Whenever I talk to practitioners about thyroid health, like I recently did at MINDD, I can guarantee I’m going to get 2 questions:
Shouldn’t we aim for the high iodine intake of Japanese?
Can we use the patch test for testing iodine levels in our patients?
I am so glad you asked. The answers are no and no.
I am a nutter for minerals and iodine just won’t go away right now. Too little = a problem, too much = often the same problems. To boot we are faced with radically contrasting views on assessment and dosage and just about everything iodine related. It’s not you – it’s iodine. Trust me it’s a complex little mineral that requires some extra thought and caution. If you imagine the Japanese have no thyroid problems – correct that big myth right now by reading this scientific paper that refers to health problems that result from too much dietary iodine. It also explains that the typical first step in treating hypothyroidism in Japan is to reduce their iodine intake!(more…)
I’ve been given a lot to think about. With ACNEM Science of Nutrition Conference and then MINDD both this last week, I’ve heard a lot. Not all of it good, useful or accurate of course. ‘Beware the Spin!’ I would say to anyone wondering how to sift through the potentially overwhelming volume of info being directed our way. What do I mean?…well while I might be regarded by many as an extrovert and I certainly can talk people into a coma when I get excited, I am always wary of presenters who primarily seem to use the platform to demonstrate their own superior knowledge, or just their own superiority full stop! I feel a very strong responsibility as an educator – to meet people where they are starting from (as much as you can in a room of 200 individuals!), start at the beginning but end up at a clear destination (not in the wilderness!!) e.g. a few tips, some new practice skills that everyone can use tomorrow – making sure you help everyone connect up as many dots along the way as possible. I think being an educator is really a privilege and if we fail to do these things we fail all those who came to learn.
What I look for and resonate with in presenters is a) a good mix of work experience (being a clinician is not always imperative but having contact with the real world outside your lab or your invisible podcast audience is essential), b) authenticity (I always say, ‘if you feel like you’re being sold to, you probably are!’) and c) lack of bias – we need to see more sharing of conflict of interests please!(more…)
I was typing notes furiously throughout the ACNEM Science of Nutrition conference last weekend. So many gems, so many gems, from researchers & clinicians – I just got so much out of it. I love the slightly awkward mismatch between the research world, aka ‘don’t prescribe anything til you have a high quality meta-analysis to say it works!’ and the clinical reality, aka, ‘I prescribe things every day in the absence of even one RCT because otherwise we just have to completely write off this generation with all their ‘atypical’ ‘unfixable’ debilitating illnesses!’ Both perspectives are valid and both groups of presenters had some absolute gold to contribute to the current practise and understanding of integrative medicine.
The sound of my manic tapping on the keyboard was only accompanied by the constant narrative in my head, saying ‘there has to be a way to share this with everyone who’s not here…quickly!’
Being the progressive technology head that I am (not) I immediately thought…what’s that Twitter thing? That social media platform old orange face uses from his golden throne to get his message out? Surely if he can – I can! @RANutrition!!(more…)
Make the most of this special offer! If you become a12 month subscriberbefore the end of the week you will pay less than $13 per edition. Save more than 50% than if you were to buy the podcasts individually. Stay up to date with the latest in integrative nutritional medicine in less than 30 minutes.
And just so you know what we have in store for you as an Update in Under 30 Subscriber this month: Rachel delves into the “Must knows about Mo”. ‘Molly” seems to have become everyone’s best friend recently, prescribed often in combination with zinc for high copper or ‘sulphur issues”, especially in autism, but what do you really need to know about this trace element? How strong is the evidence for its clinical use, how likely is a deficiency, what are the key signs of inadequate levels and importantly what are the risks associated with too much? – new evidence points to some cause for concern and caution. In this timely update Rachel talks Molybdenum literally from the ground up…to the supplements on your shelf and the absolute must knows for every clinician.(more…)
‘How much does the Update in Under 30 podcast subscription cost?’ I hear you ask…about 1/4 of a packet of Activated Almonds per month, that’s about 1 activated almond per day I reckon. This is a Byron Shire joke, the idea being that Activated Almonds are the highest value currency in our community to which we compare all other costs and expenses 😉
But seriously, I did forget to mention the price in my last blog because I was busy being impassioned about thepurpose, so the lowdown is these podcasts costs less than $13 a month.
