Naturopathic Medicine
Renaissance Holistic Health
Philosophy
of Naturopathic Medicine
Naturopathic Medicine is a distinctively natural
approach to health and healing that recognizes
the integrity of the whole person. Naturopathic
Medicine is heir to the vitalistic tradition of
medicine in the Western world, emphasizing the
treatment of disease through the stimulation,
enhancement, and support of the inherent
healing capacity of the person.
The practice of Naturopathic Medicine
emerges from six underlying principles of
healing.
These principles are based on the objective
observation of the nature of health and
disease, and are continually reexamined in
light of scientific analysis.
It is these principles that distinguish the
profession from other medical approaches.
1. The healing power of nature.
vis medicatrix naturae
The body has the inherent
ability to establish,
maintain, and restore
health.
The physician's role is to
facilitate and augment this
process, to act to identify
and remove obstacles to
health and recovery, and to
support the creation of a
healthy internal and
external environment.
2. Identify and treat the cause.
tolle causam
Illness does not occur without cause. Underlying causes of
disease must be discovered and removed or treated
before a person can recover completely from illness.
Symptoms are expressions of the body's attempt to heal,
but are not the cause of disease. Symptoms, therefore,
should not be suppressed by treatment.
Causes may occur on many levels including physical,
mental, emotional, and spiritual.
The physician must evaluate fundamental underlying
causes on all levels, directing treatment at root causes
rather than at symptomatic expression.
3. First do no harm.
primum no nocere
Illness is a purposeful process
of the organism.
Therapeutic actions should be
complimentary to and
synergistic with this healing
process.
The physician's actions can
support or antagonize the
actions of the vis medicatrix
naturae.
Therefore, methods designed to
suppress symptoms without
removing underlying causes
are considered harmful and
are avoided or minimized.
4. Treat the whole person.
The multifactorial nature of health and
disease
Health and disease are conditions of the whole organism, a whole
involving a complex interaction of physical, spiritual, mental,
emotional, genetic, environmental, social, and other factors.
The physician must treat the whole person by taking all of these factors
into account.
The harmonious functioning of all aspects of the individual is essential
to recovery from and prevention of disease, and requires a
personalized and comprehensive approach to diagnosis and
treatment.
5. The physician as teacher.
docere
Beyond an accurate diagnosis and appropriate
prescription, the physician must work to
create a healthy, sensitive interpersonal
relationship with the patient.
The physician's major role is to educate and
encourage the patient to take responsibility
for health.
The physician is a catalyst for healthful
change, empowering and motivating the
patient to assume responsibility.
It is the patient, not the doctor, who ultimately
creates/accomplishes healing.
The physician must also make a commitment
to his/her personal and spiritual
development in order to be a good teacher.
6. Prevention.
Prevention is the best "cure"
The ultimate goal of any health care
system should be prevention.
This is accomplished through
education and promotion of lifehabits that create good health.
The physician assesses risk factors
and hereditary susceptibility to
disease and makes appropriate
interventions to avoid further
harm and risk to the patient.
The emphasis is on building health
rather than on fighting disease.
Naturopathic Education
Naturopathic medical colleges are four-year postgraduate schools with
admission requirements comparable to those of conventional
medical schools.
Fourth year students must complete 12 months of clinic internship
where they treat patients under the supervision of licensed
Naturopathic Doctors.
