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    Naturopathic Management of Endometriosis: A Holistic Approach

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    Endometiosis Women's Health

    Endometriosis is a complex and often debilitating condition affecting many women worldwide. Characterised by the presence of endometrial-like tissue outside the uterus, it leads to chronic pelvic pain, infertility, and a host of other symptoms that significantly impact quality of life. While conventional treatments often focus on hormonal therapies and surgical interventions, the naturopathic management of endometriosis offers a holistic and comprehensive approach, emphasising the importance of treating the gut and the immune system.

    Understanding Endometriosis: Beyond Hormonal Imbalances

    Contrary to the traditional view that endometriosis is primarily a hormonal disease, recent research underscores its inflammatory and immunological nature. This paradigm shift necessitates a broader therapeutic strategy that addresses underlying systemic inflammation and immune dysfunction. By targeting these root causes, naturopathic treatments aim to provide sustainable relief and improve overall health outcomes for women with endometriosis.

    The Role of Gut Health in Endometriosis

    The gut plays a pivotal role in the body’s immune response and inflammation regulation, making it a critical focus in the natural treatment of endometriosis. Dysbiosis, or an imbalance in the gut microbiota, can exacerbate systemic inflammation and compromise immune function. Addressing gut health through naturopathic interventions and Microbiome Mapping, a comprehensive, functional gut health test, can thus significantly impact the management of endometriosis.

    Dietary Interventions:

    A diet rich in anti-inflammatory foods is essential. Incorporating high-fibre foods, such as fruits, vegetables, and whole grains, supports gut health by promoting a diverse and balanced microbiome. Omega-3 fatty acids, found in fatty fish, flaxseeds, and walnuts, are particularly beneficial due to their potent anti-inflammatory properties. Further, identifying and eliminating potentially pro-inflammatory foods, with the A1 casein from cow’s dairy being a common culprit, can reduce inflammation and alleviate symptoms.

    Probiotics and Prebiotics:

    Probiotics, beneficial bacteria found in fermented foods and supplements, can help restore a healthy gut microbiota balance. Prebiotics, non-digestible fibres that feed these beneficial bacteria, are equally important. Together, they support a healthy gut environment, reduce inflammation, and enhance immune function.

    Immune System Support in Endometriosis Management

    Endometriosis is increasingly recognised as an immune-mediated inflammatory disease. Therefore, enhancing immune function is crucial in its naturopathic management. Strategies to support the immune system include:

    Nutritional Support:

    Essential nutrients such as vitamins A, C, D, and E, as well as minerals like zinc and selenium, are vital for robust immune function. A balanced diet provides the foundation for accessing these nutrients, and targeted dosing through supplementation under the guidance of a Naturopath and Nutritionist can provide a therapeutic effect.

    Herbal and Nutraceutical Medicine:

    Naturopaths have access to some wonderful herbs that have immunomodulatory and anti-inflammatory properties. Turmeric, for example, with its active compound curcumin, is renowned for its anti-inflammatory properties. There is also building evidence for the use the n-acetyl-cysteine in the treatment of endometriosis due to its anti-inflammatory and antioxidant properties. As with any herbal and nutraceutical treatment, choosing the correct prescription, the correct form and dosage is essential to have a therapeutic benefit. It is important to remember that the triggers and drivers of endometriosis are unique for each individual, therefore, each endometriosis case will require a unique prescription.

    Lifestyle Management:

    Chronic stress can dysregulate immune function, exacerbate inflammation and trigger hormone imbalances, which can make endometriosis symptoms worse. Lifestyle counselling can identify relevant techniques to reduce stress and improve immune resilience. Naturopathic treatment will almost always incorporate lifestyle medicine into a comprehensive treatment plan.

    Women's Health

    The Importance of a Personalised Approach

    Each individual’s experience with endometriosis is unique, so too are the triggers, necessitating a personalised approach to treatment. A thorough assessment by a naturopath involves a detailed health history, dietary analysis, and possibly functional testing, including gut testing and hormone testing, to identify specific imbalances and needs. This personalised approach ensures that interventions are tailored to address the root causes of each patient’s symptoms.

    Integrating Naturopathic Care with Conventional Treatments

    While naturopathic treatments offer significant benefits, they can also complement conventional medical approaches. Integrating naturopathic care with conventional treatments can provide a more comprehensive management strategy, potentially enhancing overall outcomes. Open communication between naturopaths and conventional healthcare providers is crucial to ensure a cohesive and collaborative approach to patient care. In some cases, a minor surgery, known as a Laparoscopy, is recommended to remove endometriosis lesions. A Laparoscopy is the gold standard treatment for diagnosing and treating endometriosis. However, it is nonetheless essential to address the root causes of endometriosis to reduce the chance of recurrence post-surgery.  

    Managing Endometriosis with Sydney-based Naturopath & Nutritionist Liana Madera

    For those seeking natural treatment of endometriosis, finding a qualified and experienced naturopath is essential. The most common situation I see in my clinic is women who have undergone a Laparoscopy for endometriosis, only to find it returns in 12-24months post-surgery. This is why I strongly believe it is essential to treat this condition at it’s core – by addressing and eliminating drivers of inflammation and immune dysregulation. Book an appointment with me today to start your journey towards better health and effective management of endometriosis.

    Liana Madera
    Book an Appointment

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    Men’s Health: Natural Solutions and Naturopathic Support  

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    men's health

    Considering men’s health, when compared to women, men visit the doctor less frequently, have shorter visits, and only attend when their illness is in its later stages. When men are more likely to get sick from serious health problems, and see greater mortality rates than women from almost every non-sex-specific health problem1, it’s crucial that men have a health support system in place.

    Testosterone

    Testosterone is a key determinant of men’s health, being the main male sex hormone that is responsible for key male characteristics. Testosterone is present in women too, however in much lesser amounts. Unlike female hormones that ebb and flow every month, testosterone levels in men are fairly stable all their adult life. From about age 40, testosterone levels start to gradually decline by 1% each year2.

