From Rationalwiki | Against allopathy Alternative medicine |
| Clinically unproven |
| Woo-meisters |
“”Naturopathy is a cornucopia of almost every quackery you can think of. Be it homeopathy, traditional Chinese medicine, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine, it’s hard to think of a single form of pseudoscientific medicine and quackery that naturopathy doesn’t embrace or at least tolerate.
|
| —David Gorski[1] |
Naturopathy, or naturopathic medicine, is a field of practice in healing and maintaining health wherein practitioners use various "natural" remedies to treat their patients. The main idea behind naturopathy is that it supposedly helps the body's own self-healing process; this is based on the pre- and pseudo-scientific theory of vitalism, according to which the body has some sort of "energy" that is necessary for one's health. Naturopathic medicine disfavours surgery and drugs, preferring more friendly and fuzzy treatments like herbal medicine or outright woo such as "natural energy fields". Unlike medical or osteopathic doctors (M.D. and D.O, respectively), naturopathic doctors (N.D.) are not universally regulated,[2] so on this page the term naturopath is used for both licensed and unlicensed practitioners of naturopathy.
Naturopathy doesn't have any real standards; what therapies one can expect from naturopathic care can vary wildly from practitioner to practitioner,[3] and are very often contradictory. Some naturopaths, like nutritionists, may give quite good advice ("eat fruits and vegetables"), mixed with concepts that have no basis in reality, such as homeopathy, Reiki, unproven supplements, or whatever fad diet they happen to believe in. (The practice of naturopaths themselves selling their patients supplements is widespread and in fact encouraged by naturopathic organizations.[4] No conflict of interest there at all.)
Naturopaths also very frequently claim to be holistic, meaning that they listen to their patients and sympathize with them, rather than just coldly treating them without any regard for their feelings. They "focus on the patient, not the disease". Which is actually pretty accurate, given that more often than not the "treatments" have no effect on the disease anyway.
Naturopathy claims ancient roots based on the Hippocrates quote, "vis medicatrix naturae"
("the healing power of nature"),[5] but in reality it was cobbled together by a German immigrant to the United States named Benedict Lust. Lust used "Dr." before his name and claimed to have a degree from the New York Homeopathic Medical College in 1901 and a degree in osteopathy in 1902 from the Universal College of Osteopathy in New York,[6] but there was no evidence that he was licensed for anything in the state of New York and he was convicted there of practicing medicine without a licence.[7]:122 Lust was aware of the German Lebensreform
movement that had begun in the 1870s (he had translated one of the movement's books in 1903[8]) and the movement was undoubtedly an inspiration for his own writings.
The term "naturopathy" was coined by Lust's colleague, John Scheel, in 1900. Lust popularized the term through his publications, by opening the first naturopathic school (the American School of Naturopathy in New York City), and from the establishment of health resorts known as "Yungborn" in Butler, New Jersey and Tangerine, Florida.[6]
Lust credited several men who preceded him for the development of naturopathy, including Sebastian Kneipp (popularizer of the Water Cure), Friedrich Eduard Bilz (who wrote the book Das Neue Naturheilverfahren[9] (translated as The Natural Method of Healing in 1898[10]), and Louis Kuhne (see below).[11]
By 1918, Lust included the following fields of treatment quackery within naturopathy in his book Universal Naturopathic Encyclopedia: electro-medicine, radiology, ozone therapy, magnetic field therapy, light therapy, vibration therapy, milk diet, chiropractic, raw foodism ("apyrtrophy"), fasting, hydrotherapy ("The Water Cure"), "astroscopy" (astrological medicine), phrenology, Christian science, iridology, diagnosis by facial expression, and "chromopathy" (color therapy).[11] The main ideas during the Lust-era of naturopathy (roughly 1900 to 1945) were all-inclusiveness — all natural "cures" were of value and to be included under the umbrella of naturopathy, and "drugless healing" in the form of strong opposition to the medical establishment.[11]
Lust's views on what is and is not naturopathy leads to irony both during and after the Lust era, when:
