But sadly, still not cloned!  While it may sound like Big-Brother was responsible, it was the efforts of my tremendous team responding to feedback from fans – who said things like:

I just
LOVED EVERY SINGLE MINUTE
of the MasterCourse in Diagnostics
but would love to be able find a little gem I know I’m digging for, or re-listen to a very particular section without having to
RELISTEN TO EVERY SINGLE MINUTE?
Someone with a life,
Somewhere not in lockdown

Ok I am paraphrasing, but you get the gist. So we thought, reasonable request really. With over 24hrs of core training modules plus all the bonus sessions that you get to have & to hold for the rest of your RAN’s life, even we might be out of lockdown by then and have other things to do!! And while I personally couldn’t stomach my 99th listen…I made St Sally do it 😂 This now means you can find the time-stamp from the video on the top right hand corner of your pdf copy of the notes and go, ‘Hey, that amazing animation of what’s behind increased Neutrophil counts – here I come’ & go directly there (39minutes & 21 seconds) without listening to a single extraneous, ‘you know’, ‘right?’ & ‘ummmmmmmmmmmmmmmmmm’

So, while I am already working up a serious head sweat (too much information?) working on the development of MCII which will kick off early next year…oh boy…did I just say that?!*%#@ and already getting outrageously excited about our next adventure together – we thought we’d go back and increase the value of the investment many of you have already made…and maybe entice a few others with our trail of breadcrumbs that takes you to the best treasure trove of all in our toolkit! I think this was Western Herbalist,  Penny Henderson’s experience 🤩

 

“I’ve been in practice as a herbalist for many years and have to say that your master course has been one of the most exciting, inspiring courses I’ve done for a very long time! What a ripper!  Your understanding and love of biochemistry and pathology brought it out of the too hard basket and into the sunshine for me. I can’t thank you enough. I have piles of patients blood tests on my desk as we speak which I have to say is rather daunting. Hopefully with much practise I won’t feel quite so laboriously slow!
 
Anyway thanks so much Rachel -you’re an inspiration to so very many practitioners!”

You know when you learn about a ‘new’ dis-ease driver and then you actually have to stop yourself from diagnosing every patient with it? I’ve done this dance with Gilbert’s Syndrome for over a decade, so too maybe have some of you?  And while there have been many, many occasions when I’ve been certain it’s Gilbert’s (clear robust & reproducible patterns of high bilirubin without other explanation) there are other times when I’ve been left wondering, and with questions.  Like – what about a fluctuating pattern – sometimes ‘within range’ sometimes above or at least high-normal – with no other explanation? What about the patient whose symptom-story is a perfect fit – prone to nausea, early satiety, gut issues, food reactions and anxiety all worse for increased oestrogen…but the total serum bilirubin is 14 micromoles/L? I mean, 14, right? that’s well below the top of that range, but remarkably higher than the majority of women of the same age, eating the same diet. And you ask yourself…could it…be??

It could.

The latest UU30 offering on Gilbert’s Syndrome constitutes a complete overhaul of everything we’ve previously been told about how to recognise and diagnose this polymorphism & it’s going to answer a lot of those ‘could it be’ questions we’ve all had!  Known also as familial non-haemolytic jaundice and episodic hyperbilirubinaemia under stress – is everyone with Gilbert’s prone to jaundice? Uh, no. Total bilirubin levels typically have to get to 45 micromoles/L to evoke this effect – many of our GS patients won’t ever get there, some will with increased illness or other stress and may yellow a tad (like a fading bruise), while other patients of mine routinely have a bilirubin at this level but won’t experience jaundice unless they impair their UGT further via doing what they know they shouldn’t: extreme exercise or excess alcohol. The latest deep dive into GS diagnostics 

But as much as we don’t want to miss this diagnosis we don’t want to mis-diagnose patients with it either!

Can you spot the difference?  Don’t forget total serum bilirubin levels are the net result of haem catabolism – so you need to account for rate of blood production, destruction and of course rule out any biliary dx before you can take a guess at Gilbert’s.  Oh and watch out for expected high bilirubin values in the fasting fan(atic)s!

Living on Gilbert Street

For those people living with Gilbert Syndrome at last the research world & the real one are uniting – with greater detailed documentation of how this very common polymorphism presents and the mark it may make in their health story. However, given only 1/5 with Gilbert’s syndrome actually know they have this condition, who are we missing?  This latest instalment rewrites our diagnostic criteria and corrects our past misunderstandings based on the very latest science, while shedding further light on what it’s like to live in Gilbert St.

 

If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account.
You can purchase Living on Gilbert Street here
OR become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audio’s and resources here.

Are we all just a bit prone to panic at the moment?  I received a 9pm call from my 21year old son. Trying desperately to disguise my reflexive s’mothering, I ask in a voice feigning carefree, ‘Everything ok?’ to which he replies, ‘Well, [long pause] not really…”

⚡NOT REALLY??????!!!!!!!!!!!!!!⚡

My fingers are poised to dial 000, I just know I’m not going to sleep tonight now (or possibly ever again!!) I become aware of a lot of background noise around him (?is he at hospital), my heart is in my throat as I ask, “What’s going on?!!”

“There’s no organic kale

…I mean there’s rainbow chard, but that has things in it that reduce the absorption of minerals, right, mum? But is it ok to buy just once?” 

Ok everyone exhale. He’s not in ER just the produce aisle of his local late-night supermarket and his main concern is optimising his nutrition 🙄😂 Oh and not overly relying on food delivery services because, “well that’s just depressing and I know whatever I cook is so much better’. And while he might be the scientific one of the siblings his area is oxy-fuel combustion as opposed to oxalates so he thought he’d call a friend 😅 My children have demonstrated the most incredible resilience under some trying times in their young lives of late but good to know their #kidsofnaturopaths qualities are alive & well 🥰  Now I could have kept him on the line for longer to explain all the ins and outs of oxalates and how to keep the levels low…but nah…with my heartrate returned to normal I was suddenly very ready to sleep, he can just listen to the recording😂 …and so can you!

Do You Know How To Recognise Oxalate Overload?

