Hear Hear…on all levels, right. But this is actually the first recommendation of an easy to read patient resource for families dealing with adolescent depression, that you and your patients can access here.  As lovely as the picture above makes parenting look, the one to one (or even 2 to 1) ratio isn’t realistic or necessarily optimal for anyone. I think we can all make a great addition to any parent’s team, especially given the emphasis these recommendations place on nutrition, sleep and exercise as being central to improving mental health…full-stop..and in this age group.

But while some things are the same between depressed adolescent and adults, there are important differences we need to be aware of: like the best assessment tools and the barriers for teenagers (and parents) in admitting there is an issue.  Think, parent guilt and over-attribution, standing defiantly on the top rung of that ladder!

They also mention different types of therapy for this age-group and I have to say the old CBT…oh yes it gets wheeled out yet again…really does offer something, given the kind of kids I’ve seen this work a treat on.  This is a developmental staged characterised by curiosity and a desire to understand more about the real stuff of life…rather than the soft focus lens we got them to look through in primary school.  I’ve seen teenagers benefit enormously from sitting with a good psychologist or GP who can explain the ‘brain mechanics’ of depression, or anxiety (amygdala activation that sends the frontal lobe executive control offline etc). They love the demystification and, in the best cases, feel re-empowered by this knowledge.  Not perfect for every teenage but it does work for many.  And then there’s the parental advice to discuss suicidal ideation.

Yes parents, even more than practitioners, fear the ‘planting of seeds’ when contemplating this topic with their teens but the opposite is true.  This paper is hot on the heels of an editorial, revealing that 50% of parents were unaware of their teenager’s suicidal thoughts.

There is much to be gained from the ‘knowing’ and so much to lose from avoiding this one. It’s the beginning of another school year (at any level) and with this can bring significant stressors and provocation for mental health challenges.  Let’s encourage every parent, to get themselves a team and take our own place in that invaluable roadside assist crew.

From the UU30 Archives: Investigating Paediatric Behavioural Disorders

This is a succinct recap of the many investigative paths we need to follow when presented with kids or teenagers with behavioural disorders.  From grass roots dietary assessment through to the key pathology testing that is most helpful in clarifying the role & treatment approach of integrative nutrition for each individual child.

My second speaking gig for 2019 is approaching at a vertigo-inducing speed (hey…wait..someone stole January??), heading to Hobart as part of the NEW primary training course that ACNEM have created and will be rolling out this year around the country. I am really pleased to be one of the new presenter/practitioners to help ACNEM deliver their renovated course, with a renewed focus on delivering independent, unbiased and high quality training. My specific mission, the Micronutrients…I am like a pig in mud!

Here’s a snapshot of what the Primary Program covers:

Primary Modules in Nutritional and Environmental Medicine (NEM)

The Primary Modules in NEM, designed for GPs, registrars and other graduate healthcare professional, are ACNEM’s foundational training in post graduate Nutritional and Environmental Medicine. The modules will be delivered over 2 days face-to-face, plus equivalent of 2 days online (4 months online access) to view the lectures and to complete the required learning activities.

These modules provide an introduction and overview of NEM within primary care. Each major biological system is explored covering the key nutritional, environmental and biochemical factors affecting health and disease. Through case studies delegates will gain practical tools to aid integration into daily practice. The Primary Modules enable practitioners to begin practising NEM confidently and safely.
More information on the Primary Modules can be found here.

On the same weekend, ACNEM are also presenting a GIT Health module – so I’ll be front and centre to get the latest Jason Hawrelak goodies along with those from doctors, James Read, Robyn Cosford and Nadine Perlen, which will go a little something like this:

Gastrointestinal Health

This module will address a number of the most common functional and inflammatory gastrointestinal complaints that present to clinic. Conditions to be covered include gastritis and reflux, constipation, Inflammatory Bowel Disease and Irritable Bowel Syndrome, from pathogenesis to treatment.

Our highly regarded presenters will bring their clinical experience and knowledge on the application of nutritional and environmental medicine in collaboration with conventional medical practice. Current scientific evidence for the effectiveness of treatment modalities will be presented including nutraceutical prescription, dietary manipulation, lifestyle modification and environmental factors, alongside the range of available testing and investigation options. More information on Gastrointestinal Health can be found here.

When you get clinicians with extensive real-world experience talking about the things they know best, not just academically but also clinically…then you’re in for a very practical & clinically impacting learning opportunity.

ACNEM Face-to-Face Training
Hobart, 2-3 March 2019 at the Wrest Point Casino

https://www.acnem.org/events/training

So you’ve gone to all the effort.  Be that writing referral letters suggesting some pathology investigations might be warranted or you’ve coached your patients endlessly to get copies of ones done elsewhere so that you may be privy to their findings. Worse still, you’ve directly requested the pathology, with your patient paying out of pocket for the tests. Then the results come in and they look…well wrong.  You, as the conscientious clinician, typically do 3 things:

Step 1 Spend hours pouring over & over the labs and back over the case notes

Step 2 Worry about the new differential diagnoses that are now suddenly seemingly a possibility in your patient. It doesn’t look good.

Step 3 Doubt your own pathology reading ability, ‘Hey maybe I just don’t understand these bloods like I thought I did’

But (often)…it’s not you, it’s them.

And that’s what I often explain to practitioners who contact me (step 4). You see sometimes what they’re losing sleep over are what I call, Bad Bloods Occasionally, the fault of the pathology company…but way way way more often the fault of the patient and the referring practitioner, who has not educated the patient correctly about what to do and not do prior to blood collection for certain tests. I am excited to see how many practitioners are competent with pathology reading these days and building their skills and confidence all the time, that’s why it is so so disheartening for the practitioners (and for me as a mother hen mentor) when they lose time (& sleep) getting to Step 3 when they should be able to spot ‘Bad Bloods’ fast.  There are 7 classic give-away patterns.

Will are unlikely to know every quirk of every blood test our patients will ever have done, but knowing what constitutes the ideal time and conditions for the most commonly performed ones, can go a long way to minimising any future Bad Bloods between you and patient as well.  This includes things like exercise, alcohol intake, duration fasting and even sexual intimacy…yup! 

This month’s Update in Under 30 installment  Beware of Bad Bloods teaches you the 7 patterns to watch for and provides you with a great resource stipulating the best collection conditions for the most common blood tests.  Don’t let Bad Blood come between you and your patient, the right diagnosis & management or just some well-deserved sleep! 

