What do you do again?
It still seems that many people do not know what Naturopaths do and many doctors still think we just hand out fluffy essences and fix chakras! So I thought it might be a good idea to clarify what happens in a Naturopathy Consultation.
At your first appointment
First of all, before you attend clinic, I ask you to complete a complete online health appraisal questionnaire which takes about 15-20 minutes and covers all aspects of your health/body systems and will give me much needed insight along with a visual chart. Natural Medicine is also holistic in nature whereby we are not breaking people down into different body parts common to allopathic medicine but it does help me to see which areas are flagged.
I spend 90 minutes with you at your first Naturopathy consultation and always start off by asking the reason why you have come in. This is to ascertain your main presenting complaint (or 2 or 3!). After asking searching questions around that complaint: the location, onset, provocation/palliation, timing, severity, history of the complaint etc… I then move into each body system one by one starting with the most relevant eg. for gut discomfort I would focus on the GIT system then move to the Nervous system, Endocrine system, Integumentary system, Cardiovascular system and so on. Once those areas are covered I move into family history, supplements & medications taken, travel history, diet in detail, sleep, energy levels and so on. Once the case taking is complete I then look at the iris for an Iridology assessment which can give me insight into your general health and tendencies. I may perform some simple in clinic tests like a zinc taste tally or other physical examinations such as looking at tongue and nails, palpating lymph glands and performing blood pressure testing.
I then discuss what I think may be going on and form a rough differential diagnosis or working hypothesis. Naturopaths believe a disease or disorder is not formed out of a vacuum: there is a rhyme and reason to any imbalance. It is our job to find the cause and treat it so that it is less likely to recur. To that end we may recommend further testing which is functional in nature: meaning it is looking for what is out of balance rather than just looking for ‘dis’ease. We do not diagnose conditions and you may have already been diagnosed by another medical professional. We may consider Stool, Hair, Urine, Saliva or blood testing or we may want to try an elimination diet for a short time to see if eliminating certain foods alleviates symptoms. An elimination diet is usually followed by food challenges.
Once the tests are discussed, agreed on and ordered or referrals written, I write out a treatment plan that involves dietary measures: meeting certain macros such as protein for instance or increasing magnesium rich foods and essential fats. I may give recipes and suggest meals for breakfast, lunch and dinner. I find handouts very useful here as they can provide much needed supplemental ideas/recipes/education. I have a range of handouts available that I readily give to my patients eg. protein sheets, feeding fussy kids, magnesium rich foods, dairy free options, gluten free diets, fibre gram sheets and so on. I give a lot of support around following a treatment plan.
As well, we discuss supplements and herbal medicines. I prefer to give combinations of supplements that combine different vitamins, minerals and nutrients in order to reduce the amount of supplements taken. I also generally only prescribe practitioner supplements that you can only get from a Naturopath or Nutritionist which ensures they are high quality, evidence based and in the right dose/form. I feel confident knowing these are much more effective than those you can buy off the supermarket shelf which often have lesser amounts of the ‘active’ ingredients in poorer absorbable forms. Here is an article I wrote for body and soul about supplements, which to avoid and which are worth the money in my opinion.
I may make up a custom blended herbal supplement for you. I find that blending a tonic individually is much more effective for my patients and they love them! You may have heard of liquid herbal tinctures containing Echinacea or Elderberry but on my shelves I have over 100 different herbal fluid extracts that as a registered herbalist I am qualified to blend into individual tonics to help with a range of issues. They are high quality extracts generally in a 1:1 or 1:2 ratio depending on the herb, are checked to make sure they are the correct herb and extracted in specialist factories (there is a lot of adulteration in the herbal industry as many of the herbs look very similar and may be wild crafted). A few brands you may have heard of are The Herbal Extract Company (a fifth generation Herbal Company) or Mediherb another well known Australian herbal manufacturer started by Professor Kerry Bone.
What next?
Then there may be lifestyle recommendations such as stress management techniques or exercise goals to follow. These are also agreed on so it becomes like a contract between you and myself. Once you leave you can contact me to ask me any questions via email. I generally like to see you for a follow up after about 2-4 weeks or when test results have returned. Everyone is treated differently there are no ‘protocols’ for conditions, it is holistic and individual. Some patients may need to come multiple times and some only a few, it really depends on the condition, how quickly you respond, your vital force, health, compliance and willingness.
I base all my clinical decisions on evidence based medicine and research. This allows me to utilize a broad range of resources both clinical trials, case studies, articles, books and meta-reviews. Alongside this is my own evidence base from being in practice over 15 years. Herbal Medicine has been in practice for many thousands of years and has a strong history of use and evidence base of its own. In Traditional Chinese Medicine years ago doctors were not paid if their patients got sick and only if they stayed well. I love this!