Oxalates are found in high concentrations in many of the ‘healthy food choices’ we promote and are even higher again, when these are organically farmed!  Given the importance of individualising therapeutic diets are we able to quickly recognise those who need to lower their level of these naturally occurring plant products? Who shouldn’t be drinking green juices?  And which of our patients might benefit from being educated about different food combinations and preparation to lower the oxalate load from these otherwise fabulous foods?

 

After our group session I suggested the low fat trial but she was ‘no, no, no….I can’t take anything more out of my diet’. It was at the beginning of lockdown & she had other stressors as well. So I asked her to be mindful of her fat intake & if one meal was higher in fat then go low fat for the rest of the day. I saw her last week & she did this & guess what her diarrhoea has dramatically improved. She is not experiencing watery diarrhoea nor the sense of urgency nor leakage.  Mostly 4, sometimes 5 on Bristol Stool. She’s now happy to trial low fat (<40g/d)”

This is the story of a 50-something female who has battled IBS-D for over 30 years. Along the way she has diligently sought the help of so many health professionals and tried numerous ‘tried and true’ IBS approaches, like FODMAPS minimisation, gluten minimisation, dairy minimisation & joy minimisation with hardly any minimisation of her symptoms!  Why? Because her loose stools and urgency were BAD. A very particular form of bile acid dysregulation that is present in almost half of IBS-D patients and responds best to low fat intake, together with a few other tricks.

And with the corresponding slowed transit time, we now can more clearly see if there are additional actual food reactions at play – without all the background BAD confounding and now  that her gut has time at last to actually correctly absorb things that she couldn’t before due to inadequate time in contact with digestive enzymes and absorptive surfaces.

Ahhhhh we love a great ending – especially one that reminds us the most powerful prescription is getting to the root cause such that we can empower patients 💪🧐 This patient and her practitioner inspired the recent Update in Under 30 on how we can all learn to recognise….

When is I.B.S. B.A.D?

This is not a trick question. Up to 50% of all patients diagnosed with IBS-D actually have bile acid diarrhoea (BAD) underpinning their digestive complaints as well as some patients with unresolving diarrhoea post-cholecystectomy and gastro.  Knowing which ones do and how to manage this, which requires distinctly different approaches from our general management of IBS, is the key.  As always, good lessons come from those we learn in the clinic and this story starts with a patient and how we came to recognise the BAD in her belly. Get this as a single download here

 

No, this is not a trick question & it’s certainly not a silly one. IBS, as many of us know, has a very loose diagnostic criteria: visceral hypersensitivity coupled with altered motility in the absence of organic disease. Hence it tends to ‘loosely’ fit a vast number of patients struggling with GIT issues. The differential diagnostic algorithm all health professionals are encouraged to use for patients presenting with GIT issues leads us to this IBS label, just as soon as we’ve excluded the red flags. But this ‘early opt out’ according to many experts, including Schiller et al in the American Journal of Gastroenterology, tends to propagate the illusion we’ve reached our diagnostic destination: practitioners stop thinking about the ‘why’ & stop looking for the real drivers & causes, which is the key to shifting the refractory patient into remission.

For those presenting with chronic diarrhoea, Bile Acid Diarrhoea (BAD) is in the diagnostic algorithm & there is strong evidence it’s at play in almost half of these patients!
It’s just that BAD, is the next station along the line after IBS-D, which means most clinicians have sadly disembarked already 🙁

Bile acids, as key biological agents, in both the behaviour & health of the gut & metabolic dx, are getting a lot of attention right now.  While Bile acid malabsorption (BAM) in disorders of the small intestine such as Crohn’s & undiagnosed or refractory Coeliac dx, as well as other miscellaneous GIT disorders that clearly disrupt the bile acid balancing act of the gut-liver axis, have been known for a long time, there’s a new kid on the gut block, previously only known as the idiot, I mean, idiopathic BAD. But us idiots have finally worked it out!  This is not about malabsorption but about excess production of bile acids and this pathophysiology is drastically over-represented in IBS-D patients.

And knowing if your IBS-D patient has a ‘BAD-thing’ going on, every researcher wants you to know, is game-changing. Explaining the strong heritability of this particular IBS subtype and the reason so many patients are refractory to standard IBS approaches.

We need to use distinctly different dietary strategies when IBS is BAD.  Once again patients are our greatest teachers & I’ve relished the excuse one practitioner and her patient gave me to deep dive into the enormous body of BAD research, that is ‘so hot right now’!  The way I look at, ask questions about and assess patients with chronic diarrhoea, especially IBS-D, is forever changed 💪🙏

When is I.B.S.  B.A.D?
This is not a trick question. Up to 50% of all patients diagnosed with IBS-D actually have bile acid diarrhoea (BAD) underpinning their digestive complaints as well as some patients with unresolving diarrhoea post-cholecystectomy and gastro.  Knowing which ones do and how to manage this, which requires distinctly different approaches from our general management of IBS, is the key.  As always, good lessons come from those we learn in the clinic and this story starts with a patient and how we came to recognise the BAD in her belly.
You can purchase When is I.B.S. B.A.D? here.
If you are an Update in Under 30 Subscriber, you will find it 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 audio’s and resources here.

I’m 100% confident that, as a professional group, among our highest values about healthy, preferable, food choices, would be characteristics like: ‘as close to nature as possible’, ‘unrefined’, ‘unprocessed’, ‘unadulterated’.  Tell me I’m wrong.

So, when I keep hearing about NEW! “Never seen before” (read: never in nature) modified (read: more processed, adulterated) nutritional supplements: water soluble vitamin D, fat soluble C, bioflavonoids with unprecedented (read unnatural) bioavailability

I’m left wondering what these companies are missing about their customer group (because we are clear about our valuing of nature & what’s natural & have a desire to minimise exposures to things that are not, right?

or what are we missing here, in the clear conflict of our core values these constitute?

I think if we find ourselves forsaking this core value & prescribing highly modified, unnatural supps, it’s the result of both hype & fear.  The hype is self-explanatory and I’ve written recently on how modifications exponentially increase profit margins for companies, all the while possibly reducing ours because patients are spending more on product and therefore there is less left over for the practitioner fees 🙁 [The ones spending hours with them face to face, not to mention years & thousands on our training]  The fear is perhaps less apparent, more insidious.  The fear is that we’re not using the best, being the most effective, and deeper still, inevitably that we will fail to action our patients return to health. This is a big one. I think it’s pervasive, if not omnipresent, and works as a motivator for many positive actions by practitioners – like engaging in further education, reading that latest journal edition on your lonesome laptop when you could be streaming some series on a shared sofa. But this same fear can also undermine us, overwhelm us and shake our tree of trust, that we believe to be so firmly rooted within us, of the healing power of nature.

