Phone

Therapies

naturopathy

What Is It?|
How Does It Work?
What You Can Expect
Health Benefits
How To Choose a Practitioner
Cautions

References
Evidence Based Rating Scale

 

What Is It?

Naturopathy is a distinct system of medicine that is based on a belief in the healing power of nature--and especially in the body's innate ability to fight disease and heal itself. Practiced by naturopathic doctors (also known as naturopaths or NDs), it incorporates a wide range of natural treatment methods, rather than drugs or surgery, to stimulate the body's own healing powers. Among the therapies many naturopaths frequently prescribe are diet and lifestyle modifications, nutritional supplements, homeopathy, acupuncture, hydrotherapy, detoxification, spinal manipulation, and more.

Although the term "naturopathy" wasn't coined until the late 19th century, it is one of the oldest forms of medicine known to mankind, tracing its roots to the healing traditions of ancient China, India, Greece, and to Native American cultures.

The therapy became a formal profession in the U.S., when German emigrant Benedict Lust (1872-1945), a naturopath, osteopath, chiropractor, and MD, founded the first school of naturopathic medicine in New York City in 1902. A primary focus at the school was hydrotherapy because Lust had been a devoted disciple of Father Sebastian Kneipp, the famous Bavarian hydropath, before coming to the U.S. Students at the school were also taught herbal medicine, nutrition, physiotherapy, psychology, homeopathy, and many other techniques--but not what the founder termed "poisonous drugs and non-adjustable surgery."

Naturopathy had a growing following in the early part of the 20th century, with 22 colleges of naturopathic medicine operating in the U.S. But by mid-century, with the introduction of "miracle drugs" such as antibiotics, and a campaign by the American Medical Association to discredit alternative forms of medicine, interest in the profession declined and most schools closed their doors. Since the early 1970s, however, there has been a rapid resurgence of interest in this healing technique.

Currently in the U.S., naturopathy has two main groups of practitioners,  naturopathic physicians, who seek training and licensure as biomedical health care providers through four-year programs of post-graduate education; and “traditional naturopaths”, who typically function as educational consultants in areas of healthy lifestyle, herbs, and nutritional supplements.

“It is important to distinguish the difference between the ancient practice, or traditional naturopathy, and the evolved practice, naturopathic medicine—both on a philosophical level as well as on an educational level.

‘Traditional naturopathy can be easily confused with naturopathic medicine by those not familiar with the differences in philosophy and practice between the two. Although the two overlap in many areas, they differ significantly.’

‘Traditional naturopathy: Practitioners trained to be traditional naturopaths may obtain their training at any number of institutions, some of which may even be correspondence schools, which require little, or no actual classroom time. Traditional naturopaths believe that natural healing is an art based on observation and experience. They typically study the alternative medicine belief system, but are not qualified physicians.’

‘Naturopathic medicine: Those trained in naturopathic medicine attend accredited four year schools, and graduate as naturopathic doctors (NDs). They believe naturopathy is a system of medicine based in scientific roots, and their practice may include diagnosing and treating diseases, some types of invasive surgical procedures, and prescribing of pharmaceuticals.” (15)

“Currently, 15 states, the District of Columbia, and the United States territories of Puerto Rico and the United States Virgin Islands have licensing laws for naturopathic doctors. In these states, naturopathic doctors are required to graduate from a four-year, residential naturopathic medical school and pass an extensive postdoctoral board examination (NPLEX) in order to receive a license.” (14) Because state regulations vary widely in this field, consumers should inquire as to the training and experience of anyone who uses the initials “ND”

How Does It Work?

Naturopaths have a different approach to symptoms than do conventional doctors. According to naturopathic medicine, symptoms are viewed as evidence of the body's attempt at self-healing and, thus, should not be suppressed with drugs. A fever, for example, is seen as the way a healthy body reacts to a virus or bacteria. To treat the fever, a naturopathic physician believes in supporting the body system involved in producing it--in this case, the immune system.

