MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

naturopathy

A recent post of mine prompted this categorical statement by one of the leading alt med researchers in Germany: naturopathy does not include homeopathy.” This caused several counter-comments claiming that homeopathy is an established part of naturopathy. Now a regular reader has alerted me to the current position paper on homeopathy by the ‘AMERICAN ASSOCIATION OF NATUROPATHIC PHYSICIANS’ (AANP). It clarifies the issue fairly well, and I therefore take the liberty of citing it here in full:

“Overview of Naturopathic Medicine and Homeopathy

Homeopathy has been an integral part of naturopathic medicine since its inception and is a recognized specialty for which the naturopathic profession has created a distinct specialty organization, the Homeopathic Academy of Naturopathic Physicians. Homeopathy has been recognized, through rigorous testing and experimentation, as having significant scientific evidence supporting its efficacy and safety. Single medicines are given on the basis of an individual’s manifestation of a disease state in comparison to combination remedies which are given on the basis of a particular diagnostic category.

Homeopathic products are being subjected to intensified federal regulations and restrictions. Products are being promoted and marketed as “homeopathic” for a variety of uses ranging from weight-loss aids to immunizations. Many of these preparations are not homeopathic and many have not been satisfactorily proven to be efficacious. Homeopathy is practiced in a variety of traditional and non-traditional forms.

Position of the American Association of Naturopathic Physicians:

  • Homeopathy is taught in the naturopathic colleges and its practice should be included in the naturopathic licensing laws. Naturopathic physicians recognize other licensed practitioners of the healing arts who are properly trained in homeopathy.
  • The naturopathic profession initiates more clinical trials and provings to further evaluate the effectiveness of homeopathy.
  • Naturopathic physicians shall be authorized to prescribe and dispense all products included in the Homeopathic Pharmacopoeia of the United States (HPUS).
  • Homeopathic products shall be subject to strict labeling requirements. Preparations which are not prepared in accord with the manufacturing principles in the HPUS should not use the term “homeopathic.” If parents choose homeopathic preparations for their children or their wards for the prophylaxis of infectious disease as an alternative to conventional immunizations, the physician should clearly state that they are unproven and that they are not legal substitutes for the state-mandated requirements.
  • Homeopathic prescriptions should be made with careful evaluation of their effect on the entire organism.
  • Electro-diagnostic testing is an investigational tool. Electro-diagnostic testing should be used according to accepted protocol and it is recommended that it not be relied on as the sole determinant in homeopathic prescribing.”

So, was Prof Michalsen wrong when he stated that “naturopathy does not include homeopathy. It is established in Germany as the application of nutritional therapy, exercise, herbal medicine, balneotherapy and stress reduction, defined by the German Board of Physicians. In conclusion, my general and last suggestion to these kinds of comments and blogs: Please first learn the facts and then comment.”? Not wrong, perhaps – but just a little Teutonic and provincial? The Germans like their own definitions which do not apply to the rest of the world. Nothing wrong with that, I think. But, in this case, they should make it clear that they are talking about something else than the international standard, and perhaps they should also publish their national drivel in their provincial journals in German language. This would avoid all sorts of misunderstandings, I am sure.

But this may just be a trivial aside. The more interesting issue here is the above AANP-statement itself. The AANP has the following vision: “Naturopathic physicians will guide and empower people to discover and experience improved health, optimal wellness, and effective management of disease through the principles and practices of naturopathic medicine.”

These are very nice words; but they are just that: WORDS. The AANP clearly does not believe in their own vision. If they did, they could never speak of ‘EFFECTIVE MANAGEMENT OF DISEASE’ while condoning the use of therapies that have been shown to be ineffective.

And this is where, in my view, the importance of their ‘position paper’ really lies: it demonstrates once again that, in the realm of alternative medicine, organisations and individuals make statements that sound fine and are politically correct, while at the same time disregarding these pompous aims/visions/objectives by promoting outright quackery. This sort of thing is so wide-spread that most of us just take it for granted and very few have the nerve to object. The result of this collective behaviour is obvious: on the one hand, charlatans can claim to be entirely in line with public health, EBM etc.; on the other hand, they are free to exploit the public with their bogus treatments.

Could this be the true common denominator of naturopathy in Germany and the rest of the world?

