Respectful Insolence

It’s just one more cut on the road to the proverbial death by a thousand cuts.

I’m referring, unfortunately, to last week’s development in the state of Colorado. Specifically, I’m referring to the Colorado legislature’s truly boneheaded decision to license naturopaths, thus giving the imprimatur of the state to quackery and, in essence, legalizing a whole lot of that quackery. It’s been a long time coming, and, say what you will about Colorado naturopaths, they’re persistent and disciplined. As a result, after years of effort, they finally got what they wanted, although apparently not all that they wanted in that they didn’t get the full scope of practice that they wanted. Although some supporters of science-based medicine (SBM) had hoped that the governor might veto the bill, I had little doubt that he would sign it, and sign it he has. Not surprisingly, the American Association of Naturopathic Physicians (AANP) is crowing over this development:

Governor John Hickenlooper today signed into law a measure to allow naturopathic doctors to register with the state to legally practice naturopathic medicine. Colorado becomes the 17th state to do so, along with the District of Columbia.

“I am proud that Colorado has taken the lead in ensuring that well trained naturopathic doctors, appropriately regulated, become a viable health care option for the citizens of our state,” said Rep. Joann Ginal (D-Ft. Collins), the bill’s lead sponsor. Sen. Linda Newell (D-Littleton), the bill’s sponsor in the Senate, commented that “naturopathic doctors are going to be a key component in health care, saving the state millions of dollars through their focus on disease prevention and natural treatment, such as nutrition, lifestyle counseling and botanical medicine.”

Naturopathic doctors are trained to prevent and treat chronic conditions associated with lifestyle – such as hypertension, weight gain, obesity, and diabetes – as well as most other illnesses. The law will enable Coloradans to distinguish between naturopathic doctors and lay or traditional naturopaths, who lack extensive graduate-level clinical training. The law allows naturopathic doctors who have completed a 4-year post-graduate program at an accredited naturopathic medical school and have passed a national science and clinical board exam to register with the state.


If I’ve pointed it out once, I’ve pointed it out a million times (well, actually not a million times, but a lot): Naturopathy is a hodge-podge, a cornucopia of quackery. Indeed, it’s the very essence of “integrative medicine” in that it “integrates” quackery with conventional medicine. Actually, I should put it the other way around. In reality, naturopathy is mostly quackery but co-opts some science-based medicine, sprinkling it on the same way people will spritz air fresheners in a bathroom that hasn’t been cleaned for a while to mask the rancid odor. In the case of naturopathy, that rancid odor comes from quackery and pseudoscience. Indeed, it galls me to no end to hear naturopaths claim that they are some sort of “experts” in nutrition and lifestyle changes. Naturopathy and what SBM says tend to overlap only by coincidence or only because naturopaths have tried to represent parts of SBM, such as diet and exercise, as being somehow “alternative” and part of naturopathy when they aren’t. Meanwhile, as I have described before, you can’t have naturopathy without The One Quackery To Rule Them All, homeopathy, because all naturopaths are trained in homeopathy and homeopathy is even part of the Naturopathic Physicians Licensing Examinations (NPLEX), which is required in states that license naturopaths. Indeed, homeopathy is part of the Core Clinical Science Examination.

That alone ought to tell you all you need to know about naturopathy, but there’s more, so much more, to demonstrate that it’s pure quackery. Ironically enough, the first place I looked to give you some examples is on the very website of the AANP. Specifically, it’s the web page for the 2013 AANP Annual Conference and Exposition, which is being held, appropriately enough given the developments in Colorado, in Keystone this year from July 10-13. Bummer. That overlaps TAM, which means I can’t go, as I’ll be speaking at the Science-Based Medicine workshop, doing a talk to introduce a panel discussion, and, of course, participating in that very panel discussion. Oh, well, I’ll live. To help me, though, look me up if you plan on going too.

But I digress, as I am wont to do.

Let’s compare and contrast a bit. Let’s take a look at what AANP says about itself in its press release about naturopath licensure in Colorad compared to what it presents at its annual conference. First, here’s what the AANP claims about this new law:

“An increasing base of scientific research is affirming that naturopathic medicine is useful in the treatment of numerous chronic illnesses,” observed Jud Richland, MPH, Chief Executive Officer of the American Association of Naturopathic Physicians (AANP). “A good example is the recent study in the Canadian Medical Association Journal, documenting that naturopathic medicine may reduce the risk of cardiovascular disease among people at high risk. Naturopathic medicine, with its emphasis on self-responsibility and body’s inherent self-healing capacity, is effective in many cases of preventable illness, which affect a vast and increasing number of Americans.”

Not surprisingly, I’ve discussed that study before. It’s nothing more than yet another beautiful example of how naturopaths “rebrand” SBM modalities as somehow being “alternative” and part of naturopathy when they are not. More importantly, it is ludicrous to claim that an “increasing base of scientific research” supports naturopathy for the treatment of chronic disease. To help demonstrate that, why not go straight to the horse’s mouth, so to speak, and examine what sorts of “science” is being presented at the annual AANP conference? Let’s take a look at the speaker list, for instance.

One thing that caught my eye immediately is a guy by the name of Glen Nagel, who is billed as “assistant profession and NCNM Zidell Healing Garden Curator” who “teaches Botanical medicine and Naturopathic Vitalism and naturopathic philosophy at NCNM.” For those who try to deny that naturopathy is based on prescientific vitalism, I always find it entertaining to point out that vitalism it taught in naturopathy schools and that there are even classes on it. Vitalism, for those not familiar with the lingo, is the belief that there is something different about living matter such that it contains some non-physical element that animates it, that makes it “alive” rather than inanimate. That element is often given names such as the “vital force,” the “life energy,” or “life force.” In China, it is called “qi,” and that’s why so much of traditional Chinese medicine is considered vitalistic. Acupuncturists, for instance, explicitly claim that sticking needles into certain lines on the body known as “meridian,” through which, it is claimed flows qi, redirects the flow of qi to healing effect. Not surprisingly, here in the West, Samuel Hahnemann, the founder of homeopathy, promoted a vitalistic view of health and disease. Much of so-called “complementary and alternative medicine” (CAM) is a throwback to prescientific vitalism, which has far more basis in superstition and religion than it does in science. Think reiki, which is faith healing substituting Eastern mysticism for Christian beliefs. Think other “biofield” therapies, such as therapeutic touch. Science has moved on, to the point where vitalism is no longer considered a viable belief, much less a viable hypothesis or theory. Yet naturopathy remains rooted in it.

