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The true test of a man’s character is what he does when no one is watching.

— John Wooden

 

Regular readers might have gathered from reading this blog that we are not particularly fond of naturopaths. Actually, naturopaths themselves might be perfectly nice people; rather it’s naturopathy we don’t like, mainly because it is a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu “one from column A, two from column B” approach to picking quackery and pseudoscience to apply to patients. Indeed, Scott Gavura features as an excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, and, of course, the Infertility Edition. Of course, as I’ve pointed out, any “discipline” that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based, and this blog is, after all, Science-based Medicine. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as we’ve explained time and time again, naturopathy is pseudoscience and quackery.

A couple of weeks ago, over at my not-so-super-secret other blog, I was “celebrating” (if you will) Naturopathy Week. During that week, one of my readers brought to my attention something that, more than anything else, shows the truth of the quote with which I started this post and another similar quote by J.C. Watts that goes, “Character is doing the right thing when nobody’s looking.” I’m referring to the contents of a subreddit posted by a user going by the ‘nym “Naturowhat,” Read what naturopaths say to one another. Conclusion: manipulative, poorly trained, and a threat to public health. Now, I’m not a big fan of Reddit, largely because I can’t figure out how to find things easily, and I hate the sheer ugly and user hostile format of it. However, beggars can’t be choosers; so Reddit it was to examine what naturopaths say to each other when they think no one is looking. I hadn’t planned to comment on this again, but Jann Bellamy thought that our readers would be interested, and who am I to question Jann’s judgment, particularly on a weekend when I was deep into grant writing?

Into the belly of the beast (at least, as much as I can go)

This particular subreddit makes its interesting tidbits available in various ways. Originally, when it was posted two months ago, there were links to a .zip file with a bunch of .txt files representing a private Yahoo! Group named Naturopathic Chat (a.k.a. NatChat). It’s a discussion group in which naturopaths basically let their hair down and discuss…well, everything. In particular, they discuss patients, treatments, and naturopathy. The file is in dBase3 format and, according to the person who tried to upload it, zipped to 62 MB. Ultimately, an anonymous reader pointed me to a copy of the database online containing the entire archive for the NatChat Yahoo! Group. Unfortunately, I have not been able to figure out how to access the actual messages easily using a Macintosh app or, more importantly, to search the database efficiently. So, for the most part, I will be discussing what I found in the subreddit, although I’ve supplemented what some of you might have seen before elsewhere with a couple of examples from the database that are not, as far as I know, online anywhere other than in the database. It’s instructive indeed to peruse them, particularly if you’re sympathetic to claims of naturopaths.

Naturopaths, as regular readers know and as we’ve discussed since the very beginning of this blog, like to claim that they are well-trained to be primary care health providers, a delusion that leads them to try to get states to change their laws to given them that privilege, along with prescribing rights. Across the river from where I live, Ontario made the mistake of granting naturopaths prescribing rights, with an unintended consequence, namely that they can’t find enough pharmacists to test their knowledge of drugs and prescribing. Meanwhile, they lobby states for increased scope of practice and Medicare for reimbursement for their services. Never mind that they regularly demonstrate themselves to be grossly unprepared for the role of primary care practitioner, which is not surprising given their lack of training and how steeped they are in pseudoscience. So little of what’s on that subreddit will likely be a surprise to regular readers here.

It’s actually rather revealing to see what naturopaths themselves have to say about these expansions of their scope of practice. I was simultaneously surprised and not-so-surprised by the reaction of naturopaths to the issues that arise in states where they are both licensed and permitted to prescribe actual pharmaceutical drugs. For instance, see this post by Jared Zeff:

My concern is several-fold, but mostly that WE continue to define ourselves and our standard of practice. I have heard some doctors, particularly younger doctors, tell me that since we now have the prerogative to prescribe antibiotics, for example, we are required to prescribe them exactly like MD’s, as the primary treatment for infections such as cystitis. This means that when confronted with an infection, such as a cystitis, or a Strep pharyngitis, our first treatment must be antibiotic therapy. We may certainly give herbal medicine or whatever in addition, but the standard of care for MD’s is antibiotics, and since we have the same prescribing privilege, we have the same standard of care. I could not disagree in stronger terms. NO, NO, NO!!! I am a naturopath, and I have a separate license, a separate licensure board, and a different standard of care, determined by naturopaths, not by MD’s. Because I may prescribe antibiotics does not meant that I am required to prescribe them, and because I may prescribe pharmaceuticals does not mean that I am required to prescribe them, either. I am a naturopath!

As a naturopathic physician, I am trained and licensed to diagnose and treat the sick, with naturopathic methods, according to naturopathic philosophy. I did this for 30 years without a reliance upon pharmaceuticals, just like Jacob and James. And now, practicing in a state that has given me the privilege of such prescribing, after nearly 100 years of “denying” me such a privilege, does not meant that my practice fundamentally changes. To me, the double-edged sword is that someone may think that because I have this new privilege, I have a new requirement, and am now, suddenly, governed by the same standards as an MD/DO in the treatment of, say, infection, and am somehow suddenly required to use an antibiotic, where 5 years ago I was forbidden from using an antibiotic. This expansion of my prescribing privilege does not fundamentally change my standard of care. My standard of care is determined in part by the therapeutic order concept. Within the therapeutic order, antibiotics are a higher level intervention, after establishing the basis for cure. I may integrate them into my treatment according to my clinical judgement, but by no means am I, or does it make any sense for me to be, required to use them.

Yep. Be careful what you wish for. You might actually get it. Naturopaths in a handful of states and provinces in Canada, have won from the legislature prescribing rights, not because they actually have any clue how to prescribe actual pharmaceuticals to treat real diseases. As was so wisely stated in Spider-Man comics, with great power must also come great responsibility. We physicians know that. Indeed, as a surgeon, I feel this responsibility every time I enter the operating room, because I know that nothing can cure like surgery but nothing can mess a patient up quite like surgery, either. It is a serious responsibility to be permitted to take sharp instruments to the human body to cure disease, and I never forget that.

On the one hand, I have to give Zeff credit for realizing the inherent conflict between medicine and naturopathy that makes laws giving naturopaths prescribing privileges highly problematic—to put it mildly!—but on the other hand, their professional societies (such as they are) are fighting for this. It’s hard not to feel a bit of schadenfreude over the discomfiture of Zeff and other naturopaths like him, but then the fact is that it will be actual patients who will be the victims of the incompetent, non-evidence-based prescribing of real pharmaceuticals by naturopaths. Perhaps Zeff just has more self-awareness than most naturopaths when he realizes that he shouldn’t be allowed anywhere near prescribing pharmaceuticals.

Quackery, quackery, quackery

Even in the relatively small sampling available on the subreddit, there are plenty of examples of just why naturopaths should never be allowed to be primary care practitioners—hell, why they shouldn’t be allowed to be health care practitioners of any kind. Perusing them, I was naturally drawn first to this one on IV peroxide:

Hi there,

Looking for experiences that anyone has had with results from IV hydrogen peroxide therapy.

A patient who is ultrasensitive is considering this but hesitant since she reacts so severely even to the minutest amount of homeopathic drainage. I am concerned as well.

Just that she she has severe dysbiosis and many methods we have tried she reacts to.

Any thoughts?

Thank You
Anna Bunda ND
Ottawa, Ontario

Intravenous hydrogen peroxide, of course, is not indicated for, well, anything. Of course, what I’m wondering is what homeopathic drainage has to do with intravenous peroxide therapy or why sensitivity to “homeopathic drainage” would predict problems with intravenous peroxide? But what is homeopathic drainage, anyway? Don’t ask. OK, I’ll tell you. It’s a form of homeopathic “detoxification,” as described here and here. Here’s what Homeopathy Today says about it:

Homeopathic drainage therapy is one of the best ways to promote body`s natural process of detoxification. Clinical experience in homeopathy has shown that some homeopathic medicines are able to improve blood circulation and help the body gently release the accumulated toxins and wastes from all cells and tissues. Homeopathic drugs have a drainage action when prescribed in low potencies (3X,6X, 3C, 5C).

Homeopathic drainage therapy is very useful and effective in every detox program. Complex preparations containing mixtures of such drainage medicines are available and widely used for maintaining health and well-being. The length of treatment may last from 3-10 weeks and usually depends on the person`s state of health. Homeopathic drainage therapy is natural, safe and compatible with other therapeutic modalities. It also minimizes detox side effects.

I do so love how “low potency” in homeopathy-speak means stronger concentrations of homeopathic remedies, you know, not the super ultra-dilutions like 30C. A 30C dilution, as you recall, consists of 30 serial 100-fold dilutions, or a 10-60 dilution, which is, of course, nearly 37 orders of magnitude more than Avogadro’s number, meaning that a 30C homeopathic dilution is incredibly unlikely to contain a single molecule of the starting substance, other than what might have been carried over as a contaminant on the glassware used to do the dilutions. In other words, the “strongest” homeopathic remedies are water. In contrast, 3C and even 5C (albeit to a lesser extent) could have enough compound left to be pharmacologically active, while 3X and 6X could definitely have pharmacologically active compound. (One also can’t help but note that 6X is the same as 3C.) In other words, “low potency” homeopathic compounds are actually the only ones that might do anything, although, given that most of these herbal remedies that form the basis of homeopathic remedies, are not by themselves generally known to do much of anything, it is unlikely. I suppose aloe might actually be useful for “detoxification of the rectum,” if by that you mean “soothing,” as aloe soothed a particularly bad sunburn I acquired on my chest and back during my honeymoon on a certain tropical island over 20 years ago.

As for the rest, there’s the ever popular Strychnos nux vomica, which is derived from a tree that produces strychnine. If I were to apply Food Babe reasoning, I’d cringe in horror because it’s active ingredient is still used in pest control products, in gopher bait, and in some rat poisons, but in reality it’s never been shown to have therapeutic value for any condition.

But I digress. Another naturopath is only too happy to help out and tells exactly how he likes to administer IV peroxide:

Anna,

I do a lot of IV H2O2 mostly for acute viral infections, it works very well if this is your goal for treatment.

Mix in 250cc D5W 2.5cc of 3% H2O2, add 5 Manganese sulfate (0.1mg/ml) to prevent phlebitis and irritation on the veins from the peroxide, also add 1cc of Mag sulfate 500mg to help dilate vessels. Drip time is approx 2 hrs.

You may want to half the above formula in the same volume of carrier solution and infuse over 3 hrs for the sensitive person as an initial treatment and then go to full strength if tolerating. Be ready with Benedryl if a reaction occurs.

Jeff Hanson ND
The Nevada Center

See the bizarre mixture of quackery (remember, IV peroxide is not a treatment for infection, viral or otherwise) and seemingly conventional medicine, with manganese sulfate and magnesium sulfate being given, as well as a good old standby of conventional medicine, Benadryl, being available in case of hypersensitivity reaction. And, of course, chronic Lyme disease is a favorite bogus diagnosis of quacks everywhere, an undefined disease characterized quite properly as the latest in a series of many labels that have attempted to attribute medically unexplained symptoms to infections. Antibiotic treatment is not warranted for it, and there are many unvalidated tests to “diagnose” it sold in the clinics of naturopaths and other dubious practitioners.