Recently I have seen such varied cases as peri-menopause, ADHD, heavy metal contamination (confirmed via hair testing), tic disorder, ulcerative colitis, Hashimoto’s disease and insomnia. While I do not guarantee I will be effective with every condition 100% of the time, I will always refer on if treatment is not working.
At the end of the day, it is the patient doing the work after that first session… they have to make the changes and take the ‘medicine’ but I am always there for support and guidance. Many people are put off by this fact and that as humans we all want that ‘magic bullet’. I sometimes see subconscious programming get in the way of positive changes and doing some work on these areas by referring to a psychologist or kinesiologist may be appropriate. In addition, I have a wonderful referral network of massage therapists, acupuncturists, counsellors, yoga teachers, reiki practitioners and Integrative GP’s that I can reach out to and use for my patients who need that extra support.
Case Study
Here is a case study of a patient who came to see me in 2020.
Freddie (name changed for confidentiality) was an 11 year old boy who had been diagnosed with ADHD and a tic disorder the previous month. He was struggling at school and his mother was concerned.
We discovered during functional testing he had PANDAS (* see below for more info) – a Strep overgrowth in the gut which was affecting dopamine receptors in the brain and causing the tic disorder. He also had some nutritional deficiencies and Pyrrole disorder.
I prescribed a range of supplements to eradicate this dysbiosis (imbalance of gut flora) and support the growth of beneficial microbes and the health of the microbiome in the gut as a whole. We also used nutrients to provide the building blocks for neurotransmitter balance, support brain health, mood, learning and for healthy sleep. Some nutrients were prescribed in larger amounts than you would gain from food to correct the imbalances uncovered during hair and blood testing. Supplements for children are generally in a liquid, spray or powder form. Freddie was luckily able to swallow some small capsules which made dosing easier.
Freddie and his mum were luckily both very motivated and compliant, sticking with the dietary changes and supplements prescribed. Within 4-6 weeks the tics were noticeably improved and within 10 months they were practically gone. On follow up 2 months later the ADHD diagnosis had been removed and Freddie was back to his old self and was top of his class!
I do not mean to imply all patients respond this way but this is just one example of where the medical profession did not have the means (functional testing) and the tools (herbal and nutritional supplements) to implement effective treatment. We do not want to suppress symptoms or bandaid with drugs we want to uncover the cause and treat that gently and naturally.
Did you know for instance that SSRI (selective serotonin re-uptake inhibitor) drugs commonly prescribed for depression do not in fact give you more serotonin, they just stop the serotonin you already make being broken down? But natural supplements like zinc, magnesium, saffron, NAC and omega 3 fish oils can support your body to make more serotonin and dopamine!
Did you also know that 80% of serotonin is made in the gut? So if your gut is not healthy then your mood can be affected. I commonly see this in children who have constipation for instance. Also serotonin is converted to melatonin so sleep issues may be related to conversion issues or deficiencies in neurotransmitters balance or even gut health.
I hope I was able to better explain what my job entails. I love my work and I love treating all kinds of people especially children!
If you want to know if I can help or just to meet me and discuss your issue please book a free 15 minute discovery appointment. This can be face to face or via phone/Telehealth.
I look forward to meeting you!
*PANDAS also known as PANS is an acronym for Paediatric Autoimmune Neuropsychiatric Disorders Associated with Strep Infections. The condition is a treatable autoimmune disorder that affects children with the average age of onset between 4 and 7 years. (It is possible that adolescents and adults may have immune mediated OCD, but this is not known.) The condition is believed to be triggered by an infection.
PANDAS/PANS occurs when the antibodies in the body has made to fight an infection mistakenly attack healthy tissue in the brain contributing to a host of movement disorders, neuropsychiatric symptoms, and abnormal neurologic behaviours.
Parents often describe the onset of symptoms as the day they “lost” their child. Typically the change is dramatic, with symptoms developing within a 24-48 hour period. The OCD symptoms and/or eating restrictions begin so suddenly that most parent can recall the exact day and time that the OCD or restrictive eating began.
Common Conditions:
- Vocal tics
- Obsessions
- Motor tics
- Behavioural regression
- Compulsions
- Anxiety
- Irritability
- Sleep disturbances
- Depression
- Impulsivity
- Changes in handwriting
- Anorexia
- Aggression
- Sensory abnormalities
- Emotional
Thank you for reading!
