October 10, 2024 • 32 mins
Explore the integration of conventional pharmacy and natural medicine with Jacqui Coote, owner of Whole Life Pharmacy in Brisbane. This episode delves into innovative approaches for digestive health, migraines, and mental wellbeing, combining pharmaceutical expertise with nutritional interventions. Discover evidence-based strategies for managing common health issues and learn about the importance of personalised treatment plans in integrative healthcare.
Episode highlights:
- Integrating natural medicine with pharmaceutical treatments
- Digestive health: Bitters, PHGG, and alginates for reflux and constipation
- Probiotics and antibiotic treatments: Focus on Saccharomyces boulardii
- Histamine intolerance and its connection to migraines
- Iron deficiency anaemia management: Beyond iron supplementation
- Personalised treatment plans in integrative pharmacy
- Interprofessional collaboration and patient advocacy
- Quercetin and fermented foods: Balancing for optimal health
. Tune in to gain valuable insights from her experiences and learn how you can access additional resources on the Designs for Health website.
About Jacqui
Jacqui is an experienced Integrative Pharmacist and Nutritionist with extensive experience in helping people with a variety of conditions through her work as a pharmacist and also in a clinic setting. She loves taking a holistic approach with clients and will bring the wisdom of medical science and complementary medicine together to find a solution to suit your needs.
Jacqui has been a sought after clinician for many years and enjoys a variety of clinical cases, including helping people with: Pain Management; Mood disorders; Insomnia; Digestive health (including Irritable Bowel Disease and Reflux) and optimising medication management. Jacqui runs a busy Wholelife Pharmacy and Healthfoods store and creates a warm and inviting space for people to continue their healing journey.
Shownotes and references are available on the Designs for Health website
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DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:20):
Music.
This is Wellness by Designs,and I'm your host, andrew
Whitfield-Cook.
This is Wellness by Designs,and I'm your host, andrew
Whitfield-Cook.
Joining us today is JackieCoote, a pharmacist and
nutritionist who owns the WholeLife Pharmacy in Strathpine,
brisbane, and today we'll bediscussing patient-centred care.
Welcome to Wellness by Designs,jackie.
How are you?
Speaker 2 (00:39):
Very well, thank you for having me.
Speaker 1 (00:42):
Thank you so much for taking time out of your busy
day.
I know how busy it can get inpharmacy, so I think, first to
start off, did you do nutritionor pharmacy first?
What drive you?
Speaker 2 (00:55):
I did pharmacy first and, to be honest, I picked
pharmacy because I loved sciencebut I also loved people, so it
seemed like a natural fit for me.
Speaker 1 (01:09):
But I was very young, so I didn't know what I was
getting into.
Oops, what about nutrition then?
Why go further into?
Speaker 2 (01:20):
nutrition.
It's not the obvious step thatmost people make, no, so it was
definitely nothing that I'd everreally forward planned to do
that either.
But throughout my pharmacyjourney I'd really grown to love
helping people and that's whatmade my job rewarding.
And it was actually mycustomers that wanted to know
more about health, naturalhealth, and how that would
(01:41):
benefit them, and I really feltlike I had to do further study
to be able to answer thosequestions effectively and really
make a difference in people'slives, and that's why I chose
nutrition, but from a naturalmedicine perspective, because
that's what I was interested inlearning the philosophies behind
natural medicine therapies andlearning it from that
(02:04):
perspective.
So that's why I pickednutritional medicine rather than
, you know, going into dietetics, for instance.
Speaker 1 (02:12):
Gotcha yeah, gotcha Okay, but that's a big leap,
like when you not sure aboutnutrition, but certainly
naturopathy.
It was a big leap for me from aparadigm perspective, if you
like, to go from a disease modelto a wellness model, or a
(02:33):
rather instead of a diagnosismodel to a problem solving model
, if you like, with naturalmedicine.
With natural medicine, Bigissue for me like, instead of
saying there's lupus, anaturopath would say there's a
patient, their diagnosis islupus, but they've got problems
with their skin integrity andthat's linked to gut dysbiosis
(02:54):
and inflammatory markers andthings like that.
So, instead of tackling thediagnosis per se, a naturopath
will tackle the body systemsthat are out of alignment if you
like, are out of balance.
Speaker 2 (03:08):
How did you?
How did?
Speaker 1 (03:09):
you grasp that?
Speaker 2 (03:12):
um, I think well, I mean, I guess I live in both
worlds, so I guess I still thinkboth ways.
But um, the more you see peopleand the more you delve into
your own health journey as well,you realise that people are not
just body systems or a disease,and we are complex beings.
And you know it's not justabout the process that's going
(03:36):
wrong in that one little area,it's about the whole person.
So I think it fits quitenaturally once you start to
think about, you know the, thethings that can lead to disease,
for instance, um, you know,even lack of sleep or living in
such a stressful environmentthat you're not taking time to
(03:57):
break that cycle and help yourbody to maintain its integrity,
so to speak.
Speaker 1 (04:03):
Um, yeah, I think it fits quite well hand in hand
those two so so this need, orthis, this interest, if you like
, that drove you to studynutrition.
It was indeed patient driven.
It was the demands of thepatients wanting more info.
Yeah, what were they after?
Speaker 2 (04:22):
uh well, I think at the time because I'm going back
maybe at least 10 years probably, when I first started getting
really interested in it, um, I'dsay it was probably more
digestive health was probably abig one at the time that really
got me interested.
But probably because I I thinkI had some of my own issues that
(04:45):
I was like delving into as faras like, oh well, what could
these probiotics do, forinstance?
It's a very simple thing, butyou know, even back then I mean,
they're way more complex nowthe research that's been done on
probiotics.
But back then there wasn't hugeamount of choices, but even the
few that were available Iwanted to know a bit more about
why you would pick one thingover another.
(05:07):
So I started going to naturalmedicine conferences and I just
found this whole other world andit was way more detailed and
researched than I had been ledto believe.
Speaker 1 (05:19):
Basically, Same here.
I went through that exact samediscovery um what are the most
common inquiries that you getfrom customers, patients that
you feel you have the greatestimpact on yeah, uh.
Speaker 2 (05:38):
Well, I guess I'm in a fortunate position where
people are walking through mydoor.
I get to see hundreds of peopleevery day, so there's a huge
variety of things that peopleask for help for.
But I guess we see definitely alot of digestive health issues
is a really common one.
Headaches and migraines andmental health they're probably
(06:03):
three big ones that we see a lotof and they're three big ones
that I feel works really wellfor integrative medicine and
helping people with a naturaloption as well as whatever else
they're doing.
It can work in quite well withwhat they've been prescribed.
It's really helpful being apharmacist so I can have a look
at their regular medications andprovide advice on what is going
(06:26):
to be safe to use with thosecombinations.
But yes, I'd say they're thethree big areas that I feel we
can have big impacts in.