    Testosterone helps men maintain muscle mass, promotes clear thinking, supports mood and motivation, and is also essential for fertility2.

    Dihydrotestosterone, or DHT, is an offshoot of testosterone. About 10% of daily testosterone secretions are converted to DHT by an enzyme known as 5-alpha-reductase. DHT is a much stronger form of testosterone. In puberty, DHT is essential for the development of a deeper voice, muscle mass and bone mass, and body hair. Throughout adulthood, DHT is important for the maintenance of muscle and bone, male vigour and libido3.

    However, DHT is also the culprit in many hormone related male health conditions. In adolescents and young adults, excess DHT conversion in the skin can cause acne. In older, susceptible men, DHT can promote hair loss and enlargement of the prostate gland4. Susceptibility to DHT can occur in two ways; susceptibility of excessive conversion of testosterone to DHT, or excessive sensitivity to DHT in tissues such as the skin or prostate gland4.

    Men's health: Preventative healthcare during young adulthood

    Men in their 20s and 30s are physically in their prime. This period is characterised by a drive for achievement, recognition and success. 

    Young men need to go out of their way to exercise and enrol in sports that used to be so accessible during education years. To maintain muscle and bone mass, prevent weight gain, and support healthy testosterone levels, men need to continue exercising for at least 30 minutes a day5. 

    Stress and mental health support

    The 20s and 30s are often decades marked by major life changes. Finishing higher education degrees, entering the workforce and building careers, getting married and starting a family — all important life events to look forward to and enjoy, but also may be accompanied by periods of stress. 34% of men say they would be embarrassed or ashamed to take time off work for mental health conditions such as anxiety or depression6. Younger men need extra support given two thirds of deaths under 35 are male and the largest cause is suicide7. Given chronic stress is a leading factor in the onset of mental health conditions8, stress management techniques, lifestyle support and natural medicines such as adaptogenic herbs, are a large feature in naturopathic men’s health protocols.

    Sleep

    Sleep is important throughout the lifecycle but often neglected in younger men, and sleep loss in younger men has been found to dramatically decrease testosterone levels. Inadequate sleep is associated with a number of chronic illnesses including obesity, hypertension and type two diabetes9. Naturopathic sleep support includes identification and correction of problem sleep habits, respiratory assessment, stress support and nutritional and herbal medicines that aid relaxation and sleep onset.

    Fertility

    Sperm counts are declining at an alarming rate. Global figures suggest sperm concentrations have halved in the last 40 years, and the rate of decline is accelerating10. As a result, men, even in their 20s and 30s, can experience fertility issues. There are many factors that negatively influence fertility, including obesity, oxidative stress caused by a high sugar diet, zinc status, tobacco and drug use, excessive alcohol consumption, and exposure to environmental toxins and heavy metals10. Environmental toxicity can occur in certain occupations, those exposed to chemicals and fine particles, as in construction work and farming. Naturopathic support for men who are concerned about their fertility involves a nutritional, lifestyle, toxicity and hormonal assessment. Once the area(s) of issue is identified, a Naturopath can use nutritional, herbal and lifestyle medicine to  improve sperm quality and boost fertility.

    Men's Health: Optimisation during the middle years

    middle aged men

    Beginning in their early 40’s, men experience a decline in testosterone of 1 percent each year. These reductions coincide with increased incidence of depression and anxiety. While this decline in testosterone often goes unnoticed by some, 1 in 5 men experience symptoms like low energy, mood, and libido, poor concentration, weight gain and reduced muscle mass 2.

     

    Chronic stress can exacerbate hormonal imbalances, as the body shifts its resources to synthesizing stress hormones at the expense of sex hormones such as Testosterone2. Again, we can see the importance of a toolkit of stress management techniques. 

     

    The risk of heart disease, hypertension and diabetes is exacerbated by obesity, and middle age is when men are likely to be overweight. Men lose 3 to 5 percent of their muscle mass for every decade after age 2511. Reduced muscle mass and physical activity, and declining testosterone levels, conspire to decrease men’s resting metabolic rate. Therefore, as men age, they burn less energy while resting and can gain weight even without changing their eating habits. 

     

    Cardiovascular health

    All men in their 40s and 50s should have an annual heart health check-up. This involves checking blood pressure, glucose, cholesterol, and liver function. If any of these markers show up abnormal, diet and lifestyle changes should be implemented, and a follow up conducted in 3 months. From there, a bi-annual heart health check should be done until markers are consistently normal. 

     

    Digestive health and bowel cancer 

    Bowel cancer screening begins at age 50. However, increasing incidence of bowel cancer in younger years means GPs can request regular screenings for men of average risk from age 45. Being overweight or obese would categorise you as average risk. High risk involves a family history of bowel cancer, obesity, and an inflammatory bowel disease such as Crohn’s or Ulcerative Colitis. Although rates of bowel cancer are increasing, bowel cancer is one of the most treatable cancers, and research from 2021 indicates that up to 34% of bowel cancer cases may be prevented by a healthy lifestyle, increasing to 61% when combined with regular screening12.

     

    Naturopathic care moderates the risk of bowel cancer by: 

    • – Supporting maintenance of, or achieving a healthy body weight 
    • – Lifestyle support to increase physical activity and moderate alcohol intake
    • – Reducing the intake of red meat and strictly limiting processed meats 
    • – Support to quit smoking 
    • – Implementation of the naturopathic diet – plenty of fibre from fruits, vegetables, legumes, nuts, seeds and wholegrains 
    • – Assessment and support of a healthy gut microbiome

     

    Key objectives of naturopathic healthcare to optimise men’s health in the middle years includes:

    • – Achieve or maintain a healthy weight
    • – Get seven to nine hours of sleep per night
    • – Optimise diet by eating more vegetables, fruit, whole grains, and high-quality protein-dense foods; along with consuming less sugar and refined carbohydrates
    • – Adequate intake of zinc-containing foods like lean meat, seafood, cashews and pumpkin seeds support healthy testosterone levels
    • – Exercise regularly, and include strength training to support healthy testosterone levels, maintain lean muscle mass and bone mass 
    • – Implement daily stress management techniques, like deep breathing exercises, meditation, exercise and mindful movement like yoga or daily walking 

    Men’s Health: Looking ahead and preserving health and fitness for the golden years

    men's health in the golden years

    While the health areas above are always relevant in men’s health, for men in their 60s and 70s, additional factors to consider are bone health, prostate health and bone hair loss. One thing that experts in all fields of health agree on is that it is never too late to positively affect one’s health.