Naturopathic Education
Naturopathic education may be completed at one of six
four-year postgraduate schools in North America that are
part of the A.A.N.M.C. (Association of Accredited
Naturopathic Medical Colleges) including:
•Canadian College of Naturopathic
Medicine in Toronto
•Boucher Institute of Naturopathic
Medicine in British Columbia
•National College of Naturopathic
Medicine in Oregon
•Bastyr University in Washington
•Southwest College of
Naturopathic Medicine in Arizona
•The University of Bridgeport,
College of Naturopathic Medicine
in Connecticut
Naturopathic Education
The degree of Doctor of Naturopathic Medicine requires four years of graduate level study in the
medical sciences including:
•
anatomy
•
physiology
•
biochemistry
•
pathology
•
microbiology
•
immunology
•
pharmacology
•
laboratory diagnosis
•
clinical and physical diagnosis
•
cardiology
•
neurology
•
radiology
•
minor surgery
•
obstetrics
•
gynecology
•
pediatrics
•
dermatology
•
other clinical sciences
Naturopathic Regulation
Professional Licensing / Regulatory Boards
Canadian Association of Naturopathic Doctors (CAND) www.cand.ca
The College of Naturopathic Physicians of British Columbia (CNPBC) www.cnpbc.bc.ca
Ontario Board of Directors of Drugless Therapy - Naturopathy (BDDT-N) www.BoardofNaturopathicMedicine.on.ca
Manitoba Naturopathic Association www.mbnd.ca
Saskatchewan Association of Naturopathic Practitioners www.sanp.com
Alberta Association of Naturopathic Practitioners www.naturopathic-alberta.com
Provincial Naturopathic Associations
British Columbia Naturopathic Association (BCNA) www.bcna.ca
Alberta Association of Naturopathic Practitioners (AANP) www.naturopathic-alberta.com
Saskatchewan Association of Naturopathic Practitioners (SANP) www.sanp.ca
Manitoba Naturopathic Association (MNA) www.mbnd.ca
Ontario Association of Naturopathic Doctors (OAND) www.oand.org
Quebec Association of Naturopathic Medicine (QANM) www.qanm.org
New Brunswick Association of Naturopathic Doctors (NBAND) www.nband.ca
Newfoundland and Labrador Association of Naturopathic Doctors (NLAND)
Nova Scotia Association of Naturopathic Doctors (NSAND) www.nsand.ca
Prince Edward Island Association of Naturopathic Doctors (PEIAND)
United States Affiliate: American Association of Naturopathic Physicians (AANP) www.naturopathic.org
Naturopathic Accreditation and Examinations
Council on Naturopathic Medical Education (CNME) www.cnme.org
North American Board of Naturopathic Examiners (NABNE) www.nabne.org
Naturopathic Physicians Licensing Examination Board (NPLEX) www.nabne.org
Naturopathic Regulation
Change in regulation from DPA (Drugless
Practitioners Act) to the RHPA (Regulated
Health Practitioners Act)
May 28, 2007 Naturopathy Act is passed as part
of Bill 171, Health Systems Improvements
Act to ensure regulation under the RHPA
Other professions regulated by the RHPA:
College of Midwives
College of Dental Technologists
College of Pharmacists
College of Chiropractors
College of Respiratory Therapists
College of Dental Surgeons
College of Optometrists
College of Dieticians
College of Occupational Therapists
College of Physicians and Surgeons
College of Psychologists
College of Chiropodists
College of Massage Therapists
Research
Peer-reviewed Medical Journals
Journal of Integrative Medicine
Integrative Medicine: A Clinicians
Journal (IMCJ)
The Journal of Alternative and
Complementary Therapies
The Journal of Alternative Therapies
in Health and Medicine
International Journal of Naturopathic
Medicine
American Journal of Clinical Nutrition
Journal of Orthomolecular Medicine
The Alternative Medicine Review
Journal of Environmental Medicine
Applied Nutritional Science Reports
(ANSR)
Naturopathic Modalities
Clinical Nutrition
That food is the best medicine is a
cornerstone of naturopathic
practice.
Many medical conditions can be
treated more effectively with
foods and nutritional supplements
than they can by other means,
with fewer complications and side
effects.
Naturopathic physicians use
dietetics, natural hygiene,
detoxification, and nutritional
supplementation in practice.
Naturopathic Modalities
Botanical Medicine
Many plant substances are
powerful medicines.
Where single chemicallyderived drugs may only
address a single
problem, botanical
medicines are able to
address a variety of
problems
simultaneously.
Their organic nature makes
botanicals compatible
with the body's own
chemistry; hence, they
can be gently effective
with few toxic side
effects.
Naturopathic Modalities
Homeopathic Medicine
Homeopathic medicine is based on the
principle of "like cures like."
It works on a subtle yet powerful energetic
level, gently acting to strengthen the
healing capacity of the body.
Naturopathic Modalities
Traditional Chinese Medicine
Oriental medicine is a complimentary healing philosophy to
naturopathic medicine.
