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Tuesday, August 13, 2013

Naturopathy for the beginning Skeptic

Hello folks.  How have you guys been?  Its been a little jacked up here, mostly due to poor timing and various injuries.  The world of pseudoscientific bullshit keeps rolling along.  I am really starting to understand why James "The Amazing" Randi calls it all "Unsinkable Rubber Duckies".  And just so you know, I'm about to go on a rant, so if you want to skip over it, you may just want to skim past the rest of this paragraph, and the next one too.  I was in the Oklahoma City Bass Pro Shop the other day to kill some time between errands I had to do.  While I was walking through the store, looking at fishing equipment, clothing, and the wide variety of "stuff" they carry, 1) I saw something that pissed me off, which doesn't seem to take much these days, and 2) I had a realization.  What I saw were the damned Power Bands being sold to help with "Stability, Strength, " and I believe it said stamina.  It had the goofy little "hologram" in it and the cheap rubber bracelet. This is ridiculous.  The manufacturers of these things just seem to bounce them from retailer to retailer trying to find somewhere the skeptical community doesn't go.  With the large number of skeptics that don't own firearms, let alone hunt, I think they may have found a safe haven for the time being.  The question is, is it worth it? Would this be a fight worth the time and effort to take up, or would it be a fruitless venture?  Because they actually carry very few things that promote Woo, it may actually be a good thing to nip it in the bud before it has a chance to spread much farther.  I know that the backwoods skepticism seems to be my individual niche, and I may be the only one that cares that these things are being sold here, but on the other hand, if they are successful at Bass Pro Shop, what's to stop them from slowly leaking back out into the general market place again?
    And now for my realization, which is totally unrelated to the power band bracelets.  The realization I had is this: If you ever need a visual or physical representation of the concept of false choices, go through the fishing lure section in any sporting store.  Yes, they may have what looks to be hundreds of different types, but upon closer examination, you'll come to realize that, no, there are only a handful.  You have plastic lures, that while they come in hundreds of colors and various sizes, there are only a scant few designs such as worms, crawfish, fish, tubes, and a few that readily defy an easy description.  Then you have the hard lures (which ironically are plastic while I think the plastic lures are rubber) You can get ones that mimic crawfish, fish, grasshoppers, and mice, and some that are hard to define their general shape.  Once again, they come in a variety of colors and sizes, but for the most part, you only have a few things to choose from.  I know you can use stink bait, live baits, metal lures, and fishing flies, but still not a lot of choices.  So you have roughly 10, maybe 15 choices to make, yet you may see an area that takes up about 1/2 an acre with thousands of different colored packages with wildly promotive descriptions of how much better their product is than all the others.  Yet, in the end, you end up asking yourself do I want a worm or do I want a grasshopper?

First off, before I begin the topic, I would like to thank everyone that has responded to my call for help on the activism project I'm trying to do.  I am currently working on posts for their suggestions, and hopefully I will have them up soon.  I'm also trying to develop a title for the project, rather than continuing to use "New Skeptical Activism Project"  I originally wanted to call it "Project Bullshit", but I don't know how well people would respond to it, and I don't want Penn and teller to think I lifted one of their ideas.  Personally, I think it's to the point, but if you have a better suggestion, let me know.

Naturopathy
Todays topic is another one that the beginning skeptic is going to come across a lot.  You may see it and not actually realize it.  You may even have it in your house at this moment.  Basically any time you see the phrases "All Natural"  "Natural Ingredients" "No Chemical Additives" etc..., you are more than likely dealing with a form of naturopathy.  There are many different forms of alternative medicine that fall under the blanket term of naturopathy, and I'll discuss some of these later in the post.  The basic concept behind naturopathy is no chemicals (which is rather silly, if you think about it, everything is made up of chemicals) and no or minimally invasive surgery.
 The definition of naturopathy according to Wikipedia says:
Naturopathy, or naturopathic medicine, is a form of alternative medicine based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation.[1] Naturopathy favors a holistic approach with non-invasive treatment and generally avoids the use of surgery and drugs.[2] Among naturopaths, complete rejection of biomedicine and modern science is common.
It's actually a fairly long article, so I'm just putting the first paragraph here.

