Just to be clear: I’m talking about herbal medicine, administered by practioners both qualified by mainstream universities and certified by widely-accepted trade bodies. Not self-defined ‘holistic therapists’, and if there’s a thing called a ‘naturopath’ I’m lucky enough to be unfamiliar with the term.
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I’m glad to hear that things went well for your health, Dave – but I’m not sure where the naturopath fits in in that account. If you had just gone to a doctor when you felt ill, been given vitamins after consultation with a thoroughly trained professional who worked in evidence-based medicine, and then got better, how would that have been different from starting the journey with a practicioner whose work is a mixture of some evidence-based practices and some that run contrary to best evidence?
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Again, lack of framework, not lack of efficiency (well, except for the cases where none of the marketed active molecule is present).
But I didn’t suggest everything should be available to anyone without any control. Today you cannot buy opium, although it’s a perfectly natural molecule.
And fish oil is a blood thinner. Who knew? I guess that’s why you disclose to your physician what supplements you take before starting a round of prescribed blood thinners. Simple, right?
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Because it is dead easy to get addicted and die from an overdose. And you can buy it just not at the corner store and for very good reasons. It used to be available everywhere and it was not a good thing which is why it is now a controlled substance.
And you know the whole natural thing. FUCK THAT SHIT. NATURE WANTS TO FUCKING KILL US. Hemlock is fucking natural but I sure as fuck don’t want to drink some tea made from it. Ebola is natural and I don’t think you want to line up and have some of that do you?
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Thanks Cory. To answer your question, the naturopath had ideas about diet and supplements that the physician didn’t have. Thankfully my physician is open to trying new things, and monitoring the effect — for example a kelp supplement to address subclinical hypothyroidism, instead of a synthroid, which is the standard treatment, and not without side effects. If I had not brought the idea to my doctor, and had she not been open to collaborating with her patients, I would be on synthroid now, a prescription pharmaceutical, instead of kelp, which is food that has some extra iodine.
It isn’t. Homeopathy is one of the base techniques of naturopathy. Naturopaths spend a disordinant amount of time during their schooling studying it, and the “its only part of what we do” dodge is a pretty standard dodge from the field. They de-emphasise their focus on that practice because its problems are so well known. Coasting on the fact that fewer people are familiar with the massive problems in the practices they do cop to focusing on.
While that particular analysis may not have specifically been replicated it isn’t an example of the sort of studies that have replication and confirmation problems. First its a meta-analysis. It takes as many decent studies as can be found, collates the data and results, and reanalyses them to establish what the over all concensus is, clarify the severity of effects, and uncover factors that may have been missed by the smaller sample sizes of the individual studies. While mitigating or side stepping the sort of short comings that can make the individual studies less difinitive. In other words rather than being totally new research in need of replication, its the sort of study we do to replicate and confirm things. Its one of the solutions to the problems you’re citing. Additionally over the past 20 years or so there’s been a number of review articles (including very expansive ones), studies, and other meta analyses of the subject that indicated the same thing. Albeit less conclusively, and often on the subjects of specific categories or specific vitamins. Anti-oxidents and Vitamin C being two of the subjects that were much earlier tied to cancer (and heart disease!) risk. The more recent meta-analysis garnered so much press not because it was shocking and new, but because it strengthened the case for something that was long suspected and long researched.
and @nodachi : Not really. There’s no specific scientific peer-reviewed basis for the practice of herbal medicine. What (good, valid, replicated) studies on that subject almost universally find is that herbal medicine as practiced is ineffective and/or often dangerous. And that individual herbs do little to nothing. What there is a scientific basis for is certain compounds in certain plants that are used in herbal medicine being effective. But that doesn’t equate to herbal medicine, or use of the herbs themselves being effective. In order for the these compounds to have a practical effect in human beings they have to be used in volumes that would be impossible with the plants themselves. When you look into it you see numbers like the effective dose from a whole plant being dozens to hundreds of pounds in a day. The compounds are only really effective if extracted, purified, and delivered at medical doses beyond what a whole plant could provide. And most often under study they are found to be ineffective, or less effective than existing treatments. And to compound issues a whole plant contains more than just the sort of hypothetical substance in question. Some of the other chemicals in there could be harmful, at much lower doses. Or may cause the condition being treated to the same or greater extent as the other chemical that treats it (this is especially true with cancer). Then there’s the fact that although there are a great deal of plant derived pharmaceuticals in the world very few of them come from plants used as medicinal herbs. And even fewer are derived directly from the Herbs used in medical systems used by alt-med practitioners in the developed world (typically Traditional Chinese Medicine and Auravedic/Indian herbalism). Taken together you have a situation where while individual plants used in these systems might be worthy of scientific investigation, there is very little value (and quite a lot of danger) in herbal medicine as practiced.