For instance, a naturopath named Renee Lang of Biologic Integrative Healthcare asks whether IV peroxide is good for “stubborn Lyme infection,” and is told by Stacey Rafferty:

I have used H2O2 a fair amount in the vast protocols needed to treat lyme. I believe it addresses the co-infections the best. Almost all lyme patients have EBV, mycoplasma, yeast et…. I am not convinced H2O2 helps with borrelia. If one is using HCl along with H2O2, the immune stimulation that occurs with HCl might be the therapeutic value.

HCl is hydrochloric acid, for those without a background in chemistry. So, here we have a naturopath injecting not just peroxide but hydrochloric acid, into patients. I’m guessing that’s mighty rough on veins, as rough on veins as some chemotherapeutics, although the 3% peroxide is diluted 1:100, which is relatively dilute and we don’t know what concentration of HCl was used along with H2O2. One wonders if Rafferty puts a Portacath in to administer this rather toxic concoction. It’s probably not nasty enough to do really serious damage to veins unless she’s giving it every week, but I’d be worried about extravasation, just as I would be for chemotherapy. Whatever the case, one wonders where these naturopaths get their H2O2 and HCl. Both are “natural,” but isolating them involves a lot of that evil chemistry that naturopaths so dislike.

Consistent with the love naturopaths bear for the nonexistent entity that is chronic Lyme disease, there’s a letter from a naturopath about her child upon whom a tick was found. The tick was removed by a physician, and the discussion turns to all sorts of concerns about—you guessed it—chronic Lyme disease. Naturally, this naturopath is waiting for homeopathic nosodes, which homeopaths think protect against infection. There’s the usual recommendation for nosodes and “naturopathic care,” but one naturopath named Kathleen Riley helpfully suggests:

Are you able to see the site of the tick bite? If you can , I recommend using a drawing salve until the site is no longer visible. Research presented at a past ILADS conference demonstrated live spirochetes at the bite site when it remains inflamed, even if the bite was a year before. To prevent a possible reservoir of Lyme, I have all my patients use a drawing salve on the bite site until it is no longer visible. This is in addition to using homeopathics and antimicrobials for a minimum of 3 weeks and monitoring for symptoms for 3 months after the bite. Earth Botanical Harvest’s Herbal Compound Ointment has been useful for extracting remnant mouth parts. Patients have also successfully use old fashioned black salve for this purpose.

Black salve? That’s downright delusional. It’s basically acid that burns away skin lesions. It’s not for nothing that I once referred to it as “cutting, poisoning, and burning naturally.”

Speaking of black salve, one of the few discussions I could find in the actual database involved the application of black salve on tumors. In a discussion from 2006 under the subject header of “Black Salve for a Huge Protruding Tumor – Q” we find this question:

I had a patient this morning with multiple large fruit sized tumors erupting from her left axilla and chest. The left arm is completley immobilized and edematous. She is terrified that the tumor will eat into her aorta or jugular vein and she’ll bleed to death. She had DCIS in 1999 which was excised with a lumpectomy, clean margins, 2 lymph nodes of 18 were positive. Clear for 2 years after multiple rounds of chemo; now she’s maxed out on radiation too. Considered inoperable. The armpit looks like a gaping mouth filled with yellow custard. On top of this she has a bad case of shingles under the left breast. I treated her with a B12/ADP shingles IM protocol and helped her devise a smoothie using Thorne Supportive Care nutrients, Hoxsey formula, berries, yogurt. Taught her how to make whey fermented veggies. She came to me for a black salve remedy because she knew I did escharotic Tx for cervical dysplasia. I recommended debridement of the oozing, crusty, erupting tissue with saline and bromelain, twice daily, air dry, then for bed placing an occlusive dressing with a “yellow” salve including calendula. Also hp silica. Any ideas where to get a good black salve, or any other thoughts on helping draw this tumor cluster out of her body? Clearly, she is trying to push this goopy mass out and there are 2 discrete “tops” to what literally looks like a volcanic field on her left chest. I’m concerned that if the tumors don’t come out they will spread laterally and cause further compression and intractable pain. She already takes Oxycodone and has a Dilaudid pump.

Thanks,

Emily Kane
Juneau AK

These sorts of cases are the ones that I as a breast surgeon dread. Fortunately, for the most part, they are almost completely preventable if the tumor is treated when it’s diagnosed. We might not be able to save the life of the patient, but at least we can usually prevent this outcome. In this case, however, it appears, at least as far as I can tell from the question, that everything was done more or less properly at the beginning, although I would point out that it must have been cancer, not ductal carcinoma in situ (DCIS) because otherwise the surgeon would not have performed an axillary dissection (removal of all the lymph nodes under the arm). I would also point out that, whatever this naturopath thought to be shingles, was far more likely to be skin involvement by the tumor. In any case, this is what we call carcinoma en cuirasse. It’s something I’ve described before in the context of the quackery that is New German Medicine, alternative medicine use in breast cancer, as well as another post. It’s a horrible condition, and once surgery, chemotherapy, and radiation have failed, there’s very little left that can be done other than palliation. In any case, Kane seems to misunderstand the significance of these masses in that she thinks that if they don’t “come out” they will spread laterally. Generally, when disease gets to this stage such masses are spreading both ways.

To be honest, I feel a little sorry for Kane, who is utterly out of her depth, although I feel much more sorry for the patient. So what sorts of answers did naturopaths come up with? Well, there’s this one:

She is so lucky to have found you. Last year I did a seminar in Canada and saw pictures a woman took of her breast cancer as it moved out of her body using the Black Salve. It took her 40 days for the tumor to come to the surface and move out. I spoke to a woman in Canada who will go to someone’s house and apply the salve for them. The website I have is http://www.cancersalves.com/. The only notes I have are as follows: Apply Goldenseal paste first and then add Bloodroot on top. Change the bandage every other day. This is very painful. The more cancer, the more painful. Please let me know how this goes for you and if she is successful.

Deanna Hope Berman, ND, CM
Naturopathic Doctor, Certified Midwife

Another naturopath from Portland, OR named Virginia Osborne recommended yampavalleybotanical.com. One naturopath from Seattle named Eric Yarnell was actually skeptical and mostly reasonable, pointing out that black salve fries healthy tissue as well as cancerous tissue and is extremely painful and gruesome. He described melanoma patients who died horrible deaths, although it wasn’t clear if it was due to metastastic melanoma or injury from the black salve. Berman would have none of this:

I have seen people who use naturopathic medicine as they do allopathic medicine for cancer care. What I mean is they come in, do a treatment – black salve or other – and then return to their previous life. I am wondering if the people who did the black salve and later died from metastatic disease were like this. Did they continue to use naturopathic therapies and continually work at healing? If not, I am not surprised by the outcome. If someone “treats” cancer naturopathically, I don’t think there is any turning back. I think they need to change their life and work every day towards health.

In other words, you have to believe, and if naturopathy doesn’t cure your cancer you weren’t dedicated enough to the naturopathic cure (or your naturopath didn’t have enough faith to give up anything resembling conventional medicine and use only naturopathy). You didn’t “change your life and work every day towards health.” I’m sorry, but once you have a bona fide invasive cancer, working towards health involves using the best science-based treatment there is. If the cancer is incurable, nothing a naturopath can do will make a difference, other than, in the case of using black salve, interfering with good palliative care.

Moving away from cancer, as a surgeon, I was interested in a discussion “Ulcerative colitis – abscess on j-pouch.” Basically, not infrequently, the variety of inflammatory bowel disease known as ulcerative colitis requires a total proctocolectomy (removal of colon and rectum). However, thanks to the wonder of modern surgery, it is possible for such patients not to have to have a permanent ileostomy stoma through the construction of an ileo-anal reservoir more commonly referred to as a “J-pouch.” Basically, the operation involves taking a piece of terminal ileum (the end near where the small intestine dumps into the colon) and bending it back on itself to form a reservoir, which is then sutured to just above the anal sphincter. It forms a reservoir that partially replaces the reservoir function of the rectum and allows a patient to live without a permanent stoma, although the price is several loose bowel movements a day because the water reabsorption function of the colon is missing. Still, most UC patients consider not having a permanent ileostomy to be worth that price. Here was the problem:

I have a 40 year old female with an abscess on her j-pouch. She has ulcerative colitis and had a complete colectomy 4 years ago and had a J-Pouch created. Her chief concern right now is that she has an abscess on her J-Pouch and the antibiotics aren’t helping. She’s had it drained but it just came back. The MDs suspect it is bacterial but haven’t been able to culture anything She’s coming to me acutely to help with the abscess or else she will have to have surgery to have a stoma created. Any ideas on how to treat the abscess?

Also, once that is treated, she wants overall help with digestion, frequent and spasming BMs, fatigue, pain, energy, etc. She had a colectomy but I’m assuming I still treat the ulcerative colitis since it is an autoimmune condition and the underlying process hasn’t been addressed. From another ND, she’s on VSL#3, lots of omega 3, glutamine, Absolute Veggie protein powder, DIDA tablets, Oregano Oil, Marshmallow tea, Chaga tea, Vit C, Genestra Herbal GI, Thorne Ferrasorb, Thorne Muti-B6, Vit D, New Chapter Bone Strength. She’s currently on a liquid diet – protein shakes with fresh veggie/fruit juices. Anything striking that is missing here? I was thinking of trying a low-sulfur elimination diet and am hoping to get her eating again. She’s losing lots of weight and I find that concerning.

What this patient probably has is pouchitis, a common late complication of J-pouches involving chronic inflammation of the pouch that occurs in 15-50% of patients. It’s a difficult and poorly understood complication whose etiology is thought to be multifactorial and involve genetic, immune, microbial, and toxic mediators, with possible causes including fecal stasis, increased anaerobe/aerobe bacterial ratio, ischemia, and underlying disease. Also 1 to 2 cm of anal canal mucosa is usually retained and can develop recurrent UC. The usual treatment consists of antibiotics and antidiarrheal agents. More concerning is the recurrent abscess, which could mean fistula formation. When fistula formation occurs late, a concern should be raised that the patient actually has a different kind of inflammatory bowel disease, Crohn’s disease. In any case, the treatment for recurrent abscesses and fistulae, such as what this patient sounds as though she has, are treated surgically, with a diverting ileostomy that is usually temporary to divert the fecal flow and allow healing.

In jumped Emily Kane again to suggest ozone. She doesn’t seem to realize that the abscess is intra-abdominal, as she suggests that “bagging the wound and applying ozone would be fabulous.” (No, not so much.) Another naturopath, Jennifer Shalit from Toronto, does actually ask the right question, namely “How does that work when the wound is internal?? Answer: It doesn’t. Or maybe ozone enemas will be proposed.

There were a bunch of other discussions, few of which involved anything other than purest quackery, such as this discussion where—of course—chelation therapy is highly recommended for a patient with cardiovascular disease on Plavix (an antiplatelet drug that slows coagulation) and aspirin because he’s had cardiac stents. Jeff Hanson helpfully suggests:

Are you able to do IV Na-EDTA chelation with this patient? Refer to the Alt Med Review from June 2007 regarding chelation, dual anti-platelet tx, and stents. In this review article, “studies demonstrate EDTA inhibits platelet aggregation…… via three mechanisms while it maintains a safety factor my not inhibiting collagen-induced aggregation…whereas, Clopidogrel inhibits by only one”. I have seen a number of patients outlive the expected life of their stents and not requiring re-stenting. Chelation is one of those treatments you can hang-your-hat-on for stable angina sx and cardioprotection post stenting. Chelation is not proven to remove arterial plaque but I have seen clinically in 2 pts receiving this tx that did a before and after Carotid Intima Media Thickness scan, they saw a 50% reduction in the amount of carotid plague and artery thickness. I would recommend 20-30 IV’s 2x/week then 1 tx monthly as maintenance. Don’t include vitamin C in formula because it can promote inflammation (see “alt med review” original study from March 2009 on EDTA and Vit-C). In addition, ozone tx with Major Autohemotherapy before chelation can promote RBC oxygen utilization and add a boost to the chelation tx.

