Why aren’t they doing what I told them to?

Our patients are faced by more health & nutrition messages via multiple mediums than ever before yet escalating rates of obesity & lifestyle related disease highlight the failure of these. It would seem behavioural psychologists are right when they assert that information does not change behaviour in the majority of people.  Therefore if we too simply add to our patients’ information overload, we’ve missed the point. One of my favourite & at the same time terrible illustrations of this was when I walked into a local café and saw a man sitting at a table by himself having just finished a cup of coffee and something sweet.   On the table next to his coffee was a very recognisable ‘prescription’ from a naturopath he’d obviously just been to see.

It read:

  • Reduce coffee
  • Reduce sugar
  • Reduce fat
  • Increase exercise

Oh the power of such words!!  If we spit out advice/instructions/directives at our patients, even with all the best intentions, we seem to make very little progress or only create short-term change.  In contrast, if we take the time to focus in on each change we wish the patient to make, individualise the approach and solutions then we may have only given them a small fraction of the ‘advice’ we ultimately want to but at least this time it’s actually met it’s mark and created life-long healthy habits.

An understanding of the components behind successful behavioural change (readiness, empowerment, barrier identification & resolution etc.) is essential to improving patients’ health & wellbeing.  If you want to hear  more about how to successfully promote behavioural change in your patients follow this link https://rachelarthur.com.au/product-category/premium-audio/   to a premium audio download I recorded on this topic last February.  I really believe it can make the difference between success and failure with individual patient’s treatment & the success of your practice overall. Enjoy and remember more information isn’t the answer!

The Canary in the Mine – Assessing Androgens in Men

Often I find practitioners are a bit mystified by the male hormonal milieu and their skills at interpreting androgen results are patchy compared with their confidence in female hormone investigation.  Yet, just like in females, understanding the sex hormones is a critical part of the whole health puzzle in our male patients – leading us to a better understanding of possibly the cause of their presentation (impaired motivation and mood, subfertility or infertility & osteoporosis etc.) or perhaps the consequence of unhealthy behaviours & other health risks (e.g. obesity, excess alcohol, chronic inflammation etc.).  The natural decline in androgen levels with ageing (so called andropause or PADAM) gets talked about a lot but when does it start (typically in the 4th decade), why does it happen (primarily due to reduced number, function & responsivity of testicular secretory cells) & how low does it go? Is it possible for men to age and not become hypogonadal in the process?  Well the answer to the last question is emphatically, ‘Yes!’ according to Australian research.  Often, however, I’m finding younger males with very low testosterone levels which require thorough investigation to determine any direct cause. When none emerge, we are left with the ‘canary in the mine’ scenario, whereby testosterone production, not considered essential for survival, will be sacrificed when the organism is ‘under threat’.  To hear more about how to comprehensively assess & interpret androgens, the real causes and consequences of low testosterone and some treatment suggestions check out the following premium audio https://rachelarthur.com.au/product-category/premium-audio/

Numb feet reveal deeper woes

Mid-40 female presents with acute onset pain in both feet and hands. Questioning reveals that she has experienced episodic numbness in her feet over the past 2 years.  Patient suspects gout but blood urate levels are normal and patient’s diet and lifestyle not ‘typical’ of the gout sufferer (high alcohol and meat intake, central adiposity etc.)


Coeliac disease presents as behavioural problems

Recently I started seeing an 8 year old girl diagnosed with ODD and ADHD as well as impaired IQ at 6yo. 

Notable features include:

  • She has variable bowel and bladder control – often coming home from school with wet pants and a Bristol type 1 stool in her underwear.  She increasingly complains of abdominal pain and an itchy bottom in spite of being ‘wormed’.  (more…)