While it seems like every second patient is on statins in Australia, NZ, America and most developed countries, over the age of 70, they actually are!
But can you name a patient who has had their Lipoprotein (a) measured and is being managed for this by their GP?
So while the controversy and contention surrounding the “curse” cholesterol places on our cardiovascular health continues to rage, general practice guidelines are full of green lights for statin prescriptions but what if I told you that there’s another lipoprotein that is more atherogenic, more directly implicated in arterial disease & whose levels are more powerfully predictive of atherosclerotic disease and valvular aortic stenosis…than any other biomarker we have? Well, I just did.And so did all these global authorities!!!
But you and your statin-saturated patients are unlikely to hear about this lipoprotein because there’s ‘no drug for that’, right? In fact, up until recently we’ve all been told there’s nothing you can do to lower an elevated level and accordingly reduce the associated risk…guess what…new research says we can! Yes, it’s finally time to switch off the snooze function on this one and tune into what could be the most important test your patient takes.
A New Era in Cardiovascular Risk: Lp(a)
”If there’s no pill there’s no ill”, is a cynical saying about how the availability of pharmaceutical-fixes determines the practice of mainstream medicine. In the case of Lipoprotein (a), reported to exhibit the strongest independent correlation with both atherosclerosis and valvular aortic stenosis causation, in the face of its complete omission in general practice guidelines, this would seem particularly apt. Instead, the fixation in prevention and management of cardiovascular disease has almost exclusively been on things we have drugs for: like cholesterol. But at long last national and international heart health authorities are conceding this is a biomarker that offers insight &, especially given its independence from all traditional risk factors (hyperlipidaemia, diabetes, smoking etc), helps to identify and avert the CVD “no one saw coming”!
You can purchase A New Era in Cardiovascular Risk: Lp(a) here. If you are an Update in Under 30 Subscriber, you will this episode 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.
Cracking the Case: Uncovering Cardiovascular Risk – Elevated Lipoprotein (a)
How do you conduct a comprehensive cardiovascular risk assessment? It should always include a Lipoprotein (a) result, having been declared the biomarker with the strongest indication of causality in both atherosclerosis & valvular aortic stenosis. But what use is getting this tested, if, when we identify increased risk due to elevated results, we have no means to lower it? Until now. This is a 57 year old female with a striking personal and family medical history, a peachy coronary calcium score, mildly elevated LDL-C but significantly elevated Lp(a). We describe in detail the meaningfulness of this, as one element in our understanding of her overall inter-connected health story and reveal the prescription and approach that got results. We also discuss the challenge that is inherent in both ‘uncovering risk’ in someone while remaining on the right side of hope vs despair and of the nature of CVD risk reduction which requires lifelong management.
You can purchase this Cracking the Case episode: Uncovering Cardiovascular Risk: Elevated Lipoprotein (a) here.
Ok everyone, we need to stay calm, which I know is the biggest challenge with something this serious, but let’s focus on the steps we all need to take:
Step 2: Inform all your patients – not just the ones you have prescribed these to this year, all your patients can potentially pass this essential information on to others who might be affected. Practice your real due diligence, and email your entire client base. We need to spread the word fast to limit the fallout for those of you old enough to remember theBonsoy debacle, the magnitude of the error in iodine doses in these products is on scale with that – potentially providing people with 200mg (6,000 X UL) of Iodine) per serve
Step 3: Update your understanding of how an iodine excess can affect individuals, the markers and the manifestations – especially regarding delayed presentations & pathology resulting from cumulative exposure. This is something we will need to keep assessing & screening for over the coming months in these clients via not just TSH but repeat thyroid Ab assays.
Step 4:Conduct a risk-benefit analysis in each individual for the case of additional Selenium. This nutrient naturally has its own U-shaped dose response and adverse effects if we overshoot the mark but anyone who has been potentially consuming an iodine excess will, as a direct consequence, have a greater need for Selenium to protect the thyroid against damage from this. Iodine & Selenium are intrinsically integrated with one another in nature, in every diet, in our physiology and, accordingly, doses should be never considered in isolation.
Step 5: Know where to actually direct your anger! This is not the fault of these brands – though I note how fast some were to inform practitioners while others took their own sweet time, which is truly reprehensible. The blame lays squarely with the manufacturer, the only company name not being publicly shared and shamed! This manufacturer substituted a new unapproved raw material for their K-Iodide in January into their production line. The manufacturer worked this out retrospectively late last week and started contacting companies to alert them Friday evening!!! And for those inclined to TGA-bashing…it ain’t the time! At least we have a regulatory authority to respond – send out alerts to everyone etc.
Step 6: If you stock these products contact your supplier to enquire about your rightful reimbursement while not forgetting number 5! All these companies (practitioner only) are suffering a stain on their name that they had no power to prevent. It’s the manufacturer that needs to make amends here….big time.
This is so incredibly unfortunate…
😨 Of all the nutrients – the risks of iodine excess is something I talk about OFTEN and especially of late in pregnancy!! …and
😨 of all the products – it is these HUGE HITTERS in terms of numbers out there on shelves, in circulation & currently being consumed and
😨 of all the patient populations – two of the most vulnerable
Let us know if you have other suggestions regarding steps we, as individual practitioners and, as a professional community, should be taking in response to this
If you listened to our latest Update in Under 30 episode on Postpartum Thyroiditis and how to implement an optimal risk assessment (before, during & after pregnancy), you’ll have been expecting this new arrival with much anticipation 🐣🤓 because the true value of accurately predicting risk, and at the earliest possible time-point only becomes realised, when we successfully avert or reduce that risk, right?!
And guess what? The science has well and truly spoken on this one.
However, because success has only been demonstrated with nutritional & nuanced nutritional interventions at that, mainstream medicine sadly has no 👂ears👂 to hear it.
That’s right. Thyroxine, as a preventer during pregnancy or following the birth, has failed to reduce risk – so too yet more iodine…oh lord…not more iodine!! So, as is the case in many conditions where there’s no pharmaceutical fix, there’s no reason to risk assess if you’ve got nothing to offer! We’re in a very different position, with all the tools in our existing dispensary, in addition to our strong foundation in food as medicine. Accordingly here comes part 2 of our PPT – Risks…and now the Remedies and a case workup on a patient where we look at her risks in the rear-view and look ahead to remedies to resolve this condition now. Yep, we been busy this last month with 3 hatchlings🐣🐣🐣 in total and no cyclone to be seen 😶 Stay safe you all!
