Naturopathy’s fiercest and most-knowledgeable critic is being sued by a naturopath

 Naturopathy
Jan 142018
 

britt_pic_2_crop
Britt Marie Hermes is an ex-naturopath who has come clean about her time as a naturopath. This video explains her transition from naturopathy to science and evidence, and is well worth watching:

Britt is being sued by a naturopath who believes you can treat cancer with vitamins and baking soda. From Britt’s post:

Colleen Huber is a naturopathic cancer crusader and owner of Nature Works Best (NWB) naturopathic cancer clinic in Tempe, Arizona. She is not a medical doctor and, to the best of my knowledge, has no formal training in cancer research. Yet, Huber promotes herself as a cancer expert (here, here, and here) and is an outspoken critic of standard-of-care treatments for cancer. She wrote that “conventional treatments (chemo, radiation, etc.) sicken and weaken you and ultimately strengthen the disease.”

Huber treats cancer using alternative therapies, including intravenous injections of vitamins and baking soda. She staunchly advocates that her cancer patients should follow a strict sugar-free diet. She advertises that a sugar-free diet increases a cancer patient’s overall survival, regardless of cancer stage or type.

Naturopathy is based on the idea of vitalism, a pre-scientific belief that some type of magical “energy” is a part of all living things. The idea of vitalism was disproved by Wöhler in 1828, yet the idea remains central to naturopathic ideas about medicine. Naturopaths believe their treatments restore this “vital force”. The practice of naturopathy has evolved over time into a mix of disproven or unproven health practices that includes homeopathy, acupuncture, “detoxification” and herbalism, along with the occasional science-based belief repackaged as “alternative”. (For more information, see my series of naturopathy vs. science posts at Science-Based Medicine.)

If you support science-based medicine you’ll recognize the importance of helping Britt defend herself. See her post here. If you can’t donate, please amplify her post by sharing it widely on social media.

Click for detailed story

What is Naturopathy?

 Naturopathy
Feb 192016
 

It is not rare for people to ask me what exactly it is that I do professionally.

  • What is a naturopath?
  • Do they use crystals?
  • Are you a massage therapist?
  • Under what circumstances would I actually book in to see a naturopath?

The following is my attempt to clarify this.

A qualified naturopath is a health professional that is trained to have extensive knowledge of the physiology, anatomy and biochemistry of the human body and the pathophysiology of many illnesses and diseases. They utilise a number of modalities when applying treatment to patients such as nutrition, herbalism, diet and lifestyle modification. Their approach to practice is to adhere to the following naturopathic principles:

  • The healing power of nature
(Vis Medicatrix Naturae): recognising and removing obstacles to allow the body’s inherent self-healing process.
  • First, do no harm: use methods and medicines that minimise the risk of harmful side effects, know when to refer and practice within your scope.
  • Treat the cause (Tolle Causum): aim to identify and remove the underlying causes of illness, rather than suppressing symptoms.
  • Treat the whole person: Understanding the unique physical, mental, emotional, genetic, environmental and social factors that contribute to illness and customising treatment protocols to each individual patient.
  • Education: share knowledge with patients, motivate and encourage individual responsibility for health.
  • Prevention: assess risk factors and recommend appropriate interventions to maintain health and prevent illness.

Naturopaths vary in their experience and areas of specialising however can assist with several health issues including:

  • Weight loss
  • Detoxing
  • Stress
  • Anxiety
  • Depression
  • Poor memory and concentration
  • Fatigue, Chronic fatigue syndrome (CFS)
  • Acne
  • Digestive disturbances i.e. bloating, cramping, Irritable Bowel Syndrome (IBS)
  • Food intolerances and allergies
  • Autoimmune diseases i.e. coeliac, Crohn’s, Hashimotos and Graves disease
  • Cardiovascular disease i.e. dyslipidemia, hypertension
  • Skin disorders i.e. eczema, psoriasis
  • Low immunity i.e. recurrent respiratory infections, viruses, Glandular Fever
  • Candida
  • Urinary Tract infections
  • Hair loss
  • Pre-conception and pregnancy care
  • Reproductive disorders and hormonal imbalances i.e. Polycystic Ovarian Syndrome (PCOS), Endometriosis, Menopause, Pre-Menstrual Syndrome (PMS), dysmenorrhea, low libido, erectile dysfunction

When deciding to seek treatment with any health care professional it is important that you choose a qualified practitioner in order to ensure you receive the best care possible.