The 1918 Universal Naturopathic Encyclopedia also includes within it a posthumously published book by Louis Kuhne (1835–1901) titled, The New Science of Healing or The Doctrine of the Unity of Diseases (pages 223-488).[note 1] The book contains some remarkable cures treatments that amount to a combination of vitalism, germ theory denialism and antivax.[11] For measles, scarlet fever, diphtheria, smallpox, whooping cough, scrofula (lymphadenopathy), rheumatism, gout, and sciatica, the treatment consists of combinations of friction sitz-baths, cold baths and steam baths.[11] Other ailments that Kuhne claimed could be treated include: cold extremities, hot head, nervous and mental diseases, lung inflammation, tuberculosis, pleurisy, lupus, venereal diseases, bladder and kidney disease, diabetes, uremia, bed wetting, liver disease, gall stones, intestinal diseases, heart disease, dropsy (edema), spinal cord diseases, hemorrhoids, chlorosis (anemia), epilepsy, anemia, epilepsy, agoraphobia, eye and ear diseases, dental diseases, head colds, influenza, throat diseases and goiter, headache and migraine, brain inflammation, typhus, dysentery, cholera, diarrhea, tropical fevers, malaria, yellow fever, leprosy, scabies, worms and parasites, hernia, cancer, wounds, and "diseases of women".[11] The total lack of understanding of disease causes and treatment by Kuhne would seem to be evident simply by his placement of wildly unrelated diseases within the same chapter (e.g., "Epileptic Fits. Agoraphobia", p. 366).[11]
By 1932, Morris Fishbein (1889–1976) had recorded an A-to-Z of quackery that fell within the naturopathy umbrella.[7]:128-139 Fishbein was an M.D. and was editor of the Journal of the American Medical Association from 1924-1949.[23] The quack treatments that he documented have since mostly fallen into obscurity:[7]
“”The things naturopaths do that are good are not special, and the things they do that are special are not good.
|
| —Harriet Hall, MD[24] |
As has been noted, naturopathy doesn't really entail anything very specific, and practitioners can run the gamut from slightly dubious lifestyle counselors to completely crazy germ theory denialists.[25][26] Nevertheless, there are some positions which can be considered to be quite common among naturopaths as a whole. There is the appeal to nature, which is ubiquitous (although, as "natural" is a pretty vague term, the conception of which therapies are natural or not can vary depending on the practitioner)[13][27][28]; a distrust of vaccines and other "synthetic" products; use of herbs and vitamins; a tendency to prefer exotic, Eastern medicine (the more expensive and obscure, the better!) such as Ayurveda and traditional Chinese medicine (TCM); and the belief that our bodies are full of toxins like lead and mercury, which need to be purged by means of detoxing or chelation therapy. Ironically, Ayurveda and TCM actually consider mercury, lead, arsenic, and asbestos to be legitimate medical remedies, even as naturopaths wholeheartedly recommend these systems of "medicine". In addition, the American Textbook of Natural Medicine lists Unani (in addition to Ayurveda and TCM) as an acceptable form of naturopathic treatment,[29] even though bloodletting and leeching are integral parts of it (even more so than in Ayurveda and TCM).
Quite a few naturopaths seem to have no problem prescribing pharmaceuticals or synthesized supplements, despite the anti-Big Pharma rhetoric of many. Chelation drugs, Benadryl®, colchicine, and various other pharmaceuticals are prescribed by naturopaths on a regular basis.[13][27][30][28] It seems each individual naturopath just arbitrarily mixes and matches "synthetic" and "natural" treatments with no real rhyme or reason, depending on what "feels right". What is a toxic synthetic pharmaceutical for one naturopath may be a perfectly acceptable naturopathic treatment for another. To give just one of many examples, some blast Botox (which, incidentally, is completely natural) as being a horrible poison,[31][32][33] while others use it quite happily.[34][35]
The principles of modern naturopathy according to the Association of Accredited Naturopathic Medical Colleges are:[36]
“”
|
These may sound like common sense, but because they are not evidence-based, there is little understanding by naturopaths about what is less harmful or what is more effective. Why, for example do naturopaths eschew vaccines for their invasiveness (generally very safe and effective), but recommend invasive colonics (ineffective and potentially dangerous[note 2])? Why are vaccines considered to be unnatural by naturopaths (originally performed with cowpox and a simple lance[38]) but colonics are considered to be natural (which use plastic tubing and modern plumbing)?
