A Naturopath@Google

Last year I was privileged to give one of my talks at Google’s headquarters, called an Authors@Google talk.

Google is a very interesting environment, intellectually speaking. There genuinely are a lot of really smart people there. There are also an even larger number of “smart by association” people. Google is located in the San Francisco bay area, which is one of the world’s vortex focal points of New Age woo. It’s also very metro – lots of foodies and environmentalists, and a lot of style. Many Google folks are young and hip and see themselves on the Cutting Edge. Thus, smart as many of them may be, or indeed are, my experience was that they are one of the world’s great low-hanging fruit customer bases for anyone selling anything positioned as alternative, enlightened, or “open-minded”.

Thus I was not surprised to hear from the informal skeptics’ group on campus (who sponsored my talk) that a naturopath was coming to give an @Google talk of her own. The intent of this blog post is to offer a foundation on naturopathy for those in the audience to better contextualize what they’re about to be told, and to ask informed questions. If this naturopath is coming in and planning to state that any of her treatments can diagnose, treat, cure, or prevent any disease, that’s an illegal medical claim; and her information should not be promoted by Google as true or reliable. My sense is that this naturopath feels this opportunity is going to be her free sales pitch. Not if we can help it.

Although naturopaths almost universally claim otherwise, there is no training or licensing required to hang out a shingle, call yourself a naturopath, call yourself Doctor, and give naturopathic treatment (except in a very few jurisdictions where it’s illegal to call yourself a doctor unless you actually are one). The reason for this is that the treatments are not regulated, since no good evidence exists that they might have any effectiveness beyond placebo.

Naturopathy is not recognized as a legitimate medical specialty by the American Board of Medical Specialties, so naturopaths cannot claim to be board certified by a legitimate medical board. They’ve solved this by creating their own certification boards. There are nearly as many of these as there are naturopaths, similar to the situation that exists for chiropractors. For a naturopath to claim to be board certified is equivalent to me calling myself Certified by the Board of Brians. It carries no meaning whatsoever in any recognized medical arena.

Similarly, doctorate degree programs in naturopathy are not accredited by the Council for Higher Education Accreditation; thus naturopathic training institutions “self-accredit” through their own accreditation board, the unsurprisingly-named Council on Naturopathic Medical Education.

I have researched and written extensively on many of the treatments that this naturopath offers, which, according to her web page, are naturopathy including herbal treatments and detoxification, craniosacral therapy, and homeopathy. Before we get into any of these specifically, I’ll begin with a few general questions I would like to ask her:

  • The FDA does not allow naturopaths to claim that their services can diagnose, treat, cure, or prevent any disease. If a customer comes to you with an expectation of receiving treatment for a medical condition, what do you tell them?
  • Obviously you’re aware that naturopathy is not recognized as a legitimate medical specialty, and that it receives harsh criticism from medical science. Do you think medical science is wrong?
  • Naturopaths are legally prohibited from providing services that have been found to diagnose, treat, cure, or prevent any disease. If you want to help people, why become a naturopath when you could provide proven treatments as a medical doctor?
  • I noticed on your web page that you place a lot of importance on spending time with your patients, listening to your patients, and discussing your patient’s specific health issues.  Practitioners of science-based medicine assert that it’s actually this time and attention that provides any beneficial effect that’s realized, as opposed to the “naturopathic” remedies themselves.  What is your response to this?

So let’s move onto the specific treatments, beginning with detoxification. The body has a natural detoxification system that has proven effective for millions of years: poop and pee. The liver and kidneys are remarkably good at what they do. Yet, paradoxically, naturopaths are the ones telling us that we should not rely on nature’s detoxification system; rather, that we should purchase expensive products and services from them to do the job.

Why? Because we live in a “toxic environment”, they usually tell us. See this 3-minute YouTube video I made that discusses this in a pretty good overview. Note that they never tell you what the “toxin” is, how you got it, or what the safe/normal level is compared to the level found in your blood.

Most “detoxification” involves little more than the sale of worthless herbal supplements that probably don’t do any harm to anything except your wallet, but there is a darker side to detoxification. It’s called the Provoked Urine Test or Urine Toxic Metals test, used to defraud victims into believing they have a dangerous level of toxic metal in their body. These tests always read positive. This “diagnosis” is sometimes followed with chelation therapy. When given with actual active ingredients, chelation therapy is dangerous and very hard on your liver, and is only indicated in true cases of acute heavy metal poisoning. Read this lengthy article on Quackwatch to learn more about the provoked urine test, and how and why it is used by practitioners who are either willfully ignorant or deliberately deceptive.

