For those of us who always asked too many questions.

I was the Naturopathy student who arrived in the first lecture as a Medical Scientist. I remember I was wearing a suit (cringe), I was 24 and had a good amount of years working in science behind me. I went in very committed, but sceptical. Very impartial, and cautious. I needed an abundance of convincing about certain modalities. Twenty years later, I’m still not convinced by some of them. Over those 4 years, I did find the science, and if the lectures did not cover it, I knew where to go to find it. Naturopathy is deeply scientific, and it is a deeply human art, like Medicine. At some point, both were the same, and then a split occurred.

For me, it all began with -ologies.

As a child and teenager, I was fascinated by the human body, by animals and our organs. We are all colonies of trillions of individual cells, each one governing something extraordinarily specific, communicating, responding and adapting. If a lesson or book mentioned bacteria, disease, organelles, or any type of ‘-ology’, I was hooked. I recall a memory of being in the local hospital for year 10 work experience at age 15. I was doing hospital pharmacy, and I visited the hospital pathology lab with my ‘boss’ for the week, John. There were so many “ologies” listed in a directory on the wall. I recall this vividly, I was in love with the words, and I just wanted to know MORE. I did not become a pharmacist.

I was also a student of classical ballet and dance. In the repetitive discipline of learning to move and move properly, with precision and intention, some days went smoothly, yet others were very difficult. We would get injured, and some of us would heal faster than others. We would practice and rehearse through colds, flu’s and general illness, and some students became very run-down. It just got me thinking, even as a kid: the body responds to all kinds of inputs. Correct movement, decent rest, illnesses, our meals, stress/being upset about something. The body is not a static entity you diagnose and fix. It is a dynamic, responsive, constantly adapting system of systems.

I had extraordinary school teachers.

In primary school, it was a teacher who took us outside, into nature, and taught us to pay attention. In high school, it was two science teachers who gathered a small group of us, the ones who asked too many questions, whose minds were a little too intense in class, who were clearly having lots of fun talking about science with each other. These teachers pushed us and expanded our minds, they didn’t simplify things for us, they went deeper and wider. I feel so very lucky to have had this. I attended public schools in regional NSW for all my school years, just as an aside :) I have been trying to be this type of learner and disseminator of knowledge ever since. Someone who asks, “yes, but why”, and someone who analyses endlessly until the details emerge.

When it was time to choose a direction, I chose Medical Science. Medical Science is four years of the foundation of a medical degree. After graduating, I worked in hospitals, research laboratories, and the Australian Institute of Sport. I ran a lab. I analysed pathology results and reports. I talked to Doctors about their patients. I talked to patients. This was when I realised, I loved the people. I loved the clinical conversations, I loved the patients, and I loved the detective work. I loved the mechanisms and the WHY behind their presentations. And, somewhere in the back of my mind, I wanted to know what they were eating, and if they were moving. I actually have my time at the AIS to thank for this.

I knew I needed to return to university, for something more clinical. More focused on the human being, not just their results from the lab. I considered Medicine. Actually, I considered it more than once, and I did take the GAMSAT once. But what I actually wanted was not Medicine. I spent a year observing consultations with Dietitian's. I felt resignation when I realised what I wanted didn’t exist yet: a degree in Preventive Medicine, in the biochemistry of how our lifestyle shapes disease. In 2003, that wasn’t a medical specialty. It barely even had a name. Naturopathy was the closest thing I could find.

I want to be honest about my entry into Naturopathy.

If you’re a GP reading this, your opinion of Naturopathy might be neutral, or negative. When I was a student, opinions were largely negative. It was the early 2000s, and there was abundant contention around Naturopathy education in university settings. If you’re a Naturopath reading this, you may be surprised by what I’m about to say.

I studied Naturopathy with a twitchy eyebrow that rarely came back down.

The scientist in me never left. I questioned everything. There are modalities that made me feel uncomfortable, and they still make me feel uncomfortable. I have never used them and never will. But here is what Naturopathy gave me that nothing else could: wholefood-based nutrition. This is everything, it was so much better than anything I had observed previously. Phytochemistry. Nutritional biochemistry. Phytopharmacology, Philosophy. The Anatomy and Physiology I loved, revisited and revised all over again with clinical eyes and a few years of professional Medical Science experience behind me. It provided a philosophy for medicine that asked three very important questions:

1) What is happening upstream?

2) What created the conditions for this disease?

3) What does the body need to restore its own capacity?

The lecturers I had the privilege of learning from were as good, if not better, than many of my medical science lecturers. I continue to be in awe of many of them, 25 years later. I’m so grateful for those four years, they were exactly what I was looking for, with the discerning mind of still being able to ask, yes, but why? It was a form of Lifestyle Medicine, whilst it was still being ridiculed, dismissed and attacked by many. At some point in our history, conventional and natural medicine were not so far apart. We branched. But the underlying questions, the mechanistic, biochemical, and physiological questions, those never changed, we all ask those questions. And those are the questions I never stopped asking. I know I annoyed a few of my lecturers on certain topics!

