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A naturopathic “apostate” confirms that naturopathy is a pseudoscientific belief system

Naturopathy is 80% quackery, 19% science-based modalities like diet, exercise, and lifestyle changes rebranded and infused with woo, and maybe 1% valid medicine. Yes, I know I’m probably being generous given that naturopathy is based on a vitalistic, prescientific worldview and originated in the 19th century German “natural living” movement, but I’m in a generous mood right now. The reason I’m in a generous mood is not because naturopathy has suddenly become less quackery than it was. Just view a few of my posts on naturopathy if you think my opinion’s changed. I still believe that naturopathy is pseudoscience and quackery, and naturopaths are only too happy to confirm that assessment discussing cases with each other when they think no one else is listening.

Naturopathy is, like many forms of alternative medicine, rather religion-like, cult-like, even. Belief matters more than evidence, and being “natural” matters above all else. That’s why it’s refreshing when a member of the cult actually leaves the cult. It’s unusual. Once a person has become a naturopath, it’s rare for that person to leave the pseudoscientific cult that is naturopathy. For one thing, it’s hard—very hard—for a naturopath to switch careers. I’m happy to say that such a thing has happened. A naturopath named Britt Marie Hermes got fed up with the fake medical system that is naturopathy and left. She more than left, however. She turned and started a blog about naturopathy called Naturopathic Diaries, describing her deconversion thusly:

For about 3 years, I practiced as a licensed naturopathic doctor in the United States. In 2011, I graduated from Bastyr University in Washington state and then completed a one-year residency in a private clinic. After my residency, I briefly practiced naturopathic medicine in Arizona.

I left the profession of naturopathic medicine to pursue a career in biomedical research. Since my departure, I have been working to understand my former biases towards naturopathic medicine and explore the ethics and evidence, or lack thereof, of naturopathic philosophy and practice. I’ve concluded that naturopathic medicine is not what I was led to believe. It is a system of indoctrination based on discredited ideas about health and medicine, full of anti-science rhetoric and ineffective and sometimes dangerous practices. This blog reveals what I’ve discovered about naturopathic medicine. Herein lies my story based on my personal and professional experiences.

This is big. This is great. Britt is just what we as supporters of science-based medicine need: a former naturopath who can shed some light on what naturopaths really do. Particularly informative is Britt’s story of why she became a naturopath. It begins with her suffering from psoriasis. Psoriasis, of course, is a disease that is very frustrating for both patients and practitioners. It’s a disease that waxes and wanes, that can be very difficult to treat, and that causes patients considerable distress. But that wasn’t so much the reason why Britt became disillusioned with medicine as it is currently practiced. This is:

My psoriasis story contains the necessary ingredients to reinforce misconceptions and myths about medicine and an attraction to alternatives. First, it paints allopathic medicine as cold and indifferent. The doctor in my story was unmoved by my grief over my diagnosis of psoriasis. He seemed like he was in a hurry. He offered me no sympathies. In my naturopathic bias, he did not care about the patient. He did the most terrible thing ever: he offered me a prescription drug and no other treatment options. (I even asked about other choices.) Lastly, he only treated my psoriasis, not me, the person. I remember that he did not ask about my family history, lifestyle, eating habits, or my spirituality. He stood in the doorway and only treated my disease.

These are classic arguments made by naturopaths to defend their medicine and demonize allopathic medicine. Naturopaths claim to treat the whole person, while medical doctors treat disease. Naturopaths claim to use the least force necessary, while medical doctors push pills. Naturopaths claim to have time for their patients, spending anywhere from 30 to 90 minutes with a patient, while medical doctors spend a mere 60 seconds with a patient. Lucky me, my doctor set me up for a powerful story to validate the use of naturopathic medicine!

In reality, I just got a grouchy doctor. One dermatologist clearly does not represent the entire field of dermatology, and truthfully, I have had many wonderful and warm dermatologists since this experience. But this one psoriasis story cemented my faith in naturopathic medicine, and I used it to convince others of the the miracles of naturopathy.

This is exactly the sort of disillusionment with science-based medicine that leads patients to quackery like naturopathy. I’ve heard the story again and again and again. Unfortunately, the current model of insurance-based reimbursement encourages—nay, demands—the sort of behavior that Hermes’ dermatologist exhibited. With reimbursement barely covering the cost of providing medical services, physicians find themselves forced to try to make a living on volume. It’s true for surgeons, but its especially true for primary care physicians. Spending 30-90 minutes per patient is a recipe for going out of business. Quacks like naturopaths, however, base their model on this. Indeed, as I discussed this very issue earlier this week when I discussed “integrative medicine” as the lure of the shaman-healer.

In fact, Hermes is very explicit about “belief” being central to naturopathy as she continues her deconversion story. And, make no mistake, that’s exactly what it is we’re talking about here, a deconversion story. She describes how doubt began to creep in, describing it as a slow process. First, Hermes encountered practices that to her seemed to portend only small clinical risks, but then, the longer she was in the profession, the more she saw and, as she put it, “began to witness serious and dangerous naturopathic practices.” She then points out that, even though she was a quarter of a million dollars in the hole due to student loans, she had to “drop her faith.” Those are the exact words that she used. She then justified them:

I intentionally use the word “belief” to describe my experiences with naturopathic medicine. Naturopathic medicine is a philosophy, a worldview, and even a lifestyle. It is not a real and distinct medical system. Not everyone has heard of naturopathic medicine, but its principals can be found in any alternative medicine doctrine. In fact, it’s as if naturopathic medicine includes any and all tropes counter to science and borrows loosely from medicine when convenient.

For naturopaths, it does not matter if science refutes the traditional ways of healing. Because for naturopathic believers, what matters is not about what science says, but about beliefs in an alternative, magical healing force. Naturopathic medical beliefs include pseudoscientific ideas like vaccines cause more harm than good, any disease can be successfully treated with homeopathy, alternative cancer therapies are safe and effective, and nutrition can cure mental illness. These beliefs are dangerous and their promotion is unethical.

Yes, as I’ve pointed out so many times before, you can’t have naturopathy without The One Quackery To Rule Them All, homeopathy. It’s part and parcel of naturopathy. It’s in all the curriculae of major naturopathy schools. It’s part of the NPLEX, the naturopathic licensing examination. Based on their belief system that “natural” is always better, naturopaths frequently promote antivaccine views. (I know there has been one naturopath featured on this blog who claimed not to be antivaccine, but even she couldn’t resist seasoning her writing and videos with antivaccine talking points. Not surprisingly, naturopaths contribute to the fear mongering about vaccines and genetically modified organisms (GMOs), the latter of which leads the lack of political will to strengthen vaccine requirements.

What’s amazing, and so much to Hermes’ credit, is that, unlike so many, she actually admitted she was wrong and did so explicitly in her application to the Medical Life Sciences program at the University of Kiel, which is a Master’s of Science program focusing on biomedical research. In particular, she described her deconversion as “getting out of the rabbit hole.”

One of the incidents that turned her on the path of knowledge, noting that naturopaths accuse her of “misrepresenting” the “good” naturopaths who provide what they describe as “high quality care.” As a counterpoint she describes a patient with “multiple chemical sensitivity disorder.” This patient showed up to her clinic for a regularly scheduled intravenous vitamin C and glutathione injection. Because the patient was late for the appointment and his naturopath was unavailable, Hermes had to see the patient to do the IV. She noticed that the patient’s hand was bleeding due to a dog bite.