So while my position sometimes makes me feel very ‘old school’, I’m not suggesting we return to nutritional prescriptions composed exclusively of bee pollen & brewer’s yeast and I absolutely recognise and respond to an individual who has very specific barriers to benefiting from nutrients in their natural normal forms.
But let’s be clear, they are a minority.

Some of you will know naturopath Dawn Whitten & know that she is one of my mentors.  I’ve had the benefit of speaking with her over the years about herbal prescriptions but also about the principles & philosophy behind our practice & in one of many conversations she told me that a key objective she has with her patients is to rebuild their trust in their body, their own biological resilience (I love this concept and that’s a talk for another time!) and ultimately in nature. Well jeepers Dawn – how did you get to be so wise so young?  But isn’t that central to vis medicatrix naturae? Maybe that Naturopathic Nanna’s club isn’t so fuddy-duddy after all.  Want to join us?

Speaking of using nutrients in their most natural state for the best health outcomes – the best B3 is probably not what you think!!….
The Balance of B3

Most of us have been taught to ‘balance the Bs’ when supplementing, which discourages the use of single B vitamins in case this interferes with the regulation and roles of others. In reality, outside of a couple of dynamic duos like B12 and folate, there is little concrete information & evidence of this. In the case specifically of B3, however, we now know, the risk of an excess of the most common B3 forms found in supplements and fortified foods, results not only in disruption of other nutrients but imbalanced B3 biochemistry itself. Given B3, in its coenzyme form NAD+, is regarded as highly valued currency in the prevention of many diseases, as well as the key to our optimal health and longevity, it’s critical to understand the different forms and functions of the various B3 sources.

 

 

Maybe it’s tax-time, just my wintery whinge or a tirade triggered by missing my twins’ 21st birthday due to border restrictions 😶 but I’m sorry for all the shouting of late…about interpreting iron studies, about the copper misinformed etc etc. and my gorgeous new grad mentees copped a full monologue, with links to articles, recordings & the Coeliac Society, when they asked me to expand on why we must exclude coeliac disease before removing gluten from anyone’s diet.  I was so glad they asked though!  I’m now using my inside voice.  

But I don’t want my message to be misdirected and I fear it might be.
It’s not you and it’s not me

‘We’ are doing our best.  We are working in a field that demands us to be across soooooo many domains of knowledge and information, from the basic & not-so-basic medical sciences, to pathology interpretation, nutrition, herbal medicine and beyond.  It’s a lot.  None of us are across it all. I’m certainly not.  And I’m aware, that the frustration I feel at others’ misunderstandings sometimes is unfair, because I’ve benefited from excellent early teachers all the way through to having a job now, that keeps my head in the research daily. And even still, without a doubt, the gaps & shortfalls I observe and criticise in others, I could have made of myself, earlier in my career. We don’t know what we don’t know, until we know better, right.

It’s them

Who is this ‘them’ of which I speak? Well, 25 years ago when I completed my under-graduate (and walked 10 miles to school in the rain, without shoes or breakfast 👵) I believe I received the training required to be the naturopath that I needed to be. Safe, effective, knowing my scope – which was basically coughs. colds, atopy and risk mitigation for future chronic disease.  I never saw a lab test during my under-grad. I would have read a set of iron studies badly and something like ELFTs, like it was Latin. I wasn’t made aware by my lecturers of the critical part I could play in my patients’ lives, either by advocating and advancing correct diagnosis or by obscuring, confounding and delaying it (sorry, still thinking about the gluten debate!).  But back then, I think this was appropriate for the time, the state of play of our collective medical knowledge and for the role naturopaths were playing in the health landscape. Not any more.

If you haven’t had a chance to read the extensive research about ‘us’ (Australian nats, nuts & herbalists) published of late,  who we are, what we do, how we are viewed and what our patients expect, then you could be in for a surprise.

We’re perceived by many, if not most, of our patients to be a primary health care provider – either flying solo or co-piloting with the patient’s GP (& no auto-pilot function!!!) and as clinicians for chronic comorbid cases not the acute cold. My how times have changed and the question is – has the knowledge and level of competency of those in educational roles & the quality of what they deliver a good fit? Sorry, but if the majority of a large new graduate cohort have left their training with a mantra of ‘we must not diagnose’ and INTSEAD are likely to advocate a gluten free diet RATHER THAN Coeliac testing with the patients doctor first – then we’re falling at the first: Primum non nocere. Sorry,I forgot, inside voice 🙄🤐

Closing the Gap on Coeliac

This Update in Under 30 recording speaks to the seriousness and primacy of identifying Coeliac Disease in any patient reporting a suspected reaction to gluten and takes you through the latest evidence on the best screening protocol.  With an increased understanding about the strengths and limitations of gene testing, serology and biopsy, we have a clear map to follow now.  Along the way Rachel outlines 3 additional potential mechanisms for ‘gluten’ reactions amongst our patients, what to look for and how to tell the difference. 

I haven’t personally seen every medical condition known to occur, nor every micronutrient deficiency  & toxicity picture in the flesh but that doesn’t mean I doubt their very existence.  Sadly, it would seem some practitioners due to a) not knowing ‘where’ to look in terms of best assessment medium and/or b) not knowing ‘what’ they’re looking at, when faced with an actual Copper deficiency, have declared this uncommon, but certainly not unknown, nutritional issue to be a figment of others’ imagination!

I know I’ve been fortunate to see more labs than most would want to in an entire lifetime , a collection of my own, my student’s & my mentee’s patients, so let me share just 3 sets of results from 3 different individuals: an 11Y boy, a male teenage athlete and a female in her early 20s with an eating disorder, all with Copper deficiency.

Don’t worry, I have more – just ask.  What’s so dangerous about people spreading myths and misinformation in relation to copper in kids and teenagers specifically, is it shows complete disregard or ignorance of an understanding of how Copper is critical for development during these life-stages and how regardless of which developed country you live in Copper is expected to dominant over Zinc in blood, especially pre-puberty.

