Progesterone is a female sex hormone produced by the ovaries that helps balance the menstrual cycle. It is important in fertility as it is released by the ovaries after ovulation to thicken the uterine lining to help accommodate a fertilised egg. It is not only needed for pregnancy but also as an antidepressant, calming agent, regulate blood sugar levels and to balance out oestrogen.
Symptoms of low progesterone
PMS and mood swings
Irregular periods – Heavy bleeding, painful cramping etc.
There should be the right balance of oestrogen and progesterone. However, a hormonal imbalance resulting in low progesterone levels may increase oestrogen dominance. Because of the increase in exposure to xeno “bad” estrogens such as plastics in day to day life, this type of hormonal imbalance with low progesterone is quite common. Progesterone is also needed to protect against the negative effects of excess oestrogen which is why it is important to address hormonal imbalance.
A mental health care plan is a plan that your GP writes about treating and managing a mental health condition.
It enables you to access certain allied health professionals, such as psychologists, social workers or occupational therapists who can provide you with psychological support.
Mental health care plans are a part of the Better Access initiative, which aims to improve access to mental health care services through Medicare.
Am I eligible for a mental health care plan?
You are eligible for a mental health care plan if you have a mental illness or mental disorder that has been diagnosed by a doctor.
If you are experiencing mental health issues but you have not been diagnosed with a mental health disorder, you will need to see your GP for a mental health assessment to determine whether you are eligible for a mental health care plan.
What is a Medicare rebate and how much do I get back?
A Medicare rebate is when Medicare refunds you part of the cost of your appointment. If you have received a mental health care plan referral from your GP, this enables you to claim a Medicare rebate of $84.80 for a general psychologist or $124.50 for a clinical psychologist per session.
If you are not eligible for a mental health care plan, you may be eligible for a enhanced primary care (EPC) plan. With an EPC plan, you will receive a rebate of $52.95. These amounts are set by Medicare.
How do I claim my Medicare rebate?
Most of the time, your rebate can be processed straight after you’ve completed the session with your psychologist. You will be required to pay the total cost of the appointment first and then your refund can be processed.
You will need to have your Medicare card and a debit card (refunds cannot be processed with credit cards) with you for the rebate to be completed so please make sure to bring these with you when you attend your appointment to be able to receive your refund on the spot.
Alternatively, you can claim your Medicare rebate online through the myGov website.
How much am I out of pocket?
The ‘gap fee’ or the ‘out of pocket’ cost will depend on the psychologist’s fee. With a GP referral, you will still need to pay the difference between the psychologist’s fee for the session and the Medicare rebate. This amount will vary.
It is best to ask what the ‘gap fee’ is when you book your appointment.
Can I use my private health insurance as well as claiming a Medicare rebate?
You cannot use your private health insurance to pay for the ‘gap fee’. You can use your private health insurance to claim a partial rebate (depending on your level of cover) if you do not claim a Medicare rebate.
However, the two cannot be used together to pay for one psychological session.
Can I see any psychologist with a referral from my GP?
If you have a mental health care plan or an enhanced primary care (EPC) plan and would like to claim your entitled Medicare rebate, you must see a psychologist who is registered with Medicare and has a Medicare Provider Number.
Your GP can refer you to a specific psychologist or other mental health service, or, you can do your own research and choose a particular mental health professional you might like to see.
How many psychology sessions are covered under Medicare?
To access psychology services under Medicare, you need to have a referral from your GP, a psychiatrist or a paediatrician.
People who are eligible for a mental health care plan can receive up to 10 individual or group therapy sessions covered under Medicare in one calendar year (12 months from 1 January to 31 December). However, referrals do not cover all 10 sessions. With a mental health care plan from your GP, you are entitled to a maximum of 6 Medicare rebatable sessions.
If you complete these six sessions within the calendar year and need to continue treatment with your psychologist, you will need to visit your GP for a mental health plan review. Your GP will determine whether further sessions are needed and if so they will provide another referral for the remaining four sessions.