And for a laugh, Conservapedia says:
Naturopathy is a New Age alternative medicine. The practice of this medicine include vegetarianism, nutritional and exercise counseling, hydrotherapy, heliotherapy, thalassotherapy, manual therapy, herbalism, acupuncture, aromatherapy, electrotherapy, magnetotherapy, musictherapy, chromotherapy, homeopathy and chiropractic.
Some important names in naturopathy are: Vincent Priessnitz (1799-1852), Theodor Hahn (1824-1883), Arnold Rikli (1823-1906), Sebastian Kneipp (1824-1897), Tadeo Wiesent (1858-1926), Wilhelm Winternitz, Benedict Lust (1872-1945), Eduardo Alfonso, Manuel LezaetaAdrian van der Put, Nicolás Capo and José Castro.
In 1902, Benedict Lust organized the Naturopathic Society of America, which was reorganized as the American Naturopathic Association (ANA) in 1919. [1] In America, licensing and training requirements vary from state to state. In some countries the practice of naturopathic medicine is unregulated or the industry is self regulated.
Naturopathy is a whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with therapies such as herbs, massage, and joint manipulation; the emphasis is on supporting health rather than combating disease.
A central belief in naturopathy is that nature has a healing power [2]
Like all New Age practices, reconciling it with Christianity can be problematic.
This is their entire article on the subject.  For once, there is no mention of atheists though.
And the American Naturopathic Association states:
Naturopathy is the oldest form of health care.  It means, essentially, "to follow the path of nature"... in healing.  And as such, naturopathy is directly based on observable scientific principles.  

Terminology:  The words "naturopathic" and "naturopath" are generic terms describing a process or person following the path of nature, generally in health care, but also in other reaches of life.

TITLES:  Traditional Naturopaths title themselves in various ways-  Naturopathic Doctor, Naturopath, Doctor of Natural Health, Natural Physician, Traditional Naturopath, Certified Traditional Naturopath, Naturopathic Practitioner.  This may vary by state/region and by the type of degree or diploma each School conveys.

This term - that of "naturopath"  is our western equivalent of "ayurvedic".  We do not, and encourage others not to buy into the false assumption that this term belongs to an elite few people- namely- the naturopathic medical practitioners.  It is a term that we must share, if we wish to use it at all.

This one seems to be a little more in depth than some of the other associations that I looked into, so for the naturopaths benefit, I am going to use them as the pro side of the article.

History
The history of naturopathy technically goes back to the beginning of human civilization.  The use of herbs has been documented by the Greeks, the Chinese, and even the Sumerians.  What we now call an herbalist was back then called a healer (or a witch when times were bad).  People have known for centuries that chewing on willow bark would help alleviate pain.  This is because willow bark contains salacin, which is basically the same ingredient you find in aspirin.  The term naturopathy was coined, according to Wikipedia, in 1895 by John Scheel and the term was bought by a man named Benedict Lust.  In 1901, the School of Naturopathy was founded by Benedict Lust in New York, which was dissolved in 1919.  Lust then formed the American Naturopathic Association, which survives to this day.  Interest in Naturopathy has had both high and low periods, but it has never completely disappeared.  Due to the fact that until the middle of the 19th century, there weren't really any chemists or doctors working to derive beneficial compounds, I am going to use the 1880's as the beginning of what we know call naturopathy.  Wikipedia is about the only reliable place I was able to find anything on the history of naturopathy, and I've hit most of the high points, so from here, we'll jump right into the practices.

Practices
Like I mentioned earlier, there are a many different alternative practices that can fall under naturopathy, and rather than write an individual post on each one, I am going to list them along with a brief definition.  In no particular order, they are:
Ayurveda- From the Indian sub-continent, it is a combination of herbal medicine and energy manipulation
Herbal medicine- Exactly like is sounds, medicine from herbs.
Homeopathy- Highly diluted substances that are supposed to treat the symptoms
Acupuncture- Needles stuck into "mapped" points on the body to help manipulate energy.
Chinese herbal medicine- Once again, exactly like it sounds, medicine made from herbs, from China.
Color Therapy- This is a new one to me.  It's basically using different colored light to "balance the energy".  I wonder how well it would work on a color-blind person like me?
Reflexology- A form of acupressure used on the feet, hands, or ears.
Manipulative therapy- This includes chiropractic, osteopathy, massage, and anything else that parts of the body are physically manipulated.
Unani-Another new one.  This is a Muslim form of medicine based on the 4 humours.
Yoga- A form of physical exercise from India
Nutrition and diet- A lot of naturopaths tend to lean towards vegetarian or vegan diets to cleanse the body;
Hydrotherapy- Baths.  They actually refer to it as healing with water.
Reiki- Sort of like faith healing.  Hands are placed on the patient and their "energy" or "aura" is manipulated