If anyone is interested in precisely what the REAL situation with naturopaths is. I’d point you towards The Naturopathic Diaries. A blog written by a former practicing, licensed, credentialed naturopath. She covers a lot of ground, including the huge, bizarre problems in their training. What exactly they study, and exactly how they practice. Even as some one who follows this stuff it was kind of shocking how much woo they study, how little medicine, and how wholly unsuited they are to act as primary care physicians (what they’re fighting for by going “legit”).
You also might want to look into the continuing leaks from a Yahoo group for professional naturopaths. Apparently the vast majority of these guys (in the US at least), especially some of the most prominent people in the profession participate (or used to) in a private Yahoo chat group where they discuss their jobs. And some one leaked an awful lot of the discussion. There in you can see some things about how naturopaths actually practice. The embrace of debunked or dangerous alt medical treatments. Attempts to treat cancers (something naturapaths often say they don’t do without consulting with oncologists). Anti-vaccine nonsense. Violations of medical ethics (especially patient confidentiality). And a lot of really weird paranoia.
The leaks were tossed out on Reddit initially:
https://www.reddit.com/r/medicine/comments/2cm43z/read_what_naturopaths_say_to_one_another/
David Gorski (actual oncologist!) has covered it from time to time as things went on:
http://scienceblogs.com/insolence/2014/10/08/sht-naturopaths-say/
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Hmm. I suspect we might be talking about different things - quite possibly my fault; as I said, I’m unfamiliar with the concept of a ‘naturopath’.
My understanding is that ‘naturopathy’ is a whole suite of alternative therapies, and a diverse range of practitioners each with individual specialisms; say, a homeopath OR a herbalist. That herbalist might be as contemptuous of homeopathy as you or I, rather than buying into ALL ‘naturopathy’ (and certainly not justifying his/her specialism solely “because it’s natural” - I happen to know at least one UK degree scheme specifically rejects that attitude).
That was my criticism of the original article: that Cory seemed to be dismissing all alternative therapy (including the vitamins industry) as one homogenous thing.
If I’m wrong, and ‘naturopathy’ IS a single thing: oops… 
Yeah naturopath is a specific job title, like nutritionist. Rather than a catch all. Its effectively short for Naturopathic doctor/healer (because they often can’t call themselves doctors, because they aren’t). Its rather a lot like Chiropractic actually. They attend specific naturopathic schools where they are trained in naturopathic “medicine”. These schools are typically credentialed too, so the degrees are technically valid. But the curriculum is often hidden from the public view to prevent/mitigate criticism and basically save face. Naturopaths basically work with any an all CAM treatments no matter how debunked or how wonky, and sometimes utilize actual medicine (though they lack the training to apply it properly). The profession sits in many ways at the heart of the “integrative” medicine thing. Where in disproven alt med is “integrated” (this often means “replaces”) legitimate medicine, and often through programs at actual legitimate universities and standard hospitals. The push from Naturopaths has been increasingly to be livensed by the state, so that they can gain prescribing rights for actual pharmaceuticals and act as primary care doctors. But as I’ve mention they recieve little or none of the training necessary to do either of those thing safely. But the base of it is in a whole suite of alternative med practices. Broadly the biggest focus seems to be on homeopathy, herbalism, energy healing, and various diet based treatments. They often present themselves as treating less serious conditions, every day illness. And working with specialist doctors on dangerous or more chronic conditions. But those claims are increasingly looking hollow. There’s been no end of prominent naturopathic clinics claiming miracle cures or revolutionary protocols. And there have been a rash of high profile cancer deaths (particularly of children) among vocal supporters of naturophathy, or those under treatment by naturopaths and other quacks the last few years. Effectively it is your typical dangerous woo dressed up with sciency language to appear more legitimate.