Make no mistake: Herbs are pharmacological compounds, and therefore drugs – untested and unapproved drugs. If she administers drugs to a customer, even if she calls them harmless all-natural herbal supplements, she’d better have a damn good reason.

  • How do you define the word “toxin”?
  • If you find that a patient requires detoxification, shouldn’t you first recommend that they visit a medical doctor for a blood test to confirm a dangerous level of the toxic compound, before undergoing any kind of drug therapy?
  • You’re undoubtedly aware that medical science does not recognize detoxification as a medical field. How do you account for this?
  • Why don’t medical doctors ever recommend detoxification procedures such as those you sell?
  • What do you think of detox products such as the pills that create rubbery bowel movements and vinegar-charged adhesive footpads? Why are your products better?
  • What are the symptoms of “need for detoxification”, and how often do you refuse drug therapy to someone who does not exhibit those symptoms?

Homeopathy is next on the list. This technique from 1807 asserts that water can carry a “spiritual imprint” of something it once came into contact with; and that the spiritual imprint of a poison can cure the very disease the actual poison would cause. By diluting the substance with water far beyond chemical purity (Avogadro’s number, 6 × 1023) until none of the substance remains, it becomes an incredibly powerful cure. They call this spiritual imprint “water memory”.

A typical homeopathic dilution, 30C, means 100 (Roman numeral C) to the 30th power. One molecule of ingredient in 10030 molecules of water would be a sphere of water approximately the size of the Earth’s orbit.

Some homeopaths say that a tiny diluted amount of a toxin works just like a vaccine, by stimulating the body’s natural responses. This is an invalid comparison. Vaccines contain active ingredients, whereas homeopathy, by definition, has no active ingredient at all.

But pointing out all the flaws in the concept don’t prove that homeopathy doesn’t work. It may, through some yet-unknown mechanism. The problem is it doesn’t. This has been borne out in testing time and time again. All the studies showing an effect have been poorly designed, usually uncontrolled, and published only in the homeopathy industry’s own journals. For more, see my Skeptoid episode about it.

  • Are there any medical conditions that you’ve found homeopathy doesn’t help, and if so, how did you reach that conclusion?
  • The head of the British Homeopathic Association said that the only way to tell different homeopathic remedies apart was by reading the label, that there is no chemical difference. If you’re out of compound A, why not just give them compound B?

Here’s my favorite question that I’d love to hear a homeopath answer:

  • Even assuming that water memory is real, homeopathic pills are dry. According to the ingredients, they contain no water. How do the only ingredients listed – lactose and sucrose – carry water memory?

Craniosacral therapy is fatally flawed from the outset. It is the intended manipulation of bones in the skull through manual pressure, thus affecting the pressure of cerebrospinal fluid and membranes. However, the bones of the skull are fused and do not move at all when massaged (which was unknown to the technique’s 1899 inventor). Even though this is now understood, craniosacral therapy is still practiced, in flagrant contempt of basic anatomical knowledge. For an excellent in-depth discussion of how foolish and unscientific this practice is, see Dr. Stephen Barrett’s excellent article on Quackwatch.

In my experience, practitioners merely give a scalp massage. Like all massages, these have legitimate benefits of relaxation and stress reduction. That’s fine. But there are two problems with a naturopath selling a scalp massage as craniosacral therapy:

  1. It’s not craniosacral therapy. It’s a scalp massage. Craniosacral therapy is the manipulation of your skull bones.
  2. If called what it is, it’s illegal. To sell a massage requires a license in massage therapy. Perhaps some craniosacral therapists also have this license. The legal loophole is to call the massage craniosacral therapy, which is unregulated.

Reflexologists use this same trick to legally sell a great-feeling foot massage. Reflexology is, of course, very different.

My questions on this practice:

  • The bones of the skull are fused, yet craniosacral therapy is defined as the manipulation of cerebrospinal fluids and membranes through moving these bones. How do you reconcile that?
  • Are you a licensed massage therapist?

