Naturopathic Medicine

More of a philosophical approach to health than a particular form of therapy, naturopathic medicine offers a wide variety of natural, noninvasive remedies for an array of troubling minor ailments. Some naturopathic recommendations, such as certain dietary modifications and the use of selected vitamins and food supplements, have been shown in scientific studies to confer lasting health benefits, and have been wholeheartedly adopted by conventional medicine. (Natural childbirth and acupuncture also fall into this category.) Other naturopathic prescriptions, such as detoxifying enemas and the use of homeopathic medicines, lack any scientific support.

Naturopathy offers a wealth of mostly harmless and possibly helpful approaches to a healthier diet and lifestyle. Many of its tenets, such as a diet high in fruits, vegetables, and whole grains, are now standard recommendations for those hoping to reduce the risk of cancer, heart disease, and obesity. Its noninvasive physical therapy techniques offer significant relief from a variety of muscle and joint complaints.

Be selective, however, in adopting naturopathic recommendations. Heat treatments and hydrotherapy, for instance, are not necessarily the most effective way to treat an infection. And the various "detoxifying" regimens advocated in naturopathy are even more suspect. There is neither evidence of any "toxic build-up" to be dealt with, nor proof that the regimens could eliminate one if it existed.

Naturopathic practitioners range from physicians to massage therapists, and their approach to diagnosis varies accordingly. Among all practitioners, evaluation of diet and lifestyle is considered crucial. However, if your practitioner has a high level of medical expertise, diagnosis may also involve laboratory analysis, allergy testing, X-rays, and a physical exam.

Recommendations for treatment may include any of the following, depending on your symptoms and the practitioner's experience and philosophy:

Homeopathic Remedies: Preparations containing an extremely diluted amount of a substance that causes the symptoms, prescribed on the assumption that "like cures like."

Herbal Medicines: Whole herbs or standardized extracts, prescribed as mild, natural alternatives to synthetic medications.

Dietary Supplements: Vitamins, minerals, enzymes, and other food substances, recommended as a natural boost to health and resistance.

Dietary Restrictions: Vegetarianism or elimination of certain food categories (such as dairy products), recommended to relieve sensitivity reactions and clear the body of toxins. Dietary advise often includes instruction on "proper combining" of groups.

Physical Medicine: Manipulation of muscles, bones, and the spine, and physiotherapy using water, heat, cold, ultrasound, and exercise, employed to relieve a broad array of ailments.

Stress Reduction: Counseling, hypnotherapy, biofeedback, and other methods, employed to heal physical damage from stress.

Detoxifying Regimens: Fasting, using enemas, or drinking large amounts of water in an effort to purify the body.

Naturopaths typically recommend an assortment of these approaches in an attempt to boost your natural defenses (the immune system), restore good health, and prevent disease.

Naturopathy endeavors to cure disease by harnessing the body's own natural healing powers. Rejecting synthetic drugs and invasive procedures, it stresses the restorative powers of nature, the search for underlying causes of disease, and the treatment of the whole person (emotional, genetic, and environmental influences included). It takes very seriously the medical motto "first, do no harm."

Naturopathic medicine began as a quasi-spiritual "back to nature" movement in the 19th century. Reacting against the often misguided medical practices of the day and the disease, dirt, and degradation caused by the Industrial Revolution, the European founders of naturopathy advocated exposure to air, water, and sunlight as the best therapy for all manner of ailments, and recommended spa treatments such as hot mineral baths as virtual cure-alls.

In the late 19th and early 20th century, naturopathy evolved and grew enormously, rivaling conventional medicine in popularity. Benedict Lust, a German doctor who emigrated to the U.S. in 1892, founded the health food store as we know it, and crystallized the focus of naturopathy on diet and nutrition as the chief route to health. During this period, health-food faddism rivaled that of the present day, with influential practitioners like Dr. Kellogg (of cereal-company fame) insisting that meat and other "unnatural" foodstuffs were wreaking untold havoc on human health.

With the rise of increasingly sophisticated drugs and advanced medical technology after World War II, naturopathy fell from favor (with a hearty push from organized medicine). Grains and herbs seemed like mere snake-oil in the brave new world of antibiotics and polio vaccines. Science reigned supreme until the 1960's, when the discovery of unsuspected side effects from DDT, thalidomide, and other high-tech wonders reminded Americans that "better living through chemistry" sometimes had shortcomings of its own.

Meanwhile, a new and more scientifically-minded crop of naturopathy advocates, including nutrition writer Adele Davis and vitamin C researcher Linus Pauling, helped bring fresh respectability to the idea that nature still held healing powers. This new breed was quick to adopt the research techniques of "conventional" medicine to prove the effectiveness of age-old remedies like herbs and newer options such as vitamin pills. Placebo-controlled, double-blind clinical trials, in which neither the doctor nor the patient knew who was getting genuine treatment and who was getting a fake, soon became common not only for drugs, but for diet as well. As the results accumulated, it became clear that our choice of food can indeed have significant impact on our health.