Postpartum Thyroiditis Risks…
Postpartum thyroiditis is said to affect 1 in 20 Australian women but in reality the rates are much higher and the risk much greater in many of our patients. Given up to 50% of patients diagnosed with PPT will end up with permanent hypothyroidism, a risk assessment radar that works in real time to better predict, pre-empt and prevent the condition is essential. Summarising the research we showcase both baseline risks prior to conception and the best schedule for thyroid health monitoring throughout pregnancy and post-partum.
Postpartum Thyroiditis …& Remedies
Accurately identifying women at an increased risk of developing postpartum thyroiditis only makes sense if we have evidence-backed means to successfully mitigate this risk. As a follow up to our recent related episode on this topic, this one is all about the remedies to implement at each level of identified risk, while also discussing how to treat both a hyperthyroid and hypothyroid phase, should the condition come to fruition. This recording comes together with an extraordinarily helpful clinical tool, a visual summary of what to assess, when along with the appropriate treatment with each new level of risk identified.
You can purchase Postpartum Thyroiditis Risks… here & Postpartum Thyroiditis …& Remedies here. If you are an Update in Under 30 Subscriber, you will find both episodes waiting for you in youronline 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.
Cracking the Case: Postpartum Thyroiditis: Risks in the Rearview, Remedies & Resolution
Odds are, you see women who are trying to conceive or are already pregnant. Odds also are that their likelihood of developing postpartum thyroiditis might be higher than most, but do you always know how to spot this? And from there, how to optimally assess them moving forward to know how their static risks they started with, are responding under the influence of pregnancy and postpartum physiology. If we can be clear about this and their shifting PPT propensity, then what we have is an opportunity for effective risk mitigation. In this PPT case we take a look in the rear view at what her risks were, where we could have redressed these and now ask the question, how to treat the PPT and avert permanent hypothyroidism. This case discussion comes together with an extraordinarily helpful clinical tool summarising assessment timepoints and interpretation along with appropriate treatment with each new level of risk identified.
You can purchase this Cracking the Case episode: Postpartum Thyroiditis: Risks in the Rearview, Remedies & Resolution here.
Wanna see behind the curtain here? Sometimes in my pursuit of perfect clarity I go totally OTT. <GASP👀> But when you know that for women diagnosed with Postpartum thyroiditis it was likely to have been missed or misattributed for months to, ‘You’ve had a baby! Of course you’re…(insert adjective)!’, yet for up to 50% it will result in permanent hypothyroidism…well I guess PPT is a good reason to go OTT.
Oh and don’t get me started on the complete lack of risk assessment and mitigation for women. Your risk is different from her risk is different from mine…and how these risks behave under the influence of pregnancy is what we need to watch. Just like in Hashimoto’s disease, this condition has a long prodrome – so its diagnosis is only a ‘surprise!’ for those who choose not to see!
So in pursuit of perfect clarity regarding exactly when, and precisely how, we should dynamically assess a woman’s risk and then, better yet, what research backed risk reduction strategies should be implemented at every step, I may have got a little carried away 🙄 Now on the other side of reading and summarising and then re-reading approximately 200 published research articles and reviews, quantitatively analysing ever single prenatal formula on the Australian market, recording 2 episodes of Update in Under 30 (which tbh took the better part of my working and general waking hours for more days than I am prepared to admit!) and with my tireless and tenacious team, designing a clinical reference tool to summarise all this, just for you(!) I can confirm clarity is indeed where we’ve arrived…and also beddy byes 💤😴
Postpartum thyroiditis – Risks (part 1) available now…& Remedies (Part 2 soon to be released)
Postpartum thyroiditis is said to affect 1 in 20 Australian women but in reality the rates are much higher and the risk much greater in many of our patients. Given up to 50% of patients diagnosed with PPT will end up with permanent hypothyroidism, a risk assessment radar that works in real time to better predict, pre-empt and prevent the condition is essential. Summarising the research we showcase both baseline risks prior to conception and the best schedule for thyroid health monitoring throughout pregnancy and postpartum.
You can purchase Postpartum Thyroiditis Risks… here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
If you’ve been following the story of ‘my little white spot’ you’ll know that it’s part of me keeping myself (& my whole new framework for nutrition prescribing as per the Nutrient Prescriber’s Program) extremely accountable! Based on all the very latest research that speaks to down-regulation of ZIP transporters in the gut when Zinc is dosed daily at levels beyond what is achievable with food, and after 30 years of dosing daily, I finally gave up the gear! For about a year now I’ve taken my Zinc supplement just twice a week and am reaping the rewards and singing my success from the rooftops!
So imagine my rather large intake of oxygen when I spotted this rather elongated version of a ‘spot’ right at the very base of my exposed thumbnail, yesterday! So, has my greatly reduced regime led me to the lion’s den of a deficiency at last?
To answer this we must first talk timeframes. Nail markings are a look in the rear-view, right? They do not speak necessarily to today but to an event, inadequate Zinc or other, that occurred at the time this nail was being made by nail matrix cells hidden from view under the proximal nail fold. Therefore, significant time has to have passed before we actually get to see these. Do you know how to read that timeline? And how that timeline might change in individuals experiencing different rates of (nail) growth, e.g. pregnancy, senescence, hypothyroidism, protein inadequacy etc. Establishing this understanding for each individual enables us then to accurately interpret any anomalies & similarly, I reckon I’ve just confirmed my nail ‘transit time’ 💩🤣 so to speak!
My year started with appendicitis and an appendectomy 6 weeks ago almost to the day 🤯
So if we accept my time-travel theory, what then do we take the marking itself to mean? Was it that the lower Zinc doses suddenly caught up with me making my appendix sad & sick? Was it direct trauma to the finger and nail bed around this same period that I’ve long ago forgotten about, in all the excitement over my misbehaving appendix? Was it that the infection, surgery and associated stress of the event probably produced a transient secondary Zinc shortfall? All the evidence says I can exclude the first option but even I can’t be certain which of the last two are true. Knowing the real power of nutrition, however, I am leaning toward the latter. As a total nutrition nerd, I’m tempted to try and recreate the event as an experiment to test my theory…just jokes…but should there be a ‘next time’ for a hospital visit, a general anaesthetic etc. I will be keeping a close eye on whatever clears the cuticle 6 wks later!
