28 May 2015 | Clinic, FAQ, News
Ever noticed that thing called RDW (red cell distribution width) reported in your patients’ haematology results? Given that this parameter is currently regarded as one of the most important & earliest markers of a wide range of serious diseases, you might start paying some more attention to it from now on!
Dr. Michael Hayter, cleverly refers to RDW as being a reflection of the ‘Quality Control’ of an individual’s red blood cell synthesis.
As it’s a measure of how similar or dissimilar our rbcs are in terms of size, smaller values (suggesting homogeneous rbcs) are regarded as healthy, while higher RDWs suggest that some part of rbc synthesis and/or clearance process is faulty.
This makes perfect sense in the context of nutritional anaemias like iron and B12/folate which all produce elevated RDW results but new research proposes that this rbc size disparity is also a common linking feature in just about every major disease, often predating diagnosis or in cases of established pathology signalling progression and warning of imminent poor outcomes for the individual.
There have been 100s of papers published just in the past 4 years on this topic and the findings are nothing if not dramatic. One of the biggest things I’ve realised is that, while Australian pathology companies suggest that all RDW results < 16% are acceptable, in the light of these new associations, a more accurate cut-off is probably around 13.5%! The big question now to answer is, is the increased RDW a passive marker of pathology or actively involved in the pathogenesis of these major diseases. For now, we should be scrutinising our patients’ RDW results more closely and being alert to what these markers are telling us about our clients threats & risks. I’ve recorded a 30min audio summarising all the information I’ve come across on this topic and how to apply it in your patients which you can access here.
Alternatively, if you’re happy to chomp into some juicy journal articles yourself then check out these ones to start with
https://jaha.ahajournals.org/content/3/4/e001109.full
https://www.researchgate.net/profile/Fabian_Sanchis-Gomar/publication/269930590_Red_blood_cell_distribution_width_A_simple_parameter_with_multiple_clinical_applications/links/5499b0e50cf2d6581ab15143.pdf
10 May 2015 | News
Last weekend I attended the Science of Nutrition in Medicine Conference in Melbourne https://nutritionmedicine.org.au/enews/2015-02-06-Program.html and for those of you that didn’t make it I can tell you, it wasn’t your regular CPE event. I’m not sure if the debate inside the presentations or outside in the breaks was more interesting but I can say that I haven’t seen this much stimulated thought, heated discussion and passion at company run events. Why? (more…)
11 Jan 2015 | Clinic, News
We now suspect that many of the drivers behind PCOS are heritable components – a genetic vulnerability passed from parents, possibly one but often both. This growing understanding has identified a phenomenon referred to as ‘PCOS families’ i.e. a family in which at least one female has confirmed PCOS.
Being a primary biological relative of someone with PCOS, it would seem, suggests a shared risk, even if you are a son, or brother or father.
So beyond the very high rates of undiagnosed PCOS in sisters of someone already diagnosed, there is much talk now about a male PCOS phenotype equivalent. (more…)
29 Dec 2014 | Clinic, FAQ, RAN Store
As we head rapidly towards the change over of our calendars we would like to offer you a special on the very best educational recordings from 2014 – buy 2 CDs before Jan 31st and receive one complimentary Premium Audio Recording of your choice OR purchase 4 CDs and receive a 3 month Premium Audio subscription for free.
It’s been a busy year during which Rachel has delivered 7 very successful new seminars in the area of mental health and beyond, most notably fortifying her role as a leader in the field of diagnostics and pathology interpretation. This has included collaborations with ACNEM, Biomedica, Health Masters Live, MINDD and Nutrition Care, however, each recording is classic Rachel – full of fresh perspectives on diagnosis & treatment, colourful analogies & humour. In case you missed some of these this year or want a copy for keeps – here’s a quick summary of the 2014 recordings included in this end of year offer: (more…)
15 Dec 2014 | Clinic, FAQ
We’ve just had another mentoring case in which a 40 something female with deficiencies of almost all other minerals but ‘pretty normal ferritin levels’ presented with a range of endocrine problems and arthralgia. Sounds as if iron’s not the problem right? Except that in this case her iron studies also tell us that her transferrin saturation % on last check was 48%. The diagnostic criteria for hereditary haemachromatosis (HH) necessitates elevated ferritin – to indicate that the iron stores are reaching saturation, however, while this becomes evident at relatively young ages in men (20s-40s), who have no specific excretory pathway for iron, is this still appropriate in menstruating female, whose monthly periods may mask the HH tendency with regard to ferritin? I’m guessing you know what my answer is already! 😉
Some would argue that HH, in spite of being an inherited disorder, is only clinically meaningful once the ferritin is elevated ( earlier and more potent elevations are seen in people possessing the C282Y genotype) but again this is very much up for debate in the current scientific literature, with a lot of research concluding that the transferrin saturation (also referred to as the transferrin ratio) being an important prognostic indicator for various chronic diseases including CVD.