     

    Bone health

    Continued production of testosterone and larger peak bone mass protects men from osteopenia and osteoporosis in the early older years. Men can stem bone loss in their 60s and 70s by undertaking weight-bearing and resistance exercises. Weight bearing exercises include walking, hiking, jogging, climbing stairs, yoga, playing tennis, and dancing. Resistance exercises – such as lifting weights – can also strengthen bones. Other exercises such as swimming and cycling can help build and maintain strong muscles, and have excellent cardiovascular benefits, but they are not the best way to strengthen your bones. 

     

    Prostate health

    The continued production of testosterone, however, can also adversely affect men. Testosterone, or more rightly, DHT, causes hair loss and stimulates growth of the prostate gland in later years. Noncancerous enlargement of the prostate gland, or benign prostate hyperplasia (BPH), occurs in more than half of men in their 60’s and up to 90 percent of men in their 70’s and 80’s13. BPH can cause symptoms such as increased frequency of urination due to inability to fully void. This is usually all that the doctor would need to know to diagnose BPH. Naturopaths successfully use herbal medicines such as nettle root and saw palmetto, along with specific diet and lifestyle support, to manage symptoms and improve prognosis of BPH14.

     

    Hair loss

    DHT is the driver of both hair loss and prostate enlargement, so management goes back to that conversion of Testosterone to DHT by the enzyme 5-alpha-reductase. We want to normalise the conversion to DHT by reducing oxidative stress in the body, in large by following a wholefoods, high fibre, low sugar diet. 

     

    There are also specific foods, nutrients and herbs that down regulate 5-alpha-reductase, and protect sensitive tissues like the prostate and hair follicles from the effect of DHT:

    • – Green tea 
    • – Spearmint
    • – Quercetin
    • – Turmeric 
    • – Pumpkin seeds and pumpkin seed oil 
    • – Soybean products, like soy milk, tofu and tempeh, edamame 

    Naturopathic care can support men in all stages of life, whether trying to optimise heath, prevent illness, or manage and improve a diagnosed condition.

     

    When working in healthcare, the first people we want to help is often the people closest to us. Coming from a largely male family, men’s health has always been an area especially important to me. The present is always the right time to prioritise your health, work towards your goals and reach out for health support if you need it.

    Liana Madera
    Book an Appointment
    Send an Enquiry

    References

    1. 1. State Government of VIC. Men’s health. Better Health Channel. Published 2022. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/mens-health
    2. 2. Stanworth RD, Jones TH. Testosterone for the aging male; current evidence and recommended practice. Clin Interv Aging. 2008;3(1):25-44. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2544367/
    3. 3. Kinter KJ, Anekar AA. Biochemistry, Dihydrotestosterone. StatPearls Publishing; 2021. http://www.ncbi.nlm.nih.gov/pubmed/32491566
    4. 4. Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone: Biochemistry, physiology, and clinical implications of elevated blood levels. Endocr Rev. 2017;38(3):220-254. doi:10.1210/er.2016-1067
    5. 5. Riachy R, McKinney K, Tuvdendorj DR. Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men. J Funct Morphol Kinesiol. 2020;5(4). doi:10.3390/jfmk5040081
    6. 6. State Government of Victoria. Anxiety and depression in men. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/anxiety-and-depression-in-men
    7. 7. Australian Institute of Health and Welfare. Deaths in Australia. AIHW. Published 2022. https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/leading-causes-of-death
    8. 8. Davis MT, Holmes SE, Pietrzak RH, Esterlis I. Neurobiology of Chronic Stress-Related Psychiatric Disorders: Evidence from Molecular Imaging Studies. Chronic Stress. 2017;1. doi:10.1177/2470547017710916
    9. 9. Knutson KL, van Cauter E. Associations between sleep loss and increased risk of obesity and diabetes. Ann N Y Acad Sci. 2008;1129:287-304. doi:10.1196/annals.1417.033
    10. 10. Skakkebæk NE, Lindahl-Jacobsen R, Levine H, et al. Environmental factors in declining human fertility. Nat Rev Endocrinol. 2022;18(3):139-157. doi:10.1038/s41574-021-00598-8
    11. 11. Harvard Health. Preserve your muscle mass. Harvard Health Publishing. Published 2016. https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass
    12. 12. Bowel Cancer Australia. Modifiable risk factors. Published 2022. https://www.bowelcanceraustralia.org/modifiable-risk-factors
    13. 13. Shergill IS, Dhanasekaran AK, Kalsi JS, McAllister WJ. Benign prostatic hyperplasia. In: Viva Practice for the FRCS (Urol) and Postgraduate Urology Examinations, Second Edition. CRC Press; 2018:279-296. doi:10.1201/9781351254540-19
    14. 14. Leisegang K, Jimenez M, Durairajanayagam D, et al. A systematic review of herbal medicine in the clinical treatment of benign prostatic hyperplasia. Phytomedicine Plus. 2022;2(1):100153. doi:10.1016/j.phyplu.2021.100153

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    The Gut-Brain Connection: Can our microbiome influence our mood?

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    Gut Health

    Ever noticed that a change in your emotions triggers a change in your digestion? We know that increases in stress hormones impact the movements of our gut, leading the what are known as ‘functional gut disorders’, i.e. IBS, constipation, indigestion and reflux. In the other direction, stress affects the lining of the gut, which in turn negatively affects the balance of the gut microbiome. 

    Your ‘gut microbiome’ is made up of the trillions of microbes in your intestinal tract. These microbes have sophisticated mechanisms for interacting with each other and influencing their environment – us. 

