Are naturopaths all quacks, and if not, how do I know I've got a good one?

November 28, 2012 9:37 AM

What advice would you give someone who just saw a naturopath for the first time and isn't sure of what's scientifically proven alternative therapies and what's just woo-woo hogwash? What are warning signs that I'm seeing a quack and on the flip side, what would be signs I'm seeing a competent naturopath?

I just saw a naturopath for the first time because he was the only one listed as a "fat friendly doctor" in my city (Phoenix), and a health at any size approach is important to me. My "quack" meter is starting to raise but I don't know enough about naturopathy and the information I'm getting off the internet seems to be either "they're dangerous whack-jobs who aren't real doctors" or "they cured my cancer", and rationally I expect that like conventional doctors, some are great and some are bad. But how can I tell?

Just as a background of why I wanted to see this particular naturopath in the first place, I'm a life-long fat lady who used to be moderately to very active and for years have eaten well—lots of roughage and low carbs, no processed crap and limited sugar, etc.—but recently I felt a noticeable loss of energy and gained weight. I wanted to go to a doctor who would address any underlying issues before assuming that I'm just too lazy to lay off the fast food and get off the couch.

My concerns about this doctor: He asked if I wanted to lose weight, which is fine, but then mentioned that he could refer me to the doctor who does the hCG stuff at their clinic. He backed off when I told him that I would never do that kind of diet and reminded him that I wasn't interested in just losing weight, I was interested in treating any health issues that might be causing weight gain. I'm fine with losing weight as the result of healthy living but it's my understanding that a 500 calorie diet and hormones are not sustainable or healthy. I'm also concerned to see that the clinic does things like chelation therapy, which seems like b.s. Is this kind of stuff something I should expect with all naturopaths? Am I right to be concerned at this point?

I'm likely going back on Friday to get current bloodwork done and I'm leaning towards giving him a shot. But since it's not quite feeling right to me, I'd like to be better informed about this type of medicine going forward. If I get the bloodwork done, should I be concerned about any certain kinds of recommended supplements that haven't been proven to do anything? I'm not a total nonbeliever in this kind of stuff (acupuncture has done a lot of positive things for my health) but don't want to take a bunch of expensive pills everyday.

Bonus question, if anyone has a stellar doctor in Phoenix, AZ that you think would be a better option for me anyway, feel free to recommend!

posted by thesocietyfor to health & fitness (28 answers total)

Naturopathy is indeed quackery.
posted by Admiral Haddock at 9:44 AM on November 28, 2012 [20 favorites]

Naturapathy has absolutely NO basis in science.

However, placebo is a proven effect. So if YOU believe that his methods work (and they are harmless), then it can indeed work. But not because it's science.
posted by ethidda at 9:47 AM on November 28, 2012 [6 favorites]

"...scientifically proven alternative therapies..." is not really something that, well, is a thing. The reason they are "alternative" is because the mainstream medical community doesn't recognize them as effective modes of therapy.
posted by griphus at 9:48 AM on November 28, 2012 [8 favorites]

I've had good results with alternative medicine, but as in any field, there are maybe 5% of practitioners who know what they are doing. Look for those who write books and teach. Demand results.
posted by Atrahasis at 9:48 AM on November 28, 2012

The fact that a naturopath may be doing a number of things in exactly the same way a conventional doctor would do them doesn't make them any less a quack. By adopting the outward appearance and behaviour of a real doctor, the naturopath deceives patients into thinking that there is a scientific basis where there is not.
posted by pipeski at 9:51 AM on November 28, 2012 [12 favorites]

Read up on it. It is totally unsupportive by science. Zero evidence it has an effect beyond placebo.

Any naturopath gets a shifty glance from me at the best of times. The second nonsense like "homeopathy" comes up I would run as fast as you can because that is utter and complete nonsense and takes fake medicine and quakery to a whole new level.
posted by PuppetMcSockerson at 9:53 AM on November 28, 2012 [1 favorite]

There is no scientific basis for naturopathy. Some of them are more well-meaning than others. You can tell which ones by the amount of money they make on the supplements and compounds they sell you (and note that they may simply be getting a kickback from the company they turn you to so this amount of money may not be immediately obvious).

I have a friend who feels she's seeing great success from naturopathy for her allergies--though I am skeptical it is due to the hundreds of dollars she's spending on naturopath vitamins and not the surgery she had for her sinuses coupled with the elimination diet the naturopath recommended.
posted by schroedinger at 9:53 AM on November 28, 2012 [2 favorites]

Also, Naturopaths (NMDs) do not receive remotely the same training as M.D.s and O.D.s, and are regulated by an entirely different organization than the A.M.A.:

In these states, naturopathic doctors are required to graduate from an accredited four-year residential naturopathic medical school and pass an extensive postdoctoral board examination (NPLEX) in order to receive a license.

via

That's it, four years and an exam. That does not compare favorably to what an actual doctor is expected to learn and do to be able to practice as a doctor.
posted by griphus at 9:53 AM on November 28, 2012 [1 favorite]

Once something is "scientifically proven" it is not an alternative therapy. Anything that has been proven scientifically to be a safe and effective treatment generally just becomes part of standard medical treatment.