At least he goes on to say that he wouldn’t use chelation in place of Plavix for 6-12 months. Good to know, given that the recommendation was to use Plavix and aspirin for six months but apparently now is to use it for a year after stent placement to prevent clotting. (The things I learn talking to cardiologists about my patients when asking if I can take them off of Plavix for a few days to do some breast surgery operation! I can operate pretty safely when a patient is on aspirin. Plavix, not so easy. It’s not unlike operating on a patient on coumadin.) Of course, as we know, chelation therapy for cardiovascular disease is also quackery, the recent clinical trial known as TACT notwithstanding.

Naturopaths versus vaccination

I could go on and on (indeed, once I figure out how to efficiently search the database it could provide endless blogging material), but instead I’ll close with—of course!—what naturopaths think about vaccination. Let’s just say they aren’t very enthusiastic about vaccines, pulling out old tropes about vaccinations during the baby’s first year, and they like Dr. Sears, although, surprisingly, one naturopath actually mentioned the CHOP website. Of course, that brought out another naturopath pulling the “pharma shill gambit” on the CHOP website. In fact, this naturopath, Doug Cutler, is in my neck of the woods and states plainly at various points:

Agreed. But the sad reality, is that the “study” is being performed today with our children as the guinea pigs. Absolutely shameful that the biggest medical fraud (perpetuated by Big Pharma) continues to indoctrinate the public (“milk does a body good”) that vaccines are safe and effective. As you stated, we still don’t know the longterm vaccine safety so hoping that they are safe and effective for the “greater good” is unacceptable and completely immoral until we fully know.

You are right though, we need to question our personal “dogma/bias”. I fully believed in vaccines until my intimate association with hundreds of mothers that had vaccine injured children, changed that entire belief set completely around. The same amazing mothers that knew more about vaccines than any doctor or scientist out there, hands down. Then with my training and knowledge of environmental toxins, just analyzing the actual ingredients of each vaccine, one by one – I could never in good conscience justify those known toxic ingredients to have a free pass directly (no detox roadblocks) to a baby’s brain.

And:

And lastly, I would like to see a part of the topic to properly train docs (who vaccinate) on how they should prepare their patients for the above toxic ingredients by first addressing genetic polymorphisms, nutritional deficiencies, food allergies/sensitivities and parent’s toxic burden before conception. That way, I won’t have to continue to see vaccine injured patients who are very difficult in recovering and supposedly don’t exist in our society.

And:

My disclosure, I am opposed to all sources of toxins therefore I am against vaccines whose one size approach fails to account nutritional statuses, toxic burden of mom/child and genetic polymorphisms that are at epidemic levels. 10 vaccines from birth to 6 years in 1983 and 36-38 vaccines from birth to 6 years in 2010. Insane.

No, being as antivaccine as Cutler is, is not in the least bit science-based. He goes on and on against vaccines in the course of several longer-than-average entries in the discussion thread. You know, I might have to explore his website further. It is, as we say in the biz, a “target-rich” environment, and I always wonder about someone who is this antivaccine. In any case, “naturally,” other naturopaths throw out links to the National Vaccine Information Center and its highly deceptive Vaccine Ingredient Calculator. To be fair, there were a couple there, one in particular, criticizing the conspiracy mongering and antivaccine misinformation being spread there, even going so far as to state that “placating anti-vaccination isn’t responsible for our community and does nothing to further the profession,” but I actually think that one naturopath summed up the true case thusly:

Asking naturopaths to accept vaccinations is comparable in my mind to asking dentists to give up amalgams. It touches on some very deep beliefs in the professional group 🙂

Those beliefs are, of course, overwhelmingly antivaccine and baked into the very DNA of naturopaths, beginning in naturopathy school.

What to do, what to do?

Naturowhat (NW) is apparently still part of the NatChat Yahoo! Group, because he/she/it is still releasing occasional update documenting the reaction of the group to the release of its contents two months ago, one of which states that NW had published some of it on Facebook, although I haven’t been able to find it. From what I’ve been able to gather (which, unfortunately, isn’t much), NW infiltrated the Yahoo! Group. However, it’s a closed group that requires proof that a person looking to join it is actually a naturopath or a student in a naturopathy school, which would imply either that (1) NW is a naturopath or (2) NW is good at spoofing evidence of having graduated from a naturopathy school and passed the naturopathic board exam. I tend to favor the first possibility, a naturopath who has become disillusioned with the pseudoscience, but I really have no evidence one way or the other.

Understandably and not unreasonably, additional tidbits posted by NW demonstrate that the members of the group are unhappy. One naturopath, Anne Hill of Portland, for instance, suggested getting out of Yahoo! Groups and getting a private group together. I’ll give her credit, too, for seeing opportunity in disaster, financial opportunity:

Hi Mona-maybe this is a good time to reconsider getting out of the yahoo format and getting a private group together. A lot of this information that we share is really cutting edge and many of the protocols that our incredibly savvy naturopaths have come up with could be considered proprietary information. We also do sometimes share some very personal information on here about patient health historys and business practices.

I can’t help but think this breech is more about data mining then caring about what we are doing with our medicine. I mean really-who cares what we do? I haven’t seen a pitchfork or a ring of garlic in ages. Data miners tend to be looking for what they can sell, resell and make money off of themselves. I would worry that continued access might lead to something more damaging on a business level for one or more of our practitioners rather then it being a belief system thing……

I think we had all shared a while back how much we really appreciate this form and utilize it on a regular basis for researching protocols and new ideas for treatment as well as for posting ourselves. And I believe that many shared that they didn’t mind if there was an extra charge involved. Perhaps there can be a front website where advertising can be sold as well. If there was recently reported that we have 3,000 plus members here then that should be a supplement advertisers dream come true:)

Yep. The reason that whoever leaked the information on NatChat was not because he or she was appalled at the quackery exchanged therein or the belief system demonstrated in these conversations among naturopaths. Oh, no. It had to be because of all the “cutting edge” protocols and “proprietary information” that they wanted to make money off of. Indeed. I predict that this Yahoo! Group will soon go away, to be replaced by an advertising-supported web-based forum format. Three thousand naturopaths to advertise to surely would be a goldmine to supplement manufacturers. Meanwhile, the search for the “traitor” goes on, with Mona Morstein, the naturopath who started the Naturopath Chat Yahoo! Group telling members:

Well, the saga continues a bit. I guess the fellow put some stuff on FB. I appreciate everyone understanding this is not the end of the world. I am calling the AANP tomorrow to chat with them for some ideas. I also feel we should not be ashamed AT ALL at who we are, what we believe, what we write. There are always cowardly jerks out there in Internet Land who feel compelled to hate behind the safety of their computer screens. I strongly suggest we all stand firm and proud and not cower from him.

She also goes on to explain that she’s trying to get Reddit to take what’s there down (good luck with that) and hits up her members to help pay for an IT specialist who “who feels quite certain he can track down the problem and get this situation under control”—at a cost of a $300 retainer and $100 an hour. The problem, of course, is that if there is someone on the “inside” leaking information then no amount of “tracking down” in the world will help unless they can identify the person leaking the information. I have no idea who it is (although I’d love to know so that I could buy him or her a beer), and neither does anyone else. Certainly, I hope they don’t figure out who leaked the contents. In any case, it sounds as though some IT guy is making some money off of Morstein and will end up doing little or nothing to help.

In the meantime, if there’s one thing this dump of tens of thousands of messages shows, on just a cursory examination (to truly delve its contents will require a lot of time and work and to do it right is probably beyond my skill set), it’s this. Contrary to the whitewash campaign of “Naturopathic Medicine Week 2014” promulgated a couple of weeks ago by credulous legislators, naturopathy has been, is, and always will be quackery.

Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.

103 Comments

  1. Your photo looks more like what I cut from my kitchen garden to put in spaghetti sauce or stuffing, rather than anything a ND would “prescribe”. But I get the intent.

    Anyway, this was a scary read. Most striking to me was the repeated reliance on belief, philosophy, and hearsay via a user group for actual treatment plans! In spite of the horror, one wonders why these patients have taken up with ND’s and given up on their MD’s? Is it just desperation, the need to believe, or something amiss in the patient doctor relationship?

    1. Interested party October 20, 2014 at 2:38 pm

      Goodnight, you expressed my exact thoughts while I was reading the blog. I suspect that there may be too many accredited doctors who are rather quick to diagnose and prescibe remedies whithout explaining to the patient the what and whys, and the possible side effects for which watch, even when the patient asks for the information, and may even be smart enough to understand the scientific content. I can only use my own experiences and those of close friends and family members as a base for my impressions, so I may be off base entirely. I am a person of science and I would never seek the advice of an alternative medicine practitioner, but of course most patients are not educated in science and just make decisions based on “feelings” of what is right and wrong. Being sensitive and taking the time to explain the treatment and what to expect as thoroughly as possible would help to keep patients from looking for alternative treatments. I suspect that ND’s are better at “selling” themselves than MD’s are, possibly because MD’s already possess stunning credentials. What more does a patient need, after all?

      1. “, so I may be off base entirely.”

        You are. Our family doctor always was willing to explain, and had handouts for certain details (like exercises to do for runner’s knee or low back pain).

        My son’s neurologist spent a long time explaining exactly what he knew and and how my son was effected. This was followed up by very long and detailed reports that came in the mail a couple of weeks later. Plus if I called the office for an explanation of part of the report, someone in the office was willing to talk to me. This is where I learned that “static encephalopathy” meant “there is something wrong, we don’t know what or why, but it is not changing.”

        Then when the same child was diagnosed with hypertrophic cardiomyopathy, we were given lots of information. Including an extensive tour of his heart from the cardiac MRI by one of three cardiologists before his trip to the Mayo Clinic before surgery. And, oh good grief! You can’t imagine all of the explanations and educational literature we got in Rochester, MN!

        1. I’ve reviewed medical records for research projects and certainly there was reams of educational materials in some of them. In addition to recording information regarding barriers to learning so you get the right materials to the right patient presented in the best way for them to get it.

          It is no secret that educated and activated patients have better outcomes and the payers are moving to paying based on outcomes rather than for how many patients you saw in a hour and how many things did you stuck into their bodies.

          1. One of those barriers can be problems with literacy.

            I was amazed at how many people I knew who could not read, not only a consent form, but the likes of patient information leaflets without great difficulty. There are movements now towards checking how easy leaflets are to read, and writing them towards as low a level of literacy as possible, as well as encouraging doctors to go through the information in a leaflet before the patient goes out the door. Of course, that all depends on the available time…

            1. I run all my consent forms and such through a literacy checker. Too much academic reading and writing and I can’t be trusted to go it alone.

