recent editorials Healthing.com “At a time when many Canadians don’t have access to a doctor, naturopathic doctors can help fill the gap and ensure the cycle of care is maintained,” he argues. However, this article does not provide proper background on what naturopathic medicine is, relies on anecdotal evidence and poor arguments, and ends up promoting questionable medical practices.
We have written extensively about natural remedies here. SBM. This includes an inside look at naturopathic training from a former naturopathic doctor, a series on how naturopathic claims collide with science, an introduction to naturopathic textbooks, and more. Simply put, naturopathy is a collection of practices that have in common the fact that most of them are unscientific, the use of “natural” as a vague marketing term, and the lack of a clear standard of care and lack of regulation. It’s just that it’s not enough. Naturopathic doctors may have some genuine advice thrown in, but the bottom line is that everything that is specific to naturopathic medicine won’t work, and everything that naturopathic doctors do that will work is unique to their profession. It’s not that most of what they do is original or scientific.
For example, a major part of naturopathic training and practice is homeopathy. Homeopathy is a completely discredited “magic medicine” form of medicine. Practitioners who support and use homeopathy also cannot claim to be based on science.
However, naturopathic doctors are actively promoting their profession, seeking parity with physicians, greater access to patients, insurance coverage, and prescribing privileges. One of their strategies is to insert themselves into what they perceive to be cracks in the health care system. That is the basis of this article. There is a gap in access to doctors in Canada, so maybe naturopathic doctors can fill that gap. Of course, that would be an absolute disaster for Canadian drug and health consumers. Magic and nonsense cannot close the gap in legitimate health care.
As it often does, this article begins with a heartwarming anecdote about a client who was given turkey tail mushrooms (Kawaratake) To support the treatment of “blood cancer”:
He suggested Carrie try some interesting-sounding fungi, which are said to be rich in antioxidants that strengthen the immune system. A few weeks later, her blood test results came back so good that even her doctors were “surprised,” he says.
There’s a lot to unpack in this short sentence. First, the claim that antioxidants strengthen the immune system is highly problematic. Immune function is notoriously complex and difficult to assess, so using markers of immune function can be highly misleading. Clinical results from controlled studies are needed and have consistently shown that antioxidants are useless and even potentially harmful in many situations. One reason is that antioxidants can impair immune function because oxygen free radicals are actually used by the immune system to kill invaders. However, even in conditions caused by an excess of free radicals, supplementary antioxidants do not work. This is probably because they have a much smaller effect (orders of magnitude smaller) than antioxidants naturally present in the body.
But ditching the term “antioxidant” would be good marketing. That’s because the public has been fed 20 years of misinformation about antioxidants based on outdated and simplistic assumptions. That’s what naturopaths have to offer – bad science but good marketing.
Also, the statement that the doctors were “shocked” by the blood test is quite vague and lacks medical detail. What other treatments were they receiving? And how did their blood tests compare to baseline patients and other patients in similar situations? Still, one patient’s Her single snapshot is the definition of an anecdote. However, the author concludes:
As for Carrie’s use of turkey tail, her blood tests today aren’t as good as they were six months ago, even though she’s been consistent with her diet and exercise. And while Downey admits he’s heard from countless people about the benefits of taking supplements, he also believes it’s not the only thing that can make a positive difference. It’s also a combination of different lifestyles and dietary choices, and the fact that no one experiences recovery in the same way.
In other words, even in this anecdote, the turkey tail ended up having no effect. But that’s okay. Naturopathic doctors were happy to blame their patients’ “lifestyle and dietary choices.” Strangely, in an article touting natural remedies as being science-based, there was no actual science examining turkey tail as an adjunctive or supportive treatment for cancer. The 2022 Cochrane Reviews are:
There was uncertainty about ancillary effects because the certainty of the evidence was very low. coriolus Concerning adverse events caused by conventional chemotherapy for colorectal cancer (in the form of extracted PSK). This includes discontinuation of treatment due to adverse events and effects on specific adverse outcomes such as neutropenia and nausea. Uncertainty in the evidence also means that it is unclear whether adverse events are due to the chemotherapy or the extract itself. There was low-certainty evidence of a small effect on overall survival at 5 years, but the impact of reduced side effects on this could not be determined. Additionally, the chemotherapy regimen used to assess this outcome does not reflect current recommended practice.
Therefore, the quality of the evidence was so low that the authors could not make any recommendations or exclude harm from the treatment, and the patients in the study were not receiving current standard of care. This is the low-quality preliminary evidence found with many questionable treatments, and it rarely survives more rigorous study. Although this is not too far-fetched for an evidence-based practitioner, it was chosen as an example of what a naturopathic physician has to offer.
As further advertising, the article quotes ND.
“If someone is undergoing conventional cancer treatment, we support them by improving their quality of life symptoms,” says Naturopathic Doctor at Insight Naturopathic Clinic in Toronto and CAND President. says Dr. Mark Fontes. “[That includes] Improves sleep and appetite and reduces muscle pain [through] Dietary interventions, herbal medicine, targeted supplements, minerals and vitamins. “We are highly trained in the management of chronic conditions, from inflammatory bowel disease to Lyme disease, chronic pain, digestive and hormonal issues.”
As we have documented extensively here, naturopathic doctors are not “advancedly” or even adequately trained in primary care or disease management. The legitimate things they offer, such as nutritional advice, symptom management, and sleep hygiene, are already part of the standard of care. What they add usually goes beyond the evidence and ranges from unnecessary to harmful.
For example, monitoring and carefully managing nutrition is part of standard cancer treatment. However, this must be done in an evidence-based manner. Cancers are highly metabolically active, so taking the wrong supplements can actually harm them, so some vitamins can actually nourish cancers and help them tolerate chemotherapy better. It is possible to do so. Killing cancer cells while keeping patients healthy is a delicate balance. It is important to pay close attention to the best clinical evidence, which is not provided by naturopathic doctors.
There is also evidence that clinical outcomes are worse for patients who supplement their cancer treatment with alternative treatments, such as those provided by naturopathic physicians. This evidence is clear to those looking to get into alternative medicine, and this is what it would be like if naturopathic doctors were actually filling the gap as primary care physicians. But even for those who supplement standard treatment with alternative treatments, the evidence shows no benefit and probably only a small amount of harm. Additionally, alternative medicine cultures increase the risk that users will refuse effective treatments, even if they originally desired complementary treatments.
A rational evaluation of natural remedies leads to some clear conclusions. Naturopathic physicians are not qualified to function as primary care practitioners. Most of their practices are demonstrable pseudoscience and, at best, ignore the limitations of evidence-based medicine. What they offer can range from redundant or useless to harmful. And overall, it promotes a culture of anti-scientific concepts about health and medicine.