Naturopathy can be defined as ‘an eclectic system of health care that uses elements of complementary and conventional medicine to support and enhance self-healing processes’. This basically means that naturopaths employ treatments based on those therapeutic options that are seen as natural, e. g. herbs, water, exercise, diet, fresh air, heat and cold – but occasionally also acupuncture, homeopathy and manual therapies. If you are tempted to see a naturopath, you might want to consider the following 7 points:

  1. In many countries, naturopathy is not a protected title; this means your naturopaths may have some training but this is not obligatory. Some medical doctors also practice naturopathy, and in some countries there are ‘doctors of naturopathy’ (these practitioners tend to see themselves as primary care physicians but they have not been to medical school).
  2. Naturopathy is steeped in the obsolete concept of vitalism which has been described as the belief that “living organisms are fundamentally different from non-living entities because they contain some non-physical element or are governed by different principles than are inanimate things.”
  3. While there is some evidence to suggest that some of the treatments used by naturopaths are effective for treating some conditions, this is by no means the case for all of the treatments in question.
  4. Naturopathy is implicitly based on the assumption that natural means safe. This notion is clearly wrong and misleading: not all the treatments used by naturopaths are strictly speaking natural, and very few are totally free of risks.
  5. Many naturopaths advise their patients against conventional treatments such as vaccines or antibiotics.
  6. Naturopaths tend to believe they can cure all or most diseases. Consequently many of the therapeutic claims for naturopathy found on the Internet and elsewhere are dangerously over-stated.
  7. The direct risks of naturopathy depend, of course, on the modality used; some of them can be considerable. The indirect risks of naturopathy can be even more serious and are mostly due to naturopathic treatments replacing more effective conventional therapies in cases of severe illness.

The question that I hear with unfailing regularity when talking about alternative medicine is WHY IS IT SO POPULAR? I always struggle to find a simple answer – mainly because there is no simple answer. The reasons for patients and consumers to use alternative medicine are complex and multiple. They range from dissatisfaction with conventional medicine to clinging to the last straw. However, one factor is very clearly always involved: the often bafflingly uncritical promotion of quackery by the daily papers – and that even includes those with a reputation for being respectable.

Yesterday’s article in THE TELEGRAPH is as good an example as any. In the following section, I quote excerpts from it and add my own comments in bold. 

It is perhaps easier to list what the naturopath Katrin Hempel doesn’t offer her clients than what she does. Bioresonance and live blood analysis, acupuncture, biopuncture, infusion therapy, oxyvenation…”

Katrin Hempel, B.H.Sc.,ND, Dipl.Ac. describes herself on her website as an energetic, enthusiastic and experienced natural therapist with a great passion and commitment to the health and well-being of her patients. She calls herself a ‘naturopathic doctor’. I am not sure what this actually is but I am fairly sure she has not studied medicine. I do not doubt her enthusiasm, but I do doubt that most of the methods listed above are anything else but pure quackery.

“Germany has a long tradition of natural medicine, so it’s more common to find conventional doctors who have also studied natural medicine and use these modalities. Here we are at least 20 years behind.” That is true only, if one regards the integration of quackery as progress.

“Every cell in the body puts out a certain electromagnetic frequency, that can be measured – a healthy stomach cell sounds different to a healthy brain cell – and the machine can put the right resonance back in, to trigger deep healing.”) This is pure pseudoscience; neither live blood analysis nor bioresonance are supported by good evidence (and don’t even ask about ‘biopuncture’).

The article goes on misleading the reader in the most scandalous way by promoting pure nonsense. To provide a flavour, I will merely cite a few quotes from the ‘naturopathic doctor’:

  • “If your digestion isn’t working properly there is a malabsorption of nutrients”
  • “Bioresonance can pick up a condition before it manifests as a disease.”
  • “Bioresonance measures the electromagnetic output of every cell in the body. If there’s any discrepancy with the healthy frequency for that kind of cell that gives a diagnosis.”
  • “Whatever the problem, at root it will be an imbalance in the cells.”

At no point in this article is there an attempt to challenge or critically analyse this bonanza in quackery; THE TELEGRAPH promotion of dangerous nonsense ends with the cheerful footnote informing the reader that one hour with the ‘naturopathic doctor’ will cost from £100. THE TELEGRAPH does not even shy away to print an address for booking a consultation with the ‘naturopathic doctor’.

But is it really all quackery? Yes it is! The article promotes so many unproven methods that I find it hard to choose one for demonstrating how irresponsible it really is. Let’s take life blood analysis (LBA), for instance; here is what I published about LBA some time ago:

The principle of LBA is fairly simple: a drop of blood is taken from your fingertip, put on a glass plate and viewed via a microscope on a video screen. Despite the claims made for it, LBA is by no means new; using his lately developed microscope, Antony van Leeuwenhoek observed in 1686 that living blood cells changed shape during circulation. Ever since, doctors, scientists and others have studied blood samples in this and other ways.