There is no single list of what constitutes naturopathic treatment, but common treatments are covered at accredited naturopathic universities. The list of treatments has changed substantially from the olden days, perhaps because evidence-based medicine is not used there is no clear pathway between evolving treatments as there is in Western medicine. Common diagnostics and treatments include:[39][40][41][42][43]
“”Naturopathic theory and practice are not based on the body of basic knowledge related to health, disease, and health care that has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of naturopathic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment.
|
| —Department of Health, Education, and Welfare (1968)[44] |
“”In our inquiry, we provided naturopaths and their professional associations ample opportunity to refute the conclusions of several major commissions of inquiry over the years that deemed their therapeutic rationale lacking in scientific credibility. None of our informants was able to convince us that the field had taken these earlier critiques to heart; in fact, precious few seemed to recognize that a problem still exists. Throughout, we found underestimation of the power of the placebo. At the same time, our own bibliographic searches failed to discover any properly controlled clinical trials that supported claims of naturopathy, except in a few limited areas where naturopaths' advice concurs with that of orthodox medical science. Where naturopathy and biomedicine disagree, the evidence is uniformly to the detriment of the former.
|
| —Wallace Sampson |
“”"Naturopathic medicine" is an eclectic assortment of pseudoscientific, fanciful, and unethical practices. Implausible naturopathic claims are still prevalent and are no more valid now than they were in 1968.
|
| —Kimball C. Atwood |
“”Naturopathic medical school is not a medical school in anything but the appropriation of the word medical. Naturopathy is not a branch of medicine. It is a combination of nutritional advice, home remedies and discredited treatments.
… |
| —The Massachusetts Medical Society (2015)[47] |
“”Accredited naturopathic schools are disguising the naturopathic education of nonsense as a distinct, and better, form of primary care medicine. Sadly, these schools are getting away with what I consider to be education fraud. The truth is that naturopathic education is riddled with pseudoscience, debunked theories, and experimental medical practices.
|
| —Britt Hermes, naturopathic apostate[48] |
Bastyr University, which is accredited by the Western Association of Colleges and Schools, offers a Doctorate of Naturopathic Medicine as well as acupuncture and other natural healing degrees. Other accredited universities include — National College of Natural Medicine, Southwest College of Naturopathic Medicine, University of Bridgeport College of Naturopathic Medicine and Canadian College of Naturopathic Medicine.[49] Education does include actual science (general biology and chemistry, anatomy/physiology, physics etc.) but these colleges generally reject vaccinations or the use of actual medicine. In many states the use of naturopaths is restricted or illegal.[citation needed] Some unaccredited schools also offer "degrees" in naturopathy, including Clayton College of Natural Health;[50] the Trinity School of Natural Health, which is "accredited" by an accreditation mill;[51][52] and the Natural Healing Institute, which is also "accredited" by an accreditation mill.[53][54][55]
In 1987, the Council for Naturopathic Medical Education (CNME) was approved by the US Department of Education as an accreditation agency.[56] In 2001, the approval was withdrawn based on evidence that the CNME "had not responded appropriately to violations of its standards at Southwest College of Naturopathic Medicine and Health Sciences."[56] CNME approval was apparently restored in 2003.[56][57][58]