Hermes wanted to do the right thing after irrigating the wound, namely give the patient a tetanus vaccine and oral antibiotics. This did not go over well with the patient’s regular naturopath:

The patient’s regular naturopath pulled me aside. This naturopath had overheard me consulting the patient and was furious I had recommended oral antibiotics and a vaccine, due to fears of exacerbating the patient’s “multiple chemical sensitivities.” I maintained that the patient had a deep animal bite, the patient was overdue for a tetanus shot, and the likelihood of an infection was pretty good. We debated for several minutes, and when neither of us agreed to change our minds, we decided to disagree and carried on with our tasks. By the time I had returned with the IV bag, this naturopath had spoken to the patient and made a convincing argument against my medical recommendation.

The patient said, “I don’t want oral antibiotics, and I am very afraid of getting a vaccine. Dr. so-and-so agrees with me.”

I had an idea. I suggested the patient apply a topical antibiotic prescription, take home a prescription for an oral antibiotic, and start taking this medication at the first signs of an infection (along with calling me). The patient would also get a tetanus shot on the way home. I helped arrange the vaccination appointment at a local pharmacy and dispensed a homeopathic remedy.

The only way I could convince the patient to get vaccinated was to recommend the homeopathic remedy Thuja, which is a common remedy prescribed by naturopaths for adverse vaccine reactions. When the patient outright refused to get vaccinated, I came up with the idea of using homeopathy to relax the patient’s fears.

So, in other words, in order to do the right thing, she had to trick the patient by doing the wrong thing. Why is that? Because naturopathy is so rooted in prescientific vitalism and pseudoscience that it demands the wrong thing and actively opposes the right thing. Worse, that’s what the patients want. They are drawn to this wrong thing (wrong from a medical and scientific standpoint). As Steve Novella described so accurately, naturopathy is a delusion. As Mark Crislip describes, the ignorance of naturopaths can result in the deaths of patients. As Kimball Atwood described, naturopathy is pseudoscience and prescientific vitalism. As I myself have described, it’s naturopathy versus science, with naturopathy being a a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease. As a result, typical naturopaths are more than happy in essence to “pick one from column A and one from column B” when it comes to pseudoscience, mixing and matching treatments including traditional Chinese medicine, homeopathy, herbalism, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine. If you don’t believe me, I could show you a veritable plethora of examples culled from naturopath websites.

Unfortunately, of all the forms of alternative medicine, naturopathy has arguably been the most successful at making a bid for respectability. Indeed, seventeen states, plus the District of Columbia and the U.S. Territories Puerto Rico and the Virgin Islands, license naturopaths. As documented by Jann Bellamy and the Society for Science-Based Medicine, naturopaths are constantly looking to expand that roster. Last year they succeeded (to an extent) in Maryland, but didn’t get anywhere near all that they wanted. They’ll be back, no doubt, to try to remedy that. They’re always back. They tried recently in my own state of Michigan, but the bill appears to have gone nowhere.

Meanwhile, in academia, “integrative” medicine programs integrate the prescientific belief system that is naturopathy with science-based medicine, with depressing results (e.g., the University of Kansas and Georgetown, among others). Professional societies dedicated to “integrative medicine,” such as the Society for Integrative Oncology, allow naturopaths to be full members. Indeed, both the current President and Immediate Past President of the SIO are naturopaths, Suzanna Zick, ND, MPH and Heather Greenlee, ND, PhD. A naturopath helped write the SIO’s recent clinical guidelines for breast cancer treatment. The list goes on. Even though you can’t have naturopathy without homeopathy, the “integration” of naturopathy continues apace.

That’s why Hermes’ contribution is valuable. Indeed, just this morning, she published an Orac-length description of the training that goes into the ND degree. Her key points include that naturopathic education exists in a bubble without any real oversight and that what Bastyr and other naturopathic schools say about themselves and their programs do not jibe with reality. Most importantly, she deconstructs a common deceptive trope repeated by naturopaths to make it appear that their education is the equivalent of that of an MD by detailing what her own education included. Amusingly (and a bit disturbingly), the clinical training in physical examination was risibly lacking:

Students were required to achieve physical exam benchmarks, such as a cardiovascular exam, a respiratory exam, a prostate exam, or a neurological exam. Students were only required to complete one exam in each system and may perform the exam on another student if a patient was not available or the student never had the opportunity to perform the exam on a patient. It was not uncommon for students to perform prostate and gynecological exams on each other in order to complete the required examination for competency. And in fact, the instructor of our advanced gynecology class (an elective course) asked the female students taking the course to act as standardized patients. When I learned this, I was happy that I did not register for the weekend elective course. The lack of actual patients to practice examinations significantly hinders naturopathic clinical training.

No doubt. One wonders how many female ND trainees dropped out of that particular course when they learned that they would be asked to undergo gynecological examinations by their fellow fumbling trainees. (As an aside, I’ve always admired women willing to be standardized patients for medical students. I can’t imagine what it would be like to let a succession of nervous, fumbling students anywhere near my sensitive nether regions, particularly given that they generally are not paid very much and do it more out of dedication to training doctors in women’s health.) In any case, in medical school, a lack of patients is rarely a problem, nor is a lack of supervision. In my year two physical diagnosis class, we had to do complete histories and physicals on a number of patients in the hospital. At the end of the course, our final examination consisted of being asked to do a random part of the physical examination (e.g., cardiovascular, pulmonary, musculoskeletal, neurological) and be videotaped doing it. The videotapes were reviewed by our professors and a major part of our grades. Then, throughout my clinical years (years three and four) and my residency I did more histories and physicals than I can remember, dozens turning into hundreds, and eventually thousands by the time I finished general surgery residency.

Particularly devastating is Hermes’ description of how there really isn’t a standard of care in naturopathy; basically almost everything goes. After all, when you abandon science and embrace modalities like homeopathy and traditional Chinese medicine, there really is no reason other than a combination of ideology and habit to choose one treatment over another for a given tradition. It’s an observation that I’ve made many times before, but it’s good to see it confirmed by a former naturopath, and it’s good to see a description of how there are there were “lengthy competencies for homeopathic medicine” in ND school, to confirm yet again how integral homeopathy is to naturopathy. The American Association of Naturopathic Physicians (AANP) is misrepresenting what naturopathy is to lawmakers in a bid to become licensed. Because the AANP is playing a long game, setbacks are just part of the game. The AANP always comes back again and again and again until it gets what it wants.

In the end, as I described, naturopathy really is very religion-like; so it’s not inaccurate to refer to Britt Hermes as an apostate. She’s put her fellow naturopaths on notice:

Naturopaths are notorious for blindly accepting information that fits their world-view and vigorously ignoring information that contradicts. I’ve seen it many times over.

It is easy for naturopaths to ignore information coming from critical websites and insulate themselves with others who think alike. They read the words “pseudoscience,” “quack” and “show the evidence” and run the other direction. For many years, I did the same, but now I know better. Therefore, I will do better.

To all naturopaths: You are officially on notice.

Let me just publicly welcome Hermes to the world of science and skepticism. I’m very glad she’s here and can’t wait to see her future posts. She’s evidence that, as difficult as it is to dissuade someone so invested in pseudoscience to embrace science, it can happen.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

136 replies on “A naturopathic “apostate” confirms that naturopathy is a pseudoscientific belief system”

Good on Ms. Hermes for having the gonads to admit she was wrong. Very few people do that when the stakes are as high as their careers, even when it involves something much less egregious than naturopathy.