What is new, however, is what today’s “holistic practitioners” claim to be able to do with LBA. Proponents believe that the method provides information “about the state of the immune system, possible vitamin deficiencies, amount of toxicity, pH and mineral imbalance, areas of concern and weaknesses, fungus and yeast”, as another website puts it.

Others dare to be much more concrete and claim that they can “spot cancer and other degenerative immune system diseases up to two years before they would otherwise be detectable”; or say they can diagnose “lack of oxygen in the blood, low trace minerals, lack of exercise, too much alcohol or yeast, weak kidneys, bladder or spleen”. All this would amount to a remarkable discovery if it were true. But it’s not.

No credible scientific studies have demonstrated the reliability of LBA for detecting any of the above conditions. In what was, to the best of my knowledge, the first attempt to assess the value of this method, a practitioner with several years of experience in LBA tested the samples of 110 patients. Twelve had cancer and the task was to identify their samples without knowing further details. The results could hardly have been more disconcerting – just three of the 12 with confirmed cancer were detected, and the authors concluded that the method “does not seem to reliably detect cancer. Clinical use of the method can therefore not be recommended.”

And, in case you do not trust me, here is a recent Advertising Standards Authority ruling on LBA:

London Natural Therapies is in breach of the UK Advertising Standards Code for making unproven claims on its website about Live Blood Analysis. The CAP Compliance team has contacted London Natural Therapies several times about removing claims implying that Live Blood Analysis could be beneficial for Gastro Intestinal Tract Disorders, Allergies and Hormonal Imbalances after the ASA previously ruled that Live Blood Analysis was not effective in detecting/diagnosing those conditions. Despite repeated requests to remove the problem claims, London Natural Therapies continues to feature them on its website, www.londonnaturaltherapies.co.uk. Because of London Natural Therapies continued non-compliance we took the decision to place its details on this section of the ASA website on 26 June 2012. These details shall remain in place until such time as London Natural Therapies has removed or appropriately amended the claims on its website to ensure compliance with the CAP Code.

This is but one of many examples of truly shoddy journalism published in a daily paper that most people would call ‘respectable’. If anyone cares to look at the less respectable end to the journalistic spectrum, the picture gets even more horrific. The points I am trying to make are simple and, I think, important:

  1. Journalists and editors have a responsibility which, in the realm of alternative medicine, they often disregard most scandalously.
  2. Such poorly researched, unbalanced and uncritical articles can cause very serious harm.
  3. The promotion of quackery may be good for selling copy, but it can also quickly ruin the reputation of a paper.

The fact that practitioners of alternative medicine frequently advise their patients against immunising their children has been documented repeatedly. In particular, doctors of anthroposophy, chiropractors and homeopaths are implicated in thus endangering public health. Less is known about naturopaths attitude in this respect. Now new data have emerged which confirm some of our worst fears.

This survey aimed at assessing the attitudes, education, and sources of knowledge surrounding childhood vaccinations of 560 students at National College of Natural Medicine in Portland, US. Students were asked about demographics, sources of information about childhood vaccines, differences between mainstream and CAM education on childhood vaccines, alternative vaccine schedules, adverse effects, perceived efficacy, and credibility of information sources.

A total of 109 students provided responses (19.4% response rate). All students surveyed learned about vaccinations in multiple courses and through independent study. The information sources employed had varying levels of credibility. Only 26% of the responding students planned on regularly prescribing or recommending vaccinations for their patients; 82% supported the general concept of vaccinations for prevention of infectious diseases.

The vast majority (96%) of those who might recommend vaccinations reported that they would only recommend a schedule that differed from the standard CDC-ACIP schedule.

Many respondents were concerned about vaccines being given too early (73%), too many vaccines administered simultaneously (70%), too many vaccines overall (59%), and about preservatives and adjuvants in vaccines (72%). About 40% believed that a healthy diet and lifestyle was more important for prevention of infectious diseases than vaccines. 90% admitted that they were more critical of vaccines than mainstream pediatricians, medical doctors, and medical students.

These results speak for themselves and leave me (almost) speechless. The response rate was truly dismal, and it is fair to assume that the non-responding students held even more offensive views on vaccination than their responding colleagues. The findings seem to indicate that naturopaths are systematically trained to become anti-vaxers who believe that their naturopathic treatments offer better protection than vaccines. They are thus depriving many of their patients of arguably the most successful means of disease prevention that exists today. To put it bluntly: naturopaths seem to be brain-washed into becoming a danger to public health.

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