There are probably others that that I missed and are included, and some of the above are not included, depending on the school and training that the practitioner received. None of these practices have any scientific backing that shows they work any better than the placebo effect.  According to the American Naturopaths Associations website a true naturopath does the following:
Nutrition, Healing Diets, and Food Therapeutics, Healing programs,
Massage and Applied Bodywork Therapies
Naturopathic Physical Medicine
Energy Medicine/Energy Balancing Bodywork
Hydrotherapy
Iridology / Iris Analysis
Applied Natural Therapeutics and Treatments
Medicinal Herbal Practice
Botanical Applied Therapeutics
Herbal Pharmacy and Dispensary.  Apothecary Practice
Natural Physician Assessment Methods
Community Education and Counseling
Holistic Anatomy and Physiology
Parasitology
Microbial Balancing of Inner Ecology
Eastern /Oriental Therapeutic Approaches
Flower Essences Creation and Practice


Once again, little or no evidence that any of these interventions work, except, oddly enough parasitology.  This is the study of parasites and their environments.  I don't know how it made it onto their list.  But overall, the way that naturopathy is supposed to work is that the body heals itself.  In the words of Mark Crislip, host of the Quackcast podcast, "Why do something, just stand there."  And as a side note, I found several places advertising themselves as :Naturopathic Cancer Hospitals".  This disgusted me.  They have all these quack treatments for people that are literally fighting for their lives.  I've said in the past that placebo treatments for the truly terminal may be a good thing, but if someone has a chance to put their cancer into remission through chemo or surgery and live, why go to an alt -med practitioner?  A lot of these also fall under the umbrella term "Holistic", which has just come to mean "whole body"  So they try and treat mind. body and soul when trying to cure people of various ailments.  It's just another aspect of "Supplementary Complimentary Alternative Medicine".  (To borrow again from Mark Crislip, it's all S.C.A.M.)

Licensing and Regulation
There are only about 20 U.S. states and territories that require naturopaths to be licensed.  They are:
  • Alaska
  • Arizona
  • California
  • Colorado
  • Connecticut
  • District of Columbia
  • Hawaii
  • Idaho
  • Kansas
  • Maine
  • Minnesota
  • Montana
  • New Hampshire
  • North Dakota
  • Oregon
  • Utah
  • Vermont
  • Washington
  • United States Territories: Puerto Rico and Virgin Islands
This list came from the American Association of Naturopathic Physicians
Looking through their list of licensing boards, I did not see any that did not have the word Naturopth in it.  Not a single one had the phrase "Medical Board" in it, like you would see with a regular M.D.  They appear to be largely self regulated, which in of itself is a scary thought.  South Carolina and Tennessee are the only states that actually prohibit naturopathic practices, and Utah is the only one to require a residency between graduation and beginning a practice.  Way to go Mormons!
As for actual U.S. regulation (and yes, I know I;m primarily discussing U.S. policies rather other countries.  This is because each country has their own views as to what constitutes a naturopath or traditional healer and what constitutes modern medicine.), there is very little regulation.  In most states, I could hang a sign out my front door and advertise myself as a naturopathic healer, with little fear of breaking any laws.   I could find no evidence of a regulatory board in the Department of Health and Human Services for chiropractic, hompeopathic, or any other alt-med practice. When it comes to herbal medicine, there is no regulation by the F.D.A.  All those bottles of herbal supplements lined up on the shelf at your local Wal-Mart, Target, WalGreens, or any other store, (which is the most common way people come into contact with this particularly invasive form of Woo) have no regulation.  There is no guarantee that what the bottle claims to contain is actually in it.  There is a good article on Slate.com about the lack of regulation over these supplements.  You can read it here.  Basically due to lobby groups, they were defined as dietary supplements, therefore not subject to the more rigorous F.D.A. regulation over food and drugs.  As a matter of fact, I pulled these examples straight from the F.D.A. F.A.Q. (damn, that's a lot of acronyms for one post) website concerning dietary supplements.  It states:
Manufacturers and distributors do not need FDA approval to sell their dietary supplements. This means that FDA does not keep a list of manufacturers, distributors or the dietary supplement products they sell. If you want more detailed information than the label tells you about a specific product, you may contact the manufacturer of that brand directly. The name and address of the manufacturer or distributor can be found on the label of the dietary supplement.
By law (DSHEA), the manufacturer is responsible for ensuring that its dietary supplement products are safe before they are marketed. Unlike drug products that must be proven safe and effective for their intended use before marketing, there are no provisions in the law for FDA to "approve" dietary supplements for safety or effectiveness before they reach the consumer. Under DSHEA, once the product is marketed, FDA has the responsibility for showing that a dietary supplement is "unsafe," before it can take action to restrict the product's use or removal from the marketplace. However, manufacturers and distributors of dietary supplements must record, investigate and forward to FDA any reports they receive of serious adverse events associated with the use of their products that are reported to them directly. FDA is able to evaluate these reports and any other adverse event information reported directly to us by healthcare providers or consumers to identify early signals that a product may present safety risks to consumers. You can find more information on reporting adverse events associated with the use of dietary supplements at Dietary Supplements - Adverse Event Reporting.
No, except for rules described above that govern "new dietary ingredients," there is no provision under any law or regulation that FDA enforces that requires a firm to disclose to FDA or consumers the information they have about the safety or purported benefits of their dietary supplement products. Likewise, there is no prohibition against them making this information available either to FDA or to their customers. It is up to each firm to set its own policy on disclosure of such information. For more information, see claims that can be made for dietary supplements
That is a scary thought!  You can read the rest of it here.  Like most other alternative medicines, they do not have to show efficacy before marketing their products.  Which leads us to the next point.  (I'm getting a bit better at segues)

