NEW: Clinic Notes, Issue 1 June 22

A skim-read practitioners’ digest focused on practical stuff you can use immediately in-clinic. If you’ve ever wanted someone to just get to the ‘clinic pearl’ quickly and save you the time, this digest is for you. This issue is free, but if you like it, please subscribe and show me you want me to keep it going!

THYROID. Biotin interference can result in falsely elevated T3 and thyroxine and falsely low thyroid stimulating hormone, mimicking results seen in hyperthyroidism (Graves disease). Medscape

STROKE. A serum Vitamin D of 60 nmoL/L vs 10 nmoL/L was associated with a 48% reduction in the recurrent stroke risk. A serum Vitamin D level of 40 nmoL/L vs 10 nmoL/L was linked to a lower risk of haemorrhagic stroke in the entire populations and recurrent stroke in women. Medscape 

GUT. Microbiome patterns, excesses and deficiencies found in IBD. Invivo

MIND. Research shows that even a one-week break from social media improves wellbeing, anxiety and depression scores significantly. Some even gained 9 extra hours they would have spent scrolling! Give patients a none or limited social media fast! SciTechDaily

PAIN. Patients with gout, the most common inflammatory arthritis in the UK, are not being prescribed urate-lowering drugs quickly enough, causing suffering and disease progression. Once on meds, they’re not being monitored to check it’s working. Medscape. Natural remedies include cherries, Vitamin C, magnesium, celery seed and quercetin. Dr Axe

BRAIN. Research suggests people with higher levels of certain carotenoids are less likely to get dementia. Specifically: lutein, zeaxanthin and beta-cryptoxanthin. Increase kale, spinach, broccoli, peas, oranges, papaya and tangerines. This Multi from Seeking Health and this Antioxidant formula could be useful for patients.

Eat more kale, spinach, broccoli, peas and oranges to ward off dementia. #brainhealth #dementia #foodismedicine Click To Tweet

INFLAMMATION. Enzymedica reminds us that one approach to reducing inflammation in patients is protease enzymes taken between meals. They recommend Repair Gold. It’s targeted at sports/recovery but would be useful for all types of inflammation internally. I’ve included that as many of us don’t think of this approach to inflammation often enough in-clinic. Enzymedica.

MEN’S HEALTH: ERECTILE DYSFUNCTION. Think of pre-diabetes mechanisms in erectile dysfunction. MEDSCAPE

DIET/OLDER PATIENTS. Older people in and out of care homes may benefit from regular smoothies and sesame-based snacks. Found to improve gut microbiome and antioxidant status inc. glutathione. Presumably, other nut/seed-based snacks will work just as well. NMJ

WOMEN’S HEALTH: UTI. Over 80% of UTIs are caused by E Coli, rapidly becoming AB-resistant. Other causes include: Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Staphylococcus saprophyticus, Enterococcus faecalis, Streptococcus bovis, and the fungus Candida albicans. Research suggests cranberry dose of >36mg of proanthocyanidins a day. The writer reminds us not to forget biofilm treatment and other approaches including D Mannose, Uva Ursi and probiotics. NMJ

SUPPLEMENTS: MULTIs. Nutri have done a helpful round up of their multis here. My favourite multis include Pure Encaps O.N.E because it’s a very comprehensive one-a day and ARG Multi-Vi-Min because it has high levels of the Bs, especially B6 – which I find most women need much more of – and you can titrate up one capsule at a time depending on needs. There are non iron/copper versions available.

DIET: LECTINS. Which lectins might people need to avoid? Match the lectin to body tissue with Cogence’s helpful chart.

INFLAMMATION: NEURO/MICRO-GLIAL. Nutrined has a nasal spray designed to lower microglial inflammation in the brain and nervous system. This is the first product I’ve seen designed to do this specifically. Nutrined. Amrita have it here. No idea about glial priming and NI, see my patient factsheet here.

TESTING: GUT. Genova have launched GI Effects Fundamentals, a cut-down version of the full test. There is a useful comparison chart for Genova’s gut tests. GENOVA

WOMEN’S HEALTH: VAGINAL HEALTH. Invivo have launched a handy ‘how to do a vaginal irrigation’ guide for rapidly changing the vaginal microbiome. INVIVO.

NEWS: MONKEYPOX. Useful calm overview of Monkeypox and how it is unlikely to cause more than mild infection in humans unless severely malnourished. Ideas given for prevention and treatment. ORTHOMOLECULAR NEWS

INSOMNIA. NICE is recommending the Sleepio app for appropriate insomnia patients. Px should be able to get it paid for via their GP. MEDSCAPE

NICE recommends the @Sleepio app on the NHS for insomnia patients. Check it out here: https://www.sleepio.com/ #insomnia #sleep Click To Tweet

WOMEN: ESSURE COILS. These were withdrawn a few years ago, but just in case of any unexplained issues in your female patients: they have found the tin in the coils is causing inflammation. MEDSCAPE and BBC News.