Oh and apologies for the ugly pics! I was never meant to be a nail model, I enjoy working on my bush block and eating blueberries far too much. These should come with a warning 🙄
Our new batch of Nutrient Prescriber’s are currently under construction 🔨👷♀️👷♂️ And even though there’s already brain juice flying everywhere—we’re only 1 module in – so if you’re having FOMO it’s not too late to join. Alternatively, you can do the whole program at your own pace without the pack…but I gotta say…the praccies in this pack 🐺🐺🐺 are fun to run with & you get the benefit of hearing all their questions, thoughts, experiences, input and answers to boot!
I have a lot of random interactions with health professionals when we happen to find ourselves on the same patch of real world out there. Two weeks ago someone served me in a local health food store and at the end of the transaction said, “I went to that Australian Naturopathic conference that was held here – now which one are you?” I knew immediately what she meant 😂 I said my first name, then mentioned I was actually on my way to see one of the other directors, Kathryn, and as I was leaving she said, “See you next time Kathryn!”👋
Then just last week I was in Launceston sitting in the sun in the mall and a woman walked by and waved. Given I suffer terrible face-blindness (in case you ever think I’m just being rude!) I was worried I knew her but had forgotten, so I waved back. Five minutes later we met again in a shop and with all the smiling & waving already done, she asks, “Do I know you?” I answer that I’m not sure but she follows up with, “You’re a naturopath right? 👍 You’re Rachel?👍 Greg’s wife from Devonport? 🙅♀️🙅♀️ Ahhhhh I guess 2 out of 4 ain’t bad 😂 Turns out I’m not as memorable as I had imagined 🤣
Just 24hrs later I’m at a wedding & someone who I do know & they do in fact know me (can confirm, name, profession, context, location etc. all check out 😅) proceeds to say, “I’m trying to work out what you mean in your latest emails.” I look at them with confusion about their confusion and then they add with incredulity, “Are you actually not going to do mentoring anymore?!”🤯
Ahhhhh yes that is exactly what I mean – I’m not doing a John Farnham here folks!
I have loved meeting up every month with hundreds of practitioners across the 13 years. It’s been an absolute honour to play such a consistent part in all of your professional development, witnessing your individual growth, challenging myself as much as you, while constantly adapting to changes in the profession and, let’s face it, the whole information, education, health landscape! We’ve worked up hundreds of complex cases together, supported a whole next generation of new grads to transition to clinicians who really stand out from the pack, offered many the opportunity to up-skill in mental health and most recently, we became the proud parents of hundreds of !NEW! Nutrient Prescribers – who really are the experts in nutritional medicine now. At one stage I was running 16 separate groups that met every month from February to November, then we expanded the group sizes to cut down the number of groups necessary, then we shortened the year, shortened it again, went to just half a year…yeah the pattern was patent for all to see…next stop…no more monthly mentoring.
Now of course I will not disappear all together…well maybe for a bit but I’ll be back! And my existing educational material will remain available on the website.
My intention is to keep contributing to the education & professional development of my peeps but not in the way I have been.
My compulsion to innovate rather than replicate has kicked in big time
Do I know what’s next? A break. After that? Maybe another lil break 😅 But no honestly, we don’t as yet have any clear vision about future offerings at this time…maybe that will come with a break. And if you ever see me in the same patch of real world out there – please do come up and say hello – whoever you think I am 😂
Keen to join me this one last time?
The Nutrient Prescriber’s Mentoring Program – a structured process for creating prescriptions that’s systematic, scientific and more likely to produce successful outcomes. Join here
Cracking the Case mentoring – curated cases that will build your skills in complex case work-ups, condition specific knowledge, prescription decisions and pathology interpretation. Join here
New Graduate Group Mentoring – supporting your transition from student to naturopathic powerhouse, you will find your tribe, gain support and radically build your toolkit. Join here
Wouldn’t life be a breeze if there was a calculation telling us how much to prescribe of a given nutrient for every different patient to take them out of deficiency, into repletion or even optimal? Well there is.Kinda
If the nutrient in question is Vitamin D there have been several different loading dose calculations proposed and studied. You just plug in your patient details, such as their Vitamin D result and their weight…out pops the ‘total amount of Vit D required’ to get them from there to over that finish line, as well as a prediction for how long that will take. So is it really that simple?
Ahhhhhh….no
There are 5 factors we need to consider in every decision about dose and these formulas only account for a few. There are plenty of patients for whom the predicted dose and duration would be incorrect but it works well for others. And there’s the rather small GIANT issue of Vit D assay inaccuracy to contend with too. And what happens when we choose to use a different form? Instead of using cholecalciferol which these formulas are based on, we’re employing calcifediol or, we go all ala ‘Nature Cure’ and prescribe sunshine!!☀️😎🤯 How very retro?!
Do you always know how to answer the questions, “How much?” “How often & for how long?”
Like how many minutes of sun exposure (before 10am and after 2pm) produces the equivalent of 1000 IU D? If you’re in Townsville Vs Tassie? If it’s March Vs May? The failure to recognise ambient UVB as the single greatest contributor to meeting our Vit D requirements is like giving someone a protein shake under the illusion that’s their ‘protein requirements done’! And not knowing how to prescribe sunshine safely and effectively – means we’re unnecessarily prescribing yet more pills instead. Just sayin’ 🤓
Vitamin D Decisions – What Dose Delivers The Benefit
In this continued unpacking of how to personalise & potentise our prescriptions we introduce a framework to aid us in our decisions about dose. Current beliefs about supplemental Vitamin D purport the benefit occurs when we attain a given blood level. While this suggests a certain simplicity: how big is the deficit – therefore how much D do we need – this is far from the whole story. In this episode we introduce and debate the merits of Loading Dose Calculations as a means to determine the dose and duration of treatment required for each individual – looking at who these do(n’t) apply to but also discuss dose issues specific to other forms including sunshine.