What happens if I complete all 10 sessions within the calendar year?
If you complete all 10 sessions within the calendar year, you can still see your psychologist for psychology services, however, you will not be able to claim the Medicare rebate using your mental health care plan.
If your mental health practitioner recommends to continue treatment, you may be eligible for an EPC plan.
An EPC plan enables you to claim a rebate of $51.95 for a maximum of 5 sessions per calendar year through Medicare.
If within the calendar year, you use all 10 sessions on your mental health care plan and you still wish to continue treatment with your psychologist and receive Medicare benefits, you will need to see your GP for a mental health review to determine whether you are eligible for an EPC plan.
Once a new calendar year begins (1 January), you can visit your GP for a new mental health care plan.
Do I need a GP referral to see a psychologist?
You do not need a referral from your GP to see a psychologist. If you see a psychologist without a GP referral, you will be required to pay the full amount for your session.
If you have private health insurance with psychological counselling as extras, you may be able to claim a partial rebate. It is best to contact your private health fund for further information about your coverage.
If I am already seeing a psychologist, can I access Medicare benefits?
If you have been seeing a psychologist and paying for your sessions out of your own pocket, you will need to visit your GP for a mental health assessment to determine whether you are eligible for Medicare benefits.
Can I receive 100% Medicare Bulk Billed sessions?
We do offer a limited number of bulk billed sessions per week to cater to those who are under financial strain. You will need a mental health care plan and it is subject to eligibility and availability. Please contact us for more information.
Featured in the October 2018 edition of Holistic Bliss Magazine
Authors: Kate Mason and Suzi Le Fanue
Gut decision may seem reckless and impulsive but did you know you have more neurons in your gut than in your brain?
The gut brain connection is the communication between your digestive tract and the central nervous system. This is known as the gut-brain axis which enables your gastrointestinal tract to send and receive signals to and from your brain. The foods we eat and absorb translates to how we feel, think and act.
Our digestive system contains a large community of microorganisms such as bacteria, viruses and fungi known as the gut microbiome. This microbiome is the key mediator between the gut and the brain. These organisms feed on nutrients from foods we consume and produce compounds in the body that can affect the way we feel and function.
Neurotransmitters are chemicals and they are made from protein and nutrients we absorb from our diet. If your diet is lacking sufficient protein and nutrient dense foods you may find yourself feeling more anxious, depressed, tired and unable to sleep deeply.
Approximately 95% of the body’s serotonin (our happy neurotransmitter) is produced by our gut microbiome. So when digestive bacterial balance is disrupted, a condition termed dysbiosis, you may be more prone to conditions associated with imbalanced happy chemicals such as anxiety, low mood, low energy and depression.
Another factor that can affect the brain-gut connection is SIBO, small intestinal bacterial overgrowth. It is an extremely common digestive imbalance, however, is rarely investigated or diagnosed.
The digestive tract contains over one kilogram of microscopic bacteria, usually made up of good bacteria such as lactobacillus and bifidobacteria and other bacteria that don’t provide benefit and/or cause harm, bad bacteria.
SIBO occurs when there is an overgrowth of BAD bacteria in the small intestine. This overgrowth means that before the villi can release enzymes to break down food, the bacteria will feed off the food you are consuming and cause it to ferment.
Do you have gas and bloating after meals? Cramping, diarrhoea or constipation? This could be SIBO.
SIBO causes the release of gases, such as hydrogen and methane, which cause the IBS like symptoms of SIBO. These gases also cause damage to the fragile villi on the gut lining meaning that nutrient absorption is compromised, which after a period of time may exacerbate hormonal balance, neurological issues, fatigue and sleep problems.
Many cases of IBS are actually cases of SIBO or both, they produce similar symptoms.
A breath test is a simple, non-invasive, and extremely accurate test that detects bacterial overgrowth in the small intestine.
We mustn’t forget the importance of addressing your mental wellbeing when working correcting gut imbalance. An imbalance in stress hormones such as cortisol is known to affect gut function and nutrient absorption.