Qualified, credible naturopaths will be a member of a professional body such as National Herbalists Association of Australia (NHAA) and Australia Naturopathic Practitioners Association (ANPA). These associations have certain tertiary requirements before enabling membership and if not visible on the practitioners website or business card, this information should be provided upon request.  A credible, qualified naturopath will also be trained on signs and symptoms of when to refer their client to GPs for further investigation deemed appropriate.

In light of recent and I guess long standing controversy regarding conventional medicines vs natural medicines, I believe both have their place in the health care system and people stand to benefit from both.  As long as practitioners practice within their scope and there is respect between conventional and natural medicine and additionally, respect between all natural health modalities, all should be able to coexist and continue to do what is important which is place the client’s and peoples’ wellbeing and health first.

Jessica Gorman- Naturopath Gorman Naturopathy www.gormannaturopathy.com.au

Jessica has completed a Bachelor of Health Science in Naturopathy requiring four years of tertiary study. She is a member of professional body National Herbalists Association of Australia and is a practicing Total Balance Physiotherapy & Pilates in Black Rock

Click for detailed story

Naturopathy and “biomedical” treatments for autism

 Naturopathy
Nov 202014
 

For the past several months I’ve been contrasting the advice from naturopaths against the scientific evidence, in a series I’ve been calling “naturopathy versus science”.  In past posts I’ve looked at the naturopathic perspectives on fake diseases, infertility, prenatal vitamins, vaccinations, allergies and even scientific facts themselves. From a blogging perspective, naturopathy is a fascinating subject to scrutinize, as there is seemingly no end of conditions for which naturopaths offer advice that is at odds with the scientific evidence. As a health professional,  I want to encourage the best use of health resources, and support patient autonomy and decision-making by providing credible, evidence-based information. Given repeated calls for naturopathy to be “integrated” with conventional medicine, I’ve spent a lot of time reading what naturopaths have to say about different medical conditions. What I’ve found is concerning. Naturopaths describe themselves a health professionals capable of providing primary care, just like medical doctors. And they’re increasingly seeking (and obtaining) physician-like privileges from governments.  Yet there is a lack of evidence to show that naturopathy offers anything distinctly useful or incrementally superior to science-based medicine.

Defining the scope of “naturopathic” treatment is difficult. Naturopaths offer an array of disparate health practices like homeopathy, acupuncture and herbalism that are only linked by the (now discarded) belief in vitalism – the idea we have a “life force”. From this philosophy can sometimes emerge reasonable health advice, but that has little to do with the science or the evidence. As long as it’s congruent with the naturopathic belief system, it’s acceptably “naturopathic”. One of the signs that naturopathy isn’t medicine is that it needs a prefix. Notice how there isn’t a “pharmacy medicine” or “nursing medicine” that’s distinct from science-based medicine. It’s just “medicine” – health professionals base their practices on scientific evidence and principles that reach across professions. Naturopathy doesn’t share the same evidence base as medicine, and in some cases, disagrees with its basic scientific principles. It needs to be qualified as distinct, and hence: “naturopathic medicine”. Notice how Rexall makes it easier to find the non-evidence-based products:

naturopathic and homeopathic

This week an advertisement was passed to me that promoted naturopathy at a Toronto public school:

The Learning Disabilities Association is pleased to present this Workshop for Parents and Professionals:
ADHD and LD Naturally
Guest Speaker: Dr. Joseph Steyr
Do you want to know more about natural treatments for ADHD and Learning Disabilities? Dr. Steyr is a Naturopathic Doctor and also has been diagnosed with a Learning Disability since he was a young child. His talk will start with a short introduction to what is Naturopathic Medicine and continue to a discussion of the biology of ADHD/LD. Using that foundation of understanding we will then go over ideas of how nutrition, herbal and homeopathic medicine is used to help support and treat people living with ADHD or LD.