You can purchase Vitamin D Decisions – Which Dose Delivers The Benefit here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
How has your start to 2025 been?
Mine has been humbling thanks to the grumbling of my appendix over 2 days, so much so that on the 3rd day it was forcibly ‘removed from its place of residence’!
Being unwell brings up all sorts of stuff for me. Many questions (Why do we still not really understand the aetiology of appendicitis in adults? How is it possible that RLQ tenderness was my only symptom with a CRP of 17 and neutrophils of 10X?! ) and a mini-existential crisis: I mean being a health professional who’s ‘sick’, makes me feel not only confused (‘But I live such a healthy life compared to most!!’ and ‘I thought I knew stuff!’) but also a sense of shame.
As peddlers of ‘wellness’ we feel we should never suffer illness, right?! The inner-academic (the sensible one😂) says, ‘That’s such an antiquated binary view of things….surely we’re all just different proportions of wellness & illness, at different times of our lives?’ However, I’m acutely aware ‘purism’ or ‘perfectionism’ continues to infiltrate my, and my profession’s ideology – which I personally have to work on pushing back against.
In a broader sense, re-examining these core beliefs & the prescribing practices that flow from them and, as a result being personally brought down a peg or 10, is really just a continuation of my 2024. Last year I developed The Nutrient Prescriber’s Program and in doing so, put an end to my own ‘age of innocence’. Or should that be ‘age of arrogance’? Both. In spite of being known for my knowledge in nutrition and teaching at universities and colleges, delivering foundational nutrition education to doctors etc, when we dedicated the year to researching the very latest evidence about each micronutrient, in order to create a clear prescribing framework and answer the questions: What form? How much? How often? and For how long? I was shocked by the revelation about just how wrong I have been about so many things.
But I had no choice but to keep delving into the discomfort – praccies were waiting, already engaged by the first few modules & their minds already blown.
Writing each new module we pushed into new frontiers, new ways of thinking, with respect to form, dose, timing, duration, combinations etc. I’m not going to lie, it was a scary ride, for us all(!) but an essential one – because you can’t grow if you’re not prepared to know. When celebrities accept awards and start by saying, ‘This is so humbling’, it always confuses me…I think, no, humbling would be losing! And as heath professionals, being humbled, would be recognising where we’re wrong, being prepared to push back against our desire to stay the same and stay safe (not challenge ourselves) and instead seek the honest answers. Both our original training in nutrition and our prescribing practices are based on beliefs that don’t stack up in the light of day. It’s true. This year I wish you the courage to undertake this journey of relearning nutrition with me.
Are you ready for a revolution in nutritional prescribing?
The Nutrient Prescriber’s Programis a structured process for creating prescriptions that’s systematic, scientific and more likely to produce successful outcomes. You’ll gain a reliable and robust framework to answer key questions such as: Which form? How much? How often? And, for how long?
Dive into the pharmacokinetics of micronutrients, their various uptake pathways in different scenarios, how they work in networks & how co-prescribing in the right ratios is essential for efficacy and safety, rather than as ‘single nutrient solutions’.
Join us in February for Rachel’s last year of mentoring or work through 10 transformative modules at your own pace.Click here for more details…
‘Good v Better v Best’, is often the value statement attached to each new nutritional product innovation as it enters the market…making the existing and older forms, according to the pattern, ‘Bad’…or ‘Inactive’, certainly ‘Superseded’ etc. But changing the form of any given nutrient, simply results in changes in one or more aspects of its pharmacokinetics (liberation, absorption, distribution, metabolism, elimination), or the homeostatic response of the individual (regulation). That’s how it can produce different effects & evoke different outcomes – that’s why we say, ‘Form Determines Function’
NRC & NMN have their niche actions but can’t fulfil our needs for niacinamide: the OG of B3
LIkewise, MK7 while a boon for our bones, is MIA when it comes to the full suite of actions we require from the essential K1
& [shock horror!] Magnesium oxide & sulphate both continue to constitute ‘the form that fits best’ in a number of applications
And when it comes to the options we have on offer for Vitamin D, sunlight [the OG of all OGs 😎] Cholecalciferol, Calcifediol & Calcitriol, there is a ‘prescription pocket’ each one occupies. Every one a different tool for a slightly different job: ‘all wrenches but for differently sized bolts’. But do you always know, ‘Which form when?’
Vitamin D Decisions – Which Form Fits Best Every prescription is the culmination of numerous individual decisions we have made, from choice of form to different aspects of dosing and sometimes this happens understandably on autopilot. We all have ‘favourite forms’ and ‘familiar formulations’, but it is important to remember that every decision we make is an active one that can make a difference to overall outcomes. In this episode we dig into the decision-making process regarding Vitamin D forms to ensure we know how to answer the question: Which Form When?
You can purchase Vitamin D Decisions – Which Form Fits Best here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
By virtue of our profession we all have an ongoing relationship with science but the nature of that may differ. Slave? Submissive? Subscriber? Sceptic? Or of course it could be all of these on different occasions depending on the science in question! But as integrative health practitioners we straddle the chasm between two very different planets & paradigms at times: the reductionism of science & the holism of our philosophy and principles & our medicines. At times, that straddle can become almost the splits(!) and can be just as painful & fraught with clash & conflict as it sounds!
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 Thyroiditishere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
In January, after 30 years I finally got off the gear. That’s how long I’d been taking good quality, high dose (minimum 20mg elemental) zinc daily for. Originally the rationale was I was a vegetarian. Then the 20 years that followed my reintroduction of meat saw me continue the practice, born of the belief & ’empirical evidence’ that I was healthier when I took it than when I didn’t, especially with respect to my immunity.
And on the surface that certainly seemed correct. If I lapsed, went for a period without, I would invariably quickly get sick and then some time later a white spot or two would emerge on my fingernail to mark the occasion retrospectively.
So like many others I was scared to go without it. But as I’ve mentioned, I decided last year to go on a research gathering and reading expedition of the very latest science on all micronutrients including best practices when it comes to their supplementation and lo and behold what did I find? Discomfort. Challenge. My world, or prescribing practices at least, turned upside down.
The science (employing a variety of excellent methodologies to produce very high level evidence for those wondering and playing devil’s advocate!) says, Don’t Dose Daily. Not if you’re using 20mg or more per day.