Good practitioners are being led to bad conclusions by some patients’ pathology results. Not because they can’t interpret them or the testing has no merit but because they just don’t know when to discard a set because they are ‘bad’.  Occasionally, the fault of the pathology company but much more often the fault of the patient and the referring practitioner, who has not educated the patient correctly about what to do and not do prior to blood collection for certain tests. This recording clearly describes the 7 classic give-away patterns of ‘Bad Bloods’ which will enable you to spot them fast in the future.  In addition to this.  while we are unlikely to know the idiosyncrasies of very lab our patients will ever have done, knowing the ideal collection times and conditions for the most common ones assists you and your patients to avoid any in the future – handy clinic resource included.

Hear all about it by listening to my latest Update in Under 30: Beware of Bad Bloods.
For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.

While we’re on the topic…I tend to think, that as good as we are at asking a lot about a patient’s health, we can always do better.  One of the classic pitfalls for practitioners is having to rely so much on patient self-reporting: Is your period heavy,moderate or light?; How would you rate your appetite?; Do you suffer from excess flatulence?  When our patients answer these questions, who are they able to compare their own experiences with? Or do they only compare them with themselves at another time in their life, e.g. my periods are heavier/lighter than they were before?  Either way, this may lead to unintentionally misleading information from our patients, producing erroneous conclusions for us as clinicians. Do you suffer from excess flatulence?  Well do they?? How exactly would most of us know?! Unless we can define what ‘normal’ looks like…?

14

(But as many as 22 times a day – that’s almost one on the hour)

That’s the average number of ‘pop offs’, ‘air biscuits’, ‘bench-warmers’, ‘fluffs’, or whatever you want to call them, healthy humans do per day as cited in this great evidence based & entertaining article. Funnily enough I had exactly the same lecturing experience as the author: performing a snap poll on my students, asking for averages…and can I just say almost everyone was clearly under-reporting!! But the point is clear.  How can our patients accurately rate the magnitude, severity or normality V abnormality of their bowels, menses, appetite, pain threshold etc – unless we provide some goalposts? And are we, in fact being lead to believe there is a problem when perhaps there isn’t? That certainly has been the conclusion of several studies into the matter of self-reported excessive flatulence.  Hippocrates himself put in a good word for bottom trumpeting, saying “passing gas is necessary to well-being” and as a recent article in the Harvard Health Letter reads,  “A little bit of extra flatulence, could be an indication that you’re eating the way you should!” Here here!

But my favourite quote from this article has to be about the high tech solutions on offer – for those who do accurately fall into the excessive category:

“Such as carbon fiber odor-eating underwear (cost: $65),  which were put to the test in an American Journal of Gastroenterology study that included such gems as “Utilising gas-tight Mylar pantaloons, the ability of a charcoal lined cushion to adsorb sulphur-containing gases instilled at the anus of eight subjects was assessed.” Assessed, that is, by a panel of fart-sniffing judges. And the name of the charcoal lined cushion? The “Toot Trapper.”

How different that scene in Bridge Jones’ Diary would have been had these been her undergarment of choice instead of the control briefs!

Of course, if there is associated pain or an odour (which the article discusses as well) that makes the family dog leave the room…well, that’s another matter…;)

A Gut full of Glutamine?!

Is Glutamine your go-to prescription for patients with gut problems?  Do you look for good levels of it when you’re choosing your gut repair formulas? Most of us do this because we’ve heard that a deficiency negatively impacts the gut tight junctions , villi structure and immunity etc. but how long has it been since you’ve reviewed the latest human studies on the digestive effects of Glutamine supplementation?  The time is now. This previous UU30 installment cuts to the chase on the big research findings that warrant our urgent attention and necessitate big adjustments in how we use glutamine for guts.

 

 

 

 

 

How long?  How long must we sing this song?  I’m feeling a bit 80s anthemic  and righteous.  It turns out that patients’ bowel movements could be improved by using a foot stool?!! Who said that??

Only every naturopath, ever. Right?

But now medical researchers are singing the praises of the Stool Stool too…sorry, I mean the ‘defaecation postural modification device’…because lo and behold a new study of over 1000 bowel movements revealed using a stool to elevate your feet while on the toilet improved the speed and ease, improved full emptying, reduced the strain etc of laxation, >70% of the time, even in ‘healthy, non-constipated patients’.  There’s a quick video you can watch to get across this groundbreaking research, or you can read the full article here I’ve been educating patients about this for about 20 years and it never fails to revolutionise their world!

It would seem that elevating your feet results in straightening “the unnatural bend in the rectum that occurs when sitting on the toilet by placing the body in the squatting position nature intended”…hang on a second…who’s calling what unnatural???…I think the highfalutin anti-anatomical bathroom contraption, we westerners call a toilet, wins the ‘unnatural’ crown!

Next thing you know there’ll be a study that tells us squatting to have babies makes more sense that lying on your back…right?! 🙂

Love talking all-things Stool?

Fabulous Farty Fibre is a previous UU30 recording. Rachel at her warmest and funniest reminds us that fibre is a critical component to good nutrition and is often overlooked, partly due to the popularity of paleolithic and no grain diets. This UU30 details the important functions  of different types of fibre and therefore the importance and therapeutic applications for fibre diversity.

 

Remember the good old days when we understood everything about food allergies and life was simple?  IgE was the culprit – short and sweet – which made patient assessment (SPT) & management (never eat this again, never feed it to your infants if you don’t won’t them to develop the same health issues and never doubt that it will never be an option for you to consume it) real tidy. What’s that thing about never say never?

It hasn’t escaped our attention that the so-called rule-book on food allergies appears to have been shredded, set on fire and then eaten by someone not suffering from an ash allergy, in the last few years.  Now, we’re told that many of these truisms…weren’t just a little, but a lot, wrong and in some instances have lead to the further escalation of adverse food reactions that we’re now facing.

So what else did we get wrong?  Well in the good ol’ days we were also informed that there was no role for IgG antibodies in immune mediated food reactions and that of course there was no interplay between the IgG system and say mast cells…right???!!!!  Want to get up to speed on the real story on how IgG is involved in well book yourself a ticket and strap yourself in because there is loads to learn in addition to a whole new way of thinking about food allergies and intolerances!

As clinicians there is perhaps no more complex a labyrinth than the correct diagnosis of adverse food reactions. In part, this is because of the multitude of potential mechanisms driving them. However, the long lag time between radical-re-writes in immunology and reciprocal changes to mainstream medicine’s approach & understanding, has marginalised our views, planted seeds of disbelief & stymied our progress in diagnosis and management.