Naturopaths using homeopathy is nothing new (it’s a “clinical science” within their practice, and hence overlap in the photo above), but this bulletin was distributed by the Toronto District School Board, the largest school board in Canada. As a Toronto resident [full disclosure: I have family members in TDSB schools] I’ve always understood that the TDSB was large enough to manage children with special needs and learning disabilities appropriately. It’s a big board with the capacity to offer specialized, focused care. So I was disappointed to see the school board describing homeopathy as “medicine”, and permitting a naturopath to speak. This is especially concerning given that Toronto Public Health notes that some Toronto public schools have up to 40% of students with “exemptions” from the vaccination schedule. Given naturopathy as a practice is antagonistic to vaccination, I wondered if this naturopath shared the perspective of his peers. What I found was troubling. I’ve been reading far too much this week about how how alternative medicine and its purveyors can harm children, so it’s frustrating to see poor thinking about science promoted by academic and charitable organizations that should know better. What’s even more alarming than naturopathy for ADHD and learning disabilities is the naturopathic approach to autism, a condition that naturopaths claim is caused by vaccines, and can be treated with naturopathy.

Autism is related to vaccination only because of a manufactroversy that the two are related, a link that was never based on any credible evidence. Autism is also the unfortunate target of a cornucopia of quackery, all claiming to offer benefit in areas where science-based medicine may not offer satisfactory answers or treatments. The problems with the “naturopathic” approach to autism become clear with an understanding of the science of the disease. Autism can be described as a spectrum of neurodevelopmental cognitive disorders and delays, with variable effects on communication and socialization. There’s no known single cause, and while the disease seems to be strongly influenced by genetics there are a number of factors that are hypothesized to contribute, which include environmental components. While the scientific understanding of autism continues to grow, there are still maddening gaps in the evidence base. There is no cure for autism, but there are evidence-based approaches that can be effective.

Autism biomed

The lack of a “cure” for autism hasn’t stopped alternative medicine proponents from bringing forward their own (unproven) treatments. “Autism biomed” is short for biomedical, and is the umbrella term for the interventions used to “treat” autism medically. There are countless “biomedical” treatments for autism, and they’re offered by alternative (and sometimes conventional) practitioners. What proponents of “autism biomed” treatments always have in common is that they proclaim a superior understanding of autism over “conventional” medicine. And with this special insight comes the confidence that their particular biomed treatments are effective. Their entire perspective on autism as a disease may be quite different. Because they believe autism has external triggers and causes, they see autism as something “done” to a child that can therefore be “undone” with the right treatment: biomed. Consequently it’s not uncommon to see biomed practitioners claim that autism is either curable or highly treatable with their treatments. Biomed treatments can range from mild interventions (like modest dietary changes) to the truly horrific, like chemical castration or bleach enemas. Joseph Steyr, the naturopath noted above, is a proponent of autism biomed. Taking a closer look at his website, his description of biomedical treatment neatly encapsulates the biomed belief system:

The Biomedical Approach believes that environmental triggers (infectious agents, vaccines, foods, pesticides, pollutants/heavy metals) accumulate to a threshold point where Autism starts. These factors can trigger Autism on their own, or in conjunction with genetic susceptibilities. Once Autism begins, untreated triggers and nutrition deficiencies will lead to a worsening of the condition. Starting Biomedical Approach treatments, along with Behavioural therapies, as early as possible increases the chances that Autistic behaviours can be reduced or possibly eliminated. Naturopathic medicine offers many treatment options, from therapeutic diets, herbal (botanical) medicines, vitamin and mineral supplements, to homeopathic remedies, hydrotherapy (waterbased therapies such as foot baths and low‐heat infrared saunas) and (needle‐free) acupuncture.

To biomed purveyors like Steyr, autism is “triggered” by products like vaccines. Other naturopaths hold these same beliefs. Hilary Andrews, a naturopath in Portland Oregon claims:

While the measles-mumps-rubella or MMR vaccine has been strongly linked to the onset of autism, I believe that prior vaccinations also play a cumulative role in this disease. Current vaccination schedules overload very young, fragile immune systems with a huge number of viruses. The number of vaccinations administered to children has more than doubled during the last decade. Today, a child receives approximately 33 doses of 10 different vaccines before the age of six.