I was that dog bite patient, I let a deep cat bite fester in service to the notion that the body is self-healing, and in obedience to the anti-antibiotic/anti-vaccine axioms instilled and reinforced by my alt-med providers. With my infected swollen hand and forearm, in the moment when I accepted the standard of care as rendered by a legitimate physician, I allowed myself to be violated. That’s the gift alt-med gave me, complete and abject misplacement of my trust. The lesson learned since is that alt-med and its apologists accept no responsibility EVER for the harm they cause, both physical and mental.

Bastyr says,

“A regionally accredited, globally respected institution of natural health arts and sciences, Bastyr University is improving the planet through innovative education, research and clinical service.”

to which I say I can only hope a class-action lawsuit will be possible at some point for the students whose useful minds were derailed at great personal and financial cost.

I think it would be easier to make a case against alternative medicine if real medicine didn’t have so many skeletons in its closets. It’s hard for me to argue effectively with relatives who buy into all of the CAM nonsense when they point out that traditional has much entrenched fraud, greed and incompetence. How would you respond when it is pointed out that tens of thousands of needless surgeries are performed each year in the United States? That ineffective drugs, often with serious side effects, get to market due to fraudulent manipulation of clinical trials? That up to 200,000 deaths each year are due to medical errors? That the CDC estimates that over one million infections occur in hospitals each year, many due to poor practices. It would be much easier to argue against CAM if traditional medicine cleaned up its act.

Yay for Ms Hermes. Just this morning I was listening to an interview with a “naturopath” and all she could oofer was that she required ‘alopathic’ (read- real science/medicine) prove her wrong. And here was silly old me (an Intensive Care Trained Nurse) thinking that it was up yo the claimant to prove their assertions as correct. Bugger, back to the drawing board for me.

Sorry for my typo’s, I was a bit infuriated and didn’t proof-read my comment.

@ Alfred Nyby

Because the guy next door is a thief doesn’t give me the right to go around mugging people. From the point-of-view of the victim, he got robbed either way.
I would answer it would be a better world if, in all professional fields, medical included, we were a bit better at improving and enforcing standards.
Unless the alternative could prove it is faring better, then it is not a better choice.

Which leads me to:

That the CDC estimates that over one million infections occur in hospitals each year, many due to poor practices.

It’s easy to criticize and second-guess when it’s not your job.
I dare CAM proponents to be better at preventing secondary infections in the same circumstances. No cheating like having twice the room and four times the man-hour resources; or comparing non-invasive settings with surgery or long-stay wards.

BTW, in the interest of fact-based discourse, [citation needed] on the 200,000 deaths due to medical errors and the few other numbers you quoted. And don’t forget to report the denominator. 20 deaths among 100,000 patients shows a lot more good medical skills than 2 deaths among 10 patients.

I agree comparing rates of various outcomes from an outpatient clinic not doing any invasive procedures with a hospital setting really isn’t fair. Now comparing CAM with outpatient well visits from the doctor rather than CAM vs ICU and ER-trauma situations might be a bit more fair.

Of course comparing a system with active surveillance and required reporting of adverse events (including not giving the medication when needed so the patient died) with one that doesn’t have any oversight keeping watch isn’t particularly fair, either.

Being $250,000 in debt and giving up recouping that debt as a practicing “doctor” – ouch!
I bet a lot of ND’s realize on some level how much bogosity there is in it … but that debt is a psychological trap.
Good for her and amazing to walk away from it.

It’s nice to have a counterpoint in Ms.Hermes to the former-doctor-turned-woo-artist types.

“I think it would be easier to make a case against alternative medicine if real medicine didn’t have so many skeletons in its closets.”

On the contrary, I think the importance of CAM cleaning up its act should be even more imperative to those who emphasize how terrible mainstream medicine is. If your only alternative is CAM, it had better have the highest possible standards and be constantly vigilant to root out quackery.

@Helianthus
One source of infection in hospitals is toilet aerosols. See http://www.tandfonline.com/doi/pdf/10.1080/02786826.2013.814911

Our results and those of previous investigators present a consistent body of data that demonstrates the potential forgeneration of infectious droplet nuclei bioaerosols when a contaminated toilet is flushed. Pathogens including
Shigella, E. coli, Clostridium difficile, SARS coronavirus, and norovirus can be present in vomit or stools of infected persons and can survive on surfaces for weeks or even months. As has been shown, hundreds to thousands of potentially infectious bioaerosol particles, capable of remaining airborne for extended periods and migrating with air currents, may be generated in a single flush of a toilet contaminated with these organisms.

Closing the lid may help:

We performed in-situ testing, using faecal suspensions of C. difficile to simulate the bacterial burden found during disease, to measure C. difficile aerosolization. We also measured the extent of splashing occurring during flushing of two different toilet types commonly used in hospitals. … C. difficile was recoverable from air sampled at heights up to 25 cm above the toilet seat. The highest numbers of C. difficile were recovered from air sampled immediately following flushing, and then declined 8-fold after 60 min and a further 3-fold after 90 min. Surface contamination with C. difficile occurred within 90 min after flushing, demonstrating that relatively large droplets are released which then contaminate the immediate environment. … Lidless conventional toilets increase the risk of C. difficile environmental contamination, and we suggest that their use is discouraged

Knowing this helped me prevent the urinary tract infections I’ve been bedeviled with – so many times, I’ve gotten a UTI and been mystified about how the bacteria got there.
After I started cleaning the toilet bowl often, and closing the lid before flushing – no more UTI’s.

Dangerous @10:

If your only alternative is CAM, it had better have the highest possible standards and be constantly vigilant to root out quackery.

Once the quackery is rooted out, what’s left? — cheers – P

The APA now stands by this diagnostic criteria. Naturopathology: The persistent belief that a framework of empirical restraints is unnatural.

Wow, another person to admit they were wrong and to change! I’m starting to have some hope.

I hate the Cancer Centers of America ads on TV with a white-hot passion, and I notice that they offer naturopathy as one of their treatment modalities. It’s a for-profit hospital, which means someone (patient or insurance company) is being billed for all that quackery. I think a lot of people who go there think it’s some kind of nutritional counseling.

I LIKE the term “apostate.” Nice. Wink, wink.

Thank you everyone for your efforts and integrity, particularly Orac.

This is a repetition of my current SBM comment for those who wish to be activistic:

“FYI:

Today is the deadline to electronically submit testimony to the State of CT regarding what naturopaths here term licensure “modernization” [the irony!!!]:

NDs want prescriptive rights here in Corrupticut.

The email address where you can submit either PDF or Word attachments as testimony is:

[email protected]

I’ve written a specific Podcast episode, BTW, regarding this topic, just up:

http://naturocrit.blogspot.com/2015/03/the-naturocrit-podcast-episode-009a-mp3.html

And I’ve written a specific lesson plan for my Saturday Medical Law and Ethics course tomorrow that goes something like this:

should a group of practitioners who IGNORE science and CORRUPT science be given prescriptive rights when medicine’s code of ethics is obligated to ‘scientific integrity’?”

I think the obligatory joke that isn’t funny is to then state:

“Discuss.”

