Are You A Finger-Pointing-Prescriber Or A Change-Maker?

Are we doing ourselves out of a job?  I’ve been talking treatment plans with my New Grads recently. Given, only recently these were major assessment items in their clinic units, they have been trained to create ALL-ENCOMPASSING (biopsychosocial) prescriptions and recommendations of utterly EPIC PROPORTIONS – to simply prove they know it all. Problem is this doesn’t work in the real world. 

Emailing your client multiple pages of advice that covers: a whole sizeable supplement schedule that only a military-training could nail (2 tablets 1 XTID 1 X BID, a liquid, a powder, some with food, some definitely not with food) plus dietary advice, plus hyperlinks to exercise advice, mindfulness exercises and a request for follow up investigations before the next appointment…is…a L*O*T!!

It is also ineffectual – because it completely disregards the human on the other end. Let me ask you this, how much change are you capable of between a first and second appointment, roughly a period of 2-3 weeks?  Personally, I gotta say not that much. It took my dentist years to get me just embrace flossing & I don’t think I am an exception! With all the knowledge we possess its hard not to see people as (a long list of) problems (& problematic behaviours) that we translate into, and solve via, a prescription.

Effectively we are saying to patients with this practice model, ‘Go change & come back when you’re done & then I’ll probably ask you to change some more!’
That’s both a big ask and a huge missed opportunity.

I hear from reliable sources over the ditch, that GPs are increasingly referring their patients to, or teaming up with health coaches, rather than naturopaths. Given what I’m observing, I get it.  Doctors on the whole only have time (and barely then) for a finger-pointing prescription – certainly not the time and touch-points required to actually support patients with the very difficult thing that is, behaviour change. Nor the skills to truly facilitate patients making the necessary and desired changes – so they outsource this role.  But we shouldn’t.

After all – I want to be on my patients’ support bench & health care team always – not a flash in the pan, that blinded them with science or my ‘smarts’ and proved to them in one over-stretching prescription – that naturopathy is not for them, or at least, they’re not fit for the task.

Compliance Changers – Strategies for Success

At the end of an information & insight heavy appointment, formulating a list of products and doses for our patients to take can feel like a bit of a ‘tada moment’, like a magician pulling a rabbit out of the hat.  “Here is the solution – now off you go!”  Research tells us, however, that treatment-plans that are a co-creation between you and your patient – evolving from a discussion that not only allows them a voice, but a major role in the decision making – are far more likely to succeed. While we are the authority on our medicines, our patients are the authority on what makes them tick & what’s likely to succeed, in terms of taste, texture, temperature & timing!  This is called Patient Centred Prescribing and together with some other tips tricks and hacks I share with you in this episode, can really increase patient buy-in, compliance and therefore bring your treatment plan to fruition and fulfilment!

Real-time Diagnostics on the Couch!

Well, this is different, now I’m watching you! 😆 In early 2021 we released our very popular MasterCourse I: Comprehensive Diagnostics, as a ‘self-paced’ online offering for the many who missed out on attending live in 2020.  Many have grabbed this opportunity with both hands (& a headset and some hardcore Do Not Disturb! signs) but we know that for some, doing the entire course on your own, >24hrs of video presentations, can be a tad onerous & overwhelming. We want to remove these barriers and empower & upskill as many practitioners in pathology interpretation as are keen, and as a means to achieve this, we’re offering the MasterCourse I Watch Party.  So bring your bhujia and a beverage and let’s do this!!

Practitioners who sign up for this will be able to watch each session’s video replay live with other practitioners and have the opportunity to ask Rachel questions & participate in case discussions at the end. Another key detail is that we will run the sessions weekly, so that the full course is covered in just 6wks, from July 8th to August 12th.

MasterCourse I: Comprehensive Diagnostics LIVE WATCH PARTY
24 hours of live Zoom sessions + Bonus sessions!
8, 15, 22, 29 July & 5, 12 August on Thursday at 3.30pm to 7.30pm AEST.
Each Thursday, the video presentation for that week will be played so we can watch it together. Then Rachel will open up her webcam and mic, inviting you to do the same, to participate in a Q&A  as well as set case discussionsWhen you register, you get immediate access to watch our preliminary/preparatory sessions, prior to 8 July: Accurate Pathology Interpretation Starts Here and the RAN Patient Pathology Manager Tutorial.

Below is an overview of the Watch Party schedule.

Week 1 – 8 July | SESSION 1: Acid Base Balance & Electrolytes
Week 2 – 15 July | SESSION 2: Renal Markers
Week 3 – 22 July | SESSION 3: Liver Enzymes
Week 4 – 29 July | SESSION 4: Lipids & Glucose
Week 5 – 5 August | SESSION 5: Immune Markers
Week 6 – 12 August | SESSION 6: Haematology

“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.” – Rohan Smith, Naturopath


Join Rachel on MasterCourse I: Comprehensive Diagnostics Watch Party and register here.
MasterCourse I is a pre-requisite to join MasterCourse II which will be delivered live in 2022.

Would you believe January?!

Cone Of Silence GIFs - Find & Share on GIPHY

We have been madly working towards our anticipated December 2020 release. We’ve been in our own little cone of silence, busy editing over 20 hours of videos, putting together resources and extra bonus audios.

We’re really excited because we’re in the process of building, for the first time, quite an amazing comprehensive training package in diagnostics, that we know will not just serve, but surpass, integrative practitioners of all persuasions’, educational needs in this area.  We wanted to let you know flooding, storms and resultant internet failure will not deter us from getting it done, but these forces of nature have slowed us down a little 🙄

So we now have a new release date of January 2021.

We’ve set the bar high and want this to be as fabulous as possible and ensure that the content translates cohesively from what were very dynamic live interactive sessions to an excellent ‘off the shelf” DIY learning experience so…. take the rest of the year off people!” Step away from the computer and enjoy time with your family during the festive season. You deserve it.

We wanted to thank you for your patience and know it will be worth the wait…

“Absolutely loved this course, I’ve listened to each of the recordings at least 3 times now taking furious notes and am still picking up new gems. Love that it’s helping me build up my knowledge and confidence in such a fundamental area of practice. The case studies are super valuable as they bring the labs to life, I’d be keen for more of these!  Really appreciate all the extra PDFs / audios that have been added also. Eagerly awaiting MasterCourse II” – Naturopath | Australia

“Why wasn’t this content covered in medical school? As a psychiatrist,  I have greatly benefited from attending this course which comprehensively covers the ins and outs of interpretation of pathology labs and how this applies to clinical cases – many of which have both physical and mental health considerations.  I believe all doctors from general practitioners to specialists will gain from attending! ” – Psychiatrist | Australia

“Thank you so much for this course, it has been brilliant. It has ‘fuelled my practice’ and many people have benefited already – from such insights. It’s quite thrilling!!! I’ll definitely be signing up for the second course later next year” – Naturopath, Medical Herbalist | New Zealand

 

 

MasterCourse 1: Comprehensive Diagnostics is a self-paced online program due for release in January 2021.
The course has over 20+ hours of video presentations plus 2 free bonus sessions 1) Accurate Pathology Interpretation Starts Here and 2) Patient Pathology Manager and access to resources and tools within, for your own use.
This is a pre-requisite for MasterCourse II that will be delivered live in 2021.

