Why an MRI could actually make your back pain worse.

Why an MRI could actually make your back pain worse.

Back pain is the most common reason that people visit an Osteopath, it is so ubiquitous that 80% of us will experience back pain sometime in our lives.

So it makes sense that we should get all the information we can about our backs so we can make the best possible treatment choices and what better way than the magic of Magnetic Resonance Imaging that allows us to see inside us with unprecedented detail, the same can be said for CT scans and X-rays as well.

Well this is wrong for all but a few cases...

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Why am I bloated? The skinny on SIBO

Bloating, cramping, burping, reflux, constipation and diarrhoea. These are symptoms of SIBO (Small Intestine Bacterial Overgrowth).

We have trillions of bacteria in our large intestine, but we’re actually not supposed to have much bacteria in our small intestine. The small bowel is meant for digestion and absorption of food. When the bug population in our small bowel is too high, fermentation happens too early and gases are produced. That’s SIBO in a nutshell: an overgrowth of bacteria in your small intestine that produces gases causing bloating, pain, constipation and diarrhoea.

SIBO damages the small intestine and affects our ability to digest and absorb food, bringing with it a host of issues like nutrient deficiencies, worsening food sensitivities, joint pain, and skin rashes.

How do I know if I have SIBO?

If you think your symptoms are ticking the boxes for SIBO, you can do a breath test to confirm. To organise the breath test, chat to a SIBO savvy practitioner, or visit sibotest.com for more information.

Why do I have SIBO?

SIBO can be caused by an infection like gastroenteritis, certain medications (proton pump inhibitors, antibiotics, opiates, and narcotics) chronic stress, low stomach acid, and a poor diet with lots of simple carbs.

How do you treat SIBO?

SIBO treatment uses a two pronged approach: decrease the bug population with either antibiotics or herbal antimicrobials; and starving the bugs with a SIBO diet. You will need to be guided by a practitioner to be supported through this properly.

What’s the SIBO diet all about?

Basically, the bugs feed on sugars, carbohydrates and starches. So we avoid foods that contain sugars that the bugs like to ferment.

The SIBO diet is a modified low FODMAP diet. It has an intro phase that initially excludes all dairy, grains, fruits, legumes, and certain vegetables. We then move patients through to the maintenance diet that allows the reintroduction of some of these foods. It is recommended that the SIBO diet be followed for a minimum of three months.

When starting a SIBO diet, you can have a fast and profound improvement in digestive symptoms. However, knowing what to eat in the beginning can be difficult and stressful. The Health Lodge offers patients the option to come and stay for one to two weeks at the beginning of treatment. Having your SIBO friendly-meals prepared by our Wellness Kitchen, spending time in the kitchen learning how to cook delicious SIBO-friendly dishes, and getting support from our naturopaths on how to follow the SIBO diet at home takes the difficulty out of starting a SIBO diet, making the transition as smooth and stress-free as possible.

A Story of Hope

“It all began with a random tick bite. None of us can say when, or where, it happened. With little warning, an active, healthy and happy 12-year-old boy was reduced to a shocking level of disability”.

This is the story of Ben (name has been changed), who’s health journey with tick-borne disease began three years ago.   Reine DuBois has been working closely with Ben and his family for over two years, and has had the pleasure of watching Ben’s return to health. Recently, Ben has returned to playing football after a three-year absence. Ben says “it feels so good to be back playing footy with my team mates, a sport that I love but wasn't sure I would be able to play again".

The question of whether Australian ticks carry the bacteria that causes Lyme disease is controversial. However, we know that we do have tick-borne diseases. Ticks can carry a host of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa that can be passed on to a person when bitten. The three major tick-borne diseases in Australia are Queensland tick typhus, Flinders Island spotted fever, and Q fever.


While each person’s journey with tick-borne disease is different, we follow some clear guiding principles that allow us to move through the different stages of treating this condition.

Stage 1: Help the body metabolise the neurotoxins created by the different pathogens. This supports the body to detoxify many of the neurotoxins that cause most the neurological symptoms, muscle and joint pain, brain fog, fatigue, and vertigo. Establishing a person's individualised detox support is an essential first step to bring relief.

