Naturopathic medicine is a primary healthcare system based on the recognition that the human organism has an incredible self-healing capacity. Naturopathic medicine supports this self-healing potential using an eclectic mix of traditional therapies. The therapies used by naturopathic doctors include clinical nutrition, botanical medicine, traditional Asian medicine, homeopathic medicine, acupuncture, physical medicine, hydrotherapy, and lifestyle counseling. In its own way, each therapy supports the self-healing efforts of the body. The naturopathic physician selects appropriate modalities to use on a given individual patient based on traditional knowledge, modern research, and clinical experience. This practice of medicine is at once founded on the healing wisdom of many centuries and a distillation of current scientific research. This makes naturopathic medicine truly a mix of art and science.
Naturopathic Medical Tradition
Naturopathic medicine developed from the ancient Greek medical tradition founded by Hippocrates, the father of Western medicine, based on the premise that the body has an inherent ability to heal, referred to in Latin as Vis Medicatrix Naturae (Healing Power of Nature). The human being was considered by the ancient Greek physicians to be a dynamic creation of body, mind, and spirit that was more than the sum of its parts.
These premises inform the founding of the naturopathic medical profession at the turn of the 20th century by a group of European and American physicians dedicated to the practice of botanical medicine, home-opathy, spinal manipulation, hydrotherapy, and nutritional therapy. Their vision was to educate a profession of medical practitioners who could synthesize the techniques, observations, and practices of many healing modalities. A name was needed for this profession: naturopathy, a neologism from the Latin for nature and the Greek for suffering, was chosen. While naturopathic medicine thrived in the early 20th century under the influence of such notable physicians as Dr Benedict Lust and Dr Henry Lindlahr, the profession was eclipsed by surgical and pharmaceutical technological therapies. Naturopathic medical training was revived in the 1950s by Dr John Bastyr, after whom Bastyr University is named.
Today there are five colleges of naturopathic medicine in North America: Bastyr University in Seattle, Washington; National College of Naturopathic Medicine in Portland, Oregon; Southwest College of Naturopathic Medicine in Tempe, Arizona; Bridgeport University College of Naturopathic Medicine in Bridgeport, Connecticut; and The Canadian College of Naturopathic Medicine in Toronto, Ontario.
Together these institutions have an enrollment of more than 2,000 students. The curriculum is standardized and there is an accrediting body, The Council of Naturopathic Medical Education (CNME), which is recognized by the United States Department of Education. Graduates write international (Canada and the United States) licensing exams, which are known as the Naturopathic Physicians Licensing Exams (NPLEX). Upon passing NPLEX, they are eligible to practice in jurisdictions where naturopathic medicine is regulated. Recently, naturopathic medicine has been given many alternative names — alternative, complementary, integrative, and holistic, to name a few. Regardless of the term used, one or more modalities of naturopathic medicine are now used by an estimated 42% of the North American population. Visits to natural healthcare practitioners exceed visits to primary care physicians by more than 200 million visits a year. North Americans spend more than an estimated $30 billion a year on these services.
A common misunderstanding about the practice of naturopathic medicine is that it is not ‘scientific’. The naturopathic doctor is believed to be interested in diet and lifestyle factors only, not in the medical condition, and recommends treatments that have no evidence of efficacy. Nothing could be further from the truth. For the patient’s safety, the naturopathic doctor must establish a diagnosis based on medical history, physical examination, and standard laboratory tests. The diagnosis yields the information needed to select the appropriate naturopathic treatment. Once the etiology, pathogenesis, and pathophysiol-ogy of a condition are understood, the doctor can then recommend steps to restore normal physiological function. These therapeutic protocols are evidence-based in scientific literature and clinical practice, as the many references to peer-reviewed articles and refereed medical journals in this book testify.
Naturopathic medicine approaches the patient from a holistic perspective. The role of the naturopathic physician is to support the self-healing ability of the whole being, in contrast to the symptom management we see in conventional surgical and pharmaceutical medicine, where each organ in the body has its own specialist.
The fundamental difference between these medical practices is the focus. Holistic medicine looks at the body as a whole, not as a collection of organs functioning independently. Holistic medicine is interested in understanding how, when one system is not working properly, it causes other problems in the body. There is a myriad of possible interactions within the human body. The physician must consider the “trees” and the “forest” at the same time.
