The Naturopath in the Newspaper part II

This is the follow up to my previous article where a naturopath makes some rather extreme suggestions for a mother concerned about her 11 year old son. In this instalment, she tries to sell a number of her products to address the issues she imagines this child might be struggling with.

Addressing an article like this can be difficult as there are a lot of things just thrown out, some very specific and some quite vague, and there are varying amounts of evidence to back each of them up, but I’ll give it a try.

As before, naturopathic comments are in bold.

Lacking in energy in general affects mental energy. Providing the brain with the right fuel will go a long way in optimizing your child’s learning ability.

This statement is uncontroversial. Eat a healthy diet and get adequate amounts of exercise and your mental and physical health will be optimized. It’s certainly not advice that is unique to naturopaths or other practitioners of alt-med.

Look at them as a whole and consider all factors that can take away from their well-being such as digestive discomfort, allergy symptoms, recurring infections, headaches, vision problems, hearing difficulties, poor sleep, too much sugar, not enough protein and nutrient deficiencies.

These are the aspects I addressed in my other post.

Deficiencies in B3, B5, B6, folic acid and B12 are especially common.

This is one of those statements that are very difficult to verify or refute. In my searches, what I found is well summarized at WebMD.

Vitamin B12 deficiency can have a number of possible causes. Typically it occurs in people whose digestive systems do not adequately absorb the vitamin from the foods they eat. This can be caused by:

  • Pernicious anemia, a condition in which there is a lack of a protein called intrinsic factor. The protein, which is made in the stomach, is necessary for vitamin B12 absorption.
  • Atrophic gastritis, a thinning of the stomach lining that affects up to 30% of people aged 50 and older.
  • Long-term use of acid-reducing drugs.
  • Vitamin B12 deficiency can also occur in vegetarians, because the best food sources of the vitamin are animal products.

And of course, the treatment for this unfounded diagnosis of vitamin deficiency is to use some of the Vitamin supplements that she sells.

I recommend starting with a multivitamin mineral formula that has at least 10 mg of B6

Multivitamins that she sells, or course. What does WebMD say about dealing with these relatively rare deficiencies?

Most people can prevent vitamin B12 deficiency by consuming enough meat, poultry, seafood, milk, cheese, and eggs. If you don’t eat animal products or you have a medical condition that limits your absorption of nutrients, experts recommend taking a B12-containing multivitamin and eating breakfast cereal fortified with vitamin B12.

There are details in the article that are specific to each of the B Vitamins, but to summarize the whole thing, for the vast majority of us, a well balanced diet will take care of all our vitamin B needs.

Magnesium deficiency can manifest as poor sleep, hyperactivity, anxiety, restless legs, muscle cramps and constipation along with many other signs and symptoms.

What does WebMD say about Magnesium? First of all, most of us get all the magnesium we need from a balanced diet. However, those in certain circumstances may not be metabolizing as much as they need.

What does a magnesium deficiency look like?

Symptoms of a magnesium deficiency include weakness, dizziness, irregular heartbeat, shaking, twitching, and seizures.

So, borderline magnesium deficiency might cause some restlessness and tiredness. What might cause such a problem?

Deficiencies can be caused by:

  •  Alcohol abuse or withdrawal.
  • Complications from diabetes, such as diabetic ketoacidosis.
  • Diseases that block with the way food is absorbed in the intestines, such as sprue.
  • High blood calcium levels (hypercalcemia).
  • Infection and swelling of the pancreas (pancreatitis).
  • Kidney disease.
  • Long-term diarrhea.
  • Not getting enough magnesium in the foods you eat.
  • Pregnancy, especially in the second or third trimester.
  • Underactive parathyroid glands (hypoparathyroidism).

The solution to this imaginary magnesium deficiency is another supplement.

Low hemoglobin, that which carries oxygen in the blood, delivering it to your tissue, also affects mental energy, sleep, immunity and growth.

Low haemoglobin, also known as anemia, is treated by iron supplements, although, just like the items above, the first answer is found in your diet.. Anemia can be caused by a number of conditions, each has specific symptoms to aid in diagnosis and treatment.

  • Iron deficiency
  • Vitamin B12 deficiency
  • Chronic lead poisoning
  • Chronic red blood cell destruction
  • Sudden red blood cell destruction
  • Sickle cell anemia

Best to get a blood test first.

It is best to have hemoglobin and ferritin (iron stores) checked before supplementing as some can have a genetic tendency to excessively store iron and therefore it would be dangerous to supplement iron. Telltale signs are very pale individuals without pink in their cheeks, complaints of being tired and cold and dull eyes with darkness underneath.

She is correct in stating that too much iron in your system can cause damage, but she doesn’t give any details about those consequences might be.

Side effects. Taken at normal doses, iron supplements may cause upset stomach, stool changes, and constipation.
Risks. Don’t start taking iron supplements unless your health care provider tells you that you need them. That’s especially true if you have a chronic health condition. Women who plan to become pregnant should also check with a health care provider before they start daily iron supplements.
Interactions. Iron can interact with many different drugs and supplements. They include antacids, anti-inflammatory painkillers, antibiotics, calcium, and others. If you take daily medicine, ask your health care provider if it’s safe for you to take iron supplements.
Overdose. Iron overdose is a common cause of poisoning in children. It can be fatal. Signs of an iron overdose include severe vomiting and diarrhea, stomach cramps, pale or bluish skin and fingernails, and weakness. Treat these signs as a medical emergency. Call poison control and get medical help immediately.

Now we get a major scare.

If you determine your child is one of the estimated 40 per cent of children who are iron deficient then I recommend iron amino acid chelate and nothing else as iron’s absorption is inhibited by many dietary factors and this form ensures maximum absorption.