AM I SHOUTING???!!!

I’m sorry it’s just that my blood tends to hit boiling when exposed to the misinformed, misinforming others…
and that can make one call out in pain 🤯

You see, I literally heard a practitioner in an “educational” webinar purport that
‘Copper Toxicity is so prevalent in kids in her clinic’ and I was like,
OH.        EM.      GEEE.

Because if you start with that misunderstanding, and are unclear about what constitutes an accurate Copper assessment and how to recognise the pattern that follows low serum levels (each of these patients above had abnormalities in their FBE consistent with Copper deficiency) you are not only going to miss the thing you need to make a priority to fix, you’re going to make it worse!  Take ‘Volatile Vince’ the gorgeous sensitive 11Y boy I saw, whose increasing mood volatility had been misattributed to pyrroles and given large doses of Zinc!  So, Copper Crimes are a thing.  Guilty until proven innocent but in fact, never found innocent by some practitioners it would seem.  The ramifications of unchecked Copper deficiency include negative effects on mood and cognition, immunity, and the balance of other nutrients and kids are going to feel this impact the most!  What are the causes? Inadequate intake being uncommon outside of eating disorders, and excessive Zinc rarely the cause, we’re likely looking at a marker of malabsorption or a genetic issue.  Don’t buy into the confirmatory bias many use when they choose which research to read (risk of excess) and which to ignore (Copper as an essential mineral, critical to kids)  and let’s not discredit something as not being a thing because we haven’t seen it ourselves, yet, hey, anyway, at least, now we all have, right?!😵🥴😆

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.

 

Name a B vitamin. Hey, Bingo! It’s on the list!   What list? The complete one from all the review papers & references to possible links between individual nutrient deficiencies & Angular Cheilitis – inflammation & cracking at the corners of the mouth. So does that mean more Bs are the answer for people presenting with this painful, recurring issue?…Ahhhhhh No.  Yes, you heard me correctly, these deficiencies rarely cause the breakdown of the integrity of this very specific area of skin in the patients we see.   So now we have a double ouch, right?

We might send patients away with a B complex and some lip balm and over a week the cheilitis resolves – which one was the most therapeutic?
…I hate to tell you 👀

What is the underpinning cause(s) & the important message we are missing with this presentation?  Well, it could be one or more of a long LONG list of differentials, ranging from anatomical, habitual, immune related to iatrogenic. And while many nutrient deficiency pictures can include this feature and therefore make the ‘possible’ list, only one makes the ‘probable’ list. And that’s iron but only in severe deficiency, aka anaemia and only affecting 1 in 5.

Me???
…Telling anyone to push the nutritional issues further down the list of differentials for any condition?
Well, that’s unexpected
…possibly unprecedented

And no, antifungals aren’t the answer either. Yep, that might be worth a listen….👂

 

Just an annoying, embarrassing, cosmetic condition or could it be the clue that helps you ‘crack the case’?  There is a surprisingly long list of differentials for this condition but most of us only know a few, reflexively reaching for either B vitamins or anti-fungal creams. Does either make sense?  Does either address the cause(s) which we now recognise to be a unique series of risk factors in each individual?  Or are we at risk of shooting the messenger and missing the message of Cracking Corners altogether?
You can purchase Cracking in the Corners – Angular Cheilitis here.
If you are an Update in Under 30 Subscriber, you will find it 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 audio’s and resources here.

I’m a fluoro gal myself.  I take copious notes the old school way, on paper with pen and vast swathes of highlighted sections….I deface research articles much the same way. [And resist drawing moustaches on author pics😆] so I LOVE Ang’s hot tip with her hot tab system in her GIANT exercise book, that she filled (yes FILLED) with notes from our MasterCourse in Comprehensive Diagnostics last year.  Angela Haldane was one of many  people I saw firsthand making the absolute most of the course, applying something we’d just learned immediately in her patients and being rewarded with results 🤩

And now with another ‘EOFY- Lockdown-Cocktail’ upon us, maybe we can put our time to good use with 6 wks of intensive learning & up-skilling that will pop you out the other side of this – with a whole new skillset for patient work-up, prescription development, effective, objective monitoring of treatment & a common ground for us to walk, when we’re communicating about patients, with their GPs.


And there’s just just a week to go til 🐱‍🏍

And whether you’re a Onenote Wonder, a Diagram Diva, or anything outside of a savant, Good News!!!  We are in the process of ‘time-stamping’ these MasterCourse recordings.  That means that whether you have the recordings already, or purchase them in the future as a DIY package or, jump in now while you still have a chance and attend our Weekly Live Watch–Party that kicks off on the 8th Julyover the coming months we will be adding in time-stamps or bookmarks on your powerpoint notes, a la Angela tab style!  This means that you can more easily go back to a particular section of any presentation in the video and find the spot you need to rewatch.  This development was off the back of some lovely feedback we received from a package purchaser, who requested this, or even transcripts….yeah about transcripts…Some of these sessions go for 4 hrs and I speak on average a million words a minute (sligexaggerationion) and we still don’t have software that can understand my accent apparently 🙄  But we know this is going to make life a lot easier for you all because we hear from so many, they have these recordings on high rotation 🤩

This MasterCourse in Diagnostics is a goldmine of information and, as always, we’ll keep working on ways to help you reap even more from your investment! 

Come Dine Out On Diagnostics With Me – Every Thursday Afternoon-Evening!!

Starts on 8 July 2021 at 3.30pm AEST
Every Thursday for 6 weeks.
Each session starts with video presentation
Plus each session has LIVE Q&A with Rachel Arthur

You get to keep the 24+ hours of video presentations in your online account to watch anytime in the future. Bonus video presentations, audio, notes and resources as well. Live Q&A’s will not be recorded.

While many of us have made it our business to ensure we are competent IN the business of understanding patients’ iron studies, it sadly seems, many even in teaching and training positions, still have not 🙁  I was sent 2 messages this week that had me lost for words (other than expletives).  The first, an email from a final year nat in student clinic with the subject: Please tell me I’m not crazy!!

“Fasted male with high ferritin & high-normal transferrin saturation at two time points, with constantly raised Liver enzymes & neurological Sx. He is currently being treated for blasto in student clinic because they think the high ferritin comes from “blasto infection!!!
He needs to be checked for an HFE mutation, right??”

