I continually take education courses. Most of them are updates on this or that illness. Sometimes I take ‘side courses’ to learn topics I don’t treat but are nevertheless important to know. Currently I am relearning Nutrition. My medical school was proud ‘it was one of the few medical schools that offered a course in nutrition”. I recall it wasn’t that long or practical. And it was 25 years ago. It makes me wonder how little physicians know about this oh so important topic.
One of the leitmotifs of the course is we tend to eat high caloric foods without much nutrition, and then we try to supplement the rubbish with vitamins, usually too much. By asking my patients ‘do you take any vitamins?” I am uncovering all sorts of things. Mind! Patients are sometimes referred to me because they have a physical problem all the tests can not diagnose. Thus, their somatic problems are labelled ‘psychosomatic’. Patients are often irritated by this, feeling they have been ‘dumped’ as screwballs. I educate patients the majority of complaints do not have specific etilogies (alas).
Here is where the nutrition course helps. I now ask what supplements and vitamins my patients take. Bingo! Their gingko or daily aspirin is the cause of their bleeding. Too much vitamin C is causing that diarrhea. Their megadoses of B vitamins are producing the ‘hysterical’ numbness/tingling and loss of strength
My “favorite” so far < IBS/constipation coming from taking too many laxatives.
By telling patient to lay off the mega doses, their ‘psychosomatic’ problems dissipate and I look a genius.
I think from time to time I will pass on some what I learn in this course. I am about to get to dieting/exercise/and the care of obesity.
After this course, I have “Stress and the Body”. Won’t that be jolly good fun!