are laughing and crying simultaneously. Craughing, is the technical term, I believe. And at all of us. I mean I am not always an exception. I have routinely said to my team when they’re creating emails or long product descriptions or anything notably not capped at 125 characters…”No one is going to scroll down that far! I would not scroll down that far!” But as a result, look at the mixed and missed messages we’re getting?!!!
Please note I have indeed hung up my group mentoring hat 🎩 Our new offering is a packaged up series of recordings of our previous very popular New Grads program
And (ahem) that image of ‘old me was photoshopped…& quite frankly I’m concerned I need to clarify 😮
So what else are we missing with all our very busy looking at everything but actually at nothing habits? A lot. I try to keep my tirades tight. My synopses succinct..in fact I think you’ll find under 30mins (mostly)!!! But if you haven’t got that long to spare…well…😶 🎤
“It takes me exactly 30 minutes (give or take Melbourne traffic) to get from home to work and my favourite drive is when the latest RA UU30 podcast comes out. Usually I have to listen again when I arrive so I can scribble notes down to remember the Aha moments that invariably leave me wishing I was at a traffic light with a pen…
Rachel, I am continually inspired by your dedication to the naturopathic profession and so grateful for the information you so generously share. Your contribution is unique and invaluable. Your enthusiastic passion for everything you present is contagious and leaves me loving what we do more and more each time I see or hear you speak.”
CHARMAINE DENNIS | Founding Director & Naturopath at Fertile Ground Health Group
I certainly pride myself on possessing an impressive level of endurance for an argument, as most of you surely know 😊 But the record for this is held by all practitioners of nutritional medicine. Because we’ve actually been debating the same 3 facets of what makes a good iron form since the late 1800s!🤯 Inorganic vs organic, soluble vs insoluble and ferrous vs ferric state! And for those playing along at home, I heard that & I have to tell you your ideas about iron have passed their ‘best before’!
Even the idea that these 3 aspects are central to the success of any oral iron supplement. Wrong. You’re welcome 🙂
Because this ignores all that we’ve learned (and had to unlearn) of late about iron digestion, absorption& regulation. And I would know! Eight years ago I released an episode, the ‘definitive’ download called, ‘So You Think You Know The Best Iron Supplement’. Recently, I re-listened to it like this 🙉 thinking it too might be past its use-by. But you know what? It isn’t. I was right about the lack of difference in overall efficacy between bisglycinate, citrate, gluconate, [insert any non-haem chelate or salt] & even sulphate forms! But that was then and this is POW! 💥
That’s the sound that’s made as yet another new supplement hits the market & throws us all into the ropes of the boxing ring 🥊 Leaving us scrambling to keep up, catch up & keep our heads off the canvas with all the new must knows!
Which now includes knowing all the important stuff about every new iron option…and there are a lot! From patches to (nano)particles, the resurgence of rewilded ‘herbal’ iron tonics, pea and other plant ferritins and of course organ meats and so SO much more. These new preparations are wildly different. Not only as a reflection of different product preferences, as an extension of our principles and prescribing philosophy but the very way they behave in our digestive tracts and beyond is not the same. And accordingly, each form arguably a particular ‘fit’ for a certain clinical context. So, are you absolutely clear about which form of iron when? Best you go check your ‘best befores’ on your beliefs about iron supplements….I’ll wait 😉
One of our most popular past episodes explored the relative efficacy of the many iron supplements on the market. Since then, the landscape has changed dramatically. New and novel forms have emerged — including haem iron products, phytoferritins, nanoparticles, dermal patches, and more — each claiming to solve long-standing issues with iron interventions. In this episode, we begin by retracing the evolution of iron as one of nutritional medicine’s most commonly prescribed interventions. From there, we examine the renewed interest in food as medicine and food-like forms: molasses and grape syrup, offal, iron-rich herbal tonics, and naturally iron-containing mineral waters.
To do this properly, we revisit some of our long-held assumptions about what makes a “good” iron form and hold them up against emerging evidence that is reshaping our understanding of digestion, absorption, regulation etc. It’s time to rethink iron — and update old ideas in light of new science.