This skillset has been found by many to be biggest ‘game-changer’ in Integrative Health
You can view the full course outline here.

Priming Your Practice For Mental Health

28 years ago I was in the midst of my own mental health crisis
24 years ago
I graduated
20 years ago I dipped my toe into first year uni psychology units

18 years ago I worked in psychoactive medicines with a pharmaceutical company
16 years ago I began combining all my learning (pharmaceutical, psychological, naturopathic) to truly reinvent & optimise my approach to supporting patients with mental health presentations
…And every day since I’ve remained passionate that we can offer an important and potent contribution in the management of mental health, when we do it well, and I want all of us to do it well.

So 2 years ago I started the Mental Health Primer Mentoring, to do just that.

Every year I learn more about mental health (from patients, mentees, mentors and via my ongoing active research) and each year this learning is reflected back into the content for the Mental Health Primer.  It’s an exciting dynamic process.  I don’t share the same beliefs I did, 5 years ago on certain testing and a few treatments, the research has moved on and in the last year alone I have refined my models for CNS histamine imbalance, reacquainted myself with a couple of old forgotten friends prescription-wise, which are working well, and discovered a couple of totally new BFFs!  In this group, we keep it real, nothing stayed and static, no questions unaskable.  And by mapping out and really taking the time to learn a tried and true ‘process’ by which we can navigate our way with seeing, recognising and supporting each individual in front of you, we feel confident in designing truly individualised mental health management approaches

“Honestly, I have to say all of it was valuable.  The info re neurotransmitters, pathology,
questionnaires – truly brilliant. Changed the way I practice!” 
– Chris, Naturopath

“Very relevant to myself and practice, as it will completely change some of my
treatment methods and gave me more confidence.” – Di, Naturopath 

The Mental Health Primer Group gives you all the other skills and knowledge needed to really help patients with their mental health…that are as a) important as anything in a bottle and b) help the ‘bottles’ work better and c) direct you to the best ‘bottle’ in the first place. Like understanding the trajectory of certain diagnoses, recognising red flags, the need to rewrite your regular consult for patients with primary mental health presentations to get the most important information and adjust your expectations: never setting them up to fail etc.

Our Mental Health Primer Mentoring Group is topic based and here are some of the ones we cover…

MH Safety – Keeping You and Your Patients with Mental Health Problems Safe
Neurobiology in a Nutshell – Digging Deeper into the Diagnoses
Questions and Case Taking Skills
Mental Health Assessments – Learning How to Use the Best Tools Out There
Interpretation of Pathology Markers Through a Mental Health Lens
Referring & Referral Letters for Mental Health Case;
Treatment Options in Mental Health
Boundaries, Barriers & Behaviour Change in Mental Health Management

I hope you are as passionate as I am about the enormous contribution we can make here but we also agree that a) we are flying under the radar as significant contributors in mental health care with the rest of the providers unaware and b) our training might be falling short in preparing us for this kind of client base and important role.  Now is the time to step up to that plate en masse as soon as we can.

If you’re interested in joining our Mental Health Primer Group for 2021
then email us at admin@rachelarthur.com.au to receive your application.

For more information on Group Mentoring and the extra bonuses you have access to click here.
APPLICATIONS CLOSE 22 NOVEMBER

Finding Your Path For 2021

In addition to all the lessons we learn from our patients there is an abundance of professional development on offer to facilitate your growth as a clinician.  We offer several (Group Programs, Self-directed Learning Packages, a live MasterCourse &Alumni, Clinic toolkit boosters) and we believe they offer some of the best returns on your investment. Whether you are a ‘fresh out of college’ graduate, got a ‘few years experience under my belt’ practitioner or a ‘seasoned’ (been in practice for many years) practitioner you’ll find a pathway for you.  But just so you don’t get lost out there in the wilderness of all our options (!) this year we’ve put together a map to help you find the fit for you!

Rachel Arthur Nutrition is a respected provider of education and mentoring for all integrative health practitioners
– Naturopaths, Nutritionists, Herbalists, GP’s, Pharmacists, Chiropractors, Osteopaths and Physios

 

We think this visual aid will make it easier and quicker to find your ‘fit’!
If you want to wallpaper your house with it (!!) download a copy here. If you have more questions and or want to claim a spot email us!

Our 2021 Group Mentoring’s application open 9 November and if that’s your chosen path, let us know so you don’t miss out. Or you are not sure which way to go, send us an email at admin@rachelarthur.com.au

 

Boundary Breaches

Well that got tongues talking!  We’ve cried, and we’ve laughed, hearing from practitioners about their ‘over-delivering donkey experiences’ for 2020. We’ve heard many memorable & relatable tales of either failures to set the best boundaries or even, in instances when we do, patients’  incredible dexterity to scale these in single leaps, ala James Bond style.
Practitioner: “On the very same day we talked about this important and ignored topic, I’d received an email at 9am from a patient asking for advice and a 2nd opinion about the prospect of surgery (first mention of this and clearly outside my scope!!!!), which they wanted before they saw the surgeon in 2 hours!!”
Sometimes it’s not patients, but professional colleagues (& friends)! I personally took an urgent call on Sunday morning from one of my psych colleagues, only because she is a dear friend, only to discover she needed help regarding a friend with mental health escalation…ah…yup…nup. Her blurred boundaries breached mine and then I bugged another colleague out of hours for further assistance…bad boundary blurring behaviour all round!  We’ve been talking about the uncomfortable truth that a lack of healthy boundaries is a fast track to burn out for health professionals in group mentoring and the end of the year is always…opportune!
Mentee: “I felt challenged in a way where I was reviewing my own boundaries from an overall perspective over a period of time.  I’ve worked in retail for 15 years now (as a student nat initially and then as a qualified naturopath) and I still find myself questioning how far I will go in certain respects especially when it comes to mental health (or people who appear vulnerable).  When I was initially in practice I found my boundaries challenged to another degree, where I would accept every person who came through the door, whether I felt ready or not, or willing to take on the case, which essentially led me to burning out. 
Now as I get ready to start again in practice, I feel more prepared to set clear boundaries from the get go (give myself permission to do that) and check in with myself if I feel they are about to be crossed or not in alignment with me.  It feels like an important and healthy assessment tool to utilise as a health care practitioner.”
As a profession we need to pool some solutions. 
Instead of the reflexive, ‘Just pop me an email if you have any questions’, at the end of each consult which can constitute the equivalent of a blank cheque (!!), perhaps we can say, “If you need to clarify any advice I’ve given you today drop me an email and for any other questions that arise, we can decide whether we need to bring your next appt forward or schedule a between appointment phone consult”   Or if you’re a practitioner who sees the value (and there is much research to support this) in increased touch points with patients, for better compliance and improved outcomes, then structure your billing accordingly.  This from one of our cluey new grad mentees, ‘If you want to offer this add-on time as part of your service then you need to account for it e.g. shave 15 mins off the actual face to face time that they’ve been charged for, so as to have this ‘up your sleeve’ for this express purpose.  They breed ’em smart these days!  Love it!  
The end of the year is such an important time for reflection. What have you learned this year about your professional boundaries? Got some tips you’d like to share?  