    Research over the last 10 years has demonstrated that what happens in the gut does not stay in the gut. Rather, the gut has a significant effect on brain health via a bi-directional signaling pathway known as the gut-brain axis. 

    So, what does a healthy microbiome look like, and how can we modulate our gut microbiome to improve our mental health? 

     

    A healthy microbiome has a balance and diversity of microbial species that work synergistically within our gut. Given that the surface area of our digestive tract is thought to measure about the size of a tennis court, long-term dietary change is needed to ensure a healthy and resilient microbiome. 

    The more diverse your diet, the more diverse your microbiome will be. Every time you eat, you are feeding your gut microbiome! Choose unprocessed foods, as close as possible to their natural form. A high vegetable intake (at least 5 cups a day) and regular servings of legumes will provide natural fibers, the preferred fuel source of many bacterial species. Choose wholegrains over processed grains, and choose whole, fresh fruit over juices. 

    Take good care of your gut, and your mind, by consistently following a whole foods diet. Your dietary choices should be an essential feature in your mental health toolkit.

     

    If you’d like to put a plan in place to improve your gut health, and your mental health, use the link below to book an appointment with Naturopath Liana Madera.

    Book an Appointment
    Liana Madera

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    Restoring hormonal health after a PCOS diagnosis

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    PCOS

    Although most commonly associated with androgen excess, Polycystic Ovarian Syndrome (PCOS) is the outcome of a systemic metabolic and reproductive hormone dysregulation. So, what is PCOS and how can we restore hormonal and metabolic health once it has been diagnosed?

    PCOS affects circa 12-20% of Australian women of reproductive age, and is more common in women who are overweight or of indigenous background. The prevalence of PCOS has been steadily increasing over the last decade1.

    It is also the most common cause of anovulatory infertility in Australian women1. Ovulation is the essential prequal to conception, which is why women with PCOS may have issues with fertility.

    The term polycystic ovarian syndrome (PCOS) is a misleading name for what is essentially a multifaceted metabolic condition that has broad-ranging systemic effects, which impact hormonal and metabolic health. In fact, having polycystic ovaries is only part of the PCOS diagnosis.

    A PCOS diagnosis comes with the presence of at least two of the following criteria:

    1. Oligo-anovulation (irregular or missing periods)

    2. Clinical or biochemical evidence of high androgens (excess facial / body hair growth, male pattern hair loss, acne, elevated androgens on blood test)

    3. Polycystic ovaries on ultrasound examination

    AND the exclusion of other causes of irregular periods and high androgens, such as a thyroid disorder or high prolactin2.

    A diagnosis of PCOS comes as a shock to most women, and its potential to lead to fertility problems are legitimately cause for concern. Often, women are put on the contraceptive pill by their doctors, and told to come back when they want to have a baby.

    On the other hand, natural medicine, along with dietary and lifestyle modifications, can address the causes of PCOS to achieve great results. With the right type of support, PCOS can be successfully managed, and symptoms can be completely reversed in some cases.

    There is no single triggering factor in PCOS. Rather, it is the result of a complex interaction between genetics, environment and lifestyle factors.

    Hormones

    Genetics:

    We all carry subtle genetic variations that may predispose us to certain conditions. In the case of PCOS, it appears that stress and poor diet can trigger genes that influence insulin signalling, hormone metabolism, and the production of androgens from the ovaries and adrenal glands.

    Insulin Resistance:

    Circa 80% of women with PCOS have some degree of insulin resistance. For this reason, insulin resistance is rightly the main focus on research and treatment. Insulin is a hormone that acts like a key, allowing glucose (sugar) from the blood stream to enter the cell, where it is used as fuel. In insulin resistance, cells do not readily open to insulin, forcing the pancreas to produce more and more insulin to try to get sugar out of the blood and into the cells. What this means is that we have excess sugar and insulin in the blood stream, but not enough sugar in the cell where it is actually needed. Hello fatigue (due to lack of cellular energy) and sugar cravings, despite high levels of sugar in the blood. Excess circulating insulin leads to weight gain, but it also overstimulates ovarian follicles, causing the appearance of polycystic ovaries. This overstimulation results in excess production of androgens, and disrupts the hypothalamic-pituitary-ovarian axis (signals from the brain to the ovaries), resulting in oligo/anovulation.

    Once only associated with obesity, normal weight women with PCOS can also have insulin resistance. However, overweight women are more likely to experience more pronounced menstrual irregularity and signs of androgen excess.

    The development of insulin resistance relies of several factors, including diet, stress and inflammation.

    Diet:

    A typical diet that would lead to insulin resistance is a high sugar, low fibre diet. That is, a diet that pertains refined carbohydrates, sugary foods and drinks, and inadequate vegetable intake. Some women may be more sensitive to a diet high in refined carbohydrates, due to individual genetic susceptibility. What this means is, carbohydrate tolerance is individual. Just because you don’t eat as many carbohydrates as your friend who doesn’t have PCOS, doesn’t mean that your intake of carbohydrates may not be a factor in your insulin resistance.

    Stress:

    Stress can play a significant role in PCOS development due to its ability to alter glucose metabolism, insulin sensitivity, and impact the production of adrenal hormones. In women, both the ovaries and adrenal glands produce hormones that act as androgens. In women who have been ‘burning the candle at both ends’ so to say, the adrenal glands start to produce higher levels of androgenic hormones, such as DHEA-S. In fact, chronically stressed women with PCOS may present with normal testosterone levels (the androgen secreted primarily from the ovaries), but elevated DHEA-S levels, which can be the cause of their male pattern hair loss, excessive facial or body hair, or acne.

    Inflammation:

    Inflammation is an overlooked factor in PCOS. It is a double-edged sword that drives both insulin resistance and the production of androgens from polycystic ovaries. There are many causes of low-grade inflammation, but one of the most common is poor digestive function and dysbiosis. Dysbiosis is the imbalance of the billions of bacteria living in our guts. Causes of dysbiosis include a high sugar, high saturated fat diet, pesticides, food additives, medications such as antibiotics and the oral contraceptive pill, and stress. Dysbiosis may lead to increased intestinal permeability, whereby toxins or undigested food particles leak into the blood stream, causing chronic low-grade inflammation. Healthy bowel function is also imperative for hormone metabolism (as hormones are excreted via the bowels). Therefore, when gut symptoms are present, treating the gut is essentially the first step in treating PCOS.