To naturopaths, vaccines are yet another “toxin” triggering autism spectrum as well as conditions like food allergies and “nutrient sensitivities”. To detoxify your autistic child, Steyr offers useless but probably harmless treatments like homeopathy and foot baths. He also offers treatments with greater risk for harm, like herbalism or the quackery of hyperbaric oxygen. But Steyr is no rogue naturopath. There is no shortage of naturopaths offering biomedical treatments for autism. A comprehensive list of treatments would be impossible – but here are some of the common treatments promoted by naturopaths:

CEASE therapy

Anke Zimmerman, a naturopath in Victoria, British Columbia, offers Complete Elimination of Autistic Spectrum Expression (CEASE) therapy which uses homeopathy to allegedly rid the autistic child of vaccine toxins. Homeopathy is an elaborate placebo system, with no medicinal effects. Here it is pseudoscience that’s neatly packaged snake oil and promoted to parents of autistic children.

Autonomic Response Testing

Eugene Quan, a Calgary naturopath claims he can cure autism:

We now know that autism is not a psychological disorder. It is biomedical … viruses, bacteria, candida, parasites, and heavy metals cause the behaviours that lead to an autism diagnosis. Once you remove what is causing the symptoms, you can remove the diagnosis … Dr. Quan at Western Naturopathic in Calgary can help your child become autism-free in 1-2 years. Dr. Quan uses Autonomic Response Testing for clear patient assessments, resulting in successful individualized treatment plans. Dr. Quan guides us through a myriad of options, organ-supportive protocols, the vaccine issues, healing the gut, parasites, mould sensitivity, stemming, seizures, speech issues, tonsils, soul awareness, and biofilm elimination. His approach is making a positive difference in the lives of many children and parents searching for options.

Autonomic Response Testing is a variation of applied kinesiology, where muscles are “tested” to determine “sensitivities” to different products. ART is complete pseudoscience and there’s no scientific evidence that ART or applied kinesiology is anything other than a parlour trick – or in this case, a bogus diagnostic.

Food intolerance testing

Sharon Behrendt, a naturopath in Orleans, Ontario, claims that children with autism are suffering from food allergies:

Many children with ASD have food allergies, due to abnormalities in their digestive and/or immune systems. If food is not broken down and digested, then the partly digested food can pass from the gastrointestinal tract into the bloodstream. The immune system recognizes those foods as foreign to the body, and may launch an immune response to those foods, including brain inflammation. These food allergy reactions are called IgG, or delayed, food reactions, as they can take hours or even a couple of days to occur.

Perhaps not surprisingly, Behrendt wants you to stay away from gluten and milk. She also claims:

Removing allergic foods can result in a wide range of improvements in up to 65% of ASD children, in particular improvements in behavior, focus and concentration.

Citation required. I’ve blogged extensively about how naturopaths do not diagnose or treat allergies according to scientific principles. IgG food testing offered by naturopaths is clinically useless and is not recommended by medical professionals for allergy testing. IgG testing leads to unnecessary and potentially-harmful food restrictions, with no relationship between the IgG test and autism.

Behrendt also recommends juicing (delicious, but medically useless) and B12 injections (useless, unless you’re deficient).

Supplements, supplements, supplements

Marianne Fernance, a naturopath in Brisbane, Australia, recommends detoxification, but also vitamin B12, zinc, and magnesium, as well as essential fatty acids for children with autism. The reality is that many children with autism are placed on (sometimes highly restrictive) diets, which increases the risk of nutritional deficiencies if close attention isn’t paid to nutrient intake. The evidence seems to show that special diets do not work for autism, so unless there is a clear dietary restriction or deficiency, supplementation should not be necessary.

Low-dose naltrexone

Nicola McFadzean Ducharme, a naturopath in San Diego, California, recommends low-dose naltrexone for autism. Steven Novella has a much longer summary of the lack of evidence that supports LDN. In short, LDN is an opiate antagonist, usually used to treat narcotic overdoses by blocking the drug’s action at the cell receptor. When used at very low doses, there’s no convincing evidence it has any established role in the treatment of autism.