If you think that there is an underlying medical reason for your lack of energy and weight gain, an actual MD is the way to go. Even if they are not specifically labeled as "fat friendly," you need to advocate for yourself and not let them get away with brushing you off as simply lazy. If that happens, move on and speak to a different doctor.

One thing you might want to try is changing up your diet. Your body is going to get most of its energy from fat and carbs in your diet. If you are going low-fat/low-carb, that might account for part of the low energy feeling you described, regardless of total caloric intake.
posted by Nightman at 9:54 AM on November 28, 2012 [3 favorites]

In my anecdotal experience Naturopath's have done a better job getting patients to comply with things like exercise, eating well, lowering stress etc. A senior cardiologist I once spoke with had almost given up on this.

There are good and bad Naturopaths. I have seen Naturopaths significantly improve peoples health and well being.

If I could guess the good Naturopath's I know would likely likely have referred you to an MD to rule out some potential causes of your energy loss and weight gain. Then proceeded with their treatment.

I should also point out anecdotal evidence is effectively worthless.
posted by samhyland at 9:55 AM on November 28, 2012 [4 favorites]

naturopathy+hcg diet+chelation= 100% woo, sorry.

where did you find this person listed as a "fat friendly doctor"? I hope not your insurance website or any other reputable referral source. (Dr Google, alas, does not distinguish).

My biases are certainly showing, but "naturopaths" are not doctors in the primary-care-provider sense. Naturopathy is "alternative health", largely unregulated, with no unified set of requirements/standards. The vast majority of states do not allow naturopaths to prescribe medications.

MD/DO's attend a four-year university followed by a four-year medical school (with a science based curriculum). They then complete a residency (like an apprenticeship: salaried at this point, but heavily supervised in their work) in their chosen specialty, which lasts anywhere from 3-7 years. Those that choose to subspecialize (as in an internal medicine doctor who specializes in cardiology) do a fellowship: additional training that takes 1-3 years. Many include 1+ years of research in that training period. They are subject to state licensing regulations, have to participate in continuing education, etc etc.

[N.B. this is not to say that MD/DO doctors don't sometimes dabble in woo. Alas.]

I understand your wish to see a doctor who treats you with respect. I am sure there are many such in your area, even if they don't advertise as "fat-friendly". I would stongly recommend seeking out a family practioner, internist or ob-gyn (if you are of the female persuasion) for your primary care needs.
posted by maryrussell at 9:56 AM on November 28, 2012 [12 favorites]

It is not science. Once an 'alternative' treatment is proven by science, it is just a treatment.

Does that mean it can't work? Who's to say.

I'm not against religion or magic but they are practices of faith, not medicine.
posted by French Fry at 10:00 AM on November 28, 2012 [1 favorite]

Pretty clear answers here, thanks, my plan going forward is to try a family practitioner and not go back to this naturopath. I wish I'd used my weekly question to simply ask for a good doctor in Phoenix, but oh well! Suggestions for that still welcome, obviously, but you guys don't need to say more to convince me that my feelings of quackery are well-justified. Thanks again!
posted by thesocietyfor at 10:02 AM on November 28, 2012 [3 favorites]

Just an idea: your profile says you are female, what about a Women's Health specialist doctor (I love mine), a Nurse Practitioner (had a great one in another part of the state; they have more time to give you and can be more open to alternative treatments), or if you are looking into reproducing, a Nurse Midwife? All three of these receive extensive training and are part of the established medical system (and thus would be covered by insurance in at least some cases), but may be less traditional in their outlook than a family practice physician.

Also, as a former medical librarian, my very favorite website for checking out alternative therapies: http://www.quackwatch.com/ (Beware, I can't visit this site and just read one article--hours later I'm still on it!)
posted by gillyflower at 10:29 AM on November 28, 2012 [1 favorite]

I wanted to go to a doctor who would address any underlying issues before assuming that I'm just too lazy to lay off the fast food and get off the couch.

Yup, family practitioner. Things really changed in terms of the treatment of overweight patients in the mid-aughts, a lot of dogma went right out the window. The usual diet-and-exercise regimin wasn't working, and they had a large enough pool of overweight patients to begin to realize it was the treatment, not the patient, that wasn't working. Since then, in my experience, docs are aware of issues that heavy folks have, but their first response is no longer "eat a salad and call me when you drop two pant sizes" to general health problems.