    Womens Health

    Treating PCOS:

    Dietary intervention is the first line treatment in most PCOS cases. An anti-inflammatory diet, such as one which is high in plant foods, with moderate intake of fish, seafood, nuts and seeds to provide healthy fats and adequate protein, is the best way to improve insulin sensitivity, and support hormonal and gut health.

    Exercise is an important feature in PCOS recovery, but must be tailored to the individual. For example, women with a typical picture of insulin resistant PCOS would benefit from a more intensive exercise protocol than women with elevated DHEA-S only (stress induced), who would get more benefit from a more restorative routine.

    To support diet and lifestyle intervention, both nutritional and herbal medicines work exceptionally well in PCOS. Nutrients such as magnesium3, chromium4 and alpha lipoic acid5 help to stabilise blood sugar levels. Nutraceuticals such as inositol6 and N-acetylcysteine7 have been shown to improve insulin sensitivity. Herbs such as Peony and Licorice8 have been used for centuries to support ovarian function, ovulation and the adrenal glands, while also reducing the production of androgens in the ovaries.

     

    Naturopathic medicine has a huge role to play in women’s health. It is safe, effective, and actually addresses the root causes of conditions such as PCOS. You do not need to be on the contraceptive pill to manage PCOS. The pill effectually stops the natural production of your reproductive hormones, making it a band aid solution that may not actually improve symptoms, and will likely lead to more problems when stop you taking it.

    A Naturopath can work with you to address what is causing your PCOS, and develop a personalised protocol to improve your hormonal and metabolic health, naturally.

     

    Book an appointment with Naturopath Liana Madera to uncover the root cause of your PCOS, and start experiencing the benefits of a natural cycle.

    The journey to hormonal health is not always easy, but once you find your balance, you’ll have the key the lifelong female vitality.

    Book an Appointment
    Liana Madera

    References

    1. Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences. 2020;13(4):261-271. doi:10.4103/jhrs.JHRS_95_18

    2. Azziz R. PCOS: A diagnostic challenge. Reproductive BioMedicine Online. 2004;8(6):644-648. doi:10.1016/S1472-6483(10)61644-6

    3. Morais JBS, Severo JS, de Alencar GRR, et al. Effect of magnesium supplementation on insulin resistance in humans: A systematic review. Nutrition. 2017;38:54-60. doi:10.1016/j.nut.2017.01.009

    4. Ashoush S, Abou-Gamrah A, Bayoumy H, Othman N. Chromium picolinate reduces insulin resistance in polycystic ovary syndrome: Randomized controlled trial. Journal of Obstetrics and Gynaecology Research. 2016;42(3):279-285. doi:10.1111/jog.12907

    5. Evans JL, Goldfine ID. α-Lipoic acid: A multifunctional antioxidant that improves insulin sensitivity in patients with type 2 diabetes. Diabetes Technology and Therapeutics. 2000;2(3):401-413. doi:10.1089/15209150050194279

    6. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: A systematic review of randomized controlled trials. Gynecological Endocrinology. 2012;28(7):509-515. doi:10.3109/09513590.2011.650660

    7. Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N. A comparison between the effects of metformin and N -acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. Gynecological Endocrinology. 2016;32(4):285-289. doi:10.3109/09513590.2015.1115974

    8. Goswami PK, Khale A, Ogale S. Natural remedies for polycystic ovarian syndrome (PCOS): a review. International journal of pharmaceutical and phytopharmacological research. 2012;1(6):396-402.

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  • Article

    Holistic Acne Treatment

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    Holistic Acne Treatment

    Acne affects primarily adolescents, but also affects adults, and for some can be a condition that follows them into their 50s. In fact, acne will affect 80-85% of people to some degree, at some point in their lives1.

    Medical treatment of acne typically involves Antibiotics, Roaccutane, and for females, the Hormonal Contraceptive Pill.

    Unfortunately, these treatments come with significant side effects, and are often not effective.

    As someone who personally struggled with acne throughout my teens and early 20s, and had tried all of the aforementioned medical treatments without success, I can honestly say that a naturopathic and holistic approach to acne management is the best treatment strategy.

    What Causes Acne?

    The simple answer is hormones and genetics. A hormonal imbalance leads to the production of excess androgens. Androgen excess increases the skin’s production of sebum, and triggers abnormal keratinisation. What occurs as a result is blockage of the skin’s pores, and pimples.

    The sensitivity to androgen excess in the skin may be influenced by the genetics, explaining why some are susceptible to acne during periods of hormonal imbalance, while others are not2.

    In inflammatory acne (think multiple red, sore pimples), the hormonal imbalance occurs simultaneously with an imbalance of the skin’s microbiome. This microbial imbalance on the skin may be directly due to the hormonal imbalance (as excess sebum production favours the proliferation pro-inflammatory bacteria such as Propionibacterium acnes), or may be a reflection of another imbalanced microbiome in the body, i.e., the gut3. P.acne hydrolyses the excessively produced sebum into pro-inflammatory fatty acids, creating a cycle of more pimples, and more inflammation1.

    Complications - More Than Skin Deep!

    The complications of acne can be psychological and physical. Acne can lead to depression, anxiety and reduced self-esteem4. Unfortunately, the added stress caused by the psychological impact of the acne can lead to an increase in acne severity.

    Physically, acne lesions can result in scarring. When acne becomes chronic and inflamed, it is important to seek help sooner rather than later, to minimise the risk of scarring. Naturopathic treatment will focus on clearing the acne, but also supporting skin healing and collagen synthesis.

    Holistic Acne Treatment

    Effective treatment of acne requires an individualised and holistic approach. Every acne patient may present with a set of unique triggers, which will best respond to a personalised dietary, nutritional, herbal and/or topical protocol.

