Interesting stuff I think might help us get even more people well. Enjoy x
Hi peeps, here’s the first of the monthly Clinic Notes Digest for practitioners. Emails go out to all subscribers, but if you don’t want to receive this publication, all you need to do is go to www.substack.com/settings, click on your Purehealth by Micki Rose subscription and toggle sections on and off, depending on what you want to receive or not. Simples. If it becomes a pain, I’ll set up a separate newsletter, but let’s see how it goes. I have a LOT of very sophisticated and expert patients too who I know like to see the more technical stuff.
Here’s goes – hope you find something useful.
PS. Apologies if you got this twice – I had the settings wrong – doh, still learning Substack!
IHCAN Summit, April 25
Take note that the superb IHCAN Summit takes place on Saturday 26 April at 155 Bishopsgate, London. Topics this year include thiamine deficiency, oral microbiome, hormones and fatty liver. Tickets are limited, so guarantee yours today.
New Magnesium type
I see Nutri Advanced is bringing out a new Magnesium Relax sachet soon with magnesium glycerophosphate in it. That’s a new form for me – never heard of it. They point to a study that shows (unsurprisingly) that forms like glycerophosphate and bisglycinate are more absorbable than oxide. I look forward to learning more about this form. I’ll have to add it to my ever-growing Magnesium factsheet, where I list all the different forms and which is best for what type of use!
Chronic Illness – don’t just fix the window…
Loved this reminder from Dr Yanuck at Cogence:
Most symptom patterns that chronically ill patients bring into a functional medicine clinic setting can have their origins in a wide variety of causal origins. Fatigue, GI dysfunction, metabolic dysregulation, inflammation, autoimmune disease, hormonal issues, brain fog, chronic infection, and a host of other issues arise in webs of underlying biology that can be completely different from one patient to another, despite similarities in their symptom presentations.
Most chronically ill patients have interconnected webs of factors that keeps them entrenched in their patterns of dysfunction, with self-reinforcing loops….
Getting rid of the baseball that broke the window doesn’t fix the window. It’s certainly fair to say that if you don’t stop throwing baseballs through that window, it will never get fixed, or certainly never stay fixed. Definitely. So, it’s great to wonder why the window is broken and trace back what the broken window tells you. But if you center your focus on the baseball discovery, you might not be focused enough on what it’s going to take to actually fix the window.
The idea of a single root cause can easily make the clinician too susceptible to the effects of intermittent reinforcement, if they develop a tendency to think that the root cause is always the same thing. Always mold, always Lyme, always dysbiosis, etc.
It’s always biology. And it’s always complex and interconnected.
Mycobiome Training
Have I been under a rock as I’ve not come across it called the mycobiome before? Of course, it’s referring to the yeast/fungi part of the gut microbiome. I note that PLMI are doing a free workshop with the Vojdani’s – I try to listen to anything Aristo Vojdani says about immunity myself.
An imbalance of the gut mycobiome due to many environmental factors, including diet, can contribute to the pathogenesis of both intestinal and extra-intestinal problems and afflictions, including biofilm formation, systemic infection, inflammation, autoimmunity, neuroautoimmunity, neurodegenerative and even neuropsychiatric disorders.
Based on recent literature, Aristo Vojdani, PhD, MSc, CLS will present evidence that these disorders may be induced by the disturbed mycobiome releasing a variety of antigens. These include antigens from commensal and food-derived yeasts, fungi, and molds such as Candida germ tube, Candida mycotoxin, and Candida enzymes, as well IgG/IgA antibodies produced against them.
Understanding how fungal organisms like Candida and food-derived yeasts contribute to gut barrier disruption — and recognizing the dual role of immune cells in both protection and pathology — could pave the way for earlier intervention and more effective therapeutic strategies for patients with these conditions.
I’ve not done anything much on candida/yeast infections for ages, so this would be good, I think. I’m especially interested in how it contributes to leaky gut for my hypersensitivity patients. April 29th, 5-7pm. You can register here.
Practice Better templates
I’m liking the template library in Practice Better, which saves you a lot of time creating eg. food symptom diaries and whatnot. Take a peek if you use PB. I see they’ve also improved the supplement and meds tracker too. It’s quite a lot of money to use PB, and it’s geared much more towards US and Canadian practitioners, but I do like it. Even more so after all this Trump business and tariffs, I am happy to support something Canadian, you know!
Mineral Check hair mineral testing 10 week course
This is a great idea from Karen at Mineral Check. I have used MC for about 20 years I think now and emailed Karen a fair bit for help over that time! Hair testing can be really useful IF you understand the results and can interpret them correctly! I tend to use hair for checking toxic metals and the balances between eg. zinc and copper, but I’m sure there’s a lot more I could be doing. The first course started in March, but it is also being run in June and September. Find out more here.