Speaker 1 (06:37):
Sticky situation sometimes, though, in that you
know it's not really our place,your place to sort of, take
patients off medicines, that'sthe doctors.
So sometimes, though, you getpatients who start to refuse
medication.
that may be, indeed, life savingrefuse medication that may be
indeed life-saving.
So let's say and I know this isopening up I'm going to be
(07:02):
kicked in the head for this, forsuggesting that statins might
even be of benefit to somebody.
But it's not our place tonecessarily take patients off
statins, but if their lipidprofile is such that it's low,
then of course the doctor shouldbe in the position, therefore,
to say listen, maybe we cancease this, but let's if we take
a step back.
(07:22):
Do you actively say OK, doctors, put you on a statin.
This is great for loweringblood cholesterol levels, but it
doesn't look at this, this andthis.
Do you activate the theconversation or do you wait for
the patients to activate theconversation?
Speaker 2 (07:42):
Look, I probably more .
So wait for the patient toactivate the conversation, in
the sense that pharmacy has beenunder a lot of scrutiny in the
past with like, do you wantfries?
With that type of nutritionalrecommendations, you know, just
definitely recommending certainthings with each prescription.
It's not really what I want tobe seen to be doing, but I think
(08:07):
I think the ideal scenario withwith pharmacy is that we're
going to be seeing people,usually on at least a one to two
monthly basis, for instance, ifthey are on a medication.
So it's about for me,developing that relationship
with the person so that whenthey're ready to discuss, you
know their health concerns, thenI'm there to be able to step in
(08:28):
and give that advice.
Um, so I, yes, I don't activelydiscourage.
You know, yeah, I would be veryquickly actively discouraged.
You know certain prescriptionsbeing filled or things like that
.
I don't take people offmedication, but, um, no, I guess
(08:49):
I like to think that, um, therelationship is the most
important thing, so that whenpeople are ready or they've got
a query about something and theywant to address it from a
different perspective, then I'mwell placed to help them.
Speaker 1 (09:04):
Yeah, so conditions like if we go through.
You mentioned digestive health,headaches and migraines, so
actually let's start atdigestive health, because it's a
huge one.
So are we talking about thingslike you know the old salt, you
know the antibiotics withprobiotics and things like that,
or do you do your patients askyou about more complex issues?
Speaker 2 (09:29):
Oh, yes, I mean yes, there is that I wouldn't want to
say basic recommendation butit's a very common
recommendation and a verynecessary one with the
antibiotics and probiotics, butI feel like we can help with
more complex things.
I think you know reflux is onevery prevalent condition that we
(09:51):
can have a huge impact with,and especially now that PPIs are
becoming less popular from amedical perspective, because the
side effects of long-term useof PPIs are actually becoming
more well-known and seen.
So I think that's a really goodthing, because then people are
(10:13):
coming in wanting to know whatelse they can try that isn't
going to have those negativeimpacts.
And I think you know digestivesystem, because anything we put
into our mouths is touching ourdigestive system.
It is actually a fairly easysystem to have an influence on
with natural medicine and diet,because you don't have to think
(10:36):
about absorption and all thoseother things that make you know
other formulations difficult toperhaps get into the body and
get the effect that you'rewanting to see with them um.
Speaker 1 (10:50):
So can you give us a few examples here, though?
So let's say you know ppis, youknow that one of the classics
is things like zinc carnosine,for instance, or even something
nice and simple like slipperyelm, as innocuous as that.
These innocuous fibers, do youtend to favor anything one over
the other, or do you use themconcomitantly?
Speaker 2 (11:10):
yeah, I mean digestive health.
Yeah, often there is a fewdifferent things that you've got
to consider and you know ifsomething's going wrong at the
top with like reflux, it's notoften an isolated issue, like
thinking about motility throughthe whole digestive tract.
So if someone's constipated andthey don't have good bowel
movements and everything else isjust not going to work as
(11:31):
effectively as it should.
But I would definitely considereach person individually, based
on what their diet is.
Are they drinking a lot ofalcohol?
What's their stress levels like?
But as far as things that Icommonly recommend, I do use
bitters a lot to help because Ithink reflux it's not
(11:54):
necessarily an acid issue likeit's.
It's more so an issue with theesophagus being too relaxed and
letting things back up wherewhere they really shouldn't.
So I do find bitters workreally well for constricting the
esophagus to make sure thereisn't contents refluxing.
(12:15):
Um, yeah, we use different fibersupplements.
Uh, especially, we use a lot ofphgg partially hydrolyzed guar
gum um, because I think that hasthe dual benefit of improving
the bacterial profile in thedigestive tract as well as um,
it can be helpful for bothdiarrhea and constipation,
(12:37):
depending on the dosage.
So I use that a lot differentprobiotics use a lot.
Yeah, slippery arms still stillwidely used, but I probably
more so go for the PHGG assomething that I gravitate
towards, unless there is, um,yeah, burning or something you
(12:58):
want to help with coating of thedigestive tract like, yeah, and
what?
Speaker 1 (13:05):
what about in the in the pharmacy realm?
What about using the alginatesat all as a raft antacid?
Do you ever employ that withlike after meals and so that
people can afford some benefitfrom the actions of that?
Speaker 2 (13:20):
Yeah, definitely.
I mean, that's probably mygo-to.
If I was going to use anantacid, I'd use one with the
alginate.
Yeah, definitely.
Speaker 1 (13:30):
Okay.
So antibiotics.
Now you know this is a hugeissue and I've got to say I've
now swung away from this use ofprobiotics or bacterial
probiotics because of compliance.
So I tend to just favourSaccharomyces boulardii with the
antibiotic, because it's just.
There's no issue withcompliance.
Let's take that with that atthe time.
(13:51):
You know what do you use,though at the time.
Speaker 2 (13:55):
You know what do you use, though.
Oh, I actually, yeah, I loveSaccharomyces boulardii.
I've always loved it, but Ihave moved away from using it,
interestingly enough, to using,yeah, normal probiotics, which
is it's just based purely oncustomer feedback and people
coming back saying how good theyfelt on.
(14:16):
You know different formulationsof of probiotics, and I guess
there are some some researchersout there saying that we don't
really have to worry abouttiming, so just giving it at the
same time as antibiotics nowtoo, so that that seems to be
working fine for people as well.
Speaker 1 (14:36):
Fair enough, Any any particular genera or species
that you've heard of.
Speaker 2 (14:49):
I must admit I'm terrible at remembering all the
specific bacteria.
Speaker 1 (14:52):
So no, I won't, I won't guess, all right, so okay.
So what about you know migraineheadaches you mentioned
previously?
Now you know there's goodevidence here.
There's a lot of migraineursthat don't do well.
Having said, these newcalcitonin gene inhibitors are
just a game changer, but stillthere is a section of the
(15:13):
community that they just theystill have, let's say,
breakthrough migraines.
