CONNECT 2023

Autoimmune thyroiditis (Hashimoto’s and Graves’ Disease) affects 3-4% of the populations. Since the COVID-19 pandemic those numbers have risen. The thyroid gland is especially affected by changes in immune system stimulation, as well as systemic biological systems such as endocrine and metabolic triggers. In this talk, we will walk through how to diagnose autoimmune thyroiditis (both Hashimoto’s and Grave’s Disease) as well as how to assess antibody levels, how antibodies affect the disease process, and how to manage elevated levels of antibodies. Additionally, we will discuss some of the research around the controversial use of iodine in those with autoimmune diseases, how and when to prescribe synthetic vs glandular thyroid hormone, how to manage thyroid suppressive medications, and when radioactive iodine ablation is necessary. Statistics around how autoimmune thyroiditis has changed with COVID-19 will also be discussed.

Estimated CE credits: 1 Category 1 credit, including .25 Pharmacology credit, for Washington-licensed NDs. 

Approximately 25% of the population will have a positive anti-nuclear antibody (ANA) on a lab test at some point in their life. But what does this result mean? Anti-nuclear antibodies are often a sign that there is some kind of autoimmune disease process occurring. But an elevated ANA will only give you information about certain autoimmune diseases and not others. Additionally, a positive ANA test is only informative if run with additional testing, including specific ANA markers, complement, coagulation panels and inflammatory markers. In this talk we will discuss the process of assessing when to run an ANA panel, what a positive ANA means, the different types of ANA testing to run, and additional testing that can be run to help clarify the significance of a positive ANA. Specific focus on new and innovative tests to help identify ANA conditions will be reviewed. We will also discuss the specific conditions commonly associated with ANA antibodies, pharmaceutical and naturopathic therapies for those with ANA conditions, and prognosis and management of certain ANA conditions.

Estimated CE: 1.5 Category 1 CE for Washington NDs. 

Chronic pain affects more than 100 million people in the United States  and accounts for 20 percent of outpatient visits, 12 percent of all prescriptions, and over 100 billion dollars in direct and indirect expenses.   It also comprises 20 to 50 percent of patients seen in primary care. 

A comprehensive pain evaluation is essential to developing an effective treatment plan.  Those individuals with complicated pain pictures, particularly those who are heavily medicated, need a strong, integrated team to improve outcomes and quality of life.

Estimated CE credits: 1 Category 1 credit, including .25 Pharmacology credit, for Washington-licensed NDs. 

Certain botanicals such as aconite, ephedra, yohimbe, coltsfoot, artemisia, comfrey, and more have been the subject of lawsuits. Although many of these cases have involved misuse or even misidentification, it has made it harder to access and legitimately use in practice. Learn which herbs are the ones we need to prioritize, and how to create SOP’s and disclosure agreements that keep these important, high liability therapeutics in good standing.

Estimated CE: 1 Category 1 CE for Washington NDs. 

First imaging exam negative/indeterminate. Now what? Discussion and case examples of these situations in musculoskeletal, abdominal and pelvic imaging: the who, what, when and whys of such decision-making.

Estimated CE credits: 1 Category 1 credit for Washington-licensed NDs. 

Injection therapies are easy-to-perform in office procedures that bring pain relief in so many cases. Neural Therapy and Perinural Injection Treatments are easy to apply for pain management. They use procaine and D5W as their injectates which are very safe and part of the Naturopathic formulary.

[Please note that this offering consists of 2 parts: 1 hour will be lecture-based for all attendees; the 2nd hour will be lab-based for pre-registered attendees only.]

Estimated CE credits: 2 Category 1 credits, including 1 Pharmacology credit for the lecture component, for Washington-licensed NDs. 

What is a patient to do when the ‘gold standard’ for pain treatment has failed them? What happens when the side effects from a pain medication outweigh the benefit the medication was providing? What tools are in a provider’s ‘toolbox’ to give this patient an improved quality of life? Specialty compounded medications may provide some of the answers to these questions! We will go through situations of both acute and chronic pain; including muscular vs neuropathic vs mixed mechanism. Opportunities exist for providing improved quality of life via topicals, transdermal, nasal sprays, topical sprays, oral gels and mouth rinses, and vaginal gels or suppositories. Learn more about combining multiple mechanisms of action to maximize the efficacy while minimizing side effects.

Estimated CE credit: 1 Category 1 credit, including 1 Pharmacology credit, for Washington-licensed NDs. 

