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 0.15 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 credits: 1.5 Category 1 credits, including 0.15 Pharmacology credit, for Washington-licensed 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 0.25 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 credit: 1 Category 1 credit for Washington-licensed 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. 

While eczema is a complicated disease with multiple underlying pathologies, there is abundant evidence that a large part of the underlying root cause of eczema stems from gut microbiome dysfunction. This presentation will present the latest published research on the gut/skin connection as well as an overview on how to use functional medicine tests like stool tests and organic acid tests to determine and treat the root cause of eczema. In addition, new advances in pharmaceuticals, supplements, and botanicals for treating eczema will be covered. Eczema doesn’t just affect infants and kids; many people suffer with eczema well into adulthood. Dr. Greenberg will present several eczema case studies with before and after photos and lab results. Attendees will leave this talk with an arsenal of new evidence-based clinical tools to confidently treat their patients’ toughest eczema problems using naturopathic medicine.

Estimated CE credit: 1 Category 1 credit, including 0.15 Pharmacology 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.

Estimated CE credits: 2 Category 1 credits, including 1 Pharmacology credit, 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 0.15 Pharmacology credit, for Washington-licensed 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 credits: 1 Category 1 credit, including 0.15 Pharmacology credit, for Washington-licensed 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. 

Over the past century, cumulative decisions made on prioritization of biochemistry research, changing seed varietals, chemically growing foods and food processing have combined to substantially decrease the diversity of molecules in the food supply. They were lost because they were considered “unimportant” for life and therefor did not need to be conserved as modern agriculture evolved. A considerable amount of research now shows that these “unimportant” molecules play many critical roles in health maintenance and disease prevention. Just like in plants, these diverse molecules are antiviral, antibacterial, protect against oxidative stress, prevent cancer, promote mitochondrial function, increase excretion of toxic chemicals and metals—the list is long and growing and clinically very important.

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

Through a series of case studies, you will learn an up-to-date naturopathic approach to evaluation, testing, treatment and re-evaluation for those suffering with dementia. You will also learn the history of dementia and why NDs are best positioned to meet the needs of a growing population suffering with dementia. You will understand the conventional approach to the treatment of dementia, learn the clinical course to chart and what to expect as your patients move through the process of applying precision and lifestyle medicine to reversing cognitive decline.

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

Irritable bowel syndrome (IBS) is THE most common gastrointestinal diagnosis, with an estimated 10-15% of adults in the United States experiencing symptoms consistent with this condition (Camilleri, 2021). Since the Rome IV Criteria were published in 2016, IBS is no longer considered a diagnosis of exclusion, and is instead diagnosed based on a set of clinical criteria. While this has decreased barriers to diagnosis and increased timeliness of treatment, it is also leading to a likely OVER diagnosis of IBS. There are many conditions that can present quite similarly to IBS that are not routinely assessed for in most preliminary clinical work-up, including Exocrine Pancreatic Insufficiency & Bile Acid (Salt) Malabsorption. This presentation will review these commonly missed diagnoses, with a focus on clues to recognize clinically and integrative management plans.

Estimated CE credit: 1 Category 1 credit, including 0.2 Pharmacology credit, for Washington-licensed NDs.