My experience with such practitioners is that when they are confronted with such questions, they usually have two holes they run to: First, the conspiracy of the medical establishment. It’s corrupt, greed-driven, and full of conflicts of interest. Much of this may be true; but pointing out flaws in the medical industry in no way constitutes scientific support for alternative medicine. (If she mentions greed, ask if her services are provided free. According to her web site, everything is well over $100/hour, which far exceeds the deductible you’d pay at your doctor’s office.)

Second, the tired old open-minded vs. closed-minded argument. It is not closed-minded to accept what we’ve been able to learn through science. It is open-minded to ask questions, and proper to use science to find the answers. It is, however, closed-minded to ask questions, learn the answers through testing and experimentation, but then to reject those answers in favor of your desired conclusion.

I think this is enough to get us started. I’d be very interested to see how this Q&A session goes. Often the Authors@Google program uploads their talks to YouTube, and if they do with this one, I’ll update this page with the link.

About Brian Dunning

Science writer Brian Dunning is the host and producer of Skeptoid.
This entry was posted in Alternative Medicine, New Age, Pseudoscience and tagged , , , . Bookmark the permalink.

42 Responses to A Naturopath@Google

  1. Hans says:

    Great post, Brian.

    Another great example of how otherwise perfectly sane people can get lost in the merky waters of unscientific claims. There is still much to do for us skeptics :)

  2. Stephan says:

    This was so worth the read.

    A very good and diligent post.

  3. Max says:

    “Make no mistake: Herbs are pharmacological compounds, and therefore drugs – untested and unapproved drugs.”

    Legally, drugs are any substances that are claimed to prevent or treat disease. When a producer of walnuts claimed that “omega-3 fatty acids found in walnuts may protect against heart disease, stroke and some cancers,” the FDA warned them: “Because of these intended uses, your walnut products are drugs.”
    http://www.fda.gov/iceci/enforcementactions/warningletters/ucm202825.htm

    But omega-3 fatty acids ARE proven to reduce very high triglycerides, which is why there’s an FDA-approved prescription fish oil drug called LOVAZA. There’s also a prescription Vitamin D2 drug called Drisdol, which may be less effective than OTC vitamin D3 supplements.
    http://www.medicalnewstoday.com/articles/237943.php

    So you get this dichotomy, where substances claimed to treat disease are sold as drugs, while the same substances claimed to “support your health” are sold as dietary supplements.

  4. Max says:

    A toxin is anything that doesn’t help your body and potentially damages it. Mercury in fish, pesticides on produce, fungicides in orange juice, arsenic in apple juice, BPA in canned food, preservatives, artificial colors and flavors, etc. It’s impossible to study every possible combination of these things over the long term starting with the embryo, determine how they interact with drugs, how they affect epigenetics, and so on. I don’t know of any detox that’s proven to work, so it’s safer to avoid toxins in the first place.

    • Eric Hall says:

      Max – I don’t think anyone would disagree with you on the idea that we should avoid things that are known to be toxic. But many things are toxic only based on their dose. The classic example would be water. Water can actually be dangerous – http://www.msnbc.msn.com/id/16614865/ns/us_news-life/t/woman-dies-after-water-drinking-contest/#.TxSKjW_POf4

      We know one drink a day has been shown to have health benefits, but more than that is than harmful. Formaldehyde is formed in our body during metabolic processes. It is really all about how much (in most cases) and not about the substance itself.

      I am always looking for ways to try to avoid unnecessary use of chemicals. I do think we should try to cut down on the use of some of these substances when simpler alternatives are available. Why worry about what dose might be toxic or have to try to contain a complex chemical when a simpler alternative is available. That being said, I don’t spend my life worrying if I eat some fish or canned vegetables.

      • Max says:

        I agree with all that, but I’d say that water is “toxic” at extremely high doses, but it’s not a “toxin,” because you need a good amount of it to survive, and only a huge amount above that is toxic. I guarantee that naturopaths don’t count water as a toxin, and arguing that there’s no basic difference between water and mercury is kind of silly.

  5. Adam petherick says:

    I’m guessing she will dodge the specific questions altogether and blame the “close mindedness” of the medical science community for lacking meaningful accreditation.

    • It is a shockingly irresponsible health claim made by the Fox News headline. I really wish the FTC would prosecute newspapers for stuff like that.

      • Eric says:

        But Brian, Brill says so. . . and it’s on fox news.

        Doesn’t that make it true? An unsupported claim backed by a completely credulous news outlet?

        Skepticism is so hard.