What do you do to help thesepeople?
Speaker 2 (15:23):
Yeah, I actually feel like sometimes migraine is
maybe misdiagnosed.
To be honest, I think a lot ofpeople have headaches that are
called migraines, but I dobelieve it might be something
else causing them.
Yeah, but I like to take a fullhistory with migraines.
It is probably something I'dprefer to see in the clinic room
(15:48):
rather than just a quickconsultation, because I feel
like it really depends on theperson as to what I'm going to
recommend.
But I think something that Ilook for now, more so with
migraines as well is someone'shistamine tolerance or
intolerance.
So I think a lot of people inthe pursuit of being healthy can
(16:10):
sometimes have things that maynot be so.
They are considered a healthfood, but they're not actually
great for that particular person.
So I think you know one exampleis a lot of kombucha or
fermented foods.
Yes, they've got great bacteriain there, but they also have a
lot of histamines.
(16:31):
So I, if I identify thatsomeone's getting quite frequent
migraines and they're having alot of fermented foods, I trial
a reduction or removal of thosefoods to see if that improves
the frequency, and I might evenlook at using quercetin to help
with the histamine response aswell.
Speaker 1 (16:51):
Yeah, and any particular dose that you use of
quercetin um, I like to use.
Speaker 2 (16:58):
Well, what is it it's about?
I'm trying to think what thesupplements dosage.
Speaker 1 (17:07):
Anywhere between 200 to 600.
Speaker 2 (17:11):
Yeah, I was going to say 400 to 600.
I use that three times a day.
Speaker 1 (17:15):
Three times a day About 12.
Speaker 2 (17:16):
Cool, because I love Crescent.
Yeah, it's actually.
Oh yeah, well, it's actuallyvery versatile nutrient as well,
um, extremely extremely, um,okay, so uh, headaches.
Speaker 1 (17:36):
mental health now, this is an interesting one.
So I can remember when I workedfull-time in a pharmacy and you
know I saw my fair share ofmental health issues and people
seeking help from that.
That was in an era where StJohn's Wort was the new kid on
(17:57):
the block, if you like, and itwas in favour.
Since then there has been thiswhole evolution of nutritional,
herbal means of helping peoplewith mental health issues and it
seems like St John's Wort hasfallen out of favour in favour
of things like Afron and, I'mgoing to say, other nerve irons
(18:22):
have gone blank, forgive me,lemon, barn, passion Flower.
Speaker 2 (18:24):
Lemon Barnons have gone blank, forgive me, lemon
balm.
Speaker 1 (18:26):
Lemon balm.
Yeah, yeah, passion flower.
What's been your experience ofwhat helps and how in depth do
you have to get, or do you haveto delve with these patients'
histories to sort of find outwhat might be some triggers?
Speaker 2 (18:45):
these patients' histories to sort of find out
what might be some triggers.
Yeah, it's interesting becauseI think St John's has gotten a
St John's wort had a bad rapjust because of the interactions
, you know, and but it isprobably one herb that doctors
do actually recommend people touse semi-regularly as a starting
point before they put them onto medicinal antidepressants.
(19:09):
So I think it still hasdefinitely has a place.
But yes, it does have moreconsiderations with interactions
and so on.
But I guess, because a lot ofpeople that I see are already on
prescription antidepressants orother medications for mental
health, then I love things thatI know they can use together
(19:31):
with with no issues.
So I do use and recommend a lotof saffron and turmeric.
You know, explaining that it'sworking in a different way.
It's not just, you know,increasing serotonin, so there's
not really that risk there ofserotonin storm.
But it is going to help peoplethink more clearly because it's
working more so with the bdnf,um and and I think a lot of
(19:53):
people find that theirpharmaceutical medication it is
working but it's only reallydoing.
You know one thing it's nothelping them overall like it's
quite narrow.
So yes, they might be able tobe, you know, get up and do the
things that they need to do eachday now, whereas before they
were on the antidepressant theycouldn't.
But they still can't thinkclearly and they still lack
(20:16):
motivation to, um, you know,think longer term and things
like that.
So that's where I find addingin those other herbs can be
really beneficial.
Um, you know, sleep patternsare often still disturbed.
So, looking at magnesium andpassionflower, california poppy
all those things that workreally well for that deeper
(20:36):
sleep, um, you know, it's reallygood and and that's really
improving their mental health aswell, because they feel like
they have a choice in what theyare doing to support their
mental health.
Yeah, and I mean, there's somany different conditions under
that umbrella of mental healthtoo.
So we have a lot of populationwith ADHD.
(20:58):
They might be on stimulantmedication, but you know they're
finding it difficult to relaxat night time.
So I love being able to usetheanine.
I don't really see any issueswith using that with most things
.
It's and safe with children aswell.
So, yeah, there's, there's lotsof options, and I think having
(21:19):
options makes people excited aswell, because customers often
come to you because they feellike they've exhausted all the
options and then you say oh hey,have you tried such and such?
Speaker 1 (21:30):
and they're like no, no one's ever told me about that
before well, it's such animportant point you make because
, um, I remember an example, um,of a child who was like he was
weeping because he felt just sobombed out because of not the
(21:50):
first dose in the morning, butit was a second dose at I think
it was 10 o'clock or 11 o'clock,and he was saying, please, can
we just put it back?
Just put it back, that's allI'm asking.
I'm not saying I don't want totake it, I'm just saying can we
put it back till 12.01?
And he was pleading with peoplewho, of course, didn't listen.
It was heartbreaking, you know,and if patients are offered or
(22:17):
if they can talk to theirpharmacist in an open manner
with these things that may helptheir child, you know, god, what
a different healthcare systemwe'd have.
I mean seriously, just hugedifferences.
So, l-theanine, I love your useof that, and particularly with
kids, because it's safe.
Speaker 2 (22:37):
It's big yes and it's not hard to give it either, as
in it doesn't have the tasteissues that a lot of things have
either, you know, because youcan get it in a powder.
It's very easy to you know,adjust dosages and so on.
So, yeah, I love the use oftheine.
Speaker 1 (22:56):
Well, practically on that note, what sort of dosages
do you use?
Obviously, this is somethingthat is not a one-size-fits-all.
What's your range of dosagesthat you use?
Speaker 2 (23:06):
obviously, this is something that is not a one size
fits all.
What's your range of dosagesthat you use with ortho any uh,
for kids or adults?
Yeah, well, kids, I guess 100milligrams is probably where I'd
start, but you can go higherdepending on the age of the
child and the circumstances.
But yeah, I'd probably startwith 100 milligrams.
Speaker 1 (23:27):
And adults.
Speaker 2 (23:28):
Adults, I'd start with 200 milligrams a few times
a day, depending on what you'reactually trying to achieve with
it.
But yeah, but I also, being apharmacist every person that I
see I usually just do a quickdouble check of my resources
before I decide on a dose.
