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Vol. LXII, No. 7
April 2, 2010

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Naturopathy Gaining Foothold, and Under Study by NCCAM

On the front page...

Unless you are a left coaster who graduated from Evergreen State College within the last 35 years, you cannot be faulted for knowing little about naturopathy, a branch of medicine that originated in the late 19th century in Europe, migrated to the United States in the 1890s in the person of German physician Dr. Benjamin Lust, went dormant for the better part of the 20th century and then re-emerged in the 1970s as young people sought natural alternatives to conventional medicine.

Evergreen State, in Olympia, Wash., is at the geographic epicenter of interest in naturopathy, which is most popular on the west coast and Canada, where the majority of the six accredited schools that teach the discipline are located.


  Dr. Wendy Weber  
  Dr. Wendy Weber  

A graduate of one of those schools [Bastyr University] now works at NIH as a program officer at the National Center for Complementary and Alternative Medicine. Dr. Wendy Weber offered a primer on naturopathy Mar. 8 in Lipsett Amphitheater.

A Ph.D., M.P.H. and N.D. (“No, that’s not a typo,” she joked. “I am a doctor of naturopathy.”), Weber studied the requisite 4 years for her degree—the same as an M.D.—and practiced naturopathy, mainly seeing children and adolescents, before taking over an NCCAM portfolio that includes research on traditional medicine, pediatrics and clinical studies in mental health, cardiovascular and gastrointestinal diseases.

Naturopathy is based on the premise of a “nature cure,” she explained. “Clean water, balanced diet, fresh air and exercise” are essential tenets of an approach that relies on the human body’s basic inclination toward self-repair. “The body has an innate capacity to heal itself,” Weber said. “Naturopathy takes advantage of the healing power of nature (vis medicatrix naturae), and treats the whole person.” N.D.s, like physicians, believe “first, do no harm” and relish their role as teachers.

NCCAM’s Weber gave an overview of the practice of naturopathy in a Mar. 8 talk in Lipsett Amphitheater.
NCCAM’s Weber gave an overview of the practice of naturopathy in a Mar. 8 talk in Lipsett Amphitheater.

Though Weber could only speculate about whether naturopathy is gaining adherents in the U.S., she did say the number of trained naturopaths is growing. “About 40 percent of Americans use some form of complementary or alternative medicine,” she reported. “Less than 1 percent of the population uses naturopathy, but usage varies according to region.” Washington state is a relative hotbed of naturopathy; South Carolina and Tennessee prohibit the practice.

Weber outlined the most common modalities employed by naturopathy: dietary and clinical nutrition; botanical medicine (where how substances taste is as important as knowing how to make them); homeopathy; hydrotherapy (no smirking—you use it yourself when you apply ice to a swollen ankle); physical medicine (akin to physical therapy and chiropractic treatment); behavioral change techniques (this may be where naturopathy earns its adherents, suggested NCCAM deputy director Dr. Jack Killen, who thinks patients appreciate the time N.D.s spend in conversation with them); prescriptive medicine (pharmacology) and minor office procedures including drawing blood and placing intravenous lines.

Licensed N.D.s must pass a national board exam, Weber said, and currently practice in 15 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and four provinces in Canada. “Many states offer N.D.s authority to prescribe medicines,” she added.

Weber described a clinical case that allowed her to explain the “therapeutic order” or ladder of options that naturopaths typically pursue with patients. This includes establishing conditions for health (removing irritating or disturbing factors, adjusting diet, addressing physical activity levels, assuring adequate sleep); stimulating the healing power of nature; addressing weakened or damaged organs or systems (in the case she presented, a teen with stomach aches benefited from a herbal tea containing slippery elm and chamomile); correct structural integrity (by use of orthotics to treat a fallen arch, for example); address pathology using natural substances or modalities (sea cucumber and curcumin are among the armamentarium) or via prescription.

Naturopathy is not so doctrinaire that it eschews standard medical practice, Weber emphasized. “If you have a compound fracture, it needs to be set. If you have arrhythmia, you need to see a cardiologist.”

Weber concluded her presentation by describing some characteristics of the practice of naturopathic medicine and summarizing a handful of clinical studies where the benefits of a naturopathic approach seemed clear, both to patients and their pocketbooks. Providers tend to be women, as do patients. Few patients are smokers, most self-refer and 80 percent are between 15 and 64—they know hemp from granola.

NCCAM currently funds two studies of naturopathic medicine, one on diabetes and another on unexplained chronic fatigue. To see Weber’s talk in full, visit NIHRecord Icon

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