    A key feature of holistic acne management is to support hormone metabolism, and/or hormone modulation. Hormone metabolism occurs in the liver, and hormones are then excreted via the gut and kidneys. Therefore, it is important that all of these organs are functioning optimally.

    Hormones can be modulated both directly and indirectly. Direct hormone modulation using herbal medicine can be saved for adult acne patients, who are no longer experiencing the normal hormonal ups and downs of puberty.

    Indirectly, the best method to modulate hormones is to normalise insulin levels. Elevated insulin sees increases of insulin like growth factor and androgens. Elevations of these hormones can cause abnormal keratinisation and excess sebum production, thereby acne.

    Stable insulin levels require stable blood sugar levels, which is achieved by eating a varied, high fibre, low GI diet, and exercising regularly. In some cases, acne patients may need additional nutritional and/or herbal support to keep blood sugar and insulin levels within normal ranges.

    Optimal immune system function is essential for maintaining an anti-inflammatory microbial balance in the skin. We can support the immune system by consuming a diet rich in Zinc, Vitamin C, Vitamin A and Selenium, as well as maintaining an adequate Vitamin D status.

    Importantly, the gut is host to most of our body’s immune cells, and plays a huge role in the regulation of the entire immune system5. So, the gut microbiome is as important as the skin microbiome in acne management.

    Reducing inflammation by following an anti-inflammatory diet, and if necessary, supplementing with herbal and/or nutritional anti-inflammatories, supports skin healing and reduces the risk of acne scarring.

    Stress can wreak havoc on hormones, gut function, the immune system, and therefore acne6. In some cases, stress management may be the most important tool in acne management. Stress can be managed using lifestyle medicine, as well herbal and/or nutritional medicine where necessary.

    Topical Treatment

    Purely trying to treat acne using a topical only approach simply will not work. The aim of a topical protocol should be to support the natural keratinisation processes of the skin, allow the skin’s microbiome to resettle, and possibly use spot treatments during initial phases of the protocol to reduce acne lesions and risk of scarring. The best way to achieve this is to use a minimalistic, natural skin care routine that does not strip the skin’s natural barrier. 

    Inversely, if you try to rid the skin of all bacteria using harsh chemical cleansers and peels, you create an even more imbalanced environment, where it is more likely that opportunistic bacteria will proliferate and create more and more inflammation.

    Naturopathic Acne Solutions

    Naturopathy treated my acne after nearly ten years of trying every treatment that conventional medicine had to offer. I only wish I had found it sooner!

    In fact, the successful Naturopathic treatment of my acne is what inspired me to study Naturopathy all those years ago. That is why helping adults and adolescents to leave acne behind using Naturopathic medicine is a special area of interest for me as a practitioner.

    Book an appointment with me to start your journey to clear-skin wellness.

    Book Now

    References

    1. Paller A, Mancini A. Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence. 5th ed. Elsevier; 2016.

    2. Hechtman L. Clinical Naturopathic Medicine. Elsevier; 2020.

    3. Pessemier B de, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut–skin axis: Current knowledge of the interrelationship between microbial dysbiosis and skin conditions. Microorganisms. 2021;9(2):1-33. doi:10.3390/microorganisms9020353

    4. Uhlenhake E, Yentzer BA, Feldman SR. Acne vulgaris and depression: A retrospective examination. Journal of Cosmetic Dermatology. 2010;9(1):59-63. doi:10.1111/j.1473-2165.2010.00478.x

    5. Yoo JY, Groer M, Dutra SVO, Sarkar A, McSkimming DI. Gut microbiota and immune system interactions. Microorganisms. 2020;8(10):1-22. doi:10.3390/microorganisms8101587

    6. Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology. 2017;10:503-506. doi:10.2147/CCID.S14849

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    The Naturopathic Toolkit: Lifestyle & Wellness Techniques

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    Wellness

    A Naturopathic treatment plan will almost always include lifestyle recommendations. That’s because Naturopathy is a holistic medicine that takes mind, body and spirit into account.

    Have you noticed that your physical symptoms flare up when your stressed or sad? Perhaps you’ve noticed that chronic pain dissipates when you’re engaged in an activity that you enjoy?

    Your mind isn’t separate from your body, nor are your emotions from your symptoms. Being healthy isn’t about having the ‘perfect’ body or magazine shiny hair, it’s about actually feeling good.

    There’s no denying that impact that stress can have on our health. Common physical symptoms of stress include headaches, digestive issues, fatigue, insomnia, anxiety and depression. Chronic stress can lead to behavioural changes, such as over or under eating, increasing alcohol consumption and social withdrawal1.

    Naturopathic lifestyle and wellness techniques aim to alleviate stress, improve mental resilience and increase positive emotions.

    Some examples of lifestyle and wellness techniques include good quality sleep, spending time in nature, moving your body and practicing mindfulness.

    Sleep and sleep hygiene

    A good night’s sleep is the foundation of good health. Seven-eight hours of sleep per night is associated with the lowest risk for cardiovascular disease. Interestingly, a sleep duration of less than five hours a night has been found to increase the odds of obesity and type two diabetes2.

    Sleep hygiene refers to behaviours and habits that help you get a good night’s sleep. A Naturopath can identify factors that may be affecting your sleep, and help you instil new habits that support a quality night’s rest.

    Fresh air and nature

    Nature bathing can be as adventurous as a hike in the woods, or as simple as a picnic lunch in your local green space. To demonstrate the physiological effects of nature bathing, a study compared a walk in the city to a walk and the woods. It showed that, compared to city walking, nature walks resulted in lower cortisol (stress hormone), lower pulse and blood pressure and greater parasympathetic activity (better immune and digestive function)3.

    Movement and exercise

    The benefits of exercise are undisputed. Exercise is proven beneficial for our hearts, bones, guts, skin and mental health4. Despite the endless list of benefits, most Australians simply do not exercise enough. Exercise does not mean slogging it out at the gym seven days a week. I often prefer to use the word ‘movement’. Movement can be an afternoon walk, gardening on Sunday morning, a bike ride or a swim at the beach. Find the type of movement you enjoy and move for around thirty minutes a day, at least five times a week.