So yeah, I'm always doublechecking things, yeah.
Speaker 1 (23:53):
Okay, and with mental health issues like, for
instance, so anxiety, forinstance, and people who are
just absolutely worn out and sothey're in this constant
sympathetic drive.
Is there anything that youfavour using in these people?
Speaker 2 (24:15):
I actually love using ashwagandha in those people.
Speaker 1 (24:19):
Okay.
Speaker 2 (24:20):
And then, depending on whether they're, you know,
struggling for energy or not,you know you can add in the b
vitamins, but sometimes I don'talways use b vitamins.
I do find ashwagandha veryversatile, um.
And then again, just looking attheir ability to relax at night
time, um, that's where I woulduse, you know, magnesium formula
(24:43):
.
If they are struggling withsleep or just feeling anxious at
night time, you know magnesiumformula would be is usually
really good as well.
But yes, I do like usingashwagandha with them.
Speaker 1 (24:58):
Gotcha Jackie.
Can I ask because I've seenthis is just such a huge issue
in pharmacy the amount of womenparticularly, but not solely.
But let's just concentrate onthe female population, because
it's known just how many womensuffer from iron deficiency,
anemia, and they have realissues getting their iron up
(25:19):
like real issues.
Is it iron that's the issue?
I actually don't think it.
It iron that's the issue.
Speaker 2 (25:25):
There's a I actually don't think it is iron.
Speaker 1 (25:27):
That's the issue, yeah, so let's delve into this.
How do you navigate this?
What do you use?
Speaker 2 (25:35):
Look, putting you on the spot here with this one.
It's more just what I've beenthinking about.
I haven't really researched it,to be honest, but just knowing
how the body sequesters ironwhen it's under attack, say, for
instance, with an illness, youthink you start to question what
long-term stresses is the bodyunder that might be causing it
(25:57):
to not, you know, have ironreadily available like it should
?
That's kind of where I've beenthinking.
Yeah, as far as like how toactually help, I can honestly
say I haven't really gone toofar into it except to think
about maybe.
You know You've got me thinkingnow.
Speaker 1 (26:16):
Yeah, yes, so you're thinking about the possibility
of hepcide and being activatedin not just iron insult but also
infective insults or stressorinsults.
Speaker 2 (26:30):
Yes, right.
Speaker 1 (26:31):
But I haven't insults , yes.
Speaker 2 (26:32):
Right, but I haven't researched it.
Speaker 1 (26:34):
My next bit project.
Speaker 2 (26:36):
It's just the way my brain goes with it.
Speaker 1 (26:39):
No, that's really good, that's really interesting.
I'll look into that.
That's cool.
So, jackie, what else?
What else do you use nutritionfor?
What do you commonly sort ofsee in the pharmacy?
Speaker 2 (26:50):
that are the big issues facing people oh, there's
so many, I think, constipation,and it's very, yes,
constipation.
I think people very rarely justhave one issue too.
They, more so, have more thanone.
So it's, you know, you can.
You can go in thinking I'mgoing to treat this person,
you've got the best protocol orrecommendation for constipation,
(27:13):
but then they'll throw the ohno, I'm allergic to this or I
can't tolerate this, and thenyou have to reinvent your whole.
So that's why you can't just goin with like a rule book, for
instance, of X, y, z patient hasthese symptoms, give this
supplement, because everyone isso different.
(27:34):
And I think that's why I lovednutrition, because it was almost
more creative.
You've got to be creative tohelp the individual because you
can't just go by a textbook or arule book because everyone is
so different with it.
Yeah, but I think, yeah, I meanconstipation.
(27:55):
We see all the time Diarrhea isactually kind of a fun one to
help people with, because it'sprobably more has such a huge
impact on people's social lives.
Uncontrolled diarrhoea, thenconstipation is difficult but
it's, you know, more easilymanaged.
I feel like people that havechronic diarrhea is something I
(28:17):
feel like a challenge to helppeople with, because often it's,
you know, figuring out thecause of why the body is doing
that, and there's multiplereasons why it could be that.
Um, and there's multiplereasons why it could be.
(28:38):
Um, yeah, I mean, uh, hormones,I feel like I can see you've
got the ruth tricky book in thebackground there.
I'm about to reread that becauseI feel like I need to brush up
on.
I've got so many, um, you know,perimenopausal and menopausal
women that really, really,really want help and I feel like
I need to relearn that wholetextbook.
Speaker 1 (28:57):
But yes, they're very common yes.
So, yes, okay.
So what about?
We're talking about people whoare very often on medications.
You get them to come in.
Potentially, you'll say listen,this is complex.
We need to have a consult.
(29:17):
That may require some dialoguewith the medical professions and
indeed other professions.
How do you respectfullyinteract with these other
professions, because they comefrom a paradigm where very often
they don't believe in nutrition?
Speaker 2 (29:35):
I think yeah, I think you'd be surprised, though I
think a lot of doctors reallywell, I mean, there's lots of
different practitioners we'retalking about here, but I think
the one I find the most scary tointeract with is, you know,
doctors, because they do have arespect and a they do, they have
done a lot of training to getwhere they they are, so you
(29:57):
don't really want to go againsttheir opinions.
So, um, I guess you know whatyou can do to consult the
practitioner.
But I think if you do reallybelieve that something strongly
should be changed, then you haveto write them a letter or give
them a call.
But I think patients alsoadvocate for what they want.
(30:19):
So, you know, I've had peoplethat definitely want to come off
medications and I haven'tinitiated that.
That that's what they've come tome wanting help with, and I,
you know, tell them.
Well, you really definitely needto talk to your doctor about
that, because for a number ofreasons firstly, they need to be
overseeing that, but also, ifthe doctor keeps prescribing a
(30:41):
prescription, thinking that aperson is taking it, and then
they see them down the track andtheir condition is worse and
they need to know that theyhaven't been taking that
medicine.
So, yes, I think I think at theend of the day, we are all
people and I think having theability to just, you know, write
(31:02):
letters and pick up the phone,it will surprise you how well
you can actually collaboratetogether, because a lot of times
these people have been seeingthe doctors and the doctors have
actually run out of ideas.
So they're actually thankfulfor, you know, a different
perspective on what could betried, and if the patient's
(31:22):
coming and saying that they'regetting results from that, then
they're often happy to continue.
But I think they just want tobe informed and know that that's
what's happening and I thinkdefinitely they should be
informed of that.
Speaker 1 (31:35):
Gotcha Jackie.
Speaker 2 (31:37):
But as far as working with like natural, as far as
other natural medicinepractitioners working together,
I think that's fantastic andshouldn't really come with too
many issues you would hope.
I mean I have a naturopath onstaff, and I really enjoy
collaborating with her too.