In fact when you do, you create a dependency of sorts. You heard me but I will say it again for those in the back: when you give this amount daily you shut down your GIT ZIP transporters (and potentially target tissue ones as well) which makes you less and less effective at absorbing zinc. But what about my ’empirical evidence’ that daily dosing worked because every time I took a break I got sick?? Yes well that’s what I now recognise as ‘dependency dosing’.
So what happened when I got off the gear after 30 years, aligning my prescribing practice with the research and dosing zinc only twice a week?
I got better. I have not been sick once this year. My iron levels increased, my plasma zinc levels stayed exactly the same and I’ve been able to take less magnesium because the zinc is no longer pushing it out. And every individual for whom I initiated the same change reports back the same or very similar findings. Oh and don’t be surprised when that lil’ white spot comes a calling. It took until about June for mine to appear about midway along the length of my pinky nail and just now it has almost reached the end of my nail. Just there to mark the occasion…not to signal a current deficiency (because that is not how nail signs work right…they have a long lag time before they reflect a shortfall and repletion!). And of course in spite of still taking my zinc only twice a week there has not been another…So, so long little white spot and goodbye dependency dosing 👋🏼
Now anyone who did our Nutrient Prescriber’s Program this year knows all about ‘dependency dosing’ and the need to work with the science of regulation, synergism, ratios etc rather than against it. These practitioners know the most effective way to prescribe zinc for the correction of a deficiency and supplementation of primary or secondary shortfall….and much muCH MUCH more! But if you missed out…
The Nutrient Prescriber’s Program is a structured process for creating prescriptions that’s systematic, scientific and more likely to produce successful outcomes. You’ll gain a reliable and robust framework to answer key questions such as: Which form? How much? How often? And, for how long?
Dive into the pharmacokinetics of micronutrients, their various uptake pathways in different scenarios, how they work in networks & how co-prescribing in the right ratios is essential for efficacy and safety, rather than as ‘single nutrient solutions’.
Join us for mentoring in 2025 or work through 10 transformative modules at your own pace. Click here for more details…
Are you ready to reexamine the science when it comes to nutritional prescribing?
Testimonial: Anna Sangster, Naturopath Perth Health & Fertility “I am very glad I did this course. I feel it should be taught in every naturopathic college to ensure the intricacies of prescribing are understood. A key point Rachel makes early on is paramount – the impact your nutritional prescription has, is not influenced by your wish or desire when prescribing it. Understanding how a micronutrient is broken down, absorbed, carried through the body, metabolised, utilised, eliminated and all of the regulatory controls the body has in place when it comes to our micronutrients means we can then prescribe accurately with greater certainty in the desired outcome.
The course brings to our attention how micronutrients interact together in the body, how and which micronutrients are stored, how they move from mouth to target tissue, how inflammation or fatty liver may impact your prescription, how understanding hormonal impacts on regulation and circadian rhythms means we can optimise our prescribing, how a micronutrient is eliminated so we can ensure our prescription is safe.Understanding micronutrient ratios and how your prescription may unknowingly be causing undesired impacts in unintended places, these are just a few of the things covered. This course is a tool to sharpen your prescribing and take your treatment to a whole new level. This is what our profession needs.”
We’re weirdos in the nutrition world, right? Tell you something you don’t know?!😅 Ok, how about this, with respect to sodium, our positions, perspective and for some of us, prescriptions set us completely apart.
Say the word, ‘sodium’ to a room filled by any other health profession and they’ll chant in unison, ‘restriction’ In a room full of nats, nuts, herbies & integrative medicos you’ll get a very different response, in fact several! But arguably the top 2 would be: ‘Essential’ and ‘Adrenals’
My voice would be loud amongst that chorus, of course 🙄 📣 but in good company 📣 📣 However, just as recent research has rewritten endocrinology chapters on the adrenals and HPA dysfunction in the last decade, are we across how this affects sodium’s sophisticated regulation and response to varying intakes? In our previous Update in Under 30 episode we discussed the micromanaged minerals (Ca, Fe, Iodine and Sodium) and were left in no doubt, that due to its critical roles in our basic moment by moment survival, sodium is the most micromanaged of all…we’re subject to relentless regulation to prevent a sodium shortfall. Hmmmmmmmmm so how do we fare in the contemporary context of consuming about 10 times more than necessary?
What’s the significance of adrenal dysfunction and could salt offer part of the solution in these cases, just as we were promised in a very popular book 30 years ago – that almost no one owns (anymore) but everyone knows!
I am SO glad you asked…
The Salt Solution in ‘Adrenal Fatigue’? While the concept of ‘adrenal fatigue’ has gone out of favour, has the practice of recommending salt as part of the ‘solution’ in low cortisol clients? And should it? The fact that sodium is so rarely a talking point in integrative health compared with mainstream medicine is a talking point itself! In this episode we not only discuss those interprofessional points of difference, we also ask the question: should the only sodium related recommendations be about restriction, or can some patients actually fall short? We also reexamine the intrinsic links between this micromanaged mineral and our adrenals.
You can purchase The Salt Solution in ‘Adrenal Fatigue’?here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
Isn’t it always the case that when something takes on personal significance – ‘we’ give it more attention? Whether that ‘we’ is a country, a group of researchers, a practitioner or a patient. Let me explain…
🌍Denmark, among many other European countries, I love your hyperfocus!
Having regulated Nickel content of certain consumer goods since the 1990s they continue to monitor compliance, exposures, calculating not only food content but other sources and correlate changes in these with the impact on Danes & their Nickel related dermatitis!! Recent research, for example, picking up that many common kitchen kettles were leaching Nickel – which lead to their subsequent removal from sale! Sadly, ‘down south’ there’s no such regulation or interest and so our ongoing Nickel exposure continues to go unchecked.
😎😎 Two retired scientists personally affected by severe Nickel Allergy, motivated to make more information available for everyone – I can’t thank you enough!
These two researchers have together created the most up to date, evidence based, full referenced Nickel food tables in addition to a bunch of other invaluable resources for practitioners and patients alike…helping us take huge steps forward in understanding how to undertake the Low Nickel diet with the scientific rigour it requires. And as part of this, identifying previous invisible sources of oral Nickel exposure by way of our SUPPLEMENTS!😲 Yes you heard me 😥
👩⚕️The practitioners who keep bringing me their Nickel Allergy cases & sharing the success stories of our approach!