Essentially, it’s important to address both the gut and the brain when looking to correct an imbalance of either mental or digestive health as they both affect each other.
Kate Mason & Suzi Le Fanue Naturopaths at Integrated Wellness Clinic
In certain circumstances there is a place for pharmaceutical intervention, however, do medications really address all facets of mental health? Mental Health is so multidimensional – there are many neurotransmitter, hormonal, biochemical imbalances, lifestyle and psychological factors that an antidepressant simply cannot address.
Nutrition & Gut Health
All neurotransmitters are made from amino acids and nutrient cofactors. Amino acids are essentially from protein in your diet. For example, the production of the neurotransmitter serotonin, which is important for mood regulation, requires the amino acid tryptophan. This means it is incredibly important to make sure you are eating sufficient levels of protein. As well as this, over 90% of serotonin is found in the gut, and more and more research is confirming the link between the health of the gut and the health of the mind. The types and levels of bacteria in the gut have been shown to play a role in the production of serotonin.
Numerous genes have been linked to mental health conditions. One that has significant supportive research is the MTHFR gene, particularly the C677T polymorphism. This gene is fundamental in the process of folate utilisation. Low serum folate can be seen in those with mental health conditions, such as depression.
Pyroluria is a genetically determined metabolic condition characterised by elevated kryptopyrroles in the urine. It is thought that around 10% of the population have “pyroluria”. When pyrroles are high it can be more difficult to produce neurotransmitters like serotonin. This is because your body requires higher amounts of nutrient cofactors needed for neurotransmitter production, such as zinc and vitamin B6. Elevated pyrroles can be seen in the urine of many people with depression, anxiety, insomnia, alcoholism, IBS, anger, inability to cope with stress, strong fatigue and children with behavioural issues.
A Naturopathic Approach to Mental Health
We take an extremely integrated approach to treating mental health conditions. We consider all possible underlying causes, and work alongside other health professionals such as psychologists, counsellors, and GPs. Generally, treatment plans include pathology testing, nutrient analysis, improving gut health, lifestyle changes and the care of a psychologist.
Irritable Bowel Syndrome (IBS) Vs. Inflammatory Bowel Disease (IBD) – what is the difference?
You may have heard of these two common digestive disorders. They share many of the same signs and symptoms, but did you know there is a significant difference between the two?
IBS is a functional gastrointestinal disorder that causes a range of digestive signs and symptoms, most commonly altered bowel motions (diarrhoea and/or constipation) and abdominal pain. The cause is not well understood, and there is no diagnostic test, so IBS is usually diagnosed using a symptom checklist. Natural treatment of IBS can involve correcting gastrointestinal bacterial imbalance, identifying and avoiding foods that exacerbate symptoms, and reducing stress and anxiety. There are many medications that are prescribed to help control IBS signs and symptoms, however, there is no single drug that has proven to be effective.
IBD is an umbrella term for a range of diseases, including Crohn’s disease and Ulcerative Colitis. IBD is characterised by inflammation due to the fact that it is an autoimmune disease, meaning the body’s immune system mistakenly attacks its own cells. In IBD, this response takes place in the digestive tract, causing debilitating signs and symptoms, such as abdominal pain/discomfort, diarrhoea, constipation or both, and blood in the stool. IBD can be diagnosed through blood tests and endoscopy examinations. Medical treatment usually involves anti-inflammatory medication, immunosuppressants, or sometimes surgery. A natural approach to IBD aims to reduce inflammation, regulate the function of the immune system, and address environmental and lifestyle factors that worsen signs and symptoms.
Adrenal fatigue with our Sunshine Coast & Brisbane Naturopath
Are you just tired or do you have adrenal fatigue?
The common statements I hear range from “I am just so tired all the time, but I cant sleep” to “I just cant be bothered its all too hard”. Should you just sleep more, de-stress and take a vitamin B?
It is really a lot deeper than this most of the time.