Countdown is on for 2021 Group Mentoring

We are getting ready to launch our new look Group Mentoring for 2021! We are now counting down the weeks days (gULp!!) until we open up applications for Group Mentoring next year. We’re keeping everything our practitioners have told us they love, over the past 8 years, and simply improving the formula, with some great new bonuses for 2021! 
So with 2 weeks to go, we’d thought we’d introduce what’s on offer.
  • Live sessions are starting in February for 2021. January is often a period when we’re recovering from ‘recovering’ e.g. Christmas holidays, so we thought it would be good to start a month later this time around, in February when everyone’s recharged and ready to get back in the swing.  There will be 10 live sessions in 2021 starting Feb and ending November.
  • Fly on the wall options on offer! Want to present a case? Great!  Not ready or have enough time to present one? Great!  Having successfully launched the ‘fly on the wall’ (non-presenting participants) experience this year we’ve been left in no doubt that practitioners loved this & continued to learn just as much as those in the ‘hot-seat’. Hence, it’s back again!
  • BONUS: Update in Under 30 Subscription is now included for those in General Group Mentoring (GM1 or GM2), either of our Mental Health Groups (Primer &  MH Applied) or to those in our  MasterCourse Alumni  (not included for New Graduates)  You gain access to the ENTIRE back catalogue of Rachel’s UU30 recordings (30 min podcasts), with a total value of over $1800, and receive a new podcast each month for 12 months. For those mentees who are already current subscribers, when your subscription expires in 2021, you’ll get to renew for free! This provides you with even more of an opportunity to drill down and dig deeper into certain areas that we routinely come across in our session cases and content. This gives you a much greater opportunity to seriously expand your learning in those areas most relevant to you.
  • We’ve broadened your 30% discount to ALL Rachel Arthur Nutrition products on our website for 2021. 
  • Certificate for CPE Hour
Here’s what one of our mentees had to say this year…

“I’ve listened to the recording of the live mentoring sessions multiple times and sooo sooo much goodness in each session.  I love how your mind works Rachel.  This is also my second year in mentoring and I am so grateful for this safe space to continue to enlarge our thinking.  I learn something new every single time.  I am also loving the update in under 30 – that is also changing my practice with every single listen.  Eg the ones regarding interpreting iron studies and prescribing.  TOTAL GAME CHANGER.  I was a novice in iron prescription kind of going with whatever my patients Dr’s were prescribing but then understood why they were getting such crappy results – both in actual improvements in their iron test results but also negative symptoms.  Honestly, the combination of mentoring with the little individual nuggets in the updates is totally transforming my practice so I’m so grateful. Rachel please keep mentoring forever.  I love it.”
Bek DiMauro, Functional Nutritionist, Adelaide 

 

We have a great range of groups to choose from. Whether your a nervous newbie or have 15+ years experience…

  • General Group Mentoring – our regular case presentation groups, with one practitioner presenting a case each month, or just listen in.
  • New Graduate Groups – great opportunity for New Grads to build confidence as they leap from student to practitioner, or for practitioners wanting to refresh their core clinical skills such as MindMaps, Pathology, Case Taking etc
  • New Grad Next Level group – for graduates of the New Graduate 2021 group to continue to build on your skills and apply all the great learning from this year to real client cases.
  • Mental Health Primer – topic based tutes & interactive sessions to build on your knowledge in the role of naturopathic medicine in Mental Health – from screening tools to key management issues, specialist diagnostics and beyond.
  • Mental Health Applied – practitioners presenting their client cases with a focus on primarily Mental Health presentations.
  • MasterCourse Alumni Monthly – NEW for 2021 – Participants from this year’s MasterCourse In Comprehensive Diagnostics can continue to build on their knowledge and application of Pathology interpretation with this Live monthly session and online community.

 

For all those Mentoring Virgins 😇 out there wanting a clearer understanding of what it’s really like to be part of my group mentoring, this video is a little snippet from a session with one of my groups. This year has flown by and I have thoroughly enjoyed working with each fabulous group of dedicated ‘life-long learners’.

And don’t forget some of the offerings our Group Mentoring already reliably provides – the high level of applied knowledge, our incredible Basecamp platform for communication and support between sessions and our ongoing sharing of pearls of knowledge from my 22+ years of experience and research together with the collective wisdom and know-how of each group.

Can you see yourself in this collective?

REGISTRATIONS OPEN 9 November!

Information on how to apply will be released soon, to find out more click here.
Join the waiting list now so you won’t miss out by sending us an email on admin@rachelarthur.com.au.

Where To Now?

As a health practitioner, you are always actively building: your reputation, your practice and your knowledge. There’s theoretical …and then there’s applied. Some of the biggest leaps we take forward as practitioners come with being shown how (rather than told) & then being forced to ‘do the work’ ourselves, rather than being exposed to simply more information, be that about pathology, patient prescriptions or practice structure!  The slogan ‘Just Do It!’, might have already been nabbed and TMed by a huge corporate beast, but this doesn’t undo the universal truth of it! Prefer your mantras to come from mystical philosophers rather than monster multinationals?  How about this then?

I hear and I forget. I see and I remember. I do and I understand.
Confucius

This mentoring community that I am a part of, we are about applied learning.  We learn by doing.  We learn, not just through each individual’s patient encounters but through the collective clinical experience.  We make what can otherwise be an isolating experience of constantly, seemingly, reinventing the wheel, if not many wheels (!), into one of collegiality and ‘using the force’.  If you haven’t experienced Group Mentoring with me previously and are thinking about next year being your year (see below to find out more about our 2021 offerings), we put together this fun little video here to get across that mentoring isn’t about a conversation between just two people. 
So….HoW dO YoU gET FroM HeRE tO tHeRe?

With Group Mentoring you’ll be learning, through the application of core clinical skills, improved patient questioning, methodical information gathering, evidence based answer finding  & getting access to resources that you can apply in real-time in your own practice.

“Having the group session each month, as well as having Basecamp to bounce ideas around in, is a reassuring connection to know is there if I need it. Having just started practice this year and working in an environment without other Nats around, I have noticed the occasional feeling of isolation. So having the monthly catch up keeps me feeling connected to other clinicians and gives me exposure to other cases and perspectives that I wouldn’t have otherwise had.” – Georgie

 

We have a range of groups on offer to suit all levels and most types of integrative health modalities. Go to our Group Mentoring page to discover the groups and bonus extras on offer for 2021.

Going by the landslide registrations for 2020, our ongoing excellent retention rate of practitioners from year to year & our already overflowing waitlist for 2021, the reputation of RAN Group Mentoring is highly regarded and a popular choice.  

So, if being part of our community excites you and if the thought of learning and applying collective knowledge from expertise outside of our own, now’s the time to put your hat 🎩  in the ring, put your hand up ✋🏼  &  join the conversation 📣  through Group Mentoring.

2021 Group Mentoring Program Applications Open on 9th November!
Email admin@rachelarthur.com.au to let us know you are interested.