Evidence
The evidence for the efficacy of any naturopathic intervention is nearly nil.  I trolled pub-med and couldn't find any trustworthy studies that showed any of the treatments were actually capable of helping.  I will allow one caveat though.  Many medicines we have today are indeed derived from natural products.  The main example is willow bark, which once it was analyzed, we were able to make aspirin.  Like all other alt-med treatments, the pro side constantly uses anecdotes and subjective measurements as evidence that their ideas work.  My personal favorite tactic they use, especially in the energy healing and manipulation group, is that science has no way to measure what they are doing, but they know they are doing it.  You will hear naturopaths use several arguments during debates.  The most common ones are:
The argument from antiquity- " People have been using this for thousands of years, so it must work."  People have also been sacrificing animals, babies, and virgins for centuries.
The argument from nature - "If it's natural, it must be good for you."  Well asbestos, hemlock, and uranium are all natural, so sit down and enjoy the soup.
The argument from conspiracy -"Big Pharma doesn't want people to be healthy or to know that this works because it will eat into their profits."  Bullshit asshole.  Last year, people spent about $34 billion on alt med.  When you figure these companies don't have to pay for research and development, licensing, years of testing, years of waiting for approval for sale, and yes marketing, it;s almost pure profit.  So much for the mom and pop market model..
Yes almost all alt-med practitioners will throw out the "Big Pharma" or "Big Government" conspiracy card at some point in a discussion.  As I said earlier, the scientific evidence for the efficacy of a naturopaths "treatments" is sorely lacking.

Conclusion
My personal conclusion when it comes to medical treatment is that I would rather go and get poked and prodded by someone that earned their white coat with years of education from a school with the word "medical" in it than chew on a piece of tree bark while someone tells me to eat more green and orange food and then gives me a bottle of saw palmetto.

I know this article wasn't as organized as the other 2 "Woo for the beginning Skeptic" posts were.  I didn't realize exactly how much the topic actually encompassed, and because of personal experience with some aspects of it, I kept finding myself getting frustrated and going off on rants that I had to come back and edit out later. (This one is very heavily edited.  It's taken me several weeks to write it.)  I still may come back and revisit some of the subdivisions later, if people request that or if there is a news article concerning one of them.   I know I cursed a bit more than usual, and I hope that impressionable young children aren't reading this.  If you are,I hope you learned something.  The lesson is "Don't do alt-med.  It's bad, mmmkay?"  And now we have my first promo as a matter of fact!  One of you lovely readers has written a book on homeopathy, which will hopefully be published soon, and was kind enough to let me know about it.  When it's published, I will give you all the details, where to get it, cost, formats, and where to send any letters of praise and appreciation.  Or at least as much info as they want me to put out. Until next time, be good, be reasonable, and be yourself.

The Skeptical Okie

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