[The following is an excerpt from Naturopathy: A Critical Appraisal, reprinted from Medscape General Medicine, Kimball Atwood, M.D., 2003. (Coypright: Medscape, 2003) Dr. Atwood served on a commission created by the Massachusetts legislature to evaluate naturopathic licensing in that state.]
The Naturopathic Belief System
Naturopathic beliefs -- including those of "naturopathic physicians" -- are rooted in vitalism, the pre-20th-century assertion that biological processes do not conform to universal physical and chemical principles. . . .
Naturopaths invoke a few simplistic theories to explain the causes of disease. These include the actions of ubiquitous "toxins" (including most pharmaceuticals); widespread food allergies; dietary sugar, fat, and gluten; inadequate vitamin and mineral intake; epidemic candidiasis [yeast]; vertebral misalignments; intestinal "dysbiosis"; imbalances of Qi; and a few others. To diagnose these entities, naturopaths use an assortment of nonstandard methods, among which are iridology or iris diagnosis, which holds that the entire body is represented on the iris of the eye; applied kinesiology, by which an allergy to a food is detected by placing the food particle in one hand of a patient and observing a resulting weakness in the other; hair analysis for alleged toxins and vitamin and mineral deficiencies; electrodiagnosis, which can purportedly detect parasites and other problems by measuring the skin's resistance to a tiny electric current; "live cell analysis"; "pulse" and "tongue" diagnosis; and others.
Naturopathic treatments include colonic irrigation (enemas) and fasting for "detoxification," hydrotherapy (wrapping part or all of the body in wet towels), homeopathy, acupuncture, chiropractic manipulation, aromatherapy, arduous dietary regimens, intravenous vitamin C, hydrogen peroxide and ozone, whole enzyme pills, herbs, desiccated animal organs, and other "natural remedies." Naturopaths sell these preparations to their clients at a profit, a practice that is both formally approved and joined by the AANP [American Associaiton of Naturopathic Physicians].
How does this translate into the practice of naturopathic medicine? The following recommendations and practices are representative:
The repudiations of standard treatments of streptoccal pharyngitis, acute otitis media, and other childhood infectious diseases, offering instead homeopathy, hydrotherapy, and "natural antibiotics" (e.g. herbs such as Goldenseal).
Affiliation with the antivaccination movement.
The repudiation of standard treatments of asthma, offering instead, for example, a hydrogen peroxide bath "to "bring extra oxygen to the entire surface of the skin, thus making the lungs somewhat less oxygen hungry" or "gems and minerals . . . worn as jewelry, or placed around the home in special places." This quotation is from "Articles written by Naturopathic Physicians for the general public" (on the AANP website). The author is listed as a "senior editor of the Journal of Naturopathic Medicine, the official publication of the AANP."
Recommendations, by the Bastyr University [a naturopathic "medical" school] AIDS Research Center, for treatment of HIV-positive patients with St. John's wort and garlic (both of which have been shown to reduce blood levels of highly active antiretroviral therapy agents [a treatment for HIV]), "acupuncture detoxification auricular program," whole-body hyperthermia, "andrenal glandular" [dessicated animal organs], homeopathy, cranioelectrical stimulation," digestive enzymes, colloidal silver, and nearly 100 other dubious methods.
Warnings against proven medical and surgical treatments for hypertension, hyperlipidemia, and atherosclerois, while instead recommending herbs and EDTA chelation [an ineffective treatment for these conditions].
The insertion of endonasal balloons, followed by their inflation in the nasopharynx, to "release tensions stored in the connective tissue and return the body to its orginal design," thus curing learning disorders and a host of other problems. [Editors' note: this treatment has caused fractures of the nasal bones.]
Treatment of the acute stroke patient for at least 20 minutes with an "ice-cold compress . . . over the carotid arteries under the jaw bone on the neck" (which may even "abort the stroke") and subtle energy medicine. The author of these recommendations is listed as a "senior editor of the Journal of Naturopathic Medicine, the official publication of the American Association of Naturopathic Physicians."
The early detection of multiple sclerosis by "pulse" and "tongue" diagnosis, such as to effect a cure by hydrotherpy, homeopathy, acupuncture, diet, and other methods. The author of these claims is Chief Medical Officer of the Southwest Collge of Natural Medicine [which grants "naturopathic doctor" degrees].
The prevention and cure of breast cancer by an assortment of nonstandard tests and "supplements" The author of these claims "has lectured regularly at the Canadian College of Naturopathic Medicine on breast health and stress management."