Ok so high ferritin because of ‘blasto’ is NOT A THING! And on the HFE front…Correct! I ask, “Have you mentioned this to the supervisor?  What do they say?” Student’s reply, “They say HFE mutations are uncommon so, in  a word, it’s not it. But THANK YOU!!!!!!!!!!!!!!!!!!!!! I feel sane again” So, what do I do? The student is studying at a leading institution, one that has sought advice and input from me in the past regarding their diagnostics curriculum, but it would seem, the clinicians they allow to supervise our precious next gen of nats are not expected to be even as competent as the students themselves. Danger Will Robinson! Danger! [old tv show reference…apologies, young folk!] I’ve [not] recovered from this when I get hit with the old 1-2! A naturopath messages me with a screenshot of a FB group exchange over a set of iron results: Ferritin over 400 but low serum iron and transferrin saturation values…which another health professional, who offers training to naturopaths, says is ‘Iron Deficiency’

Email says, “Please help me, I’ve worked so hard to understand iron studies and this has just CONFUSED THE #@*^ out of me!” 

Again someone who would typically defer to the voice of authority here, fortunately knows enough to know to question this (mis)interpretation.

I tell you…you may have thought that when I previously wished for all health professionals to be competent in reading studies…but it’s actually a big ask, it would seem 🤔  Could we just, as a start, get anyone who professes to teach, train or mentor health professionals, to actually get up to speed on this themselves or…keep their mouths 🤐

No wonder our “So You Think You Know How To Read Iron Studies” is in our top 3 downloaded resources!!!

Overt Iron Deficiency Anaemia or Haemochromatosis aside…do you understand the critical insights markers like transferrin and its saturation reveal about your patients iron status?  Most practitioners don’t and as a result give iron when they shouldn’t and fail to sometimes when they should.  This audio complete with an amazing cheat sheet for interpreting your patients Iron Study results will sharpen your skills around iron assessment, enabling you to recognise the real story of your patients’ relationship with iron.

Or better yet, go the whole hog, with our Iron Package

 

Last week I had my say about acknowledging our elders & mentors, this week I want to speak to the power of the young peeps.  Just like a younger sibling, nipping at your heels can act as a great motivator to move faster, or having children can inspire us to do more to improve the ‘world’ we’re welcoming them into, my interactions with naturopaths, nutritionists & herbalists of the younger generations generally effect both responses in me! The best of these come from cluey ‘youngsters’ (mature-age-second-career-new-nats included!!) who ask the most difficult questions & show dogged determination in getting answers to these either via me or in spite of! 

This is exactly what’s been in play over the last few years (yes, you heard me…years) while I’ve been under the watchful gaze of Jostling Josh Weymouth! He’s a youngun’ – it’s all relative right – who has kept us both on the straight and narrow writing: The accuracy and interpretation of plasma selenium in our patients: a literature review, which has just been published in the the Australian Journal of Herbal & Naturopathic Medicine.

At the outset I was able to hand over a substantial selenium research hoard I had obsessively compiled, Josh was able to build on this, refine some fledgling theories I had and then completely redefine my appreciation & understanding of how chronic over-treatment (not toxicity…) is so deleterious to human health.  Check this out:

When Selenium (Se) saturation point occurs in plasma, there is a potential reduction in health protection… Se will progressively pool within plasma non-specifically as SeMet in lieu of regular, sulphur containing methionine, in albumin and other proteins…inducing oxidative stress via a complex disruption of cell reactions/signalling
This is likely to be how Selenium over-treatment increases the risk of both CVD and T2DM

Many of you may ‘Know Your Numbers’ when it comes to Serum Se targets in thyroid health or just generally know how to Stay Safe with Selenium Supplementation because I’ve spoken extensively about these in the past and you will be relieved to know neither my ‘numbers nor my message’ have changed BUT I encourage everyone to read this new article because Josh has added so much more, including the interplay between our microbiota and our individual selenium needs, handling and tolerance and and and….I could go on but…what I really want to say is, thanks Josh for your academic rigor, your firm determination & diligence and for nipping at my heels all this time. This important piece of work just wouldn’t have happened without it 🐶

 

I stand on the shoulders of my elders.  [I hope it’s not too painful for them, it’s been going on a long time now!!]  And I regularly lean on my mentors – who are often my peers, practitioners specialising in areas different from mine.  I recite their names often like a little mantra in our mentoring sessions: Kate Worsfold, Dawn Whitten, Tini Gruner, Michael Hayter, Jason Hawrelak and a few others that are on high rotation like ‘Rhiannon-repro’ Hardingham and I feel this is important to reaffirm that learning is lifelong for us all and to make clear the passing on and around of knowledge in our profession.  There’s been a long history of honouring our history, so to speak, in naturopathy.

My training definitely acknowledged, paid homage to & revered elders past and present & while I’ve never been one to participate in the making of herbal preps by a full moon, at solstice, in a field somewhere, in the company of said herbal elders (you know who you are!!)…

I do try to continue & foster this important collegiate quality of our professional community by reciting the names of the saints source of clinical pearls I have been given so generously by others.  

Lately, I’ve been wondering if we’re losing this tradition. I’m hearing practitioners present concepts as ‘theirs’, ‘develop’ & distribute teaching tools ‘adapted’ from others work, parrot identical ‘catch-cries’ even, with no mention of the origin, the source – even the inspiration.  Now perhaps I am showing my age, reflecting a very different time in naturopathic training when we were so fortunate to be taught by some of these amazing (solstice honouring, field dwelling, herbal making) elders, but even by today’s standards and the dominant EBM model, surely every emerging clinician understands the need to cite their sources?

The green tea & lactulose intravaginal wash recipe I use and frequently share with mentees always comes with the prelude – “I got this from Gould’s”
The tips on testing tools in mental health, I propagate like mad, has the epilogue – “All that I know, is because Kate taught me so!” 

Of course I say more than I cite (otherwise the sessions would be impenetrable!) but I like the way it helps us all to see we are a part of something bigger.

 

Cortisol – Have You Been Caught Out?