Indeed, at the AANP conference, naturopaths let their vitalistic freak flag fly, so to speak, with a talk by James Sensnig, former Academic Dean and Vice President for Education and Services at the National College of Naturopathic Medicine, the founding Dean of the College of Naturopathic Medicine at the University of Bridgeport, the founding President of the American Association of Naturopathic Physicians (AANP), the former Chairman of the AANP Government Affairs Committee, the founding President of the Institute for Natural Medicine, and Senior Editor on the Foundations of Naturopathic Medicine Project and textbook. That’s right. Mr. Sensnig is not just your average naturopath. He’s a big name in naturopathy. And what’s the title of his talk? “BACK TO THE FUTURE: Why Vitalism is the New Medicine.” It’s described thusly:

Naturopathic medicine cannot simply be understood as being rooted in “Nature”, but rather “Nature” as understood by the vitalist tradition. This world view defines THE difference between the currently dominant school of medicine and naturopathic medicine. It holds that “Nature” is intelligent, orderly and purposeful and that the physician’s role is support the inherent tendency toward order. This view of the universe is beginning to be articulated by the science of our time after coming full circle from a materialistic model. Articulating this paradigm demonstrates that naturopathic medicine and the vitalist thinkers have not only understood the “Laws of Nature” but have presaged by millennia the “New” medicine.

Dream on, Mr. Sensnig. Dream on! The science of our time is most definitely not “coming around” to vitalistic naturopathic views, no matter how much you might wish to present naturopathy as somehow being ahead of its time and SBM as only just now coming around to views embraced by naturopathy.

As for the rest of the speakers, I see very little there resembling science. The closest I see there to any sort of “cutting edge” science is a talk by Mark Davis entitled “Fecal microbiota transplantation.” However, I have no doubt in a naturopath’s ability to woo-ify virtually anything. Disappointingly, there is one real scientist there, Edward J. Calabrese, who is an expert on hormesis, an aspect of pharmacology in which certain dose-response curves can actually show more potent effects at lower doses. Although homeopaths often try to claim hormesis for their own as a justification for their quackery, it is not. What’s really depressing is that Dr. Calabrese appears to be buying into the whole “hormesis as homeopathy” scam:

This presentation provides an assessment of hormesis, a dose-response concept that is characterized by a low-dose stimulation and a high-dose inhibition. It will trace the historical foundations of hormesis and its relationship to homeopathy, its quantitative features and mechanistic foundations, and its risk assessment implications.

Somehow, I doubt that the “relationship to homeopathy” hormesis has will be presented as it really is: Homeopaths deceptively using hormesis as an “explanation” or “rationale” for homeopathy. I’d love it if he did, but I rather suspect he won’t.

As for the Colorado law, Jann Bellamy points out that naturopaths didn’t get the full scope of practice that they wanted, which was to function as primary care physicians. I doubt they’re worried. They’ll be back again and again and again and again until they do get what they want. Count on it. In that they’ll be aided and abetted, no doubt, by a “health freedom” bill that was also signed into law in Colorado. It’s a law that Jann Bellamy has quite appropriately labeled the “quack full employment act,” as it lets virtually anyone practice medicine, as lon as it’s “alternative” medicine.

Truly, in two quick strokes of the pen, Colorado has become a happy home for quacks. Let the Colorado patient beware.

Comments

  1. #1 Marc Stephens Is Insane
    June 11, 2013

    Organic, herbal, naturopathic cookie please.

  2. #2 elburto
    June 11, 2013

    That’s legitimately terrifying, given the number of Americans lacking access to affordable healthcare.

    All it takes is for ‘Groovy Gary’s Quack Shack’ to open up shop as a “doctor”, offering low, low prices, and BAM! The vulnerable people, who are typically economically barred from accessing regular GP or urgent care, think they finally have access to affordable services. Give them some positive stroking about their ‘decision’ to utilise ‘natural care’, and it’s all fun and games until something terrible happens.

    Someone with an undiagnosed seizure disorder offered homeopathy to… I dunno, soothe the mind, takes out a crowd at a bus stop.

    Baby given (ugh) an ‘adjustment’ to help with crankiness and fractiousness,dies that night of damage caused during said procedure, or of missed meningococcal septicaemia.

    Oh, and as for vaccination against VPDs… yikes.

    How the hell can anyone think that letting these vitalistic, superstitious, patchouli-drenched fantasists assume the mantle of ‘Doctor’?

    Letting the Bastyrds play doctor is like allowing the local butcher to perform organ transplants in humans, and letting his friend Kenny the *ahem* “chemist” take care of the anaesthetic, using whatever he’s acquired from Mickey the Mule, who’s just returned from Koh Samui.

    Mindbogglingly stupid.

  3. #3 ChrisP
    In a land of no Colorado cookies
    June 11, 2013

    Colorado over recent years has become a bit of a haven for alties. The legislature has shown itself happy to accomodate them, with new legislation if necessary.

  4. #4 herr doktor bimler
    June 11, 2013

    “BACK TO THE FUTURE: Why Vitalism is the New Medicine.”

    Well well. “Pre-modern and proud of it!” What next? Why Paracelsus was right? Why the Four Humours are the New Medicine? How to expel the Evil Ailment Spirits?

    Enjoy your new Dark Age.

  5. #5 Bob Applebaum
    June 11, 2013

    Calabrese is not a real scientist. He has been called the ideological toxicologist because he misrepresents science using numerous fallacies. He has formed his own pseudo-scientific organization called the International Hormesis Society….ooops, hormesis has no scientific backing, so he changed the name to International Dose Response Society.

  6. #6 Eric Lund
    June 11, 2013

    founding Dean of the College of Naturopathic Medicine at the University of Bridgeport

    That institution rang a bell, so I went off to check Wikipedia and found that my recollection was accurate: The University of Bridgeport was bailed out in 1992 by an organization affiliated with Rev. Sun Myung Moon’s Unification Church, and to this day it has extensive ties with the Moonies. Many of the faculty severed ties with the university as a result, and the law school became part of Quinnipiac University. The Naturopathic Medicine program was added in 1996.

    Something else at Wikipedia I hadn’t known: UB offered the first university-affiliated chiropractic program, although that one can’t be blamed on the Moonies, as it started in 1991.