Semaglutide is an old diabetes medication that has received a lot of press recently for weight loss. It seems like everyone is using it from celebrities to the next door neighbor. In our society’s struggle to deal with an obesity epidemic, the search for a magic solution is unending. But how safe is this medication for weight management? This talk will review the prescription and management of semaglutide, cost and supply issues, as well as naturopathic therapies for supporting heathy incretin hormone response.

Estimated CE credits: 1 Category 1 credit, including 1 Pharmacology credit, for Washington-licensed NDs. 

Enteroendocrine system is the largest endocrine organ in the human body and plays a crucial role in the regulation of post-prandial physiology. Via enteroendocrine system, gut speaks to the brain and other organs. This is fundamental in maintaining homeostasis both in feeding and fasting and in health and disease. The gut hormones provide the capacity for integration of nutrient signals to the CNS and exert both acute effects on afferent neurons and longer term effects that determine neuronal phenotype in a way that reflects nutrient status. This mechanism appears to be subverted in obesity, infection and inflammation. Understanding of the regulatory peptides involved in enteroendocrine system should validate the traditional therapeutics for gastrointestinal conditions and pave a new way to develop effective and safe naturopathic treatment modalities.

Estimated CE credits: 1 Category 1 credit, including .15 Pharmacology credit, for Washington-licensed NDs. 

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) are relatively new diagnoses impacting as many as 1 in 200 children. Often mistaken for a psychiatric illness, tic disorder or a behavioral health problem, this autoimmune condition is frequently unrecognized and more often misdiagnosed. This may lead to the patient being treated symptomatically with psychotropic medications which, in addition to often causing troubling side effects, do little or nothing to relieve the symptoms. New and ongoing research in the emerging field of psych-neuro-immunology has demonstrated that these disorders can be caused by infection(s). Appropriate treatment involves the administration of antimicrobials and often anti-inflammatory treatments both of which require careful medical observation and ongoing evaluation. Patients with moderate-severe presentation may require immunomodulatory which can be financially devastating to families due to the lack of insurance coverage.

PANDAS/PANS are clinical diagnoses in which formalized diagnostic and treatment guidelines have been established by leading experts across the country and published in the Journal of Adolescent Psychopharmacology. However, many medical providers are unaware of these guidelines and/or aren’t well versed in screening via their differential which may contribute to delayed recognition, missed or incorrect diagnoses and delayed care. The role of medical support staff and providers is to be aware of these disorders and recognize the temporal relationship of an infection and the onset of neuropsychiatric symptoms. Typically, patients will exhibit tics, obsessions, compulsions, rage outbursts, self-injurious behaviors, mood instability, separation anxiety, food restriction and urinary issues. As these symptoms also occur in other conditions such as Tourette syndrome and a host of psychiatric disorders, it is important for medical clinicians and staff to consider initiating a discussion regarding the possibility of PANDAS or PANS as this recognition may lead to timely, appropriate, and sometimes lifesaving treatments. Research and clinical experience has shown that early recognition of these changes in a child’s functioning and behavior, thorough assessment of the child’s infectious history and exposure and appropriate evaluation of laboratory findings results in timely application of appropriate medical therapies to address the immunological dysfunction and return the child to optimal functioning. It is through this lens of improved focus on post- infectious symptom presentation that we ensure we avoid the pitfalls of overlooked medical disorders with psychiatric presentations which will better serve our communities as we deliver care.

This presentation will provide an overview on methods of early detection of Parkinson's - with a focus on the prevalence of hyposmia as an early symptom. Recommendations for health care providers attempting to manage asymptomatic individuals with positive test results.

Estimated CE: 1 Category 1 CE for Washington NDs. 

The presentation will first introduce the scope of public health in our state and provide an overview of the policy process. Then, we will focus on holistic approaches to public health practice, providing key examples of foundational public health program areas, including maternal child health, chronic disease, and communicable disease. For each program area, we will discuss real-world examples from my experience overseeing a rural health department in Washington State. We will review common laboratory tests and medications utilized in public health practice, with a focus on infectious disease, including STI medication and a brief overview of TB medications for LTBI and Active TB. Overall, the goal is to broaden exposure of NDs to the field of public health practice in Washington State. The presentation will include resources and opportunities for additional training.

Estimated CE: 1 Category 1 CE and .25 Pharmacology CEs for Washington NDs. 

Low Dose Naltrexone use in various Autoimmune diseases, Long Covid, GI issues, Dermatology & More.