This upcoming seminar presents a scientific summary regarding IgG mediated food reactions, their validity, their correct assessment & their meaningfulness and along the way…it will introduce you to the ‘even better’ new days, where the lid has been lifted on what we kind of suspected was going on all along!

Immune Mediated Food Reactions – What’s IgG got to do with it?

It all starts in Sydney on February 16, Melbourne on February 23 and Brisbane on March 2.
Email info@lifebioscience.com.au to confirm your place.

I hope you’ll join me at the IgG Food Intolerance Workshop.
For more details download the flyer here for more details.

……………………………………………………………………………………………………………………………………

If you would like to know more about my other upcoming 
speaking engagements check out my calendar here…
https://rachelarthur.com.au/live-appearances/

Virginal skin, as my sister calls it, is on the endangered list.  She also predicts that as a result, it will be a highly sort after commodity in the future and I agree but our reasons are a little different. Hers are aesthetic and mine are well, health-based.

I dislike spreading fear in the wellness world, especially around the area of autoimmunity, which is already plagued with podcasting puritans, espousing the notion that people with autoimmune conditions need to give up every single source of joy in their lives and then, and only then, they will be healed

[Silent Scream !!!!!!]

The essential formula for autoimmunity is generally thought to be: genetic susceptibility + environmental trigger = Bingo! i.e. Hashimoto’s or Grave’s or AS or or or…There are already so many candidates, both confirmed and speculated, on the environmental triggers list, from individual nutrient deficiencies, to food groups, from infectious organisms to of course, the big monster under the bed and everywhere else (!), environmental toxins.  But wait there’s one more.

“Black inks likewise have been shown to induce production of reactive oxygen species (ROS) such as singlet oxygen or peroxyl radicals, which are free-radicals that can steal electrons from neighboring molecules and damage cell constituents. One study by Regensberger and colleagues (2010) found that in the presence of ultraviolet light, some black inks reduced activity of the energetic powerhouses of the cell, the mitochondria, of human dermal keratinocytes, the type of cell that predominates in the outermost layer of skin”

Recently I was prompted to ask one of my mentors whether tattoo inks contained heavy metals. His reply, “I seriously doubt that heavy metal-free tattoo inks even exist.”  Then someone on my team forwarded me this well referenced article that contains the above quote titled, Toxic Chemicals Found in Tattoos: Links to Autoimmune & Inflammatory Diseases.  I haven’t had a chance to read their citations and understand the real implications of this very plausible biological threat and I can’t do anything about the skull & crossbones on my back but I can warn my kids, my patients and anyone else with virginal skin to rethink the ink.

It’s summer time for all of us in the southern hemisphere & that means….Slip Slop Slap?!

Vitamin D deficiency has been associated with a long list of major health conditions: from autoimmunity to mental health & almost everything in between. This has lead to many of us recommending high dose vitamin D supplementation for a large proportion of our patients but do we understand everything we need to to be certain of the merits and safety of this? In this provocative podcast, Should We Rethink High Dose Vitamin D, Rachel outlines the key unresolved vitamin D dilemmas that should encourage us to exercise caution with supplementation and outlines how adequate sun exposure is associated with improved health outcomes independent of the production and action of vitamin D.

 

 

Did you read something fabulously non-work related over the break?  I did. Basically opening any book by Isabelle Allende evokes a Pavlovian relaxation reflex in me – ok admittedly some salivation as well!  Then I decided to seamlessly segue into some work-related reading that I intended to catch up from the previous year.  Good idea, right.  Just slip it into the beach-bag among the sunscreen (sorry Pete) and the sunnies (double sorry Pete), as if I would not even notice I was actually working, while not working.  Only then…I started reading and thinking and thinking and thinking…which was not the intention of these authors

You see I’d gathered a collection of hard-copy newsletters and new product information from some practitioner only companies – these lovely multi-page shiny things were full of clever graphics, so colourful,  so eye-catching I was tempted to wallpaper the clinic with them. There’s one on methylation and mental health, there’s another on approaches to immune modulation in allergy management and so forth.

Then I read the accompanying text…not so impressive…references often only provided on application & when provided often quite out-dated, one even referenced the 3rd edition of Braun & Cohen…heck I’m not sure why we bothered to put out another edition since then that’s twice the size and content! Or, in those materials where primary studies were cited in support (of the product…let’s face it) were of very poor quality, with sample sizes of 20 for example, or other major methodological issues and only ever had positive findings. Then, a lightbulb moment.

I looked back at these lovely eye-catching graphics that make effective gut protocols appear a cinch or complex mental health management a bit of a dawdle & 2 thoughts landed

No.1: ‘Holy guacamole…beyond the engaging colours, lovely fonts and stylised imagery, most don’t really say anything other than…we have the perfect thing for this,’

Shortly followed by thought No.2: ‘Gosh these remind me of the landfill the pharmaceutical companies wanted to fill GP in-trays with’

I’m not surprised by this parallel with the pharmaceutical world of course, just disappointed.  Others do better…but therein lies the key.  We, the practitioners, have to be discerning.  Now I know I am a boring old nag about these things and at the ANS last year together with Jason Hawrelak and Nirala Jacobi, really did dance on our soapbox about 1) the need for independent and unbiased education and 2) the need for us all be vigilant about being discerning when the information comes from a vested interest.  And boy did we cop some flack about this!  But we also received enormous support from practitioners, ex-company employees & even some current company employees who echoed our concerns and agreed  it is up to us, the practitioners to force the bar higher for all providers of goods and services to our patients.

So how can we do this when our schedules are already full?  Form a collective of colleagues – pose the same set of questions and comments to each company representative you encounter and then share your findings.  Basically…use the force.  What kind of questions, I hear you ask?  Well maybe ones along these lines:

  1. Can you please provide me with full text copies of your key supporting papers – for this product or test?
  2. Can you also provide me with full text copies or links to studies which produced negative findings – for this product or test?
  3. Could you please explain to me why the form/dose/combination used in the study your company is citing is different from the form provided in your product – and can you provide evidence of equity?
  4. Could you please explain to me why the testing method, sample, collection etc used in the study your company is citing is different from those employed in your test- and can you provide evidence of equity?
  5. Can you please provide me with the method used to derive your reference ranges for this functional test – including sample size, gender and age distribution, location (think about it….minerals, heavy metals), reported health issues and outline how frequently you review and update this reference range?
  6. [if relevant] Why don’t you include all your references in your materials rather than demanding more of my time having to call and request them? It is essential to me, in order to make an informed choice to have immediate access to these

I undertook a holiday..not a lobotomy or a personality transplant 😉

Let’s make 2019 a great one professionally and raise the bar!

