I was lucky enough to hear Jason Hawrelak’s excellent presentation at the Australian Naturopathic Summit last weekend, titled: A Case of Blastocystis Infection – Or Is It? Timely, highly valuable, immediately usable, provocative education (just how I like it 😉 ) on how perhaps often Blasto is playing the scapegoat for another condition/cause of patients’ GIT symptoms. During this case study, Jason detailed the shonky diagnostic work-up of his current patient by a naturopath 12 years prior…that naturopath was him.
There was so much to love about his telling of this case study and the discourse around it but here are my Top 3 Takes:
- None of us know everything or practice perfectly but rather we do what we do, until we know to do differently…even Jason 😉
- As there are 9 strains of B.hominis found in humans and many of these are in fact benign commensals, even perhaps important ‘apex predators’ for the microbiome, attributing someone’s health problems (digestive or otherwise) to the presence of this parasite should in fact be a diagnosis of exclusion…always asking yourself first, what else could it be?? e.g. coeliac, SIBO, food reactions etc etc
- The cost of being a ‘premature evaluator’, to your patients and to yourself, can be very high…
These little blighters are getting a lot of airplay this month and rightly so…..! Oh Em Geeeeeeeee….so much misinformation out there!! It’s time to set the record straight
Worm infestations never conjure up a pretty picture in our minds although a video of humans trying to bum slide across the floor like some dogs we know would get a fair few laughs (…will share that vid later)
Despite much talk of the potential therapeutic activity of helminths for things like autoimmune diseases and allergies due to their immuosuppressive effects, there’s nothing nice, friendly or ‘good for us’ about a chronic Enterobius vermicularis (threadworm) infestation in a child or adult (YES! You heard me). Oh and don’t forget the possible link with your D.fragilis patients…you just might need to treat these guys instead.
It was great to get down and dirty on worms with Andrew at FX Medicine. This podcast has us uncovering and debunking myths on these creepy critters that have more to answer for than you probably realise…
The outcry from the public is enormous, in terms of their need for help and the gaps that are there at the moment in terms of getting it. There is an online resource called thewormwhisperer.com.au, which is primarily there for the public to meet this need and practitioners can learn a lot by going on there as well.
Ever feel like you’re chasing your own tail trying to treat & find the source of GIT parasites in some patients?! Well guess what, you just might be!
We’re seeing more & more patients test positive for Dientamoeba fragilis and increasingly patients struggling to eradicate it and prevent relapse. And then there’s Blastocystis hominis affected patients… and then those lucky enough to have both.
Well, while we might have been grouping D.frag together with B.hominis, being the two most common GIT parasites in humans, looking for what they share in common, they are worlds apart (we think!) in terms of how they are transmitted to humans. (more…)
Standing at the podium, I looked down at my notes & slowly read out the title of my presentation to the hundreds of people attending, ‘Paediatric Digestive Issues & Neurocognitive Abnormalities’ and briefly froze thinking, Holy Heck (!) this is someone else’s presentation! Seriously. No, this is not one of my work stress dreams. This happened. I thought…oh my how am I going to deliver this, it sounds very complex and lofty and scary!!
Then I saw my scribbled hand notes on the page, the unofficial name I had affectionately given this presentation as I researched, compiled my case studies and brought it into being, months prior and I instantly relaxed…oh…Kids’ Guts Are Mental…now that I have some serious experience with and something to say about! (more…)
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…)
“Two great speakers – inspirational in the first half and bang on in the second – I now know how much I don’t know”
Just out now in time for Christmas…no seriously though… this year I had the good fortune to team up with Biomedica and in particular Rachel McDonald and we delivered a 3 hour seminar called Mental Health in Holistic Practice. The intention behind this collaboration was to shift the education focus for practitioners from a prescription based approach, to one really about the clinical reality of managing mental health clients. Probably most of you will agree that the ‘treatment’ counts for only a portion of the positive outcomes in your patients and this is particularly true in clients challenged with mental health issues. After more than 20 years in practice working in this area, I’m keen to share what I’ve learned so other practitioners can get there much much faster! (more…)
Many of you would now be aware of the shift from culture (stool MCS) to gene-based stool testing (stool PCR) which has now become available under Medicare subsidy. While this has been an exciting development that promised greater accuracy for the detection of parasites in our patients, there remains limitations. One of the biggest is the fact that the PCR test is based on just one stool sample compared to the 3 day samples used in the culture test.
While this is rationalised, both by the pathology companies and some doctors, by higher test sensitivity and specificity, it flies in the face of our understanding about the irregular shedding of parasites i.e. the presence of the parasite in an infected individual’s stool can vary from nothing to severe, just day to day, therefore diagnosis must be based on several days of stool collection to account for this.
A practitioner I mentor, faced with several patients with negative PCR results but a clinical picture and other pathology results (raised eosinophils, impaired iron levels etc.) that strongly suggested the presence of parasites has been debating this with her shared care providers trying to encourage them to still refer patients for the stool PCR but performed over several samples.
She came across this article as a nice piece of supportive evidence Irregular shedding of Blastocystis hominis (Venilla et al 1999): ncbi.nlm.nih.gov/pubmed/9934969
While there are numerous other studies confirming the irregular shedding of most parasites this is a handy paper perhaps to use to strengthen the case for PCR stool tests performed over 3 days rather than 1. Let’s face it – it’s a big enough ask to get our patients to collect stool – we should really ensure we have optimised their chances of getting an accurate result!