Thus, a successful treatment for an endocrine illness, such as endometriosis, must consider not only the reproductive tract but also the liver since it functions in the degradation of the hormone produced in the reproductive tract. Someone who treats osteoporosis should consider all the organs involved in calcium metabolism — the skin, liver, kidney, thyroid, parathyroid, and gastrointestinal tract. By supporting the health of the organs not only will the osteoporosis improve but many other health complaints will often improve as well. The health of the individual may improve to the extent that other potential diseases are prevented.
Another example is allergies. We do not develop allergies simply because we are deficient in antihista-mines. We develop allergies for a host of reasons. Perhaps it is due to omega-3 oil deficiency in the mast cell membranes. Maybe the liver is not able to detoxify foreign substances properly, irritating the immune system. A dysbiosis in the intestinal tract may be irritating the gastrointestinal lymphoid tissue. Therefore, a successful treatment for allergies may involve treating the liver, improving digestion, and balancing the immune system.
Holistic concepts may actually help explain the therapeutic variability always seen in human clinical trials of both herbs and pharmaceutical medications. Contemporary medicine focuses on the diagnosis of disease, seeking medicines that chemically counter the pathologic results of the condition. Clinical trials of such medicines are conducted on large groups of people lumped together by the fact that they all suffer from the same diagnosis. We have already seen with the above examples, such as the possible causes of allergies, why this may be a problem. No investigation is made into the cause of the disease, only its manifestations. Success in these trials is measured by how well the medicine is seen to counter the pathologic change or its symptoms, quickly and effectively, in a significant proportion of the studied population. Variability in results from person to person is usually considered to be due to such factors as individual variations in the number of receptor sites, enzyme systems, liver detoxification pathways, etc.
From the holistic viewpoint, there are no disease entities, only individuals suffering the results of an imbalance of ordering principles. The same disease, such as allergies, could result from any number of causes. Treatment would be very different in each case, and a medication that would be effective at curing the disease in all patients is inconceivable. All that could be hoped for (and this is often the case in modern Western pharmaceutical medicine) is to control the symptoms. Thus, the antihistamine is considered efficacious for allergies, yet side effects are common, and there is no mitigation in the disease state, as evidenced by the fact that the medication must be consumed regularly and indefinitely. Conventional Western medical reductionism and specialization may be hindering our ability to understand the use of herbal medicines as agents whose clinical effects demonstrate their ability to re-establish health.
Traditional Chinese medicine, Indian (Ayurvedic) medicine, and the Eclectic tradition of Western herbal-ism have classified disease in ways that are very different from Western conventional medicine, based on seeing patients as individuals, each with a unique manifestation of a disease state. Many of the drugs of the modern pharmaceutical compendiums were derived from medicines used by these ancestors. However, by isolating and concentrating ingredients, or making molecular changes to naturally derived medicines to ensure patent rights, the synergy of multiple ingredients acting in concert may be lost — and the side effects and toxicities of modern pharmaceuticals may be gained. This is not to say there is not a time and a place for modern pharmaceutical interventions; however, it is time for these approaches to share the stage with holistic approaches.
This book is a humble attempt to examine the endocrine system from a holistic perspective and to demonstrate that natural medicine has an integral and valuable role in promoting the health and balance of the endocrine system.
May we all better understand the art of medicine, the science of the human organism, and the need for compassion and understanding.
Case Study - Multiple Endocrinopathy: Patient Suffering from Diabetes, Hypothyroidism, Polycystic Ovary Disease, and Adrenal Insufficiency
My first patient with endocrine disorders had been suffering for more than 20 years when she was referred to our practice. When I first saw her as a patient, I was skeptical that dietary and herbal remedies could have such a profound restorative effect on her illness. This patient inspired me with confidence in naturopathic medicine, not as an adjunctive treatment for endocrine patients, but as an effective main treatment. Since treating this patient successfully with naturopathic treatments, I have been satisfied to see many of my patients recover their health, but also disappointed by my lack of ability to restore other patient’s health for reasons I don’t understand. Julie was first treated at The Canadian College of Naturopathic Medicine, and this case was first presented in my endocrinology course at the University of Bridgeport. The case was subsequently published in The Journal of Ortho-molecular Medicine. This case clearly illustrates the interconnection between endocrine disorders and naturopathic treatments.
Julie was the first diabetic patient I treated in my practice as a naturopathic doctor. When she came to my office, she was 54 years old and had been suffering from diabetes and multiple secondary diabetic complications for 25 years. As a result, Julie had developed 19 distinct clinical pathologies, primarily endocrine related, that required immediate attention. Over the years she had been prescribed a copious variety of pharmaceutical drugs, totaling 20 different drugs for her 19 conditions. Despite the amount of medicines she took, her illnesses were progressing to a dangerous level. The magnitude of her serious health problems seemed almost impossible to reverse, but she was not an ordinary person. Julie had developed a remarkable inner strength and utmost determination to obtain emotional and physical health, something that she had never felt before. Her childhood was scarred with abuse: emotional, physical, and sexual. At the age of 19, she started to suffer from depression and was treated with eight electroconvulsive therapies. Since then, she has been hospitalized eight times for psychiatric episodes. At age 44, she was diagnosed with a personality disorder. At the age of 53, she became homeless.