Stage 2: Restore immune function. Here we address diet (also essential), digestive health, and individual genetic polymorphisms (SNPs) like MTHFR.

Stage 3: Treat pathogens with herbal antimicrobials. Antibiotic and essential oils may also be used in some cases.

Stage 4: Restore mitochondrial and adrenal function to improve energy levels. In many cases, it is beneficial to see a psychologist in this stage, helping to make sense of nervous system feedback that occurs during the entire phase of illness.


Below, Ben’s father has generously provided an account of their journey into the maze of tick-borne disease – and out the other side.

“Conventional medicine in Australia refuses to acknowledge the existence of Lyme disease in Australia, saying that “there is no evidence that it exists here”.

This is so, even though many of the people who suffer from it have never left Australia’s shores. The effects of the disease are devastating. An apt way to describe it is to compare it with a sledgehammer blow to an electronic circuit board. Nothing works as it should any more.

There are physical aches and pains, there is brain fog, much of one’s mobility is lost and symptoms which mimic Chronic Fatigue Syndrome, fibromyalgia, MS and other diseases, set in. Many Lyme patients find themselves wheelchair bound and unable to get out of bed in the morning. For months, Ben’s mobility was restricted to crawling along the floor. For the last half of 2013, Ben was unable to go to school at all. For the following 2 years he attended school on a part-time basis.

The search for curative remedies was endless, extending to local alternative therapists, an integrated medical clinic in Byron Bay, and an expert based in the USA

This year Ben returned to school on a full-time basis and in recent months he began to express a desire to return to football. With great trepidation we watched as he played in his first practice match, not knowing how things would go and hoping fervently that he would not suffer any setbacks.

To his enormous credit, he has embraced his return to football. It has been instrumental in allowing him to regain his physical freedom. Of equal value has been his reconnection with many of his old team mates, and he has made new friendships as well. As “medicine” goes I don’t think that anything could be better. He has been prepared to put in the hard yards at training and to give his all on match day.

The icing on the cake is that Ben’s sister has also fallen in love with football and has joined him at the Sharks.

Our family is grateful that they have both been given the opportunity to play and we couldn’t be more proud of their effort and determination.

We hope that of all the medicines which Ben has tried, football turns out to be the silver bullet that kills this disease.”


Why the Long Cycle? What you need to know about PCOS.

By Quilla Watt – Integrative Naturopath


Irregular periods. Acne. Excess body hair. Obesity. Difficulty conceiving.

These are signs of Polycystic Ovarian Syndrome (PCOS). It’s a common condition, affecting up to 21% of women of reproductive age. Yet only about 30% actually get diagnosed. Some women don’t realise there’s an issue with their long cycle until they have trouble getting pregnant. Other women might get popped on the pill to regulate their cycle without the cause being fully understood. Plus, diagnosis is a little tricky – there isn’t a single test for PCOS, and other conditions need to be ruled out.

Why should we care about PCOS? Because it’s the most common cause of female infertility. Seventy-five percent of women who don’t ovulate and experience infertility have PCOS. And, early diagnosis and management of PCOS decreases the risk of developing Type 2 Diabetes or heart disease later in life.

So what are the main features?

The main features of PCOS are long cycles (lasting more than 35 days) or no periods at all; polycystic ovaries (seen on ultrasound); and high androgens. Androgens are the hormones that give “male” characteristics like increased body hair, deeper voice, and more muscle mass. It is also common to see obesity, insulin resistance and raised blood sugar levels in women with PCOS.

What do we need to know? When I see a patient with a long cycle, or if she has already been diagnosed with PCOS, I have a list of things I want to know:

  • Is there insulin resistance? High insulin pushes the body to make more androgens. With many PCOS patients, weight loss and blood sugar regulation through diet and exercise can be the best tools to regulate the metabolic madness we see in PCOS.
  • Was the pill on the scene? Some women stop the oral contraceptive pill and do not get their period back for months (sometimes years!). In these cases, something as simple as Vitex can help switch on the hormonal signalling you need to have a period.
  • Is prolactin high? High prolactin suppresses ovulation. About 75% of women with absent periods will have high prolactin. It’s a good idea to see your GP and investigate why prolactin is high before treating it.  
  • Is thyroid function ok? It’s a good idea to consider low thyroid function in PCOS, especially if prolactin is also high.
  • Is there low-grade inflammation? We can answer this question with blood tests like ESR and CRP. We know from research that women with PCOS have low-grade inflammation, which stimulates polycystic ovaries to produce androgens.