A symptom that persists or recurs is explored by a naturopath for its underlying cause. A headache, for example, is not treated with an aspirin. Instead it is evaluated in various ways: as the possible result of musculoskeletal imbalances in the neck and upper back, a nutritional problem (such as low blood sugar); or an emotional problem, such as stress or poor sleep.

In general, naturopathic practitioners follow six basic principles when treating patients. These help to distinguish the profession.

1. Nature has the power to heal. According to naturopathy, the body has the inherent ability to establish, maintain, and restore health. The naturopath's role is to facilitate the self-healing process by removing obstacles to a patient's health and recovery.

2. Treat the cause, not the effect. Rather than suppress symptoms, the naturopath should treat the underlying causes of disease.

3. Treat the whole person. Illness rarely has a single cause, so every aspect of the patient--mind, body, and spirit--must be brought into harmonious balance.

4. Do no harm. The naturopath should utilize methods and substances that are as nontoxic and noninvasive as possible. Methods that suppress symptoms without removing underlying causes are considered harmful and are to be avoided or minimized.

5. Encourage prevention. A naturopath should help to "create" health as well as to treat disease.

6. Act as a teacher. Part of the naturopath's task is to educate the patient and encourage lifestyle habits that promote good health. The emphasis is on building health rather than on fighting disease.

The naturopathic physician movement carries these principals into a primary care “drug-less” medical provider role. The preference of naturopathic physicians to evaluate the whole person rather than just the disease itself, places them in the center of the movement to make health care more “holistic” by giving special consideration to the patient's mental, emotional, and spiritual attitude, as well as to lifestyle, diet, heredity, environment, and family and community life. In contrast, conventional medical training biases allopathic physicians to view all patients with a given condition as essentially alike (allowing for some variation in susceptibility). In conventional medicine, especially in drug therapy, the focus has been on the scientific study of the disease itself.

Significantly, in naturopathy, as in many other traditions of health care, every patient is regarded as unique--as someone with self-healing potential. Because the naturopath's emphasis is on the person, the first question often asked is, "What were the circumstances in this patient's life that set the stage for this illness?” 

What You Can Expect

When consulting with a medical school-trained naturopathic physician, the consultation will typically begin with the practitioner taking a very detailed medical history, as well as asking about the patient's diet, exercise regimen, lifestyle, stress, sleep patterns, bowel habits, and mental and spiritual outlook.

The naturopathic physician will then conduct a routine medical exam, just as a medical doctor would, but with more emphasis on the musculoskeletal system. If needed, X rays may be taken and laboratory tests recommended (these may be done through a hospital or independent laboratory).

If a problem requires immediate medical treatment or surgery, the naturopathic physician will suggest that patients contact a medically trained family physician, internist or specialist.

Although some of the diagnostic tests used by naturopathic physicians are the same as those used by conventional medical doctors, others are quite different. Naturopaths often order a series of tests that measure how well a particular body system may be functioning. For example, the Comprehensive Stool Digestive Analysis is a lengthy examination of fecal material that evaluates the whole process of digestion. The Liver Detoxification Capacity Test measures how efficiently the liver clears toxins.

Depending on the naturopathic physician's clinical approach, other physical evaluations may be used. These can include an evaluation of the tongue and pulse, common in Traditional Chinese Medicine; or iridology, which tracks how an illness within the body manifests itself in the irises of the eyes; or applied kinesiology, which tests how the muscles respond to a variety of potential allergens. These alternative methods of diagnosis generally fall outside the purview of science-based mainstream medicine.

With exam and test results in hand, the naturopathic physician then devises a natural treatment program unique to each patient. This is in major contrast to conventional medicine, in which two patients with a headache usually receive the same basic tests and drugs. This individualized treatment program is gradual and can be adapted as the patient's health improves. Treatments used by a naturopath can include acupuncture, detoxification (fasting, use of enemas), herbal medicine, homeopathic medicine, hydrotherapy (water therapy), lifestyle and psychological counseling, nutritional counseling, physical medicine (massage, touch, etc.), and spirituality.