I checked Julie’s blood pressure. It was 200 systolic over 100 diastolic, a dangerously high level. This was far higher than normal (120/80), despite the fact that she was taking three pharmaceutical drugs to regulate her blood pressure. She was at immediate risk for a heart attack, and in conjunction with extremely high blood sugar levels, she was also in danger of a diabetic coma and renal failure in the near future.
High levels of sugar and the presence of the protein microalbumin were found in the urine. The kidneys ensure that water is secreted, while substances like microalbumin are kept within the body through the filtration system of the glomerulus. Damaged kidneys from long-term assault of high blood sugar and blood pressure cause the glomerulus filtration to break down. It was clear from the presence of microalbumin in her urine that Julie had the beginnings of renal disease.
Blood sugar control with the use of pharmaceutical drugs was clearly not effective enough, evidenced by an extremely high level of glycosylated hemoglobin (blood test that measures long-term blood sugar control). It was apparent that the secondary complications due to hyperglycemia would only get worse. And it was getting worse. She had the textbook list of secondary complications: kidney, heart, eye, nerve, and circulatory disease.
High blood sugar can cause all of these complications. High blood sugar leads to high blood pressure. High blood pressure leads to heart and kidney damage. In turn, kidney damage causes further hypertension. At the same time, the hyperglycemia continues to produce free radicals, initiating a cascade of chemical reactions destroying tissues throughout the body. It was clear that the pharmaceutical drugs she had been taking were not addressing her problems effectively. This was indicated by the fact that her blood pressure was 200/100 mmol/Hg and her blood sugar was 22 mmol/L, despite the fact that she had been taking oral hypoglycemic drugs intermittently for 20 years. The drugs Julie had taken had caused many secondary problems and side effects that eventually caused her to discontinue using them. As a result, she experienced flu-like symptoms, diarrhea, edema, and fatigue. She preferred to let her high blood sugar levels persist rather than to deal with the additional discomforts she faced while taking the pharmaceutical drugs Glucophage and Glyburide.
Julie had suffered from edema, which is fluid buildup in the body and legs. There are multiple causes for edema in diabetic patients. Edema often occurs when a patient’s kidneys are not adequately removing water from the body. Diabetic patients often have kidney problems, and edema is a common consequence. However, in Julie’s case, edema was caused by the drug Glyburide, which she took to lower her blood sugar. The Glyburide she had taken had caused a condition called SIADH (Symptom of Inappropriate Antidi-uretic Hormone Secretion). As soon as Julie stopped taking Glyburide, her edema subsided and, surprisingly, her blood sugar did not increase. One of the main reasons for taking oral hypoglycemic drugs in adult onset diabetes is to prevent hyperglycemia-induced kidney disease among other complications. She currently had kidney disease and was taking Glucophage, an oral hypoglycemic drug that only instigates further kidney damage.
I treated Julie with an aggressive program of natural medicines. To lower her blood sugar as quickly as possible, I prescribed botanicals, mineral supplements, and diet.
I gave her herbs that nourish the pancreas, liver, and adrenal glands — the three organs responsible for the metabolism of blood sugar. Her treatment consisted of traditional herbs that have been used around the world in the treatment of diabetes. These herbs included jambul, milk thistle, devil’s club, globe artichoke, and nopal. These herbs were given in equal proportions in alcohol extracts. The dosage prescribed was 40 mL of tincture daily.
Syzygium jambolana (jambul seed) is an Ayurvedic medicine that has been used for thousands of years in India to treat diabetes and its secondary complications. Jambul not only helps with lowering blood sugar but also with the secondary complications. It has been found to increase formation of the essential enzymes superoxide dismutase and glutathione, which serve as powerful antioxidants in preventing denatu-ration of proteins found in hyperglycemia.
Oplopanax horridum (devil’s club), a Native American herb from the Pacific Northwest, is traditionally used for hyperglycemia, digestive problems, and a host of other conditions. Native Americans used it for almost all conditions. It has immune-supportive and antiviral properties. It also functions as an adrenal and a pancreatic tonic.