Have you heard of adrenal fatigue? It can strike anyone, even if on the exterior they appear physically healthy and like they are totally composed.
Many question whether or not adrenal fatigue really exists. So this often makes it hard for those to know if they have it or not. Those with adrenal fatigue will often visit their doctor many times and feel as though many questions are left unanswered.
What sort of symptoms would you display if you had adrenal fatigue? The biggest one is obviously excessive fatigue. This may be accompanied with poor immunity, feeling run down, changes in blood pressure, difficultly waking up in the morning, low libido, mental fogginess, poor memory and irritability, particularly when overwhelmed. You will generally feel like it doesn’t matter how much you sleep, you will still be tired!
How does this happen? The biggest cause is long term stress and essentially burnt out. Our body is only suppose to be put into a stress response for a very short period of time. If on a day to day basis we are continually stressed, busy or overwhelmed the body keeps on producing massive amounts of the stress hormones from the adrenal glands. With time they fatigue and the production of the hormone, cortisol, reduces.
The big question is, what do you do if you have adrenal fatigue? These are just a few of the simple changes you could implement.
Reduce carbohydrates and remove refined sugar. Generally our diets sit too heavy towards carbohydrate. When you eat refined sugar, processed or simple carbohydrates your body releases insulin. This hormone causes your blood sugar levels to peak and then drop. Those with adrenal fatigue are usually more sensitive to these peaks and troughs.
I tend to recommend keeping carbohydrate to a low-moderate level (never very low) and making sure there is protein at each meal and at least 3 cups of low starch vegies to help balance your blood sugar levels. Getting your carbohydrates from sources like quinoa, sweet potato and pumpkin are generally better sources than the grainy types.
Eat smaller portions. You may also benefit from eating 6 smaller meals over the day rather than 3 big meals to help balance your blood sugar levels. And reduce the heaviness of food as the day goes on, to assist in the digestion of your food. A stressed gut can impact the adrenal glands.
Increase the vegies. Ensure you are eating plenty of colourful vegies and high antioxidant fruits in your diet. Fantastic fruit examples include berries and kiwi fruit. I always say your shopping basket should look like the rainbow. Of course, only natural colours!
Cut out the caffeine. Your morning coffee may feel like it is giving you a boost, but that is very short lived. It is adding pressure onto your adrenals and over the long term can contribute to fatigue. It may seem like it isn’t important to cut out, but if you do have any form of fatigue it is an important factor to address.
Add in some gut boosting goodness! Bone broth is incredible. It contains an abundance of anti-inflammatory, immune boosting and gut healing nutrients. You can use it as either a base for soups and cassoroles or sip as a hot drink.
Brew some tea. A combination of licorice and Siberian ginseng is a blend that comes to mind. A tasty combination and great for a subtle pick up.
So if you are presenting with these sorts of symptoms I always recommend requesting to have your adrenals and the nutrients essential for adrenal function tested with both the assistance of your GP and Naturopath. We generally prefer the hormone cortisol to be measured over the day and not just a single sample to see where your adrenals function at their highest and lowest. Following this a plan can then be customized based on those results and your presenting symptoms.
Most people welcome spring with open arms, embracing the warmer and longer days, flowers blossoming and summer on its way, but for others spring is a time of the year they would prefer to hide from. Seasonal allergies are often triggered at this time of the year with wood smoke from burning off, allergens in the air such as pollen and with the humidity beginning to rise, mould also becomes an aggravating factor. So what can we do to help reduce our response to these?
You may have been told that you could benefit from using mucolytic remedies, but what does that mean? Mucolytics break up mucus and help your body then expel it and include fennel, ginger, cinnamon, aniseed, garlic and pineapple. What is also particularly beneficial about pineapple is that the whole fruit (core included) contains bromelain that acts as a powerful anti-inflammatory as well as mucolytic. Nasal sprays can be a godsend for some, especially if they include xylitol and saline to help reduce nasal dryness and clear build up of thick mucus. Essential oils often used in nasal sprays include thyme and tea tree which also help reduce the bacteria from growing and adhering to the nasal passages.