Indeed, because naturopathy involves lifestyle changes (exercise, stress reduction) and changes in eating habits, as well as the use of supplements and herbs, the therapeutic plan requires much more patient involvement in the process of getting well. Again, this is unlike mainstream medicine, in which prescription drugs--and sometimes surgery--are by far the dominant therapeutic tools.

The initial session with a naturopathic physician is generally about an hour long, and follow-up sessions typically last 30 to 45 minutes. The number of sessions needed depends on the seriousness of the ailment. If a patient has a chronic condition, treatment for six months or more may be required.

Some health insurance companies will cover certain aspects of naturopathic care, such as massage and acupuncture treatments. In many states, naturopathic physicians are seeking to increase their eligibility to serve as primary providers for insurance reimbursement.

Health Benefits

Although few controlled clinical trials have been undertaken to study the efficacy of naturopathy as a system of treatment, many respected studies have been conducted on the individual therapies often recommended by naturopathic physicians. For example, diet and lifestyle changes have proved extremely valuable in treating heart disease, chronic digestive illnesses, and joint problems. The use of acupuncture to treat pain is widely accepted. And there are also many reputable studies showing that nutritional supplements can be useful in treating a variety of ailments. Some anecdotal evidence, along with studies published in naturopathic medical journals, has demonstrated the effectiveness of naturopathy in helping patients to combat many acute and chronic diseases. These include chronic digestive disorders, musculoskeletal problems, migraine headaches, hormonal imbalances, urinary and prostate disorders, high blood pressure, and heart disease.

Specifically, naturopathy may help to:

Treat cancer patients. Patients diagnosed with cancer often seek naturopathic care for various reasons, such as to control side effects of conventional treatment, receive a comprehensive management approach to fighting cancer, improve nutrition, support immune function, maintain a positive attitude and healthy lifestyle, and/or to ease pain in late-stage cancer. A survey with the parents of 75 pediatric cancer patients found that 73% of patients had used at least one alternative treatment or therapy, and that 21% had consulted an alternative provider, such as a naturopathic doctor. Most patients reported using alternative medicine to cope with disease symptoms and ease the side effects of conventional treatments. (1) A survey of 356 adult patients with colon, breast, or prostate cancer indicated as many as 56% of patients sought alternative medicine (including naturopathic doctors) for the treatment of cancer, and almost all patients reported that the alternative therapy improved their well being. (2) However, scientific evidence confirming or refuting the use of naturopathic medicine to ease symptoms and side effects is lacking.

The American Cancer Society warns patients against claims that naturopathic medicine can cure cancer, as studies evaluating naturopathy as a whole are lacking. (3) The American Cancer Society notes, however, that some aspects of naturopathic medicine (proper diet and nutrition) help to lower the risk of cancer, that acupuncture treatment may help to reduce pain associated with cancer, and other aspects of naturopathic medicine may be useful when used in conjunction with conventional medical treatment. (3) Preliminary evidence indicates acupuncture treatments may be useful in reducing pain associated with cancer, when conventional medications are not working. (4) And a 2006 Cochrane Database analysis of clinical trials showed that acupuncture point stimulation in combination with conventional anti-emetics can significantly reduce the occurrence of acute vomiting in patients undergoing chemotherapy treatment for cancer compared to the conventional medications alone. However, acupuncture does not reduce acute or delayed nausea in these patients. (5) More research is needed to evaluate naturopathic medicine as a whole in the treatment of cancer.