Speaking of a reliable source of non-biased independent education.  I know that was a conflict of interest, right?! Well spotted.

If you’re not an Update in Under 30 subscriber yet…you might want to get on board.  Open to all ages (LOL) a monthly podcast of less than 30 mins that delivers something dynamic and immediately clinically relevant to help you keep informed, growing and improving as a clinician. With our next installment ready for release at the end of January – now’s a good time to put your best foot forward education-wise in 2019. Find out more about the subscriptions here.

 

Relax, no one is leaving RAN central – they’ve deadlocked all the doors (!) but I’ve left another online abode I built and time-shared in last year….The Worm Whisperer…which is exclusively focused on educating the public about worms. Not the compost ones, but the ones that like to inhabit us humans and cause so many health conditions that most people, & sadly many practitioners alike, are not aware of. So back to my wormy tale… In 2018  I started up a Facebook page: The Worm Whisperer.  I recognised from the many talks I’d given that there was a need to educate people more about threadworms because the information just wasn’t getting through and affected individuals were basically being grossly medically mismanaged. There are just so many cases where children have been diagnosed with an alphabet soup of physical or behavioural disorders only to discover that chronic treatment refractory threadworms were in fact the culprit. And no…mebendazole is not going to fix that.

Then there are the women, who have had years of sleepless nights and complex disturbing health issues. They visit many different medical & allied practitioners who can’t seem to pinpoint the issue. Or even if the practitioner accurately does diagnose Enterobius they mistakenly use inappropriate anti-parasitic strategies and therefore struggle to get any long-term resolution and reflief. I can’t tell you how many women have discovered The Worm Whisperer Facebook page and told me how they cried with relief when they read the information in our eBook and understood for the first time that this was not in fact ‘all in their head’ and help was on its way.

I’m so glad I started this up. It’s been an amazing privilege to support women, children and whole families from around with world with their worm journey and see such positive results. And it’s only the tip of the iceberg because there are so many more out there being told their pre-pubescent daughter just has ‘thrush’ (impossible by the way in this age group) or referring women to psychologists and telling them they’re ‘hysterical’  (that’s an old chestnut that has made a strong & unwelcome comeback in this area) when they present with myriad symptoms that just don’t fit neatly into other diagnostic boxes.   Anyway, together with the joy of being able to help so many came..who would’ve thought (!)…more and more followers…and more and more work…and well..The Worm Whisperer is continuing to grow at a rapid pace and now it’s time to hand over the baton to a team of people who have the time to focus just on this issue and who are just as passionate about worms as me. So I wanted to let you all know, there is a new team at the helm and I have officially left the (WW) building…but you know…they’re cheeky little blighters…so I’m sure they haven’t left me 😉

Check out The Worm Whisperer Facebook page, support this great Australian initiative and let others know. There is a great eBook, resources and products to treat all worm conditions.

www.thewormwhisperer.com.au

 

Sheesh…who turned down the music and turned on all the lights…are the holidays seriously over??! That’s right, pack away the Christmas tree (somehow), drag yourself away from your (endless tennis/cricket watching) meditation practice and start looking at your calendar because my first tour is kicking off in February! That’s right, you heard me, F.E.B.R.U.A.R.Y So given my computer (the mothership) also didn’t want the holidays to end…staging a pathetic ‘sorry, no power, protest’ for the last week…I too have now got my skates on, getting ready for this juicy and thought-provoking seminar to jump-start all our brains for 2019:

Immune Mediated Food Reactions – What’s IgG got to do with it?

Because let’s face it, identifying, testing and understanding food based reactions, is typically plagued by myths and misunderstandings among the public & can be a source of confusion & frustration for many practitioners. The testing technology has advanced so far, however, that if we combine these improved methods with astute case taking and sound clinical reasoning, well while, food based reactions are always going to be a complex area, now we at last can be systematic in our approach of investigating these and better understand the clinical significance of our findings.

I kick off in Sydney on February 16, Melbourne on February 23 and Brisbane on March 2. Early Bird price of $50 ends 11 January, so don’t miss the early bird discount and email info@lifebioscience.com.au to confirm your place.

I hope you’ll join me at the IgG Food Intolerance Workshop. For more details download the flyer here for more details.

……………………………………………………………………………………………………………………………………

If you would like to know more about my other upcoming 
speaking engagements check out my calendar here…
https://rachelarthur.com.au/live-appearances/

 

 

Oh no, it’s her again 🙁 I mean the chick in the photostock image not the other ‘her’, me. I know. It’s the end of another mammoth year, you’re tired, worn out, used-up all your brain-power quota (a little projection?) and I can hear you begging for mercy when I start a sentence with…”So you think you know….” followed by, “blah blah blah Iron,” but hear me out.

Correctly identifying & managing iron issues is a bread & butter part of our business, right?

With Iron deficiency affecting an estimated 1 in 5 women and Iron excess almost another 1 in 5 – patients with one form of iron imbalance or another tend to be over-represented in waiting rooms.

Anyone can spot overt iron deficiency anaemia or full-blown haemochromatosis but many health professionals find the ‘in-betweens’ confusing and fail to recognise some key patterns we see over and over again, that spell out clearly your patient’s current relationship-status with this essential mineral.  This often results in giving iron when it wasn’t needed and missing it when it was. If you’re imagining someone else, i.e. the person who ordered the Iron Studies for your patient, will step in and accurately interpret the more curly results can I just say D-O-N’-T...they’re often as perplexed or even more so than you. After starting this conversation a year ago with So you think you know how to Treat Iron Deficiency, & its baby sister, So you think know the best Iron Supplements, our (imaginary) switchboard went crazy.  While practitioners got the message loud and clear about how to improve the likelihood of treatment success in iron deficient patients, hot on the heels of this came email, after fax, after carrier pigeon, with examples of patients’ Iron Studies, the ‘somewhere in between ones’, accompanied by the equivalent of a dog head tilt…aka ‘I don’t get it’. 

And this is to be expected. 