How well does naturopathy work? That depends on the aspect of naturopathy in question. Organized medicine, which ignored nutrition for decades, now swears by low-fat, high-fiber diets to prevent a host of diseases that plague industrialized societies such as ours. Mainstream doctors are also gaining new respect for certain antioxidant vitamins, such as vitamin E, as potential bulwarks against disease, and some are even acknowledging the effectiveness of certain herbs (such as St. John's Wort for depression).

On the other hand, many time-honored tools in the naturopathic toolbox have little or no scientific basis. The naturopathic notion that illness arises from vaguely defined "toxins" in the body that must be purged through fasting, enemas, sweating, and water consumption has never been verified through clinical research. Likewise, many popular food supplements, as well as the mega-dose use of vitamins, have so far failed to show definitive effects--while a few have even proved harmful. Naturopathic use of "natural" hormone preparations can also be dicey, since the potency of these products can vary to dangerous degrees.

The vegetarian diet--a mainstay of the naturopathic lifestyle--is also subject to question. It is not necessarily a "perfect" diet, according to the latest scientific research, especially if it contains large amounts of high-fat foods such as cheese. While a vegetarian diet is less likely to boost cholesterol (and will almost certainly provide more fiber), mainstream nutritionists continue to recommend a diet that contains modest amounts of meat, pointing out its nutritional benefits, such as healthy amounts of iron.

Other naturopathic ideas about nutrition are on equally shaky footing. There's no evidence, for example, to support the contention that certain types of foods should never be combined. Scientists also question the heavy emphasis that many naturopaths lay on food allergies as a purported source of countless vague symptoms. And they warn that the naturopathic tendency to eliminate dairy products can result in an unbalanced diet deficient in calcium.

For the most part, naturopathy focuses on gentle treatments that do no harm, and most people can undertake this type of therapy without undue worry. However, drastic dietary restrictions can undermine good health and should generally be avoided, especially by the very young, the elderly, and those with a medical condition (such as diabetes) that requires special dietary modifications. If a dietary recommendation seems extreme, your wisest course is to first seek the approval of a registered dietitian or a conventional physician knowledgeable about nutrition.

Potential adverse effects of most naturopathic therapies are few and mild. Nevertheless, "natural" does not invariably equal "safe." Some herbal preparations can be quite toxic, and excessive fasting or use of enemas can upset the body's balance of fluid and minerals, leading to potentially dangerous consequences such as irregular heartbeat. The greatest hazard, however, is that using naturopathic therapies without any conventional advice could allow a serious medical condition to go undiagnosed and unchecked.

Although various naturopathic remedies are offered by other health care providers, including chiropractors, nutritionists, holistic nurses, and massage therapists, if you want the complete package, you need to seek out an ND (Doctor of Naturopathic Medicine). Such practitioners have completed four years of graduate-level training at a naturopathic medical college. (There are currently three accredited colleges in the U.S.: Bastyr College in Seattle, WA; National College in Portland, OR; and Southwestern College in Tempe, AZ.) A referral directory is available from The American Association of Naturopathic Physicians.

In the 11 states where they are currently licensed, naturopathic physicians must pass either a national or state-level board examination. Their scope of allowable practice varies from state to state, but generally conforms to their training in the types of therapies described above. Some states also grant certification in specialties such as natural childbirth or acupuncture. There are now about 1,500 NDs practicing in the U.S., but that number (which is minuscule compared to the number of MDs) is expected to double in the next five years based on current enrollment in naturopathic colleges.

NDs frequently refer to themselves as "general practice family physicians" or "primary care doctors." They are also fond of pointing out that the naturopathic curriculum actually offers more hours of basic biological science than do leading medical schools such as Johns Hopkins and Stanford. But beware: According to mainstream MDs, such claims can be misleading. They charge that, despite the use of scientific-sounding terminology, most naturopathic research consists largely of isolated case studies and untested theories. It's best, they say, to avoid naturopaths who try to impress you with elaborate explanations, and ones who claim to know as much about medicine as any MD.

Given the broad range of therapies under the umbrella of naturopathy, no general guideline applies. Dietary modifications to reduce the risk of chronic disease or control food allergies, for example, may need many months to make a significant difference, whereas therapy for an acute condition such as an infection or minor injury should reasonably be expected to produce much faster results. Use common sense, and consult the appropriate profiles in this book for more detailed advice on what to expect from specific types of therapy.

Appealing as the idea may be, nature doesn't have the cure for all our medical problems. Although naturopathic physicians have considerable medical training, they are not necessarily qualified to diagnose and treat urgent or potentially life-threatening conditions. (Responsible naturopathic physicians refer such cases to more appropriate medical specialists.) If you have symptoms that may indicate a serious disease, consult a regular physician as well as a naturopathic practitioner.