Manage diabetes.  In a 2004 study of 493 patients in India with type II diabetes who sought alternative care, the patients reported that naturopathy was one of the most beneficial alternative therapies used to control diabetes. (6) A 2006 retrospective analysis of medical records from a naturopathic outpatient clinic found that most naturopathic medical care for type II diabetes was adjunctive, or used in combination with conventional treatment. The glycemic control and other vital statistics of patients with type II diabetes receiving naturopathic care were on par with the published national averages at that time. Naturopathic physicians had prescribed lifestyle change recommendations consistent with science-based evidence: 100% of patients received dietary counseling, 69% were taught stress reduction techniques, and 94 percent were prescribed exercise. Patients also received botanical and nutritional supplements, often in combination with conventional medication. (7) A 2009 retrospective study of 37 patient records from the Bastyr Center for Natural Health in Seattle, WA found that risk factors (i.e. blood glucose levels, cholesterol levels, blood pressure) for type II diabetes improved in patients receiving naturopathic care for a mean time of 27 months. However, researchers could not determine whether naturopathic care was the sole contributing factor to these improvements. (8)

Prevent heart disease and reduce risk factors. A healthy lifestyle and good dietary choices can help prevent many diseases, but perhaps none so effectively as heart disease. Research has shown that stopping smoking, losing weight, exercising regularly, and eating a low-fat, fiber-rich diet, can prevent the build-up of arterial plaque and can slow, stop or even reverse the atherosclerotic process. These lifestyle and dietary choices can be part of a naturopathic treatment to prevent heart disease and reduce risk factors, such as high blood pressure and high cholesterol. However, scientific research in this area is lacking. The Canadian College of Naturopathic Medicine is currently conducting research to determine if a comprehensive naturopathic approach can reduce risk factors for the development of heart disease, but results are not yet available. (9)

Reduce pain in arthritis. A 2005 review of complementary and alternative therapies used to treat pain and/or musculoskeletal problems found that naturopathic medicine is a popular choice among patients suffering from rheumatoid arthritis. The review indicates that naturopathic practitioners attempt to alleviate symptoms of arthritis through dietary means, such as modification of dietary fats, antioxidants and proteolytic enzymes. (10) However, scientific evidence is lacking. Research is needed.

Ease ear pain in children. A 2001 study of 103 children aged 6 to 18 years with ear pain associated with acute otitis media showed that naturopathic ear drops are as effective as anesthetic ear drops in relieving pain. (11) In a 2003 study of 171 children aged 5 to 18 years, the patients were treated with either naturopathic ear drops, or anesthetic ear droops with or without the antibiotic amoxicillin. Pain improved in all three groups over three days, and the naturopathic drops were more effective than the anesthetic drops. The study showed that the antibiotics did not ease pain and actually may have slowed recovery. (12) A Cochrane Database review of four studies comparing various ear drops to treat acute otitis media, including three trials with naturopathic herbal ear drops, found that naturopathic ear drops were more effective than anesthetic ear drops with or without antibiotics every time.

 How To Choose a Practitioner

In states that license naturopathic physicians, an ND can serve as a primary-care physician. In some of these states, NDs are also allowed to prescribe certain classes of drugs and to do minor surgery. Some NDs also perform natural childbirth in the home or at a birthing center. In non-licensing states, persons using the term “ND” may not have had the medical training to accurately diagnose medical problems. Patients should consider them to be self-trained naturopathic educators or natural health coaches and remain under the care of a licensed physician while exploring holistic “alternatives”.

The training for a naturopathic physician is not the same as that for an MD, although both conventional and naturopathic physicians are required to complete four years of medical school. The ND schools include significant training in diet and nutrition as well as correct use of herbal agents—items typically missing in conventional medical school training. Postgraduate clinical training is different, as well. In order to become a practicing specialist in family practice, orthopedics, rheumatology, or some other discipline, an MD or DO must also serve a minimum of three years of residency in a hospital program after medical school. Naturopathic physicians, by contrast, do not have to complete additional clinical training after naturopathic medical school.

