Laboratory Diagnostics Course for Naturopaths

What You'll Learn

Labs aren't straightforward. It's not always about falling inside or outside of a range. Why does the range exist? How do we appropriately interpret positive results? Are we aware of the exceptions to the rules? We want to answer all of these questions and more because we use labs every day to make clinical decisions about our patients. NDs tend to adopt their own way of utilizing conventional labs, which can get really confusing for patients. Hopefully, with understanding why labs are the way they are we can better use them. From endocrine to GI and hematology we're aiming to cover it all!

The Webinar Series includes:

Ferritin

Learn why ferritin is our best test for iron deficiency, but also requires so much interpretation. In this course we delve into iron deficiency, effective interpretation of lab ranges, flaws with iron tests, transferrin, transferrin saturation, anemia of chronic disease, iron replacement supplementation options, issues with paediatrics and pregnancy, the pitfalls of oral supplementation, new guidelines in diagnosis of iron deficiency, conditions and foods that alter iron absorption and a whole lot more. Ferritin should be simple, but it's far from it.

Interview with Dr. Adam Davidson:

0:38 - Why as an ER doctor are you all about treating iron deficiency?

3:20 - Who should get IV iron infusions and why?

4:00 - Are MDs reluctant to test and treat iron deficiency and why do they often say a ferritin of 21 is ok?

6:05 - New diagnostic cutoffs in ferritin!

7:30 - Is a ferritin of 100 even possible in menstruating women? How can we keep women there?

10:15 - How can NDs refer for IV iron?

12:30 - NDs are on the ball!

15:25 - How often should your ferritin be rechecked and how often should you be taking oral iron?

16:35 - What is your favourite iron supplement?

18:25 - Why the "danger" of getting an iron infusion is all fake news? What are the risks of IV iron and what can a patient expect for side effects?

21:40 - Patients with lots of allergies getting iron infusions, what to do?

22:10 - Special considerations for patients with autoimmune diseases and anemia of chronic disease.

23:40 - Using iron in people with chronic infections (local vs systemic including chronic lyme).

26:25 - Patients with malabsorption including IBD and SIBO

28:40 - Iron deficiency in pregnancy shouldn't just be accepted. Does it matter what trimester she is in? How this influences the post partum period.

32:00 - What is the real benefit of iron infusions and what can a patient expect after getting one?

35:00 - Why would ferritin go even lower AFTER taking iron?

36:25 - The deep dive into iron

37:00 - How MD and NDs need to work together

41:00 - Why Intramuscular (IM) Iron isn't effective or reliable?

42:50 - Transdermal iron

44:20 - Pediatric iron considerations

46:25 - Postpartum depression and iron deficiency - the connection to dopamine and serotonin.

47:00 - What else does Mainline offer for patient referral and does insurance cover IV iron? How much does it cost and what is the cost benefit?

Dr Davidson has graciously said our members can contact him by phone or by email about any questions you have about iron. If you want to delve even deeper than his interview give him a shout!

Dr. Adam Davidson, MD

Clinical Assistant Professor, UBC Faculty of Medicine

Mainline Sport and Wellness Ltd.

Owner / Director

[email protected]

mainlinewellness.ca

(604) 816-0179

Instagram | Facebook | Twitter

Interview with Dr. Romina Reyes MD

Category is...Infectious Disease!

We interviewed leading microbiologist Dr. Romina Reyes MSc MD FRCPC. Dr. Reyes is graciously lending us her expertise in this interview series on microbiology and pathology. We are asking her questions ranging from the ins and outs of lab diagnosis to infectious disease control.

Dr. Reyes is a Medical Microbiologist, Lifelabs Clinical Director of Microbiology (BC), Deputy Medical Director (BC), Clinical Associate Professor, Department of Laboratory Medicine, University of British Columbia.

Dr. Reyes is a fellow of the Royal College of Physicians and Surgeons of Canada with a specialty designation in Medical Microbiology.

She is currently the Clinical Director of Microbiology and the Deputy Medical Director for LifeLabs, BC. In these roles she helps to guide the direction of the Microbiology department from an operational, clinical and quality perspective. She also has many external projects that she works for on LifeLabs behalf including working with the BCCDC Provincial Laboratory, the various health authorities and also the University of British Columbia.