You know who you are! Since learning about Nickel allergy you’ve become dogged in diagnosing in your patients with skin/gut presentations and determined to do better all the time! I salute you and I celebrate your successes with you! 🤓
🤕The affected patients who continue to teach us about Nickel Allergy by way of sharing all their experiences
So thanks to everyone above 👆 I keep learning & expanding my understanding, my tool kit and can keep sharing these with you – check out the latest Update in Under 30 to reap these rewards 👇🤓
New Tools For Lowering Nickel
As many of us move into a new area of practice, the recognition, management and treatment of Nickel allergy, we find ourselves in search of more scientific support. Given most of our patients will not have access to the proper investigations required to confirm Nickel as the culprit, there’s almost total reliance and emphasis on the diagnostic dietary intervention: The Low Nickel Diet. Questions about how to undertake this correctly and in a way that ensures sound conclusions are reached, in addition to, the equally important question, ‘What happens next?’, are answered in this episode which is accompanied by the very latest referenced Low Nickel diet resources
You can purchase New Tools for Lowering Nickel here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
Back when I used to go to parties, I remember the kind of things that got passed around 🤐 but these days the nature of the shared-substance has changed… Activated charcoal, anyone?!😶
Sure this says a lot about me and even more about the kind of people I hang out with…others also full of gas?!!😁 But seriously…would we all benefit from a bit of ‘burnt organic matter’?
To know the answer to that we would first need to answer these:
1.What exactly was burnt to produce this?
2.What type of ‘activation’ was applied?
3.Does the end-product now meet the definition of medical-grade AC? (radically different in composition, structure, function & therapeutic benefit)
4.What are you presenting with, or in what way are you hoping to benefit from taking this orally?
Because if you or someone you know is still using this to ‘relieve gas, flatulence, bloating etc’ or as a heavy metal chelator, or a general detoxifier, or a hangover cure, or a teeth whitening agent, you might want to point them towards a better prescription. But let’s not throw the baby out with the bath water! Let’s learn also about its strengths and applications as much as its myths and limitations!! So that at the next party you know whether to partake or not!!
Activated Charcoal Anyone?
Activated charcoal has had the most incredible and long-lasting medical career! From the good old days of 1550 BC in Egyptian medical writings to modern day medicine, where it remains part of the essential emergency room arsenal for treating overdose of many common drugs. And right this very minute it’s hitting the headlines (and the hype) again. But between these timepoints we’ve come to learn a lot about its structure, function, application & limitations.
You can purchase Activated Charcoal Anyone? here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
These days it’s all about who you know right? So if we applied that same mindset to rating and ranking our organs then the kidneys would’ve amassed the largest number of followers, ‘top fan badges’, likes, watches, you name it. The kidneys are nothing if not ‘connected’ – with reciprocal relationships with our vascular, neurological & respiratory systems, liver, haematopoietic tissue and…🥁
We’re forever in debt to the 1960s ✌ The decade that brought us all peace love and mung beans but more importantly (!) an awareness about the connection between our gut and our kidneys.
Their union becoming more ‘official’ when someone first applied the term, ‘Gut-Kidney Axis’, in research around 2010 and ever since attracting the attention of researchers, nephrologists and now naturopaths alike! These two organs are involved in significant ‘job-sharing’ which typically works well for us, ensuring our survival (generally a feature of a good day at the office in my opinion!) through their combined efforts of noxious waste removal. This is especially when they both ‘bring their A game’. Many of us know that in severe renal impairment the negative ripple effects on gut function are substantial but how often are we thinking about it the other way around. How does the gut dysfunction or disease in a patient actually drive renal impairment? Let me count the ways!!
There’s a rapidly growing body of evidence attesting to the causative, or at least contributory role, things such as coeliac & inflammatory bowel diseases, abnormally increased intestinal permeability, dysbiosis and even periodontal disease can play in causing kidney conditions, and more generally, chronic kidney disease (CKD).
This places our food preferences, our bugs, their biome, by-products and our barrier integrity all at the forefront of the gut’s ‘good guy’ status when it comes to kidney care. This is important to know, not only for the purpose of understanding why someone with ‘no traditional CKD risks’ presents with CKD but also to arm us with solutions and opportunities for course correction when they do. I started this conversation in last month’s Update in Under 30 episode: CKD- Causes Catalyst & Contributors, talking about our urgent need to ‘broaden the lens’ when working up cases of CKD but in the latest episode I’ve taken a very targeted look just at the role of gut dysfunction and disease – including a very intentional discussion of IgA nephropathy (a strong link between the two) that is grossly over-represented in Australia and NZ and therefore a ‘must know’ for us all 🤓
When GIT Dysfunction Drives Kidney Dx
The gut is a ‘good guy’ when it comes to supporting renal function for the majority of us via a balance of bugs, their beneficial by-products and an intact barrier. Additionally, there is direct job-sharing with respect to elimination of wastes. However, if the gut ‘goes down’ due to disease or even, on occasion, just dysfunction, this can then add substantially to the vulnerability, burden and risk of renal decline. The gut-kidney axis offers many advantages including a key point of indirect access for treatment of renal impairment when this bidirectionality goes ‘bad’. In particular we take note of IgA nephropathy – a prevalent and under-recognised cause of intrinsic renal disease that is a potent illustration of this.
You can purchase When GIT Dysfunction Drives Kidney Diseasehere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
I know you haven’t heard a lot from me of late. 📢 I repeat I been BUSY📢 . Anyone currently undertaking our Nutrient Prescriber’s Program this year or Cracking the Case Series will vouch for that and fill you in on the insanely dynamic details!! But something has come to my attention that I can’t keep quiet about..
🤸♀️⭐Man we’re awesome!⭐🤸♀️ Seriously.
