On Sunday there were deafening bells going off in my brain. By Monday they were going off in 11 others.
Alessandra: “Holy s#*t this has just ticked so many boxes for a couple of Rx resistant patients. Thank you!”
Tess: “Me too – finally the gut and pain connection explained”
(more…)
Let’s play a little word association game:
I say ‘Fibroids’ – you say, ‘Oestrogen’.
I say ‘Cyclic Breast Pain’ and you say, ‘Ouch!’ [because it just slipped out] but then you say, ‘Prolactin’, right? Me too.
Prolactin driven breast pain’s most characteristic form is the premenstrual ‘oh my goodness get these off me!!’ kind, with patients experiencing anything from burning, aching, bruised feelings and acute hypersensitivity to touch, which builds in intensity for days leading up to their bleed. Of course cyclic mastalgia can progress to being full-time mastalgia in women whose breasts start to exhibit structural tissue change in the form of cysts, fibrosis and ultimately fibrocystic breast disease. If you’ve ever experienced even a day of mastalgia it is truly hard to conceive there are so many women (about 50% of premenopausal women!!) living with it daily.
Adding to our concerns about this so-called ‘benign breast disease’ (BBD) is that researchers are now certain it’s a significant risk factor for breast cancer, with women with any form of BBD experiencing at least a doubling of risk of a subsequent breast cancer diagnosis, while those women with proliferative BBD exhibiting a risk of 3.5X that of women without BBD. Castells et al 2015 (more…)
My partner and I have a well rehearsed script whenever he is suffering from man flu, he says, “Am I going to die?” and I say “Yes, just not today.” First world peoples tend to specialise in the denial of several absolutes: like time & death. As Professor David Cameron-Smith, from the University of Auckland says, ‘old’ is something we always define as ‘other’. We are not old but we know people who are! I personally used to define ‘old’ as over 50 until that became rather close and uncomfortable at which point I noticed a completely unconscious increase in the lower limit! Now old is over 75 yrs…and stay tuned for more updates 😉
Similarly none of us are ageing, right? (more…)
Setting: Local cafe
Scenario: Run into friends of friends who join us in the sunshine for a cuppa & we’re discussing the finer details of chai (western version V the real streets of Delhi stuff), tumeric lattes etc etc. as you do. I comment on how unpleasantly strong I found the cow’s milk in those downtown Delhi chais we had when we were there.
50 something man: Oh I LOVE that – I just LOVE cow’s milk. I drink loads of the stuff. I used to drink 2L a day but now it’s more like 1L a day.
Me: Seriously?
50 something man: Absolutely. Then there’s the cheese as well – I would eat at least 1kg of that a week. But it’s good for my bones, right? I have that thing, you know, before osteoporosis…brittle bones. (more…)
While I did diagnose this one correctly, I didn’t get 100% in this quiz – Can you? Speaking of the devil, Medscape, has this great little visual quiz to test your knowledge about physical signs & other hidden clues of nutritional deficiencies.
While we all know there can be a lack of specificity when it comes to some deficiency signs…like glossitis…eyeyiyi..naming a nutritional deficiency that doesn’t include this sign would be a tougher question 😉 but what a great reminder of some quirky things you may have forgotten or in fact deficiency features you may not have even known about.
A gem I love and apply frequently, is about zinc the ALP levels…watch out for the that later in the slideshow quiz.
Also note the distinct difference in opinion when it comes to vitamin D adequacy – with Medscape citing blood vitamin D result < 75 nmol/L unequivocally associated with osteoporotic change…in contrast to the …’anything over 50 nmol/L is a bonus’ line we’re being fed here in Aus and NZ! While we may not ever see some of these severe deficiency presentations walking through our doors – you can’t be so sure…given the reported resurfacing of scurvy in good ol’ Sydney just last year!
Is it just me? I love going back to nutrition 101. So tomorrow with your cuppa…test yourself and then let us know how you go 😉
Are you keen to keep developing your naturopathic knowledge in areas of diagnostics and nutrition? Rachel has a range of services that can help accelerate your learning. From the long list of great downloadable recordings in the store, that help fill your ‘knowledge potholes’ in a fun and engaging way that really brings these topics to life, to our Update in Under 30 Subscription: 30 mins of power-packed up-skilling delivered to your inbox every month, as well as our individual and group mentoring programs! There’s content galore and a delivery format to suit every clinician – come check out what’s on offer.