 

The last last LAST! Word On Worms

 

 

I’ve been trying to wriggle my way out of perpetually presenting on this topic.  I guess, like the poor patients afflicted by them, theses stories and my preoccupation with how to help, has kept me awake many a night and once apparently ‘resolved’, returned on many an occasion…every time, in fact, I hear another heart-breaking story of a child with a chronic infestation that is ‘slipping through the gaps’ in diagnosis, support and successful management. This recording brings together all the very latest research with the most explicit prescriptive protocols (CAM & pharmaceutical) with one of my patient cases that has so much to teach us all. So this is the last time (yes the last time 🙄, hold me to it!!!) I’ll be releasing a talk on the little critters: Enterobius vermicularis.

 

Intestinal Worms – Impacts on Health and Overall Wellbeing

Are you faced with families coming undone because of one child’s behaviour – whether that’s aggression, emotional lability or just serious sleep problems? Are you treating patients with recurrent or treatment-resistant Dientamoeba fragilis?
Enterobius vermicularis is more commonly known as Threadworm and is a pervasive issue that remains frequently mis- or un-diagnosed in children and adults. In this 1 hour presentation we will look at chronic manifestations, how threadworms negatively heath across the board. We look at the very latest research not just on the impact of these sometimes insidious infestations but also the very latest on complementary medicine treatments and the potentially important role for pharmaceuticals. As practitioners, we don’t currently have all the solutions but we need to keep the conversation going, as we continue to encounter patients with pervasive problems that can bring the world and wellbeing of a little one (and their family) quite undone.  This is the final (fingers crossed!) instalment on the topic of Enterobius from Rachel and constitutes the culmination of all the years of research & experience, into her most detailed discussion yet.
Click here to add Intestinal Worms – Impacts on Health and Overall Wellbeing to your online RAN Library.

You’ve Got This…Making Your Own Survival Plans

 

I am feeling concerned about many of you because chances are, given you’re reading this, you’re running a small business in healthcare right now. Relax, I am not a ‘Doomsdayer’…I don’t think the current situation has to be the death knell for our clinics and businesses, nor even a near-death experience but I do think it requires:

  • Dedicated and directed thought
  • Dedicated responsive planning
  • Follow through actions NOW to pave your way to a sustainable TOMORROW

I do not think it requires a paid business coach. I am a little horrified to see we are already being preyed upon by coaching businesses wanting us to invest more at this financially fickle time to be ‘shown the way to emerge triumphant from this’. That gives me the creeps. Enough said.

But I do know burying our heads isn’t the answer. In fact, that is probably the best way to bury your business for good. From connecting with hundreds of practitioners regularly I can confirm there is a trend emerging that many of us had absolutely predicted: some reduction in return appointments (patients not yet shifting to online or deprioritising long-standing health concerns and prioritising panic instead) and a much more worrying, more financially impacting, bigger drop in new patient bookings. We will only have this unprecedented run on ‘immune herbs and supplements’ for so long. We all need to do the maths…and fast.

Most of us know well enough the bare bones of our business to know this spells income trouble in terms of right now: via a lower hourly fee and moving forward, in terms of loss of expected growth of client base, in a nutshell a process of ever diminishing returns.

Wringing our hands and worrying is not dedicated directed thought. Which is instead about taking business advice from established experts (who have global experience in previous major financial crises) that is already out there for free and just committing the time to reading it and applying it to your own circumstances.  The best I’ve found so far featured in Forbes Magazine…and no I have never read this mag before in my life either, only ever bought it for the pictures  🤣😂  BUT this article contains the essentials of what you need to consider right now and you can use it to form the basis of your planning, decision making and actioning.  It applies to business generally and some of it is bit hard to translate out of CEO-speak but I’ve put my hand to it here for you.  Please look at this, take the time to ask yourself these important questions about what may happen and how you could improve the outcomes of each new challenge.  And if you find that still too difficult on your own, grab a couple of practitioner pals online and see if by putting your heads together you are better able to answer the questions this poses. If we learned anything from our horrendous fire season, it was, hopefully, that plans are meant to be made in advance…not when the flames are beating at your door. I recommend you make one, now.

To make it easier for you (and you know how I love creating resources!!), I have extracted and reproduced a table from this article – Forbes’ Business Strategies for 4 Phases of COVID. I’ve just modified it for you to download and use to create positive business strategies and vision for your future.
You can download it here.

What We Learned in Lock Down Last Week…

What does lockdown look like for you?  More time spent…

A) Learning or
B) Losing sleep over things outside of our control or
C) Losing days just watching Tik Tok

I’m choosing ‘A’ and I know I’m keeping good company because last week many of my ‘nearest and dearest’ gathered on 2 occasions for some serious extra brain gym. The first was the ACNEM Fellowship Community of Practice that I had the privilege to co-chair with Dr. William Ferguson.  A fantastic new initiative by @ACNEM to offer more hands-on mentoring and support to their doctors.

The second, our own Give-back-Gratitude Live Q & A for our Update in Under 30 Subscribers where I used the time to check-in and see if we could further the learning offered by our monthly audios and clinical tools.

Having all of those who attended, in my ‘home’ was a fabulous contrast to our social distancing ‘new norm’, and seeing all those lovely faces and buzzing brains behind them, warmed the cockles of my cortex!

For those of you that couldn’t make our UU30 date, I wanted to share a few things we learned in lockdown this week:

  1. Copper can be absorbed through the skin and penetrate to deeper layers potentially increasing serum levels but the degree of uptake is highly variable and more likely with prolonged contact e.g. jewellery and pastes not showers etc
  2. Just like the Zn:Cu, when reviewing patients’ albumin:globulin, we must first look at each value individually and consider causes and consequences of low or high values, otherwise we can ‘miss the message’
  3. When understanding labs of anybody who is not a couch potato we need to ditch reference ranges based on the general population because they essentially are…couch potatoes and ask ourselves 3 questions: 1) Who is this person outside of being ‘sporty’ 2) What is the nature of their sportiness because exercise ain’t exercise in terms of physiological effects and 3) When are the tests being done in relation to any exercise

On that last note, I am so thrilled to be able to share my brand spanking new presentation The Impact of Exercise on Pathology Tests – Beyond Artefact to Understanding which I put together B.C. (Before COVID19) for a NZ speaking engagement.  This actually has been one of the most satisfying areas of research to expand my own knowledge in…explained a LOT about what labs go whacky (and why and how to navigate around and through this) not just in what you might call ‘real athletes’ but in weekend warriors, crossfit crazies, MIL (men in Lycra) and the increasing number of middle-aged or older women who just love pounding the pavement.  Know the types?  Our clinics are full of them…it is time to learn their labs properly.

 

The Impact of Exercise on Pathology Tests – Beyond Artefacts to an Understanding

Overwhelmingly when we look at our patients’ labs we compare their results with a reference range derived from ‘the general population’ aka couch potatoes!  Therein lies our first problem. Exercise is recommended for health but we don’t know what this ‘looks like’ in terms of labs. The reference ranges reflect and assume ‘average’ muscle mass & haemodynamics & ‘average’ nutritional requirements in people consuming the SAD (standard Australian diet) none of which apply to the exercise enthusiast, weekend warrior, least of all the professional athlete! Given an increasing number of our patients are embracing exercise, this is an important instruction in what healthy looks like, how to make meaning of otherwise meaningless comparisons and ultimately enable you to distinguish between what is healthy exercise-induced adaptation, an artefact and an actual aberration that flags possible negative impact of emerging pathology for other reasons.