You can have poly-cystic ovaries without having PCOS. Wha…..? Yeah, I know. I love it when things are simple like that. Not. 

PCO is more common than PCOS, with up to a third of women of childbearing age having polycystic ovaries on ultrasound. But these women have none of the hormonal imbalances, can have perfectly normal periods and no difficulty conceiving.

What’s the take away message? If your cycle is longer than 35 days, or your period doesn’t come at all (and you aren’t pregnant!)– talk you your integrative GP or naturopath and find out why. 

What does a normal cycle look like?

By Quilla Watt, Integrative Naturopath


Some people get squeamish when I start asking them about their cycle, but the fact of the matter is that I ask every single female patient (in epic detail!) about their periods. And it shouldn’t be any weirder to talk about than the symptoms you get when you have a cold. In fact, not talking about periods openly is one for the reasons we have so much uncertainty around what a “normal” cycle looks like.

So when I ask a patient how long their period lasts and they say: “you know, just the normal amount of time” I always get them to clarify. If they have only ever had periods lasting 10 days, that is normal to them, and they may not realise that in actual fact their periods are lasting longer than average. Then there are patients that think their heavy periods are normal, or their period pain is what all women experience.

So what does a normal cycle look like?

Firstly, and perhaps confusingly, there is a broad range of “normal”. But here are some guidelines:

·      Most women get their first period between the ages of 13 and 16. If you are 16 years or older and have never had a period, it’s a good idea to see your doctor for some investigations.

·      It is normal to have longer cycles for the fist couple of years of menstruation, and then to see your cycle get more regular.

·      Your cycle is counted from the first day of your period. A normal cycle is anywhere from 21 to 35 days.

·      A normal period lasts two to seven days. Most women will fall in the 3-5 day range, with the last day or two being light.

·      A normal cycle can be amazingly punctual (exactly 28 days every time), or vary slightly (27 days one cycle, and 29 days the next).

·      With healthy hormonal balance there should be minimal pain or cramping with your period. A sense of heaviness in the pelvis can be common and natural. Mild pain just before and during your period can be completely benign (though we can improve it!), but more severe pain should be investigated, as it can be a sign of endometriosis.

·      Light spotting at ovulation is common and normal. Spotting at other times, like just before your period, can hint at a progesterone deficiency or something more serious. Either way, it’s a good idea to get some investigations done to understand the cause.

·      With a normal flow you shouldn’t need to change your pad or tampon more than every 2 hours. If you do need to, or if you are waking in the night to change pads, you should speak to your GP or naturopath.

·      A few small clots in your flow can be normal, but larger clots suggest your flow is too heavy to be managed by the anti-clotting agents your body releases. Heavy flow can be caused by a number of things, including fibroids, high oestrogen, and iron deficiency, and should be investigated.

·      You should get your period 11-14 days after you ovulate. If you are ovulating and then getting you period only 7 days later, it can impact your ability to conceive. To find out when you ovulate, look for fertile mucus (an eggwhite consistency), a rise in basal body temperature, or use one the ovulation test kits available at chemists like the Maybe Baby Ovulation Tester.

·      PMS is incredibly common but should not negatively impact your life. It is especially important to seek help if you have major mood changes leading up to your period. PMS suggests you may have too much oestrogen or not enough progesterone, and there’s plenty in the herbal and nutritional tool kit to help with this.

·      Menopause most commonly occurs between the ages of 45 and 55, with the average being 51. Early menopause occurs between 41 to 45 years, and usually makes me wonder about stress and adrenal function. Premature menopause occurs before the age of 40, and requires proper management to prevent osteoporosis.  