              It is even worse when translating materials, to not only get the literacy level correct but account for various cultural nuances that often are difficult for a non-native speaker to pick up on, but can make something read very differently even it technically translated correctly.

              1. “I run all my consent forms and such through a literacy checker. Too much academic reading and writing and I can’t be trusted to go it alone.”

                The downside – and perhaps I am alone in this – is when I am given something to read that has been written for a low bar of literacy – I presume that the information is as basic as the language and am not likely to read it carefully on the grounds it is stuff I likely already know. I despise being spoken down to; if I am told something that I don’t understand, I’ll ask about it. Is that too much to expect of the average patient (I’m not asking that rhetorically. Perhaps it is too much to expect.)

              2. @windriven:

                It is a fine line to walk. I personally feel that a written consent form or informational packet can never be complete without at least some verbal explanation as well.

                For the vast majority of people it is not about being stupid or incapable of understanding complex medical topics. It is about not having an appropriate background of basic facts to be able to understand the more complex medical topic*.

                In any case, I do think it is a failing of our approach to the topic in the medical profession that we are taught to speak and interact at a very low level with our patients. How widespread this is I do not know, but I have good reason to believe it is the norm. I also think it is changing, albeit too slowly IMHO. I was chastised in medical school for my simulated patient interactions for speaking at too high a level. In my actual interaction with patients I always try and gauge where I think they may be and try and aim ever so slightly above and adjust accordingly. This takes practice, time, and extra effort but I find it to be extremely worthwhile. I also do the ludicrous thing of flat out stating that I don’t know my interlocutors’ level of understanding and to apologize upfront if I speak at too high or low a level. I encourage my patients and families to speak up and I take the time to explain the concepts and pathways whenever they need it.

                For my trouble I managed to be in a position I felt both privileged and terrified to be in. The short version is that I came on service to find my patient actively dying. The family refused to make him DNR and my colleagues expressed their frustration at this given the futility of this situation. I went to the wife and spoke to her and she said:

                You were the one that sat down and explained everything to us so we could understand and I trust you to make the right decisions. If you tell me that there is nothing left to do, then what you say goes

                To have that level of trust with someone gives me goosebumps right now as I write this. But at the time, even though I was 99% certain in my assessment, I felt a wave of terror that I had to hide. I needed to be better than 99% sure in what was the most final decision possible. I was certain, and I spent the next hour with the family keeping my patient alive long enough for his sister to show up and say her goodbye.

                And all because I managed to explain septic shock and the basics of how we make decisions in medicine to the family.

                *Of course, there are plenty of people who simply do not have the desire and/or ability to get even that far, at least not in a timeframe remotely compatible with reality. So far I have found these to be a minority of cases, though my sample size is admittedly limited

              3. @ Drey

                “It is a fine line to walk.”

                Agreed. I think my first comment came off perhaps sharper than I had intended. I really do hate being talked down to. But I really do understand that some people are intimidated and afraid to ask questions.

                ” I also do the ludicrous thing of flat out stating that I don’t know my interlocutors’ level of understanding and to apologize upfront if I speak at too high or low a level.”

                The perfect solution.

              4. It is a fine line and it does take a lot of skill to actively listen to each person as you go through the process.

                I do remember the last time I was consented for a study. She was about to launch into the topic 101 info needed to understand what the study was and I stopped her and recited my thesis topic. She gave that “alrighty then” look and skipped the next page and half of exposition.

                Luckily most of my docs are academics and can put up with my know-it-all-itis.

              5. I met someone who was illiterate, hadn’t had much of an education because in his day it would have been a shocking luxury. He had the best understanding of his medical conditions of anyone I’ve ever met. It was just the right combination of really smart guy, and doctor who took the time to really explain everything to him. He said the doctor would sit down with pictures, and never used a ‘technical’ term without explaining it: “cardiology – that’s to do with the heart” and so on.

                Of course I’ve heard it the other way, friends who came home infuriated because the doctor had patronized them by trying to explain basic things. It must be a tricky thing to get right.

              6. @ simba

                Knowing not only the right words to use, but the right linguistic tools (simile, metaphor, etc) to use with a person is a great way to help even the most illiterate or undereducated person understand a topic. I wouldn’t doubt if your acquaintance’s physician used a lot of those tools as well. Everyone is very smart about something , if you can find that and relate to it the can understand just about anything.

                I had a preceptor once tell me his trick to getting old farmers to understand what their CHF was. It was more detailed then this and he’d use it as a starting point, but in a nutshell: your heart is the sump pump, lungs are the basement. Pump fails for some reason (no power, worn out, something is blocked), basement floods. Works every time.

      2. InterestedParty

        You perhaps misinterpret me a little, or else we’ve had vastly different experiences. I concur with Chris who also responds to you. Any questions I don’t get answered by the MD, especially regarding medication, I check with the pharmacist–an underused and valuable resource. They always make the time and give a thorough answer.

        My remarks were meant to convey more about patient perception. People want the “good vibes” they get from alt practitioners and condemn doctors when they are sometimes told that there is nothing wrong with them. They want the doctor to lose weight FOR them, exercise FOR them. reduce stress FOR them. The ND (or fill in the blank pseudodoc) offers lots of “magic”–supplements, potions, detoxes, lots of pseudo diagnoses, all of which make the patient feel that something is being done for her.

        If I had the answer, I wouldn’t still be reading this blog faithfully. I think some of this is tied to low information (in spite of its counterpart info overload) and a tendency of the general population to devalue education and expertise. There’s also the human inclination toward “faith”. Many people have traded in church for new age-y practices of one kind or another. There’s also the naturalistic fallacy that is used prolifically by marketers.

        1. “Any questions I don’t get answered by the MD, especially regarding medication, I check with the pharmacist–an underused and valuable resource. They always make the time and give a thorough answer.”

          Yes! My local brick and mortar pharmacy makes it a policy that all new to customer medications require a discussion with the pharmacist on staff. This is in addition to the very long and detailed printout they give with all of the side effects.

      3. Being sensitive and taking the time to explain the treatment and what to expect as thoroughly as possible would help to keep patients from looking for alternative treatments. I suspect that ND’s are better at “selling” themselves than MD’s are, possibly because MD’s already possess stunning credentials. What more does a patient need, after all?

        I’m not sure how true this is, or if interventions aimed at training physicians to be more warm and fuzzy would help. For me, the best example, as mentioned in the post, is chronic Lyme Disease. Would training ID physicians (or PCPs) to use motivational or comforting language when dealing somatoform patients demanding to be tested for Lyme Disease really help the situation? It could provide a nicer patient experience, but the real problem has to do with the LLMDs or NDs laying in wait, ready to make false promises of miracle cures and promulgating the notion that the horrible, cold-hearted healthcare system just doesn’t “get it.”

        1. WilliamLawrenceUtridge October 31, 2014 at 10:55 am

          The asymetry of the professions is profound. On one hand, doctors have to be scientific, are heavily monitored and controlled, and if they’re even aware of CAM, they aren’t allowed to use the word “bullshit” to describe it.

          On the other hand, CAM practitioners can’t rely on science, have no objective standard against which their care can be measured, and primarily define themselves in terms of conspiracy and criticisms of real medicine.

          It’s the difference between a museum guide and a carnival barker.

  2. If you have MS Office, Microsoft Access can import dbase3 files natively and then convert them to other formats (access files, text files, etc)

    I realize many of the contributors use Macs so my invoking the Company That Shall Not Be Named could get me banned. Other alternatives that support dbase3 are openOffice & LibreOffice

    1. I am a Mac person. There is no Microsoft Access in Office for the Mac.

      1. And here I thought you made science based decisions?

      2. But there is OpenOffice, and according to their wiki anyway, it can open dbase files using its Base component.

      3. This is because MS Access is a blight upon the surface of the Earth, and is like antimatter to a Mac. 😛 No, actually it’s a tactical decision on Microsoft’s part. By restricting Access to Windows, they make it harder for businesses that rely on it to jump ship to some other platform.

    2. There are versions of Open Office for Mac. I don’t do databases, so i don’t know if they support dbase3. They’re free though.

      A number of studies have shown Macs increase productivity, and while having less tech whiz bang and higher initial cost, have lower cost of ownership in the long run.

      And they’re way cool.

      1. MACS now adays are much more secure than Windows. With the new password hashing algorithm and the fact that most malware is built for windows, you are much less likely to get hacked.

        1. Macs have always been more secure than Windows, in part because most business applications run preferentially on Windows (go where the $ is) and because Apple has a much smaller market share centered around academia and graphic arts.

          Moreover the Mac OS is derived from the rock solid Unix operating system while Microsoft grew willy-nilly from a not very interesting operating system called CP/M. Windows, of course, is a huge departure from the CP/M –> DOS days, but that really made matters worse rather than better.

          Sadly, Apple was never embraced in the business world largely because Apple made it very, very difficult to modify and add on to hardware while IBM took more of an open source approach publishing bus layouts and timing and making the BIOS coding widely available. To this day, even a graphics intense program like SolidWorks (a powerful and widely used CAD program) is only available for Windows.

      2. I’d be interested to see the studies that show Macs to increase productivity. Would you be kind enough to link one or two?

    3. If you use Apple, then using Base; part of the Libre Office suite.

      http://www.libreoffice.org/discover/base/

  3. Holey-crap…..all those poor people, I can’t even imagine the suffering they went through….

  4. A little bit off-topic, but I saw a bill-board advertisement for an “alternative exterminator” while drive down to Cape May, NJ, last week. We had a good time thinking what the exterminator would use and how only the termites would be happy with the results.

    1. Smudging with sage and lavender?

      1. @n brownlee: The esoteric mag I pick up for free (for the giggles) had an article where someone was using a shamanic drum against garden snails… (actually drumming it, not for squishing) and “inviting the snails out of the garden” or some such BS.

        1. Better to invite them out for a beer…

          1. At least that actually works. 😉 My grandma used to put little dishes of beer out to lure the garden slugs, who would then drown in it.

            1. Works like a charm- or, um, better than a charm, actually. 😉

  5. Years ago, the National Lampoon ran a “Diagnostic Doctor” column by Ed Subitzky, with the preface: “Most doctors, because they know so little, are afraid to diagnose in print. But the author of this column got a B+ in high school biology and has read a lot of health hooks , many of them several hundred pages long.”

    The Q and A would run about like this:

    Q: I get nauseous in the mornings.
    A: If you were a woman, you could be pregnant. But because you’re a man, you’re probably sick.

    Q: Is my knee broken”
    A: If it hurts a lot, it may be.

    Q: I’ve been coughing a lot.
    A: You could have anything from a simple infection to a dread disease. Try to keep warm.

    Could he get a license today?

    1. Ha! That reminds me of “Ask Doctor Science” https://www.youtube.com/watch?v=Elpbs6kb8Ys

  6. I apologize if I missed this but do they verify whether you are a naturopath or not? Could I join this group as “Crankyepi, ND” and start spewing any crap that came into my brain? (Not that this is too far off from what the degreed ND’s do.) But, if there is no verification of identity why aren’t they savvy enough to wonder who might be giving them advice?

  7. Wow this is definitely a weird experience reading this thread so many years later….

    I actually attended Naturopath school at SCNM in Tempe, AZ for about a month in the fall of 2006. I dropped out because I had ulcerative colitis and it had gotten so bad I couldn’t function anymore. (“Despite” the fact that I was doing every alternative therapy in the book, so put that in your peace pipe and smoke it, NDs!)