Last year, I finished my Masters in Lifestyle Medicine. With distinction.

I am now a Fellow of Lifestyle Medicine. I wrote a thesis on mitochondria. I remember doodling mitochondria in my notebooks at school. I tell you this because I want you to understand my own through-line. You have your own extraordinary academic journey and credentials, and I respect them deeply. As a little kid obsessed with science, I didn’t grow up and select a lane. I have just kept following the science, wherever it leads. I completed my HSC 30 years ago this year, and I suspect I’ll be following the science for at least another 30 or more. I am not sure where it will lead next, but it's coming, and there is nothing I want to do more than learn with people like us.

Just last Friday, following science led me to a mitochondrial health summit that stopped me in my tracks. A doctor stood up and presented some research that made every neuron in my brain stand to attention:

“We may not need to treat gut dysbiosis anymore.”

And then, she made the methodical and rigorous case for WHY. Everything I have been thinking about for twenty years: the stress response, the gut, our mitochondria, the upstream mechanisms that conventional medicine and natural medicine have both been circling without quite connecting, it’s coming together in a way I haven’t stopped thinking about since. I thought not just about patients, but kids of my friends who are struggling with weird symptoms that I suspect are mitochondria-related, but now I feel certain. The mitochondria-microbiome axis, the stress-dysbiosis loop, and why the most powerful gut intervention might have nothing to do with the gut at all. It’s the impact of light and auditory deficiencies on our gut health, the impact of emotional stress, physical stress, poor sleep, sedentary lives, screens, water quality, food choices, in person connection, social health, meaning and awe. Our inputs. Probiotics are OK and more fibre is fine, but they will never work completely. We need to get the mitochondrial inputs correct, and we are doing a huge disservice to health if we are not recommending basic mitochondrial health practices.

Every single pillar of Lifestyle Medicine targets and supports our mitochondria, and mitochondrial dysfunction is often the driver of disease, it is NOT the downstream consequence of pathology, though this is true and is part of the vicious chronic disease cycle. Yes, the old joke of don’t go to a Naturopath or LM Dr if you are haemorrhaging to death or having a heart attack, that’s never changing, go to the ED. But in everyday practice settings, I know we are facing a tsunami of chronic, non-communicable disease presentations. It is getting worse. But we have reason to be open and pliable to LM interventions that support mitochondria. Spend 5 minutes in the research, and you will see how robust it is.

The other thing is this. The same feeling that sometimes made me uncomfortable in a Naturopathy lecture raised its hand in my mind in the conference last week, but it was not a question this time. It was a frustration. Many of the interventions presume a few key things about the patient: a good income, high self-efficacy individuals with high self-determination or very informed family/carers seeking treatment, willingness to be very compliant, and a certain level of health literacy. Some of the interventions, while completely evidence-based, are costly. They won’t reach certain demographics, particularly those who desperately need them. That is where we come in, as practitioners, family members, and for ourselves. Food, sleep, type of light exposure, type of sound exposure, movement, grounding, connection, meaning, emotional health. So much of what we can do here is free, lower cost, and exquisitely simple. We just need to promote it, prescribe it, research it, and disseminate it.

The science and the evidence are NOT the barrier here. The dissemination is.

Writing Analyse now, I see clearly what I’m striving for. It’s depth, rigour and growth that I’m seeking, and I have wanted to write directly from me for 20 years. I have done this, but always for other organisations, for universities, for textbooks, or for journals. However, I want to be more direct with clinicians now, and I want it to be direct from me. I want to write with depth and rigour and awe, on the intersection of biochemistry, Lifestyle Medicine and clinical practice. I don’t like the common tendency to separate the mechanism from the intervention. The clinicians I respect and admire are intelligent, curious, deeply motivated humans. And I am trying to find you all! Knowledge should be like a decent meal, not a quick snack. If you are someone who asks “OK, sounds good, but WHY”? You are exactly like me. This was my thought, on repeat, spanning 12 years over three degrees. I’m proud to say that this has never left me.

Thank you for reading. I am glad you’re here.

- Annalies

PS: I'm very grateful you choose to read and learn from my work interests. Let me know your questions. I read them all, doing my best to incorporate these into future issues and podcasts. I don't take your time for granted. Thank you! If Analyse was recommended to you, and you have not joined yet, please consider doing so below. You are welcome to refer this to any colleague or friend interested in the mechanistic/clinical interface of Lifestyle Medicine, Orthodox Medicine and Naturopathy.

Be well,

Annalies

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