You can purchase Iron: Primal Nutrient to Primetime Prescription here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
Yeah nah — I’ll settle for the increasingly old me, thanks.
Vanity aside (and ouch, by the way), I’m perfectly happy remaining Insta‑unsuitable. I refuse to reinvent myself in the name of naturopathy meets neoliberalism, so I’m okay with being off‑trend. Liberated by it, actually. Because it means I get to focus on what matters more to me: that I’ve learned a lot — which, it turns out, required unlearning a lot too. Ideally softened with wisdom. Hopefully. I’ve taught many of you as undergraduates. Mentored many more. And somewhere along the way I seem to have helped birth a whole cohort of next‑gen naturopathic mentors and teachers. So yes — I’ve earned these age spots and laugh lines. And we all know I’m not done laughing yet.
And I am definitely not done with you.
I am the self‑appointed nagging Nanna of the naturopaths.
Forever pestering us about our potential — to do better, to be better. Forever banging on about aiming higher. Laying it on thick with my best “I’m not mad, I’m just disappointed” routine 🤣
I ask the questions that apparently hadn’t been asked yet… well, by anyone other than me (soz). From the ones we all probably should be across — like: • Where is the true sweet spot for nutrient dosing, where fractional uptake is maximised rather than squandered once transporters are saturated? • When so much of a supplement dose is left sitting in the lumen, what does that actually mean for our marvellous microbiome? • And when we insert nutrients into our nether regions to treat the taco… where do they actually go?
I ask. I research. I publish — because better answers make better practitioners. Honestly, search my site with almost any term. I dare you.
But I think that’s the role, right? The role of anyone a little further down the track.
To offer a view of the profession from a different vantage point. To ask questions that are sometimes uncomfortable. To set some goals — and then gently (or not so gently) nudge us toward them. Because we’ve had longer to ponder. And because us Nannas — we’ve seen every season of this profession. Every bloody episode of every bloody season tbh. Every wellness trend too — which are now officially just looping 😵 And we are no longer falling for any of it.
But whatever you do, don’t call me an Elder. Don’t offer me your seat on the bus (yes, someone actually did this the other day). Because you might suddenly discover what decades of healthy eating, peak physical condition (lol), and strong mental acuity can do… when combined with a slightly dodgy knee 👵😅
As part of our current audio series on the pros & cons of non-enteral administration of our medicines, we’re finally up to the foof. The vajayjay. The bajingo. The coochie. I mean what exactly does happen when we start delivering nutrients direct to this target tissue?! Do they just lurk within the lumen? Do they get taken up into the epithelium? Do some break curfew and sneak right over into our systemic circulation?
What do we need to know if we’re inserting things into our nether regions? 🍑
The history of food as medicine delivered straight to the foof makes for a great read & features some of my favourites (foods that is), garlic, wine, olive oil, yoghurt. But we’re a long way past inserting the occasional clove up there. Increasingly, we’re finding reason to employ evidence-based intravaginal therapeutics: Zinc washes, Vitamin A, D and E based pessaries or good ol’ boric acid (popping into a peach near you since the late 1800s!) But whenever we deliver nutrients or herbs into the body via anywhere other than the gut there are a series of questions we should be able to answer to ensure this approach is both successful and safe.
In this episode we also visit up the bum, inhaled into the lungs and even atop the eyeball!
Can we cut out the middle man with our medicines and just deliver direct to door? To any mucosal target tissue with an accessible opening to the outside? When could we? When should we? When does it still make more sense to go back to standard supplements and boost blood levels? Oh you can bet there’s plenty to talk about here and a plethora of fun puns to be made. This is just yet another moment I am so glad we have a real live awesome human transcribing our audio for you…I can only imagine what R rated romp AI might have turned this into!🤣
With trends of innovation heading towards novel offerings sending nutrients anywhere but the mouth, Where Next for Nutrient Delivery? takes a curious look at what these alternative routes can genuinely offer. This episode celebrates where local applications—intravaginal, lower bowel, lower respiratory and ocular—make real clinical sense, whilst at the same time, keeping one foot firmly on the ground, reminding us why the humble gut still does a very good job for most people, most of the time. A sharp, physiology-first look at what must change with our medicines when nutrients interface with different epithelial linings & environments —and why novelty alone is never a good enough reason to change the route.