Chelation

McFadzean Ducharme also advertises chelation, a common pseudoscientific treatment offered by naturopaths:

Heavy metal toxicity is a key component in many children suffering with autistic-spectrum disorders. Whether through exposure via environmental factors such as contaminated food or water, or vaccinations these toxins are detrimental to your child’s health. The detection of toxicity levels of heavy metals is challenging and sometimes difficult to quantify. Tests such as hair analysis (Great Plains or Doctor’s Data) are a good place to start and can give some useful information with regards to the potential of heavy metal poisoning. However, it is important to realize that hair testing is a screening tool and further diagnostics may be necessary to qualify heavy metal toxicity.

Chelation has legitimate uses when it’s part of a protocol for actual heavy metal poisoning. You don’t diagnose heavy metal poisoning with hair testing, however. The hair testing is simply used to give the provider the impetus to recommend useless treatments. When used by alternative medicine providers, chelation is quackery used to remove fictitious “toxins” in the body. There is no credible evidence that supports the use of chelation in autism. What’s concerning about chelation is that the intravenous infusions are not without risks, and chelating children with autism has caused deaths.

Conclusion

Like the other medical conditions they claim to treat, naturopaths do not look at autism from a science-based perspective. Many appear to place a strong emphasis on environmental factors as causes, regularly calling out out vaccines as contributors. Naturopaths offer an array of pseudoscientific treatments they call “biomedical”, with some practitioners claiming that autism biomed can “cure” autism. The reality of autism biomed is quite different than the vision promoted by practitioners. There are countless autism biomed interventions, but there is one universal feature: There is no convincing evidence that autism biomed treatments have any meaningful therapeutic effects on the features of autism. Autism biomed is anecdote driven experimentation. There is no convincing evidence that naturopathy has anything meaningful to offer for the treatment of autism.

Click for detailed story

Naturopathy, Paternalism and Infertility Treatments

 Naturopathy
Oct 092014
 

Pregnancy Test
This is another post in the naturopathy versus science series, where a naturopath’s advice is assessed against the scientific literature.

It’s Naturopathic Medicine Week in the United States, so it’s time for another look at the alternative medicine practice that blogger Orac likes to call the One Quackery to Rule them All. Naturopathy is an oddity among alternative medicine, because it’s a hodgepodge of other practices linked by an underlying belief in vitalism: the pre-scientific notion that living things have a “life force”. Vitalism disappeared from medicine when Wöhler synthesized urea in 1828, yet the belief in vitalism is a central tenet of naturopathic philosophy. Naturopaths liken themselves to be primary care providers akin to family physicians (general practitioners) but their practices are quite different: rather than make decisions based on scientific evidence, naturopaths pick and choose based on what they feel is congruent with their vitalistic philosophy, sometimes despite good scientific evidence that shows they are wrong. For example, homeopathy is an alternative medicine practice that is very popular with naturopaths. It is an elaborate placebo system where “remedies” contain no medicinal ingredients: they are literally sugar pills. There is no demonstrable medical effect from homeopathy, and so it isn’t part of science-based medicine. Yet homeopathy is a “core clinical science” for naturopaths, and the practice of homeopathy is part of their licensing exam.

Naturopathy: Alt-Med Paternalism

According to naturopaths, what they offer is a return to the practice of medicine that’s now been lost:

While the training and approach of ND’s is progressive, they practice in ways reminiscent of old-fashioned family doctors. They take the time and effort to learn about each patient and his/her family. This means seeing fewer patients a day. Naturopathic physicians commonly spend 60 to 90 minutes per patient visit, listening to patient concerns, diagnosing and treating each patient as an individual. This is a practice that benefits both patient and doctor.