If you have no idea how long your cycle lasts, download one of the many period tracking Apps. They are a fantastic and simple way to get to know your cycle.   

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Should I go on the pill? 

By Quilla Watt, Integrative Naturopath


Someone recently asked me if I thought they should go on the pill, but I couldn’t give a simple “yes” or “no” answer. Figuring out what is the best form of contraception is very individual – you have to work out what is going to work for you. 

For many women, the pill is a convenient and reliable form of contraception. The pill supplies synthetic hormones that suppress our own hormones, and prevent ovulation. Women can take either the combined oral contraceptive pill (contains an oestrogen and progestogen combination), or progestogen-only pill. A regular course of the pill usually has a series of placebo pills that contain no active hormones, and this is when you get your “period”. I say “period” because while it looks like a regular menstrual period, it is not- the synthetic hormones have built up your uterine lining, and stopping them makes it shed, however no ovulation takes place during the cycle.


Why take the pill?

Some women want to take the pill because it is more convenient that using condoms. Firstly, let’s get something straight – the pill is a form of contraception. It in no way protects you from STIs. I have to admit I’m a little surprised by the number of young women that think because they take the pill they don’t need to worry about anything else. Just because you are on the pill, does not mean you should throw out the condoms.

Some women want to take the pill because it is more effective that using condoms. The combination pill is more than 99% effective at preventing pregnancy. Condoms are 98% effective. So if you are using condoms correctly, your chance of getting pregnant is 2 in 100, as opposed to less than 1 in 100 with the pill. For some women, this feels like a worthwhile difference, but other women are not happy to put up with potential side effects for such a small difference.

Then there are women who are thinking of going on the pill for other reasons – to manage painful periods, heavy periods, absent or irregular periods, polycystic ovarian syndrome (PCOS), or endometriosis. For these women, the pill will mask the problem without fixing the cause. There is so much more we can do to address the underlying cause of the condition than just taking synthetic hormones.


Known side effects of the pill

Spotting: If you start taking the pill, it is common to get some light bleeding (spotting) during your cycle in the first 3 months. This usually settles by the third cycle, but for 10% of women, spotting can continue.

Headaches: Women can experience headaches when first starting the pill, and if you do, its important to have a chat with your GP and let them know.

Weight gain: Women often complain of weight gain when they start the pill. However, studies haven’t found this to be the case. It looks like the pill causes fluid retention, especially in the breast, hips and thighs, which can look like weight gain. There are also questions around whether the pill causes insulin resistance, however I haven’t seen enough research to be able to confirm this as yet.

Breast tenderness: You can experience breast swelling and tenderness when starting the pill. This may just be due to retaining fluid in the breast, however if you notice a lump or severe breast pain, you need to chat to your GP about this.

Mood changes: While the research isn’t conclusive that the pill can cause depression, there are a few researchers in the field that are quite convinced of the mood changes that can occur with the pill. Certainly in clinic, we see women who experience low mood, irritability, or become more emotional when going on the pill. If you have a history of depression, you should chat with your GP about this before going on the pill

Decreased libido: The hormones in the pill can change your body’s testosterone and DHEA levels, and lower your libido. You may find you have less interest in sex, and fewer sexual thoughts. Some women do not realise that this can be a side effect, and blame themselves for not feeling interested. This can have a profound effect on your mood and your relationship.

Cardiovascular side effects: The newer combination pills with the form of synthetic progesterone called drospirenone may have a higher risk of blood clots including deep vein thrombosis and pulmonary embolism.  All combination pills come with a slightly increased risk of cardiovascular events such as heart attack, stroke and blood clots. If you have a history of any of these, the combination pill is not for you. Its also not recommended in women who are obese, have a family history of heart disease, or are over 35 and smoke.

Cancer: The pill appears to increases your risk of some cancers (cervical and liver), and decrease your risk of others (ovarian and endometrial cancer). The evidence around breast cancer is not clear – earlier studies showed a link between pill use and breast cancer, while more recent studies have not.