What were you taught about reading Iron Studies? Was it made out to be all about ferritin?  And TSH is a solid stand-alone marker of thyroid health, right? 😉

Were you introduced to the other essential parameters included in Iron Studies, explained how they contribute to your diagnosis and reveal important details about the patient’s ability to regulate this mineral or not? About when to dose and when to hold your fire?

Nah…I didn’t think so.  But it’s up to us, people, to hone our skills in Iron Study interpretation…because individualised nutrition is our ‘thang’ and more than any other nutritional assessment, this collection of markers, actually allows us to go beyond the ‘one size fits all’ model…everyone must have X of this and Z of that in their blood tests…and see each patient’s actual individualised need and relationship with this mineral.  In the latest Update in Under 30, I introduce you to 3 key players in iron assessment and the insights each offers become so clear, you’ll be able to read any combination or permutation of iron results that walk through your door.  To boot, I’ve included a wizz-bang cheat-sheet of those iron patterns that are frequently seen and rarely recognised, including one totally novel one that I’ve never talked about before…to make your job even easier and put you well and truly ahead of the pack in understanding iron nutrition.  It’s Christmas…and as the mantra goes…we can always fit just a little more in at Christmas time, right? 😉

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.

 

Hear all about it by listening by my latest Update in Under 30: So You Think You Know How To Read Iron Studies? For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.

 

Yes them’s fightin’ words. It’s 6 days til Christmas and we’ve all got way too many things to do before Santa visits, right? But this will take you 1 minute and takes precedence over finding excuses not to attend Christmas parties, half-crazed-mad present buying, watching Love Actually….again and building tension with loved ones in preparation for the big day/fight.  I joke but I am serious.  I don’t know how you feel about the proposed PHI reforms which are due to come into effect from the 1st April, removing Naturopathy & Herbal Medicine as modalities that can be covered by Private Health Insurance, but in the least amount of words, here are mine:

For me, the financial impact on patients and secondarily on me, is not my primary concern.  Our profession represents a significant proportion of the health workforce in Australia and according to 2005 data, a form of healthcare that 69% of Australians engaged with, and according to Wardle & Adams research, often as primary healthcare providers.  We provide such an important service, the public knows this better than any political party, and they will continue to come through our clinic door, seeking the kind of quality care we can offer.

No, what really concerns me about this (among other things) is the marginalisation of my profession, my colleagues and by virtue of this, the implied message to both patients and other healthcare professionals alike, that we are not active contributors to the improved health and wellbeing of a substantial proportion of the population…and as a further extension of this – we should not be part of ‘the conversation’.  It is yet another step backwards away from any shared care or integrative model that truly puts patient outcomes first or that recognises the importance of an individual’s right to choose in regard to their healthcare.

Now the NHAA have created a petition that is going straight to the health minister, Greg Hunt.  Their focus is a little different from mine – about the  potential for more ‘fake naturopaths’ to hang up a shingle post PHI reform and therefore increase public risk.  This is not my major beef and it may not be yours IT DOESN’T MATTER.  We need to all sign this petition – naturopaths, herbalists, nutritionists, integrative doctors and healthcare providers of every persuasion.

Just my thoughts…what are yours?

PS It doesn’t matter if this is your association or not…let’s all sign it...& get some groundswell going

Did you and all your patients survive Spring?  Have you had a chance to restock the shelves with all the big-gun-Quercetin-products for the next allergy onslaught…or maybe for patients presenting with other conditions that respond well to this, like leaky gut, asthma, MCAS, Grave’s disease?  Either way…can I ask you a Quiet Quercetin Question…how high do you go? 

I ask this because I know myself to be pretty heavy-handed at times, especially in those severely affected by traditional allergies..and the results are so impressive for patients and practitioners alike, it’s easy to perhaps get very enthusiastic with this approach, with doses sneaking higher and higher… if a little is so good then a lot must be great!

“Severe eczema and allergic asthma – [Insert preferred big-gun-Quercetin-product] 2 three times a day – STAT!”

And we use it across all patients, right?  I love it in kids, teens and adults, men and women.  So I kind of stopped dead in my tracks when a colleague recently said…”I do the same…buckets of Quercetin especially over hayfever season but Rach, what about it’s phyto-oestrogenic effects? Should we be worried?” Ah…yup…that’s right…being a flavanoid…it has them. Now let’s be clear about one thing, unlike  some practitioners I am NOT, I repeat, NOT against phytoestrogens nor even (ahem) soy 😉 but the question was great because it got me thinking…at high-end supplement doses we are producing levels in the body 100s if not 1000s of times higher than a fruit and vegetable rich diet ever can….is it time we knew a little bit more about what Quercetin does at this level, or is suspected of doing and not just the benefits. Therefore we can be more informed about who we should not be so generous or so long-term with our big Quercetin prescriptions?

So I started busying myself in the literature and it turns out THERE IS A LOT OF LITERATURE!

[Note to said colleague who asked me question, you owe me some sleep] But at least I got an answer! 

If you want a bit of DIY drilling then this Andes et al paper is an excellent overview of quercetin supplementation safety concerns…but it doesn’t cover everything.  We need to talk.  We need to talk about that dang estrogen aspect but it’s bigger than that – you see Quercetin doesn’t just engage with oestrogen receptors like a ‘normal’ phytoestrogen…it messes with levels of this hormone via several other paths…and where does that lead us…?  Listen in to the latest UU30 Querctin – Are We Pushing the Limits? and you’ll know exactly our destination. This is important for the Quercetin Queens (both male and female) among us…and that’s like…everyone…right? 🙂

Quercetin has become an absolute go-to treatment for many practitioners faced with patients affected with allergies and high histamine.  It is in this context, that often we find ourselves using large amounts over long periods. Supplemental quercetin exhibits a 5-20 fold higher bioavailability than its dietary counterpart, therefore increasing body levels beyond what a diet could ever achieve. This introduces more potent novel actions: anti-thyroid, pro-oestrogenic, detoxification disrupting…are we pushing the limits of desirable effects and introducing some undesirable ones and who should we be most conservative in?

Hear all about it by listening by my latest Update in Under 30: Quercetin – Are We Pushing the Limits?
For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.