Speaker 1 (31:55):
Right, okay, jackie, there's so much more that we
could learn from you, but thankyou so much for taking us
through some of the essentialsthat you see in community
pharmacy, helping your patientsto achieve better health
outcomes.
I really do appreciate yourwork.
I mean, you've done this forover a decade, I know, but to
see your growth and yourconfidence in what you do, you
(32:19):
have become a real, you know, astalwart, if you like, a
vanguard for patient health andpatient advocacy in your
community.
So thank you for all the workyou've done over the years.
Speaker 2 (32:29):
Thank you, thank you for having me and thank you for
all the work you've done overthe years, thank you.
Speaker 1 (32:32):
Thank you for having me and thank you everyone for
joining us.
Remember you can catch up onall the podcast notes.
We'll try and put as muchinformation as we can up there
on the Designs for Healthwebsite and, of course, all the
other podcasts.
I'm Andrew Whitfield-Cook.
This is Wellness by DesignsMusic.
Music.
This is Wellness by Designs,and I'm your host, andrew
Whitfield-Cook.
This is Wellness by Designs,and I'm your host, andrew
Whitfield-Cook.
Joining us today is JackieCoote, a pharmacist and
nutritionist who owns the WholeLife Pharmacy in Strathpine,
brisbane, and today we'll bediscussing patient-centred care.
Welcome to Wellness by Designs,jackie.
How are you?
Speaker 2 (00:39):
Very well, thank you for having me.
Speaker 1 (00:42):
Thank you so much for taking time out of your busy
day.
I know how busy it can get inpharmacy, so I think, first to
start off, did you do nutritionor pharmacy first?
What drive you?
Speaker 2 (00:55):
I did pharmacy first and, to be honest, I picked
pharmacy because I loved sciencebut I also loved people, so it
seemed like a natural fit for me.
Speaker 1 (01:09):
But I was very young, so I didn't know what I was
getting into.
Oops, what about nutrition then?
Why go further into?
Speaker 2 (01:20):
nutrition.
It's not the obvious step thatmost people make, no, so it was
definitely nothing that I'd everreally forward planned to do
that either.
But throughout my pharmacyjourney I'd really grown to love
helping people and that's whatmade my job rewarding.
And it was actually mycustomers that wanted to know
more about health, naturalhealth, and how that would
(01:41):
benefit them, and I really feltlike I had to do further study
to be able to answer thosequestions effectively and really
make a difference in people'slives, and that's why I chose
nutrition, but from a naturalmedicine perspective, because
that's what I was interested inlearning the philosophies behind
natural medicine therapies andlearning it from that
(02:04):
perspective.
So that's why I pickednutritional medicine rather than
, you know, going into dietetics, for instance.
Speaker 1 (02:12):
Gotcha yeah, gotcha Okay, but that's a big leap,
like when you not sure aboutnutrition, but certainly
naturopathy.
It was a big leap for me from aparadigm perspective, if you
like, to go from a disease modelto a wellness model, or a
(02:33):
rather instead of a diagnosismodel to a problem solving model
, if you like, with naturalmedicine.
With natural medicine, Bigissue for me like, instead of
saying there's lupus, anaturopath would say there's a
patient, their diagnosis islupus, but they've got problems
with their skin integrity andthat's linked to gut dysbiosis
(02:54):
and inflammatory markers andthings like that.
So, instead of tackling thediagnosis per se, a naturopath
will tackle the body systemsthat are out of alignment if you
like, are out of balance.
Speaker 2 (03:08):
How did you?
How did?
Speaker 1 (03:09):
you grasp that?
Speaker 2 (03:12):
um, I think well, I mean, I guess I live in both
worlds, so I guess I still thinkboth ways.
But um, the more you see peopleand the more you delve into
your own health journey as well,you realise that people are not
just body systems or a disease,and we are complex beings.
And you know it's not justabout the process that's going
(03:36):
wrong in that one little area,it's about the whole person.
So I think it fits quitenaturally once you start to
think about, you know the, thethings that can lead to disease,
for instance, um, you know,even lack of sleep or living in
such a stressful environmentthat you're not taking time to
(03:57):
break that cycle and help yourbody to maintain its integrity,
so to speak.
Speaker 1 (04:03):
Um, yeah, I think it fits quite well hand in hand
those two so so this need, orthis, this interest, if you like
, that drove you to studynutrition.
It was indeed patient driven.
It was the demands of thepatients wanting more info.
Yeah, what were they after?
Speaker 2 (04:22):
uh well, I think at the time because I'm going back
maybe at least 10 years probably, when I first started getting
really interested in it, um, I'dsay it was probably more
digestive health was probably abig one at the time that really
got me interested.
But probably because I I thinkI had some of my own issues that
(04:45):
I was like delving into as faras like, oh well, what could
these probiotics do, forinstance?
It's a very simple thing, butyou know, even back then I mean,
they're way more complex nowthe research that's been done on
probiotics.
But back then there wasn't hugeamount of choices, but even the
few that were available Iwanted to know a bit more about
why you would pick one thingover another.
(05:07):
So I started going to naturalmedicine conferences and I just
found this whole other world andit was way more detailed and
researched than I had been ledto believe.
Speaker 1 (05:19):
Basically, Same here.
I went through that exact samediscovery um what are the most
common inquiries that you getfrom customers, patients that
you feel you have the greatestimpact on yeah, uh.
Speaker 2 (05:38):
Well, I guess I'm in a fortunate position where
people are walking through mydoor.
I get to see hundreds of peopleevery day, so there's a huge
variety of things that peopleask for help for.
But I guess we see definitely alot of digestive health issues
is a really common one.
Headaches and migraines andmental health they're probably
(06:03):
three big ones that we see a lotof and they're three big ones
that I feel works really wellfor integrative medicine and
helping people with a naturaloption as well as whatever else
they're doing.
It can work in quite well withwhat they've been prescribed.
It's really helpful being apharmacist so I can have a look
at their regular medications andprovide advice on what is going
(06:26):
to be safe to use with thosecombinations.
But yes, I'd say they're thethree big areas that I feel we
can have big impacts in.
Speaker 1 (06:37):
Sticky situation sometimes, though, in that you
know it's not really our place,your place to sort of, take
patients off medicines, that'sthe doctors.
So sometimes, though, you getpatients who start to refuse
medication.
that may be, indeed, life savingrefuse medication that may be
indeed life-saving.
So let's say and I know this isopening up I'm going to be
(07:02):
kicked in the head for this, forsuggesting that statins might
even be of benefit to somebody.
But it's not our place tonecessarily take patients off
statins, but if their lipidprofile is such that it's low,
then of course the doctor shouldbe in the position, therefore,
to say listen, maybe we cancease this, but let's if we take
a step back.
(07:22):
Do you actively say OK, doctors, put you on a statin.
This is great for loweringblood cholesterol levels, but it
doesn't look at this, this andthis.
Do you activate the theconversation or do you wait for
the patients to activate theconversation?