    I don’t know how deeply the Unification Church is into medical woo, but it would not surprise me in the least.

  7. #7 Bob Applebaum
    June 11, 2013

    More on Calabrese:
    http://www3.nd.edu/~kshrader/pubs/ksf-2010-calabrese-synthese.pdf

    He recently made headlines claiming that Nobel Laureate Hermann Muller lied:

    http://www.sciencedaily.com/releases/2011/09/110920163320.htm

    Muller didn’t lie, Calabrese did.

  8. #8 naturocrit
    http://naturocrit.blogspot.com
    June 11, 2013

    Per ND James Sensenig and vitalism, if you really want a magic carpet ride, I recommend his lecture

    “The Heart of Naturopathic Medicine: The Power of Vitalism” at treefarmdownloads.com from the 2011 NorthWest ND conference, which I recently transcribed.

    Some highlights:

    vitalism via a lot of quotes from Lindlahr, Hahnemann;
    “flat earth allopathic medicine”;
    Benveniste as martyr [!];
    god galore;
    “the new religion of the 21st century, science”;
    “no, no, no. No vaccinations.”

    -r.c.

  9. #9 Mu
    June 11, 2013

    I still think the major breakthrough in homeopathy research in the last 200 years was the realization that it doesn’t work independently of what bible you use to succuss the dilution on.
    Oddly enough, the religious connotation has been removed from the Wikipedia article on Hahnemann, one wonders why.

  10. #10 prn
    June 11, 2013

    Cheap competition sucks. Just ask the price leader.

    1. Most (all?) people I’ve ever met that went to a naturopath or similarly oriented MD struck out with several regular MDs first. And often have unexpected success or long lasting improvement in that “quack nutrition” sector. So naturopaths may be potentially a relief valve, or court of last resort, with a free style menu. Caveat emptor.

    2. For any unfortunate incidents Orac cites, I see corresponding medical disasters except more agonizing deaths, and $1+m bills. Last one wasn’t cancer either.

    3. I suspect that some of the support for non-biologically based CAM comes from the financial sector. Many really don’t care what works, they simply want a piece of expanded or chronic economic activity.

    Note: I’ve never directly paid for ND services. The closest is that I bought what was the leading cancer pharmaceutical in Japan but is a supplement in the US from a buyers club with NDs. What did we talk about most? Off label use of another US pharmaceutical in a broader class that they had recommended over 15 yrs ago. Several years later now, regular US medicine may be starting to see the light in recent small scale trials with a large change over expected survivals. Or as seems to happen, 1-2 more standard MDs may become redefined as “alternative” after it becomes generic. Standard oncology patiently waits or ignores everything in the meantime.

    I saw a nice drop in CEA and inflammation in the blood results, lowest ever in 3+ years over several months with residual disease . Am I going to wait 5-15 yrs for standard oncologists to pull their heads out of their ASCO, if ever? Nah.

  11. #11 Denice Walter
    June 11, 2013

    Although I have been in many alt med, new agey places **, I think that Boulder is probably packs the most woo per square inch.

    There is a main street called, “Pearl St” ( why anyone would name a street that at the foot of the mountains rather than at the seaside is beyond me- perhaps it’s after Mr Pearl?) which purveys every type of fantasy-driven business scheme you can imagine- herbalists, yoga studios, vegan cuisine, feng shui, quasi-medical services of all stripe,Tibetan buddhist sanctuaries,
    transplanted Afghan teahouses, crystal/rock shops- you name it. The restaurants run the gamut of ethnic – third world delights. Celestial Seasonings is based there.

    They have a tree shaded pedestrian mall – no cars allowed- where musicians play and wandering artisans peddle their wares.
    I bought myself silver celtic knot earrings from a hippie girl ( who looked as though she money for food) who assured me that they enhanced luck – well, the plane back didn’t crash. I guess she created powerful magic with her silver wire benders and clippers- and that’s why my life is good and celts like me.

    Unfortunately, Boulder is a lovely place that attracts woo but it also has a university, science ( NOAA) and i business set in spectacular visual beauty – you follow the creek to the canyon to the mountains where there are even more hippies in their own little town.

    I now realise that South Park is not a parody- it’s a true-to-life documentary illustrating the half hippie/ half backwoods-backwards nature of this very odd state.

    ** including one with druids. I rest my case.

  12. #12 Calli Arcale
    June 11, 2013

    prn:

    And often have unexpected success or long lasting improvement in that “quack nutrition” sector.

    I’m sure that is what they perceive as having happened. But history tells us not to be satisfied with “unexplained success”. And as the Doctor once remarked to Leela, “to the rational mind, nothing is inexplicable — only unexplained.” That science has not explained their cases does not mean it is impossible to explain them, nor that the nutritional efforts of their NDs were responsible. Alas, nutritionists are seldom interested in going that far. They are content with the appearance of success, and leaving the details unexplained even though they will let that experience guide their future practice. Doctors are by no means immune to the same sort of wooly thinking, but that’s hardly an excuse.

  13. #13 DrBollocks
    June 11, 2013
  14. #14 Roadstergal
    June 11, 2013

    “vegan cuisine… They have a tree shaded pedestrian mall – no cars allowed- where musicians play and wandering artisans peddle their wares.”

    I love all of these things. I just wish they could be divorced from woo, so I could properly enjoy them. :\

  15. #15 mho
    June 11, 2013

    “Boulder began as a supply town for gold miners in the mountains, and Pearl Street is believed to have been named for the wife of one of the town’s 54 founders. “
    (from promotional material for a Boulder Business improvement district assoc)

    Naturopaths won’t alleviate physician shortages. They all want to live in hip, cool places that already have plenty of physicians. There aren’t many hip cool people in sparsely populated farming and ranching communities, and the ones who are go to Santa Fe for shopping and woo.

  16. #16 Eric Lund
    June 11, 2013

    Naturopaths won’t alleviate physician shortages. They all want to live in hip, cool places that already have plenty of physicians.

    Part of that is wanting to live in places where there are people who will pay for their services. That’s why New Hampshire’s woo providers tend to congregate in Seacoast towns like Exeter and Portsmouth, rather than the big (by our standards) cities of Manchester and Nashua. And that’s why Colorado’s woo crowd will congregate around places like Boulder and Aspen, which are two of the most expensive places in the state to live. (The celebrities and the super-rich have largely taken over Aspen, but it was a hippie town a few decades ago, and much of the local workforce still consists of hippie types who ride the bus 30 miles to work–yes, Aspen has a public bus system, and a rather extensive one for such a small US city.) It’s hard to make a good living as a simple country doctor, whether you’re an MD or an ND.