    Mindfulness and meditation

    Mindfulness means being truly and consciously present in the moment. Our modern lives demand that we think fast, multi-task and plan ahead. We are so busy that we rarely have the opportunity to just be in the moment. After all these years of multi-tasking, we’ve simply forgotten how to let it all go and just be. Mediation is a means of practicing mindfulness. Meditation generally involves sitting quietly and focusing on your breathing. However, this is only one form of meditation. Visualisations, walking meditations and progressive muscle relaxations are just a few other techniques. Mindfulness is an evidence-based practice, with proven efficacy in alleviation of chronic pain to depression to improving immunity5–7.

    Naturopathic treatment is individualistic. There’s no ‘one size fits all.’ A Naturopath will spend time during your consult analysing how your lifestyle may be impacting your health. Lifestyle recommendations will be tailored to your individual needs, with a focus on what you enjoy and what is going to be sustainable for you.

    Change can be challenging, but I absolutely encourage you to be open-minded and willing to experience the benefits of lifestyle medicine. Implementing healthy lifestyle habits can make the most lasting and sustainable difference to your health and wellbeing.

    Book an Appointment

    References

    1. 1. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI Journal. 2017;16:1057-1072. doi:10.17179/excli2017-480
    2. 2. Luyster FS, Strollo PJ, Zee PC, Walsh JK. Sleep: A health imperative. Sleep. 2012;35(6):727-734. doi:10.5665/sleep.1846
    3. 3. Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): Evidence from field experiments in 24 forests across Japan. Environmental Health and Preventive Medicine. 2010;15(1):18-26. doi:10.1007/s12199-009-0086-9
    4. 4. Viña J, Sanchis-Gomar F, Martinez-Bello V, Gomez-Cabrera MC. Exercise acts as a drug; The pharmacological benefits of exercise. British Journal of Pharmacology. 2012;167(1):1-12. doi:10.1111/j.1476-5381.2012.01970.x
    5. 5. Davis MC, Zautra AJ, Wolf LD, Tennen H, Yeung EW. Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity. Journal of Consulting and Clinical Psychology. 2015;83(1):24-35. doi:10.1037/a0038200
    6. 6 .Goldberg SB, Tucker RP, Greene PA, et al. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review. 2018;59:52-60. doi:10.1016/j.cpr.2017.10.011
    7. 7. Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1):13-24. doi:10.1111/nyas.12998

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  • Article

    The Naturopathic Toolkit: Herbal and Nutritional Medicine

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    the naturopathic toolkit: herbal and nutritional medicine

    The use of herbal and nutritional medicines are key features in the Naturopathic toolkit. In Naturopathy, the objective is to treat the person, not the disease1. As such, a condition does not have a specific herbal or nutritional protocol. Rather, the Naturopath’s skill is in thorough case taking and developing a holistic understanding of their patient. Then, the Naturopath uses their knowledge, expertise and research skills to formulate a unique herbal and / or nutritional protocol for each individual patient.

    Herbal Medicine

    Herbs that are used in medicine contain an array of active constituents that have a known physiological effect on the body. The active constituents of the herbs are extracted and stabilised in powder, tablet, capsule or liquid form. These medicines are highly concentrated and often standardised.

    Naturopaths love prescribing liquid herbs! Liquid herbs can be easily blended, thus allowing a Naturopath to create a custom blend of herbs to address the nuances of each individual’s presentation.

    Not all herbal supplements are created equally! A qualified Naturopath has access to practitioner only extracts that are exceptionally potent and rigorously tested for safety and quality.

    Herbal medicines can interact with pharmaceutical drugs2. Where appropriate, a Naturopath can select herbs that are safe to co-prescribe with your medications.  

    There are hundreds of herbal medicines in a Naturopathic dispensary. A skilled Naturopath utilises both traditional knowledge and scientific research to determine which herb(s) will be best for you.

    Nutritional Medicine

    Modern Naturopathic nutrition includes the use of a whole foods, therapeutic diets, high dose nutrients, modified nutrients (i.e. liposomes), nutraceuticals (amino acids, molecular compounds) and probiotic therapy3. Simply put, nutritional medicine can be classified as dietary or supplemental.

    Dietary

    Generally, the Naturopathic diet includes whole foods, with a focus on fresh and seasonal ingredients3. However, as with all elements of Naturopathic treatment, there is no ‘one size fits all’. Dietary advice is tailored to each individual’s history, background and genetics.

    Supplemental

    Nutrients may be prescribed to correct nutritional deficiencies, which are usually identified through laboratory testing. Nutrients may also be used therapeutically. This requires dosage at a therapeutic level that is often far higher than the recommended daily intake. Over the counter multi-vitamins generally don’t contain a sufficient dose to have a therapeutic effect.

    Correct form is just as important as correct dosage. There is a difference between Magnesium citrate and Magnesium glycinate, for example. Citrate may be most useful in cases of muscular spasm, whereas glycinate is more likely to reduce nervous tension. Moreover, the form of the nutrient also determines its absorbability4.

    There has been significant research into the use of nutraceuticals over the last decade. You may have heard of compounds like DIM, N-acetyl-cysteine, or PEA. The targeted use of such supplements is increasingly backed by scientific research5,6,7. Additionally, specific amino acids can be used to support the synthesis of certain neurotransmitters and hormones8, and pre- and probiotics can be used to support gut health, which in turn improves immunity and mental health9,10. The scope is truly endless.

    Naturopaths use practitioner only, high quality nutrients and nutraceuticals to ensure that you receive the sufficient dose in correct form to match your individual needs. To ensure safety and efficacy, these supplements need to be prescribed by a qualified Naturopath.

    Information overload complete…

    Herbal and nutritional medicines are just part of the Naturopathic toolkit. A skilled Naturopath has a deep understanding of human physiology and pathophysiology, so as to use these amazing medicines effectively and efficiently.