Meridian theory offers an important understanding of the
unity of the body and mind, and adds to the Western
understanding of physiology.
Acupuncture provides a method of treatment which can
unify and harmonize the imbalances present in disease
conditions, which, if untreated, can result in illness.
Naturopathic Modalities
Traditional Chinese Medicine
Element: Fire
Organ: Heart
Function: Houses the mind (emotions)
Emotion: Grief
Analogy: Give someone your heart
Example: Adam Sandler in Reign Over Me
Western Diagnosis: Bipolar Disorder
TCM Diagnosis: Fire Harassing the Heart
Naturopathic Modalities
Psychological Medicine
Mental attitudes and
emotional states may
influence, or even
cause, physical illness.
Counseling, nutritional
balancing, stress
management, and
other therapies are
used to help patients
heal on the
psychological level.
Naturopathic Medicine
Intravenous Therapy
IV therapy allows therapeutic
doses of vitamins and
minerals to be administered
to an individual in an acute
state of illness, or a
chronically debilitated state
so as to more rapidly bring
upon healing.
Intravenous therapy is an
effective tool to use in
chelating heavy metals, and
as well may be used as
adjunctive cancer therapy.
Naturopathic Medicine
and
Autism
Prevalence of Autism
Autism now estimated to affect 1 in 166
children
Frequency of autism estimated to have
increased 3.8%/year from 1966-1997
Ratio of 3:1 boys:girls
Causes of Autism
Autism undoubtedly has a multifactorial
causation profile.
1. Genetic
2. Environmental
-
Toxins
Infections (vaccinations)
Inflammation
Oxidative stress
Adverse reactions to foods
Treatment Objectives
To remove offending substances from the diet;
introduce only hypoallergenic foods into the diet.
To repair damage in the gastrointestinal system.
To control the immune system.
To eliminate any presence of yeast.
To address possible heavy metal toxicity.
To minimize oxidative stress and repair free
radical damage.
To introduce systemic (whole body) antiinflammatory agents.
To address possible impact of vaccinations.
Typical Naturopathic
Treatment Plan
Heavy Metal Toxicity
Asses presence of heavy metals
Investigate heavy metal exposure
Undergo chelation therapy for
removal of heavy metals
Gastrointestinal Health
Wheat (gluten) and milk (casein) free diet
Candida diet (sugar, arabinose, tartaric acid)
Hypoallergic diet to prevent autoimmunity
Anti-inflammatory diet to control inflammation
Supplements including EFA, probiotics, glutamine,
MCT
Brain Chemisty
Evaluate levels of
Glutamate/GABA,
serotonin and dopamine
Nutrition
Why does food matter?
Anecdotal evidence of over 30 years demonstrates high
incidence of impaired GI tract function and food
intolerance in autistic children.
Goodwin et al, 1971
In a survey of 500 parents of autistic children, over 50%
reported loos stools or frequent periods of diarrhea.
Lightdale et al, 2001
In a survey of parents of 116 autistic children the following
data was collected (see next slide):
Horvath & Perman, 2002
Nutrition
Intestinal Disorders Associated Autism
Autistic child (% of 116 aged 3-10)
Sibling (% of 43)
Number of GI Symptoms
0
1
2
3
4
17
10
17
15
41
72
16
7
0
5
Specific Symptoms
Abdominal Discomfort
Gas (2-3 events/week)
Bloating
Belching
Reflux
44
54
34
24
16
9
19
5
9
5
Frequency of Bowel Movements
> 3/day
2-3/day
1-2/day
3-4/week
1-2/week
20
25
35
7
6
2
13
72
2
7
Stool Characteristics
Loose/watery
Soft
Normal
Changing
Foul Smelling
Sour Smelling
Normal Smelling
32
18
13
23
49
8
43
2
21
81
0
0
7
93
Nutrition
Why does food matter?
The Intestine as a protective barrier
Miller AL. “The pathogenesis, clinical implications and treatment of intestinal hyperpermeability.” Alternative Medicine
Review, 1997; 2(5):365-376.
Walker M. “The leaky gut syndrome.” Explore!, 1996;7(3):9-12.