Speaker 2 (07:42):
Look, I probably more .
So wait for the patient toactivate the conversation, in
the sense that pharmacy has beenunder a lot of scrutiny in the
past with like, do you wantfries?
With that type of nutritionalrecommendations, you know, just
definitely recommending certainthings with each prescription.
It's not really what I want tobe seen to be doing, but I think
(08:07):
I think the ideal scenario withwith pharmacy is that we're
going to be seeing people,usually on at least a one to two
monthly basis, for instance, ifthey are on a medication.
So it's about for me,developing that relationship
with the person so that whenthey're ready to discuss, you
know their health concerns, thenI'm there to be able to step in
(08:28):
and give that advice.
Um, so I, yes, I don't activelydiscourage.
You know, yeah, I would be veryquickly actively discouraged.
You know certain prescriptionsbeing filled or things like that
.
I don't take people offmedication, but, um, no, I guess
(08:49):
I like to think that, um, therelationship is the most
important thing, so that whenpeople are ready or they've got
a query about something and theywant to address it from a
different perspective, then I'mwell placed to help them.
Speaker 1 (09:04):
Yeah, so conditions like if we go through.
You mentioned digestive health,headaches and migraines, so
actually let's start atdigestive health, because it's a
huge one.
So are we talking about thingslike you know the old salt, you
know the antibiotics withprobiotics and things like that,
or do you do your patients askyou about more complex issues?
Speaker 2 (09:29):
Oh, yes, I mean yes, there is that I wouldn't want to
say basic recommendation butit's a very common
recommendation and a verynecessary one with the
antibiotics and probiotics, butI feel like we can help with
more complex things.
I think you know reflux is onevery prevalent condition that we
(09:51):
can have a huge impact with,and especially now that PPIs are
becoming less popular from amedical perspective, because the
side effects of long-term useof PPIs are actually becoming
more well-known and seen.
So I think that's a really goodthing, because then people are
(10:13):
coming in wanting to know whatelse they can try that isn't
going to have those negativeimpacts.
And I think you know digestivesystem, because anything we put
into our mouths is touching ourdigestive system.
It is actually a fairly easysystem to have an influence on
with natural medicine and diet,because you don't have to think
(10:36):
about absorption and all thoseother things that make you know
other formulations difficult toperhaps get into the body and
get the effect that you'rewanting to see with them um.
Speaker 1 (10:50):
So can you give us a few examples here, though?
So let's say you know ppis, youknow that one of the classics
is things like zinc carnosine,for instance, or even something
nice and simple like slipperyelm, as innocuous as that.
These innocuous fibers, do youtend to favor anything one over
the other, or do you use themconcomitantly?
Speaker 2 (11:10):
yeah, I mean digestive health.
Yeah, often there is a fewdifferent things that you've got
to consider and you know ifsomething's going wrong at the
top with like reflux, it's notoften an isolated issue, like
thinking about motility throughthe whole digestive tract.
So if someone's constipated andthey don't have good bowel
movements and everything else isjust not going to work as
(11:31):
effectively as it should.
But I would definitely considereach person individually, based
on what their diet is.
Are they drinking a lot ofalcohol?
What's their stress levels like?
But as far as things that Icommonly recommend, I do use
bitters a lot to help because Ithink reflux it's not
(11:54):
necessarily an acid issue likeit's.
It's more so an issue with theesophagus being too relaxed and
letting things back up wherewhere they really shouldn't.
So I do find bitters workreally well for constricting the
esophagus to make sure thereisn't contents refluxing.
(12:15):
Um, yeah, we use different fibersupplements.
Uh, especially, we use a lot ofphgg partially hydrolyzed guar
gum um, because I think that hasthe dual benefit of improving
the bacterial profile in thedigestive tract as well as um,
it can be helpful for bothdiarrhea and constipation,
(12:37):
depending on the dosage.
So I use that a lot differentprobiotics use a lot.
Yeah, slippery arms still stillwidely used, but I probably
more so go for the PHGG assomething that I gravitate
towards, unless there is, um,yeah, burning or something you
(12:58):
want to help with coating of thedigestive tract like, yeah, and
what?
Speaker 1 (13:05):
what about in the in the pharmacy realm?
What about using the alginatesat all as a raft antacid?
Do you ever employ that withlike after meals and so that
people can afford some benefitfrom the actions of that?
Speaker 2 (13:20):
Yeah, definitely.
I mean, that's probably mygo-to.
If I was going to use anantacid, I'd use one with the
alginate.
Yeah, definitely.
Speaker 1 (13:30):
Okay.
So antibiotics.
Now you know this is a hugeissue and I've got to say I've
now swung away from this use ofprobiotics or bacterial
probiotics because of compliance.
So I tend to just favourSaccharomyces boulardii with the
antibiotic, because it's just.
There's no issue withcompliance.
Let's take that with that atthe time.
(13:51):
You know what do you use,though at the time.
Speaker 2 (13:55):
You know what do you use, though.
Oh, I actually, yeah, I loveSaccharomyces boulardii.
I've always loved it, but Ihave moved away from using it,
interestingly enough, to using,yeah, normal probiotics, which
is it's just based purely oncustomer feedback and people
coming back saying how good theyfelt on.
(14:16):
You know different formulationsof of probiotics, and I guess
there are some some researchersout there saying that we don't
really have to worry abouttiming, so just giving it at the
same time as antibiotics nowtoo, so that that seems to be
working fine for people as well.
Speaker 1 (14:36):
Fair enough, Any any particular genera or species
that you've heard of.
Speaker 2 (14:49):
I must admit I'm terrible at remembering all the
specific bacteria.
Speaker 1 (14:52):
So no, I won't, I won't guess, all right, so okay.
So what about you know migraineheadaches you mentioned
previously?
Now you know there's goodevidence here.
There's a lot of migraineursthat don't do well.
Having said, these newcalcitonin gene inhibitors are
just a game changer, but stillthere is a section of the
(15:13):
community that they just theystill have, let's say,
breakthrough migraines.
What do you do to help thesepeople?
Speaker 2 (15:23):
Yeah, I actually feel like sometimes migraine is
maybe misdiagnosed.
To be honest, I think a lot ofpeople have headaches that are
called migraines, but I dobelieve it might be something
else causing them.
Yeah, but I like to take a fullhistory with migraines.
It is probably something I'dprefer to see in the clinic room
(15:48):
rather than just a quickconsultation, because I feel
like it really depends on theperson as to what I'm going to
recommend.
But I think something that Ilook for now, more so with
migraines as well is someone'shistamine tolerance or
intolerance.
So I think a lot of people inthe pursuit of being healthy can
(16:10):
sometimes have things that maynot be so.
They are considered a healthfood, but they're not actually
great for that particular person.
So I think you know one exampleis a lot of kombucha or
fermented foods.