Never say never, right.  Back in my old uni teaching days, I scorned the very notion of treating someone with ‘actual melatonin’. Always in favour of upstream approaches over downstream, I was keen instead to give patients the ‘ingredients & cofactors’ so they could whip the right amount up themselves.  Well fast forward another decade in clinical experience, and research too, and while I refuse to give in with many other ‘replacement remedies’, melatonin, has snuck well and truly into my list of treatment considerations for some very specific presentations such as silent refluxtreatment refractory GORD and Barrett’s oesophagus, buoyed by some amazing clinical successes. So much so…that in fact I’ve embraced this replacement approach, whose results in this setting especially, can’t be replicated by treating with ingredients and cofactors. Turns out of course I am not alone – melatonin has won a lot of fans over the last decade.

A recent Australian article from 6 minutes revealed a significant increase in GPs prescribing melatonin for sleeping issues in children and then of course, there is its substantial use in cancer and typically at mega-doses that will make your toes curl.

But always in the back of my mind is the old me. Whispering things like, ‘ but melatonin isn’t a nutrient, nor a herb, so it’s not naturopathic’ – hence we can’t even prescribe it, needing to refer patients to others for access and yet more pressing, ‘what do we really know about the full implications of replacing such a potent and ubiquitous neurotransmitter?’ I know.  This old me, she’s annoying, right. 

But she’s also important. 

So absolutely perfect timing then to hear about a homegrown (2 Aussie Naturopaths in fact) systematic review on the adverse effects & safety of melatonin which is full of important and surprising info and I think ….everyone…single…one…of…us needs to read it:

“While this review reveals a high degree of safety for melatonin with few adverse events that cannot be easily avoided or managed in most populations, it also reveals lack of clarity regarding melatonin’s relationship to endocrine processes, and its effect on hypertensive patients and potential drug interactions in this population.”

But the devil is in the detail.

So here’s a newsflash for you – 4 human studies found melatonin had negative effects on key aspects of reproduction, like sperm counts and ovulation and not at mega-doses my friends, no…at 2mg/d over several months.  We shouldn’t be  surprised, right, melatonin is critical to fertility cycles in all other animals…but how many health professionals know this, or not just know it…but make our recommendations with this in mind?  Other studies reported fascinating impacts on insulin sensitivity (5mg) and amazingly, (or not being the king of all things circadian), opposing effects depending on the time of administration.  Then there’s the drug interaction with anti-hypertensives…a negative one, I must add. No information still unfortunately about the impact of long-term replacement on our own endogenous production.  Anyway…enough spoilers… READ THE ARTICLE. This hasn’t wiped melatonin off my list of potential recommendations all together but it has given me some serious food for thought and much greater clarity about in whom this suggestion should be off the menu.  

‘Melatonin – Misunderstandings and Mistakes’ – this important 2017 clinical update about what we are getting right and wrong with Melatonin answers in particular, one of the most common sources of fascination & frustration for clinicians, the reasons behind the Melatonin non-responder. We’ve all encountered patients who have taken Melatonin for sleep problems and reported no benefit, or initially responded and then lost efficacy quickly, or even patients who experienced insomnia after taking. What does this tell you about your patient and what should you do to resolve this and better still, prevent it?  This UU30 from 2017 reveals all! 

Well who’d have thunk?!  I had no idea cigarettes contain sugar and turns out about 95% of smokers don’t either, according to this recently published article! Now while we’re not purporting this is going to be of caloric significance enough to prove a deal-breaker for the ‘I Quit Sugar’ devotees and others watching their waistlines 😉 its presence in cigarettes is far from benign for other reasons…

“Sugars naturally occur in tobacco leaf but are also commonly added to cigarettes by tobacco companies.

Added sugar increases levels of toxic chemicals in cigarette smoke. “

Never mind that we have a long list of much more terrifying chemicals more commonly known by smokers to be found in their affectionately-named, cancer sticks!  Maybe our current overwhelming fear (for some!) of sugar might be the great tipping point in their decision-making process?! I’m not sure but it’s worth a try…one final factor to build on the already impressive impact of our anti-smoking public health campaign here in Australia?  I still meet clients who eat ‘organic’, regularly do pilates or yoga but still confess to slipping in ‘social ciggies’ on the side, – do you?! So for this popular patient paradox anything is worth a try…perhaps tell them about the sugar! 😉

 

What is this thing you call, Update in Under 30?!

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. Subscribing (Standard or Premium) offers you a fast efficient and inexpensive way to stay up to date in under 30 mins a month!

Don’t find yourself sad come November 15th when we close applications for Group Mentoring in 2019!! You still have a week left to to jump in! (if you haven’t already) and make this investment in building  your incredible naturopathic skill-set and subsequently, your clientele.

So let’s recap what your group mentoring options are for 2019… Which one will you choose?

– STANDARD GROUP –
Nothing ‘standard’ about being in this group. You’ll be plugged into 11 other practitioners and together with Rachel’s brain, you’ll receive the knowledge and confidence to assess, investigate and manage no matter who and what walks through the door. We are adding some enhancements to our already successful formula –  structured follow up on client cases presentations; a 30% discount on Update in Under 30 Subscription; using Zoom platform; serious supplement sleuthing; and CPE Certificates. (read more)

I would pay a million dollars for her brain but instead I just pay
for my mentoring which is just as good.” –
Tess

 

– NEW GRADUATE GROUP –
The New Graduate Group Mentoring Program will give you an exceptional advantage, help you to grow as a professional and take some serious edge off being a newbie! This way you’re able to set yourself and your clients up to succeed! This group is designed specifically for the new (or newish) practitioner, with a combination of tutorials and active participation. You’ll be able to bring your own clinic case, patient pathology results, referral letters etc into these interactive sessions and take home mini-assignments to work on. (read more)

“I went from nervous newbie to confident and capable practitioner in 1 year” – Georgie

 

– MENTAL HEALTH GROUP –
This group will help you get building on what you already know and help you gain more confidence when working with clients who present with myriad mental health issues. We’ve attracted practitioners from mixed disciplines: naturopathy, nutrition, IM GPs, psychologists, psychiatrists so that we can draw from our collective knowledge base and clinical experience while familiarising ourselves with a ‘team approach’, so essential to mental health management. (read more)

“I really love the cases and listening and seeing how you interpret complicated presentations and methodically break them down in a way that digs down to the core/genesis of the issues.” – Deborah

 

But Wait There’s More!!….. If you work in a clinic environment and have a team of practitioners (minimum of 5), you can have your own monthly mentoring sessions that best supports your clinic.
Email us at admin@rachelarthur.com.au for more information.

 

Can you see yourself in one or more of these groups? 