IgG Food Allergies and the symptoms of an overactive
immune system
Gaby AR. “The role of hidden food allergy/intolerance in health and disease.” Alternative Medicine Review,
1998;3(2):90-1000.
Jacobson MB, Aukrust P, Kittang E, et al. “Relation between food provocation and systemic immune activation in
patients with food intolerance.” The Lancet, 2000; 356:400-401.
Rudat K-H. “Intestine-specific overstress diseases – concerning the functional utility of the intestinal tract and the
immune system.” Explore!, 1996;7(3):24-28.
Contribution to chronic inflammation and therefore further
destruction
Sutter, Frederick T. “Natural Therapies for Rheumatoid Arthritis and Other Chronic Inflammatory Conditions.” Applied
Nutritional Science Reports, 2000;419.
Lerman, Robert H. “A Case Study Evaluating the Effects of an Inflammatory-Modulating Medical Food and a Nutritional
Supplement Containing a Proprietary Blend of RIAA, Vitamin D3, Selenium, and Zinc in a Patient with Crohn’s
Disease.” Applied Nutritional Science Reports, 2005;1271.
Nutrition
Why does food matter?
Opium, gluten and milk in Autism
Breakdown of gluten and casein by secretions of the pancreas and the
intestines create peptides (small proteins) that are similar in
structure to endorphins (the body’s natural pain killer). These
peptides have opiate-like qualities.
Normally, these peptides are degraded and excreted with little effect.
In autistic patients, these peptides can lead to reduced brain electrical
activity and thus altered behavioural changes.
This activity is improved by naltrexone administration (an opioid
antagonist) therefore proving opioid action.
Much anecdotal evidence exists of significant improvement in autistic
symptoms when milk and wheat are eliminated from the diet.
A study using 15 autistic children correlated significantly increased
urine exorphin level with autistic spectrum patients. Elimination of
milk and gluten from the diet resulted in improvement of social,
cognitive and communications sills, commensurate with reduction of
urinary exorphin level. Knivsberg et al, 1990
Nutrition
WhyWhat
does
food
matter?
is the deal with yeast?
Byproducts of yeast, including arabinose and tartaric acid, are frequently
elevated in urine samples of people with autism.
History of frequent ear infections, and therefore anti-biotic use, strongly
correlates with presence of these byproducts – kill bacteria, more food for
yeast to thrive on.
Arabinose is found in greatest amounts in apples. Values may be significantly
increased after drinking apple juice or eating apples/applesauce. Several
parents have reported worsening of symptoms within a short time after their
children ate apples.
One child with a very high urine arabinose was examined by MRI and found to
have diffuse demyelination. Without an intact myelin cover, the nerve
impulses in the brain are “short-circuited.”
Tartaric acid is most likely a product of the breakdown of arabinose. It is
available as a food additive (from the wine making industry) in baking
powder, grape and lime flavoured beverages, and poultry. It may also be
found in grapes and grape products. Cream of tartar is nearly pure tartaric
acid.
Tartaric acid disallows the formation of malic acid which then interrupts the
process of gluconeogenesis which then decreases the amount of glucose
available to the brain leading to foggy thinking and decreased energy.
Shaw, William PhD. Biological Treatments for Autism and PDD. Lenexa: The Great Plains Laboratory, 2002.
Nutrition
Autism and Brain Chemistry
Balancing glutamate and GABA
Glutamate is an excitatory neurotransmitter that plays a role in cellular memory and pain
perception.
When glutamate is imbalanced symptoms such as chronic pain, mood lability, and mania
are existent and signs such as neurodegeneration become apparent.
GABA is the primary inhibitory neurotransmitter of the brain and is of utmost importance
for cell to cell contact. It can be thought of as enhancing communication by quieting
the noise caused by excitatory neurotransmitters, as the case would be in a bar
where it is difficult to communicate because of so much excitation and background
noise, while in a quiet living room by the fire communication may be enhanced simply
by listening.
When GABA is out of range (high or low), it is likely that an excitatory neurotransmitter is
firing too often in the brain.
GABA is said to be the ‘radiator fluid’ for the brain in that it is meant to cool the heat
caused by the metabolic function of the excitatory neurotransmitters.