Likening naturopathy to “old fashioned” medicine is apt. On the positive side, naturopath consultations are much longer than medical doctors. But that’s where the positives end. Like old-fashioned medicine, naturopaths don’t practice according to what the scientific evidence says. Without a scientific basis for decision-making, “treating each patient as an individual” is justification for making treatment decisions on the fly, without any standard of care, or even an expectation that naturopaths must defend or explain their decisions from an evidence perspective. And despite all the claims that naturopaths do “individualize” their treatments, what naturopaths offer for virtually every condition tends to be based around the same pseudoscientific beliefs: You’re toxic. You’re acidic. You’re filled with yeast. Your adrenals are tired. And lately, gluten is poison. And the solutions offered are strikingly similar: homeopathy, acupuncture, and lots and lots of supplements.

The era of paternalism in modern, science-based medicine largely disappeared with the “old time family doctor” too. Today’s medical model is based on principles of patient autonomy and informed consent. Health professionals are responsible for providing objective information on treatments to support informed decision-making by patients. This advice must be defensible and is judged by what is considered that profession’s standards of practice — which are scientific standards. Patients, as partners, take information provided by health professionals and make care decisions based on a consideration of their own values and preferences. In an informed consent model, lying to patients about a treatment’s efficacy, or withholding information about the evidence, is not only unethical, it could put a health professional’s license at risk.

Naturopathy, like other alternative medicine practices, appears to be highly paternalistic, and consequently may be compromising patient autonomy and choice. It does this by first promoting the idea that science and evidence is relative, poisoning the well for what comes next — the erosion of an objective standard of care. Second, providers fail to offer full disclosure on the efficacy of their treatments. Naturopaths do not offer treatments based on good evidence (as I’ve described in my series of posts and as documented in the literature). While naturopaths can offer science-based advice, they can also promote practices that are are either not proven to work, or are proven not to work. Third, vitalistic beliefs push naturopaths to shift responsibility for illness on to the patient, a tactic which has been described as “Your disease, your fault”, implying that many illnesses are preventable — confusing patients about the scientific facts of their own health conditions. Finally, naturopathy creates fake diseases like adrenal fatigue out of whole cloth, and conveniently offers the treatments for them as well. True patient-focused, autonomous care requires discussions that are grounded in honest disclosures between provider and patient, which seem incompatible with the philosophy and practices of naturopathy. An illustrative example of naturopathic paternalism can be found in today’s case study: naturopathic treatments for infertility.

The Facts of Infertility

Infertility is formally defined a failure to conceive after 12 months of regular intercourse without use of contraception (in women under 35 years of age) or after 6 months of regular intercourse without contraception (women 35 or older). The number of couples that are infertile isn’t clear. Current estimates from the CDC [PDF], suggest around 6.0% of America women are affected, which is over 1.5 million women between the ages of 15-44. Infertility isn’t rare, and many women (and couples) seek medical advice for what’s perceived as impaired fertility.

It’s important to note that failure to conceive isn’t an issue for an individual — it’s an issue for a couple, and should not be assumed to be due to the female. Infertility is a disease of physiology, not psychology. Causes include a lack of sperm, tubal obstruction, or a failure to have regular periods. Often it may not clearly be an identifiable cause, and it can be difficult to sort out probable from possible causes. But medical science has made significant progress in identifying the (true) root causes of infertility, and addressing them. Treatments either target reversible causes, or the attempt to circumvent causes that can’t be reversed. Lifestyle factors that are usually suggested include smoking cessation, minimizing caffeine and alcohol, and ensuring coitus is attempted regularly around the appropriate time in the ovulatory cycle.

Medical therapies for infertility include drug treatments with fertility drugs. Other treatments can include surgery and procedures like intrauterine insemination or in-vitro fertilization. Medical advances have brought significant advances in treating infertility, and up to 50% of infertility cases can be addressed with medical interventions.

Naturopathy and Fertility: Where Anything Goes

Fertility is big business for naturopaths. An Alberta survey of naturopath websites found that 45% advertised that they could treat fertility issues. And it’s not surprising that there would be a search for alternative options. “Medicalizing” what usually occurs naturally can be quite distressing. If only there were a “natural” approach to infertility that could eliminate the poking, the prodding, and all the drugs. So is there? Here are the themes from among the 251,000 sites featuring naturopathy+infertility. Perhaps not surprisingly, most naturopaths offer similar lists of causes (and treatments):

Toxins, toxins, toxins: According to naturopath Iva Keen, you’re not pregnant because you’re toxic:

Most chemicals used in everyday life do not go through the same checks medicines do. Consequently; poisonous chemicals end up circulating in our environment, food supply, air and water. … Unfortunately, our waterways are constantly being polluted by industrial waste and by products, pharmaceutical drugs, pesticides and herbicides and commercial cleaning products. Heavy metals are the most common of the reprotoxins reaching our water supply through industrial waste, jet fuel exhaust residue and a variety of other sources.