Just a couple of important friendly reminders…

  • In those groups involving case presentations, you can present any kind of condition EXCEPT (!!) patient who present with fertility concerns and cancer diagnosis – for these two areas there are better mentors, who specialise in these areas, out there and so these cases are not suitable for the RAN groups
  • The Mental Health and New Graduates Groups are self-selecting, we’re happy to give you input now, help you to be better informed about each group, but ultimately you make the call about which group seems the best fit for you and we’re then unable to shift groups…so once you’ve signed up for these, you are committed for the 12 months

 

Time is running out to be a part of Group Mentoring in 2019!
Group Mentoring is fast becoming a popular choice (going by the landslide of expressions of interest coming in for 2019!) and could be an integrative part of your practice & your career progression.

Applications close on 15 November, so make sure you complete the registrations form by sending us an email at admin@rachelarthur.com.au

 

“Certainly picking up some great pearls with the biochemistry. Love the research papers you add in after each case. I’ve also started using your flow charts helps put everything in perspective. Every case presented teaches and guides me. They also remind me what I do know and have forgotten. Being mentored builds confidence with those difficult cases. Thanks so much.” – Joanne

 

 

While this ABC article is written for the public it’s a great checklist to have written up somewhere to prevent against placing your confidence in the wrong sources of info.

Just recently, I had a practitioner ask about the ‘risks’ of B12 dosing…& while B12 is considered to be free of a toxicity profile in just about any textbook or in-depth review paper you can find, a ‘methylation’ expert had made mention of there being demonstrated increased oxidative stress.

My response, ‘Have you checked their references?’
Their response,’No’

I get it, right, we’re all busy people and don’t have the time for a full literature review of every claim made by every educator, ‘expert’ or company… BUT sometimes a credibility check can be lightning fast!!!! As was the case in this instance.

I did check this expert’s reference (singular). I read the full article just out of interest but actually, I didn’t need to. I had my answer just by reading the title and abstract…the study was conducted in genetically altered rats made alcoholic and injected with B12 or something to that effect. Relevance?? Which is in stark contrast to the absolute consensus from 100s of human studies concluding that B12 toxicity is NOT a thing.

That also means this particular expert’s references probably need to be checked every time of course…until you can be more confident in the quality of their claims – tough but true. Below are the 7 top Qs to try and answer to determine the quality of any claim and remember you rarely have to complete the list to get your answer…just start with reading the title of their key reference!!! 

1. Who says? (….and what agenda/bias might they have)
2. Sample size ( a response rate of 20% might mean something in a sample of 10000 & nothing in a sample of 10!)
3. Lab-bench or real world
4. Correlation V causation
5. Statistically significant V clinically significant (…if something was shown to reduce people’s migraine pain by a rating of 0.5 – but most people rate their pain at 10/10…is it actually clinically meaningful?!)
6. Does the dose relate? (…watch out for animal studies where they are using doses at mg/kg body weight…that we could never match with oral dosing in humans because they would be eating buckets of the stuff!)
7. Got some time?…then dig a little deeper…if your article has passed all the above checkpoints and you’re still dubious (and this does happen!) check out who has cited this paper (easy via Google Scholar) and whether other researchers are in agreement or not with their findings. What’s been published in this area since then?

Oh and this article is also handy for the occasional misguided patient – who’s found some incredulous online info about something that contradicts your contrastingly well-sourced & quality-checked knowledge! 😉

Our new – New Graduate Mentoring Program kicks off in late January and offers an incredible opportunity for successful applicants to develop their core clinical competencies in record time during their transition into practice.  Real world research cheat tips, is just one of the many practical competencies covered across the year’s curriculum.  But if you’re interested in applying,  jump onto it!  Applications close on the 15th November

Oral sex. There I said it.  Last month when I talked about Helicobacter pylori and where people might ‘catch’ this – if they didn’t inherit the little critter from their mum or family as an infant – we thankfully were able to rule out kissing as a source of transmission between couples P.H.E.W…but I sort of got shy (Who, you, Rachel?!!) and danced a little bit around the question of whether other forms of sexual contact represent a possible route of exposure (pardon the pun).  Until a lovely colleague after listening to Blowing the lid on H.pylori-who gets it & why – said, ‘Now seriously Rach, are you trying to say, oral sex may be an issue?’ Well…ahem…maybe.  You see, remember what I said about candida being a vector for H.pylori and therefore H.pylori being present in the vaginas of women who have this bacteria residing in their stomachs. Ok…enough of that now I am blushing..but if you want to read more on this grab this article in BMJ from 2000 by Eslick who discusses (and seems a little too interested in, can I just say), the risks of H.pylori transmission via a myriad of sexual activities.

A month has passed since that last UU30 edition and it’s time for another instalment. This month, I’ve taken the giant leap forward many of you requested, into the fascinating realm of how best to manage H.pylori positive patients, in whom this bacteria really does constitute a pathogen.

Do we just try with multiple relentless antimicrobials to blast holes in this critter, a lot like the conventional approach…which, thanks to its significant capacity for developing resistance, is like aiming at a constantly moving target,…or…?

I’ve got a very different suggestion and approach.   Increasingly we realise that the GIT microbiome is a vulnerable & dynamic balancing act and as a result, when treating patients with confirmed parasites, or worms or potentially (but not always) pathogenic bacteria such as H.pylori, most of us are doing much less ‘weeding’, less ‘eradicating’ and definitely less ‘shooting at things only to hit others’, these days.  Instead we think about how we can best change the environment.  So, what is it about someone’s stomach that opens the door to H. pylori and lets it in, and then perpetually ‘feeds’ it to ensure it stays longer and wreaks some real havoc, we identify & treat what about this over-friendly stomach is amenable to rehabilitation? As it turns out…that’s a lot.

And surely if add to our antimicrobials a larger focus on rejuvenating the gastric environment of H.pylori patients, to control the growth and activity of this bacteria, and in some cases even kick it out of the big brother house altogether…the chances of relapse and reinfection (a big one in this condition) will be dramatically less..not to mention the broader benefits on the greater GIT function, now the stomach has been remediated.

Or you could just keep trying to hit the moving bulls-eye?

For a bacteria identified just a few decades ago as being a cause of chronic gastritis, atrophic gastritis and gastric carcinoma, the escalation of number of antibiotics used to eradicate it (4 at last count + PPI) has been nothing short of breathtaking.  A management approach more consistent with both integrative medicine and with an improved understanding of the delicate microbiome includes a bigger focus on changing the gastric environment to ‘remove the welcome mat’. What do we know about how to do this successfully? It turns out…quite a lot.