ALLERGY. KBMO Lab has recently released a very comprehensive Practitioner’s Guide to Delayed Food Sensitivities. I’ve not read it fully yet, but it looks very useful with cross-reaction tables, detailed food alternatives and a run-through of allergy types. It’s focused on their FIT (Food Intolerance Test) but useful for all. KBMO.

CLINICAL PEARL: ALLERGY TESTING

After assessing all the various tests available to us in the UK, I now recommend mostly the P88 Allergy Test from Precision Point and Cyrex testing. I don’t think we have any test that is 100% accurate as that simply doesn’t exist yet, but these are great for finding where to start.

Remember that the point of these tests is really to see how far a px has gone. If they have a few foods showing, is it a digestive acid/enzyme issue, do they need a bit of SIgA/butyrate-boosting? Or, if they have a lot of foods showing, have they lost oral tolerance and need a much more comprehensive treatment strategy?

My clinical aim nowadays is much less to cut foods out, but to support the immune system, digestion etc and stop the problem developing further. I wish someone had done that with me many years ago! I now have MCAS, Oops.. One approach I’ve been looking at recently is the Yanuck/Pure Encaps Immune Support Protocol, which is all about modulating an overactive immune response. NB. Need more info on food testing, see my px guide here.

TOXINS. The EU Chemicals Strategy for Sustainability (CSS) has identified 388 potentially harmful chemicals in food packaging and is calling for the protection of public health by banning the use of chemicals of concern that are carcinogenic, mutagenic, or toxic to reproduction (CMRs), or persistent and bio-accumulative, or endocrine-disrupting chemicals (EDCs). FOOD PACKAGING FORUM

INTERNATIONAL MEN’S HEALTH WEEK 13-19 JUNE 22. Men’s Health Forum are championing Men’s MOTs for the week. They have a useful DIY MAN MOT on their site here. Don’t forget FDX’s very useful Man Ultra test if you want to do a comprehensive MOT test. I’ve done it quite a lot now and it always comes up with something useful to work on!

In the UK, one man in five dies before the age of 65! It's International Men's Health Week this week. The theme is MAN MOT. Start with this DIY MOT questionnaire from @MensHealthForum. https://www.menshealthforum.org.uk/diy-man-mot Click To Tweet

PRACTICE PEARL: CLICK TO TWEET

Keeping up with social media and sharing useful content is a time-drain, isn’t it? It’s time we could be spending honing our clinical skills or helping more people. So, to help make it a tad easier, I will share some Click To Tweet quotes that you can easily share on your Twitter feed to provide useful stuff to your followers if you wish.

Note you don’t need to actually use Twitter at all if that’s not your chosen social media platform – it’s all automated; you just need to have an account set up and these will cross-post without you ever even going on Twitter! Read on for how to do that…

There doesn’t seem to be a similar app I can use to give you easily-shareable Facebook or Insta posts, sadly. Instead, you can either copy and paste the text into those apps or be clever and set up Zapier so that every time you tweet, Zapier will automatically share it to Instagram (if there’s an image) and Facebook. You can set it up however you like with cross-posting going on all over the place. There’s a useful video here showing you how to do Twitter to Instagram, for example, and it’s pretty intuitive to set up.

You get 5 free zaps for free, which should be plenty to do:

Twitter – Facebook Page
Twitter to Facebook Group
Twitter to Instagram

You can do it any direction you want, of course. If you post in Instagram usually, then set up a zap for those to go to Twitter or Facebook. If you post most often in Facebook, then set it up so it automatically cross-posts to Twitter or Instagram. You get the gist. If you want to go all clever on me, you can pay for the next stage up on Zapier and do multi-steps. That might be Twitter to Facebook to Instagram. Nice.

Alternatively, you can use a service like Sendible, Hootsuite or Sprout Social to send your content out to them all at the same time. Just copy and paste the quote into your service and Bob’s your Uncle.

RESOURCES: DONE FOR YOU PATIENT HANDOUT – TAKING A FINGERPRICK BLOOD SAMPLE. A quick one-pager to send to patients if doing fingerprick samples, or put on your website as a resource. Download here. I’ve kept it as a Word doc so you can change it, put your logo on etc.

TESTING: IRON/ANAEMIA. I see Healthpath Pro have just issued some new Interp guides for their iron/anaemia tests. There are two: the first is a simple iron assessment with the usual markers. The second is much more comprehensive, looking for reasons for low iron/fatigue and includes hormone, active B12 and folate markers. I have used the TDL Pathology Anaemia profile for years, and it’s a shame this one doesn’t measure red cell folate instead of serum, but other than that, I think they look great. Both are fingerprick too, always a bonus. Tip: remember that inflammation can make ferritin look higher than it is as it is a marker of inflammation, not just iron stores. If a px has high ferritin, they could still need more iron. To improve these tests, I’d like to see ESR or hsCRP measured too. Interestingly, they do include CRP in their Fatigue Profile. HEALTHPATH

Did you like it? Let me know any thoughts: micki@purehealthclinic.co.uk and please subscribe! Please ask other colleagues to subscribe, too, thank you.

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