    Anyway, I was classmates with Doug Cutler. I actually wasn’t sure, so I dug back into my old email account I had back then and sure enough, I found a bunch of emails we had exchanged when I was on leave from school and in the hospital. Incredible the kind of absurdity I believed back then. I recall FREQUENTLY getting blamed for the ineffectiveness of the therapies I was using. The trope of “not believing hard enough” hits home all too closely.

    I had the “dreaded surgery” and now have a J pouch and I’m healthy, happy, and living my life. I would have had it a lot sooner if I had never been mixed up with the false promises of naturopathy, and perhaps I could have moved ahead with my adult life sooner. In fact, the emotional damage I suffered from the false hope of alternative medicine has long outlasted the physical symptoms of my actual disease.

    I’ve had pouchitis twice in the last 4 years and thankfully, I got lucky and both were successfully treated relatively quickly. My thoughts on this whole experience are that while science based medicine may not be able to put a stop to the autoimmune disease process the way I wished they could have (sparing my colon), and there’s of course always a chance that this hell is not over for me, and perhaps, yes “The Underlying Problem of the Autoimmune Disease Has Not Been Addressed” and I could develop M.S., Crohns, or chronic recurring pouchitis. I’ll give the natural medicine folks this much – because nothing is perfect.

    But, at least when I sought treatment for my condition, at my darkest of hours, when every hippie I knew had “given up hope on me” because “I just wasn’t motivated enough to heal myself” — the doctors I crawled to for help were (surprisingly, to me, at the time, based on the bullshit I was indoctrinated with about the “evil ignorance” of MDs) informative, rational, helpful, and kind. They adequately informed me of the risks and benefits of the surgery, took their time explaining to me what would be done, and how long the recovery would take, how it all worked, and what the success rate was. I researched it well ahead of time myself and made sure to ask them about infertility, incontinence, pouchitis, and cancer. I asked them about how to properly wean from prednisone. They weren’t huge fans of me being on prednisone as long as I was without seeking alternatives. I wasn’t a candidate for TNF alpha blockers and the 5-ASA drugs weren’t effective for me. I had been on 6-mercaptopurine for a few years and even that had stopped controlling the symptoms after a while. I had tried so many alternative therapies that I nearly died. Not kidding. (I wrote a book about it that I’m still editing.)

    Now I’m well. Science based medicine gave me my life back. I have come to accept that perfect health is a myth and that accepting myself in the body I came with and rolling with the punches is way way way better than false promises. I am so fortunate to have my health. Now I teach biology at a community college and a significant portion of my semester is spent teaching my students about critical thinking. Maybe someday one of them will think twice before buying into false promises and it might save their life.

    Thanks for reading my novel. I just got kind of emotional from reading this post.

    1. “I have come to accept that perfect health is a myth and that accepting myself in the body I came with and rolling with the punches is way way way better than false promises.”

      Exactly. I did not choose to have an allergy to nickel, nor high cholesterol and blood pressure… all of which are genetic. My dad also has the same issues.

      Though unlike him I never had to have cancerous mouth lesions removed due to a history of cigar smoking, nor do I have to visit a dermatologist on a regular basis to remove possible skin cancer lesions on my fair freckled skin. This is because of his experience I never smoked tobacco and was an early adopter of sun screen.

      I also did not choose to give birth to a child with multiple medical issues that started with neonatal seizures on his second day of life, followed by several hospitalizations due to croup, a “grand mal”seizure due to a now vaccine preventable disease, a severe speech disorder*, migraine headaches that sometimes mimic a stroke, a severe genetic anatomic heart condition that required open heart surgery and on and on.

      But stuff happens. You just have to roll with the punches, and make decisions based on evidence, not “just so” stories. And I have been given lots of those stories. I have learned to ignore them, or ask a pointed question like when someone told to try cranial sacral therapy… I told them that a homeopathic head massage was not going to fix damage in Broca’s Area.

      * Semi-amusing anecdote: when my son failed to speak when he was almost two and a half years old he was referred to a speech therapist who relieved his lack of communication frustration by teaching him sign language, which was his first communicative language. So when I was at the playground, zoo, etc we communicated with a version of ASL. A couple of people noticed it and asked if my son was deaf. I honestly explained that he was not but he could not speak so we used sign. They would then get a confused look on their face, immediately lose interest and then ignore us.

      I always thought that was interesting. Apparently having a deaf child is interesting, but having a child with hearing who could not speak was too much to process.

      By the way, despite the fact he used the school’s sign language interpreters up through third grade, he later rejected ASL as his speech became more competent (his special ed. program was created from the hard of hearing program because they got kids who would not be able to speak but could hear… so it was not coincidentally at the same school that had the deaf/hard of hearing program plus the district’s audiologists).

      1. People are infuriatingly dumb sometimes. If its not standard fare like whats on they cant process it. Never could grasp that approach to life.

        Your son sounds like an amazing person and so do you for being conscientious in your care of him.

        1. I am not amazing, I am just resilient.

          Someone once asked asked me how I dealt with it all… The only response I could think of was “What else was I supposed to do but to meet his needs?”

          I mean, was I supposed to go nuts, buy into nonsense, what? You just have to roll with what you have been dealt with and nothing else. We deal with crud everyday, it is up to yourself if you succumb to the nonsense. This is why this website is a good resource, it helps to filter fantasy versus reality.

      2. “I have learned to ignore them, or ask a pointed question like when someone told to try cranial sacral therapy… I told them that a homeopathic head massage was not going to fix damage in Broca’s Area.”

        Sadly, my sister is extremely into pretty much any kind of woo there is out there. I was noticing on her facebook feed the other day I conversation she had with some friends talking about how since they had become ‘educated’ on vaccines and such, that they felt empowered to voice their opinions even when it was awkward to try and help others. One of my sisters’ friends then relayed an incident where she saw baby having a seizure in public and she actually went up to the parents and told them this was caused by vaccine injury and that needed to get their child in for chelation ASAP.

        I was pretty floored at the amount of hubris that takes. Way to blame the parents, not to mention the fact that there are dozens of things that can cause siezures, but they magically know, without doing any examination or diagnostic procedures what is causing everything.

        Some people just don’t know when to shut up…

    2. @Beta Marie:

      Thank you for sharing your story.

  8. I dream of a medicine world where money hungry asshole would not have a say in anything. So that plants remedies, antibiotic and vaccine could coexists. I can see why you would go for antibiotics with an infection because no traditionnal remedies have had the job done in history, doesn’t take a degree to figure this out. But then again why do you have to rely of chimicals drugs for everything when some plants do the job just right, especialy for small things ie (pine sap for small cuts, plantago for mosquito bites). Well the problem is you don’t do a lot of money on Afterbites if everybody would just apply crushed herbs from their back yard. The only way to turn all those mosquitos bites into money is by making a transformed product that nobody could reacreate at home so homeopathie and chemical drugs are to way to go. We have to see the good of modern medecin (by good I mean a lot of things), but also the motivations behind it (and behing homeopatic/naturopatic shit) as they are not here to help us: Helping us (or not) is a by product of themselves making money. (I’m talking about the corporations not the doctors).

    We need to take medecine (and a shit load of other stuff) out of corporations and into our own hand. I’m pretty sure if we put as much research energy (with a neutral science oriented mind and not a “I’m gonna prove my beliefs with this research) into “simple medecine” than we do with High End stuff we could sort out the shitty traditionnal remedy from the good ones and all save money + less people in the hospital for rediculus problems.

    1. “I dream of a medicine world where money hungry asshole would not have a say in anything.”

      OK. How’s that going to work? Think for a moment about the amount of money it takes to develop a new drug or to translate an interesting observation in physical chemistry into a powerful diagnostic device such as Magnetic Resonance Imaging. Perhaps, you say, the government should do it. And my answer is to give you the US Department of Defense, home of the $800 hammer and the $1200 toilet seat. Governments are generally pretty good at spreading research funds around where they are most needed; not so much on translational efforts.

      “But then again why do you have to rely of chimicals drugs for everything when some plants do the job just right,”

      This is the branch of science called pharmacognosy. Many drugs in the modern armamentarium are derived from plants. But the problem is that in nature, plants produce different amounts of various compounds and if you don’t know how much a certain plant has, how do you know how much to use? And some plants produce both beneficial and toxic compounds. Some nasty, money-grubbing prick has to figure out which are the good compounds, how to isolate and purify them leaving the toxic compounds behind, study what the best dosing is and testing how much is safe.

      But look, nobody says you can’t grow your own. Foxglove is a beautiful plant – it grows wild here in the Pacific Northwest. The cardiac drug digitalis was first refined from this plant. Make yourself a nice tea. It will improve the contractile efficiency of your heart and may straighten out your atrial fibrillation. Or it may kill you. A little – in the right circumstances – can do a lot of good. But the wrong dose can spoil your whole day.

    2. “I dream of a medicine world where money hungry asshole would not have a say in anything.”

      OK. How’s that going to work? Think for a moment about the amount of money it takes to develop a new drug or to translate an interesting observation in physical chemistry into a powerful diagnostic device such as Magnetic Resonance Imaging. Perhaps, you say, the government should do it. And my answer is to give you the US Department of Defense, home of the $800 hammer and the $1200 toilet seat. Governments are generally pretty good at spreading research funds around where they are most needed; not so much on translational efforts.

      “But then again why do you have to rely of chimicals drugs for everything when some plants do the job just right,”

      This is the branch of science called pharmacognosy. Many drugs in the modern armamentarium are derived from plants. But the problem is that in nature, plants produce different amounts of various compounds and if you don’t know how much a certain plant has, how do you know how much to use? And some plants produce both beneficial and toxic compounds. Some nasty, money-grubbing jerk has to figure out which are the good compounds, how to isolate and purify them leaving the toxic compounds behind, study what the best dosing is and testing how much is safe.

      But look, nobody says you can’t grow your own. Foxglove is a beautiful plant – it grows wild here in the Pacific Northwest. The cardiac drug digitalis was first refined from this plant. Make yourself a nice tea. It will improve the contractile efficiency of your heart and may straighten out your atrial fibrillation. Or it may kill you. A little – in the right circumstances – can do a lot of good. But the wrong dose can spoil your whole day.

      ****

      Eventually, this will be a double post. I failed to self edit and the original is in moderation.

      1. Never mind. I failed to self edit the second version tightly enough. It isn’t worth a third go-round.

    3. Mosquito bites? I treat them with a very old natural remedy called tincture of time (not thyme). It always works. No plant-derived chemicals needed.

    4. WilliamLawrenceUtridge October 31, 2014 at 1:35 pm

      So that plants remedies, antibiotic and vaccine could coexists

      They do. It’s just that most plant remedies are, upon testing, ineffective (and many are simply untested). St. John’s Wort now exists as a treatment for mild to moderate depression. Ginger is used as a safe and effective antinausea treatment.

      All I want out of CAM and regulators is that a treatment be tested and found efficacious before being sold, but apparently this is too high of a standard.

      The only way to turn all those mosquitos bites into money is by making a transformed product that nobody could reacreate at home so homeopathie and chemical drugs are to way to go.

      Two points:

      1) I just scratch my bites until they bleed, after which they cease being itchy. It’s free!

