Clinic Notes: Issue 2, June 22

Thanks to everyone for your kind words after my first issue :). And thanks even more to those of you who subscribed and/or sent me coffees, yay! I truly hope it will evolve into something really helpful – and enjoyable – for you all.

“Hey Micki, thanks so much for this it’s just what I need. Different to everything else and hits the spot quicker!” D, June 22

ALLERGY: IgE TESTING. TDL have a new serum ALEX test for around 300 allergens including pollen, mites, fur, insect venom, mould, yeasts, latex as well as foods and Total IgE. This is the most I’ve ever seen. I’m assuming you can access it direct or probably via Biolab when they re-open. See sample reportTDL Pathology.


I mentioned last issue that I use the P88 Allergy test quite a bit now in addition to Cyrex food testing. Some of you asked me for more info about it. Cheryl Burdette from Precision Point Diagnostics, the creator of the P88, happened to do an explanatory video that hit my Inbox this week: how opportune! You can watch it here. I have actually already done a video myself about it here too, taking you through some actual results as I see them. I hope those help. 

TESTING: TDL TINIES. TDL Pathology do TDL Tinies home collection test kits (ie. no phlebotomy required), which are then returned and processed by the lab. There is a helpful list of the tests that can be ordered here and a video you can share with patients on how to do them here. I think the nasal, vaginal and urine swabs are particularly useful and the Tinies makes it easier to regularly keep an eye on things like ferritin, HbA1c, PSA, single hormones, Vitamin D etc.

Having trouble getting blood taken for a test? Ask me about the new fingerprick tests available. #functionalmedicine #personalisedmedicine #labtesting Click To Tweet

If you’re not sure how Click to Tweet works, check out Issue 1.

MEDICINES. Doctors have launched a Beyond Pills campaign suggesting an urgent review of multiple meds and recommending more social prescribing. 8.4million people take more than 5 drugs a day. Dispensing in primary care doubled from 10 prescriptions items a head per year in 1996 to 20 in 2016. Many people missed their meds review due to Covid. PM LIVE and DAILY MAIL

Did you miss your meds review during Covid? Make sure you book in with your health professionals and get it done – do you still need to take everything? Click To Tweet

TESTING. FDX have also launched the first of their Index fingerprick tests including iron status, thyroid and lipids. FDX

CANCER. Fascinating piece describing the specific nutrients/deficiencies involved in tumour progression, the role exercise plays and how to cook/season meat with certain herbs and spices to mitigate nitrosamines/PAHs etc. MEDSCAPE

BOOK REVIEW: NITRIC OXIDE. Nathan Bryan’s 2018 treatise on nitric oxide, Functional Nitric Oxide Nutrition, concentrates on the problem of widespread deficiency. Between 20 and 60, we typically lose about 85% of our ability to make nitric oxide. This is not helped by use of fluoride, mouthwashes or PPIs. Beet juice helps, as does consuming green leafy veg.

DIABETES/KETO. Research suggests a ketogenic diet is beneficial within a week for Type 2 Diabetics. The interesting bit I found here, though, was the noted side effects experienced by those on keto diets at various stages. Quite useful to know and to be able to recognise them if you’re using keto in any patients, not just diabetics. NUTRITION EVIDENCE

INFLAMMATION/PAIN: SPMs. I see that Nutri is doing a webinar about SPMs to launch their new product OptiResol. SPMs (specialised pro-resolving mediators) are a new (ish) approach to help resolve inflammation rather than dampen it down. Since most medical conditions involve some form of inflammation, I always keep my eye out for new approaches. You can register for the webinar here and there is a ton of info on SPMs here from Metagenics.

BOOK REVIEW: THE POLYVAGAL THEORY IN THERAPY, DEB DANA. If you are at all interested in the mind-body connection in chronic illness and trauma-triggered illness, then vagus nerve therapy should be on your radar. This book is written for psychologists but is pretty easy for anyone who wants to learn more about the topic, to recognise when a referral might help ‘get in’ to a patient who is not responding to usual interventions, or encourage the use of some of the techniques with patients. If you need more of an intro to the subject, I’ve written a factsheet on it. 

CLINICAL PEARL: Vagus testing and treatment

The best way to test the vagus nerve is to check the uvula moves consistently when a patient keeps saying ahh. Use a tongue blade and torch so you can see properly. Does it jump up strongly and keep doing that for 10 aahs (OK), does it hardly move at all, or tire over the 10 aahs (NOT OK)? 
An easy way to stimulate the vagus nerve nowadays is with the Sensate ‘pebble’ and app. I’ve used it myself and given it to several patients who have all found it beneficial. You can get more info here and get £20 off it with this link if you want to try one. People have a 40 days free trial. 

ORAL HEALTH. Really liking the look of Designs for Health Periobiotic toothpaste for patients with gum disease/infections. See more about it here and ND sell it here.


WOMEN: MISCARRIAGE. Women who were vitamin D deficient (<50 nmol/L) had nearly a two-fold increased risk of miscarriage compared with peers who were vitamin D replete (>75 nmol/L. MEDSCAPE. I actually look for Vit D to be 120-160nmol (50-70ng/L) myself so <50nmol is pretty low.

Worried about #miscarriage? Make sure your Vitamin D level is high enough – research suggests more risk under 75nmol/L Click To Tweet


See what I did there?! Here’s a useful list from Houston Enzymes of what each enzyme type breaks down food-wise. I’ve done it as a Word doc for you so you can save it. Houston do some brilliant enzymes and I have often used their products successfully, especially Trienza. They have a great Q & A on enzyme therapy here.

TIP: Some Houston products contain DPP IV to help break down gluten-, soya- and caso-morphines. We are finding Tolerase G helpful for gluten-sensitives who have accidentally ingested gluten; it helps to lower reactivity. There are not many products with it around yet: Wheat Rescue is one from Amrita. Pure Encaps is doing one called GlutenDairyDigest but it doesn’t seem easily available yet in the UK. We have found some others, see page 56 of the free TrulyGlutenFree Supplements Master List (all grain and dairy free).


I notice that Practice Better, the clinic system company, has raised prices again. It is now becoming out of reach for many of us. Just to say I have swapped from PB to (free!) HealthPath Pro myself. It’s still evolving, but I like it so far and I think it has the potential to be very useful for UK practitioners especially. They have a long way to go in terms of listing tests, but have now got a ton of supplements for recommending. I find adding patients, notes etc all really easy. 

The only thing I don’t like so far is that many of the resources available to share with patients link back or promote HealthPath itself – who clearly still run their own clinic. I can’t blame them, but it doesn’t look very professional and you run the risk of sending your patient to them, so sadly I’ve not been able to use the resources yet, which is a shame because some of them are really good! I have mentioned it to them and I believe plans are in place to start removing the HealthPath links and promo.

Anyway, I thought I’d share that in case you are a frustrated PB user and were wondering what to do. Might not suit you, but I know a few people who have swapped so far. Give it a look – and no, this isn’t sponsored by HealthPath – maybe it should be 😉

I hope you found something useful for your practice there.  Please share this link:… on your practitioner groups/forums and encourage them to sign up so we can keep it going, bless your cotton socks. Any comments always welcome. 

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