So you’ve heard part of that BIMA story…now here’s the rest. To be honest, I was pretty surprised to win anything given I’ve spent the last 20 years ‘agitating’, challenging the misinformation and strongholds of the big companies etc. Funnily enough, in my post award ceremony interview, my interviewer dished up the biggest compliment of the evening when he said, “Rachel, we all know you can’t be bought!”
Nutritional & naturopathic medicine is an exciting dynamic field that is growing its evidence base every day but we need to be vigilant about our sources of information, their credibility etc. I know that what motivates me the most to share what I know is the desperate need for independent voices, free from commercial bias that can help us move our medicine forward on solid ground. (more…)
Psssssssssssst….just thought I would share a special moment from a couple of weeks ago when I received the BIMA for Lecturer of the Year.
Thanks to all those practitioners who nominated me for Lecturer, Nutritionist & Researcher of the year! It was really special to be acknowledged in this way for my role in education. I am so grateful to have had the support of so many throughout my career – from my own exceptional teachers, Sue Evans, Assunta Hunter, Gill Stannard, Helen Margulies, Fay Paxton, and most influential of all, Dr. Tini Gruner, right through to all the fabulous practitioners that I have the privilege to mentor (and secretly learn from at the same time 😉 ) (more…)
There are many different potential sources of satisfaction that come from working in integrative health. The first that comes to most of our minds of course is the deep satisfaction that comes with solving a complex health riddle for someone and knowing that you have helped to change their health trajectory – sometimes for ever. That’s an extraordinary role we can play. I carry many of these patients’ stories with me, very close to my heart, they give me hope and encouragement and light in the dark.
I know this isn’t the only thing that triggers a sense of achievement though. Sometimes there is deep gratificaton in strange places.
Like when a patient comes to see you & you tell them they’re in the wrong place.(more…)
I keep hearing the name, ‘Molly’: “I think I’ll use ‘Molly’ for this patient” or “A bit of ‘Molly’ might go well with the zinc for their high copper”... a moment of confusion on my behalf, (Molly who?) and then the slightly late…’ooooooooh Molybdenum’. Gotta love a trace mineral that is having it’s heyday…right?…right?
There are often jokes made about how little time medical degrees dedicate to teaching nutrition in general – was it 1 lecture or 3? – but let’s be honest, who among any of us really knows the ins and outs of this transition metal. I reckon we spent maybe 15 mins in my undergraduate on it and that was BC (Before Computers!) so I am guessing that 15mins has expanded about a gooooooogle times and we’ve come to a more comprehensive perspective. What do we need to update on?(more…)
Recently, I posted about my very positive experience of the AIMA NZ conference, prior to that I was gabbing on about the upcoming ACNEM Brain Health conference in Melbourne in May and now I am going for the conference hat trick! I want to revisit a really impacting lecture for me at last year’s Australasian Society of Lifestyle Medicine (ASLM) conference, delivered by the Emeritus Professor Mark L. Wahlqvist AO, BMedSc, MBBS, MD (Adelaide), MD (Uppsala),on the relationship between ecology and human health.
Why did I find his talk so impacting? Why should every integrative practitioner take the time to watch this?(more…)
Just back from a truly wonderful Australasian Integrative Medical Association (AIMA) conference in NZ. I don’t know what it is about the land of the long white cloud but they seem to produce some of the loveliest, most earnest health practitioners and this conference reflects this, setting itself apart each year as a result of its very organic mix of speakers (general practitioners, naturopaths, nurses, specialists) who are all equally embraced and lauded. To boot we had medical students invited to attend this year and guess what, these 20 or so med students…they stayed for the full weekend much to everyone’s surprise(!), loved it and want more. Really. At the AIMA NZ conference, on the two occasions I have spoken, I feel a sense of coming home…no I don’t mean I am about to move there (too cold!!) but I mean coming home to integrative medicine.(more…)
Duck duck GOOSE!Do you know this game? That’s how I’m feeling with oestrogen – high-high-high-LOW!-of late. Likely similar to your experience, the majority of my female clients battle with oestrogen dominance, therefore I get so used to looking for it, expecting it: the high Cu, the profoundly elevated SHBG, maybe a raised ESR. So much so that sometimes the low ones can catch you out, especially of course when it happens in women way way before menopause.
We’re so resolved to hear bad press about oestrogen and to be armed ready to saturate our patients with broccoli extracts of the highest order – do we remember the clinical features and markers of an oestrogen deficit and know what to do with those women who simply don’t have enough?(more…)
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…)
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?
