Help me figure out if my nutritionist is a quack
June 21, 2010 8:39 AM   Subscribe

Does my nutritionist seem like a quack? How can I tell if there is really anything left to gain by seeing her?

I started seeing a nutritionist after my older brother was diagnosed with type II diabetes. My dad and everyone else on the paternal side of my family over age 38 has type II diabetes, even those who seem to be in relatively good shape. I also have a strong family history of cancer, obesity, depression, anxiety & ADHD.

At first, I found it quite helpful. We talked about the priorities I should focus on in my diet, supplements that were worth taking, and questions I should be asking my doctor. She encouraged me to ask my doctor about getting my vitamin D levels checked, which I did and found that I am seriously deficient in vitamin D.

However... I'm starting to wonder if she's starting to go off the rails with me a bit. For starters, even though I have seen an endocrinologist, had ultrasounds and comprehensive testing on my thyroid done (I have a slight goiter and always have), she's still convinced that I have a thyroid problem that should be treated. She also keeps talking about "managing inflammation" and doing food sensitivity tests. She's also started mentioning supplements and food bars she sells, with low pressure but at every session. I am particularly skeptical about the food bars because they are loaded with soy protein and sugar alcohols, neither of which I have any reason to believe are particularly healthy.

I can't find any clear cut information on whether this type of stuff on inflammation and food sensitivities is kind of quackish or legitimate. I've read a few books that touched on these ideas, and they seemed to really encourage unrealistic behavior. Does anyone have any thoughts or experiences with this stuff?

I've looked at QuackWatch and tried other searches, but so far haven't found any clear cut information that did not seem to have an agenda. I guess I am just feeling like maybe at this point I am throwing money away and need to just focus on applying the things I've learned that DO make sense to me to my daily life.
posted by tastybrains to Health & Fitness (17 answers total) 1 user marked this as a favorite
 
Maybe you should find another nutritionist and see what the new one says. Her trying to sell you on products seems fishy to me.
posted by anniecat at 8:46 AM on June 21, 2010


Is she a "nutritionist," or a registered dietitian? (What are her professional and clinical qualifications to give nutritional advice?)

How did you come to find her?
posted by FergieBelle at 8:47 AM on June 21, 2010 [2 favorites]


If she's so concerned about your thyroid, she wouldn't be pushing the soy proteins on you. High concentrations of soy isoflavones are not good for folks with thyroid conditions. I'd change nutritionists if I were you.
posted by rtha at 8:50 AM on June 21, 2010 [2 favorites]


> ... supplements and food bars she sells
No dedicated health professional will sell you products directly.
posted by scruss at 8:50 AM on June 21, 2010 [13 favorites]


I wouldn't entirely discount the food sensitivity thing, although I don't know if she's like "your meridians are misaligned" or "studies have shown that X can lead to Y." I've known multiple people with various sorts of depression and autism issues who have seen some success with lowering sugar and carbs or gluten, etc. Who knows; they're very individual things, but if it works, it works.

But I agree that the selling of supplements, etc. is fishy. I used to go to a gym where the guy sold his own equipment and advocated shakes with whey protein, etc., but he never pushed particular brands other than "this is the one we sell here, so it's handy."
posted by Madamina at 8:51 AM on June 21, 2010


She is a registered dietician. I found her through my therapist's office.
posted by tastybrains at 8:52 AM on June 21, 2010


In the US, a "dietitian" has a minimum education standard and is a legally protected term. You can't legally call yourself a dietitian without getting certified and licensed. On the other hand, who a "nutritionist" is depends on your state legislature. Some states have minimum requirements, other states anyone can claim to be a "nutritionist" without having undergone any certification.

She's also started mentioning supplements and food bars she sells, with low pressure but at every session.

Now, nutritionist or dietitian, that's a walking, talking red flag. Find yourself a qualified and registered dietitian. Here's a link to your state's Dietetic Association. They'll be able to help.
posted by griphus at 8:58 AM on June 21, 2010


Sigh, should've previewed. Either way, the selling-you-stuff is a red flag.
posted by griphus at 8:59 AM on June 21, 2010


Honestly, the kind of line this dietician is giving you is exactly the kind of thing you hear at LA Weight Loss and similar companies that sell their own bars, shakes and supplements as diet aids. Thyroid, "inflammation management" and food sensitivities are all also buzzwords in places like those for reasons why people aren't losing weight.

Reading between the lines, I'm hearing this lady telling you that she would like to see you lose weight. But she seems unwilling to broach the subject directly.