 

Click here to add The Impact of Exercise on Pathology Tests to your online RAN Library.

For all UU30 Subscribers
the full Live Q&A Recording is now available in your ‘active content’ of your online account.

LIVE Q&A With Rachel Arthur

We’re keen to keep a bit of normal in all the noise. Are you? Here’s another way to keep your collegiate connections connecting and your brain blossoming!  Our monthly podcasts are 30 minutes of jam-packed information and here is your opportunity to get more bang for your buck and expand on those 30 minute downloads with some serious drilling down!  Keep the conversation going and get your questions, answered…

Rachel will be running a FREE 1-hour live Q &A to answer UU30 Subscribers questions about the first three episodes that have been released in 2020 (see the list below).

The live Zoom session will start at 6 pm (Syd time) on the 2 April.

Let us know you will join us so we can email the Zoom link on 1 April to you directly.

You are invited to pre-submit questions to admin@rachelarthur.com.au by noon 31 March.
We have extended this pre-submission due to the current circumstances.
 

Rachel will do her very best to answer the ones that are the most common and/or offer the best-extended learning for everyone and, as many as possible.

What kinds of questions CAN you ask?

Specific topic-related short questions😊

What’s is the copper (Cu) absorption rate like through the skin? I’m thinking of a couple of patients where Cu is high in bathing/showering water but it’s filtered from drinking water. Just curious about absorption rates through the skin with water as the medium, versus through ingestion/food/drinking water etc.”

***

Here are the three episodes you can submit questions on. As a subscriber – you will find all these episodes in your ‘active content’.  If you can’t make it, please still submit your questions as we will be adding this free bonus to your subscription account.

JANUARY: COPPER IN KIDS Copper, as a kingpin in angiogenesis, brain & bone building & iron regulation is a critical mineral during paediatric development. So much so, the kind of blood levels we see in a primary schooler might cause alarm if we saw them in an adult. So too their Zn:Cu. But higher blood Copper and more Copper than Zinc are not just healthy but perhaps necessary during certain paediatric periods.  This recording redefines normal, low and high with a great clinical desktop tool to help you better interpret these labs, as well as reviewing the top causes and consequences of both types of Copper imbalance in kids. 

FEBRUARY: YOUR MASTER INFLAMMATORY MARKER Patients’ labs lie, not often, but sometimes and the inflammatory markers performed routinely like CRP and ESR have been known to tell a few. Like when everything about a case screams inflammation but both of those say there’s none there. Why do they miss it?…well basically it’s not their lot. CRP and ESR have specific signals they only respond to and therefore reflect only certain immune reactions and at specific stages of that response. But there’s a nifty little calculation you can perform with all of your patient’s labs and suddenly see the immune activation, inflammation and oxidative stress that was lurking beneath.  

OUTRUNNING ‘ATHLETE’S’ ANAEMIA Persistent ‘hard-to-resolve’ anaemia is a common presentation for anyone participating routinely in sport and that can be at any level, not just among the professionals. From our lovely ladies who take up running or Crossfit in their middle-age to our MIL (men in Lycra) and ‘weekend warriors’, they may love it but their haemoglobin and their iron doesn’t! Anaemia equals reduced oxygen-carrying capacity, a concern for anyone interested in optimising their performance but equally relevant to patients just trying to manage their energy throughout the day. In this important episode, we identify 4 different types of anaemia seen in patients as a result of exercise, incorrectly lumped together as ‘Athlete’s’ Anaemia. 

JOIN RACHEL LIVE ON 2ND APRIL AT 6PM (NSW TIME)
Make time to connect with like-minded practitioners to hear what they are asking about these topics and/or have your questions answered too.

This is a special bonus for our current premium subscribers only, so if you are not a UU30 Subscriber yet, you can sign up here.

TAKE UP THIS OPPORTUNITY!!  RESERVE YOUR SPOT AND SUBMIT YOUR QUESTIONS BY 31 MARCH AT 12PM
Email admin@rachelarthur.com.au so we can send you the link to join the meeting.

Waving Not Drowning?

Yes, the news is – the current regulations may last for a while and as the social-distancing and best-to-stay-at-home message is slowly but surely sinking in. If you’re like me, more time ‘not out in the world’, means more time to get my creative thinking going and put my mind to how to sustain our humanity, sanity, professional and financial viability.

We have put together a few tips on how you can best support your clients, your community, yourself and your business.

PERSONAL

Look after yourself, both physically and emotionally. For most of us this is in fact an opportunity for more of this.

1. Build your benevolence muscle! Foster a rescue animal. Check-in on your elderly neighbours, family members, new mums – maybe trade a roll of toilet paper for a cup of rice or the other way around LOL 

2. Keep some structure in place and your brain active. Can you use this opportunity to catch up on all the things you’ve always wanted to do but never really had time to? E.g get stuck into some of the online training, webinars, podcasts, papers, books etc. that you’ve never managed to watch, listen to, read about…the enormous library of ‘Medscape Fast Fives’ alone should see you through til August!

3. Do the 30-minute COVID-19 infection control training for healthcare providers – stay informed and up to date.

4. ‘Follow a routine’- this may include exercise (if you used to go to a gym maybe go for a walk outside), get ‘dressed for work’ as if it was a casual day in the office… etc. My team and I have independently established that our work gets done a little slower and our minds get a little sloppier (!) when we are wearing UGGs or slippers …so beware!!!

5. Keep connected with your support networks. Social distancing does NOT equal social isolation. Just take it online if you can (thank you technology!)… Your weekly book club, fortnightly visits at your aunty’s aged care facility, religious meetings, etc. It can all still happen.

BUSINESS

Stay dynamic, creative, and open-minded. Our profession requires us to come up with individual treatment plans for each patient so thinking outside of the box and on the spot is nothing new to us…Yet, it can be challenging when the structure as we’ve known it for so long is becoming more dynamic. So, what can we do in amongst all this…?

1. Shift to 100% online or phone consultations and offer smaller acute care-type appointments to reduce the costs for clients who are currently not able to afford comprehensive consultations

2. Consider further reduced-prices for so many people who are currently facing financial uncertainty – offer this online letting people in your community know about the kind of support you CAN (and can’t offer)

3. Put a few extra safety measures in place if your business includes a dispensary: Get clients to pre-order and pay via phone so that they can pick up their order when it’s ready (they could even wait in the car if preferred). Let any “walk-ins” wait outside, better still encourage them to call and pay over the phone instead and pick up the order when it’s ready. 

4. Or use patient ordering systems more often and stay right out of the handling for the time being.  Lessen your capital risk etc

5. Buyer beware of ‘CORONA CAPITALISM’ which is already afoot.  Remember post-bushfires when every possible business’ marketing message became suddenly fire-friendly?!  Well, there are plenty of businesses already rubbing their hands together over this pandemic 🙁 so stay smart and discerning. Only buy what you truly need personally and what you really can be certain of selling, professionally, and don’t over-commit because the true financial fall-out will not be felt for some time to come 🙁 

6. If you are still treating people in clinic, introduce extra safety measures such as phone screening them (OS travel, current URTI sx) before even allowing them to present in person, getting your clients to wash their hands before entering, keeping a safe distance, and clean all clinic surfaces thoroughly every night.