      2) I’m always astonished that homeopathic remedies are even sold. The method to make them is incredibly simple, all you need is water and a vessel. How is it a multi-billion dollar industry?

      OK, a third point:

      3) In addition to many plant-based remedies being simply ineffective, I’m happy to pay for something that comes in a standardized dosing, that I don’t need to pull out of my garden (I get winter, no plants grow in my garden), and has a shelf life measurable in years. So thank you Big Pharma, for making products that work, and I can buy nearly anywhere, for an incredibly low price given how long I will own them.

      We need to take medecine (and a shit load of other stuff) out of corporations and into our own hand. I’m pretty sure if we put as much research energy (with a neutral science oriented mind and not a “I’m gonna prove my beliefs with this research) into “simple medecine” than we do with High End stuff we could sort out the shitty traditionnal remedy from the good ones and all save money + less people in the hospital for rediculus problems.

      Embodied in your entire post is the idea that traditional remedies and in particular herbs are actually effective. Most aren’t, and some (like aristolochia) are actively dangerous. Research currently goes on into plants, it’s called pharmacognosy, and I’d happily roll the entire NCCAM’s budget into it if it were up to me.

      SBM proponents don’t object to plant-based remedies, in fact they are frequently referred to as the branch of CAM most likely to bear fruit. But the reality is most plant-based remedies are being sold in the US without adequate (or any) testing, because the laws allow it. Which is dumb.

      Anyway, plants aren’t a panacea, they aren’t magical, and above all they do not exist as a form of natural pharmacy for human’s ills. Sometimes they are indeed helpful, but this is an accident of history. There’s no need, or proof, that the world’s flora contains the cures for all of our woes.

  9. I find it hilariously (and depressingly) ironic that NDs blame everything on “toxins” yet enthusiastically give their patients intravenous HYDROGEN PEROXIDE. Amazing cognitive dissonance.

    1. It would be nice if they’d make up their minds if everything will be cured by massive doses of antioxidants or massive doses of oxygen via oxidizers like H2O2.

    2. My sister is heavily into woo, and one time I was watching my niece and was going to feed her something that had some sugar in it. My sister freaked out saying that my niece was on a strict ‘no fructose’ diet and that the only sweetener she was allowed to eat was honey. I wish I were making this stuff up…

      1. One of my friends had diabetes, thought she could eat all the honey, dried fruit, and ‘no added sugar’ cereals and other ‘health food’ junk she liked (like ‘no added sugar’ ‘good for you’ jelly sweets which were mostly grape juice). Because of those kinds of ideas, all that marketing.

        She was genuinely trying really hard, overhauled her whole lifestyle, couldn’t keep the blood sugars down…

        1. Was she never referred to a dietician for counseling?

          1. She was, and she told me about the various changes she had to make and how she had to eat healthier and avoid sugary foods. So she was swapping out the ‘bad’ foods for the ones I mentioned. Of course I don’t know what exactly the nutritionist said, or how it related to what she heard.

            1. Oy Vey!

              I thought I already posted a response once, but maybe I forgot to hit post. So forgive me if I repeat myself.

              1. I hate when that happens. Just disheartening.

              2. I think it wasn’t clear. “Oy Vey!” was my reply to your response.

                As in Oy Vey! It’s bad enough to have misperceptions about sugar, but to have them when you are a diabetic is just dangerous. 🙁

              3. I understood that, I just meant about not being sure if a post has been lost, wasn’t written, or is going through.

              4. Ha – The worst is when I right a lengthy post, then my ipad shuts down right before I post it, losing everything.

                Don’t suppose this would be helpful for your friend?

                http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/

                I know some people are not open to advice, though.

      2. At least she wasn’t saying only Agave nectar.

        Funny how syrup from corn processed to have a high fructose content is bad.
        Syrup from agave that is just as processed that has an even higher fructose content is good.

        Of course concentrated apple or pear juice really isn’t any better, although sometimes contains enough sorbitol to be a dandy laxative.

        1. My sister is also heavily into coconut oil as being a cure for everything. I was trying to explain to her that it was still a heavier oil that should be taken in moderation as it could contribute to atherosclerosis.

          She just couldn’t accept it. Sadly, she exemplifies the binary, no shades of grey CAM mentality that something is either all good and rainbows and sunshine, or it is all evil and meant to destroy one’s health.

          1. Have you met someone that flipped from one mode to the other? The most common flip of that sort I have seen is a couple of individuals who went from soy is the cure for everything and you must work to get as much of it in your diet as possible to soy is the destroyer of worlds and nothing should ever eat any of it, ever.

            It is probably only a matter of time before coconut oil is reviled again.

            1. My sister exemplifies a lot of that as well. I have noticed that her thinking is very emotional, and trying to engage logic doesn’t work well. Which is why I think she is susceptible to CAM in the first place. Obviously, I have given up on trying to talk to her about CAM since all it does is tick her off, but I am still quite concerned for my niece and nephew who are completely unvaccinated. Furthermore, they are living in a Christian commune where pretty much no one vaccinates and everyone embraces CAM. Even furthermore, this is located in an area that as a whole already has one of the lowest vax rates in the country. If any epidemic starts, they are a prime spot for it to invade.

              She has bounced all over the place on what is good/bad though she has most recently decided that the GAPS diet is the way to go (Dr Hall did a good article on it last year, it is searchable here on SBM). I do find it odd that when she would try a CAM treatment and it wouldn’t work, it didn’t trigger the thought of re-evaluating CAM, she takes it as a sign to try a different sort of CAM.

              I hate to say that she has also started her own blog about anti-vaxx and other CAM stuff. I think she is trying to become a CAM pundit along the lines of Food Babe.

              1. Oh dear, my condolences.

              2. “Oh dear, my condolences.”

                I truly appreciate that. It has been incredibly depressing. The really odd thing is that about ten years ago, my sister was very logical and mature, and she just kind of got sucked into CAM and it seems as though her critical thinking has just disintegrated since then…

              3. WilliamLawrenceUtridge October 31, 2014 at 1:41 pm

                The really odd thing is that about ten years ago, my sister was very logical and mature, and she just kind of got sucked into CAM and it seems as though her critical thinking has just disintegrated since then…

                People want stories, not facts. They are story-telling apes. It’s easier to have a lovely, simple story with heroes and villains than to have to confront nasty reality where most people are both.

  10. Kerwin Flaherty October 22, 2014 at 9:08 pm

    Here is a handy primer for Reddit. http://i.imgur.com/vRKWU.png

    I also recommend highly Reddit Enhancement Suite. http://redditenhancementsuite.com/

  11. There are some comments here that seem to suggest that people who say doctors can be dismissive of their patients are lying (for want of a better word – perhaps exaggerating?) because every doctor they’ve ever encountered has been basically perfectly saintly in every facet. Maybe they have been, and if that’s the case you’re lucky.

    I have met many doctors (both at work, as I have worked in hospitals; and personally, because I’ve moved around a fair bit and have had three babies) and while many are really amazing people in every way, others are quite horrible. Rude, arrogant, ignorant, misinformed (one or two have been all four; most of the bad ones are only one or two). But, they’re all just human. People who are clearly intelligent, but there is no test for saintliness when you get into medical school. There are going to be a range of personality types in medicine, just as there is in any discipline.

    The thing is, the science is real no matter what I or anyone else thinks of their personality. So long as that personality and ego doesn’t get in the way of science (and I have met a couple of doctors – one as a patient, one as a co-worker – who did seem arrogant enough to think they were better than science). But ultimately, I’d rather have a medical doctor who was a complete asshat, so long as he or she practiced SBM (and not all MDs do, unfortunately – plenty have swallowed the woo pill), than an ND who was the nicest person alive.

    1. Which comments?

      I agree that doctors are human and show the normal range of human personality and behaviour.

      I can’t see any comments that say/suggest that people who say doctors can be dismissive of their patients are lying and every doctor they’ve encountered has been saintly. InterestedParty said that there are ‘too many doctors’ who do not provide information about what and why they are prescribing, and suggested that this may be because doctors feel they have ‘stunning credentials’ and need nothing further.

      People have challenged the idea that this is one of the major drivers of use of alternative medicine or that this is the experience of most people with their doctors. InterestedParty was careful to add that this was their personal experience and that of people they know, so it’s not unnatural that people who’ve had differing experiences would add them.

      It would help if you referred to or quoted specific posts to support your argument.

    2. Doctors have the full range of human personalities. Doctors even admit some are jerks,for example, at an educational thing for residents I was at yesterday we were given an example of how detrimental that can be for the patient’s family and standard of care.

      What usually gets people bothered is the all doctors are that way because fill in the blank conspiracy that implies doctors are deliberately keeping you sick and part of the cover up is their attitude and only fill in the blank alternative can possibly heal something.

    3. WilliamLawrenceUtridge October 31, 2014 at 1:52 pm

      I have met many doctors (both at work, as I have worked in hospitals; and personally, because I’ve moved around a fair bit and have had three babies) and while many are really amazing people in every way, others are quite horrible.

      Yes, which is why I brindle at the CAM trope that doctors, as a profession, are all greedy, heartless PharmaShills.

      Ultimately having a nice doctor is a bonus for me. What I want is a doctor who can correctly diagnose me and prescribe a treatment that alleviates my symptoms. That will never, ever be an ND or homeopath.

  12. Recently from Natchat:

    Hello, all,

    I just got off the phone with the AANP about our little mishap.

    They said, essentially–don’t worry, let it go, any publicity is still publicity, which is overall good.

    They also explained that another naturopathic organization, some new one, just lifted a bunch of copyrighted articles from naturopathic.org and plastered them on their own new website, which the AANP’s Mandisa Jones is going after. So, this kind of thing is continually happening.

    I also learned that the owner of Wikipedia apparently completely dislikes us, and allows any type of smear of NDs on Wiki and won’t take it down.

    Yet, we are still here, are still doing good work, still understand our philosophy is fantastic, our aid to patients super helpful if not out and out curative.

    REDDIT took down the original post after I sent them a particular letter explaining why they should. I hope pastebin does as well.

    No one can edit or upload any database associated with Natchat; only I can. If someone feels they need something along those lines, you can contact me privately.

    Be strong. Deep breathe. Relax. We’re in the right. We’re growing. Even MDs, as we know, are “discovering alternative medicine”.

    Let’s keep moving on as we were doing and continue to feel pride in our profession, our own practices, and in NaturopathicChat’s capacity to give us all a place to seek help, advice and camaraderie.

    If anyone does learn of any member copying and pasting anything inappropriate on the web from NatChat, please let me know as I will ban their sorry selves from Natchat forever. 😉

    Sincerely,

    Mona Morstein, ND, DHANP
    Tempe, AZ
    http://www.diamend.info
    Official Sponsor of NatChat–Doctors Data Lab

    James Prego, ND
    Message 2 of 2 , Today at 4:44 PM
    Good to know.

    BTW, a bit about wiki: its totally open. Its not the owner of wiki having a thing against us. Its someone(s) who are making updates to the wiki that is the problem. The ONLY way to combat this is to continually make update back to what we want it to say. This ‘open source’ style of updating has its advantages, but also drawbacks…this is one of them. As usual, the more citations in the wiki you create, the better it is received by people using wiki, however anyone can update anything at any time with anything, true or not. This is why Wikipedia is not usually allowed as sources in college papers.