  17. #17 Old Rockin' Dave
    In the Gall Bladder of Darkness
    June 11, 2013

    I know this is a callous thing to say, and I will undoubtedly regret it tomorrow, but maybe it’s a good thing. When a sufficient number of people have their lives ruined or ended by naturopaths in spectacular ways, the backlash will either shut them down or force them to go the way of the osteopath; here in New York, DO’s have the same license as MD’s and have to take essentially the same curriculum and pass the same exams and licensing requirements. In fact, many (maybe most) DO’s here went to osteopathy schools because they didn’t get in to medical schools.

  18. #18 Roadstergal
    June 11, 2013

    ^ ORD – The difficulty with that approach is that the woo-ful seem immune to data.

    On a complete and utter tangent, Ken Burns is taking on Emperor of All Maladies:
    http://www.emperorofallmaladies.org/

  19. #19 Yodelady
    June 11, 2013

    Does this bill force insurance companies to pay for the services of the registered NDs?

  20. #20 Politicalguineapig
    June 11, 2013

    That’s legitimately terrifying, given the number of Americans lacking access to affordable healthcare.

    And most of Colorado’s pols want to keep it that way. I feel about it the same way I feel about Arizona, Florida, and the Dakotas: lovely states, the only thing keeping me from visiting is that I don’t want any interaction with the denizens there.

  21. #21 Doctor 1
    June 11, 2013

    Sounds like the author of this article has an ax to grind and has presented a very superficial evaluation of this profession. Better luck next time.

  22. #22 Denice Walter
    June 11, 2013

    @ Roadstergal:

    Right. I relish all that stuff- not a vegan though.

    A travel writer from CA wrote about how these places come to be:
    artists are poor and go to out-of-the-way scenic places with cheap rents, then tourists come to see the art and scenery, then rich people come in and buy up housing thus destroying the low rent factor; established artists stay and sell their work…. younger artists find other places to live and truck in their wares ( like the hippie silversmith/ wire bender);
    you might also see the phenomenon in cities- artists and hipsters go to poor areas, make them trendy then they can no longer afford to live there.

    The alternative/ outsider outlook and the money both bring in woo.

  23. #23 AOA=so disturbing
    June 11, 2013

    http://www.ageofautism.com/2013/05/appeal-to-chicago-autism-community-alex-spourdalakis-about-to-be-moved-to-psychiatric-facility.html

    I realize this if off topic but the story of this autistic child is very disturbing and was wondering if anyone here was aware of it? Today it was reported that this child, who had been hospitalized for quite a while (and apparently for good reason), was stabbed multiple times and killed (yesterday I believe) . His mother and caregiver were found with his body. They were not harmed. I believe they are being investigated.

    What is very disturbing to me is for many weeks now AOA has been posting this story (see one of the posts above), and having all of their nutty commenters call Loyola to complain that the mother’s rights were being ignored, he wasn’t being treating in a biomed fashion and so on. It seems to me Loyola may have known this poor child had no good caregiver to go home to. Well, it appears he did go home after all (was it possibly after many complaints to the hospital?) and what happens? He is murdered! AOA has some blood on their hands IMO if his mother had anything to do with his death. If you look back, you will see several posts on this poor kid in Loyola on AOA and Kim and company bitching up a storm that his rights were being violated, clearly NOT knowing the true situation at all. AOA also posted his death today and the commenters are still blaming the system! Sickening!

  24. #24 janet
    June 11, 2013

    @ Roadstergal
    Maybe not on such a different tangent…. One of the supporters of the Ken Burns documentary is Cancer Treatment Centers of America.

  25. #25 elburto
    June 11, 2013

    @Doctor1 (or is it Not a Doctor1?) – would you care to lay out your rebuttals, or do you just wish to poke your tongue out at our esteemed host?

  26. #26 Sandy
    Canada
    June 11, 2013

    Alternative “medicine” practiioners are fond of telling us that medical errors are the 3rd (or 6th) leading cause of death in the US. I’d very much appreciate an article on that. IMO, since most people with chronic diseases die at home or outside hospitals, and since most conditions are treated successfully in hospitals and discharged, this is probably likely – one can perhaps say that medicine has in this instance become a victim of its own success? however, comments, references etc. will be appreciated

  27. #27 TBruce
    June 11, 2013

    Sounds like the author of this article has an ax to grind and has presented a very superficial evaluation of this profession.

    You want more depth? This blog has a search function. Use it and enjoy.

  28. #28 Khani
    June 11, 2013

    #20 Too late. I’m here.

  29. #29 Desert Rat
    June 11, 2013

    Santa Fe, NM rivals Boulder, CO for woo-woo practitioners per square meter. I always enjoy the ad in the local weekly wherein a photo of a lovely woman is accompanied by the identification “Jane Doe, DOM.” I suppose that means “Doctor of Medicine,” but one might hope for something more interesting.

  30. #30 Denice Walter
    June 11, 2013

    @ AOA= so disturbing:

    I’ve been following it but not in great detail. I’ll refrain from commenting about the heart of the matter for now.

  31. #31 Mephistopheles O'Brien
    June 11, 2013

    Sounds like Doctor 1 (presumably not William Hartnell) has an ax to grind and has presented no evaluation or useful thoughts. Better luck next time.

  32. #32 prn
    June 11, 2013

    I’m sure [“…unexpected success or long lasting improvement in that “quack nutrition” sector”] is what they perceive as having happened. But history tells us not to be satisfied with “unexplained success”

    Actually a lot of their success in the nutritional-digestive arena is explained in unused sections of post graduate medical texts and meandering themes in medicine going astray. It’s corruption in regular medicine that this is not recognized.

    They are content with the appearance of success, and leaving the details unexplained even though they will let that experience guide their future practice

    I have to acknowledge that I don’t know what is typical for NDs. At least some of their “renegade MD” authors can have both a cogent theory of practice based on medical literature and a predictable, measurable, superior result in the nutritional-gastro area.