If this were me, I'd get this into the open. Tell her politely but firmly that you are NOT interested in the supplements and bars. Then ask her point blank if all her talk of thyroid and inflammation is related to some concern she has about your weight. You may even want to point out to her that you'd prefer she address concerns directly rather than through "back door" methods like the ones she's using now. At least this way, you can have a frank discussion with her about your (and her) priorities going forward and come to some agreement.
posted by LN at 9:03 AM on June 21, 2010


Do you have any of the other symptoms of thyroid disorder?
The "what's normal" for thyroids is still in a lot of flux, as there are quite a few people who 'test normal' for thyroid disorders, but have the physical symptoms, and perk up with treatment. It's the kind of hazy-edge that nutritionists love to champion.
Other than that...

Depends how she's testing for 'food sensitivities'? Do you feel healthy?
Is she suggesting blood tests/food elimination diets, or something more wack? When it comes down to it, she's going to keep trying to provide you a service, probably even after you need it, so if you feel good, work on your current recommendations, and maybe check in with her in 3-6 months, by which point you might both have something new to discuss.
:)
posted by Elysum at 9:09 AM on June 21, 2010


"Managing inflammation" is one of those concepts that sounds exciting but doesn't have a lot of meaning (like "boosting the immune system"--a lot of problems, like allergies, are due to a too-ACTIVE immune system). Inflammation has a purpose, and some inflammation is necessary and useful. You *want* your body to be able to respond with inflammation when it's appropriate. There are people who think that inflammation is the source of all evil humors in the body, though, and that's a kind of wackiness.
posted by galadriel at 9:09 AM on June 21, 2010


I wouldn't necessarily say it's a red flag that she sells supplements and nutrition bars. I used to work for a very sincere, really great doctor who recommended dietary solutions to some of his patients' problems, and we sold some of the vitamins and supplements at the office. He didn't care if they bought them elsewhere; he just genuinely felt that patients could benefit from supplements and made them available in the office for convenience's sake. He made very little money on them.

I don't know what's going on with your nutritionist, but it is possible that she just believes in the product and thinks it will help you. Whether you (or a different nutritionist) would agree is a different matter completely.
posted by something something at 9:11 AM on June 21, 2010


She's also started mentioning supplements and food bars she sells

This is always a potential red flag. Consult with another nutritionist.
posted by davejay at 9:51 AM on June 21, 2010


I agree with others about your thyroid. There are other things to look for, I have low thyroid and had body aches, my hair fell out, my memory was shot, no energy, depression. And I take medication that, for the most part, straighten it out. I think your endrocrinologist is the person to guide you on that. And soy is not good for people with thyroid problems.

Also, have you ever considered a DO? I was totally closed minded about these folks, until my husband had knee replacement, and his docs were DO's. They did a blood screen as a routine part of their care, and found him low in Vitamin D and B12. It was pretty great.

Andrew Weill has some interesting information on inflamation that may be worth checking out. But these people are right, it is getting to be a buzzword.
posted by chocolatetiara at 10:27 AM on June 21, 2010


As my brother once memorably explained to me, saying you have "inflammation" is like saying you have "-itis." It doesn't mean anything unless it's referring to a particular system or part of your body.

It is a major ethical breach for a health care provider to sell supplements, ESPECIALLY to his/her patients. This person needs to be fired, and then reported to whatever regulating body controls dietitians in your area.
posted by overeducated_alligator at 11:13 AM on June 21, 2010


There is thought to be a link between inflammation and insulin (in)sensitivity, but I'm extremely wary of medical professionals who try and sell me products as opposed to services. Without understanding why a diet is important, how could one possibly stick to it?

I would definitely find a new nutritionist/dietician/nutrition doctor. You may want to start with the patient education classes at Joslin Diabetes Center affiliate at Southern New Hampshire Medical Center.
posted by BrotherCaine at 1:49 PM on June 21, 2010


Thanks all for your feedback.

When it comes down to it, she's going to keep trying to provide you a service, probably even after you need it, so if you feel good, work on your current recommendations, and maybe check in with her in 3-6 months, by which point you might both have something new to discuss.

I think the above is probably right on the money ... there really isn't that much more for me to do with her, since I've pretty much gotten the information I needed on changing my diet to lose weight & reduce diabetes risk. It seems like she's just fishing for new things to keep "offering" me so that I continue to see her, or something. Because these appointments are not covered by my insurance, I think my gut feeling & the responses here have pretty well convinced me that my money would be spent better elsewhere.
posted by tastybrains at 7:25 AM on June 22, 2010


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