I am just back from the NHAA Summit so I am understandably all inspired all over again but this is not limited to those on the stage. In fact, as impressive as the ‘big names’ are – there are some other names you may not have heard of, or that shall not be mentioned because they would simply wither with embarrassment but impress the pants off me, that make me burst with pride to be a part of this profession. Here’s just a taster (with names and details slightly changed to avoid unwanted attention!! 😉)
The 50 odd (in number not in nature!) naturopathic students that were in attendance at the summit 👩🎓 with their bright sparkly eyes, sharp minds & effervescent enthusiasm 🧠🌟
‘Barbara the Brave’ also there who had to take her employer to the fair work commission after she raised concerns about unsafe prescribing protocols and in turn lost her job (and won by the way)!! 🙌
Every single praccie young or wise who came up & said, ‘You don’t know me but I know you and thank you!’🙏 each shining a light on a way in which their practice had been impacted by something I’ve written or said via 1-2 or 10 degrees of separation
An awesome experienced naturopath who works in the intersection between farming, food production, remote health care & naturopathy
who let me know about her new lil’ passion project, a soon to be launched podcast to bring us big bites of this amazing nutritional enviro nexus, via chats with regenerative farmers👨🌾
My New Grads in my New Grads 2024 Group showing up and showing themselves to have some kick-arse clinical skills I’ve had a sneak peak inside their cranial kits by way of case notes & clever questions that demonstrate their critical thinking is firmly ‘ON’ 💡
Nina Lange, Cathy Bisset, Katie Ayscough & Peter Christinson No anonymity allowed for these 4! This crew support me and enable me to get out there and deliver something of real value every single time…they really are the dream team 🎯
I could go on and on and on. Let’s all take a moment to reflect on this and celebrate our pride-inspiring peeps…oh except for that Vicki she’s such a 🐮
No one panic, Vicki will laugh herself silly and I just got even! 😂
Anyone noticed I have ants in my pants? Can’t sit still. Can’t keep things the same. Always have new questions that I suddenly realise we all desperately need to know the answers to?!
I’m always changing my education offerings, formats, time-frames etc. For example you might have noticed this year mentoring is only running in the first half. Next year will be different again. So if you want to be across all your options at the earliest opportunity so you can plan ahead for your PD and be sure to not miss out…make sure you’re on our mailing list! We’re not so keen on (and also just too busy for!) socials these days but if you’re on that list you can be confident you’re in the loop and hearing things first and first hand!
It’s so wonderful to know kidney health is moving address. From the darkest bits at the back, now to the front of our clever clinical minds. We’re easy to impress when it comes to any ‘axis’ – gut-brain, brain-immune etc. so we all need to take a moment and take note of arguably the most well ‘connected’ organ of all… 🥁 our kidneys, with their individual axis with the CNS, CVS, Respiratory, Liver, Bone Marrow, Bone, GIT etc etc etc No wonder we should be taking active steps to protect their structure and function as part of our ‘whole health approach’, rather than accepting the short-sighted ‘short-list’! of so called causes of kidney harm…that’d be: HBP, Diabetes, Obesity, Smoking…oh and Age!
I’ve been on a kidney health crusade for many years now and I’m thrilled to see an increasing number of praccies beside me at the frontline! But I think where our conversations & clinical skills have still been coming up short is with regard to ‘true cause’ and therefore also ‘course-correction’
Now that renal markers have our attention (!!) we’re noticing premature decline in GFRs in patients who actually do not fit with anything on this list…oh except ageing…the good ol’ explain-all for everything 🙄 I’ve seen patients in their 90s with better renal function than their children 30 yrs younger. Age does not cause CKD, something…a culmination typically of many things in fact – primary (causes) secondary (catalysts) and tertiary (contributors) – unique to each individual, crushes our kidneys! And is the real place of understanding we need to reach – such that we can actually personalise the prescription required for course correction.
Both of these come with our, can I just say…⭐kick-arse clinical tool⭐ that guides you through the work-up of every case of lower GFR than expected, including a comprehensive compendium of medications implicated and they are some of our most common! So if you’re a clinician with not much more than ‘corn silk’ filed in your cranium under ‘kidney’…ummmmmmmmmmmmmmmmmmmmmmmm the time is now!⏰
CKD: Causes Catalysts & Contributors
Increasingly integrative health is taking a keen interest in renal health and engaging in important conversations about chronic kidney disease, but where all modalities and messages tend to pull up short is with respect to: Why us? Why this? Why now? There has been a dramatic rise in CKD in the space of one generation which means this is not simply explained by the ‘wear & tear’ of ageing. There are very likely environmental factors at play that may have escaped the attention of the medical community but not the researchers. This recording and accompanying clinical tool helps you to identify all the ingredients in an individual’s unique recipe for renal decline and, in turn, helps you to identify how to course-correct for their kidney health.
You can purchaseCKD – Causes, Catalysts & Contributorshere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
Do you realise we’re often giving our patients Crabs? Stay with me 🙄 We’re all BIG fans of polyphenols right, but did you know that one of the key ways they qualify as antioxidants is that they chelate metals?
Chemically speaking that means that polyphenols (flavonoids, isoflavones, tannins, stilbenes etc) have a structure that looks and works like two ‘crab claws’ 🦀 the ends of each claw attracting and binding metal ions, following which, the claws kind of ‘close’ around the metals and trap them within. 🦀
Now sometimes the closing of those claws results in a clear ‘stop & block’ effect – the metal will remain trapped and be lost from the gut or other parts of the body along with the polyphenol but not always…other polyphenols can be favourable chelators just temporarily binding a metal but ultimately making it bioacccessible to us and increasing its bioavailability & bioefficacy. So polyphenol prescriptions, aka ‘crab medicine’, need to be precise. Every different class of chelator or ‘binder’ e.g. MCP, zeolites etc will have different metal affinities. Our beloved polyphenols have a predilection for one metal above all…and that happens to be iron!
As clinicians, we can harness their polyphenol power to either enhance iron uptake or block it.
