Science-based medics and researchers baulk at many of the claims of naturopathic remedies.

While reading an article on Science-Based Medicine about the battle against  legislating the naturopathic industry in Ontario, Canada, a comment pointed to a comment by Steve Thoms, Editor-in-Chief of Skeptic North in another blog which listed points against naturopathy.  (See steveisgood Nov 27 2009 1:11 Pm in this blog.)

David J Kroll (PhD) describes naturopathy in the opening passages of his article at Science-Based Medicine:

Naturopathy, sometimes called naturopathic medicine, is an unusual and inconsistently regulated alternative medical practice that co-opts some evidence-based medicine, often in nutrition and natural product medicines, but also subscribes to ’vitalism’ (vis medicatrix naturae) and makes use of homeopathic remedies that defy the rules of physics and dose-response pharmacology.

Before I list Steve’s points, Kimball Atwood’s article Naturopathy: A Critical Appraisal is worth reading for more detailed background. (Some will note that naturopathy shares with chiropractic the retention of a 19th century belief in vitalism.)

I’ve excerpted some of Steve’s points, occasionally adding my own thoughts in square brackets, keeping his original point numbers so that you can see what’s missing.

His opening paragraph is well worth noting:

The science-based community is always at a disadvantage in these sorts of outcries, because we’re limited to the evidence, and we can’t just make stuff up. There’s a lot to respond to.

2) The assertion that the body has the potential to heal itself is not a scientific one.  When given “natural” support only, the body will die by the age of 45, probably of infectious diseases.  Modern advances in medicine make long-life possible, not herbs and roots from a 2,000 year old playbook.

3) Saying “science” doesn’t make it so. The call of “the healing power of nature at work” to be not magic, but good science, is ridiculous on its face….the human body is really good at succumbing to pathogens and injury, and the “natural” world is really good at killing us.

4) Old and tradition do not a science make.  Yes, herbal supplements have been around for centuries.  So has prostitution. Old doesn’t mean effective.  It means old.  I want my medicine to be new, awesome, and if possible, administered by a robot from the future.

[I've two minds about the robot bit, but it does sound snazzy.]

5) Regulation does not a science make, even if it was 85 years ago.

[It's the testing, not the legal stuff that matters. Shades of Professor Frizelle’s "instant classic": Let’s hear your evidence not your legal muscle. (Prof. Frizelle hails from Christchurch, New Zealand, and is editor of the New Zealand Medical Journal. Her original article is available on-line.)]

7) Why the natural fetish?  If you’re dying from a disease, do you really care if your treatment is “natural” or not?  Why take an herbal supplement that a person tells you *might* work, when you could take the most recent advances in medical technology that we know *will* work?

[I'd add that there's a tendency to play the "natural" line to imply that "synthetic" is bad. This ignores that the same active ingredients are in both.]

8) Natural doesn’t mean safe.  It doesn’t mean effective.  Arsenic, poisonous mushrooms, gravel and bird-crap are also natural and you don’t see me putting them into my body.

["Natural" is often played as a marketing line, rather than anything of real meaning. What is relevant is what the active substances are, what they do, the evidence supporting claims of what they do, the dosage, and so on. As I wrote when discussing genetic tests, under the heading 'Care over ’alternative medicine’ claims': If someone makes a claim about a health product that cannot be substantiated by evidence, then they cannot say it is a medicine, only that they hope that it might be a medicine.]

9) Lets not forget that many people see a naturopath because they’re dazzled by the word “Naturopathic Doctor, or ND”.  Let’s be perfectly clear: Naturopaths are NOT doctors. The Naturopathy Act, 2007 allows them to be called “Naturopaths”, not “doctors.”  You need to go to medical school to be called a doctor.  Naturopaths just granted themselves that title as a subtle PR stunt.

[The details here are specific to Canada, but the general point remains. For example, chiropractic "doctors" in NZ are not medical doctors and are not on the medical register.]

10) What is the diagnostic method a naturopath uses to test if a body is “in balance”?  What laboratory equipment can you use to check for “wellness”?

12) If naturopathy is just as effective as medicine, then why don’t these naturopaths just go to med school?

13) The medical community is constantly advocating good health, diet, nutrition and exercise…naturopaths don’t have a monopoly on knowing the merits of preventative health.

[This one seems to be overlooked an awful lot. See Amanda's post on vitamins which in passing illustrates this.]

15) The length of time for training is meaningless if the education quality is so lackluster.  I can study levitation for 20 years but it doesn’t mean that I could fly.

16) “Every review of our record has recognized the safety of the more natural approach of naturopathic care.”  Every review? Really?  Black Cohosh, anyone?

[I'd add that safety is not effectiveness. Water is safe, except in huge excess. Remedies that don't do anything can be safe because they don't do anything!]

17) The authors conveniently left out the deaths attributed to naturopathic prescriptions in Washington and Oregon, showing once again their contempt for honest data-gathering and fondness for cherry-picking whatever information suits their pre-conceived narrative.

[The example is perhaps specific to their case, but the general message to always watch out for cherry-picking of "evidence" is worth bearing in mind. Cherry-picking data it's a sign that the person is pushing their point of view in a biased way.]

23) This is not about freedom of choice for the patient, and it never has been.  This is about granting naturopathy legislative and legal legitimacy because it can’t do so under the rules of science and evidence.

[Many would argue that this "seeking legitimacy" is a characteristic theme of many marginal or unscientific "medical" groups. A key thing in my mind is to regulate the claims made and to ask if groups are prepared to limit themselves to claims that they can back with scientific evidence and if not, they shouldn't be granted legitimacy. Legitimacy should come from the evidence backing the  claims, not the legal stuff.]

Other posts on health or medicine in Code for life:

Neti pots now validated as sound science?

The chiropractor really should stick to bones

Genetic tests and personalised medicine, some science communication issues

Genetic tests and personalised medicine

Autistic children and blood mercury levels

What the chiropractor said

Metagenomics-finding organisms from their genomes

Medical remedies-burden of proof lies with seller