Clinic Notes: Issue 3, June 22

Well, I was blown away by the fabulously-supportive comments when I launched Clinic Notes to the Nutrition Network et al. I guess you like 🙂 Thank you. And thank you to all of you who are new subscribers to Purehealth generally, for those who sent me gratitude coffees (yum) and those who have already taken out a Clinic Notes subscription. I am so chuffed.


This week, subscriber-only extras include:

Practice Pearl on setting up or expanding your clinic – Specialise? Generalise? What are the health conditions you should focus on for a fulfilling, successful clinic?

Done-for-you core blog post to tie in with July’s World Hepatitis Day – Hepatitis: the Hidden Millions. Personalise it however you like.

Clinical Pearl on one successful way to help your mental health patients.


MUSCULOSKELETAL: JOINT/MUSCLE. Over 20m people suffer with musculoskeletal conditions in the UK. That is HUGE! What can we do for them? Watch Biocare’s Connective Issue webinar if you get a chance. I went to this live and learnt a heck of a lot. Suffice to say, I give their Collagen Complex a lot more now in protocols.

Are you one of the 20 million people who suffer with joint and muscle problems in the UK? Yes: 20 million! Ask me for help with symptom control and prevention. #musclepain #jointpain #arthritis #fibromyalgia Click To Tweet

CHRONIC ILLNESS: FIBROMYALGIA, PAIN. Many of us got be be practitioners because of our own illnesses, me included (MCAS). If you don’t suffer with a chronic illness (and I thank goodness for that!), then it can sometimes be hard to really empathise with sufferers. I find The Mighty has some useful first-person stories showing day to day life with illness. Here’s one from a FM sufferer. Humbling, but the more we learn about our patient’s experiences, the better we can help them. Never forget that bedside manner and talking to someone is the most important skill we have. The Mighty

VACCINATION SCHEDULE, UK. The official vaccination annual schedule for children and adults in the UK. MEDSCAPE

GUT: BABIES, ALLERGY. Biocare have brought out a new liquid Baby Biotic. There are several around now, but I just wanted to highlight the fact that many adults with allergies/sensitivities often need ‘re-seeding’ with the baby probiotics before adult type ones will go in effectively, or so I’ve found clinically. So, Baby Biotic – not just for babies? I do wonder what the ‘vegetable oil’ is in the product too – since we’re often giving products to sensitive people, we need to be clear what ‘vegetable’ the oil originates from. BABY BIOTIC

BRAIN: ALZHEIMER’S. Researchers have found a single MRI scan can help diagnose early Alzheimer’s using a special algorithm they have developed. In 98% of cases they found that the MRI-based machine learning system alone could accurately predict whether a patient had Alzheimer’s disease or not. In addition, it was also able to distinguish between early and late-stage Alzheimer’s accurately in 79 per cent of patients.  MEDSCAPE


What would you think if a woman, aged 39, came to see you reporting diffuse muscle and joint pain, panic attacks, social withdrawal and increased food sensitivity?

You could go many ways with that couldn’t you?

But would you necessarily think of perimenopause? At 39? I’m not sure I would.

But, this is a picture of changing hormones. We don’t always associate these kind of symptoms with ‘the change’ but we should do. Some women have a perimenopausal ‘stage’ that lasts well over a decade. We might think of it starting around late 40s, early 50s maybe, but it can be a LOT earlier. And they don’t always have the classic hot flush, erratic periods picture for easy diagnosis.

I think many women wouldn’t think to ask their GP about their hormones with these symptoms, but anxiety, joint pains, wanting to go full-on-hermit and becoming more sensitive to stuff, physically, mentally and emotionally, can all be influenced by changing hormone levels.

I was reading a fantastic book called Quilt on Fire (great name!) recently. It is an hilarious, shocking, eye-opening memoir of a nurse in perimenopause. It’s at times deep and philosophical, discussing the existential crisis of mid-life, veers on the spicy side in places, but is snort-out-loud funny in others. I think it should be on our shelves and recommended to every woman ‘of a certain age’, over 35s probably. Fore-warned is fore-armed as they say. I think more of us should be looking for the non-classic signs of menopausal change – in both women and men.

MORAL OF THE STORY: remember to check hormone status, even if you think it’s too early for menopause and the px doesn’t have the classic symptoms.

COVID. Prof Tim Spector from the Zoe app explains we’re in a new Omicron BA.5 variant wave and that most of it seems to be from people getting re-infected. He also gives current symptom trends. Zoe

DIET. Recent research suggests that four of the seven most nutrient-dense foods we can eat are organ meats. Liver was more nutrient-dense than vitamin A-rich fruits and vegetables (27x), legumes (61x), chicken (100x), and whole grains (161x). Top sources of priority micronutrients found were organs, small fish, dark green leafy vegetables, bivalves (oysters, clams, mussels, scallops), crustaceans, goat, beef, eggs, milk, canned fish with bones, mutton, and lamb. Cheese, goat milk, and pork are also good sources, and to a lesser extent, yogurt, fresh fish, pulses, teff, and canned fish without bones. Frontiers in Nutrition. For organ-friendly recipes to share with px, see here and you can also see a list of allergy-friendly AIP (autoimmune protocol) offal recipes here.

SKIN. The importance of SCFA (short chain fatty acids), especially butyrate, in skin conditions. Butyrate needed to maintain the barrier. For more on the skin barrier, see my article Thinny Skinnies, I think written in 2009. NATURE

DIET: RECIPE. I’m always on the lookout for tasty ways to encourage px to eat more of their 10-a-day. Here’s an unusual one: Peach and Apricot Iced Tea. Strongly-brewed tea left to ‘muddle’ with slices of peach and apricot, jam, ice and mint leaves. I’d use fresh rather than tinned fruit here, of course, and maybe add sweetness with stevia or good honey. Source: TIGERSAREBETTERLOOKING

PAIN: HEADACHES. The top meds self-reported to cause headaches. Top were AI drugs often used for Crohn’s, psoriasis and MS. Note the arrogant comment from the doc about how self-reported info is not useful! This is US data, but probably applies to UK just as much. MEDSCAPE.

Do you get frequent headaches? Have you checked your medicine side-effects? Ask me for help. #headaches #migraine Click To Tweet

DIET: BEETROOT. Many people don’t know what to do with beetroot, I find. Here’s a useful article all about the benefits and I got my niece to do a video on how to peel them once as px kept telling me they were scared of it!

SLEEP: LONG COVID. Moderate to severe sleep disturbances and severe fatigue affect up to 40% of patients with long COVID. Obesity, mood disorders, and Black race emerged as the main risk factors. MEDSCAPE


Last week, I gave you my thoughts on the new Healthpath Pro patient portal service as an alternative to Practice Better. Healthpath have been in touch to say that the historical links and promos to them have mostly been removed now. I found a couple at the end of videos still but those are an error and are being worked on. That’s great news because it means that you can now avail yourself of all resources – with no Healthpath logo on either, so add your own logo and have them all branded as you. Some excellent resources there so do have a look.

They also confirmed for me that their plan is to refer clients to practitioners in the Healthpath Pro directory in the future

So, good news all round. I do wish them luck with it; it has the potential to be a real game-changer for us UK practitioners – and all for free. They make their money on a kickback from the supplements and tests we recommend, which is a great business model. That’s how I’ve survived for years when I couldn’t see patients because of my illness and writing/research commitments. Do have a peek and consider how it might work for you. (And, no, they are still not sponsoring this – all opinions are my own in CN, I promise! If I like something, I’ll share it, and if I don’t, I’ll share that too!)

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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