I have!  And just recently a stark contrast between the results from 2 different methods of cortisol capture in the same patient illustrated just how likely this is. How do we ‘capture’ something so ‘dynamic’ and  interpret anything of substance from a ‘static’ assessment technique?   But rather than throw up our hands and throw out the whole attempt to measure cortisol, we can improve the rigor, reliability and real-world meaningfulness of our patients’ results by refining our timing of tests, choosing the medium wisely & manipulating test conditions to answer specific questions about their HPA function.  Great ready reference resource included! 

If you’re already an Update in Under 30 Subscriber – go directly to your Active Content…it’s already there!
If you’re not and want to improve the accuracy of your Cortisol Capture in patients go
here!

What’s your knee-jerk response to 52Y Lipids Lucy & Liver, whose ALT & AST suddenly jumped above range when she was put on statins?  They’re damaging her liver?  You’d be wrong.  One of the practitioners who undertook the MasterCourse in Comprehensive Diagnostics just graduated with flying colours when she was able to correctly identify the true cause of this patient’s LFT abnormalities, can you? 

[Cheeky hint: there is more than one explanation/process at play]

This naturopath now knows her pathology patterns.  She knows the interpretation of any liver enzyme must also take into account the movement in other markers, to make meaning of the whole.  Because so-called ‘liver enzymes’ are never exclusive to the liver.  They are expressed in multiple other tissues and organs – sometimes at equal concentrations to their liver-level (e.g. ALP and bone). For some, even referring to them as a ‘liver enzyme’ is a mislabelling of sorts, with minimal expression in the liver itself compared with ubiquitous distribution all over the body (e.g. GGT & LDH).  Of course this is both a blessing and a curse.  A curse if you make the mistake of only interpreting their levels through a ‘liver lens’…a blessing if you know when they are flagging problems elsewhere through the specific pattern recognition.  So back to Lucy – the statins had induced a rhabdomyolysis not hepatocellular damage. The clues?  Significant AST dominance over ALT, above range CK and LDH.

So if the statins weren’t causing increased hepatocellular damage what is that increasingly high-normal ALP pattern all about?

Bones. And again, this practitioner picked it.  And then got to win herself some pretty BIG credit and credibility points with all the other health professionals sharing care of this patient by suggesting that they clarify and confirm this by referring her for an ALP bone isoenzyme assay, which answers the question: is the elevated ALP originating from the liver, the intestines or from the bone? Bingo, bones it is!  Or was, because this practitioner was able to alert not only the patient but all the other practitioners treating her to the increased bone remodelling taking place, independent of the statin reaction, but part of her perimenopause. Left unchecked this would escalate further of course at menopause and leave her bones in bad shape. This is just one illustration of how we can show ourselves the be the incredible one we are on the shared-care team. 

Being lab literate and pathology proficient, sets you apart from the rest and enables you to practice truly preventative medicine.
How else would we have known she was experiencing increased BMD loss that may be the start of something truly tragic?

 

Realise the true value you can extract from the most commonly performed labs.
Join Rachel Arthur LIVE on the MasterCourse I: Comprehensive Diagnostics WATCH PARTY
This skill is the biggest ‘game-changer’ in Integrative Medicine!
Want to know more? Head over to my website here and check out more of the great benefits and bonuses of joining this program
This course is a fantastic learning opportunity to identify the many intricacies in cases that have previously been missed.

The average woman & her dog (& likely every other member of her household, be they furred or otherwise), can tell you that sudden changes in sex hormones can undermine, derange, psychopathise, impact her mind and mood.  Hey, for me most days reverse parking is my mild super power, the envy of all, but on day 26 of my menstrual cycle, I can struggle with a ‘nose-to-kerb’! But if we are quick to attribute this to the fluctuating sex hormones produced by our ovaries, alone, we’d be making a mistake.  A portion of these peripheral steroids do cross the BBB and act in our brain, so changes to these levels during any kind of transition: follicular to luteal, pregnant to post-partum, menstruating to menopausal, early adulthood to andropause, will be ‘felt’ but the sex (hormones) we have on our brains at any given time, are far more abundant, potent and complex than this, thanks to the brain’s ability to make its own.

So in fact, the amount of sex hormones active in the brain represent an intersection between peripheral and central steroidogenesis. 
These Neurosteroids, made ‘on site’, are as much produced in response to our mood, our neurobiology, our psychological and environmental stress, to help us navigate these, as they are the creators of mood itself.

Yes, these particular sex hormones, due to their actions in our brain, belong to that growing list of CNS celebrities: the Non-Classical Neuromodulators.  Which, for the otherwise neurotransmitter-centric & obsessed among us (that’s everyone), makes mental health and illness much more complex than ‘serotonin deficiency’ or ‘glutamate excess’ and a whole lot more real.  We now need to consider other entities like: ‘suboptimal LDLs’, 5 alpha reductase over or under-expression & ‘xs inhibitory tone via progesterone’.

The ‘sex on the brain’ of any patient therefore is impacted by both their Endocrine (ovaries, testes, adrenals) and Synaptocrine (neural) contributions – and these demonstrate some shared dependence (for cholesterol & healthy mitochondria etc) and independence.

We all know the depressing stats in support of the ‘ovarian withdrawal hypothesis’ and the risk to women’s mental health with each reproductive transition, and also in andropause in men, but the time has come to now deepen our understanding and to recognise  we can have an imbalance of ‘sex’ on the brain – regardless of the ‘balance’ we might see in the periphery and put our thinking caps on about the options we have to address steroidogenesis either side of the blood brain barrier.

When it comes to a modern take on how sex hormones impact both the structure & function of our CNS, we need to blend the ‘old’ with the ‘new’.  The ‘old’ tells us, production of sex hormones is in the gonads and action at a distant target anywhere else in the body, including our brain. And the ‘new’ is in the form of the ‘Synaptocrine’ – where production of these sex steroids is actually within neural tissue itself and their immediate actions occur close-by, in the synpase and at the post-synaptic neuronal membrane. These two contributive pathways show some shared dependence but also independence from one another and the balance of both has now been recognised to be integral to the overall health of the nervous system.
You can purchase Sex (Hormones) On The Brain here.
If you are an Update in Under 30 Subscriber, you will find it 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 audio’s and resources here.

 

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.