Silybum marianum (milk thistle) is an extremely potent liver tonic herb that decreases the free radical formation by supporting cytochrome P450 system of the liver. It has been recently hypothesized that the liver plays a crucial role in the regulation of hyperglycemia because it produces hepatic insulin sensitiz-ing substrates (HISS) that help the effect of insulin receptor sites throughout the body. Although modern science has not always been aware of this fact until recently, traditional herbal medicine in Eastern Europe used milk thistle in the treatment of diabetes long before modern science came to the understanding of the relationship between the liver and HISS.
Nopal opuntia (prickly pear cactus) can be found in the desert regions of the Southwestern United States and Central America. Traditionally, nopal is both eaten as a food and as a medicine. One of its medicinal uses is for the treatment of diabetes. Nopal is not only effective in controlling diabetes, but it also controls the secondary problems associated with diabetes, such as high cholesterol and triglycerides. Numerous studies have documented a significant improvement in patients’ cholesterol and triglyceride levels within 24 hours of drinking nopal juice in high doses.
Cyanara scolymus (globe artichoke) contains inulin, a compound that buffers the effects of high blood sugar. It also tonifies and nurtures the liver, a crucial organ for the maintenance of healthy blood sugar levels.
In addition, Hypericum perforatum (St John’s wort), a nervine, was used to restore nerve function. Solidago canadensis (goldenrod) was used to help kidney function. Vaccinium myrtillus (billberry) was prescribed not only as a hypoglycemic but also as a tonic for the eyes to treat the glaucoma.
Mineral supplementation included a multi-mineral formula that was specifically tailored to aid in blood sugar metabolism. This included a daily dose of 600 mcg chromium, 45 mg zinc, and 150 mcg selenium.
Her diet was considered good in the conventional medical paradigm. However, this paradigm did not consider food allergens as a significant factor in the treatment of diabetes. She was very prone to food allergies due to her past history of digestive disorders and extreme dysbiosis. Studies have found that removing food sensitivities lower blood sugar levels dramatically. Thus, a hypoallergenic diet was prescribed. Within 3 months of this diet, she had consistent fully formed stools for the first time in her life.
After one year of taking this herbal formula, along with following a strict diet, receiving acupuncture treatments, and eliminating these pharmaceutical drugs, Julie’s blood sugar was under excellent control. She had a 71% decrease in fasting blood sugar and a 44% reduction in glycosylated hemoglobin.
This meant that the amount of sugar molecules attaching to the red blood cell byproducts had decreased by 44%; consequently, the saturation of sugar affecting the different tissues in the body went down by 44%. This translates into a significant reduction in cardiovascular risk, kidney disease, eye disease, and nerve disease. Julie’s mortality risk was significantly altered. The treatment time was approximately one year.
It took several months for the blood sugar to fall to 18 mmol/l. The blood sugar consistently fell below 10 mmol/l after one year of treatment. These levels were below any level that she had achieved in the previous 15 years, even with the daily use of Metformin 500 mg b.i.d. and Glyburide 5 mg b.i.d. The effectiveness of St. John’s wort in treating the neuropathy took about 2 months. When she discontinued this herb, the symptoms came back, but with much less severity. The patient is now in much better emotional and physical health than she has ever been. She enrolled full time in a school to become a healthcare practitioner and currently lectures on homelessness.
This herbal regime is an example of naturopathic medicine designed to improve the vitality of all the organs involved with blood sugar metabolism. This paradigm is quite different from the allopathic approach, in which pharmaceutical drugs are prescribed, not to foster health of an organ, but to stimulate or inhibit biochemical pathways within the body. The real test of the curative aspect of these herbs would be evident a year later. By supporting the health and vitality of the body, Julie’s blood sugar was in better control a year later even after discontinuing all medicines. This is quite a different result than with the use of conventional medicine. When she used drugs, her dosage and types of drugs kept on increasing throughout her life, while her health continually declined. The second evidence that these herbs were strengthening the organs is that these same herbs were used effectively to treat patients who had high insulin levels, low insulin levels, hyperglycemia, and hypoglycemia.
Due to the success of this naturopathic treatment in alleviating Julie’s diabetes and secondary complications, I received a grant to conduct a 15-month clinical trial for the use of herbal medicine in the treatment of blood sugar metabolism. The results of the study showed that 88% of patients with hyperglycemia were able to lower the blood sugar by one third, while at the same time the patient who had too much insulin was able to lower it by 25%, and patients with reactive hypoglycemia had a 44% decrease in hypoglycemic symptoms. This was yet another confirmation that herbs are powerful healing agents.