Or, shall I venture:

disgust!

Because I too know what its like to have a mortgage upon oneself for ND school, based upon lies.

Back in mid 1990s, the ND apparatus had stated, which I thought was true:

“naturopathic physicians are the modern day science based primary care doctor […] it is not a belief system.”

[see http://web.archive.org/web/19990221212454/http://www.teleport.com/~aanp/alliance/main.html ].

Take CARE.

-r.c.

This is kind of OT, but yesterday at Sprouts, I picked up a package of tea for treating high blood pressure — er, I mean for high blood pressure support — or something. Anyway, the back advised that the herb mixture in the tea has been used by traditional Chinese medicine to treat high blood pressure for “thousands of years”. I’m still trying to picture what a thousand year old traditional Chinese sphygmomanometer looks like.

OK, I know I’m going to be vilified for not having followed this discussion for years– until I saw it here, I had only heard the word “naturopath” and had no idea of what was involved– but I don’t get how people can

1) Pay off all that debt if they spend 90 minutes with patients.
2) Not be sued for malpractice if the outcomes are so disastrous?

I’m not sympathetic to the naturopaths, at least as described here, but I am also not sympathetic to the proposition that conventional medical practice will heal itself.

The science says, definitively for a while now, that yearly checkups have no benefit. Dr. E Emanuel, in a recent NYT piece, pointed out that eliminating those would free up PCP to better serve patients with actual complaints.

So, sorry Orac, but it isn’t a question of “Those problems will be alleviated by science, not by embracing quackery.”

I would elaborate but first I really want to answer my questions 1 and 2. I know it varies among states, but surely where there is licensing there must be some version of standard of care and liability?

1) Pay off all that debt if they spend 90 minutes with patients.

I don’t think every visit is 90 (usually the initial visit) and this may be why so many of them sell the supplements they recommend as that probably adds quite a bit of profit per patient. That and being a consultant for a dietary supplement manufacturer and other revenue streams.

2) Not be sued for malpractice if the outcomes are so disastrous?

I don’t know how many people only see the naturopath and probably if you eventually ended up at the ER the lawyer will go after them that has the deepest pockets like a large healthcare system rather than a small business. I believe naturopaths can carry malpractice insurance (not sure how the rates compare to MD/DO), if not just cover it with general business insurance types of policies. I’m sure the insurance industry has found a way to make money covering all the various alt med specialties.

So, sorry Orac, but it isn’t a question of “Those problems will be alleviated by science, not by embracing quackery.”

And who came to the conclusion that yearly checkups don’t produce measurable health benefits? Clinical researchers and outcomes researchers. In other words, scientists. Getting physicians to embrace these scientific recommendations is now in the realm of science. Change never happens as fast as we think it should in medicine, but change does come. For instance, these guidelines:

http://www.emedicinehealth.com/checkup/article_em.htm

It’s also overly broad to say that yearly checkups have no benefit. Rather, they have no benefit for the average, reasonably healthy person.

As a result, typical naturopaths are more than happy in essence to “pick one from column A and one from column B” when it comes to pseudoscience, mixing and matching treatments including traditional Chinese medicine, homeopathy, herbalism, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine. I

In other words, it’s the medical equivalent of Sheilaism.

The mantra I keep hearing from my altie friends is “it works if you believe it will.” But if that’s so, then why don’t they think “allopathic” medicine works, since so many people trust their doctors? I once asked them that question.

They hadn’t thought about that. They thought about it for maybe 15 seconds , and then said they didn’t know. Nor did they particularly seem to care. It’s not important because it’s still about choice. Free choice. Finding what works for you and leaving off the rest.

Naturopathy is spiritual and therefore they think it’s not religion. No, not at all. But they compartmentalize and shift topics like skilled apologists. I see little distinction.

Taking an overview** of recent topics in the conflict between SBM and woo ( vaccines, cancer treatment, dietary trends), I unhappily suspect that there is a reasonable possibility that the ( so-called) western world ( Europe, N. America esp) will devolve into a bi-partite entity wherein two world views and compatible services exist although I am loathe to say it: it’s horrible. Even if the whimsy-based ™ is advanced and utilised by a relatively small minority, it is becoming established. Thanks lobbyists and Mr Verkerk ( amongst others and internet proselytisers.

If you think about it, a small segment of society already accepts faith-based explanations for reality as it is- this is just another affront to reality-based medicine.

** for which I seem to have a bit of talent

Yes, welcome to Britt. I left a note of encouragement on her site to make sure she knows she has support out here once she begins coming under attack from her former colleagues. I am a transplanted Seattleite, and there’s no end to the shame that Bastyr and the Discovery Institute are in this area…. what really worries me is not just the general acceptance of Naturopathy, but the state licensing/sanctioning, possible ability to prescribe pharma, and insurance coverage that the Naturopaths are going for. Do legislatures know nothing about medicine as a business is even run? Sit in on a quality oversight meeting or compliance or patient safety meeting sometime at a hospital/medical center. Watch at how they evaluate CLAIMS for physicians and providers. How can hospitals and insurance companies support Naturopathy when their claims evaluations use Standard of Care evidence? To be brought into any kind of mainstream fold, Naturopaths would ultimately have to comply with modern medical standard of care, or the lawsuits will explode. Can someone enlighten me as to what the Naturopathic “Plan” here is with respect to this? I really don’t get it ….

#19 Orac:

“Getting physicians to embrace these scientific recommendations is now in the realm of science.”

That makes no sense at all. The science is done, and has been done for a while. Now it is a matter of policy, whether public policy or business policy on the part of the entrepreneur-MD, of whatever kind of delivery organization might be involved. And consumers of course, except that “insurance pays for it now”, so there is no incentive to pass it up.

With all due respect, we are talking about the *practice* of medicine, which is not science but more like engineering or perhaps kintsugi. What you need to combat “alternative medicine” is an actual alternative to the inefficient and sometimes harmful (physically and economically) BAU model. (And I’m talking only about the USA, so apologies to those nations that do it better.)

As I said, I don’t know much about naturopaths but some kind of different training and focus is not inevitably inferior. Even in the anecdote, Ms Hermes recognized what she thought was a need for antibiotics and tetanus shot. Where did that come from if not her training? And if the other practitioner disagreed– well, I’ve had a regular MD almost visibly flip a coin in exactly that kind of deep wound circumstance, deciding how to treat me. No woo involved.

@zebra

Even in the anecdote, Ms Hermes recognized what she thought was a need for antibiotics and tetanus shot. Where did that come from if not her training?

She said in her blog that she learned that from Medscape and Up-to-Date.

typical naturopaths are more than happy in essence to “pick one from column A and one from column B”

So TCM in this context stands for The Chinese restaurant Menu?

#25 Laura,

Thanks, I was only going by what I read here. But the story simply doesn’t make sense– how are these people licensed to prescribe the antibiotics and tetanus shots in the first place? There must be some oversight of the training for that to happen, and treating wounds like that is very basic stuff.

Really, it would help if someone could actually describe what the rules are. Are there actual MD naturopaths or not? If not, how are they held liable for the results of their treatments? And if they are so against ‘artificial’ medicine, why would they want to be able to prescribe drugs?

