I struggle and I see others struggle too – to make sense of the evidence in a way that doesn’t deny our core beliefs & understanding.
A practitioner who’d just undertaken the Nutrient Prescriber’s Program shared with me that via another training she’d been told, that according to an RCT, 30mg of Zinc TIDS for 3mo was affective in acne rosacea. She said, “but now that I’ve done the NPP I would seriously rethink that approach.” When we hear about successful studies employing nutrition or herbs in a given presentation, it’s tempting, given this evidence of efficacy, to simply replicate that remedy in our patients but this then is only EBM, not Integrative EBM, not personalised, not holistic, not crafted, not curated and arguably a substandard, certainly suboptimal, use of our medicines. Single nutrient or herbal solutions are not how we prescribe and they often push up the dose required to get a desired response. And in going high, we run the very real risk of creating imbalances and other unintended effects. For example, who tracked the bone turnover markers and Hb precursors of these individuals? Two biomarkers established to be negatively impacted by a Zinc excess without due consideration of its critical micronutrient relationships, ratios and ripple effects! Successful scientific studies using our medicines make a sensible place to start our thinking about what to use in particular presentations but not a place to stop! We should not shirk our much more developed & holistic understanding of our modality nor abandon individualised care.🎤
From RCTs to Real Patients
in Hashimoto’s Thyroiditis
If you’re an evidence-based practitioner you recognise the value of a well-conducted RCT, however, if we were limited to replicating those successful interventions from RCTs investigating CAM, the resultant prescription would be neither integrative or holistic! The success of scientific enquiry is in large part attributable to its ability to standardise (subjects in a sample, single nutrient or herb interventions administered at a one-size-fits-all dose) but success in integrative health demands individualisation. So, how do we marry the two paradigms? In this episode Rachel talks you through the journey we must undertake in order to apply the findings of RCTs to real patients to arrive at our desired destination: Evidence Based (Yet!) Integrative Medicine, using the nutritional management of Hashimoto’s thyroiditis as an illustration.
You can purchase From RCTs to Real Patients in Hashimoto’s Thyroiditis here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.