Other possible consequences of the pill

In clinic, we can see hair loss in women on the pill. We can also see acne flare up once the pill is stopped. Some women can take time to get their periods back after stopping the pill, which is known as post-pill amenorrhea. It can take your body a bit of time to start making its own hormones again, but your period usually returns in 3 months. If it doesn’t, it’s a good idea to speak to your naturopath. There’s plenty we can do the help get your periods back on track.

If you started taking the pill for painful periods, heavy periods, or for endometriosis, it’s important to work on this before you come off the pill, to prevent your symptoms returning.

As a parting comment, its good to remember that as far as contraceptives, there are far more options than just the pill or the condom. The latest non-hormonal IUDs are far safer than their earlier versions, and are worth looking in to. Like I said at the start- it’s about working out what works for you. 


Tackling Period Pain Naturally

By Quilla Watt, Integrative Naturopath

As someone who has suffered their fair share of period pain, I know how debilitating it can be. I know that feeling of dread in the days leading up to your period as you anticipate the pain.

As a young adult, my period meant missing a day of school or work, curling up in bed with a packet of Nurofen as my companion, and praying for that feeling of relief when the cramping finally stops.

If you have had period pain since adolescence, chances are you have primary dysmenorrhoea. Which means period pain without an underlying pathology. This is the most common type, affecting around 50% of women. For 15% of women, the pain can be severe.

If you have started getting painful periods in your thirties or forties then it’s more likely to be secondary dysmenorrhoea, which is painful periods because of something like endometriosis, fibroids, or pelvic inflammatory disease, and it’s important to see your GP to investigate these.

In primary dysmenorrhoea, the cramping is caused by inflammatory factors called prostaglandins causing the uterus to spasm excessively.

Women with period pain can produce seven times more prostaglandins that women who don’t get period pain. These prostaglandins are mostly released in the first 48 hours of your period, which is why days one and two are usually the worst.

Period pain is one of the reasons women choose to go on the pill. Between the pill and painkillers, many women get by. But there are many natural strategies that can help manage period pain.

What you can do…

Make sure you eat a minimally processed diet with loads of fresh vegetables and fruit. A diet low in fruit and veg, with more processed foods and refined sugars is very inflammatory. The worst my period pain ever got was when we were travelling outback Australia and fresh fruit and veg was virtually non-existent! Some women find they do better off dairy and gluten too, as these can both be inflammatory.

Eat fish twice weekly, or take a good fish oil supplement. The Omega-3 fats in fish and fish oils lower the amount of inflammatory prostaglandins your body produces. What with over fishing and mercury concerns, I suggest you get small local fish from your fish co-op. For a vegan option, algae oil is a great way to get those good fats in.

Take Magnesium- it’s fantastic for helping to balance hormones, and to ease the cramping. Try 300mg per day throughout your cycle, and increase to 600mg during your period if cramping is bad.

Stop caffeine – especially in the week before your period. It’s not going to be the cause of your pain, but it can certainly make it worse.

De-stress with exercise, yoga, and mindfulness. Stress has a major impact on your hormones. Stress can make many things worse, and period pain is one of them.

What your naturopath can do…

While there’s a lot you can do at home, seeing a naturopath about your period pain can be a big help.

Your naturopath can check for hormonal imbalances. The classic things I see in period pain are high oestrogen, low progesterone, or both. We then work towards bringing hormone levels back to balance, while helping the period pain with some symptomatic management. This is where herbs come in. Some of my favourite for period pain are black cohosh, cramp bark, wild yam and ginger. I get women to start taking them about 5 days before their period, and to continue until their period has finished.

If oestrogen is high, you may need some liver support. The liver is so important for making sure you are eliminating excess oestrogen. Broccoli sprout powder is fantastic to help support the liver in eliminating oestrogen.

While I think diet is the cornerstone of every prescription, sometimes it is helpful to bring in anti-inflammatory supplements in the short term. Things like turmeric, ginger and fish oils are fantastic to help get the prostaglandin levels under control.

What to expect…

Don’t give up to soon. Hormonal things are slow to change. You may need to follow three months of an anti-inflammatory diet and using herbal strategies before you notice real results.