GABA receptors mediate anxiolytic, sedative, and anti-convulsant activity. When GABA is
imbalanced symptoms such as anxiety, depression, restlessness, excessive worrying,
sleep disturbances, and insomnia result.
Magnesium, B6, Green Tea Extract, taurine and NAC balance glutamate and GABA
activity
Lombard, Jay. “The Neurobiology of Mood and Cognitive Disorders”. Lecture. Metagenics Educational Programs. Syracuse, New York. 7 October 2007
Nutrition
Heavy Metal Toxicity
Individual and cumulative amounts of mercury in
vaccinations exceed safety guidelines
Is a byproduct of industrial waste transformed by
microorganisms in the environment, bioaccumulates in
water organisms (largest amount in salmon and tuna)
Toxic to all tissues and organs
Important in those with candida as mercury inhibits an
enzyme that produces an ion that is one of the key
defense mechanisms against candida
Treatment by chelation including garlic, cilantro, vitamin C,
calcium, NAC, selenium, lipoic acid
Shaw, William PhD. Biological Treatments for Autism and PDD. Lenexa: The Great Plains Laboratory,
2002.
Supplements
Essential Fatty Acids (EFA)
Simoppulos AP. “Omega-3 fatty acids in inflammation and autoimmune diseases. “J Am Coll Nutr. (2002):495-505.
Review.
Probiotics (Saccharomyces boulardii, bifidobacteria, Lactobacillus reuteri and casei)
Bongaerts GPA, Severijnen RSVM. “The beneficial, antimicrobrial effect of probiotics.” Medical Hypothesis, (2001):174177
Erickson KL, Hubbard NE: Probiotic immunomodulation in health and disease. Journal of Nutrition, (2000):403S-409S.
Glutamine – fuel for cells of the colon; production of ATP used as energy by cells of colon
Souba, Smith, and Wilmour. “ Glutamine metabolism by the intestinal tract.” JPEN (1985):608-17.
Magnesium and Vitamin B6 – as cofactors bound to lysine sites that are blocked because of
pentosidine formation on that site; promotes GABA formation
Mousain-Bosc et al. “Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6.
II. Pervasive developmental disorder-autism.” Magnesium Research, (2006):53-62.
Calcium – prevention against calcium deficiency from milk-free diet (Symptom – itchy eyes)
Shaw, William PhD. Biological Treatments for Autism and PDD. Lenexa: The Great Plains Laboratory, 2002.
MTC (Medium Chain Triglycerides) – contains mostly caprylic acid which is an antifungal
Shaw, William PhD. Biological Treatments for Autism and PDD. Lenexa: The Great Plains Laboratory, 2002.
Vitamin B12 – absorbed in the ileum where damage may be apparent (as study sited 93% autistic
children had ileal lymph node hyperplasia and 8% of subjects had ileitis)
Wakefield et al, 2002
Pharmaceutical Treatment
Neuroleptics
- Reduction of aggression and irritability
Drugs: Haloperidol; (atypical – risperidone)
Nutrient Depletions: Co Q-10, melatonin and vitamin E
Serotonin Reuptake Inhibitors
- Children having co-existing depression or with obsessive or ritualistic behaviours
Drugs: Fluoxetine, Clomipramine, Sertaline, Paroxetine
Nutrient Depletions: Sodium, folic acid and melatonin
Opioid Receptor Antagonist
-
Children with self-injurious behaviours
Drugs: Naltrexone
Nutrient Depletions: unknown
Anti-convulsant
- Seizure Control
Drugs: Valproic acid and carbamazepine
Nutrient Depletions: Biotin, niacin, L-carnitine, folic acid, zinc, calcium and all fat soluble vitamins (A,D,E and K)
Naturopathic Doctors are not legally permitted to provide information on pharmaceuticals regarding their continued use
or changes in dosage. Naturopathic Doctors are however, knowledgeable about pharmaceuticals in terms of their
mechanism of action, their interactions with other drugs or supplements, and nutritional depletions they may
cause.
Consider the care of a Naturopathic Doctor
Lorraine Stuyt BSc., N.D.
While we may not be able to
control all that happens to us,
we can control what happens
inside us.
Ben Franklin