Feel free to post any further tips and tricks on our RAN Facebook page, stay safe, learn lots and above all – stay connected!!!

Rachel will be running a FREE 1-hour live Q &A to answer questions about the first 3 episodes that have been released in 2020 (see the list below). Here is your opportunity to debrief and ask any questions you may have after you’ve listened to Rachel’s pearls of wisdom on these episodes. This is a special bonus for our CURRENT PREMIUM SUBSCRIBERS only. SAVE THE DATE AND GET YOUR UU30 SUBSCRIPTION NOW. The live Zoom session will start at 6pm (Syd time) on the 2nd April. You will be invited to pre-submit questions and Rachel will do her very best to answer the ones that are the most common and/or offer the best-extended learning for everyone and, as many as possible. Here are the three episodes you can submit questions on. Please note the March episode – Outrunning ‘Athlete’s’ Anaemia – will be released early on 24 March so you can listen before the live session. 

what we CAN do

It is a challenging and confusing time for everyone.

Yet, as healthcare practitioners, we are needed more than ever, by our clients and our community, to do what we do best *educating *advocating * providing access to medicines * supporting

Our friends and esteemed peers down at Gould’s Apothecary’s (TAS) have shared some great tips on Facebook and honestly, they couldn’t have done a better job! Let’s look after ourselves and each other and collectively calm and curtail this. 

The Naturopaths and Herbalists Association of Australia (NHAA) also suggests as follows: “For those of you who want or need to move consultations to an online or phone format, this is a valid option to protect yourself, your staff and your patients during the current pandemic.” Check with other associations if you are a member of these to see how they recommend you approach consultations while minimising risk.

Below is the Gould’s post and well, we couldn’t have said it better and thought this may also be something you want to share with your patients to let them know you’re well informed and you’re there for them.

***

We’ve put together a list of simple steps you can take at this time to take care of yourselves and your loved ones.

Our list of suggestions below has been compiled with the intention of providing you with simple steps for actions you can take at home, or recommendations for things that you can access fairly easily. These treatments have the potential to support your general health and immune resilience, but to be clear, none of them have any proven action in preventing or treating coronavirus infection.

Gargle and drink GREEN TEA. Consuming green tea, in particular gargling it, has been shown to reduce the risk of contracting influenza and the common cold. The tannins in green tea have been shown to have broad antiviral effects topically. In one study, residents in an aged care facility gargling the equivalent of ½ cup of green tea three times daily were more than 15 times less likely (OR 15.7) to catch the flu https://www.ncbi.nlm.nih.gov/pubmed/?term=16970537
Take a Vitamin D supplement. Living in Tasmania is known to increase our risk of having low vitamin D. A number of studies have shown that taking vitamin D, particularly in people who are vitamin D deficient, reduces the chances of developing acute respiratory infections including influenza. Most studies reviewed used adult doses ranging from 2000IU to 4000IU a day, which is known to be safe to take long term even in the absence of deficiency https://www.ncbi.nlm.nih.gov/pubmed/?term=30675873

Eat probiotic foods daily. Consuming probiotic foods regularly or taking a probiotic supplement has been shown to reduce the risk of developing an upper respiratory tract infection https://www.ncbi.nlm.nih.gov/pubmed/?term=25927096 You can consume probiotics through foods such as probiotic yogurt (Vaalia has 3 well researched viable strains in therapeutic amounts), sauerkraut or kimchi, in addition to many others. All of these can be consumed on a daily basis. If you would prefer to take a supplement, talk to us at Gould’s about the most ideal one for your situation.

Eat plenty of raw crushed GARLIC. We don’t care if you stink, we can all stink together! Garlic is one of nature’s best antimicrobials, and it is quite amazing in that it appears to be selective in its action – it doesn’t wipe out your good bacteria. Local organic garlic is best if you can access it, but don’t worry if you can’t – eat what you can find. Ensure you are eating raw garlic according to your own tolerance as not everyone can stomach it. We find that adding crushed garlic to a meal just before consuming it, or having it with avocado on wholesome bread, improves tolerability.https://www.ncbi.nlm.nih.gov/pubmed/?term=PMC4103721
Keep any medicines you regularly use in stock and within date. This includes pharmaceuticals (check your scripts are also in date), herbal remedies and nutritional supplements. At Gould’s, we have taken measures to ensure we have enough immune and respiratory herbs in stock to get through the winter season, and while we encourage you to be prepared, we emphatically ask that you don’t stockpile herbs, so that we can continue to serve the community through the winter period. Tinctures are also not something we can accept returns for, so please think about how much you realistically need. We are setting a limit of 500ml per person for respiratory and immune mixes, and while we won’t be policing repeat visits, we ask that everyone be mindful of others within the community also having access to herbal medicines.
Keep your home above 16°C. Having a cold home reduces respiratory resilience and increases susceptibility to and mortality from respiratory tract infections. This is especially important for people who are elderly, asthmatic or have other chronic/recurrent respiratory conditions. http://www.instituteofhealthequity.org/…/the-health-impacts…
Eat a healthy well-balanced diet. Eat an abundance of plant foods, high antioxidant foods (especially berries, kiwifruit and purple grapes), fresh local fruits and vegetables, nuts and seeds, and plenty of legumes. These help to feed your beneficial gut bacteria, which will assist you with immune resilience. They also ensure you have a healthy intake of vitamin C along with other nutrients important for immune health.
Don’t overindulge with alcohol. Binge drinking is bad for your gut flora, and also impairs immune function and increases the severity of respiratory tract infections https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/
If you smoke, action a quit plan. Contact QuitTas for support https://www.quittas.org.au/…

Get enough sleep, maintain a healthy exercise regime, and try to keep stress levels in check. We understand that these things can be easier said than done, but all three of these are integral to your immune system working well. So take the opportunities that present to take care of yourself.

If you do get sick, don’t panic, but please minimise your contact with other people, and follow the guidelines about self-isolation.

SELF ISOLATION IS RECOMMENDED IF:

● You have returned from or transited through any high-risk countries within the last 14 days. (It appears prudent to extend this to moderate risk countries also.) At the time of writing this post (12th March 2020) the following countries are considered high and moderate risk: Mainland China; Iran; Italy; South Korea; Cambodia; Hong Kong; Indonesia; Japan; Singapore and Thailand. It appears that USA may soon be classed as moderate risk also.

● You have been in close contact with anyone who has recently transited through these countries.
● You have been in contact with anyone who has confirmed coronavirus or is suspected to be at risk of being exposed to the virus.

● You have recently returned from anywhere overseas and have even mild cold or flu symptoms.