I’d also argue with your implication that there may be or are alternative therapies that are worth while. One of the weirdest aspects of this whole debate is if these things worked they wouldn’t be alternative. If these treatments actually worked they would not be alternative. They would just be medicine. Many time where you hear that x alt med thing actually works you’re looking at a couple deliberate misrepresentations. Most often you’ve simple got a case where the CAM crowd has produced their own studies showing what they’d like them to show. They’re often problematically conducted, small, not submitted to pear review, and impossible to replicate under proper conditions. There’s also a lot of cherry picking involved, supporters will repeatedly point to the handful of more legitimate studies that may support their position, or reinterpret studies that don’t support the claim to do so. Both are almost always at odds with the vast majority of research on the topic. Vaccine/autism connections and acupuncture are the classic examples.
The other major (and somewhat more confusing one) is something I hit on above. Sometimes there is some sort of legitimate scientific basis buried in there some where, and that will be presented as a real scientific basis for the practice even when it isn’t. Herbal medicine has been studies endlessly, and the over all weight of this research shows pretty clearly that it doesn’t work. There are pretty well understood mechanisms for why it can’t work. But you often hear that there’s a scientific basis for it. Because people are misinterpreting or misrepresenting the long history of pharmaceuticals being derived from plants as evidence for Herbalism as a replacement for those (very same) pharmaceuticals or valid as as practiced.
So too Chiropractic. You often hear bits and pieces about chiropractic adjustment being based in science. And the answer is sort of. There’s a good basis for certain kinds of spinal and joint adjustment (similar to or derived from chiropractic) having a palliative effect for certain injuries, or low level chronic pain. Especially back pain. But this doesn’t mean Chiropractic itself is based on science, or validated by science. Chiropractors are not doctors. They are not licensed or adequately trained to treat illness or conditions other than discomfort in the joints. But they often claim to be able to treat or cure things like asthma, serious injuries, behavioral problems, infectious disease, cancer, etc. Purely by cracking your back. And often times the things they’re treating are themselves unique to Chiropractic. Every single person I’ve ever met who visited a Chiropractor, was diagnosed with the exact same 1/2 inch difference between the length of their legs. And prescribed the exact same monthly spinal adjustment for it. And some of the forms of spinal adjustment used can be quite dangerous, especially around the neck. To make it depressing again there’s been a rash of deaths connect to (but not always proven to be caused by) neck adjustments by Chiropractors. Particularly among children.
The actual doctors who study and treat bone disease and injury are called Osteopaths. They or physical therapists may utilize the scientifically valid forms of spinal/joint adjustment/cracking in treatment. But rather than “curing” you this way, its basically a fancy form of massage or PT. Designed to alleviate pain, and unlikely to do much else.
Even Reiki has sometimes claimed to have valid science behind it. Because there are tons of studies showing that human (and even animal) touch can be psychologically comforting and have a palliative effect. Sometimes these findings even come out of studies of Reiki, faith healing, laying of hands, and other contact based energy healing methods. But claiming those findings as evidence for these things ignores a few big things. First they’re the only positive findings on this subject. Second absolutley nothing else in these systems gets validated. And third its been found any non-violent touching produces the results. Reiki or not.
Reiki is energy healing. And energy is literally magic. Something special only I can control flows mysteriously through my touch and nits together you’re broken bones, or shrinks your tumor. Because magic. In many ways its the ur-alt medicine. A surprising number of CAM techniques are derived directly, or more obtusely, from this idea. Which has been disproven for centuries, have no basis in science. And has no, and can have no, plausible testable mechanism behind it. I don’t think any children have died as a result of Reiki recently. But I’m sure you could find some if you looked.
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Sounds like a gap in your doctor’s training for sure.