Internal Medicine types tend to be the least interested in patient interaction and follow-up, in my experience, and family practitioners the most interested and thoughtful. Active or Ex-Military physicians in a family practice were by far the most helpful and knowledgeable.
posted by Slap*Happy at 10:30 AM on November 28, 2012

I dig my doctor, but he's in Mesa. Dr. Thomas Edwards. He's always been respectful of me and willing to get to the bottom of my ailments.

As for naturopathy - I think there are some genuinely good naturopaths out there. And I think there are some "alternative medicines" that tend to work for some people. However, I think those "alternative medicines" may work only for a very very small number of people. Whether it's placebo or just that certain treatments genuinely do work (but only for a small number of people), I don't know. I am very open-minded to these things and would welcome any alternative methods to help with issues, but I don't think that naturopathy and alternative medicines can really and reliably help many people. I think the stories of someone taking some sort of supplement and being cured of cancer, while perhaps legit, aren't reliable methods to help the population. Maybe it only worked for that one person for whatever reason. But it did work. But you cannot absolutely cannot count on it to work for the next person in line.

I think I would consider naturopathy and alternative medicine as a last resort, after I've exhausted everything else.
posted by Sassyfras at 10:33 AM on November 28, 2012 [1 favorite]

I disagree re woo. MDs specialize in things that have been approved by mainstream medicine. If those things aren't working for you, why not try something else if it doesn't bust your budget or seem dangerous.

Not everything has been subjected to a double-blind controlled study for a variety of reasons that have nothing to do with efficacy (incentives in the pharma industry, size of target population, ease of study, ease of getting grants).

Also, people are different, and study results may not equal your results. There's no way to know how the study population of, say, 200 people is biased with respect to you as an individual. Personalized medicine is not here, yet.

Why not give it a try if you can afford it, and see what it does for you?
posted by carolinaherrera at 11:02 AM on November 28, 2012 [4 favorites]

You've already had your question answered, but if a similar question comes up again for you ("is X alternative medicine total crap or not?") I'd recommend checking out the National Institutes of Health's National Center for Complimentary and Alternative Medicine. This is the agency that federally funds research into alternative medicine and their website had terrific, easy to read information about what has actually been scientifically investigated in this field. It's really impressively fair and evidence-based, and if you get interested in a particular finding, you can easily read get citations and find the primary research. Seriously, this website is better than basically anything else on the internet for learning about this stuff.

Also, if you decide you want to keep looking around at alternative medicine for your specific problem (or another one in the future) they have this great guide for figuring out how to be an informed consumer of such things and how to separate the quacks from the nonquacks.

Good luck getting everything sorted out!
posted by juliapangolin at 12:18 PM on November 28, 2012 [6 favorites]

I can't speak to this guy, and I'm sure there is all kinds of quackery out there, but I have found a good naturopath to be an excellent addition to seeing an MD. I find them better at figuring out lifestyle related things than doctors are. I had ongoing, chronic sinus infections from my mid-teens until my late twenties. A kazillion anti-biotic rxs didn't fix it, but going meticulously through my diet with a naturopath did. Is that medicine? Maybe not, but no doctor every once asked what I ate.

As I just said in another thread, I wouldn't take a breast lump or a broken bone to a naturopath, but I have found them helpful for that kind of chronic, ongoing, nagging--but very REAL--stuff that most doctors get all hand wavy about. Especially, frankly, if your a fat lady approaching 30, which is about the age when suddenly a lot of symptoms get dismissed by doctors as being all in your head. If you do get the standard battery of tests from a doctor and they find nothing, I wouldn't rule out skeptical use of a naturopath. You don't have to do everything they say, and personally, it's the lifestyle change suggestions that have worked for me.
posted by looli at 12:26 PM on November 28, 2012 [2 favorites]

ethidda: However, placebo is a proven effect.

Actually, the efficacy of placebos is largely romanticized. The effect is inconsistent, and usually small.
posted by IAmBroom at 12:42 PM on November 28, 2012

Not everything has been subjected to a double-blind controlled study for a variety of reasons that have nothing to do with efficacy (incentives in the pharma industry, size of target population, ease of study, ease of getting grants).

True.

Why not give it a try if you can afford it, and see what it does for you?

Because the controlled trial tells you not only that it works, but that it doesn't hurt you.

Trying an untested treatment may help. It may have a mild placebo effect, or a positive impact on your mood. It may make your condition worse. It may react with something else you're taking, or with your particular body, and have horrible or even deadly side effects. It may prevent you from seeking out treatment that actually would have helped you, while doing nothing itself (this is especially common).