Blood glucose supplements and meds reminder
I thought this article from YHB was a good reminder about how some pretty common supplements, including Vitamin D, can lower blood glucose and HBA1c really effectively. That’s a good thing, obviously, but as they mention, docs hardly ever ask diabetes patients what supplements they are taking, which could make a huge difference to how their meds are working, and to how they feel!
Past studies revealed many patients didn’t tell their healthcare providers about supplement use. The largest longitudinal study of 333 hospitalised patients showed only 20% received questions about their supplement use. Just 6% had proper documentation [1].
If someone is on a diabetic medicine and is taking Vitamin D or chromium in decent amounts in a multi, for example, or something specific like berberine, the potential is there to lower blood glucose too much. Just something worth noting, I thought.
Screening for neurological/brain problems
I see Dr Kharrazian is doing some more on brain and neurological issues – his forte. I’ve done his advanced FM Neuroinflammation course, which was fantastic – do it if you get a chance; it changed how I practice straight away!
While we routinely screen everything from cardiovascular health to cancer, there’s a critical gap in the lack of neurological screening.
He’s dead right there, isn’t he? Our most important organ and we don’t regularly screen. Doesn’t make sense when you think about it. Don’t forget that neuro diseases might include things we see in practice every day: anxiety, depression, the seemingly-ubiquitous brain fog, loss of cognition, memory problems etc, not just things like ataxia, Parkinson’s or traumatic brain injury, to name a few. Now I know about it, I see neuroinflammation all the time (sadly)!
In this Neurological Disorders course, a guest lecturer is going over cognitive assessment tools including:
MOCA tests
CNS vital signs testing
VOMS assessments
I use MoCA myself in practice since doing Dr K’s course. If you’ve never heard of it, here’s some info to start you off:
For the Earliest and Most Accurate Detection of Mild Cognitive Impairment
MoCA—also known as Montreal Cognitive Assessment or The MoCA Test—was validated as a highly sensitive tool for early detection of mild cognitive impairment (MCI) in 2000. MoCA has been subsequently adopted in clinical settings around the world and is widely used as a scale in academic and non-academic research. The sensitivity of MoCA for detecting MCI is 90%, compared to 18% for the MMSE.
MoCA accurately and quickly assesses:
You can download a paper questionnaire or an app at Moca Cognition. They also recommend and offer training in how to use and interpret it effectively. I recommend you do it on yourself – mine was a bit pants, to be honest. It’s not exactly easy!! A reminder for me to sort my own neurology out.
Anyway, check out the MoCA stuff even if you don’t do the course – it might help with cognitive patient assessment. You can see more on the new Neurological Disorders course here.
A suggested toolkit for measles
A fascinating article showing how important nutrition levels are for both prevention and treatment of measles in children.
Measles: A Nutritional Deficiency Disease – Integrative Orthomolecular Medicine for the Prevention and Management of Measles
The quick takeaways are:
Highlights:
Malnourished children are 5-10 times more likely to die from measles.
Vitamin A, C, D, zinc, and antioxidants play a critical role in measles prevention and recovery.
Before vaccines, improved nutrition and sanitation had already dramatically reduced measles deaths.
Integrative Orthomolecular Medicine (I-OM) provides a powerful, evidence-based approach to immune resilience.
The writers call on governments to consider nutrition as equally important as vaccination – a two-pronged approach is likely to be much more effective.
To truly reduce measles-related deaths, public health strategies must prioritize nutrition alongside vaccines. Well-nourished individuals are far less likely to suffer severe measles complications-yet this critical factor remains overlooked.
They give a suggested protocol – although I challenge someone to find all that in a child’s multi, and at those levels – let us all know what you suggest!
Smart Kids Conference
Talking of kids, I am always interested in whatever Food for the Brain does and this Smart Kids Conference, April 24th Online, looks really useful, especially given the huge increase in mental health diagnoses in our young people. As they point out:
In recent years the number of children diagnosed with learning, behavioural and mental health problems has escalated.
Attention-deficit hyperactivity disorder (ADHD), autistic spectrum disorder (ASD) and other neurodevelopmental disorders have rocketed in both the UK and USA.
One in six children in the USA is classified as neurodivergent and one in 36 as autistic – a fourfold increase in 20 years.
This crisis is not just ‘in the genes’—something is happening to our children’s brains. Join us at Smart Kids Conference to uncover the truth, explore the latest research, and discover real solutions to support children’s brain health.
I’m starting to get really interested in the field of fertility and children’s health – especially since the shocking obesity predictions that came out recently in The Lancet – see where I wrote about this below. I’m wondering if we can get in right at pre-conception stage and ‘grow’ healthier and happier children (and parents!) and offset some of the later-onset issues that seem to be besetting our kids and younger adults, you know.
In fact, don’t forget to check out the Purehealth News I do weekly-ish too for lots of other stuff I witter on about. You’ll find the archive here, but sign up to get them as I write them. And you can see my regular titbit type of Notes here.