Whenever I talk to practitioners about thyroid health, like I recently did at MINDD, I can guarantee I’m going to get 2 questions:
I am so glad you asked. The answers are no and no.
I am a nutter for minerals and iodine just won’t go away right now. Too little = a problem, too much = often the same problems. To boot we are faced with radically contrasting views on assessment and dosage and just about everything iodine related. It’s not you – it’s iodine. Trust me it’s a complex little mineral that requires some extra thought and caution. If you imagine the Japanese have no thyroid problems – correct that big myth right now by reading this scientific paper that refers to health problems that result from too much dietary iodine. It also explains that the typical first step in treating hypothyroidism in Japan is to reduce their iodine intake! (more…)
So you’ve heard part of that BIMA story…now here’s the rest. To be honest, I was pretty surprised to win anything given I’ve spent the last 20 years ‘agitating’, challenging the misinformation and strongholds of the big companies etc. Funnily enough, in my post award ceremony interview, my interviewer dished up the biggest compliment of the evening when he said, “Rachel, we all know you can’t be bought!”
Nutritional & naturopathic medicine is an exciting dynamic field that is growing its evidence base every day but we need to be vigilant about our sources of information, their credibility etc. I know that what motivates me the most to share what I know is the desperate need for independent voices, free from commercial bias that can help us move our medicine forward on solid ground. (more…)
Psssssssssssst….just thought I would share a special moment from a couple of weeks ago when I received the BIMA for Lecturer of the Year.
Thanks to all those practitioners who nominated me for Lecturer, Nutritionist & Researcher of the year! It was really special to be acknowledged in this way for my role in education. I am so grateful to have had the support of so many throughout my career – from my own exceptional teachers, Sue Evans, Assunta Hunter, Gill Stannard, Helen Margulies, Fay Paxton, and most influential of all, Dr. Tini Gruner, right through to all the fabulous practitioners that I have the privilege to mentor (and secretly learn from at the same time 😉 ) (more…)
I keep hearing the name, ‘Molly’: “I think I’ll use ‘Molly’ for this patient” or “A bit of ‘Molly’ might go well with the zinc for their high copper”... a moment of confusion on my behalf, (Molly who?) and then the slightly late…’ooooooooh Molybdenum’. Gotta love a trace mineral that is having it’s heyday…right?…right?
There are often jokes made about how little time medical degrees dedicate to teaching nutrition in general – was it 1 lecture or 3? – but let’s be honest, who among any of us really knows the ins and outs of this transition metal. I reckon we spent maybe 15 mins in my undergraduate on it and that was BC (Before Computers!) so I am guessing that 15mins has expanded about a gooooooogle times and we’ve come to a more comprehensive perspective. What do we need to update on? (more…)
Recently, I posted about my very positive experience of the AIMA NZ conference, prior to that I was gabbing on about the upcoming ACNEM Brain Health conference in Melbourne in May and now I am going for the conference hat trick! I want to revisit a really impacting lecture for me at last year’s Australasian Society of Lifestyle Medicine (ASLM) conference, delivered by the Emeritus Professor Mark L. Wahlqvist AO, BMedSc, MBBS, MD (Adelaide), MD (Uppsala), on the relationship between ecology and human health.
Why did I find his talk so impacting? Why should every integrative practitioner take the time to watch this? (more…)
Duck duck GOOSE! Do you know this game? That’s how I’m feeling with oestrogen – high-high-high-LOW!-of late. Likely similar to your experience, the majority of my female clients battle with oestrogen dominance, therefore I get so used to looking for it, expecting it: the high Cu, the profoundly elevated SHBG, maybe a raised ESR. So much so that sometimes the low ones can catch you out, especially of course when it happens in women way way before menopause.
We’re so resolved to hear bad press about oestrogen and to be armed ready to saturate our patients with broccoli extracts of the highest order – do we remember the clinical features and markers of an oestrogen deficit and know what to do with those women who simply don’t have enough? (more…)
I know you’re out there. Reading a recent news article I had instant flashbacks of being a young, big-eyed, rosy cheeked naturopathic student of 20+years ago. While my career since may have taken me in somewhat of a different direction, I know many of my colleagues have stayed true to their roots (both weedy and herbal) and love nothing more than a bit of urban foraging. Sometimes even sharing their bounty with me, much to my delight. I salute you! (more…)
This week I must have spent more than my daily time allocation (5mins) on Facebook and as a result I stumbled across an article I actually read from beginning to finish! The title called to me, “Bad Parent, Hey Bad Parent”…it works every time right? Anyway, once I started reading it I thought, no this is useful, we all need that manual that everybody talks about but nobody seems to own and I know this relates to not only the way I am bringing up my teens but I can pass on its pearls to my patients who are parents of teens as well.