🦀 Both actions, of course, well indicated in different patients & presentations 🦀
In the latest Update in Under 30 we write a polyphenol program for those individuals ‘on the road to iron overload’, who simply ‘can’t close the door to more’! Knowing how to perfect this prescription and still allow for personalisation & preferences etc is the key to sustainable essential everyday iron mitigation between blood removals and to minimise the need for these. And if your bigger challenge is the issue of iron deficient patients who are refractory to your well-reasoned remedies then take a listen and a look at the accompanying resource and ensure they are doing the exact opposite! I am being completely serious. I don’t think many people realise the power of the polyphenols & how pervasive they are in our herbal & dietary recommendations 🤓😲🤯
For those individuals with HFE mutations on the road to iron overload, whether they ultimately reach that destination of absolute hyperferritinaemia or not, excess iron mitigation ‘every day & in every way’ is key to better outcomes. While avoidance of dietary haem iron and, where indicated, therapeutic phlebotomy, are cornerstone treatments, patients are increasingly being offered add-ons such as PPIs and pharmaceutical chelators. However our polyphenol prescriptions (both food form and nutritional & herbal supplements) offer additional novel actions to address excess iron mitigation, while also providing patients with improved cardiovascular protection, immune system support etc. This recording comes with an incredible resource for both you and your patients. Packed with evidence-based options they can choose from at each meal & across the day, it offers them their own tailored treatment plan by identifying options as (un) favourable, & therapeutic in each category of food, beverage, even cooking methods.
You can purchaseThe Power of Polyphenols In Iron Excesshere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
It’s no secret I am in the midst of some serious deep-diving through the micronutrient evidence base & at a depth of about 30 metres I struck Boron! Don’t yawn! I saw that. Thinking, ‘boring’, when we hear, ‘Boron’, is almost as bankable as watching everyone reach for their water bottles when you mention anything hydration-related 🤣 But I am here to restore your positive regard for this mineral and remediate its bad (& boring) rep! In preparation for the Nutrient Prescriber’s Program we started each nutrient review with the seminal contemporary nutritional texts and then launched ourselves headlong into the latest & greatest research. By the end of all the Boron bits in all my trusty texts the yawn was not gorn! But the moment I started reading the research I was like, ‘Are we even talking about the same thing?!’Turns out we’re not 😵🤦♀️
You see Boron has been a longstanding victim of identity theft. What we’ve been lead to believe is Boron is weed-killer and ant-poison and look it does give us some of the benefits of Boron but not all. And it possess a pharmacokinetic & toxicity profile that naturally occurring Boron simply does not.
Who decided that the Boron that is ubiquitous in our environment but almost exclusively consumed by us only after biotransformation by plants – could just skip that last bit and still be safe and optimally beneficial?! Probably the same guy that came up with folic acid, may I suggest? Anyway, enough is enough. We all need to relearn Boron – naturally occurring Boron – in the form of Sugar Borate Esters (SBE)- the evidence of benefits for which will blow all of our little minds! Well it certainly blew mine! Looks like this natural form of Boron is going to hit the Australian market in the not-too-distant-future 🐦 can’t wait to see which supplier is sufficiently progressive and research-aware that they bring this to market, having been available as a high grade supplement, employed in numerous RCTS OS for some time. But this little Update in Under 30 is not waiting around for that release date – there is much to be gained from SBEs right now – so make some noise as the real Boron at last takes the stage!🎤
Boron has been the victim of longstanding identity theft and we unknowingly have been interacting with its imposter. Contrary to everything you’ve ever been told about this mineral, naturally occurring Boron is full to overflowing with benefits for our gut, our bones, our brain, our management of other minerals and is safe in large quantities. That ‘bad guy Boron’ you were introduced to and is still present in many of your supplements is a form we never consume in food…and therein lies a world of difference! Come meet the real Boron so you and your patients can get the real benefits!
You can purchase The Boron Deception: How We’ve Been Fooledhere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
Still. And yes – like you – I don’t see any slowing down any time soon in this extraordinary paradigm shift occurring in medicine and health. Which for us humans involves one humbling discovery after another.
Here we were thinking we made our dietary choices from a place of free will & individual preferences 🤣🦠
Thinking those microscopic mates, were making those B vitamins, and SCFAs and and and…for us & our benefit 🤣🤣🦠🦠
And while there’s a lotta love going on between our microbes and our micronutrients – in both directions – Pat Benatar said it best, “Love is a battlefield”
(sorry but I feel compelled to insert a link here for the youngsters – you’re welcome 😉)
The tussle over who gets to access those nutrients that are actually essential to both of us (the hostage and the microbiota) is an absolute turf war, peeps, and this battleground has seen some bloodshed! The new new question being raised is how the prescribing of nutrients, especially at the higher doses we tend to use, trickles down to influence and impact those microorganisms who reside in the bowel. Directly – as a selection pressure we have, likely unintentionally unknowingly, introduced. Which species do well when exposed to levels of a vitamin or a macro or trace mineral that are simply unobtainable in the diet? Yes – research answering these questions has begun in earnest revealing some positive ‘prebiotic-like actions’ of some but not of course for all nor in all scenarios. Want to learn more about this latest aspect we need to consider when formulating our nutrition prescriptions? You can either jump in and join us in the Nutrient Prescribers Program which kicks off next week to get across absolutely everything new in nutritional medicine or just dip your toe in here with our latest Update In Under 30: The Micronutrient Microbiota Universe
The world of health science went microbiota-mad a few turns back and there’s no sign of an end. Research continues to reveal the breadth of the GIT microbiota’s positive & negative reach, in particular, & with discovery upon discovery we’ve come to understand how often the microbiota are ‘managing us’. Both in terms of being integral to the success of our digestive, immunological, metabolic etc processes but also in a self-serving way, for example, directing our dietary preferences to satisfy their own needs. This has understandably prompted the question about the impact micronutrient supplementation is unintentionally having as a selection pressure on our gut microbes. Which bugs like which B vitamins when taken in excess of the amounts achievable in the diet? And which microbes flourish and which falter when we radically change their mineral exposure?
You can purchase The Micronutrient Microbiota Universehere. If you are an Update in Under 30 Subscriber, you will find it waiting for you in youronline 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.
In January, after 30 years I finally got off the gear. That’s how long I’d been taking good quality, high dose (minimum 20mg elemental) zinc daily for. Originally the rationale was I was a vegetarian. Then the 20 years that followed my reintroduction of meat saw me continue the practice, born of the belief & ’empirical evidence’ that I was healthier when I took it than when I didn’t, especially with respect to my immunity.
Do you realise we’re often giving our patients Crabs? Stay with me 🙄 We’re all BIG fans of polyphenols right, but did you know that one of the key ways they qualify as antioxidants is that they chelate metals? 