Orac,
Because I throw criticisms at science based medicine does not mean that I support CAM. I do not. My argument is that science based medicine, with all the wonderful outcomes it has given the world, should not get a free pass for all of its flaws. Many of these flaws are preventable. Many are intentional. And these flaws are costly in lives lost and dollars wasted. Magnitudes more so than CAM.

I would think that you would want to do battle with quackery wherever it exists. Not just in the CAM world. The “science” in science based medicine has been corrupted and has much of its own quackery that needs to be addressed. It is corrupted by the pursuit of profits, moral and political agendas and tradition. When a drug company can withhold 17 of 20 studies for a new drug because of unfavorable results there is something seriously wrong. And when Americans are over medicated and undergo tens of thousands of needless surgeries each year. There is a long list of these shortcomings in science based medicine that can be expounded on.

Orac, with your background and communication skills I think that you could be very effective in writing more about these failings and help strengthen the trust in science based medicine. That would undermine the appeal of CAM to many people.

ut I don’t get how people can
2) Not be sued for malpractice if the outcomes are so disastrous?

I’m not sure how that would work. A naturopath who prescribes useless or (in the case of TCM) actively toxic treatments is simply following the professional standards of care.

@Alfred – there are plenty of examples of Orac & his evil twin (or is it the other way around) taking modern medicine to task for its shortcomings as well….you are tilting at windmills.

#29 herr doktor,

If they are licensed, or in some way recognized by the state, their practices would be scrutinized and regulated– you know, like cosmeticians and so on.

I don’t mean to be argumentative (on this point anyway) but so far I am hearing that there are these dangerous bogeymen out there, and somehow they are licensed to prescribe antibiotics (and other drugs?), but at the same time are immune from liability for doing harm?

If they are licensed, or in some way recognized by the state, their practices would be scrutinized and regulated– you know, like cosmeticians and so on.

I wouldn’t be at all surprised if the standards to which cosmetologists are held are more rigorous than those for naturopaths. I have a friend whose daughter qualified as a cosmetologist, and it was actually fairly difficult. Many students apparently fail.

And of course, when you miss the final test in cosmetology, you have to take a make-up exam.

@ Alfred Nyby:

As well as Orac, there is Ben Goldacre who has several books and a column.

Really, it would help if someone could actually describe what the rules are.

You want a state-by-state description of naturopathic licensing laws?

One good thing I’ll give Bastyr is that they have kept intact the lovely chapel they inherited from the site’s previous incarnation as a seminary, which has great acoustics. I’ve worked several recording sessions there.

My father went to a naturopath for years, driving two hours each way for his appointments. Along with a painful and challenging diagnosis of chronic interstitial cystitis, he suffered from high blood pressure. While an extremely intelligent man, my dad is a pharmaphobe and wasn’t interested in taking blood pressure medication. Under his naturopath’s care, he did things involving biofeedback and such. Honestly, I don’t know the specifics except that his blood pressure remained seriously high for years. My sister and I both worked in an emergency room as RNs and we’d plead with him to do something about his blood pressure. We told him about patients we’d had with uncontrolled blood pressure.

I’m sure you can see where this is going.

My dear father ended up having a stroke. After six weeks in rehab (and being very, very lucky in his recovery), he suffered a myocardial infarction. And then a second heart attack. His physicians attributed the stroke and heart attack as consequences of those years of uncontrolled hypertension. Obviously my dad has responsibility for his choices but I am so angry at that naturopath for misleading him into thinking he was doing something about his hypertension.

I realize this is anecdotal but, damn, this kind of “health care” is allowed?

Britt Hermes new blog is fascinating and, as always, I look forward to what Orac and his faithful commenters have to say about all things woo.

when you miss the final test in cosmetology, you have to take a make-up exam.

GO TO YOUR ROOM.

zebra – I don’t think they are probably prescribing all that many drugs (even where they have the authority) because pharma is evil in ND world. But the way they get the ability to prescribe is through the legislature. If you can convince your friendly neighborhood lawmakers, it is legal. Often, their only real oversight is from a board of you guessed it other NDs. If you search this blog for Burzynski you will find out that even medical boards are often toothless enough that rogue practitioners can run amok for a quite a while without facing serious consequences. There isn’t the political will to fund these mechanisms for consequences. And take litigation, in some states they have actively closed off a lot of this through tort reform so it becomes cheaper and easier to settle out of court and have the insurance pay up a sum. This isn’t a real deterrent. I imagine most NDs carry some kind of insurance. Plus having seen the fanatical devotion that many in the woo world have for their providers I doubt that many of them would sue in the event of a bad outcome because of this.

Alfred – you are really conflating two separate problems and you need to do more research. A lot of time, energy, effort, and money is being spent on the problems of hospital care in particular infection management. A lot of reimbursement is being tied to these outcomes such that if a patient gets a post operative wound infection the hospital won’t get paid for treating it. Rates of infections in the hospital have dropped dramatically in recent years due to these efforts to improve wound care. Check out Dr. Crislip’s blog as he tells these stories. Nothing is 100% perfect. For each Vioxx scandal what about the 100s or 1000s of drugs that have been improved that have saved lives? Everything has a risk. No medical intervention is a 100% guarantee. Anecdote alert – My sister-in-law was enrolled in a clinical trial for severe Crohn’s disease. The medication helped her tremendously, she went into remission for several years after that trial. But the medication was not approved because it had the nasty habit of rapidly increasing the blood pressure in an unacceptable number of recipients. But for her it was a miracle. But it wasn’t approved because of side effects and careful testing. That’s how medicine works. One patients miracle may be another’s nightmare. Plus not everything can be found in studies. If the side effect is rare enough, it may not be caught in clinical trials and it may take a lot of data, in a lot of people, captured over years to find it. Plus, some side effects aren’t seen with short term use. Medicine, statistics, epidemiology, nothing is exact and we don’t get a crystal ball to see the future. But science at least evolves and learns from its mistakes.

I do not. My argument is that science based medicine, with all the wonderful outcomes it has given the world, should not get a free pass for all of its flaws.

Give me a break.

No one—and I mean no one, least of all, I—argues that SBM should get a free pass for its faults. And I do write about the faults and problems in SBM. Geez, use the search box and look for mammography, vertebroplasty, John Ioannidis’ name, and other things that I can’t remember off the top of my head. (There are nearly a decade’s worth of posts here, more than a decade if you include my predecessor blog on Blogspot.) Hell, between my posts on mammography here and on my not-so-super-secret other blog, I’ve attracted the ire of a very prominent radiologist. Perhaps I don’t blog about SBM shortcomings as much as you would like, but that’s just tough. I suspect that, even if I ramped up my blogging to be more than half about SBM it wouldn’t be enough. So I refuse to play that game.

Also, you should know—certainly regular readers do—that I tend to get a bit testy when I receive comments saying, in essence, “Why don’t you blog about what I want you to blog about? Why don’t you blog about what I think is important?” Make no mistake. That’s what you are, in essence, asking me. My response to such comments is, depending on my mood at the time, not infrequently quite impolite and almost always very blunt. This time around I will restrain myself and at least avoid profanity. I will, however, put it very simply.

This is my blog. It is my hobby. It is for me. I’m fortunate that my writing is good enough and informative enough that I’ve attracted some pretty decent traffic for a medical blog and a stable of awesome regular commenters. (Heck, last month was my all time peak traffic.) But traffic is not why I do this. If my traffic were back at the levels it was ten years ago, I would still be blogging.