Just like Kevin, ‘Niacin’ is profoundly misunderstood and consequently runs the risk of doing us harm. Unlike ‘Kevin’, we can’t watch the movie to see how this (our arguably excessive use of the wrong forms of B3 in supplements and fortified foods) is all going to play out, so that we can be suitably alarmed and start making some different choices. The risks that follow from our B3 ignorance are twofold:

One comes essentially from our gross under-estimation of this B vitamin – we’re stuck in the Pellagra Paradigm, believing that prevention of the 4 D’s is confirmation of adequacy.

The second, is our lack of discernment when it comes to the different forms or precursors of B3 & our unfamiliarity with their very specific physiological roles – good and bad.

In this regard we’re all likely to say, ‘Well back up there 1 second, we do know that Niacin (aka nicotinic acid) is different from the other forms!’  Producing flushing, yes.  Used as a lipid lowering agent in pharmacological doses, yes. But can you tell me, which serious concerns and biochemical disruption is shared between both gram doses of niacin and everyday ‘routine’ mg doses of niacinamide? Yep, that one, the so-called ‘safe’ one. Better still, can we all list the various B3 forms in order from most to least potent, in regard to their capacity for NAD+ promotion in the human body? 

Because this is now the definition of B3 ‘adequacy’ or ‘optimisation’ according to modern scientific understanding & it is a long long way from the absence of  Diarrhoea, Dermatitis, Dementia and Death!

In fact, the boosting and optimisation of NAD+ pools in the human body is key to life – a long and healthy one according to the current research consensus – and its depletion is akin to ‘death’, or a faster one, anyway.  From increased metabolic disorders, mitochondrial dysfunction, impaired gene stability (cancer, infertility etc) and higher rates of neurodegenerative disorders, just to start, these take up the lion’s share of our chronic health burden and battle that currently dominates the dis-ease landscape. And more niacinamide might just make that worse. 

I didn’t mean to to alarm you. I am alarmed.  Want to deep dive into this yourself?  Start with this older but still brilliant review article by Bogan & Brenner.  Want me to hold your hand while we jump off the high platform diving board together into this vastly different and powerful new understanding of B3?  Let’s do it!

The Balance of B3

Most of us have been taught to ‘balance the Bs’ when supplementing, which discourages the use of single B vitamins in case this interferes with the regulation and roles of others. In reality, outside of a couple of dynamic duos like B12 and folate, there is little concrete information & evidence of this. In the case specifically of B3, however, we now know, the risk of an excess of the most common B3 forms found in supplements and fortified foods, results not only in disruption of other nutrients but imbalanced B3 biochemistry itself. Given B3, in its coenzyme form NAD+, is regarded as highly valued currency in the prevention of many diseases, as well as the key to our optimal health and longevity, it’s critical to understand the different forms and functions of the various B3 sources.

 

You can purchase The Balance of B3 here.
If you are an Update in Under 30 Subscriber, you will find it 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 audio’s and resources here.

‘Hey Alexa, What’s that formula for correcting urinary iodine for hydration status?’
Oh yes, if only she could answer these kind of questions!

There’s no one here by that name but we get these kind of emails all the time [Oh and also for Freya who hasn’t worked here in like 5 years!!😂]  But we love them because it means our blogs provide useful, sought after and (we like to think!) really really hard to get anywhere else answers . But hey try it, Ask Siri!  We’re always forthcoming with references – not just citations but the full low down and dirty full texts (as long as we’ve managed to get our hands on it!!) and we know which topics particularly hit a spot across our professional group by not just the number of enquiries but how far the actual blog they’re referring to, dates back.  So we’ve just received more comms regarding one that’s often on high rotation…a post I wrote on urinary Iodine Assessment & how and why we should adjust for hydration!  That was 2014…what a vintage 🤩 Show’s though how topical and tricky this little test is. 

So I dove back into the musty archives (no seriously we don’t use parchment) and thought it might be good to create a central source for all things Iodine…because…well there’s a LOT!
If you haven’t read the original post on the iodine creatinine correction – the fun starts HERE!
We named names (the companies that did correct for creatine and those that didn’t) – way back in 2015
We told you companies may change their reporting style but there’s one easy way to tell if the correction for hydration has been done for your patient’s results
I clarified, the Pitfalls of (so-called) Patch Testing for Iodine Status
And we linked you to my Free-for-all-FxMed talk on the Intricacies of Iodine – which discussed assessment & so much more!

Then there’s iodine and breast pain, iodine and sub-fertility & & &…& [ahem] turns out I perhaps have been a little Iodine Infatuated.  But you know, it’s still 100% warranted, right?  I mean here’s that latest Newsflash post Australia’s ‘genius’ bread fortification: Women Remain at Risk of Iodine Deficiency during Pregnancy: The Importance of Iodine Supplementation before Conception and Throughout Gestation. Oops, Britney style, I think I just did it again! Oh and don’t forget our website does have a search function – top right 😉

Iodine Deficiency, Toxicity & Treatment – Where are we now?

The iodine landscape has undergone radical change recently.  We’ve moved from recognising the resurfacing of a widespread deficiency, to large-scale food fortification that has failed to correct deficiency in most and produced excesses in a few. Parallel to this, we have the ever growing incidence of thyroid disorders and some radically contrasting ideas regarding iodine’s role in both aetiology and treatment.  Micrograms V milligrams?  Random urinary iodine or iodine loading test? Important new evidence and clinical experience helps us understand more about how to accurately assess patients’ need for iodine and know when & how to use it therapeutically & when not to!

When I was 12 tartan was in.  Like, really in.  And I rode that tartan wave as far as it could go, arguably beyond where it should go…I had a tartan bowtie I wore. 🙄 I knew it was on trend because I saw it flashed across magazine covers (we never bought them so I couldn’t tell you what was inside!), my pop icons wore it and many of my fellow grad sixers had various tartan clothing items and accessories. It was a real overload for the eyes when we congregated together as a group of girls, on the town in our tartan, I am sure. All I can say is, thank goodness, we didn’t have the internet and socials. Why? Because it would have been far worse. Because now we have constant comparison to others, an acute awareness of daily dizzying escalation of things ‘trending’ and ultimately, in spite of these aesthetics perhaps originating from something original- ultimately perpetuating a loss of originality and distinction across those that ‘follow’ and ‘watch’ and ‘aspire’. I would have been a true follower and done worse than even my bowtie.