    I’d love to use my obsession with herbal and nutritional medicine to help you optimise your health or fast track your recovery. Book a consultation and let’s get started!

    Book an Appointment

    References

    1. Broderick K. Naturopathic philosophy. In: Naturopathic Medicine; 2019.

    2. Wills RBH, Bone K, Morgan M. Herbal products: active constituents, modes of action and quality control. Nutrition Research Reviews. 2000;13(1):47-77. doi:10.1079/095442200108729007

    3. Hechtman L. Clinical Naturopathic Medicine. Elsevier; 2020.

    4. O’Dwyer DD. Navigating the maze of dietary supplements quality and efficacy. Topics in Clinical Nutrition. 2020;35(4):309-319. doi:10.1097/TIN.0000000000000214

    5. Thomson CA, Chow HHS, Wertheim BC, et al. A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. Breast Cancer Research and Treatment. 2017;165(1):97-107. doi:10.1007/s10549-017-4292-7

    6. Artukoglu BB, Beyer C, Zuloff-Shani A, Brener E, Bloch MH. Efficacy of palmitoylethanolamide for pain: A meta-analysis. Pain Physician. 2017;20(5):353-362. https://europepmc.org/article/med/28727699

    7. Shi Z, Puyo CA. N-acetylcysteine to combat COVID-19: An evidence review. Therapeutics and Clinical Risk Management. 2020;16:1047-1055. doi:10.2147/TCRM.S273700

    8. Sutanto CN, Loh WW, Kim JE. The impact of tryptophan supplementation on sleep quality: a systematic review, meta-analysis, and meta-regression. Nutr Rev. 2022;80(2):306-316. doi:10.1093/nutrit/nuab027

    9. Lehtoranta L, Latvala S, Lehtinen MJ. Role of probiotics in stimulating the immune system in viral respiratory tract infections: A narrative review. Nutrients. 2020;12(10):1-19. doi:10.3390/nu12103163

    10. Johnson D, Thurairajasingam S, Letchumanan V, Chan KG, Lee LH. Exploring the role and potential of probiotics in the field of mental health: Major depressive disorder. Nutrients. 2021;13(5):1728. doi:10.3390/nu13051728

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  • Article

    What is evidence based medicine, and how a Naturopath uses it.

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    Evidence based naturopathic medicine

    Evidence based medicine (EBM) is the integration of the best available research evidence, clinical expertise and patient preferences. Research shows that the implementation of EBM, i.e. evidence based practice, results in better patient care and patient outcomes, as well as greater satisfaction of treatment by both patients and healthcare practitioners 1.

    How does a Naturopath apply EBM?

    ­­­Personal Preferences

    Patient-centred care is foundational to the practice of Naturopathic medicine. Patient-centred care involves mutual decision making between patient and practitioner. It allows patients to take an active role in determining their healthcare plan, fostering respect and empathy, and embracing diversity2.

    Naturopathic treatment supports the use of a patient-centred approach in two key areas. Firstly, a naturopathic consultation is typically longer than an appointment with a medical doctor. This allows patients to express their concerns, wishes and treatment goals. Secondly, Naturopaths are specifically trained in communication skills and active listening. Together, these two factors foster a comfortable space for patients to express their needs; allowing Naturopaths to pick up on cues and respond to the preferences of their patients accordingly.

    Clinical Expertise

    Naturopaths have an extensive toolkit to work with, including herbal and nutritional medicine, and the application of lifestyle and wellness techniques. Naturopaths also utilise pathological and functional laboratory testing to form the basis of their clinical assessment. Modern Naturopathy utilises traditional knowledge in combination with scientific research to develop treatment protocols. The combination of traditional and modern knowledge gives Naturopaths a huge pool of information to draw from when deciding on a treatment plan.

    The clinical application of this knowledge is based on the Naturopathic Principals; do no harm, utilise natural healing methods, treat the cause, educate and involve your patient, treat the whole person and prevent the onset of disease3. These principals provide the framework by which a Naturopath can utilise their clinical experience with traditional and modern knowledge to achieve the best outcome for their patients.

    Research Evidence

    Research for the purpose of its application in EBM involves conducting a literature review of the best available evidence. The practitioner must use a medical research data base to search and appraise the literature, in order to answer a clinical question4. An example of a clinical question a Naturopath may research could be, ‘are soy isoflavones as effective as hormone therapy in the treatment of menopausal hot flushes?’, or ‘is magnesium supplementation effective in reducing blood pressure in stressed, hypertensive patients?’. Modern healthcare has the advantage of the internet, which allows for accessibility and dissemination of scientific research. Naturopaths conduct literature reviews as a part of ongoing professional development, to ensure they are providing their patients with the best possible advice.

    Bringing it all together

    It is the integration of research with clinical expertise and patient preferences that produces the best outcome for patients and practitioners. Naturopaths utilise time during a patient consultation to understand the needs and values of their patient. By actively listening, and using laboratory testing and clinical expertise, a Naturopath can form an assessment. Then, by incorporating the best available research evidence, the Naturopath can develop a treatment plan based on the unique presentation and individual needs of their patient.

    Naturopathy is a holistic and modern medical system that caters to the healthcare needs of this generation. EBM is intrinsically part of modern Naturopathic practice. If you’d like to experience the full benefits of Evidence Based Naturopathic Medicine, follow the link below to book your initial consultation.

    Book an Appointment

    References

    1.        Shortell SM, Rundall TG, Hsu J. Improving patient care by linking evidence-based medicine and evidence-based management. J Am Med Assoc. 2007;298(6):673-676. doi:10.1001/jama.298.6.673

    2.        ACSQHC. Person-centred care. Australian Commission on Safety and Quality in Health Care. Accessed April 1, 2022. https://www.safetyandquality.gov.au/our-work/partnering-consumers/person-centred-care

    3.        Hechtman L. Clinical Naturopathic Medicine. Elsevier; 2020.

    4.        Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. Evidence-based practice: Step by step: The seven steps of evidence-based practice. American Journal of Nursing. 2010;110(1):51-53. doi:10.1097/01.NAJ.0000366056.06605.d2

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