***In all of these cases you should call the Coronavirus hotline on 1800 671 738 in Hobart or 1800 020 080 nationally (in Australia) to clarify your next step. https://www.health.gov.au/…/coronavirus-covid-19-informatio…

As a thank you to our current subscribers of Update in Under 30s, Rachel will be running a FREE 1 hour live Q &A to answer questions about the first 3 episodes that have been released in 2020 (see the list below).  Here is your opportunity to debrief and ask any questions you may have after you’ve listened to Rachel’s pearls of wisdom on these episodes. This is a special bonus for our CURRENT PREMIUM SUBSCRIBERS only. SAVE THE DATE. The live Zoom session will start at 6pm (Syd time) on the 2nd April. You will be invited to pre-submit questions and Rachel will do her very best to answer the ones that are the most common and/or offer the best-extended learning for everyone and, as many as possible. Here are the three episodes you can submit questions on. Please note the March episode – Outrunning ‘Athlete’s’ Anaemia – will be released early on 24 March so you can listen before the live session. If you are not a premium subscriber yet, you can subscribe here https://rachelarthur.com.au/product/12-month-subscription-to-rachels-premium-audio/

“It’s’ Not A Prebiotic, Not A Probiotic…It’s Bathwater To The Rescue”

 

Sometimes timing is everything. I recently FINALLY had my (almost) lifelong dream come true, installing a  self-care-haven-outdoor-bath and guess what, a few days later I stumbled across an exciting study talking about the benefits of baths! But it’s not in the traditional hydrotherapy way you might be thinking.  It requires at least one co-bather…or more 😉

About now you (and my recently relocated kids) may be wondering exactly how big I’ve gone with the bath.  Relax it’s smaller than the one in this image.  Promise.  But  based on this recent study  you definitely want room for at least one more…but make it someone you’ve already seen a CDSA for  👀

We’ve all been taught ad nauseum that the establishment of intestinal gut microbiota starts at birth if the child is born through the birth canal and for those that took a different emergency exit route, via contact with surrounds in the days following. But what do we say about doing what we do, til we know better? This particular study by Odamaki et al. (2019), puts a very different spin on things regarding how we end up with the ‘gut’ we have today. Using the old tradition of Japanese families sharing bathwater to answer a very modern question: is it a possible medium for the exchange of strains of Bifidobacterium longum? 

It turns out that the number of gut microbes shared by family members of the group who bathed together was higher than that in the ‘solo-submergers’ group, reinforcing the likelihood that shared bathwater is an effective vehicle  for microbial exchange of bifidobacterial strains.

So maybe in the future, our probiotic treatments might look a lot more holistic… a new addition to our oft-repeated list of favourites: whole food diets, fibre diversity, all the polyphenols of the rainbow etc. They might just include sharing baths with some healthy family and friends rather than swallowing yet another little pill – I am certainly open to that.  Come on over but just fax me your CDSA well in advance;)

“Man’s mind, once stretched by a new idea, never regains its original dimensions.”
— Oliver Wendell Holmes

In our profession, we are confronted with new knowledge on a daily basis and the challenge is to keep an open mind. But let’s be real, the theory isn’t always easy to implement in practice…If you want to stay up to date but you don’t have the time to look for the news Update in Under 30 are dynamic power-packed podcasts that will help you keep abreast of the latest must-knows in integrative medicine. Focused on one key issue at a time, Rachel details all the salient points so that you don’t have to trawl through all the primary evidence yourself. All topics are aimed at clinicians and cover a range of areas from patient assessment to management, from condition-based issues to the latest nutritional research. Most importantly, each podcast represents unbiased education that can contribute to your CPE points.
Our Premium Subscription is ON SALE and offers you a fast efficient and inexpensive way to stay up to date in under 30 mins a month plus access to the entire UU30 Library (over 75+ epidsodes)!

NEW Dear Doctor – Upskilling in Referral Writing & Inter-Professional Communications

 

Our knowledge is subject to constant change, and it is oh so necessary to stay up to date in our field for a bazillion reasons, give or take a few 😉 So sometimes we can feel like we need eight arms (for the visual amongst us) to manage and keep up with it all. However, if we ‘use the force’ together we are stronger, learn faster and can stop with the whole ‘recreating the wheel thingo’ that so many practitioners find themselves doing out there in solo practice.  Like, like…well, how confident do you feel about putting pen to paper? How good are you at your inter-professional communicating?  

 

*Cue* the release of a brand spanking new version of our
 “Dear Doctor – Upskilling in Referral Writing & Inter-Professional Communications”

 

Referrals and inter-professional communication are just lightly touched on in the current undergraduate degrees (if at all!). But it’s actually such an important way to grow your own professional reputation while simultaneously the credibility of our whole profession.  One might even argue, a pillar that stabilises the castle of shared patient-centred care & the future of true integrative health. I hear from my “New Graduates” as well as seasoned mentees about the unease that starts to creep in at the thought of writing the dreaded referral letter.  I’ve been writing referral letters for 20+ years and it’s given me a lot of time to think! And refine.  And refine again!  To make inter-professional care a positive experience for everyone, we need to correct some misperceptions and ensure that our patients are everyone’s priority. And to fulfil our duty of care, communicating with the other practitioners on your patient’s healthcare team is fundamental. Sometimes, as you’ll learn, it’s about modelling the best kind of shared care to boot and being the bigger person 😉

 

Better still, positive experiences of inter-professional communication will bring collaborators out of the woodwork.  Medicos and other allied health professionals you may never have been aware of otherwise, with a desire and openness to shared care tend to rise to the surface.

 

To get you even more excited about referral letters (you didn’t think that was going to be possible, right?!) and unlearn that Pavlovian procrastination you may have developed, Rachel has completely redesigned an older presentation to ensure it’s truly reflective of the contemporary healthcare landscape (oh yes, RACGP position statement included!). Expect to roll up your sleeves and get seriously practical advice with loads of examples about how to medico-speak naturopathic concepts, explain your role in the patient’s care, provide rationale for consideration of investigations and present ‘red flags’ with punch but minus the sensationalism.  And above all else, reveal yourself as the asset you really are to the rest of the healthcare team.

“Thank you so much for a wonderful presentation yesterday, Rachel. It gave me a new perspective on how it must feel as a GP to receive incessant demands from Naturopaths/Nutritionists to order pathology for their clients. I am in awe of your integrity, desire for patient empowerment, humility and respect for other professionals in the mainstream health arena. I felt that every single naturopath and nutritionist out in the big wide world ought to have listened to your insightful words of wisdom when it comes to shared care of our clients. We are blessed to have you as our teacher.”  – Michelle Blum (Mentee 2019) 

If you’re interested in integrative care, want to learn the language of letter writing and follow Rachel’s SMART objectives to craft your comms and communicate clearly then you should take a listen to “Dear Doctor – Upskilling in Referral Writing & Inter-Professional Communications”

Let’s Get Down And Dirty

I arrived home from the Farmer’s Market this week ready to cook a little number I like to call ‘egg dinner’ (fancy I know 😉 ) and found my organic bunch of kale, covered in dirt. Ok, admittedly, there was a small reflexive, barely-audible-beyond-immediate-neighbours, ‘tsk’ that may have escaped my pursed lips…quickly followed by my own auto-correct that went something like this, “thank goodness we have a Farmer’s market with real farmers and they grow real food, that actually grew in real dirt and you know what else I love about it…it goes off real fast.” Seriously, that should be a selling point and proof of the kind of substances I want to put in my mouth…readily biodegradable! Not long after these thoughts popped into my head…this article popped into my inbox…

A new year, a newly issued list of the famous ‘Dirty Dozen’. And look who just made it in at number 12!!

Kale

Not my kale from the certified organic farmers at my local market, but regular Kale. The Kale that is in your green smoothie at a cafe & stuffed into every other recipe plausible on many menus. The kale that many patients will go and buy from the supermarket shelf, spurred on by sound advice from us and fabulous intentions.