    I think this nutritional-gastro area concerns a number of rabbit holes that medicine has allowed itself to be sucked into pharmaceutical and nutritional Wonderlands. Accepted societal carb load levels of the 1990s and proton pump inhibitors might qualify as two of the rabbit holes.

    An example of the inefficiency and indifference of regular medicine to gastro issues are the celicacs, one of the accentuated forms of nutritional malabsorption. Some have written that 97% of the celiacs are undiagnosed, and the ones that got diagnosed went through over a dozen doctors and an average of 7-11 years to get positively diagnosed.

  33. #33 prn
    June 11, 2013

    my reply@31 is to Calli Arcale@12 above

  34. #34 lilady
    June 11, 2013

    @ AoA=So Disturbing: I, for one, have been following the ongoing unfolding drama of the serialization of Alex Spourkalakis and his mother Dorothy on AoA.

    I’ve been posting on RI for weeks now, about the latest crusade by AoA, Lisa Goes, Andrew Wakefield and other assorted groupies, to use Alex’s developmental disabilities to trash the care he received at a Chicago hospital. I questioned weeks ago, about the deplorable “coverage” (publishing pictures of
    Alex buck naked, in restraints, with an adult diaper on him), and his mother’s insistence that he needed MRIs and invasive colon scoping…as well as Lisa Goes’ and his mother’s “expertise” in diagnostic tests…the online “petititions” and the fundraising (supposedly because Alex and his mother would have to go to a public shelter, once Alex was released from the hospital).

    IMO, Lisa Goes, AoA and Wakefield are trying to spin Alex’s problems and his stabbing death…now that he was stabbed to death in a locked apartment, with his mother and his grandmother/godmother/caregiver (the story keeps changing), unconscious nearby with a 3-page handwritten note located in that apartment.

    I will not comment further, until more information is available from the medical examiner and police officials.

    Unfortunately…the flow of information about Alex’s life and Alex’s death, has not been forthcoming since late last night.

    Let’s not derail Orac’s naturopath post. Come on over to this thread, where we are commenting:

    http://scienceblogs.com/insolence/2013/05/30/can-antivaccinationists-knock-it-off-with-the-autism-holocaust-analogies/

  35. #35 HTuttle
    June 11, 2013

    As my grandpa used to say, as long as you have your wellness.

  36. #36 Pareidolius
    Sonoma County, the Heart of the Axis of Me-Ville
    June 12, 2013

    Wow, Dr. 1, you sure showed us! But, of course you’re a chickensiht drive-by commenter and you’ll not be back with anything more substantial than the flounce you stuck.

  37. #37 herr doktor bimler
    June 12, 2013

    well trained naturopathic doctors, appropriately regulated

    With Colleges of Naturopathy having existed for so long, regulating and enforcing professional standards, does anyone know how many naturopathic doctors have been stripped of their membership for malpractice and failure to meet those standards?

  38. #38 William Mason
    CT
    June 12, 2013

    Why pick on Colorado?
    Why pick on Naturopathy?

    Americans love quack medicine!

    There are acupuncturists, chiropractors, faith healers etc. all over—every town—every state.

  39. #39 mho
    June 12, 2013

    #38, yes, they’re everywhere.

    But Colorado’s new law sb215, just created a paradise for them.

  40. #40 palindrom
    June 12, 2013

    herr doktor @ 37 — I believe I’ve commented before, that were a naturopath to be faced with a malpractice suit, the expert witnesses would engage in a War of the Woos that would provide a rich, rich vein of — COMEDY GOLD!

  41. #41 Andrew Dickens
    United States
    June 13, 2013

    Naturopaths should aspire to real medicine, like reported in Nature, that 90% of preclinical oncology drug trials are not replicable.
    http://www.nature.com/nature/journal/v483/n7391/full/483531a.html (This is sarcasm for you who do not :get it”)
    If you believe conventional medicine has the answers, God have mercy on your body.

  42. #42 lmachintelligence
    Colorado, of all places
    June 13, 2013

    This came in under the radar, at least for me. The last article in the Denver Post was back in March, indicating that the bill was in some trouble for health safety reasons. Now we have a new law.

  43. #43 Paul
    Real world
    June 14, 2013

    The fear of something that you don’t understand comes through with every blog about cam
    Just because you & all those sheep that follow your every blog don’t understand something doesn’t mean it’s not real.
    We know what you think of all cam practitioners
    Tell us what you think of people who seek their services?
    There are more and more everyday
    Do you think they’re all lying about improved health/conditions?
    People don’t trust MD’s anymore
    Because they don’t have people’s best interest
    At heart .Its all about pushing pharma drugs
    That 1)don’t work
    2)cost to much
    3) and can kill you
    Lets face it with MD’s at the helm pushing more and more useless drugs on behalf of pharma they haven’t rmeally done a whole lot of good for mankind have they?
    Doctors were once pillars of the community.
    HEROES even, somebody you could trust,but not anymore now most of them are a bunch of money hungry middleman pushers that reach for the prescription pad quicker than you can sit down
    How can you blame pharma for it ?
    You can’t
    When all they see standing between them and
    Billions of dollars in profit is some tiny little man with no backbone or morals to stand up to them,well it was only a matter of time before yesterday’s heroes gave way to
    Today’s sorry excuse for a doctor
    You expect big corporations to put profits before anything else
    But not the very people who we turn to in time of need
    In time of vulnerability .To be betrayed by a person who is in a position of great trust is I think a warning to everybody
    JUST BECAUSE THEY’RE WEARING A WHITE COAT
    DOESN’T MEAN A THING .THEYRE NOT HEROES &
    ALOT OF THEM DONT ALWAYS HAVE YOUR BEST INTEREST
    AT HEART
    Ps surgeons are worse ,think about it
    How can 12.5 %of all operations end with something being left inside the patient ?
    That’s how much they really care about patients
    What a disgrace
    What about you GORSKI
    HOW MANY TIMES YOU LEFT YOUR WATCH INSIDE SOME POOR BUGGER?
    Any surgeon that does that should be publicly
    Whipped 100 times by patient
    And salary for a year donated to charity

  44. #44 Mephistopheles O'Brien
    June 14, 2013

    Paul – could you please:
    1. quote the statements that you think show fear.
    2. provide the data that says that people get an actual clinically significant improvement from CAM, being specific on the condition, the type of treatment, and what the general progression of that condition are.