When we go back to basics and remember the higher the transferrin percentage the more iron is being delivered to tissues around the body (whether they like/want it or not! so we refer to this as being ‘iron dumping’) and the higher the serum iron, the more unbound iron is in the system – a key source of oxidative stress..it becomes patently clear that these two parameters are important early warning signs of a tendency to iron overload, increased risk of heavy metal toxicity and already active mineral imbalance. So in future keep your eyes open for women with fasting transferrin saturation values that consistently sit above 35% and men, > 40% and if you do see a series of suspicious values – consider the genotype test through mainstream labs.
16 Nov 2014 | News
I learned to drive more than 20 years ago in a mustard yellow VW beetle with my ageing father beside me playing the dual role of instructor and slightly hysterical passenger. The one catch-cry that he screamed over and over again was, “Where’s the fire? Where’s the fire?” In case you require translation, this was his way of indicating that I was almost travelling at 60kmph & essentially meant, ‘unless you are part of the emergency services & on your way to a crisis there is no reason to be travelling this fast!’ I know, it’s a wonder I ever learned to drive! But I’ve actually come to love that catch-cry, “Where’s the fire?” because for me it has become a pressing question in clinic every day. (more…)
27 Oct 2014 | Clinic, News
I’ve been re-reading lots of studies for a talk I’m delivering at ACNEM in Melbourne, investigating the relationship between selenium and a myriad of thyroid pathologies: from hypo- to hyperthyroidism and from subclinical thyroiditis to cancer. The sheer number of trials is overwhelming & increasing, in fact I think there’s more every time I go back and look (!) and the bulk of the findings keep telling us yes! yes! yes!…selenium plays a pivotal protective & corrective role unmatched by any other nutrient. Whether it’s buffering the oxidative stress that comes with high TPO antibodies or lowering antibody titres, preventing or minimising the orbitopathy associated with Grave’s or simply maintaining a better level of T3 in euthyroid individuals, there are numerous potential positive effects from selenium supplementation …in the right patient… and therefore this is the bit we need to be clear about: while the majority of both epidemiological and interventional studies all concur that low selenium levels equate with a greater risk of thyroid issues in all our patients & poorer outcomes in patients with already established thyroid disease, the big question is how low are we talking?? (more…)
11 Oct 2014 | News
When was the last time you drank or ate something that contained an artificial sweetener (AS)? I remember it well and my most striking recollection was the way it ‘hit the spot’ just like I would have expected sugar to, making me immediately suspicious of the effects it would have on my body. It seemed implausible that it could mimic the taste/the sensation/the mood effects of a major sugar hit but not evoke any of the physiological responses of sugar…whether that be in my brain, my pancreas, my whatever! We’ve been sold the concept that AS offer the western world an exit point from our collective march towards metabolic syndrome for decades but sweet relief (pardon the pun ;)), new scientific studies are piecing together the real impact of AS consumption.
“‘We found that artificial sweeteners may drive…an exaggerated elevation in blood glucose levels, the very same condition that we often aim to prevent by consuming them,’ Eran Elinav, MD, PhD, from the Department of Immunology at the Weizmann Institute of Science, Rehovot, Israel, said at a press briefing.” Medscape (more…)
5 Oct 2014 | Clinic, News
We’re all aware of the reported link between Isotretinoin (aka Roaccutane, Accure, Oratane), originally listed by the FDA in 1982 for the treatment of severe treatment refractory cystic acne, and depression & suicidality in some individuals. Any suggestion of causality however remains hotly debated by the manufacturer of course & there is a recent small RCT not only refuting a relationship but claiming that via effectively resolving acne, patients’ depressive features decrease on this drug (Marron, Tomas-Aragones, Boira. Anxiety, depression, quality of life and patient satisfaction in acne patients treated with oral isotretinoin. Acta Derm Venereol. 2013 Nov;93(6):701-6.). However most of us have read the media reports regarding tragic case studies, are aware of the warnings listed on the package insert and have met patients whose mental health problems appear to have been precipitated by use of the drug. (more…)
23 Aug 2014 | Clinic, RAN Store, Testimonials
I’ve received so much lovely feedback (fan mail!) recently I just had to share some with you (note I look much more excited than Meg does when I get mine!). It’s so exciting to be a part of our burgeoning naturopathic & integrative network. From Alyssa Tait a Brisbane based naturopath, clinical nutritionist & physiotherapist: “I am so appreciative of your mentoring and your professional development (e.g. recent Health Masters Live webinars). You make me really enthusiastic about being in this field, and you actually help me feel like I sort of know what I’m doing…most of the time!!” (more…)
28 Jul 2014 | Clinic, News
There are few complementary medicines that come onto the market with such a bang, opening up genuinely new therapeutic options for the effective management of such a broad range of health complaints. N-acetyl cysteine stands out for this reason and has changed the way I practice… seriously!