My kids have been teens mathematically speaking for 3.5 years now, but I’m pretty certain, the metamorphosis happened just last Tuesday for one and a couple of months prior for the other. (more…)
Have you still got some thyroid patients that don’t fit any sort of traditional thyroid disease model and are difficult to get results with? Oh yes me too… and watch out…I’ve been spending the last few weeks with my nose firmly embedded in hundreds of articles digging around for more answers. As I am presenting on thyroid conditions for ACNEM in Adelaide March 18-19th, I couldn’t resist going back to the literature to see if by delving a little deeper again I could come up with some more answers to these weird, wacky and hard to treat thyroid presentations that we’re increasingly seeing and guess what…I think I’ve found a few gems. (more…)
Yep, I’ve had them…and made them. I often hear practitioners say they cringe when they think back about the patients they saw in the first year because of the vastly greater knowledge they have now. I do too. But my mistakes are more recent than that!
I know more this week than I did last, and that is a good thing…right?! For me and most practitioners, there is acknowledgement that our learning is infinite, ongoing, without end. This is a source of excitement for me, not a negative. The light-bulb moments are deeply satisfying – those moments when I become enlightened about a mistake I’ve been making, or a misunderstanding I have had. (more…)
Make the most of this special offer! If you become a 12 month subscriber before the end of January (that’s tomorrow!) you receive 10% off ALL individual mentoring sessions in 2017!
And just so you know what we have in store for you as an Update in Under 30 Subscriber this month: Rachel’s kicking off the year with ‘Melatonin – Misunderstandings and Mistakes’ – an amazing clinical update about what we are getting right and wrong with Melatonin. This podcast 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? Now we know. (more…)
Have you heard what everyone is saying about the “Update in Under 30 Podcasts”? But more importantly, have you heard about “Update in Under 30 Podcasts”… fullstop?! If you’ve somehow missed out on being a subscriber & receiving these monthly gems over the last few years, you MUST read on … These dynamic podcasts 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. In Under 30! Each podcast represents unbiased education that can contribute to your CPE points and is delivered to your inbox every month for under $13 a month… how easy is that! (more…)
Ask me to name a lymphatic herb other than Cleavers and Poke Root and I might struggle (sorry Sue!) but some other things stay with us forever. One of my stayers pops into my head every time I eat a carrot. Every time I make my partner or my kids eat a carrot. Every time I see those kids in shopping trolleys slurping on those awful yoghurt squeeze pouch thingamabobs and I want to ask their parents…does your child have teeth? Well when was the last time they ate a carrot?!. A whole carrot. Yup.
Remember to Chew. (more…)
The standout gift I got this year for Christmas without a doubt was my very own copy of Sarah Lantz & Tabitha McIntosh’s, One Bite at a Time – Reduce Toxic Exposure & Eat the World You Want. Every time I walk past it on the table a strange force compels me to run my fingers over the cover, reach for it to pour over some more pages whenever I have moments to myself and show it to everyone who crosses our doorstep. This strange force…I think is called pride. I experienced a tsunami of this at the Australian Naturopathic Summit and now here is another wave. (more…)
The other night my 16yo daughter was reading through bits of reading matter that had made it home from the recent ASLM conference – one in particular was all about contrasting dietary guidelines of key western countries and comparing these using a more naturopathic lens. The materials were glossy, gorgeous in their design and quickly conveyed some basic truths about healthy eating. The fact that she picked it up and voluntarily read the thing attests to it’s aesthetic! Anyway, about 2 minutes in she says, “Eat a rainbow of colours!” [snort], “Seriously? Are you really supposed to do that?!” Like either these naturopaths have been munching on the wrong kind of mushrooms or, even more outrageous, I had forgotten among my mother duties to mention this quintessential truth…either way she was momentarily taken aback.
Let me just give you some context, unless I’m assuming too much. (more…)