Yes, they've got great bacteriain there, but they also have a
lot of histamines.
(16:31):
So I, if I identify thatsomeone's getting quite frequent
migraines and they're having alot of fermented foods, I trial
a reduction or removal of thosefoods to see if that improves
the frequency, and I might evenlook at using quercetin to help
with the histamine response aswell.
Speaker 1 (16:51):
Yeah, and any particular dose that you use of
quercetin um, I like to use.
Speaker 2 (16:58):
Well, what is it it's about?
I'm trying to think what thesupplements dosage.
Speaker 1 (17:07):
Anywhere between 200 to 600.
Speaker 2 (17:11):
Yeah, I was going to say 400 to 600.
I use that three times a day.
Speaker 1 (17:15):
Three times a day About 12.
Speaker 2 (17:16):
Cool, because I love Crescent.
Yeah, it's actually.
Oh yeah, well, it's actuallyvery versatile nutrient as well,
um, extremely extremely, um,okay, so uh, headaches.
Speaker 1 (17:36):
mental health now, this is an interesting one.
So I can remember when I workedfull-time in a pharmacy and you
know I saw my fair share ofmental health issues and people
seeking help from that.
That was in an era where StJohn's Wort was the new kid on
(17:57):
the block, if you like, and itwas in favour.
Since then there has been thiswhole evolution of nutritional,
herbal means of helping peoplewith mental health issues and it
seems like St John's Wort hasfallen out of favour in favour
of things like Afron and, I'mgoing to say, other nerve irons
(18:22):
have gone blank, forgive me,lemon, barn, passion Flower.
Speaker 2 (18:24):
Lemon Barnons have gone blank, forgive me, lemon
balm.
Speaker 1 (18:26):
Lemon balm.
Yeah, yeah, passion flower.
What's been your experience ofwhat helps and how in depth do
you have to get, or do you haveto delve with these patients'
histories to sort of find outwhat might be some triggers?
Speaker 2 (18:45):
these patients' histories to sort of find out
what might be some triggers.
Yeah, it's interesting becauseI think St John's has gotten a
St John's wort had a bad rapjust because of the interactions
, you know, and but it isprobably one herb that doctors
do actually recommend people touse semi-regularly as a starting
point before they put them onto medicinal antidepressants.
(19:09):
So I think it still hasdefinitely has a place.
But yes, it does have moreconsiderations with interactions
and so on.
But I guess, because a lot ofpeople that I see are already on
prescription antidepressants orother medications for mental
health, then I love things thatI know they can use together
(19:31):
with with no issues.
So I do use and recommend a lotof saffron and turmeric.
You know, explaining that it'sworking in a different way.
It's not just, you know,increasing serotonin, so there's
not really that risk there ofserotonin storm.
But it is going to help peoplethink more clearly because it's
working more so with the bdnf,um and and I think a lot of
(19:53):
people find that theirpharmaceutical medication it is
working but it's only reallydoing.
You know one thing it's nothelping them overall like it's
quite narrow.
So yes, they might be able tobe, you know, get up and do the
things that they need to do eachday now, whereas before they
were on the antidepressant theycouldn't.
But they still can't thinkclearly and they still lack
(20:16):
motivation to, um, you know,think longer term and things
like that.
So that's where I find addingin those other herbs can be
really beneficial.
Um, you know, sleep patternsare often still disturbed.
So, looking at magnesium andpassionflower, california poppy
all those things that workreally well for that deeper
(20:36):
sleep, um, you know, it's reallygood and and that's really
improving their mental health aswell, because they feel like
they have a choice in what theyare doing to support their
mental health.
Yeah, and I mean, there's somany different conditions under
that umbrella of mental healthtoo.
So we have a lot of populationwith ADHD.
(20:58):
They might be on stimulantmedication, but you know they're
finding it difficult to relaxat night time.
So I love being able to usetheanine.
I don't really see any issueswith using that with most things
.
It's and safe with children aswell.
So, yeah, there's, there's lotsof options, and I think having
(21:19):
options makes people excited aswell, because customers often
come to you because they feellike they've exhausted all the
options and then you say oh hey,have you tried such and such?
Speaker 1 (21:30):
and they're like no, no one's ever told me about that
before well, it's such animportant point you make because
, um, I remember an example, um,of a child who was like he was
weeping because he felt just sobombed out because of not the
(21:50):
first dose in the morning, butit was a second dose at I think
it was 10 o'clock or 11 o'clock,and he was saying, please, can
we just put it back?
Just put it back, that's allI'm asking.
I'm not saying I don't want totake it, I'm just saying can we
put it back till 12.01?
And he was pleading with peoplewho, of course, didn't listen.
It was heartbreaking, you know,and if patients are offered or
(22:17):
if they can talk to theirpharmacist in an open manner
with these things that may helptheir child, you know, god, what
a different healthcare systemwe'd have.
I mean seriously, just hugedifferences.
So, l-theanine, I love your useof that, and particularly with
kids, because it's safe.
Speaker 2 (22:37):
It's big yes and it's not hard to give it either, as
in it doesn't have the tasteissues that a lot of things have
either, you know, because youcan get it in a powder.
It's very easy to you know,adjust dosages and so on.
So, yeah, I love the use oftheine.
Speaker 1 (22:56):
Well, practically on that note, what sort of dosages
do you use?
Obviously, this is somethingthat is not a one-size-fits-all.
What's your range of dosagesthat you use?
Speaker 2 (23:06):
obviously, this is something that is not a one size
fits all.
What's your range of dosagesthat you use with ortho any uh,
for kids or adults?
Yeah, well, kids, I guess 100milligrams is probably where I'd
start, but you can go higherdepending on the age of the
child and the circumstances.
But yeah, I'd probably startwith 100 milligrams.
Speaker 1 (23:27):
And adults.
Speaker 2 (23:28):
Adults, I'd start with 200 milligrams a few times
a day, depending on what you'reactually trying to achieve with
it.
But yeah, but I also, being apharmacist every person that I
see I usually just do a quickdouble check of my resources
before I decide on a dose.
So yeah, I'm always doublechecking things, yeah.
Speaker 1 (23:53):
Okay, and with mental health issues like, for
instance, so anxiety, forinstance, and people who are
just absolutely worn out and sothey're in this constant
sympathetic drive.
Is there anything that youfavour using in these people?
Speaker 2 (24:15):
I actually love using ashwagandha in those people.
Speaker 1 (24:19):
Okay.
Speaker 2 (24:20):
And then, depending on whether they're, you know,
struggling for energy or not,you know you can add in the b
vitamins, but sometimes I don'talways use b vitamins.
I do find ashwagandha veryversatile, um.
And then again, just looking attheir ability to relax at night
time, um, that's where I woulduse, you know, magnesium formula
(24:43):
.
If they are struggling withsleep or just feeling anxious at
night time, you know magnesiumformula would be is usually
really good as well.