I feel so privileged to be a mentor to the next gen of naturopaths, nutritionists and herbalists and I worry about how this aspect is impacting them, their sense of themselves, the sense of who clients ‘want’ or ‘expect’ them to be and present.

Are you seeing what I’m seeing?  When I look at websites of many early-career practitioners I’m struck by their ‘sameness’.  Lots of white space background offsetting particular on-trend fonts, extraordinary high quality ‘visual food porn’ (there I said it!)  and of course lots of smiling, beautiful, young women often wearing linen (hardly a man in sight btw… hmmmmmm).  It’s me and the tartan all over again.  But at least I wasn’t trying to run a business that is based on communicating that I and the service I offer is accessible, relatable and inclusive, to any potential patients that happen to have found their way to my website! Older women, men, LGBTQIA+ individuals, people of different cultural backgrounds, or those with a disability.  Let alone, just people with minimal or zero interest, confidence or competency in cooking!  That includes me. When I look at some of these pages I instantly go, ‘No, not interested’, because it appears the path to health with this practitioner necessitates making vegan miso brownies decorated with rose petals and, you know what, I choose to spend my time doing other things! Brutal, but honest. We also need to remember that if we are reducing ourselves to pretty pictures and creators of healthy food we may distance ourselves further from other modalities and we may also limit people’s (patients and practitioners) understanding of how we work and what we offer. Now, of course, there will be plenty of patients to whom these same aesthetics appeal greatly.

But I have 3 questions we should all ask ourselves semi-regularly about our online presence:
1. Does this appeal to a large enough group of individuals to sustain a business?
2. Are the same individuals who ‘like’ & ‘follow’ your Insta stories also likely to pay to engage in a therapeutic relationship? Or are they there for the free *Insta Inspa* (aka inspiration)?
3. What are we communicating to potential and existing patients about what it takes to be healthy? An abundance of time, good genes, looks & money for all those ingredients & gorgeous clothes?

With Erica Mcintyre and colleagues survey mapping patterns of engagement with nats & herbalists, from the largest to date nationally representative sample of the Australian population, revealing that men and women were equally likely to have seen a naturopath or herbalist in the past 12mo and that,  approx only 1/4 of our patients come for ‘wellness’, without any chronic health condition, while a striking 16% present with 5 or more chronic health diagnoses, I wonder if we all need to rethink who we want & need to appeal and ‘speak’ to. Having had a wonderful conversation with Gill Stannard Naturopath & Mentor in preparation for my mentoring of New Grads this year, bouncing this and many more topics between us, I feel there is a need for us all to regularly reflect on our ‘messaging’, no matter what the medium,  not just as individual practitioners and business owners but as a bigger professional group.  I’m going to start campaigning to ‘bring back the tartan’, who’s with me? 

The MasterCourse in Comprehensive Diagnostics I is finally here as a self-paced learning program you can undertake yourself.  We know you’ll get as much out of it as those who attended live:

“I thought my pathology skills were pretty up there until I did Rachel’s Diagnostic MasterCourse! 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.”
– Rohan Smith | Clinical Nutritionist

MasterCourse 1: Comprehensive Diagnostics is a self-paced online program
Gives you access to 24+ hours of streamed video presentations2 x Bonus Update in Under 30 episodes (The Calcium Conspiracy & Using Urea to Creatinine Values for Protein Adequacy) PLUS resources, a template and pdfs of all presentations. This package includes $200 worth of bonus material and remains forever in your online account. You will also receive access to any future updates of resources and our template. More information can be found here.

Please note completion of MC I is a pre-requisite for MasterCourse II that will be delivered live in the second half of 2021.

 

 

Don’t know why on earth I would be discussing ‘Glassing’? I have a hunch.  I was supposed to be doing a deep dive into Taurine & Glycine & their CNS effects for the latest Update in Under 30 and due to a technical glitch we produced a software generated transcript from my first attempt at the audio recording. We’ve never done this before and it seems to suggest, I have an accent and I’m a little mortified.  I wasn’t under some delusion that my utterance was universal…my speech narrows my origins to certainly the ‘bottom of the globe’, but, ‘Strewth Sheila, how does any of yous guys understand me??!’

So we’re giving away 3 free copies of this recording to the first 3 individuals who can correctly translate the following from that transcript!:

“In fact, if we go back to their chemistry, you might recall that Glassing, well I refer to it as the naked amino acid. It refers to the fact that Glassing is the amino acid in its most stripped back form. It actually doesn’t have a side chain, which of course all other aminos do.  So therefore it doesn’t have eyes and ears. It doesn’t have an Alan O’Day form.”
🥴😵😬

What?!  Yes it took me a while to work it out…and I WAS THE PERSON IT WAS QUOTING!! So while I am currently using a medium released from my regional rhino-challenged speech, let me tell you why I am right into ‘Glassing’ as CNS support and as a sleep aid for many patients. Ever listen to the long list of enviable actions Melatonin has on the brain and think…’gee I wish we had something that wasn’t a hormone that could do that?’…hello Glassing, I mean Glycine. SCN sensitising, circadian entrainment, sleep architecture improvement without being a sedative or hypnotic…just to name a few.  And guess what?  The overlap between these two even extends to their behaviour within the upper GIT!  Both of course being shown to be helpful in aiding the healing and recovery of function and integrity in the stomach.  What else dose it do and how can we use it to its fullest benefit? The answers are in our latest instalment,  A Fresh Look: Taurine & Glycine In The CNS.

And you’ll be pleased to know, the transcript experience has certainly got me paying more attention to my enunciation than ever before. So you’ll understand every word!

Maybe my parents really were just being kind when they said, ‘Everyone sent their kids to elocution lessons back then, it wasn’t because we thought you specifically needed help” 🤣😂

Both taurine & glycine have a claim-to-fame as amino acids that effectively calm an over-revving brain, via their net inhibitory actions within the CNS.  They achieve this via different means and while in some circumstances, one, either or both will is the result of differences in the regulation of their BBB transfer, pharmacokinetics, as well as add-on benefits or detractors, unique to each.  Learn how to use both of these powerful and affordable mood-modulators, to their fullest, and be more able to know ‘which one when’, by listening to this latest narrative review.

The latest Update in Under 30 has landed!!!

You can purchase Take A Fresh Look: Taurine & Glycine in the CNS here.
If you are an Update in Under 30 Subscriber, you will find it 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.