It's a decision everyone has the right to make for themselves, but for an informed decision you need to be aware of the potential consequences, both good and bad, and ideally have a sense of how likely they are. People trying to sell you something untested have huge incentives to exaggerate or outright lie about the potential positives, and no incentive to tell you the potential negatives.
posted by randomnity at 12:43 PM on November 28, 2012 [2 favorites]

I'm with looli. Naturopaths can be great for helping you figure out lifestyle/dietary changes, and they tend to ask a lot more questions and spend a lot more time with you than the typical MD does. So for your questions I would have wanted a naturopath too. But, from what you say, your guy sounds a little less than great...

Maybe check out this guy? http://www.drscottrigden.com/
He's an MD who specializes in obesity and chronic fatigue syndromes, so he sounds like he's interested in chronic, subtle conditions.
posted by feets at 12:52 PM on November 28, 2012

carolinaherrera: There's no way to know how the study population of, say, 200 people is biased with respect to you as an individual. Personalized medicine is not here, yet.

If it harms a significant number of those 200, I'm willing to take the safe route of assuming it might harm me. Naturopathy and other quack health practices don't bother testing for harm.

Personalized medicine is not here, yet.

My doctor discusses my symptoms, medicines, dosages, and side effects at length with me. Furthermore, after putting me on new meds, she schedules me for a followup to make sure it's working, and adjusts as necessary.

Personalized medicine is here. You may need better doctors.
posted by IAmBroom at 12:54 PM on November 28, 2012 [1 favorite]

Most actual MDs and DOs these days are open to lifestyle changes, dietary changes, and the use of supplements under certain conditions. There is no need to go to a naturopath (whose training is totally unregulated in the US)--find an MD or DO at an "integrative medicine" practice and you'll get both expertise in Western medicine and evidence-supported options from other traditions.

So, from my own experience, my doctors could explore acupuncture as an option in managing my chronic pain (didn't work for me, sadface) AND write me a prescription for antibiotics (and codeine coigh syrup) when I had pneumonia.
posted by Sidhedevil at 2:15 PM on November 28, 2012 [2 favorites]

My primary doctor is a homeopath and about 80 pct of the time his homeopathic presciptions are effective treatment. However, he is also a MD/PHD, so I know that when he picks a homeopathic remedy over a traditional prescription he has evaluated the risk / reward. I love alternative medicine but 90 pct of the ones I see have dual degrees and traning.
posted by zia at 4:04 PM on November 28, 2012

Homeopathy != naturopathy. Homeopathy is by definition not provably effective medicine. It's water. Extremely diluted water that might have once been waved near a pathogen but which doesn't contain even a detectable of anything besides water now. If it did, it wouldn't be homeopathic. Homeopathy is entirely inconsistent with evidence-based medicine and I can't imagine how a doctor could retain their license while mostly prescribing homeopathic treatments.

FWIW I live in Seattle, land of Bastyr, one of the first places where naturopaths gained the ability to prescribe drugs, and even here they mostly scare the crap out of me with their lack of medical competence. Most people I know who see a naturopath also see a regular MD whenever they are ill. Attentive naturopaths can be helpful as counselors or case managers - they can help a patient keep track of a complex, multi-practitioner treatment plan. There's little professional accountability, though. Pick a random naturopath out of the phone book and you're as likely to find someone who prescribes ear candles, magic vitamins and holy water.
posted by SakuraK at 10:31 PM on November 28, 2012 [3 favorites]

if you are looking to evaluate your diet, why not see a dietitian? they are accredited nutrition professionals, and there are many who work within a health-at-every-size framework, who will not automatically tell you to lose weight. once you find a GP, they can give you a referral or eatright.org has a great lookup tool - you put in your zip code to see RDs and their specialities around you. A Registered Dietitian is key - anyone can call themselves a nutritionist - and many RDs are open to alternative practices.
posted by chickadee at 10:19 AM on November 29, 2012

Chickadee, I have a nutritionist. That's not why I'm seeking a good doctor—I have several health concerns not listed above because I don't want to share those details online, but I mentioned what I ate to ward off the inevitable suggestions that it's my diet to blame since I've been eating well for years before I started feeling off. (And despite that I still got a suggestion above that I should examine my diet re: fat intake, well-intentioned but unsolicited!) Thanks for your suggestion, just wanted to make sure any more comments to this question either have some data on naturopaths (though that's well covered) or a good doctor in Phoenix. I apologize if I wasn't clear before.

FWIW, I'm also not looking to see a bariatric doctor as I'm unconvinced obesity is always unhealthy and am not looking for a weight loss cure. Health at any size is a touchy subject on here (and in real life!) but just so it's clear where I stand, I am okay with being fat and doctors that exist to tell me it's inherently a problem are not what I'm looking for.

Thanks to those who gave another perspective on naturopaths, I find it really useful to know that in certain cases they have their uses.
posted by thesocietyfor at 12:20 PM on November 29, 2012