    1. “I also learned that the owner of Wikipedia apparently completely dislikes us, and allows any type of smear of NDs on Wiki and won’t take it down.”

      the owner probably has nothing against you, it’s REALITY that has it in for you and your phony profession. the reason those “smears” are not removed is because they are accurate, well cited, and correct. it doesn’t matter what people think about you per se it’s what the evidence demonstrates, and so far you only demonstrate your delusions of medical professionalism. Susan Gerbic and the guerilla skeptics on wikipedia are diligently making sure you “ND’s” are correctly identified for all time as ND’s, NOT a DOCTOR.

      “Be strong. Deep breathe. Relax. We’re in the right. We’re growing. Even MDs, as we know, are “discovering alternative medicine”.”

      looks like their are more bad doctors,and fake doctors, introduced into the profession every day. yikes

      1. “Even MDs, as we know, are “discovering alternative medicine”.”

        Yes, but science always wins in the end. And as it becomes ever clearer that ‘alternative’ means bull$hit in this context, those MDs will be the chaff of that winnowing process.

    2. With one sentence you two have self-identified as ass-hats. Well done.

      “The ONLY way to combat this is to continually make update back to what we want it to say.”

      “What we want it to say.” Not the truth. Not the facts. Not the evidence. “What we want it to say.”

      You want to know why rational people treat your ilk like pestilent pond scum? There’s your answer.

    3. As usual, the more citations in the wiki you create, the better it is received by people using wiki, however anyone can update anything at any time with anything, true or not. This is why Wikipedia is not usually allowed as sources in college papers.

      Reading between the lines, their take on wikipedia is absolutely hilarious. They don’t seem to have the slightest clue that wikipedia, and by the same respect the entire world of science, is not just about throwing up a bunch of random sources. It involves a systematic approach to research, where high-quality, convergent sources are given more credence than low-quality, incompatible sources. They don’t understand that winning the PR battle doesn’t count for squat with any competent doctor or scientist, and their rush to control media depictions of their craft speaks volumes of their integrity and honesty. No doubt many naturopaths have rationalized their own use of propaganda and marketing as a necessary step to gain acceptance, but at the end of the day they are employing the same tools drug companies employ to fight competitors.

  13. Actually, the comments made on NatChat about WIKI are completely accurate; the owner and board are decisively against naturopathic medicine and do not allow positive statements or corrections of misinformation.

    Unfortunately, misinformation is rampant, and so are black/white views of the world. That is, that allopathic medicine is based on evidence based science, and that naturopathic medicine is not.

    When we analyze this we see many flaws. First, evidence based medicine is a cover-all for oftentimes biased science, and hidden results. For example, how many ‘evidence-based” FDA approved medications are pulled from the market yearly due to finding out they are so much more dangerous than any previous study illustrated, or the dangerous aspects were hidden from publication. Wiki has a decent list of recalled medications, which science at first said were safe, effective medications.

    I would also have you read up on “evidenced-based medicine” in terms of MDs discussing the problems with having that guideline be the “scientific” foundation of standard care:
    1. http://content.healthaffairs.org/content/24/1/18.long where MDs in the opposing position disagree that “cookbook medicine” with specific medical guidelines is best for practices.
    2. Where Ben Goldacre, MBBS, expresses dissatisfaction that drug manufacturers do not turn over all the accumulated drug studies informations the develop. http://www.medpagetoday.com/PublicHealthPolicy/ClinicalTrials/37506
    3. An article discussing EBM and CAM: https://www.sciencebasedmedicine.org/cam-and-evidenced-based-medicine/

    While it seems that I am against evidence medicine, I’m not. However, it is not the basis solely on which to based valid medicine, as studies are oftentimes done by people with proprietary interest to hide certain facts, and promote others, to the detriment of future patients.

    Standard care medicine is fantastic for diagnosis, treatment of acute and life-threatening illness, and trauma. Where it is weak is in care of chronic conditions. For example, giving a hypertension patient 1-4 medications to control it is not the only way to treat that condition. There are methodologies to uncover etiological factors and heal the hypertension, if you can take your fingers out of your ears and are willing to listen.

    After all, many people die each year from being properly prescribed medications, for their condition, in the correct dosages, let alone from medication errors.

    To believe that drugs and surgeries are the only ways to only treat people for all conditions is a narrow, unhelpful viewpoint which helps no one.

    To also believe that what naturopathic physicians do is completely against science again is just showing ignorant biased misunderstanding of 1) the science, and 2) naturopathic medicine.

    If a naturopathic physician suggests that a patient hold off on an TNF-a medication for their child’s Crohn disease if the child is not in a crisis, and use the Specific Carb Diet, before Gorski has a seizure, and lambast that ND for not using Humira, why not look at the Journal of Pediatric Gastroenterology’s study doing just that–giving the SCD to 7 peds patients and see that their Crohns went into remission and they children did amazingly well?

    There are thousands of scientific studies regarding the modalities and treatments naturopathic physicians use–they abound in the medical literature.

    And for some things, yes, NDs use empirical medicine, which has stood the test of time. To disavow all benefits of empirical medicine is unfortunate.

    If you prefer to stand on your soapbox and say the “World is Ending” because naturopathic physicians exist, and oftentimes use science or empirical medicine to treat their patients using alternative modalities, that is your choice.

    Please be aware that Harvard, Yale, etc all have alternative medicine programs in their universities now. Dr. Mark Pimentel, an MD at Cedars-Sinai, is the physician who uncovered and advanced the use of SIBO testing for IBS, and the FODMAPS, SCD diet (etc) for treatment. I suppose Dr. Weil is a quack, too, then. What about Stephen Sinatra, cardiologist, promoting natural ways to deal with cardiologist conditions? Are you out to get him, as well? If not, you should be, as his son is a naturopathic physician.

    As MDs realize the flaws in their systems, and study more of “functional medicine”, naturopathic physicians will be continuing to successfully treat patients with a multitude of conditions.

    1. “NatChatter” (which one, I wonder):

      There’s so much misinformation in your comment and so little time (because I’m still at work). So I can only hit a couple of highlights.

      First, regarding Ben Goldacre (because it’s easy.). It’s true that Goldacre is a harsh critic of pharma, but it’s also true that he likes to say things like:

      And:

      Second, re: CAM vs. EBM and SBM. Try reading a couple of articles written by Steve Novella and myself that were just published over the last couple of months:

      http://www.cell.com/trends/molecular-medicine/fulltext/S1471-4914(14)00103-8

      http://www.nature.com/nrc/journal/v14/n10/abs/nrc3822.html

      In both articles we explain the difference between SBM and EBM and why, for example, homeopathy (which naturopaths are required to learn, with large swaths of time in naturopathy school devoted to it and the NPLEX exam testing on it) is completely pseudoscience to the point where one cannot justify clinical trials on it. I also note that you quote a post by Steve Novella in which he quite accurately discusses how EBM was blindsided by CAM.

      That other article you cite, I note, is not so much a scientific discussion of EBM and its flaws, but rather from a sociological context and how EBM has thus far been disappointing in managing to change physician behavior. It is not a rejection of EBM.

      As for your argument from authority by citing academic medical centers that have unfortunately made the decision to embrace quackery (a term I refer to as “quackademic medicine”), we’ve written about such issues time and time again here, long before anyone here had ever heard of the NatChat discussion forum or its having been leaked to a subreddit. In fact, long before the existence of this blog, one of our founders wrote what is still likely the definitive critique of naturopathy:

      http://www.medscape.com/viewarticle/465994

      As well as:

      http://www.medscape.com/viewarticle/471156

      Oh, and, yes, I do think Dr. Weil is mostly a quack. The problem is that, like so many in “integrative medicine,” he “integrates” pseudoscience and quackery with evidence- and science-based medicine.

    2. FWIW most of Pimentel’s peer-reviewed published research is in using antibiotics, but he does think diet has a role to play, but then the idea that diet has health effects is standard medical care and doesn’t have to be based on woo. Although it seems the all IBS must be SIBO which is what some people did with his early work (with a selection process designed to find a possibility of a something if there was any something there to find) is overstated. however it does seem SIBO plays a role for some people and that is found reliably over enough papers that it seems to be something real.

      Most of the FODMAP research is also published in peer-reviewed journals and is not based on some woo in the food that cannot be measured by any known detection equipment or any other woo-tastic theories.

      SCD is mostly anecdotal but it does tend to limit the FODMAPs and less gas often means reduced symptoms for those with GI distress.

      I certainly wouldn’t lump them in with most other alt med. Especially since the proponents (for FODMAPS and SIBO more so than SCD) seem determined to prove the science works rather than just hoping their mindfarts mean something.

    3. Almost all these points have been covered in this website numerous times, but I’ll just comment on a few. First, you state that “To believe that drugs and surgeries are the only ways to only treat people for all conditions is a narrow, unhelpful viewpoint which helps no one.” If you cared to look in a current medical textbook or at current guidelines, you will find that lifestyle changes are the first line of therapy recommended for many conditions, including hypertension, hyperlipidemia, and type 2 diabetes as well as copd (the ultimate outcome of which almost solely depends on whether the patient continues to smoke or not). As a hospitalist the most frequent consults I request are not from some subspecialist group, it is for physical therapists and dieticians to see the patient. Much time and effort is spent trying to get people to give up smoking and excess drinking. Alt-med people posting here make the claim often that drugs and surgery are all mainstream medicine recommends. Not true.

      Second, it is true that some drugs are released on the market based on one or two promising studies, and after release, surveillance of these meds when they are given to large numbers of people uncovers problems and issues not seen in the original studies, causing them to be withdrawn from the market. This is a triumph of SBM, in that it corrects itself as more information becomes available. This is something NEVER seen in CAM, which does the same old thing regardless of what new studies show concerning its effectiveness. If you have some information concerning a CAM treatment which has changed as a result of a valid scientific study, I’d sure like to see it.

      I’m sure some of your other points will be covered by other posters, but as I’ve said if you search the past archives these have been discussed in detail.

    4. WilliamLawrenceUtridge October 31, 2014 at 2:10 pm

      Actually, the comments made on NatChat about WIKI are completely accurate; the owner and board are decisively against naturopathic medicine and do not allow positive statements or corrections of misinformation.

      Having edited wikipedia for years, I’ve never seen “the board” or even Jimbo take much of an active interest in most individual articles. They are less “against naturopathic medicine” so much as they are (as Jimbo has said) for good quality research. The problem with naturopathy is that it’s based on unproven claims and poor quality research. It’s not wikipedia’s fault that naturopaths don’t bother to do good science. Of course, since if they did do good science and published it, real doctors would simply adopt the practices now that they’ve been properly tested, this is actually yet another indictment of the profession – unethically practicing in the absence of good evidence, totally redundant in its presence. I’m not sure how anyone can defend the profession.

      When we analyze this we see many flaws.

      I’m not sure how any of the flaws of real medicine in any way justify the unscientific approach of naturopathy. What you’re saying here is “because cars get into accidents, my carpet can fly.” Vioxx being withdrawn doesn’t mean that hydrogen peroxide or detoxification can cure cancer.

      Where it is weak is in care of chronic conditions. For example, giving a hypertension patient 1-4 medications to control it is not the only way to treat that condition.