But yes, I do like usingashwagandha with them.
Speaker 1 (24:58):
Gotcha Jackie.
Can I ask because I've seenthis is just such a huge issue
in pharmacy the amount of womenparticularly, but not solely.
But let's just concentrate onthe female population, because
it's known just how many womensuffer from iron deficiency,
anemia, and they have realissues getting their iron up
(25:19):
like real issues.
Is it iron that's the issue?
I actually don't think it.
It iron that's the issue.
Speaker 2 (25:25):
There's a I actually don't think it is iron.
Speaker 1 (25:27):
That's the issue, yeah, so let's delve into this.
How do you navigate this?
What do you use?
Speaker 2 (25:35):
Look, putting you on the spot here with this one.
It's more just what I've beenthinking about.
I haven't really researched it,to be honest, but just knowing
how the body sequesters ironwhen it's under attack, say, for
instance, with an illness, youthink you start to question what
long-term stresses is the bodyunder that might be causing it
(25:57):
to not, you know, have ironreadily available like it should
?
That's kind of where I've beenthinking.
Yeah, as far as like how toactually help, I can honestly
say I haven't really gone toofar into it except to think
about maybe.
You know You've got me thinkingnow.
Speaker 1 (26:16):
Yeah, yes, so you're thinking about the possibility
of hepcide and being activatedin not just iron insult but also
infective insults or stressorinsults.
Speaker 2 (26:30):
Yes, right.
Speaker 1 (26:31):
But I haven't insults , yes.
Speaker 2 (26:32):
Right, but I haven't researched it.
Speaker 1 (26:34):
My next bit project.
Speaker 2 (26:36):
It's just the way my brain goes with it.
Speaker 1 (26:39):
No, that's really good, that's really interesting.
I'll look into that.
That's cool.
So, jackie, what else?
What else do you use nutritionfor?
What do you commonly sort ofsee in the pharmacy?
Speaker 2 (26:50):
that are the big issues facing people oh, there's
so many, I think, constipation,and it's very, yes,
constipation.
I think people very rarely justhave one issue too.
They, more so, have more thanone.
So it's, you know, you can.
You can go in thinking I'mgoing to treat this person,
you've got the best protocol orrecommendation for constipation,
(27:13):
but then they'll throw the ohno, I'm allergic to this or I
can't tolerate this, and thenyou have to reinvent your whole.
So that's why you can't just goin with like a rule book, for
instance, of X, y, z patient hasthese symptoms, give this
supplement, because everyone isso different.
(27:34):
And I think that's why I lovednutrition, because it was almost
more creative.
You've got to be creative tohelp the individual because you
can't just go by a textbook or arule book because everyone is
so different with it.
Yeah, but I think, yeah, I meanconstipation.
(27:55):
We see all the time Diarrhea isactually kind of a fun one to
help people with, because it'sprobably more has such a huge
impact on people's social lives.
Uncontrolled diarrhoea, thenconstipation is difficult but
it's, you know, more easilymanaged.
I feel like people that havechronic diarrhea is something I
(28:17):
feel like a challenge to helppeople with, because often it's,
you know, figuring out thecause of why the body is doing
that, and there's multiplereasons why it could be that.
Um, and there's multiplereasons why it could be.
(28:38):
Um, yeah, I mean, uh, hormones,I feel like I can see you've
got the ruth tricky book in thebackground there.
I'm about to reread that becauseI feel like I need to brush up
on.
I've got so many, um, you know,perimenopausal and menopausal
women that really, really,really want help and I feel like
I need to relearn that wholetextbook.
Speaker 1 (28:57):
But yes, they're very common yes.
So, yes, okay.
So what about?
We're talking about people whoare very often on medications.
You get them to come in.
Potentially, you'll say listen,this is complex.
We need to have a consult.
(29:17):
That may require some dialoguewith the medical professions and
indeed other professions.
How do you respectfullyinteract with these other
professions, because they comefrom a paradigm where very often
they don't believe in nutrition?
Speaker 2 (29:35):
I think yeah, I think you'd be surprised, though I
think a lot of doctors reallywell, I mean, there's lots of
different practitioners we'retalking about here, but I think
the one I find the most scary tointeract with is, you know,
doctors, because they do have arespect and a they do, they have
done a lot of training to getwhere they they are, so you
(29:57):
don't really want to go againsttheir opinions.
So, um, I guess you know whatyou can do to consult the
practitioner.
But I think if you do reallybelieve that something strongly
should be changed, then you haveto write them a letter or give
them a call.
But I think patients alsoadvocate for what they want.
(30:19):
So, you know, I've had peoplethat definitely want to come off
medications and I haven'tinitiated that.
That that's what they've come tome wanting help with, and I,
you know, tell them.
Well, you really definitely needto talk to your doctor about
that, because for a number ofreasons firstly, they need to be
overseeing that, but also, ifthe doctor keeps prescribing a
(30:41):
prescription, thinking that aperson is taking it, and then
they see them down the track andtheir condition is worse and
they need to know that theyhaven't been taking that
medicine.
So, yes, I think I think at theend of the day, we are all
people and I think having theability to just, you know, write
(31:02):
letters and pick up the phone,it will surprise you how well
you can actually collaboratetogether, because a lot of times
these people have been seeingthe doctors and the doctors have
actually run out of ideas.
So they're actually thankfulfor, you know, a different
perspective on what could betried, and if the patient's
(31:22):
coming and saying that they'regetting results from that, then
they're often happy to continue.
But I think they just want tobe informed and know that that's
what's happening and I thinkdefinitely they should be
informed of that.
Speaker 1 (31:35):
Gotcha Jackie.
Speaker 2 (31:37):
But as far as working with like natural, as far as
other natural medicinepractitioners working together,
I think that's fantastic andshouldn't really come with too
many issues you would hope.
I mean I have a naturopath onstaff, and I really enjoy
collaborating with her too.
Speaker 1 (31:55):
Right, okay, jackie, there's so much more that we
could learn from you, but thankyou so much for taking us
through some of the essentialsthat you see in community
pharmacy, helping your patientsto achieve better health
outcomes.
I really do appreciate yourwork.
I mean, you've done this forover a decade, I know, but to
see your growth and yourconfidence in what you do, you
(32:19):
have become a real, you know, astalwart, if you like, a
vanguard for patient health andpatient advocacy in your
community.
So thank you for all the workyou've done over the years.
Speaker 2 (32:29):
Thank you, thank you for having me and thank you for
all the work you've done overthe years, thank you.
Speaker 1 (32:32):
Thank you for having me and thank you everyone for
joining us.
Remember you can catch up onall the podcast notes.
We'll try and put as muchinformation as we can up there
on the Designs for Healthwebsite and, of course, all the
other podcasts.
I'm Andrew Whitfield-Cook.
This is Wellness by DesignsMusic.
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