    As has been discussed many times, people are able to see patterns even when the patterns do not exist. If you get some form of treatment when you feel bad (which is the most likely time, after all) and later you feel better – hey, the treatment must have worked. Never mind that many conditions go away on their own, or that how you feel varies from hour to hour or day to day. If you get a course of, say, acupuncture for a cold and a week later your cold is gone – wow! Acupuncture cured your cold. The fact that normally colds only last a few days doesn’t enter into it.

    They’re not necessarily lying. They may be simply wrong.

  45. #45 JGC
    June 14, 2013

    Tell us what you think of people who seek their services? There are more and more everyday Do you think they’re all lying about improved health/conditions?

    Not necessarily lying, just that they’re wrong when they attribute improvements to CAM therapies, rather than other confounding effects (concurrent standard therapy, placebo effect, confirmatio bias, the fact that their illness was self-limiting, etc.)

    At heart .Its all about pushing pharma drugs That 1)don’t work 2)cost to much 3) and can kill you

    Please be aware that claiming drugs don’t work doesn’t constitute an argument that CAM therapies do. That said, exactly which drugs are you claiming don’t work? Be specific–surely you’re not saying that ALL drugs are ineffective.

    As for ‘costs too much’, this isn’t an argument that CAM therapies work but instead an argument that the price of drugs be set other than is done now and national health policies be established enacted other than exist now, to make drugs more affordable/available.

    As for “can kill you”, once again this isn’t an argument that CAM therapies work, only that risk versus benefit be accurately assessed when prescribing.

    How can 12.5 %of all operations end with something being left inside the patient ?

    Intentionally, or unintentionally? Are you including stents, drains, pacemeakers in your statistics? That’s the only way I could see the figure 12.5% as realistic.

    If not–if you’re claiming that items are unintentionally left behind in 12.5% of all surgeries, citations are desparately needed.

  46. #46 APC
    June 15, 2013

    Seems to me that in general naturopathy is simply the balance to allopathy. In allopathy, the cause of a malady is typically ignored in favor of treatment based on reductionist principles. In naturopathy, the cause of a malady is typically targeted via holistic practices in support of the body’s own ability to heal. Is not the conventional argument against homeopathy and faith healing that, when perceived to be effective, it is actually the body healing itself and not the treatment?

    In allopathy, nutritional education is woefully lacking. In naturopathy, it is critical.

    Unfortunately, allopathy is reductionist in most aspects. Bodily systems are treated as individual and isolated from the rest of the organism, which is pure fantasy. Furthermore, herbalism is fundamental to naturopathy. In allopathy, many drugs are synthesized from herbal isolates or their metabolites. Again, this is flawed reductionism as relying on isolates ignores co-factors that often mitigate side effects while supporting the benefits of the herbal treatment.

    There is no shortage of unscientific claims and practices in allopathic medicine, so attempting an argument against naturopathy in favor of allopathy based on a perceived lack of scientific support is nothing more than bias and a total disregard for objectivity.

    It is clear to me that both modalities have their rightful place in a comprehensive treatment and disease prevention regimen.

  47. #47 Chris,
    June 15, 2013

    APC:

    Seems to me that in general naturopathy is simply the balance to allopathy. In allopathy, the cause of a malady is typically ignored in favor of treatment based on reductionist principles. In naturopathy, the cause of a malady is typically targeted via holistic practices in support of the body’s own ability to heal.

    Cool. Now explain what major breakthrough has been accomplished by naturopathy in the treatment and prevention of the following conditions, accompanied with a PubMed indexed study:

    syphilis
    leprosy
    Type 1 diabetes
    measles encephalitis
    obstructive hypertrophic cardiomyopathy
    cystic fibrosis
    pancreatic cancer

  48. #48 Narad
    June 15, 2013

    Seems to me that in general naturopathy is simply the balance to allopathy.

    The barbarous neologistic plot thickens.

  49. #49 herr doktor bimler
    June 15, 2013

    in general naturopathy is simply the balance to allopathy

    The principles of balance require that anything which works should be accompanied by something which doesn’t work.

  50. #50 herr doktor bimler
    June 15, 2013

    How can 12.5 %of all operations end with something being left inside the patient ?

    This seems to be the source of the claim. The authors actually say that discrepancies in keeping track of utensils (sponges, needles and so forth) occurred in 12.8% of the operations they surveyed, requiring “on average 13 minutes” to find the misplaced item.
    Number of items actually left inside patients = 0.00%.

    How can 100% of internet trolls fail at basic reading skills??

  51. #51 APC
    June 16, 2013

    “Cool. Now explain what major breakthrough has been accomplished by naturopathy in the treatment and prevention of the following conditions, accompanied with a PubMed indexed study:

    syphilis
    leprosy
    Type 1 diabetes
    measles encephalitis
    obstructive hypertrophic cardiomyopathy
    cystic fibrosis
    pancreatic cancer”

    I am forever amused by the mantra of ‘show me the study.’ The reliance on what is known prohibits the discovery of the unknown. Regardless, the premise of your question is flawed. Naturopathy and allopathy are practices not methods of clinical research. Published studies are sources used by these practices not the basis of them. There are lots of published studies demonstrating the efficacy of herbal treatments used by allopaths. Does the fact that naturopaths also use these studies in deciding their treatment regimens render them void?

    But on your line of thinking, what major cures have been accomplished by allopathic physicians in the realm of heart disease? Statins? How many MDs recommend a high fat low carbohydrate diet to address type-2 diabetes? Or for dementia? The science supports it, but conventional dogma does not. How about mood or psychotic disorders? Antipsychotics? Anticonvulsants? These address the symptoms, but how many allopathic doctors prescribe a gluten-free diet?

    When it comes to disease and disorder, allopathy is largely concerned with symptom management. No doubt, when I break a bone or need a vaccine, I’ll go to my MD. When I need surgery, I’ll go to a surgeon. But if, Science forbid, I should be diagnosed with a chronic condition, I’ll favor the professionals trained in supporting my biology over those more concerned with suppressing it.

    “The principles of balance require that anything which works should be accompanied by something which doesn’t work.”

    Indeed.

  52. #52 Chris,
    June 16, 2013

    APC:

    But on your line of thinking, what major cures have been accomplished by allopathic physicians in the realm of heart disease?

    Septal myectomy for obstructive hypertrophic cardiomyopathy.

    Okay, I answered your question, even though you refused to answer mine. Now, go on, tell me the great naturopathy.