Keen suggests drinking filtered water — an unnecessary recommendation, as there’s no evidence that municipal water supplies are causing infertility.

You need to detox: According to naturopath Shawna Darou:

In many cases, treatment may start with a 10-14 day detoxification program with the aim to reset hormone levels, remove toxins as much as possible and remove inflammatory foods. Toxins may be an impediment to fertility and before the body can conceive it needs to detox various toxins that have built up in fat cells over many years of living in polluted environment and consuming unhealthy foods that contain fertility inhibitors.

As has been pointed out many times, “detox” as advertised by naturopaths is a delusion. Genuine detoxification treatments are medical procedures that are not casually selected from a naturopath’s menu of services. Yet the term has been co-opted to give a veneer of medical legitimacy to what is effectively a catharsis, with no objective medical benefits — and zero impact on infertility.

You need homeopathy: Darou continues:

Homeopathy is a powerful aid in stimulating fertility. In 50% of our clinical case we observed a dramatic positive change in fertility directly related to homeopathic treatment. Each case will undergo a thorough homeopathic assessment and constitutional remedy recommendation.

How magic beans stimulate fertility isn’t clear — you’d think with a 50% effect, that a clinical trial would be easy to perform. The one trial I could find showed no effect.

You need herbs: Naturopath Nicola McFadzean Ducharme is a strong proponent of herbal medicine for infertility, listing dozens of herbal remedies she recommends for infertility:

For many natural therapists, herbal remedies form the foundation of naturopathic treatment of infertility.

and

Given that hormonal balance is dependent on the hypothalamic-pituitary-reproductive axis, as well as the pineal gland, remedies to support this should be given, such as Avena, Passiflora and Pulsatilla. These herbs also act as nervines, strengthening and supporting the nervous system. Rehmania, Peony and Licorice may also strengthen pituitary function.There are particular herbs that have estrogenic, progesterogenic or adaptogenic effects. Estrogenic herbs include Alfalfa, Licorice, Fennel, Hops and Clover. Progesterogenic herbs include Wild Yam, Birth Root, Sarsaparilla and Stargrass; while Chaste Tree, Saw Palmetto and Blue Cohosh are adaptogenic, meaning they regulate either way depending on the need.

Prolactin excess can be treated with Chaste Tree or Rehmania; Bugleweed and Hops will help high levels of LH; FSH levels can be raised through use of Black Cohosh, which also lowers raised LH and increases estrogen. Chaste Tree lowers elevated FSH, testosterone, prolactin and raises low levels of LH and progesterone.

Emmenagogues are herbs used to promote circulation and menstruation, and therefore are indicated if amenorrhea is present. Such herbs include Mugwort, Pennyroyal, Tansy, Rue and Southernwood. These should be used with the herbs that promote normal ovarian function. If excessive bleeding is the problem, hemostatic and astringent herbs such as Shepherd’s Purse, Beth Root, Lady’s Mantle, Cranesbill, Raspberry and Black Haw may help.

This advice goes on for several more paragraphs. Perhaps not surprisingly, there is no established role for herbal remedies to treat infertility. No products have been demonstrated to have meaningful effects. Then there’s the teratogen (birth defect) risk of herbal medicines. Combined with the unclear quality control of herbal products in North America, herbal products bring risk, with no established benefit.