This is an extremely misleading statement designed to impress upon parents and others the necessity of supplementing with iron.

According to UNICEF, iron deficiency, caused by poor diet and the effects of malaria, impact up to 40% of the population in the developing world. This problem is also seen in aboriginal peoples living on reserves. The numbers for those of us who live typical middle class lives is much lower, although still not insignificant.

In the United States, iron deficiency remains common with 9 percent of toddlers between the ages of 12-36 months having inadequate iron stored in their bodies.

Now she assumes ADHD

Omega 3 from fish oil contains EPA and DHA. A randomized, double blind, study in Sweden of 82 children with ADHD ages seven to 12 years showed significant teacher evaluated improvement in ADHD symptoms, with the use of Minami Plus EPA 500 mg 1 capsule per day.

First of all, as I noted in my previous post, the child in question did not meet many of the diagnostic criteria for ADHD, even if the Omega 3 might help. Without a specific reference, I was unable to find the study she refers to above, however, in my searches, it appears that the case for the use of Omega 3 supplements for ADHD is not settled. One study from Sweden found a subset of children (26%) responded to Omega 3; a 2006 review in Prostaglandins, Leukotrienes and Essential Fatty Acids, suggests that Omega 3 oils are lower in children with ADHD, but does not discuss supplementation; another view in Psychiatry, found small improvements, but questioned the clinical significance; and a review in Child: Care, Health and Development, suggests that because the side effect profile of Omega 3 oils is so low, even though the evidence is weak, supplementation might be considered.

Just like last week’s article where she suggested diagnoses that were essentially highly unlikely, this week’s treatments  only peripherally, if at all, relate to this specific child. Virtually all naturopaths criticize modern medicine for treating the symptom and not the disease, and not looking at a patient holistically. In these two articles, she focuses on the use supplements and ignores any suggestion of the potential underlying causes for a vitamin or mineral deficiency.

One of the constant refrains from naturopaths and other alt-med practitioners is criticism of the use of prescriptions or other pills as quick fixes from modern medicine. In comparison, alt-med treats the whole patient. Here she demonstrates the absolute falsehood of that characterization. The best of modern medical science tells us that almost all of the potential deficiencies here are most appropriately addressed by improvements in diet and/or lifestyle changes. This naturopath is just selling supplements; and because they are not listed as medications, they are not subject to the same regulatory controls as pharmaceuticals.

In addition, one of my recurring complaints about naturopaths is also demonstrated very clearly here. Again and again physicians are referred to as pill-pushers and in the pocket of Big-Pharma. However, it is considered both illegal and unethical in most jurisdictions for physicians to dispense the products they prescribe. Here we have a naturopath recommending supplements that she will be more than happy to sell to you  from her own shop. Because there is no critical oversight for the group, this is not considered unethical by their standards of practice, and since supplements are not considered medications, there is no legal issue. My ethical standards are somewhat different, and I consider this type of behaviour to be an automatic conflict of interest.

In these two articles, we have seen a naturopath make suggestions for potential diagnoses that have very little to do with the symptoms portrayed, then recommend supplements as treatments.

I have only touched on the debate on the appropriateness of taking vitamin and mineral supplements here. Each of her suggestions would require several posts to discuss properly. One thing is sure however, ask a naturopath for advice and your answer will lie at her cash register.

6 Responses to “The Naturopath in the Newspaper part II”

  1. David Denis, ND says:

    Hi,

    I largely agree with many your criticisms here. I do think you make an error in that you generalize these critiques out to the entire profession. Many naturopaths take an evidence-based approach to their care, prescribe very few supplements and only when they are indicated, and are concerned about pseudo scientific treatments that exist within their own profession.

    In your efforts to inform the public you may be providing mis-information due to these generalizations and this strikes me as a problem. Statements such as “One thing is sure however, ask a naturopath for advice and your answer will lie at her cash register.” serve as rhetoric that does nothing to increase the likelihood of an open and intelligent discussion.

    Regards,
    David Denis, ND

    • There really aren’t very many, if any, naturopaths who actually follow science based medicine (SBM). Most Naturopaths will recommend homoeopathy, acupuncture, and chiropractic, none of which have passed the SBM test. As far a naturopaths and cash registers are concerned, many of the naturopaths I know, sell the products they recommend, whether they are supplements, homoeopathic remedies, or speciality foods. This practice is considered a major conflict of interest for physicians, and can only lead to recommending what you sell.

      An open and intelligent discussion really needs to begin with Naturopaths and their organizations repudiating the most unfounded aspects of their practices.

  2. Grateful to find this site and an entertaining, properly skeptical article.

    Particularly entertaining the ND who follows an evidence based approach. What a great start to my day :)

  3. sam says:

    Why can people not be better informed. I think they prey on low information individuals. More knowledge better choices.

  4. Actually Sam, I think they prey on semi-informed people. Those who think they know more about medicine and science, than they do. They also appeal to those who tend to buy into conspiracy theories, such as the control of medicine by Big Pharma. There are people with all education levels and from all walks of life who are taken in pseudoscience. It makes it more difficult when the purveyors believe in what they are selling.

    All in all, it makes the work of the sceptic difficult and potentially time consuming.

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  • John Underhay

    John Underhay, also known as Peicurmudgeon, is just your average atheist, left leaning, SCUBA diving, snorkeling, biker. He lives on PEI and spends some of his time attempting to point out the flaws and or dangers in promoting ideas that run contrary to the laws of physics, chemistry, or biology. He has a BSc (Biology) and an MSc (Pharmacology) from the University of Prince Edward Island, and is currently retired. You can read more of his posts at http://peicurmudgeon.wordpress.com/