Dr. Reyes also has a clinical appointment of Associate Professor of the University of British Columbia Department of Pathology and Laboratory Medicine.

Her appointments include Vice-Chair of the BC Diagnostic Accreditation Program Committee, Consultant for the BC Laboratory Agency Medical Microbiology Working Group, Executive Member of the Royal College of Physicians and Surgeons Medical Microbiology Examination Committee, Voting Member of the Royal College of Physicians and Surgeons Specialty and Regulatory Committee for Medical Microbiology, Member of the Mycology and Parasitology committees for Clinical Microbiology Proficiency Testing (CMPT).

Dr. Reyes also maintains an active teaching and educational role with University of British Columbia (UBC), Department of Medicine. She lectures in the Undergraduate Medical School, in the Post-Graduate residency training program and in UBC Faculty of Medicine Laboratory Quality Management Course.

Member

Royal College of Physicians and Surgeons

BC College of Physicians and Surgeons

Doctors of BC

Canadian Medical Protective Agency

Association of Medical Microbiology and Infectious Diseases

American society for Microbiology

BC Association for Medical Microbiology

Interview Questions

Can you walk me through how do the lab does culture and sensitivity?
When a sample is submitted to the lab how do you test against different agents?
How does resistance reporting work? Given antibiotic resistance have you ever or would you ever consider testing natural substances (grapefruit seed extract) against infections?
We see in practice that a patient clearly has an infection but the culture turns up negative. Why does this happen?
Parasite testing that returns negative in patients who complain of even seeing worms in their stool.Are there further diagnostic testing that we could be sending for a more thorough search?
A growing number of NDs treat IBS like it’s an infectious disease and test for infectious disease in this context. Do you have any experience in looking at IBS like it’s an infection?
Blastocystis hominis is a very controversial parasite. We hear often that we should leave it alone and that we should only treat it if the patient has symptoms. What do you think about Bh?
What about the rabbit hole of lymes dz? Or Chronic EBV. Is it worth testing? Via what markers? Can you comment on alternative labs that are testing for these markers and what you think of them?
We have access to Comprehensive Digestive Stool Analysis testing via private labs, is this something lifelabs offers, or would consider in the future?
Sensitivity and specificity of in-clinic screening tests -- H pylori skin prick, rapid strep swab, UA, others -- and whether they are good screening tools prior to sending patients for testing at BCBIO.
Thoughts on low-grade chronic infections (specifically UTI, sinus, lung, and skin but could be others) and how swabs and/or culturing can be used to guide treatment.
Any treatment or diagnostic pearls for chronic fungal infections (most frequently onycomycosis)?
Titre levels for infectious conditions: what is the relevance and does everything go through the CDC?
Are there exciting things about infectious disease that are coming through the pipeline?

Antinuclear Antibodies

Lab tests are sometimes too much. Rules, exceptions, thresholds! AGH! This webinar tries to demystify antinuclear antibodies aka ANA. ANA is a great test, but we need to know how she works to properly interpret for our patients. We will cover:

How to read a patient's ANA and ENA (extractable nuclear antibody) lab report
How is the test done?
What exactly is an ANA and ENA
Why is it reported in dilution ratios and not concentrations?
Why do healthy people have positive ANA?
Do healthy people have positive ENA?
When to test?
Why is ANA overtested?
What are sensitivity and specificity and what do they have to do especially with ANA and ENA?
Is it worth testing ANA repeatedly in patients who have autoimmune conditions?
Is it worth testing ANA repeatedly in patients who don't have diagnosed autoimmune conditions, but you really suspect they do because of their clinical presentation!?
How often to retest?
What is a seronegative connective tissue disease?
Why do beta blockers matter with ANA?
Why do NSAIDS matter with ANA? If a patient is taking Advil for their undiagnosed pain, does that influence the test results of ANA and ENA?
What are patterns of ANA?
Are nuclear staining patterns falling out of favour? If so, why are they being reported?

I love listening to Dr. Parmar talk about labs!

Krista Moyer

I love listening to Dr. Parmar talk about labs from his research combined with his clinical experience. It's easy to understand. His hilarity & brilliance makes it a joy to listen to. I can't get enough of these webinars! I'm so excited for al...

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