Recently I had the pleasure of presenting a webinar for Biomedica completely and utterly focussed on N-acetyl cysteine – its key actions, pharmacokinetics, applications and contraindications. In the process of researching for the webinar I learnt so much and to my surprise found even I was under-utilising my favourite supplement! How familiar are you with its application in cystic fibrosis, fertility, biofilm eradication etc. etc ? Not to mention, it’s incredible versatility in mental health. Recently, buoyed by some new research suggesting the efficacy in severe glutamate excess of much higher doses than previously studied for depression and bipolar, I have stepped up my doses in patients with some forms of addiction, OCD, refractory insomnia to 4g/d with great results! I could talk all day about NAC but perhaps for a starter if you missed the webinar you might want to listen to the recording? We have the Clinical Knack of NAC now available as a CD with audio and notes for purchase on the website:
https://rachelarthur.com.au/product-category/audio/
This in-depth 1 hour webinar offers practitioners new to NAC, the practical knowledge and tools they need to start using it effectively and for the practitioner already dispensing it, to really broaden their understanding of indications , correct many misunderstandings and get the latest research on the why, when and how to use it. From reproductive to respiratory health, from heavy metal burdens to biofilms and athletes to addicts, this webinar covers the latest information about NAC’s real therapeutic potential. Having been a favourite nutraceutical/prescription of Rachel’s for some time, she punctuates the presentation with many of her own cases.
17 Mar 2014 | News
About a decade ago there was a lot of excitement about using fish oils in the management of mental health, so much so even the American Psychiatric Association developed recommendations suggesting that people with mood, impulse control & psychotic disorders should all consume 1g EPA + DHA per day… but then what happened? Ask most health professionals (GPs, psychiatrists, naturopaths & nutritionists alike) today whether fish oils are their first choice in mental health nutritional interventions and you’ll frequently get a, ‘No’ and I include myself in that.
Let’s retrace our steps to find out how we got here. The epidemiological evidence linking low omega 3 intake to myriad mental health problems in terms of susceptibility, incidence and severity is almost overwhelming. For example, depression rates are 10 times higher in countries with limited seafood intake and post-partum depression 10-50 times higher (Kendall-Tackett, 2010).
Noaghiul & Hibbeln postulated that countries where individuals consumed less than ≈ 450-680g of seafood per person per week demonstrated the highest rates of affective disorders (2003). One study of 33 000 women with low omega-3 intake were found to have an increased risk of psychotic symptoms (Goren & Tewksbury 2011) and it goes on. Then, we have other evidence also pointing in the direction of fish oils, such as the general consensus that excess unchecked inflammation is evident in many mental health conditions (Maes et al 2013). Numerous intervention studies using fish oils as stand-alone or adjunctive treatments have been published. Interventions have included high dose omega 3 (no specific EPA/DHA breakdown), EPA alone, ethyl-EPA, high DHA, blends with high DHA:EPA ratio, flaxseed oil etc. etc.
These studies are quickly followed by the systematic reviews, meta-analyses etc. which almost invariably conclude that supplementation with fish oils isn’t effective – or more correctly, based on this terrible mish–mosh of evidence no firm conclusions can be reached.
Take the Cochrane Review on the use of fish oils in Bipolar Disorder for example, which based their negative conclusion on the results of one study (Frangou et al 2006), while > 23 others failed to meet their inclusion criteria (Montgomery & Richardson 2008).
The big take home message should actually be: Fish oils ain’t fish oils!
If you understand some of the key structural & biochemical differences between EPA (precursor to eicosanoids, able to generate DHA, little structural contribution to the brain) and DHA (major structural brain fat, precursor to the docosanoids including resolvins, mild reuptake inhibitor of 5HT and DOP), the superior bioavailability of triglyceride forms over ethyl esters and the seriously limited ability of humans to convert plant omega 3 precursors to the LCPUFAs, then you can start to see your way through the research mess and step away from the broad brush stroke conclusions of the Cochrane review and similar.
Check out some of the better written and more insightful reviews – especially this one by Sublette (2011) which found that in successful treatment of depression fish oil supplements must have >60% EPA compared with DHA and read her theories on this. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534764/ So we need to get reading and get clearer about which specific omega 3 fatty acid or blend (and in what ratios) works for which mental health problem – its definitely not a case of one-size-fits-all – do your homework and pick your products well and most importantly let’s not throw the fish out with all that fishy research!
Page 7 of 7« First«...34567