    Also remember I specifically said Type 1 diabetes. It is a completely different disease. What is the naturopathic preventive or cure for that? Would it be back to the diet designed by Dr. Frederick Allen at his Physiatric Institute?

    Now, while we are at it, how would naturopathy prevent tetanus, diphtheria, pertussis, hepatitis, measles, mumps, polio, and rubella? Provide some proof that they work.

  53. #53 Chris,
    June 16, 2013

    APC, it must be nice to live in your little fairy land where no one has any real medical issues. Obviously you have never had to call 911 when a child had tonic clonic seizures, or recurrent strep throat being passed from child to child. Or any of the other things on my list.

  54. #54 Krebiozen
    June 16, 2013

    APC,
    Firstly, you should be aware that the word “allopathic” was made up by homeopaths as an insulting term for conventional doctors at a time when they had little more to offer than bloodletting, mercury and arsenic compounds and purges. It isn’t an appropriate term for modern medicine, and on a science blog people are much less likely to take you seriously if you use it.

    I am forever amused by the mantra of ‘show me the study.’ The reliance on what is known prohibits the discovery of the unknown.

    Precisely what unknowns have naturopaths discovered in their use of unsupported, unproven treatments? I’m forever amused by people claiming that CAM treatments are effective and that the lack of evidence to support them is because the evil allopaths won’t fund the studies, when NCCAM and OCCAM have spent almost a quarter of a billion dollars every year doing just that for decades, and have found nothing of any real significance.

    There is actually a lot of evidence that strongly suggests that most of the treatments used by naturopaths are ineffective or even dangerous.

    […] How many MDs recommend a high fat low carbohydrate diet to address type-2 diabetes? Or for dementia? The science supports it, but conventional dogma does not.

    Low carbohydrate perhaps, but I would love to see the evidence that a high fat diet is beneficial to patients with type 2 diabetes or dementia. High fat low carbohydrate diets have long been thought, with good reason (e.g. the calorific value of fats is higher by weight than carbohydrates), to cause type 2 diabetes.

    How about mood or psychotic disorders? Antipsychotics? Anticonvulsants? These address the symptoms, but how many allopathic doctors prescribe a gluten-free diet?

    Leaving aside my horror at the thought of naturopaths treating psychosis or epilepsy with a gluten-free diet, too many people believe this nonsense, it has spawned a huge industry that preys on the worried well, despite a lack of convincing evidence that a gluten-free diet benefits anyone but celiacs.

  55. #55 Politicalguineapig
    June 16, 2013

    As a note, celiac disease seems to be overdiagnosed in some portions of the population.

  56. #56 Krebiozen
    June 16, 2013

    I had several years of gastrointestinal symptoms that flared up and died down for no apparent reason. I tried everything, including various alleged alternative treatments and even psychotherapy and counseling in case some unconscious psychological problem was responsible, none of which helped at all.

    I also experimented with diets to see if it was a food intolerance. I ended up avoiding various foodstuffs, including gluten, for years, never entirely convinced it was helping, but never entirely convinced it wasn’t. In the end I found out I had a chronic giardia infection, and a long course of anti-protozoal drugs ended my symptoms for good.

    This experience taught me now easy it is to attribute changes in variable symptoms to whatever you are avoiding (or taking).

    As an aside, I set up a database in which I recorded everything I ate and drank every day, and my symptoms, for several months. I extracted all the data to a spreadsheet graphed it out, and looked for correlations. I did find correlations between my symptoms and wheat consumption, but realized that the wheat consumption followed the symptoms, not vice versa. It seemed I was more likely to indulge in foods that I had been avoiding when I experienced a flare up (pizza, bread, pasta) despite keeping to a strict and rather tedious diet. I hadn’t noticed this until I put it on a graph.

  57. #57 Denice Walter
    June 16, 2013

    @ Krebiozen:

    A few things:

    Are you sure you’re not a cat? A veterinarian told me that often cats’ unresolved infections with micro-organisms and other parasites are the cause of their IBD/ IBS problems.

    There are complex woo-tinged diets for kittehs as well as for us ALL OVER THE NET.

    James Laidler discovered that restrictive diets weren’t effective for his child’s ASD ( Autism Watch) when said child ate the wrong foods and didn’t have a setback.

    Now dietary woo for ASDs has gone beyond GFCF to GFCFSF ( S for soy). ( see TMR esp).

    Some woo-meisters believe virually all people are gluten intolerant ( see PRN).

    I once suffered from severe GERD-like symptoms and tried various OTC products which all helped a little. However, going away from the vexing situation which concerned me most for a few days worked so much better. I also kept a chart of sorts: I assume it was stress.

  58. #58 Denice Walter
    June 16, 2013

    -ahem!- VIRTUALLY

  59. #59 herr doktor bimler
    June 16, 2013

    In allopathy, the cause of a malady is typically ignored in favor of treatment based on reductionist principles.

    Ah, germ theory and molecular genetics, it was nice to have known you but now we can move on to the real cause of maladies.

  60. #60 Krebiozen
    June 16, 2013

    Denice,

    Are you sure you’re not a cat? A veterinarian told me that often cats’ unresolved infections with micro-organisms and other parasites are the cause of their IBD/ IBS problems.

    I have wondered this myself on occasion – they do seem to like me a lot, I was harassed by a stray in the street just a couple of days ago, and I have given up trying to stop our neighbor’s cat climbing in our window, onto my lap and going to sleep when I’m working on the computer at home.

    I’m sure the horrible half-decomposed things cats insist on eating are responsible for their parasitic infections, and there are some interesting things we can catch from cats, like toxoplasmosis, which may (or may not) affect human behavior. The ‘madness’ of the stereotypical cat lady may be the result of her fondness for cats, not a cause. My diet is a little more refined than that of cats. I know exactly where and when I picked up the giardia – falafel from a fast food stall in Luxor, Egypt – as it was the only thing I ate that my traveling companion did not. She was fine, me not so much.

    The gluten free thing is vaguely plausible, as grains only entered human nutrition relatively recently (but so did goji berries), but I don’t think there is anything particularly different about gluten as compared to other plant proteins. I have seen the claim that partially digested gluten can be absorbed through a leaky gut, cross the blood brain barrier and cause neuropsychiatric symptoms, but the evidence for this is very thin indeed.

  61. #61 Mephistopheles O'Brien
    June 16, 2013

    Krebiozen – There is a definitive test for one’s cat-ness. When you see an empty box on the floor, what do you do?