You need vitamins: Prenatal vitamins are a science-based treatment during the pre-conception period, but there’s no good evidence that prenatal vitamins provide a fertility benefit. Naturopath Pamela Frank who claims that “We only recommend science based treatments” makes the following recommendations:

As a naturopathic doctor, my 4 years of post-graduate nutrition training and 14 years of experience makes me one of the most highly qualified diet and nutrition experts in health care. Naturopathic doctor training in nutrition is unbiased by political interests such as the Canada Food Guide, the dairy marketing board or the wheat marketing board, based instead on what is scientifically proven to help balance hormones and improve fertility. Diet can either cause or contribute to infertility. Likewise correcting your diet can help your body to reverse infertility. Special individually customized diets will be recommended, and treatment may include nutritional supplements such as vitamins, minerals, enzymes, and other natural supplements.

i.e., Your body, your fault. She continues:

Certain vitamins and minerals can help balance hormones, nourish the endocrine glands like the adrenals, thyroid, ovaries and pituitary and support liver detoxification. Most are safe to use along with fertility treatments and to continue throughout pregnancy. Multivitamins in our experience do not work to fix a deficiency. Why? Because they contain too many different vitamins and minerals, often at too low a dose, that are all competing to be absorbed. We find it far more effective and efficient to target the specific vitamins and minerals that our individual patients need. Vitamins and minerals can also have a significant impact on the health of your future child. Conditions like ADHD and autism have been linked to deficiencies of B vitamins and minerals like magnesium, environmental toxins and hormone imbalances in the mom.

Again, no references, and no basis in reality.

You need acupuncture: Acupuncture is widely touted as an effective treatment for infertility, particularly in combination with in-vitro fertilization. According to naturopath Fiona McCulloch,

We also provide acupuncture, using research driven protocols that have been proven to increase fertility by a substantial margin (40-60% increase in success rates for IVF cycles). Acupuncture provides you with the time and space to feel completely relaxed while physically enhancing blood flow to your pelvic organs and developing follicles as you go through natural cycles, or prepare for your IVF or IUI cycles. Overall, the program will substantially improve follicle health, enhance implantation, and restore hormonal and emotional balance.

Naturopath Shawna Darou claims the following:

Acupuncture is a non-invasive, all-natural way to improve your chances of becoming pregnant with assisted reproductive procedures by up to 65%1.

To her credit, Darou at least lists references. Unfortunately the facts (when you don’t cherry pick) are less impressive than the claims. The evidence for the effectiveness of acupuncture on infertility is less than established. In fact, there’s no good evidence that acupuncture has medical effects for any condition, including infertility. And why would it? Infertility has a physiologic cause. Acupuncture is a theatrical placebo which lacks any objective effects. It is a belief system that’s also based on vitalistic thinking except with acupuncture, ‘Qi’ is the life force.

Stop eating gluten: Naturopaths are proponent of clinically useless IgG food intolerance tests. They recommend these tests as part of fertility evaluations, and also recommend avoiding gluten, linking it to infertility.

Naturopathy reduces stress, which improves fertility: Naturopath Jen Newell claims:

Research into Naturopathic Medicine has found that seeing a Naturopath reduces stress for patients by 15-20%. Patients feel listened to and are able to discuss aspects of their care and lives to reduce perceived stress. Managing stress increases chances of successful conception. Naturopathic care is also helpful at reducing anxiety associated with fertility treatments.

No evidence or citations are provided. I could find no data in medical literature to substantiate this point, though I can see how a 90 minute consultation where unrealistic promises are made to patients could in fact reduce stress. However the link between stress and infertility is not clear, and while stress reduction is probably beneficial for its own reasons, there’s no established evidence that stress reduction will increase fertility rates.

Conclusion

Naturopaths claim to be primary care providers, like medical doctors, but practicing with an older model of medicine. Given the paternalism and disregard for scientific evidence displayed in this evaluation of naturopathic infertility treatments, one wonders if naturopaths realize just how accurate this statement is. Naturopaths were identified to routinely and consistently offer treatments that are either not proven effective, or are proven to be ineffective. They uniformly failed to disclose on their websites that their treatments lack good scientific support, which may leave consumers with a misleading impression about the effectiveness of naturopathic treatments. Given there is no evidence that these treatments have any meaningful effects, there is no demonstrated role for naturopathy in the treatment of infertility.

Photo from flickr user TipsTimesAdmin used under a CC licence.

Click for detailed story