In 2001, Arnold S. Relman, Emeritus Professor of Medicine and of Social Medicine, Harvard Medical School and Editor-in-Chief Emeritus of The New England Journal of Medicine, reviewed the primary textbook on natural medicine, eponymously called Textbook of Natural Medicine, which was then in its second edition.[59][60] As of 2017, the textbook is in its fourth edition.[61] The textbook has been edited by Joseph E. Pizzorno, Jr. (currently emeritus president of Bastyr University)[62] and Michael T. Murray (former faculty at Bastyr University and currently on its Board of Regents).[63] Relman found serious problems with the textbook, including:[59]
As of 2017, several states and territories within of the United States, and every province in Canada, license naturopathic physicians.[64] Legislation is pending in several other states within the US.[65] Britt Marie Hermes provides a guide to legislation of naturopathy in US states and Canadian provinces.[2] According to Hermes, as of 2015 Arizona has the "broadest naturopathic scope of practice" and "may be the worst-case scenario of any state licensing pseudoscience as medicine."[66] Problems in Arizona include:
There are currently seven colleges and universities that offer a "ND" (Not Doctor Doctor of Naturopathic Medicine) degree in North America.[69]
The following is an example of naturopaths trying to make diagnoses based on a case study that was presented at the Institutional Review Board of the International American Naturopathic Clinical Research Institute/Naturopathic Oncology Research Institute/International Naturopathic Clinical Research Institute.[70]
In real medicine, case studies are intended to have an educational purpose, either for medical students or for fellow-doctors; case studies are used to determine a proper diagnosis, differentiate between possible diagnoses and/or to determine a proper course of treatment.[71] Naturopaths also use case studies, but they often look amateurish; compared to medical case studies, they often lack detail and focus. To compare the case below to an actual medical case study, see for example "Case Study in Del(17p) Chronic Lymphocytic Leukemia".[72]
Note that all the "Dr."s below are actually NMDs (Naturopathic Medial Doctors) — not actual medical doctors.
| Case Presentation:[70] | RationalWiki Comments: |
| Dr. [Cheryl] Hamilton presented the case of a 39-yo clinically obese male patient with a chief complaint of low blood testosterone but high exogenous testosterone use and leukemia. He had a white blood cell count that grew to 50,000. He came in on an already prescribed high dose of testosterone. | This is a remarkably vague description of the case compared to an actual medical case study, which normally would include detailed test diagnostics, e.g., for blood and genetics.[72] |
| Dr. [Robert] Waters said that in testicular tissue a statin interferes with testosterone production. | This is true,[73] but it is not clear what relevance it has since the patient was not described as having taken statins. |
| Dr. [Andrew] Dickens said he is convinced that a high cholesterol is from a low functioning thyroid, and that measuring thyroid levels in the blood is as useless as appraising a car by the amount of gas in the tank. In other words, blood levels of thyroid hormones are simply residual left over from organ uptake. So thyroid is perhaps low. Also, this patient does seem to have burned out adrenals, and I would check his cortisol. | Curiously, Dickens gives a car analogy, as if he and/or his colleagues do not have a lot of medical expertise. This is not how medical professionals speak to each other when diagnosing patients.[72] Why is Dickens speculating about thyroid levels when a test could have been ordered? This is not the only time that Dickens has made a car analogy for a medical condition;[74] was he a used car salesman once? |
| Dr. [Kenneth] Proefrock said please switch the vitamin D2 out to D3. Check his prolactin. The more testosterone that gets pushed into him, the more his liver is going to process it. Plus due to previous breast reduction, he must have been aromatizing a lot of the testosterone. Consider switching him to a ketogenic diet. | What the hell is Proefrock[note 3][note 4] saying?