      First off, while medications may be used to temporarily prevent death, alleviate symptoms or prevent further harm, for most lifestyle conditions the long-term recommendations are generally standard lifestyle change advice that it is the patient’s responsibility to undertake. Don’t blame doctors because patients would rather pop pills than eat better and exercise. Second, again this doesn’t justify naturopathy’s ability to cure anything, let alone chronic conditions. Third, isn’t the naturopathic solution often the same, just with ineffective pills? What do naturopaths recommend for high blood pressure – vitamins, minerals and herbs? How is that different from antihypertension medication, aside from having no evidence to support them? What, your handful of pills are better because they are ineffective?

      After all, many people die each year from being properly prescribed medications, for their condition, in the correct dosages, let alone from medication errors.

      Yes, real medications have side effects and risks, and human error leads to morbidity and mortality. Naturopathy’s approach however, is either parasitic (eat better and exercise – standard advice from real doctors) or is essentially leaving patients with untreated diseases. Again, the flaws of real medicine, with all of its risks, doesn’t justify naturopathy’s complete lack of good evidence to support its interventions.

      why not look at the Journal of Pediatric Gastroenterology’s study doing just that–giving the SCD to 7 peds patients and see that their Crohns went into remission and they children did amazingly well?

      Because a scientifically literate doctor would look at the study, note that it’s only got seven patients and no control group, and conclude that you can’t consider this evidence for anything beyond the need for better scientific studies. And did naturopaths conduct this study? I’m guessing not – they’re parasitic – but if you recommend this course of action you are basically turning your patients into test subjects in an uncontrolled clinical trial with no ethical oversight. How do we know that the improvements are due to SCD rather than regression to the mean? Or natural variation in Crohn’s disease? You don’t, and a real doctor recognizes this fact rather than jumping on every single fad and preliminary result that gets churned out. Know who John Ioannidis is?

      Please be aware that Harvard, Yale, etc all have alternative medicine programs in their universities now.

      Oh, well then, if you’re going to appeal to authority then you might as well go for the good schools. Yeah, these schools have been criticized for embracing quackery out of faddish appeals to popularity. Citing them doesn’t help your case any more than me pointing out Hitler liked homeopathy helps mine.

      Prove your nonsense before you charge for it, you unethical quack.

      1. How are these people getting patients if everything you say is true? People want to believe…lol? Maybe some, but I think a larger percentage want results and that’s what they find or they don’t come back. In the business of selling health you have to provide results and that’s the bottom line.

        placebo only go so far people… You talk about quackery but do you actually know the success rate of any of these NDs? People that come with a real problem and find a real answer…. you think this NEVER happens at ND offices? And when it does its either parasitic ideation or placebo…? Success doesn’t exist outside of the confines of our current body of EBM?

        Who is delusional now? … seriously think it over really long and hard folks. You have someone running a practice that’s selling snake oil and whatever… they charge a large fee employing methods of medicine that according to you people have little to no evidence and thus cant have a high percentage of success…. and yet somehow they have busy and successful practices with numerous referrals??? And all this is based upon no results or limited success with placebo and other parasitic methods… Come on? Really? Could it be there are ways to get people better that exist outside of the scope of our current body of EBM? Or is it all the same scam???

        I don’t believe in coincidence, theres probably some ballony with this stuff but im sure there are people out there in the CAM field that are highly talented at getting people better…

        1. The problem is, yes, it is possible to be that completely mistaken on a therapy’s efficacy
          An example often cited is bloodletting ; lots of people, doctors and patients alike, really believed it was useful, until the first statistical studies demonstrated the contrary.
          So yes, if a given therapy doesn’t demonstrate efficacy in studies, I highly doubt it can suddenly become effective in a naturopath’s office.

          1. blood letting …really?? That’s your response..? So people that feel they have been helped actually haven’t because blood letting.

            Ok, that clears that up.

            good talk.

            1. Don’t act the specious ass. Or perhaps it isn’t an act. In any event your ‘argument’ is a fallacy called ‘appeal to popularity.’

              People have flocked to woo since the dawn of history. The reasons are as varied as the nitwits who hold them. In prescientific times there was no understanding of the causes of disease much less of appropriate treatments. Without a solid theoretical foundation everything was woo or luck.

              Today, the reasons range from the naturalistic fallacy to a fear of relinquishing control over one’s body to another.

              On this last, a friend’s husband paid for this phobia with his life. Unwilling to submit to a surgical intervention, he saw a naturopath for treatment of his esophageal varices. He hemorrhaged out while vacationing with his family on San Juan Island.

              Naturopathy is prescientific humbug, a conceit of privileged yuppies and deluded wannabes who lack the intellectual fortitude to learn the science. Physiology is as it is, not as you might wish it to be.

              1. I also knew someone whose death was accelerated by a naturopath. She apparently thought the expensive homeopathy would work better than real medication.

                Argument from popularity can be deadly.

        2. WilliamLawrenceUtridge November 15, 2014 at 6:10 pm

          People want to believe…lol? Maybe some, but I think a larger percentage want results and that’s what they find or they don’t come back. In the business of selling health you have to provide results and that’s the bottom line.

          As LouV says below, bloodletting applies (to a certain extent) but bloodletting also involves breaking the skin and, well, draining blood, both of which can result in short-term calm (or long-term calm if you induce anemia). But perhaps a better comparison might be the relief you feel after talking to a doctor that says your symptoms are minor and nothing to worry about. Nothing has changed, but your anxiety is lower. Naturopaths provide this and more – they give you a sense of control (because they sell you expensive, unnecessary) supplements, plus a lengthy consultation where they do little more than carefully explore your disease and how you feel. In fact, if naturopaths retrained as a form of health-focused mental wellness counselor who just gave you a sympathetic ear but didn’t sell you bottles full of pills, they might actually serve a useful purpose.

          Put another way – people have been ascribing healing properties to placebo effects for a long time, and there’s no reason why they would have stopped merely because we now have real medicine.

          You talk about quackery but do you actually know the success rate of any of these NDs?

          Well, they don’t actually track this sort of thing, they rely on anecdotes instead. Do we need to explain why anecdotes are not helpful? But one could equally ask about the success rate of yogic flyers – their interventions have so little contact with reality that there’s zero chance of an actual effect.

          they charge a large fee employing methods of medicine that according to you people have little to no evidence and thus cant have a high percentage of success

          Not “little evidence”, either “no evidence” or “significant evidence against”. We’ve tested homeopathy, acupuncture and supplements. They don’t work. The only discipline that might provide some actual benefits are herbal preparations, but in addition to being merely dirty drugs of unknown dose and pharmacokinetics, upon testing the majority of herbal preparations don’t contain what is written on the bottle.

          Could it be there are ways to get people better that exist outside of the scope of our current body of EBM?

          Oh, absolutely, that’s why science is ongoing. There are doubtless millions of possible approaches waiting to be discovered. But almost none of them are currently being delivered by naturopaths, and as soon as they are found and validated, they will be adopted by real medicine.

          im sure there are people out there in the CAM field that are highly talented at getting people better…

          I have zero doubt that there are lots of compassionate people who are highly talented at getting people to feel better. But it comes at the expense of, well, expense (that is money that could be spent elsewhere), opposition to vaccines and real medicine in general.

          Retrain them as health care counselors, they’ll do more good, and be more honest about it.

  14. Some doctors engage in mad science and some naturopaths spew nonsense with little basis in fact. The ultimate treatment plan includes an experienced doctor and knowledgeable naturopath who agree to work together for the benefit of the patient. This is the approach that helped my uncle get rid of cancer.

    1. “The ultimate treatment plan includes an experienced doctor and knowledgeable naturopath who agree to work together for the benefit of the patient.”

      There is no such thing as a knowledgable naturopath. They are ‘educated’ in idiocies like homeopathy. But look, enjoy you delusion, clutch it to your breast. You and your codelusionals are why this site needs to exist.

      1. you’re an idiot, go take your meds like a good sheep and stay clueless. MDs spend less than 3 minutes with you and dont know shit. Youre an idiot for believing conventional medicine and doomed to ignorance.

        1. ” MDs spend less than 3 minutes with you and dont know shit. Youre an idiot for believing conventional medicine and doomed to ignorance.”

          Really? What happened to your embrace of the synergy between “an experienced doctor and knowledgeable naturopath who agree to work together?” I guess physicians who are so careless of their profession as to consort with quacks are the ones who do know sh!t, huh? Interesting take.

          My personal care physician is an internist. She usually spends 15 or 20 minutes with me. She may not know sh!t* but she certainly knows medicine having completed medical school at a highly ranked institution and then a competitive 3 year residency.

          Medicine is supported by careful research, meticulous study, and constant testing and evaluation. In fact I am neither an idiot, nor particularly ignorant of general medical science. I am a rational student of science, base my judgments on science and evidence, and have been very well served by what you inanely term “conventional” medicine.

          There is medicine, sefrzan. And then there is stuff that isn’t medicine. “Alternative, Integrative, Traditional Chinese,” and all the other adjectives that people prepend are marketing terms, not terms of science.

          *As I noted, my PCP is an internist. If you are having sh!t problems, I’d suggest you see a gastroenterologist or maybe a proctologist if you suspect diverticula or impaction.

    2. Medical science helped your uncle. If your uncle had died in agony a year after starting treatment with a naturopath, I absolutely guarandamntee the naturopath’s post mortem would have been, “What a shame he didn’t come to me sooner! However, I certainly did help him live longer than he would have without me”.

    3. “Some doctors engage in mad science”

      I believe you’re thinking of Victor Frankenstein. He wasn’t a real person, you know.

    4. “The ultimate treatment plan includes an experienced doctor and knowledgeable naturopath who agree to work together for the benefit of the patient. ”

      That sounds like Crislip’s ultimate pie. Apple pie mixed with cow dung. Enjoy.

    5. “The ultimate treatment plan includes an experienced doctor and knowledgeable naturopath”

      I am curious: What, specifically, does the naturopath bring to the table that the experienced doctor doesn’t?

      1. Think of it like a buffet. The physician brings the apple pie and the naturopath brings the cow pie.

      2. WilliamLawrenceUtridge October 31, 2014 at 2:12 pm

        What, specifically, does the naturopath bring to the table that the experienced doctor doesn’t?

        Nothing.

        1. Windriven and WLU:
          Guys: I know what what you think. I posted my question because I’d like to hear what poster Seidler thinks (I suppose I should have addressed it him).

          1. “I suppose I should have addressed it him”

            Probably wouldn’t have helped. We both derive inordinate pleasure from hearing ourselves speak.

            But neither of our responses prevent Seidler from weighing in. I just doubt that s/he will. The initial comment felt like a drive by.

  15. […] or potentially harmful remedies is actually fairly weak and perhaps even nonexistent. After all, black salve is still around after many decades, if not hundreds of years, and it can produce some truly […]

  16. Just wanted to say that the writer of this blog is clueless about naturopathic medicine and should lay off the pharmaceuticals. Your weak-minded attempt to disregard the effectiveness of this medicine is comical with more an more states/provinces giving more and more rights to naturopathic doctors. Evolution will deal with your kind in time as it does with other lower forms of life.

    1. *yawn*
      [Citation needed]

  17. […] of posts by myself or other SBM bloggers if you think I exaggerate. In particular, pay attention to what naturopaths say when they think no one’s listening. Ditto traditional Chinese medicine practitioners, as has been explained many times here before. […]

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