Estimated CE credit: 1 Category 1 credit, including 1 Pharmacology credit, for Washington-licensed NDs. 

Did you learn venipuncture and IV placement and want some pointers? This class is designed for people who have completed all coursework in these classes and want a review and work on details of their placement of venipuncture and IV’s.

Estimated CE: 1 Category 1 CE for Washington NDs.

It is believed that the bitter taste and the bitter receptors that receive the bitter substance have predated the Neanderthal man. These ancient tastes one that has been theories to prevent toxic poisoning have now explored in recent research about the power of the bitter agents. There are over 50 types of bitter receptors in the human body, but only three types of sweet receptors. Herbalists and naturopathic and traditional healers have all understood the power of bitters to support digestion, ease bloating and gas but the new model shows that bitters have a much wider role in health and disease. Could chronic thyroid disease, heart disease, and metabolic disease and diabetes be a bitter deficiency? Is our aversion to bitter foods and herbs hurting our health? In this talk, we will cover the emerging theories and look that the reach that brings a new world of activity for the most ancient of tastes: Bitter. Participants will take a walk in Bastyr Gardens and identify 5-10 classic bitter herbs, we will discuss the clinical use of bitters and collect the herbs to make a bitter digestive tonic at the end of class with herbs and alcohol.

Estimated CE: 2 Category 1 CE and .5 Pharmacology CE for Washington NDs. 

Ever wonder what stool test you should be ordering for your patient? In this lecture, we will review the research to assess culture, PCR, and next generation sequencing stool testing, including 16S rRNA sequencing, whole genome sequencing, and metatranscriptomic sequencing. We will review best methodologies for assessing bacteria, yeast and parasites in the microbiome as well as best practices for stool collection. Lastly, we will review the most up to date research on the relative abundance of different bacteria in the large intestine.

Estimated CE credit: 1 Category 1 credit for Washington-licensed NDs. 

We all know a healthy microbiome is crucial to health. But how can we deliver personalized medicine for our patient’s microbiomes when many stool tests reveal less than 5% of the microbiome and most probiotics make up less than 3% of a healthy microbiome? In this lecture, we will explore how different next generation sequencing techniques can be used in clinical practice to fully explore and treat our patient’s microbiome. We will explore a framework to assess next generation sequencing data in order to identify microbiome imbalances that may contribute to symptoms and disease. We will then explore evidenced-based therapeutics to modify the microbiome. We will go beyond standard probiotics and discuss the clinical applications of nutrition, nutraceuticals, botanicals, prebiotics, probiotics, and postbiotics in microbiome restoration.

Estimated CE credit: 1 Category 1 credit for Washington-licensed NDs. 

In this hands-on workshop participants will review indications for biopsy of suspicious or unknown skin lesions.  We will then review performing punch biopsies and practice this skill.

Estimated CE: 2 Category 1 CE and .25 Pharmacology CE for Washington NDs. 

Dosing insulin is a complex process, not to mention one that many doctors and patients resist. Dr. Stanislaw will cover when and how to start a patient on insulin, how to overcome common barriers, the differences between the many brand options available, the difference between rapid and long-acting, pros and cons of pump therapy,, how to set an insulin to carb ratio but why carb counting at meal times to determine an accurate dose is not enough, how to use a correction factor, ways to make insulin peak faster, how to avoid insulin stacking, how to keep blood sugar steady during exercise, doctor versus patient responsibilities when on insulin, and more. Insulin is a potential lethal drug if not dosed properly. However, the strategy given to most patients who inject insulin is to either take a set daily dose, without instruction on when/why/how to adjust it, or use a dosing formula based solely on how many carbohydrates are about to be consumed. Neither is a solid strategy for achieving healthy blood sugar control given the many variables that patients experience in day-to-day life which affect how injected insulin functions in the body. This discussion will highlight the countless and often ignored variables that doctors, and patients should consider before dosing insulin.

Estimated CE credits: 1.5 Category 1 credits, including 1.5 Pharmacology credits, for Washington-licensed NDs. 

This session will review the safe clinical uses of Atropa belladonna, Hyoscyamus niger, Colchicum autumnal, Aconitum napellus, and Gelsimium sempervirens. We will review specific indications, toxicity concerns, and sample formulas demonstrating expected usage of this prescription-only botanical agents.

Estimated CE credits: 2 Category 1 credits for Washington-licensed NDs.