Naturopathy is a pleasant-sounding term for an approach to health and disease that is quite different from that of science-based medicine. It is an example of an alternative philosophy that has great appeal for from a certain perspective but which, when examined closely, has little real substance.
What Is It?
According to the American Council of Animal Naturopathy (ACAN), naturopathy is an ancient practice, “naturopathy has been around since the fall of Adam and Eve.” According to more neutral and skeptical sources, it took shape in Europe in the late 19th century. ACAN defines naturopathy as:
a philosophy and system of prevention of disease first and then treatment of disease that avoids drugs and surgery and emphasizes the use of nature or natural agents such as exercise, water, herbs, etc. to assist the body in bringing its self back into balance and health.
As is often the case with alternative therapies, this is contrasted with a rather caricatured description of conventional veterinary medicine:
Today’s veterinarians are in the business of disease care, they hold doctorate titles from colleges that teach them anatomy, biology, chemistry and surgery. They are taught how to use modern, high tech equipment to diagnose while the pharmaceutical companies teach them which drug to prescribe or use to treat or suppress the symptoms of the dis-ease or illness the animal is presenting with.
The Six Principles of Naturopathy, identical to those espoused by human naturopathic organizations such as the American Association of Naturopathic Physicians (AANP), describe the philosophy in more detail. Some key points are:
The body has the inherent ability to heal itself. This healing process is intelligent and ordered.
Every illness has a cause. Causes may occur on the physical, mental or emotional level. Symptoms are expressions of the body’s attempt to heal, but are not the cause of illness.
Animal Naturopaths use nature’s methods that minimize the risk of harmful side effects. Methods designed to suppress symptoms but not remove the underlying cause are usually harmful, their use is always avoided. [by which they mean most scientific medical therapies]
All aspects of that animal (physical, mental and emotional) are taken into account.
Illness is due to improper diet, habits, exposure to toxins and general lifestyle.
Does It Make Sense?
The assumptions upon which naturopathy is based are questionable. The distinction between “natural” and “unnatural,” and the suggestion that the former is equivalent to “healthy” and the latter to “unhealthy,” is an appealing but ultimately vacuous idea. There is no clear line dividing natural from unnatural. Are cooking, farming, tool-making, wearing clothes, or other human behaviors that alter the world we live in inherently unnatural and unhealthy? Is it a matter of degree? Is it ok to cook plants as part of preventative or therapeutic medicine, but not ok to extract medicinal compounds from plants? It quickly becomes clear that the distinction between natural and unnatural is capricious and arbitrary, and it is not a sound basis for deciding what is healthy and what is unhealthy for us or our pets.
The idea that natural things, even if we could agree on what these are, must be healthier than unnatural things is pretty obviously false. Uranium, arsenic, botulism, rattlesnake venom, and many other “natural” things are harmful or even deadly. And clearly artificial things, like the growing of food crops, sanitation and water treatment, and medical interventions such as vaccines and antibiotics have improved the length and quality of human life far more dramatically in the last few centuries than all the efforts of the tens of thousands of years before we developed a scientific approach to understanding and manipulating our world. The fact that some of the things we create are harmful doesn’t validate the belief that anything human made is unhealthy and anything unchanged from its natural state must be healthy.
Naturopathy is, itself, a complex and purely artificial set of beliefs and practices that no other animal employs and that humans invented along with all of our other unique beliefs and behaviors. Calling it natural, and labeling scientific medicine unnatural is simply s statement of belief, not a factual or verifiable claim.
Because the philosophical basis for naturopathy is so vague and ill-defined, the actual practice of naturopaths encompasses almost any form of alternative therapy. Among the practitioners listed on the ACAN website as Certified Animal Naturopaths, you find practitioners of homeopathy, Traditional Chinese Medicine, iridology, and other therapies that are questionable or completely lacking in any validity. Whatever a particular practitioner chooses to define as “natural” is apparently acceptable within a naturopathic approach apart from vaccines, pharmaceutical medicine, and many other conventional therapies.
It is important to point out that this “board certification” in naturopathy is not recognized by the American Board of Veterinary Specialties which regulates veterinary medical specialties. It is equivalent to similar certifications for homeopaths, psychics, and astrologers in that it is invented by naturopaths to legitimize themselves and is not recognized by mainstream veterinary medicine. In fact, there is no requirement that those who take the various certification courses the ACAN offers be veterinarians or trained healthcare professionals. The ACAN web site states,
as long as you are 18 years of age or older, these courses are designed to educate no matter what level of current knowledge you may have. They prepare you to be certified in animal health coaching, nutrition consulting or animal naturopathy consulting or to inform and educate you just for your own knowledge to help your own pets if that is what you are looking for.
It seems implausible that a powerful approach to healthcare superior to modern medicine is also so simple that it can be learned and practiced by anyone without any scientific or medical knowledge. Surely such a method would have replaced all other medical practices before now?
Historically, naturopathy has been a vitalist philosophy, identifying disease as a state of imbalance in not only the physical body but the mind, spirit, or vital essence of a creature. This philosophy rejects predominantly physical causes of illness and instead considers the root of disease to be in non-physical, spiritual factors. As one proponent has put it, “vitalists analyze bodily illness mainly in terms of the spiritual factors that might be contributing to it…Disease, according to vitalists, is simply a more advanced stage of the stress that we exhibit when we persistently fail in the pursuit of physical and spiritual goals.”