I blog because I enjoy it. I blog about what interests me. If large numbers of people happen also to be interested in the same topics that interest me and to enjoy what I lay down enough to read it and comment about it on a regular basis, that’s an added bonus. It’s great. But that’s not the primary purpose. If I started to “do requests’ too often or write about what people like you think I should write about, I would likely rapidly lose interest and either go back to writing about what I enjoy writing about or quit blogging altogether.

There are many, many people who write effectively about problems with SBM, such as Ben Goldacre and many others. I do that sort of blogging from time to time, but only when a topic comes up that really interests me (such as mammography studies). If you want discussions of the shortcomings of SBM, you will almost certainly not get enough of them here to satisfy you. That is not going to change in the foreseeable future.

If they are licensed, or in some way recognized by the state, their practices would be scrutinized and regulated– you know, like cosmeticians and so on.

State by state licensure and privileges differ but I believe in all states (Narad will undoubtedly correct me if I’m wrong) naturopaths are regulated by naturopaths much in the same way chiroquacks “regulate” their own*.

*That is not to say that I’m extremely impressed with the way MD’s are always regulated but do a phenomenal job compared to the quacks.

damn, this kind of “health care” is allowed?

I have been wondering what kind of solution would be consistent with personal freedom.
With supplements, there are obligatory warnings in fine print that it’s not intended to treat anything.
Maybe something similar would help with alternative practitioners – if they were required to give patients a rating from an objective source of the quality of evidence for their treatment modality. Same thing with MD’s – if it’s just the doctor’s idea coming from their clinical experience, the patient should know.

While an extremely intelligent man, my dad is a pharmaphobe and wasn’t interested in taking blood pressure medication. Under his naturopath’s care, he did things involving biofeedback and such. Honestly, I don’t know the specifics except that his blood pressure remained seriously high for years.

A really good friend of mine has had a lifelong problem with vasovagal syncope, but it’s gotten worse with age, especially in the past few years,* leading to things like him fainting in the shower and slamming his head on the side of the bathtub. Worrisome, troubling.

He’s been seeing naturopaths and chiropractors about it mainly because SBM doesn’t really have anything to fix it with, and I guess going to quacks at least feels like doing something. He did at least agree to see real specialists just in case, which is good, although given the nature of his medical issue, I’d really rather he wasn’t going to chiros. But hey, who the f*ck am I?

*If you mention that it seems to be getting worse with age, though, you will typically get a response like “SHUT UP I’M NOT GETTING OLD.”

@ Kiiri #38

I have no argument with science. Science is where I place most of my hopes for a better world. The problem is that science is constantly under attack. Political, religious, and financial agendas undermine science’s authority. When the people with power, money and agendas control the message how is the Average Joe able to discern fact from fiction? Just think of the lengthy struggle it took to overcome the perversion of science by the tobacco companies.

As for your Vioxx scandal comment, do you think it is the only drug scandal? Have you read Ben Goldacre’s Bad Pharma? He doesn’t deny the good that is done by the drug industry, but that doesn’t give them a free pass for all of the scandals. We need more articulate communicators such as him to defend science and expose the scandals.

I have been wondering what kind of solution would be consistent with personal freedom.

Well, South Carolina bans naturopathy outright. Tennessee* also has a weak prohibition on the books. Michael Cohen’s blog is pretty interesting on the general legal front.

* Not Texas, as listed on Jann Bellamy’s site.

People like Alfred are unaware of, or unwilling to acknowledge the vast amount of self-criticism and effort within the medical/scientific communities aimed at uncovering problems (generating the vast majority of the studies and reports eagerly cited by anti-science cranks). Beyond that, they ignore the tremendous amount of everyday quality assurance work that health and science professionals perform to minimize errors and improve outcomes.

If if annoys the Alfreds of the world that some professionals don’t spend 100% of their time on self-improvement but take an occasional break to criticize dangerous pseudoscience and quackery – well, too damn bad.

For the last month or so I’ve been trying to decide how I feel about this :

https://gallery.mailchimp.com/35ee0fa27d80895fef237e0b2/files/HB_1075_AAP_naturopathic_Doc_statement_copy.pdf

Which I have no doubt is a direct result of this:

http://www.bastyr.edu/news/general-news-home-page/2013/06/colorado-passes-law-recognizing-naturopathic-doctors

I guess I’m just having a hard time 1) Understanding how supporting the above bill is really aligning the wishes of patients with the best evidence based practices when there is no evidence base to Naturopathy and 2) Believing that most Naturopaths are actually going to comply with the stipulations set forth in the bill. Only the third stipulation is even moderately enforceable.

Thoughts?

zebra–

If something is licensed and regulated by the state, that means that someone convinced the state government to license and regulate it. It doesn’t mean it works. Nor does lack of licensing necessarily mean that something doesn’t work. At best, the government looks at reality before deciding what to license. At worst, they look at who is contributing to their re-election campaigns. Sometimes it’s somewhere in between, and they’re listen to whoever shouts loudest in the media, or what their cousin’s neighbor told them.

If you live in a state where the legislature and governor can be relied on never to pass a stupid or misguided law, please identify it so I can look into moving there.

Looks like a post on malpractice insurance for naturopaths and political maneuvering by the profession to gain licensure/ expand scope of practice would be of interest. Many office procedures and treatments by NDs are not actually covered by our malpractice insurance policies. For example, hCG for weight loss was not covered by my policy in Washington (and in Arizona too, I think) but many NDs currently use this weight loss protocol, despite the evidence that it does not work.
Thank you for the support, Orac and others!

zebra: In order to win a malpractice suit, you have to demonstrate that the harm you suffered was caused by the professional’s failure to follow his profession’s standard of care. In the case of naturopathy, there doesn’t appear to be any standard of care. Now spoilsport me thinks that means that naturopathy is not, in fact, a profession, but not everybody sees it the same way.

Thanks to MC at #50– I read through the Colorado bill, and I will guess from the somewhat vague Wikipedia article and other comments here that other states may allow slightly more or less scope to the practice. Still not clear on prescriptions (?).

So I will repeat my earlier point to Orac– if you want to deal with “alternative medicine”, you need to provide an alternative to the *system* that currently exists.

It is trivial and pointless to argue against idiotic treatments; you can go back and forth trading horror stories all day between conventional medicine and this stuff. It doesn’t change the fact that sewing up a cut finger and prescribing antibiotics shouldn’t require seven years of residency for the practitioner, with the associated cost multiplication. Likewise telling people they should eat less and exercise more, or ordering an x-ray to see if your ankle is sprained or broken. Or going in once a year to be reassured (falsely) that you will be fine until next year.

Set up a rational system and let the market operate; maybe people aren’t as stupid as you think.

zebra,
I will doubtless regret engaging you again, but I’m intrigued by your bizarre way of thinking about this.

I’ve had a regular MD almost visibly flip a coin in exactly that kind of deep wound circumstance, deciding how to treat me.

I’m wondering how you acquired this astonishing power to read minds. What treatments did your telepathy tell you your doctor was considering? If your doctor was considering not giving prophylactic antibiotics and a tetanus shot for a deep animal bite, I suggest you consider changing your doctor.

So I will repeat my earlier point to Orac– if you want to deal with “alternative medicine”, you need to provide an alternative to the *system* that currently exists.

