Opinions 9 April 2018

Naturopathy: neither fish, nor fowl

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Authored by
Jane McCredie
BRITT Maria Hermes is not about to win a popularity contest in naturopathic circles.

The former naturopathic doctor has become something of a scourge to her ex-colleagues through her campaign against what she now calls quackery and fake medicine.

“Pseudoscience is widely incorporated into the naturopathic curriculum,” she writes on her blog Naturopathic Diaries. “Besides taking basic science and ‘regular’ medical classes like cardiology, I also took classes on homeopathy, naturopathic manipulation, hydrotherapy, Chinese medicine, botanical medicine, and naturopathic theory and philosophy.”

The doctoral program Hermes completed at America’s Bastyr University promised future career options ranging from “primary natural care physician” and “rural community doctor” to “wellness entrepreneur”.

Naturopathic doctors have prescribing rights in some states in the United States and can bill insurers for their services, making it easier for schools to market naturopathy to prospective students as “a distinct, and better, form of primary care medicine”, as Hermes puts it.

She now thinks she and her fellow students were brainwashed: “We believed that we were being trained just like medical doctors but with the added bonus of learning the secret knowledge of harnessing the healing power of nature, which could somehow supersede science”.

Some of the subjects she studied certainly sounded like conventional medical offerings, but Hermes says these were often taught by “fake experts” and could be “a front for teaching pseudoscience and anti-medical ideology”.

Her embryology course, for example, was taught by a “doctor of naprathapy”, which Google tells me is an offshoot of chiropractic medicine offering a holistic approach to wellness focused on connective tissue disorders.

A true believer, Hermes went on to practise as a naturopathic doctor in Arizona, where among other treatments she helped her boss deliver intravenous cancer therapies. He was a FABNO (Fellow of the American Board of Naturopathic Oncology), so what could possibly go wrong?

One of the drugs she unknowingly administered was ukrain, a semi-synthetic substance derived from the celandine plant and marketed by its Ukrainian inventor as a treatment for cancer, hepatitis and HIV infection.

Hermes only found out the drug was not approved in the US when stocks failed to arrive and her apparently unperturbed employer said they had probably been seized by authorities.

While there have been reports of ukrain’s effectiveness in cancer treatment, there are no adequately controlled trials, according to the Memorial Sloan Kettering Cancer Center.

There is no evidence to support its use in hepatitis or HIV infection, and known side effects include nausea, dizziness, chronic excessive thirst and possible tumour bleeding.

For Hermes, the realisation that she had participated in illegal administration of an unproven, potentially harmful, drug to sometimes terminally ill patients was the turning point.

“Prior to this seminal moment, I was skilled at ignoring information I did not agree with,” she writes. “Today, I can no longer disregard the inconvenient fact that I was a quack.”

She is now doing a science degree and “exploring why I have a (surprisingly persistent) bias toward naturalistic philosophies, how to think critically, and what can be done to educate the public to prevent mistakes resembling mine or those of my former patients …”

Naturopathy is a strange beast. Its blend of perfectly sensible diet and lifestyle recommendations with a whole raft of largely unproven supplements and other treatments makes it hard to evaluate any possible benefit.

Take this study in cardiovascular prevention, for example.

Yes, the patients randomly assigned to naturopathic treatment in addition to normal GP care achieved a greater risk reduction than those who received GP care only. But were the naturopath’s nutritional medicine and dietary supplements responsible?

There’s simply no way to know.

Participants in the naturopathy arm likely had two health care providers advising them on lifestyle changes over the year of the study. And the naturopathic consultations were considerably longer than those of your average GP: a one-hour initial consult, followed by six half-hour sessions over the year.

The lack of quality evidence for alternative health treatments becomes a bigger issue when practitioners describe themselves or their services in ways that are likely to mislead the general public. “Naturopathic doctor” is an obvious example.

It’s not just the individual providers either. How are education providers who offer courses in naturopathy and other unproven treatments allowed to call them Bachelors of Health Science? And why can we still claim many of these treatments on our (government-subsidised) health insurance?

Jane McCredie is a health and science writer based in Sydney.

 

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.

 
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