I’m still unconvinced. The findings in the studies I cited in the OP suggest that people who patronize naturopaths are likely to neglect evidence-based medicine (reduced use of chemo for breast cancer; reduced rates of vaccination for kids).
It’s great that your naturopath gave you good advice, but naturopathy also includes a lot of very bad advice, as well as a lot of stuff that’s just wrong (e.g. chiropractors’ “subluxations,” a phenomenon known comprehensively not to exist since the advent of clinical X-ray studies).
There are lots of people who are wrong about many things and right about a few. Some of the best stuff in Getting Things Done was lifted out of Scientology courses, and learning that stuff probably does some good for the people who attend them – but it comes with a dose of wrong stuff about energy beings chained to volcanoes by galactic tyrants.
As a discipline, naturopathy lacks the rigorous footing – the practices of double blinding, peer review, etc – to build on its strengths and eliminate its weaknesses. Institutionalizing it as part of government health care won’t fix that – it’ll just weaken the evidentiary basis for all medicine. As the skeptic’s battle-cry goes, “You know what they call alternative medicine that works? Medicine.”
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A gap in medical training perhaps. They have a lot to cover in 4 years, and nutrition is a huge subject. But I think you’re missing an important point.
Bear with me. There’s always lot of non-rigorous theories about diet and disease. A popular idea right now is that many chronic conditions, from diabetes to arthritis, are caused or worsened by inflammation, which can be controlled by diet changes. I have no idea if these ideas will ever be validated. But if you had arthritis, and could make these changes while staying within a healthy balanced diet, wouldn’t you do it? Of course you would.
Twenty years is a long time to wait for a scientific consensus, if it ever comes. in the meantime, I’m not afraid to self-experiment with diet, within rational and healthy boundaries. I’ll cherry pick sensible sounding ideas from naturopathy, traditional medicine or chiropractic. If I’m addressing an actual medical condition, of course I’ll do the above in consultation with my physician.
Cory, I don’t think you’re nearly so rigid about respecting medical authority as you seem when this topic is raised. Midwives were illegal in Canada before 1994, because medical consensus said so. We have medical marijuana, and many other legitimate therapies, thanks to people who got ahead of the consensus and experimented. Again, massive emphasis on finding a physician who will collaborate and advise.
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It’s just such a pain in the ass to shave it down into a powder you can ignite with a Bic lighter. Other than that minor hurdle, it really is a panacea. See also: white phosphorus. Clears up all sorts of things.
(Banning @shaddack for an entire year seems overkill, because he’d have something to add here.)
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Thanks to Tom Harkin there has been a whole division of NIH devoted to “complementary medicine” since 1992, with a decent if not enormous annual budget. $2.5 billion in funded studies later, there’s nothing to show. Enough already!
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364 days would’ve been fair…
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Here this is a really good read on why supplements don’t measure up.
Seriously this stuff is dangerous. WTF kind modern thinking says oh this looks like a body part so it should be good for that part of my body?
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Awaiting a rebuttal from Big Vitamin’s spokesman.
ETA: it’s “100% vitamin & iron?” Sounds… crunchy.
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The sex toy industry?
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David Groff’s doctor, and thousands more.
There are all too many MD’s out there whose regimen of care is:
Read an aberrant test result. Prescribe a drug which often corrects that test result in a majority of patients.
Read another aberrant test result. Prescribe another drug which often corrects that test result in a majority of patients.
Read another aberrant test result. Prescribe another drug which often corrects that test result in a majority of patients.
Lather, rinse, repeat until the patient either gets better or, finding no improvement, leaves the doctor.
This is a major reason why patients find their way to alternative practitioners.
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If you take the substances from those plants, submit them to rigorous controlled testing to ensure efficacy and safety, then standardize and package them to ensure proper dosage and quality control, you don’t have “naturopathy” anymore. You have “medicine.”
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Yes, and the branch of pharmacology that deals with that is known as pharmacognosy. It also includes the study of essential oils (some of which can be very dangerous), as well as the antibiotic, antifungal, and cicatrizing properties of honey.