It may seem like a distant connection from the nose to the gut; however intestinal and nasal bacteria balance is also important when treating sinusitis.Prebiotics and probiotics help ‘keep the balance’ and disruptions to this beneficial microflora may exacerbate allergy symptoms. Over 80% of your immune system is in the gut, so keeping this nice and healthy is very important in controlling seasonal allergies.
Some of the major dietary factors that exacerbate sinus include dairy products,salicylates, wheat, wine, sulphites , MSG (just to name a few!) and each individual may be sensitive to one and not another. The take home message of managing your allergies during spring is minimising your triggers, checking in to see that your diet is highly anti-inflammatory and free of any personal allergens, spring clean your home with chemical-free cleaning products to minimize triggering allergenic responses.
It almost goes without saying add as many stress-reducing strategies to your day to help nurture your nervous and immune system. Stress is known to affect the inflammatory response in the body. Ensure you are looking after yourself, resting when needed and enjoying “me time”.
How Well Do You Handle Stress? Living in this day and age, stress is a normal part of modern life. You will be exposed to some sort of stress every day, whether it’s waking up to an alarm, sitting in traffic, paying bills, working, meeting deadlines – all of these can take their toll. Thankfully, the body has an amazing, protective stress response system to help you cope. The stress response was historically designed to kick in to save your life; nowadays, your stress response is being activated every day rather than just when you come into contact with a sabre tooth tiger! However, this ongoing activation by your nervous system can lead to symptoms of stress and mood disorders that are becoming increasingly common.
Recognising the Signs of Stress Depending on the type of stress and how long you have been experiencing it, you may be familiar with some of these signs and symptoms.
Signs of acute stress – Muscle tension, Increased heart rate, Sweating, Energy fluctuations, Alertness, Sleep disturbances
Signs of ongoing stress – Fatigue, Sleep disturbances, Worrying, Sadness, Irritability, Poor concentration, Weight loss or gain Getting the Right Tools
When you are under stress, your overworked stress response system requires even more nutrients than usual. This is because your body needs vitamins and minerals to produce the hormones and neurotransmitters (the brain’s messengers) required to adapt to the stress and bring the body back into balance.
B group vitamins: B vitamins are needed for healthy mood, motivation and wellbeing. They are vital for producing energy, as well as the neurotransmitters that promote happiness, relaxation and sleep.
Magnesium: When you are stressed, your body may require more magnesium than normal. Magnesium can be beneficial for many things including managing stress and improving energy. You may also know that magnesium is used as a muscle relaxant. Due to its relaxing qualities, it may improve mood and sleep.
Taurine and glutamine: These amino acids are required as building blocks for your neurotransmitters. They can also help to calm the nervous system, as well as protect against the damage that stress can cause.
Setting Up the Foundations Now that you know which nutrients can be great for use in times of stress, eating a nutritious diet can help you to maintain the health of your nerves long-term. What happens to your diet when you’re stressed? Do you eat a lot, or do you make poor food choices when short on time or patience?
During times of stress, sugars and refined carbohydrates are a no no! While they provide quick energy, they do not fuel your body with nutrients it needs to cope with stress, and can ultimately lead to weight gain.
Protein from fish, lean meats, eggs, legumes and nuts can provide you with amino acids to fuel your brain whilst sustaining you for longer, minimising those stress cravings.
Fish, in particular, contains both protein and essential fats, otherwise known as omega-3 fatty acids which can support a healthy stress response and healthy mood.
Be Strong Against Stress! If you are interested in strengthening your mind and body to become more resilient to the effects of everyday stress, book in to see one of our knowledgable and friendly Naturopaths and/or Nutritionists.
We use the ‘Healthpoint‘ health fund rebate system in the clinic our accredited Naturopaths have current health fund provider status. This means if you bring your card to the consultation you can usually claim your rebate on the spot using our Healthpoint terminal, and only pay the gap on your consultation. This helps you see your health fund benefit sooner.