Because this essentially dismisses all the progress made by science in understanding the causes and treatment of disease, and because it identifies naturopath as a purely faith-based practice, naturopaths often de-emphasize this element of their philosophy and talk more vaguely about the “inherent healing power” of the body rather than the “vital force” or spirit. It is true that the body has a remarkable capacity to heal itself and many ailments resolve without treatment, or in spite of treatment, which is one of the reasons ineffective therapies can appear to work even when they do nothing. However, naturopaths claim this inherent healing power is “intelligent and ordered,” which is a faith-based claim that cannot be examined or tested in any objective way. They also claim that this healing power can be supported by their recommendations and impeded by scientific medical therapies, which is contrary to a great deal of actual evidence.
One major problem with vitalism as a foundation for medical therapies is that its principles have to be accepted or rejected entirely on faith, which makes any claim one chooses to make immune from any objective evaluation. Given the unprecedented success of science-based medicine compared to all the methods that went before it, it seems unwise to go backwards away from the practice of objectively and critically evaluate medical claims by established scientific means.
Does It Work?
Of course the first step in answering this question is to define what “it” is, which as we’ve seen is difficult because there is no consistency to the specific interventions naturopaths employ. I have written before about homeopathy, TCM, herbal medicine, and many of the specific treatments naturopaths recommend. Many of these are unproven or clearly ineffective. Others, like herbal remedies, probiotics, and some dietary supplements may have some benefit. Categorizing them all as “natural” tells us nothing about which are helpful and which aren’t.
However, many of the recommendations naturopaths give, especially for humans, are identical to those given by conventional doctors. No one disagrees with the idea that clean, healthy food is essential for life, though what exactly this means may not be open to dispute. Similarly, clean fresh air and water, appropriate exercise, and a positive attitude are undoubtedly good for everyone, though they may not be the key to perfect health or immortality. The fact is that much of what naturopaths recommend may be perfectly reasonable, or even supported by good scientific evidence despite the fact that they are recommending it regardless of the evidence and based on a philosophy incompatible with science.
Like many alternative medicine proponents, naturopaths are happy to cite scientific research when it supports their beliefs and claims, but they are likely to dismiss any which does not. Because naturopathy is a vague philosophy encompassing many different practices, it is difficult to study in a controlled manner, and there is relatively little research on the general approach. A recent attempt at a systematic review of naturopathy found 12 studies that met the inclusion criteria, and while they appeared to show some benefits, they all had significant weaknesses and limitations that made it impossible to draw and reliable conclusions. The National Center for Complementary and Alternative Medicine (NCCAM), the American Cancer Society, and other government and private organizations have stated that there is currently no real evidence to support the claims of naturopaths. There also appears to be absolutely no controlled clinical research on naturopathy in veterinary species.
That leaves only the inevitable testimonials. For reasons I’ve discussed many times before, individual anecdotes provide no real evidence to support or reject medical therapies. At best they can suggest potential benefits or risks to be examined more closely, but despite the fact that they are highly persuasive, they are not a trustworthy source of information about naturopathy or any other medical practice.
Is It Safe?
Again, it is difficult to comment on the safety of naturopathy as a general approach because it is so ill-defined and specific therapies are not consistent between practitioners. The risks of particular practices, such as homeopathy, herbal medicine, TCM, and all the particular alternative therapies employed by naturopaths can be considered separately. The biggest risk of the philosophy itself is that it often involves counseling people against seeking and using conventional medical diagnostics and treatments. Naturopaths are frequently opposed to vaccination, for example, which is a position that clearly places people and animals at unnecessary risk of illness and death from preventable diseases. Naturopathy, like any other pre-scientific and unproven medical practice, is not a safe or reliable substitute for scientific medical care, and eschewing conventional care in favor of naturopathy risks losing the opportunity to receive effective therapy in a timely way.
Naturopaths often present themselves as appropriate substitutes for primary care doctors, for humans and animals, despite the fact that many of them lack of any real scientific or medical training. Even in those instances when the therapy they recommend is reasonable (such as diet and exercise advice) or harmless in itself (such as homeopathy), these individuals are not qualified to detect and respond to serious health problems.
Naturopathy is a vague vitalist philosophy that identifies the causes of disease as imbalances in the vital life force or spirit and in supposed dietary deficiencies or undefined environmental toxins. The basic principles of the approach are unproven and, in the case of the claim that the roots of disease are spiritual, untestable.
Naturopaths use a hodgepodge of different alternative therapies according to their personal training and inclinations. Some of these are clearly ineffective nonsense (e.g. homeopathy, iridology), others are merely unproven but at least plausible (e.g. herbal remedies, dietary supplements), and some are consistent with conventional medical recommendations (e.g. exercise, some dietary advice). It is difficult to study the overall risks and benefits of naturopathy due to the varied and inconsistent treatment offered by individual practitioners. There is little research evidence in humans and none in veterinary species to support naturopathy as an effective approach.
The risks of individual therapies offered by naturopaths are also varied. Some, such as homeopathy, have no direct effect at all, for good or ill. Others, such as herbal remedies, can cause harm directly. The greatest risk, however, from naturopathic treatment is that naturopaths often recommend avoiding conventional medical care, include vaccines, surgery, and pharmaceutical medicine. Substituting unproven, untested, or ineffective therapies for scientific medicine is not an appropriate way to seek health or treat disease.