A recent Medscape Review talks all about what the Environmental Working Group (EWG), a nonprofit organisation focused on human health and the environment, have found in their annual report about the agricultural contamination of fruits and vegetables in the USA. Even though the report is always good food for thought and a routine reminder that some of ‘best foods turn bad’ as a result of unhealthy modern agricultural practices, we should not assume complete translatability.  The Australian dirty dozen is not likely to be identical to the one from the US, given farming practices and laws around food safety vary significantly between countries. If you want to drill down more into this then make sure you read One Bite at A Time co-authored by one of very our Own Clean Fifteen 😉 Tabitha McIntosh.

Far from wanting to place any further barriers or discouragement in path of regular patients keen to increase their vegetable intake, which the report states are the (currently accused) growers concerns (hey, how about you spend more time focusing on cleaning up your farming practices guys!), It is just a gentle reminder that a bit of (certified organic) dirt is far preferable & the kind of dirt want to be eating.

PS You might also like to know that the clean list of fruit and veg for 2019 in the US includes: Avocados, sweet corn, pineapples, frozen sweet peas, onions, papayas, eggplants, asparagus, kiwis, cabbages, cauliflower, cantaloupes, broccoli, mushrooms and honeydew melons

Love getting back to grassroots with a bit of dirt therapy? 

Our famous Dynamic Balance recording is the foundational teaching resource in mineral nutrition.  Minerals represent a critical tool in naturopathic nutrition and there has been an explosion of research in this area over the last 10 years. In order to optimise patient care, practitioners need to keep up with the constant stream of information, updating their previous beliefs and understanding in the process. This seminar is designed to facilitate and accelerate this process of review and re-evaluation via a fresh look at the key minerals iodine, selenium, iron, copper, zinc, calcium and magnesium.

Double Trouble for Hypothyroid?

So we already know that thyroid problems can start in utero, right…but a recent Medscape review (the fountain of thyroid information that I frequently drinketh from 😉 ) on Hypothyroidism in childhood taught me a couple of big things I hadn’t known before! 

The diagnostic criteria for subclinical hypothyroidism are raised TSH levels in combination with a normal concentration of free serum thyroxine (FT4) but because there are some differences between accepted ranges in TSH assays, high-risk groups should be screened, especially babies with malformations, whose mum received steroid treatment during pregnancy or in the neonatal period, or who had existing thyroid dysfunction, TFTs (or at the least TSH as part of what’s called the Neonatal Screening test) should be repeated 2 weeks later. But now comes the couple of big light-bulb moments: the incidence of eutopic thyroid in twin births is nearly double compared with singletons! As you know, I’m a mother of twins and I’m guessing at 18yrs old now (and multiple peachy TFTs 😉 ) the horse has well and truly bolted for my two but geez…I had no idea of the dramatic increase in risk. And it keeps going…monozygotic twins very commonly show a delayed TSH rise and those numbers are even more prominent in multiple births. The other not-so-fun-fact is the discovery that subclinical hypothyroidism in IVF babies is approx. 10% which is noteworthy considering none were observed in the control group.

This obviously left me thinking “W.H.Y?” And of course…the first place my head goes with the latter…is iodine.

Could this phenomenon in IVF babies be due ultimately to undiagnosed or poorly managed SCH in mum or even simpler still, just basic iodine deficiency, presenting as infertility?!

The reasons behind our increasing rates of thyroid dysfunction across the life-stages are multifactorial (and don’t get me started on the very real contribution of EDCs!) and how, in spite of iodine adequacy being the first thing on the checklist for thyroid health, so many health professionals ignore this, at their patients’ peril… But now at least we know that patients with IVF babies, twins, and preterm bub, who are currently not included in the prioritised screening groups should be…and of course we should keep asking the questions, “what are the mechanisms behind this, why is it so?”

So if this has made you even more curious about the incredible butterflied-shaped gland and you’d like to go for a stroll on the vast plains of “thyroidisms” you can click on this link Thyroid Assessment in Kids and Teenagers and get completely “thyroided” up. There is always more research to come our way so keep your eyes and ears peeled.

Thyroxine Replaced Patients Left To ‘Set & Forget’?

One tree in field

Too many times we see thyroxine treated patients on the ‘set and forget’ setting. Often, they’re taking the same dose they started on a decade or so ago, in spite of weight changes, ageing of course and new comorbidities. They’ve undergone limited monitoring, with just an annual in-range TSH viewed as confirmation of efficacy.  But is it? Many patients’ re-emerging hypothyroid signs and symptoms would suggest not.

A recent Medscape review article of a large study by Gullo et al 2017, identifies another shortcoming in the rudimentary way we ‘replace thyroid hormone’, in all patients but especially in those who’ve had their thyroid removed. (more…)

NAC can knock negative symptoms down!

WOW!! Did we hear that right??!

Medical doctors are branching out in their search for effective treatments for schizophrenic patients.  You see while most of the drugs available currently for this condition are aimed at reducing ‘positive symptoms’, however they can often make patients’ ‘negative symptoms’ worse or simply fail to improve these in the same way

Need a quick lesson in positive and negative symptoms? Sure thing! In schizophrenia positive symptoms are the ones most typically associated with schizophrenia or psychosis, such as  hallucinations, delusions, disorganised thoughts and sensory processing deficits. While experiences such as apathy, anhedonia, lack of energy and impaired cognition and all the way through to catatonia, are referred to as negative.  Different patients will have their own mix of these as part of the condition but generally, as you can imagine, both are severely debilitating and impair an individual’s ability to function well.

Enter N-acetylcysteine (or NAC to friends!)…..

The neuroprotective, antioxidant, anti-inflammatory and glutamatergic properties of NAC have been shown to significantly improve the ‘negative symptoms’ of schizophrenia in recent trials, when given in conjunction with an antipsychotic drug, over a one year period. There is also hope that NAC may prevent the progression of brain mass loss that is consistently observed in schizophrenic patients.  Dopamine-receptor agonists (antipsychotics), which are the go-to treatment for schizophrenia, potentiate the negative symptoms of the disease and contribute to brain mass loss.

AND!! That’s not all folks! For the Herbalists out there…

Trials using Withania have also resulted in “significantly greater reductions in negative, general and total symptoms…in comparison with placebo.”

One doctor from the Semel Institute at the University of California went as far as to say he “used to be skeptical about the utility of herbals and nutraceuticals” but he “now believe(s) this is an up and coming field”!!  Good news all round!! Serious kudos and credit must be piled enthusiastically on Professor Michael Berk, the prominent Australian psychiatrist, whose pioneering work in the field of NAC in mental health has paved the way for truly attitude-changing studies like these.

For Medscape subscribers – read the full article online: Nutraceuticals May Treat Negative Symptoms of Schizophrenia – Medscape – Jun 13, 2018.

For those of you who’d like to know more about NAC in Mental Health, we have just what you need…a presentation brings you up to date with the latest in NAC research in a large number of mental health conditions & translates this into the clinical context.

NAC in Mental Health
Previous ideas regarding the pathophysiology of mental illness have been profoundly challenged in recent times, particularly in light of the limited success of the pharmaceuticals that ‘should have worked better’ had our hypotheses been correct.