The alternative to “the *system* that currently exists” is science-based medicine, which many of us, including Orac, are promoting. We have made great progress in making medicine more science-based, but there is a lot more to do. I see Orac’s criticism of alternative medicine as a part of this process.

It is trivial and pointless to argue against idiotic treatments;

Why should we ignore “idiotic treatments” when Orac and other physicians are regularly faced with their consequences? Orac has described seeing cases of advanced breast cancer, untreated because people have sought “idiotic treatments” instead of SBM. Is he supposed to keep quiet about this? Is this really “trivial”? Is a supposed medical practitioner risking a patient getting an infection by failing to prescribe antibiotics and a tetanus shot for an animal bite “trivial”?

you can go back and forth trading horror stories all day between conventional medicine and this stuff.

It isn’t about trading horror stories, it’s about increasing the use of SBM. Why do you have this weird idea that we can either improve conventional medical practice, or attack bogus medical treatments, but not both?

It doesn’t change the fact that sewing up a cut finger and prescribing antibiotics shouldn’t require seven years of residency for the practitioner, with the associated cost multiplication.

That’s a complete non sequitur. What does criticizing naturopathy have to do with the training of doctors? As a matter of fact there is a trend towards nurse practitioners being given prescribing privileges and carrying out other tasks that were previously the sole domain of doctors. That strikes me as a better way of dealing with the problem than licensing people who believe in pixie dust as medical practitioners.

Likewise telling people they should eat less and exercise more, or ordering an x-ray to see if your ankle is sprained or broken. Or going in once a year to be reassured (falsely) that you will be fine until next year.

This is already happening. In my GP practice (in the UK) a nurse assesses my asthma, checks my cholesterol and weight, administers vaccines and gives dietary advice. BTW “the American Medical Association and other similar groups have moved away from the yearly exam. They now suggest that medical checkups be referred to as Periodic Health Assessments or Examinations and that they be performed every five years (for adults over 18) until age 40 and every one to three years thereafter”.

Set up a rational system and let the market operate; maybe people aren’t as stupid as you think.

Yet over a million people in the US consult a naturopath every year, and the number of naturopaths is doubling every few years. Something is wrong, but I’m not at all convinced that the shortcomings of conventional medicine are to blame, and even if they are, the answer is surely more SBM, not more naturopathy.

I dont mind the middle class worried well using woo medicine, but when it comes to those who have had cancer surgery and decide that “Big Pharma” only make money out of people’s misery, I get really upset. I wonder how many parents send their children to naturopaths for so-called “vaccinations” or really serious illnesses. I believe that is child abuse. Working as an RN in the mental health area, I get really angry with really unwell patients/clients who want to try “natural medicine” to cure themselves. I realise that antipsychotics are not pleasant, but some so called “natural medicines” can be either useless or worse still, be very dangerous.

Prerequisite Coursework for entry to Bastyr, as part of your bachelor’s … and they insist on AT LEAST a C in these courses!!!

College-level Algebra: 1 course

Chemistry (science-major level): at least 4 courses. Must include a minimum of either two sequential courses in organic chemistry or one course in organic chemistry and one course in biochemistry. The chemistry sequence should include an introduction to biological molecules. (The standard prerequisite for science-major level organic chemistry is one year of general chemistry.) Appropriate lab work required.

General Biology (science-major level): 2 semesters or 3 quarters. Must cover concepts in cellular biology and genetics. Appropriate lab work required. Individual courses in the biological sciences may count if the above competencies are met, i.e., anatomy, physiology, microbiology, and botany.

Physics: 1 college-level course. It must be algebra-based; calculus-based is also acceptable. A lab is not required.

Psychology: 1 course. Introduction to psychology is recommended.

#57

Krebiozen, I value your medical opinion just as little as I do that of naturopaths– the doctor in question was verbalizing or ‘thinking out loud’, and it was clear that the case was borderline.

And I also don’t put much stock in arguments like “Something is wrong, but I’m not at all convinced that the shortcomings of conventional medicine are to blame,”.

Sounds like my discussions with climate Denialists– they are also “not at all convinced”…. .

The Colorado law was at least partially justified by the suggestion that costs could be reduced if some services were shifted to less expensive providers. Now, I have read numerous comments from MDs that argue against NP and PA as “alternatives” to BAU– even though in principle those would be providing SBM.

So, one interpretation would be that this is really about money and not about serving the public. In fact, Orac was complaining that doctors had to rely on volume to make money, which is why they couldn’t spend as much time with patients, which is why some of the more attentive woo-people were getting the business. But Orac does not explain how paying doctors more solves the problem, if there are the same number of doctors.

So, again, rationalize the system, and then we can see what choices people make. I am tired of subsidizing people who feel they need the immediate services of Dr House for every sniffle or backache or mildly depressing life event.

And please, I’ve said multiple times that I am talking about the US system, so why do you keep bringing up your anecdotes about UK?

As for problems with mainstream medicine – doctors who don’t keep up with medical research is a big one.
I came down mysteriously ill in 2007 – mentally fuzzy, fatigue, lowered consciousness. It seemed consistent with allergies to me. I had a long history of allergies and my allergy symptoms were usually just mental haziness or fuzziness – nothing obvious like sneezing, eyes watering, stuffy nose.
For years, I couldn’t find out the cause. I saw family doctors, but no help. I saw a couple of allergists, but my allergy testing gradually became negative over those years. So the allergists discouraged me from looking for an allergy cause.
One allergist, Dr. T, believed in looking for ideas in alternative medicine. He rattled off some “alternative” ideas that sounded bogus to me, like heavy metal poisoning. He suggested I might have a zinc deficiency, so I took a zinc supplement, which didn’t help. Also he ordered a brain MRI in case I had a brain tumor, that didn’t help either.
Finally, in my fuzzy-minded state I did personal experiments which showed me my sickness was indeed allergies – but more than one, so it was very difficult to figure out. I was being exposed to some molds AND I’d developed a severe allergy to my dog.
I told Dr. T that I seemed to have allergies anyway.
He repeated the allergy testing, it was still negative.
I asked him if I could have a dog allergy anyway.
He looked embarrassed, ducked his head and mumbled a bit, then came out with “No”.
So I looked at the medical research, and I found out that researchers had had evidence for years that people can have inhalant allergies with negative allergy tests – which has been dubbed “local allergic rhinitis”. Had he been in the habit of reading an allergy blog, he would have known that.
Similarly for the other allergist I saw.
That was no small hole in their diagnostic abilities, either. It means that people with rhinitis but negative allergy tests, might be able to help themselves by avoiding allergens, but they wouldn’t be told that. They also wouldn’t be offered allergy shots, which might help them.
Why would Dr. T look to alt-med to improve his diagnostic abilities, rather than keeping up with medical research??? Is this really a sensible place to look?
By the time I figured out what was happening, very slowly and with doctors hampering me rather than helping – my allergies had gotten very, very bad, with allergic reactions that lasted 5 days.
These doctors might have been able to help me figure it out earlier, before my allergies had become so bad, if they had just been keeping up with research!

61: “That was no small hole in their diagnostic abilities, either. It means that people with rhinitis but negative allergy tests, might be able to help themselves by avoiding allergens, but they wouldn’t be told that.”