  62. #62 Denice Walter
    June 16, 2013

    @ Mephistopheles O’Brien:

    Hah!
    I have to try that test- I know a person who keeps rubbing against me.

  63. #63 Krebiozen
    Typing with difficulty over a huge sleeping cat
    June 17, 2013

    When you see an empty box on the floor, what do you do?

    [Narrows eyes suspiciously] I sit in it, like any normal person would.

    I know a person who keeps rubbing against me.

    I advise a knee in the groin, unless the rubbing is solicited, of course.

  64. #64 Denice Walter
    June 17, 2013

    I had to laugh when I first saw Mephistopheles’ comment because- no joking- I currently have a 22x23x17 inch ( right, I measured it) appliance box next to my table because the giant cat likes to sleep in it and it consoles him when I leave him alone.

    Kreb, believe me, there are more than a few people in my life about whose genetics I truly wonder- and that one is numero uno.

  65. #65 Shay
    June 17, 2013

    I know a person who keeps rubbing against me.

    One mourns the demise of hat-pins.

  66. #66 Denice Walter
    June 17, 2013

    @ Shay:

    But seriously, I do have to say a word on behalf of the hybrid feline/ men creatures: they rub against you, sit in boxes, beg for salmon, they don’t do any real harm to anyone.

  67. #67 Mephistopheles O'Brien
    June 17, 2013

    Krebiozen – I see, a marked tendency towards cistatropism. Interesting..

  68. #68 Mephistopheles O'Brien
    June 17, 2013

    Denice Walter,

    I do have to say a word on behalf of the hybrid feline/ men creatures:

    Did you ever see Cat People? That might change your view.

  69. #69 Krebiozen
    June 17, 2013

    M.O’B.,
    You have to understand I don’t feel compelled to sit in the box. I could give it up any time I wanted. Probably.

    Denice,

    they don’t do any real harm to anyone.

    Some of us do have a habit of crapping in your slippers when you’re not looking, but no one’s perfect.

  70. #70 Mephistopheles O'Brien
    June 17, 2013

    Krebiozen – you just find it very comforting? http://www.youtube.com/watch?v=PTGZKmdfdzI

  71. #71 herr doktor bimler
    June 17, 2013

    When you see an empty box on the floor, what do you do?

    There are enough resident cats here at Maison d’Etre that the concept of box emptiness remains purely theoretical.

  72. #72 Mephistopheles O'Brien
    June 17, 2013

    herr doktor bimler – I love the name “Maison d’Etre”.

  73. #73 Krebiozen
    June 17, 2013

    M.O’B.,
    Precisely, just a minor compulsion.

    HDB,

    There are enough resident cats here at Maison d’Etre that the concept of box emptiness remains purely theoretical.

    I just hope none of the boxes are rigged with poison gas pellets triggered by quantum decay processes.

  74. #74 Infuriatingly Moderate
    Tired of processing pounds of spinach - CSA's ain't for everyone
    June 17, 2013

    If I fit, I sit!

    But seriously, it’s always struck me that naturopaths want all of the credit, but none of the responsibility.

    Our cat bit me a couple days ago. Usually not a big deal, but the next day I see the “red streak of death” running up my forearm. I’ve been given the MD stinkeye more than once for various ailments/injuries that I’ve kinda blown off, and eventually resolved on their own. But “red streak of death” somehow triggered me to haul my sorry stubborn butt off to Urgent Care.

    After 3 doses of Augmentin – standard of care for cat bites – the lymphangitis streak is gone, and I still haven’t turned into a newt, so I suppose I’ll be OK.

    Since I’m otherwise in reasonably good health, it’s possible I would have been just fine with a carrot poultice, or ingesting lots of raw garlic. But I did eat a nasty and tasty fast-food cheeseburger – with fries and a shake to boot – 2 weeks ago….

    That’s the kicker, isn’t it? If the “natural self-healing remedies” don’t work, then off to “allopathic” medicine you go. As stubborn as I am, I’d just as soon skip the magic and go for the science. Cat bites are not to be messed with.

    The naturopathic narrative is quite convenient, methinks…

  75. #75 Todd W.
    http://www.harpocratesspeaks.com
    June 17, 2013

    I just hope none of the boxes are rigged with poison gas pellets triggered by quantum decay processes.

    Well, if they are, just don’t look inside. As long as you don’t open the box, everything should be fine.

  76. #76 Denice Walter
    June 17, 2013

    @ Infuriatingly Moderate:

    “If I fit, I sit!”

    How does 22x23x17″ sound?

  77. #77 Narad
    June 17, 2013

    Some of us do have a habit of crapping in your slippers when you’re not looking, but no one’s perfect.

    Beats leaving a pregnant mouse. Remember, the little ones dessicate. The big ones deliquesce.

  78. #78 Narad
    June 17, 2013

    Our cat bit me a couple days ago. Usually not a big deal, but the next day I see the “red streak of death” running up my forearm.

    Wait, you got the Calvin Coolidge, Jr., without obvious local infection?

  79. #79 Infuriatingly Moderate
    June 18, 2013

    @DW #76: Sounds good – though I’d have to take out a side.

    @Narad: I had a vague memory that it was one of Lincoln’s sons that died of sepsis from a minor foot wound – apparently got my Presidents mixed up. So much for my memory….

    Actually did also have mild redness and swelling, plus the joint was getting sore….

  80. #80 jen
    Denver
    July 10, 2013

    People look to NDs for hope. I have a daughter with cystic fibrosis. CF is a lung and pancreas disease that shortens the lifespan. We were prescribed ensure, a mix of corn syrup and canola oil, for weight gain. Weight gain correlates with lung function. Makes sense, right? The insurance pays for it. Corn syrup feeds infection, canola oil feeds inflammation. Oops. Prescribed by Childrens Hospital of Denver. Look it up. Talk about Quackary. They almost started delivering insulin with her ensure before I got some help.

  81. #81 Todd W.
    http://www.harpocratesspeaks.com
    July 10, 2013

    @jen

    Corn syrup feeds infection, canola oil feeds inflammation.

    Citation needed.

  82. #82 Mayo
    NYC
    August 19, 2013

    Do you not know Calabrese uses shady statistical techniques and literature reviews as alleged evidence for hormesis? He fits right in with those he links himself to in your article.

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