 

Hear all about it by listening by my latest Update in Under 30: H.pylori – Eradicate or Rehabilitate?
For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.

Finally a systematic review puts paid to the nonsense that ‘withdrawal from antidepressants’ is problematic only for a few, is ‘mild’ & ‘lasts only 1-2 weeks’ with no treatment necessary other than reassurance, which is still being perpetuated by current prescribing guidelines both here and overseas. In fact their review found that 56% of patients experienced problems with stopping antidepressants and the majority of these rated these as ‘severe’.  Back in the good/bad old days when I worked for a  pharmaceutical company who made psych meds the phenomenon of an ‘initiation phase’ during which time suicidal risk was heightened, was acknowledged and freely discussed…in-house at least.  However, the concept of a ‘withdrawal syndrome’ was less clear.  Anyone who has witnessed patients coming off ‘even the cleanest’ SSRIs will speak to a potential myriad of worrisome experiences including…

“Typical AD withdrawal reactions include increased anxiety, flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. Dizziness, electric shock-like sensations, brain zaps, diarrhoea, headaches, muscle spasms and tremors, agitation, hallucinations, confusion, malaise, sweating and irritability are also reported (Warner, Bobo, Warner, Reid, & Rachal, 2006, Healy, 2012). Although the aforementioned symptoms are the most common physical symptoms, there is also evidence that AD withdrawal can induce mania and hypomania, (Goldstein et al., 1999; Naryan & Haddad, 2011) emotional blunting and an inability to cry, (Holguin-Lew & Bell, 2013) long-term or even permanent sexual dysfunction (Csoka & Shipko, 2006).”

Previously termed ‘discontinuation syndrome’ by expert panels – to distinguish these inconvenient effects from the more seriously viewed (read nasty) benzo-associated discontinuation problems –  was an act of smoke and mirrors, according to this scathing and insightful review by Davies and Read, who argue strongly this is a clear cut withdrawal picture and it deserves as much consideration and concern.  In particular they point out that of course, patients can experience these symptoms even without ‘discontinuation’ – but simply as a result of a delayed or skipped dose, an intentional dose reduction etc. And they provide the alarming context that one third of people in the U.K. (and likely similar developed countries) who take antidepressants for more than two years have no evidence-based clinical indications for continuing to take them. But wait..I’m just getting to the worst bit, this is the part that gets me personally…having been a peddler in the past of these meds and in certain patients still spruiking their benefits, I am in no disagreement about them being necessary, helpful & even life-savers in some patients…yes I have seen this too many times to ignore it…BUT…and now this is where I start raising my voice a tad….

Patients need to make informed choices, and having a clear understanding of what you are likely to experience on any given medication has been shown to improve outcomes but according to the 2 largest surveys conducted to date,< 2% of antidepressant users are being told any of this.  Do you know why?  Well, let’s start with the misleading guidelines… if the RACGP says it isn’t so…then can we expect their GP to know or say any differently?

Grrrrrrrr…. yes that’s me…not a wild animal in the room with you.

Because you know what happens in the absence of this?! And let me say I have also seen this too many times to ignore as well, people feel compelled to stay on them & this is truly heartbreaking to witness. The experience of a reduced dose or a period without is so terrifyingly disconcerting to that poor unsuspecting individual, and without explanation, is misinterpreted by them (and according to this review often by their doctor as well!!) as being either a sign of their inherent mental instability and need for ongoing medication, or misdiagnosed as a separate condition. Ok…apologies, this is over a decade of pent up frustration…resurfacing as a result of reading this incredibly important and disturbing review.  I think I need a little lie down now 🙁

Helping patients off anti-depressants is a challenging and important function that must be initiated by the patient with the full support of the prescribing practitioner, however there’s a role for complementary medicine here too. Rachel walks you through a range of strategies and when you might consider each. Listen to the free sample here from the Update in Under 30 from 2013 – Leaving Anti-depressants Behind. Or perhaps you’re interested in all things Mental Health and should find out more about our specialist mentoring group running in 2019.

 

 

Forever fascinated by the neurobiology of various mental health presentations, addiction included, two medical news items caught my attention this week.  If you’ve ever heard me speak on addiction, in somewhat simplistic terms, it is very much about the reward centre of the brain and how strongly all recreational drugs hit on this.  Think rats tapping levers with their feet to continually self-administer cocaine…to the exclusion of all else….kind of magnitude of reward hits.  You may have also heard me quote or misquote (!) someone famous who once said something to the effect of….and I am totally paraphrasing poorly here: if we can’t seek pleasure legitimately, we will seek it illegitimately. 

So this story from ABC news about a Newcastle addiction group support program showing some early signs of greater retention and engagement and therefore potential success with addicts…because they incorporate prizes…well that makes so much sense!

The article is important to read in its entirety as it creates the context – especially for many people suffering from addiction who tell tragic stories of lives where the only rewards/prizes and even gifts they’ve ever known, being drug-related – even from a young age.  So to normalise reward to some extent, and give individuals an experience of constructive legitimate versions of this, is actually desperately needed and ground-breaking. 

How can we incorporate some element of this in our interactions with these patients?

The second ABC news item touts ‘a new generation drug that restores balance to the brain’ but is actually just a teaser about…wait for it…cue stage right…a not so old favourite…N-acetyl cysteine!  Although this is effectively a recruitment drive for methamphetamine addicted individuals into a new 12 week trial of NAC, run by the National Drug Research Institute, taking place in Melbourne, Geelong and Wollongong, it gives NAC a great wrap and rationale for being a good adjunct in addiction, of course. Just a reminder folks that naturopaths belong on that multi-modality health care team for people struggling with addiction, and we do have some potent therapies to contribute. 

A couple of years back I was asked to deliver an educational session to a group of hospital based mental health specialists on the merits of NAC.  My favourite question/comment at the end of my detailed presentation from a very experienced psychiatrist was, “Well if N-acetyl cysteine is so good for mental health…why haven’t I heard about it before now?!”

I hope they follow the ABC news 🙂

Want to Get Up Close to N-acetyl Cysteine 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. Novel drivers such as oxidative stress, inflammation and mitochondrial dysfunction are on everyone’s lips and N-acetyl cysteine is in prime position in this new landscape, to be a novel and effective therapy for mental illness. This presentation brings you up to date with the current NAC research in a large number of mental health conditions & translates this into the clinical context.