The treatment of cancer of the prostate with "electrical current in the form of positive alvanism applied transrectally." This recommendation is from "Articles written by Naturopathic Physicians for the genral public" (on the AANP Web site.) The author is Chief Medical Officer of the Southwest College of Naturopathic Medicine.
Ubiquitous "toxin" claims, including antifluoridation statements, warnings against most proven pharmaceuticals, and the assertion that "25% of Americans suffer form heavy metal toxicity."
"Natural childbirth care in an out-of-hospital setting" using a "naturopathic approach [that] strengthens healthy body functions so that complications associated with pregnancy may be prevented." [Editor's note: there is no evidence that this is possible.]
Nearly 100 nonstandard uses for vitamin C recommended by the Textbook of Natural Medicine.
The promotion and sale of "dietary supplements" for virtually all complaints.
Naturopaths have not subjected their basic tenets to critical scrutiny, apparently because they are already convinced that they are correct. For example, the AANP position paper on treatment of streptococcal pharyngitis, offering no supporting evidence, makes this claim: "naturopathic physicans . . . have been successfully treating Strep pharyngitis with very low incidence of poststreptococcal sequelae using various natural antibiotics, and natural immune enhancing therapies, for close to one hundred years. . . "
A 1999 survey of the small number of NDs in Massachusetts, performed by two investigators from Children's Hospital in Boston, is consistent with these findings. They reported that only 40% would refer a 2-week-old infant with a temperature of 101 degrees [a condition requiring immediate medical attention] for definitive medical care.
"There’s an easy way to become legitimate: practice science-based medicine. This would be awfully difficult for naturopaths, whose practices include homeopathy, colloidal silver treatments, and chelation therapy, to name but a few." Steven Salzberg, PhD., Professor of Medicine and Biostatistics in the Institute of Genetic Medicine, Johns Hopkins University School of Medicine,"Naturopathic Shenanigans in the Maryland Legislature," Forbes Magazine, Feb. 18, 2013.
What others say:
"Available scientific evidence does not support claims that naturopathic medicine
"We sampled all 4 years of students at the Canadian College of Naturopathic medicine . . .
“Some beliefs and approaches of naturopathic practitioners are
"Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. . . . Children aged 1–17 years were
" . . . with the possible exception of vitamin D in the elderly patients and omega-3 fatty acids in patients with a history of cardivacular disease, no data support the widespread use of dietary supplements in the U.S. and other Western countries." Paul Marik, M.D. & Mark Flemmer, MBBCh, " Do Dietary Supplements Have Beneficial Health Effects in Industrialized Nations? What is the Evidence?" Journal of Parenteral and Enteral Nutrition (2012)
“There has been enough testing of homeopathy and plenty of evidence showing that it is
"Even widespread historical use [of dietary supplements] without documented ill effects is no guarantor of safety." Institute of Medicine, Dietary Supplements: a framework for evaluation of safety. National Academies Press (Washington, DC, 2004
"I borrowed a copy of the Textbook of Natural Medicine and studied it carefully over a period of several days . . . My conclusion is that the licensing of naturopathic medical practitioners as independent providers of primary health care would endanger the health and safety of the public and would not result in health benefits commensurate with its risks. There is abundant evidence in the Textbook to support this conclusion . . ." Arnold S. Relman, M.D. [former Editor of the New England Journal of Medicine, one of the nation's leading peer-reviewed medical journals.] (2002)
"These unproven products give consumers a false sense of
"Proponents claim [colonic hydrotherapy, a typical naturopathic practice] aids in weight loss, increases energy, boots immunity, and reduces the risk of colon cancer. Not only is there no evidence to support those claims, but the practice can also be dangerous." Consumer Reports (on Health), February 2013
"I would respectfully submit that their course of study pales in comparison to the rigors of medical education here in the Commonwealth [of
" . . . practitioners of homeopathy believe that the more diluted a remedy is, the more powerful it is. So, if you subscribe to this particular workdview, ironically, you want your active agents to be not just non-existent, but super non-existent." Timothy Caufield, Professor, Faculty of Law and the School of Public Health, University of Alberta; "Comment: Don't legitimize the witch doctors," National Post (Canada, 2013)
"Safety of intake of dietary supplements concomitant with prescription cardiovascular medications is largely unclear due to insufficient evidence." U.S. Agency for Healthcare Reserch and Quality , "Dietary Supplements in Adults Taking Cardiovascular Drugs," 2012