You can purchase Where Next for Nutrient Delivery? here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
After not seeing her for some time I messaged my longstanding (or should that be long suffering? 😂) psychologist chasing up a contact. Much to my astonishment she rang & left a voice message along the lines of, “Great to hear from you, I often think of you and would love an update if you want to call me back.” So I did.
I mean this was an unmistakable demonstration of care. More than that, it potently evoked a sense in me of mattering. And in this instance, mattering in the mind and crazy busy world of this exquisite professional with decades of experience and oodles of clients. And well it made my day, my week, my month… & reminded me all over again why I choose her.
The construct of ‘Mattering’ is making the headlines in health right now. It’s being proposed as the missing piece of the mental wellness puzzle psychologists have constructed around other identified important elements, such as, self-esteem, social-connectedness and resilience. But many real barriers block or impair access to one or more of these for some. Think about individuals affected by social disadvantage and the inherent inequity then in the ‘resilience’ asked of them. Another example could be people who are neuro-divergent and might therefore struggle with social connection. Mattering in its most simple terms is the sense that we matter.
“Mattering is the personal sense of feeling significant and valued by other people. The person who feels like he or she matters is someone who feels important, visible…Mattering is a vital construct and a key psychological resource that is central to the human condition; indeed, the individual person who lives his or her life devoid of a sense of mattering to others will lack the basic sense of personal significance, human connectedness, and social acceptance required to thrive and flourish. In contrast, the person who feels a persistent sense of mattering unconditionally to significant others will have a key inner resource that fuels positive responses to life challenges. That is, a clear sense of mattering can buffer various life stressors.” Flett 2022
So this year I’ve embraced two new(ish) potent therapeutic modalities: mattering & active hope, & building up a sense of both in anyone I engage with. I spoke at two conferences on the latter, which has now been identified as an essential element of positive outcomes from any health intervention. I think both are things that are at the heart of naturopathic care but in all the clutter, confusion and chaos of biochemical pathways, nutrigenomics, testing & yet more testing, spruiking to socials for our survival etc. they may have been a little lost amongst the noise. But perhaps now as we prepare to take a break and spend more time resting and reflecting we can take a moment to contemplate how our patients’ sense of ‘mattering’ adds to any other medicine we might have prescribed🤗
What if the most powerful part of your treatment plan isn’t what you prescribe—but what the patient leaves believing? In this episode, we challenge the idea that better outcomes come solely from more precise diagnoses, more detailed testing, or more targeted interventions. Instead, we explore how the therapeutic interaction itself shapes patient physiology, behaviour, and engagement through three core drivers: mattering, expectancy, and active hope. Grounded in behavioural science and clinical insight, this episode unpacks how these forces influence outcomes—and how clinicians can intentionally design for them in practice. If you’ve ever wondered why technically “perfect” care doesn’t always translate into results, this conversation will change how you think about what actually makes treatment work.
You can purchase The Medicine Beyond the Bottle here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resourceshere.
… to its target tissue, wherever possible. Yes I’ve been reading everything I can get my hands on regarding what happens when we ‘deliver medicines differently’, as part of my Supplement Boom Series. Medicines being: nutrients, herbs, pharmaceuticals. ‘Delivered differently’ includes: on the skin, across the oral lining, up the nose…and I’m entering other orifices, as we speak (!), in preparation for our next Update in Under 30 episode. And what is already abundantly clear is standard supplements are not the best route for every remedy.
And ol’ mate Iodine is such an excellent illustration of this.
Such a critical mineral for us humans, from an evolutionary and ecological perspective, performing important roles related to health, far beyond the thyroid: roles in redox, as a protector of lipid bilayers, anti-inflammatory, trophic regulator, homeostatic signal, highly effective anti-microbial etc. Yet whenever you boost blood levels of iodine, it’s the thyroid that becomes the bottleneck. It takes the lion’s share of whatever is circulating (sometimes up to 80%) even if that’s not where you wanted the iodine to go. So for patients who need that iodine elsewhere – within other body openings to maintain microbial balance say, well, wouldn’t we be best to deliver it right to their doorstep, instead? In a word – yes
Iodine has a long history of use as a topical treatment with broad & diverse applications.