|
| Dr. Proefrock said that for treating leukemia it is a situation of watch and wait. Here is a guy who's always vigilant. No wonder he has such a high WBC count, when you consider that the immune system is the vigilant police force of the body. If he could get somebody to help him work through all of his emotional issues, he may be able to undergo a profound enough transformation to break through his current state. | Here we have two bizarre assertions by Proefrock:
|
| Dr. [Glen] Ozalan agreed. He got into this because he is in red alert. Get him over to a Brain State therapy, to help get him out of a sympathetic state over to a parasympathetic state. So he’s gotten into an addictive cycle in the sympathetic state and the adrenal overdrive. In the long run, over 35 years of practice, I have seen the pattern of everything outside of work on transformational levels as only a band aid. | Brain state therapy is an unproven experimental therapy used for pain, sleep, stress, gait,[80] none of which are among the patient's symptoms. It is not clear what Ozalen is trying to treat or whether there was even a measurement of adrenal gland function. There was no indication from the presentation that the patient was addicted to anything. |
| Dr. [Andrew] Dickens said that EMF and EMDR all work in such a way to unhook the neurological loops that are self-sustaining. | EMF is electromagnetic field. EMDR is Eye Movement Desensitization and Reprocessing. |
| Dr. Proefrock said that Robert Sapolsky wrote a very good essay, "The Trouble with Testosterone." It's about the psychological problems with excess testosterone. The patient being considered seems to be having this problem. Blood testosterone levels are also a poor indicator of actual testosterone use in the body, a left over residual. |
| Dr. Dickens said that a big problem with police forces is sometimes underground steroids. | How is this relevant? The patient was prescribed testosterone; it was not stated that he was abusing it. |
| Dr. Proefrock said, I'm seeing the testosterone as the biggest problem. | Unless Proefrock somehow knows that the CLL that the patient has is not the fast growing type, he is wrong. |
| Dr. [Cheryl] Kollin said, I would look at environmental stuff. Some lead toxicity. | Lead does cause several health problems, but — surprise! — the patient's health problems are not among them. |
| Dr. Proefrock said yes, I have seen high lead in people who are long-term shooters. | Is Proefrock referring to testosterone users as "shooters", implying that they're abusing the testosterone? This patient was prescribed the drug. |
| Dr. [Colleen] Huber said that she thinks CLL is one of the more challenging cancers to actually have some effect on; often there seems to be a well-entrenched, chronic, latent pathogen involved. His shingles, the zoster virus; this could be something addressed. | Shingles was not mentioned as one of the patient's conditions. There is some evidence that the zoster virus that causes shingles (and chicken pox) is associated with increased risk of hematologic cancers generally, of which CLL is one.[83] |
| Dr. Waters said, Sometimes stem cells are absent with Agent Orange, to which this patient has been exposed. Most of the people with that have neurodegenerative conditions. In many cases this is the case, even with no dioxin left in them. We do a fat biopsy to see what is going on. | Again, we have another piece of information about the patient appear of out of thin air: in this case, past exposure to Agent Orange. TCDD is a human carcinogen that is found in Agent Orange, however it is not specifically known to cause CLL in humans.[84] |
| Dr. Proefrock mentioned that food poisoning can lead to off the wall blood counts. | Infections, such as food poisoning, will increase white blood cell counts. However, the patient was already diagnosed with leukemia, not diagnosed with food poisoning! |
At the end of this discussion, we still have no idea about what condition the NMDs thought was important to treat. There were no clear explanations on why any of the proposed treatments would be useful. And, there was no consensus on how to treat the patient. One is left to wonder whether each naturopath had their own pet treatment that they always recommended, and just happened to be offered at their own clinic.
According to Hermes, medical doctors have historically struggled with making people feel heard, particularly women and people of color. In contrast the naturopoathic experience tends more towards empathy and learning about how people feel. To overcome this, medical doctors need to have a good bedside manner, to make patients feel like they've been heard and that they have the ability to make choices based on the medical evidence and the tools available to them (e.g. pharmaceuticals or lifestyle changes).[85]
In some cases naturopathic medicine has an effect, because it is an unrefined proto-medicine such as willow bark (unrefined aspirin) or foxglove (unrefined digoxin). In many other cases, it works because of either regression to the mean (people naturally get better sometimes) or the placebo effect. It is known for example that some types of placebos are more effective than others.[86][87]
“”In the treatment of pain, for example, big, dark-colored, bad-tasting placebos are more effective than small, brightly colored, good tasting ones; placebos delivered intravenously are more effective than placebos delivered intramuscularly, which in turn are more effective than placebos delivered orally.
|
Expensive placebos are likely to be more effective than inexpensive ones.[86][88] So there are several ways that naturopaths are enhancing the placebo effect — counsciously or not — using non-evidence-based but possibly-effective logical fallacies:
Despite being fallacious, these aspects of naturopathy can be effective because the placebo effect is primarily psychological, not physiological.[91][92]
“”Placebos may make you feel better, but they will not cure you. They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea.
|
| —Ted Kaptchuk[92] |
Categories: [Alternative medicine] [Herbal medicine] [Nature woo] [Pseudoscience] [Side-by-side articles]