Many naturopathic physicians do obtain additional postgraduate specialty training.  In the case of acupuncture, homeopathy, and minor surgery, they can sit for standardized national examinations in these fields. Postgraduate naturopathic training is typically in the outpatient setting, and any certifications are similar to continuing education training certifications for other health professionals in these areas. Although both MDs and NDs undergo rigorous examinations to verify their competency, only MDs with specific hospital-based training are eligible to take medical specialty board examinations. Naturopaths readily acknowledge this and often compare their education to that of the typical general practitioner (G.P.) before Family Practice specialty board certification became prevalent in the United States in the 1970’s. When specialty care is called for, a good naturopath will send the patient to a surgeon, internist, cardiologist, and so on, as the situation requires.

Today, there are approximately 1,500 naturopathic doctors in the U.S., although the number is growing as interest in alternative therapies increases.

In some non-licensed states, naturopathic practice is not legal; in others it remains unregulated, and both naturopathic physicians and “traditional naturopaths” are using the title “ND” The situation in California may reflect the future regulation of naturopathic and similar practices across the country. With the new California naturopathic medicine law, it is now illegal for anyone who does not have naturopathic medical school training and licensure to use “ND” or call themselves a “naturopathic doctor”, but the California “health freedom” law passed in 2002 exempts “traditional naturopaths” and other alternative practitioners from regulation. The bill carves out an exemption for “complementary and alternative practitioners” from the California Medical Practices’ Act by allowing complementary and alternative (CAM) practitioners to offer their services, provided they do not conduct surgery, administer X-rays, prescribe drugs, recommend the discontinuance of prescription drugs, willfully cause or create risk of bodily harm or injury, set fractures, treat lacerations or abrasions through electrotherapy, or hold oneself out as a licensed physician. In addition, the bill requires that all CAM practitioners must disclose to all clients in plain language that the CAM practitioner is not a licensed physician, the nature of the services, and the practitioner’s educational and training experience. Finally, the CAM practitioner must obtain a written acknowledgement from the client that the client received the disclosure, and the acknowledgement must be kept on file for three years. 

WholeHealthMD recommends that consumers confirm the licensure or exemption status and training of any naturopath that they consult.

Naturopathic medicine’s professional organization, the American Association of Naturopathic Physicians (AANP), is located in Washington, DC.  The AANP recommends that patients contact the organization online (www.naturopathic.org) or at 1-866-538-2267 to verify a practitioner's certification.

Cautions

  • If seeking naturopathic treatment, beware of inadequately trained and unlicensed practitioners. In states that don't license naturopaths, there is no monitoring of the quality of care.

  • Naturopathy uses noninvasive techniques and is therefore considered generally safe when practiced by qualified practitioners. However, patients should always consult a doctor before seeking alternative medical treatment of any kind. The greatest hazard is that when using naturopathic therapies without any conventional advice, a serious medical condition could go undiagnosed. If symptoms occur that may indicate a serious disease, consult an MD before seeing a naturopathic practitioner.

  • Although most naturopathic eating programs are healthful, some (such as fasting) may initially cause unpleasant symptoms. If the diet a naturopath recommends causes concern, discuss the plan with a conventional doctor before starting.

  • Some herbal preparations can interact with conventional medications. Be sure to check with a doctor before taking any Nutritional supplement when taking other medication.

References

1. Neuhouser ML, Patterson RE, Schwartz SM, et al. Use of alternative medicine by children with cancer in Washington state. Prev Med. 2001 Nov;33(5):347-54.
2. Patterson RE, Neuhouser ML, Hedderson, MM, et al.
Types of Alternative Medicine Used by Patients with Breast, Colon, or Prostate Cancer: Predictors, Motives, and Costs. J Altern Complement Med. August 2002;8(4):477-85.
3. American Cancer Society. Naturopathic Medicine. http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Naturopathic_Medicine.asp Accessed April 15, 2010.
4. Alimi D, Rubino C, Pichard-Léandri E, et al.
Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol. 2003 Nov 15;21(22):4120-6.


Date Published: 04/19/2005
Previous  |  Next
> Printer-friendly Version