This is so contrary to my experience I have to say something. I have rhinitis, but it is gradually improving. After getting referred to one specialist by the GP I was scheduled for x-rays and simultaneously referred to another specialist (a surgeon) for an in-depth examination by scope. An allergy was suspected though I was warned by every doctor that the usual battery of tests can turn up negative. They all told me steps to take to reduce allergen load in the home, before final diagnosis, telling stories of previous cases they had treated. At no time was I brushed off. Once a test came up positive treatment began, which is now ongoing and is working.

You seem to have encountered one or more particularly poor doctors. This is either extreme bad luck or your story lacks something.

Finally, in my fuzzy-minded state I did personal experiments which showed me my sickness was indeed allergies – but more than one, so it was very difficult to figure out. I was being exposed to some molds AND I’d developed a severe allergy to my dog.

So, wait, your “severe” allergy, which you self-diagnosed as LAR, included “nothing obvious like sneezing, eyes watering, stuffy nose”?

So, wait, your “severe” allergy, which you self-diagnosed as LAR, included “nothing obvious like sneezing, eyes watering, stuffy nose”?

As I said, it mentally disabled me for years and made it hard for me to do anything physically.
And my allergic reactions lasted for 5 days (2 days now).
And I became severely sensitive to dog once I started avoiding them. I had to move out of my house, and I’ve had many allergic reactions a whiff of the air from a dog in a car.
Does that sound mild?

This is so contrary to my experience I have to say something. I have rhinitis, but it is gradually improving. After getting referred to one specialist by the GP I was scheduled for x-rays and simultaneously referred to another specialist (a surgeon) for an in-depth examination by scope. An allergy was suspected though I was warned by every doctor that the usual battery of tests can turn up negative. They all told me steps to take to reduce allergen load in the home, before final diagnosis, telling stories of previous cases they had treated. At no time was I brushed off.

I think things have gotten better in the last few years, because more recent allergists haven’t told me that I can’t have allergies with negative allergy tests.
Also you may have had more obvious rhinitis symptoms.

My allergy tests went back to being partially positive after months of being outside my house. They went negative because of chronic allergic reactions – I think I know, sort of, how this can happen.
I’m getting allergy shots now, and I have local reactions to the shots. The shots seem to be helping, at least my allergic reactions aren’t as severe.

#63

Narad, it’s comforting to know that the insurance covering Beth/Laura’s ‘non-woo’ adventure in medicine doesn’t waste money on acupuncture and other silly stuff, isn’t it?

I mean, that would just be a placebo-type treatment relying on a confused person’s perceptions, right?

@zebra
What’s your point? You think insurance shouldn’t pay for my medical care?

#66 Beth

Unlike Krebiozen and Narad I don’t give medical opinions on the internet. But I do believe your description of your atypical symptoms, and I believe that you have correlated them with allergens.

That said, it sounds like you are looking for magic answers much like people who go the ‘alternative’ route, with little success and a lot of discomfort. So my point was that for some people in your position, maybe an alternative path, even if the effect is only the placebo effect, would make them feel better.

Certainly, it is not going to be clear whether your “allergy shots” are really making a difference or it is placebo, or resolving by itself.

@zebra
What makes you think I’m looking for magic answers?

it is not going to be clear whether your “allergy shots” are really making a difference or it is placebo, or resolving by itself.

They aren’t “allergy shots”, they are allergy shots.
That’s true, there’s no way to know whether the allergy shots are helping or whether I’m just getting slowly better because of not having a chronic allergic reaction. I was somewhat better before I started getting allergy shots.
However:
– that is also true for anyone who gets allergy shots
– there’s research that says that allergy shots do help for local allergic rhinitis.
– I didn’t say it was the allergy shots that were helping. I realize I can’t know for sure, but I want to do everything I can – as anyone in my situation would.
You seemed to not believe I actually have allergies. But my allergist thinks I do, and I wonder why you think you know better than he does.

@zebra
What makes you think I’m looking for magic answers?

it is not going to be clear whether your “allergy shots” are really making a difference or it is placebo, or resolving by itself.

They aren’t “allergy shots”, they are allergy shots.
That’s true, there’s no way to know whether the allergy shots are helping or whether I’m just getting slowly better because of not having a chronic allergic reaction. I was somewhat better before I started getting allergy shots.
However:
– that is also true for anyone who gets allergy shots
– there’s research that says that allergy shots do help for local allergic rhinitis.
– I didn’t say it was the allergy shots that were helping. I realize I can’t know for sure, but I want to do everything I can – as anyone in my situation would. The allergy shots are my best hope.
You seemed to not believe I actually have allergies. But my allergist thinks I do, and I wonder why you think you know better than he does.

Unlike Krebiozen and Narad I don’t give medical opinions on the internet.

Where, pray tell, have I “give[n] medical opinions”? Naturally, I will cop to pointing and laughing at your pretensions to lecturing about physics and statistics.

How about a response from a naturopathic doctor. Some perspective is always needed when your dealing with modern medicine! Notorious pushers of injected aluminum in vaccines recalled drugs that kill people and surgeries that are not necessary! Seriously you MD’s are dangerous! Only good for emergency situations like a bullet wound or a broken leg.

Behold a scathing response

http://youtu.be/ta1NZmwjvYQ

And by the way, I would love for there to be easy answers.
I’ve wondered – maybe if I got infected with helminths, that would do it. This is illegal in the USA, but clinics in Canada and Mexico do it.
I’ve wondered if acupuncture would do it (but I haven’t tried it).
One does wonder – maybe some treatment out there, is a quick answer.
My answers right now are actually very much not easy. The allergy shots make me sick; an allergy drug that I get makes me sick. And I get better – but it’s sloooow.

Umm…

Laura
March 14, 2015

So, wait, your “severe” allergy, which you self-diagnosed as LAR, included “nothing obvious like sneezing, eyes watering, stuffy nose”?

As I said, it mentally disabled me for years and made it hard for me to do anything physically.

Am I missing something, or did Beth just respond as Laura?

#70 Narad:

“Where, pray tell, have I “give[n] medical opinions”?”

Let’s see:

“So, wait, your “severe” allergy, which you self-diagnosed as LAR, included “nothing obvious like sneezing, eyes watering, stuffy nose”?”

#69 Beth– I said I believed you, which others may not. But, despite Narad’s childish sniping, I’m actually a very good experimentalist (not in medicine, I acknowledge) and what you are describing is too many uncontrolled variables and perhaps corrupt data. I hope it works out in the end but as a general rule “doing everything” often interferes with doing the right thing. Just sayin’.

“Where, pray tell, have I “give[n] medical opinions”?”

Let’s see:

“So, wait, your “severe” allergy, which you self-diagnosed as LAR, included “nothing obvious like sneezing, eyes watering, stuffy nose”?”

And you find the “medical opinion” where, exactly?

SBM isn’t perfect, but it beats the alternatives. At age 20 I experienced a rash on my chest that recurred every 12-18 months. Over the next 33 years I sought treatment from four different physicians, Dr. C, Dr. A, Dr. L and a different Dr. L (I could add to the list my MD wife, who also had no alternative suggestion). All prescribed topical prescription meds and none cured it. Then I mentioned the rash, which had recurred, to the FNP (independent practitioners in Arizona) who was examining my teenager. She viewed the rash then wrote a prescription for two single doses of medication to be taken 10 days apart. That was 4 years ago and the rash has never recurred. The lesson for me was not to bash SBM, but to be relieved that I finally found a provider who had the correct training and/or experience to make the correct diagnosis and offer a cure.

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