In douches for a range of vaginal infections, intranasally at the first signs of a cold, as povidone at a low concentration, with evidence of efficacy. Delivering direct to the desired target tissue means we can use much lower doses and produce a more potent local effect – without the extraneous and unwanted effects from a much larger oral dose that will be widely distributed and dispersed. Zinc, of course, is another established hero ( ?Or is that anti-hero…have a listen to the episodes!) of ‘nutrition delivered differently’ & local therapeutics. But topical treatment of any tissue – the nasal or oral lining, the vagina, the colon, the respiratory tract etc – comes with its own cautions and concerns. For example, how the active, while therapeutic, may still vary in terms of mucosal compatibility – is it drying, caustic, damaging or disruptive in some other way? As well as, to what extent it’s being taken up and into where? Into the circulation to boost blood levels, to some extent, being the most common, of course. And in the case of iodine we’d need to be careful then because we may find ourselves back at that bottleneck, right? But in the case of intranasal applications, there’s also the-not-insignificant-issue of direct brain deposition…so why – oh why – something as scary as silver is available as a nasal spray <GASP> but currently intranasal iodine isn’t, I will never know.
Sounds like someone needs to revisit intranasal pharmacokinetics, no?
In fact, while we’re here…let’s look a little deeper into all the lovely places we can stick our supplements(!) – their strengths and weaknesses such that we can be clear about where to deliver them
Nutritional medicine is taking an unexpected turn—up the nose. In this episode, we unpack the rising interest in nutrient-based nasal sprays promising local, systemic and even central effects. But bypassing the gut is never straightforward. After a quick nasal A&P refresher, we cut to the evidence on what intranasal delivery can genuinely offer … and what might just be a whiff of wishful thinking.
You can purchase Intranasal Delivery – Nutrition’s New Pathway? here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
I’ve been talking about the DMT1 transporters importing iron & other divalent metals – including their presence in our nose <GASP> – since the turn of the century <GASP GASP>. This helps to explain, of course, the profound neurotoxicity, for example, of inhaled Manganese and Mercury – via the potent pathway called: ‘nose to brain delivery’. But that’s just the tip of the nose…’s capacity for picking up nutrients, as it turns out.
Every epithelial border has a different set of rules for which substances are ‘permitted passage’
Our skin, no surprises, is the most selective of all, allowing very little in
And the hostile environment of our mouth, anatomically more akin to skin than the GIT, runs a close second in shutting the door
But the nose is always open for business, baby! (just ask any addict)
And this, of course, is attracting much attention in delivery design innovation in both pharmaceutical & complementary medicines. So while nasal sprays, containing some herbs maybe some nutrients, for the treatment of hayfever or the common cold, have been around a long time, the next gen of intranasal applications are not tying themselves to topical effects alone – in fact they can boost blood levels of any nutrient you choose, faster than other preparations, outside of injections. And then the next gen – next gen (!!) are not even content with getting actives into our capillaries, to reach their targets, but bypass the whole shebang including the BBB to deposit them directly into our brain.
Sound too sci-fi? It’s not
The potential here, for putting complementary medicines up our nose, is equal parts thrilling and terrifying. And it’s imminent. And while we await more of these to evolve into commercially available products in the real world, you might want to rethink absolutely anything you put up your nose (yes including CM nasal sprays). Just sayin. So why not take my hand and together we’ll go into the furthermost depths of the nasal cavity for a comprehensive update on everything you need to know.
Nutritional medicine is taking an unexpected turn—up the nose. In this episode, we unpack the rising interest in nutrient-based nasal sprays promising local, systemic and even central effects. But bypassing the gut is never straightforward. After a quick nasal A&P refresher, we cut to the evidence on what intranasal delivery can genuinely offer … and what might just be a whiff of wishful thinking.
You can purchase Intranasal Delivery – Nutrition’s New Pathway? here. If you are an Update in Under 30 Subscriber, you will this episode waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.