  6. Don says:

    I find it so simply ironic that this:

    “unsurprisingly-named Council on Naturopathic Medical Education”

    plays out as an anagram to “Con me”. They’re just asking for trouble.

    Don

  7. Mike says:

    So Big Pharma (whatever that is) is corrupt and wants to keep us sick and dying, but unscientific “tests” that are always positive and “cures” that create the problem they’re curing…that’s nature’s way.

    How do these people sleep?

  8. Mud says:

    I am still stunned over the references to natural, homeopathy and allopathy in the Australian standard for organic product. So far I cant stop feeling very ill reading the definitions. The AOS/BFA wishlist was totally adopted.

    • Vincent Najger says:

      yeah…..depressing isn’t it…..here in Oz how can we get so many things right…..yet still get other things so wrong …..how could a monstrosity like that slip through? (my personal opinion is that life in Oz is so easy and casual, we simply don’t care to keep proper tabs anymore…..an awful lot of laws get passed in Australia too, without the public even hearing about it until its already Law of the Land….we are so indifferent that by the time we realise a particular law, government project or decision will impact negatively on our lives, its too late)

  9. Vincent Najger says:

    Good one Brian…..I can’t wait to see how this pans out. Any chance you could post a link to a vid or transcript of this particular authors@google talk on skeptoid.com (even if ya gotta get a friend to smuggle it out lol)? You’ve armed those formidable intellects with some formidable ammo…..this is one battle that I simply MUST see (perhaps it won’t degenerate into the slanging match that these things usually turn into…..and, as I am yet to see a debate on this subject that HASN’T degenerated into a slanging match, it would be rather enlightening)

  10. MJ says:

    Avogadro’s Number has become a Shibboleth for homeopathy skeptics, and that’s sad because it shows a misunderstanding of the underlying maths / chemistry.

    The substance does not magically disappear when it’s diluted to more than 6 x 10^23. The tipping point between there and not-there also depends on the final diluted volume. Let me explain:

    Avogadro’s Constant is the number of molecules in a mole, which also works out as the number of molecules you need to have the equivalent in grams of the substance’s molecular mass.

    The molecular mass of water is 18 (16 for Oxygen + 2 x 1 for Hydrogen), hence 18g of water contain 6 x 10^23 water molecules.
    If you dilute a pure substance in water 6 x 10^23 times, then you are likely to have one molecule of the substance PER 18g OF WATER.

    Without that qualifier, the use of Avogadro’s Number is meaningless. With it, things get much more interesting. If you sniffily dismiss the presence of ANY of the substance at 24X dilutions and above, you miss out on the fun of describing the volume of water you would need to consume at that dilution to find a single molecule of the “active” ingredient. eg, at 30X it would be 30 cubic meters. If the original ailment doesn’t kill you, hyponatremia probably will.

    Going the other way, if you limit your final dose to 1g of water, then the maximum dilution that would be likely to leave a single molecule present is only 3.3 x 10^22.

    • It is how chemical purity is defined: Less than 1 per mole.

    • Henk v says:

      Effectively it doesnt make a difference as dilutions tend to be quoted in anything but in terms of Avogadro’s number.

      Its hardly chemistry if you look at the “contents” breakdown of any preparation.

      So very often the proposed solutions/dilutions are so ridiculous that it doesn’t bear considering.

      Then supporting compounds at concentrations of 6X and greater are not homeopathic by any stretch of the imagination either..

      Its hardly math!

      • Henk v says:

        Mind you it isnt galling that a homeopathy supporter would pipe up like that to only expose…they do not do science.

        The skeptics complaint dear “homeopath” is and always will be, there is no reason for it to work and it has never worked. Show science that any woo is scientifically based and then do science to tailor remedies.

        Theory, application, technology is totally overridden to practice and..Show me the money!

        The same goes for any woo. If you say there is a magic force, show it. Other than that, vitalism is dead and forgive me if I say, good riddance.

        Now for the practitioners…..please consult your psychics.

  11. Gfunk20 says:

    I was with you 100% until I got to the Council on Naturopathic Medical Education, and realised that it could be abbreviated to CoNME.

  12. Anonymous says:

    First of all, the comment that follows is not necessarily aimed at naturopathy, but more at the question, “Do you think medical science is wrong?” Even among board-certified doctors, there is often much disagreement about medical science. You can always find two doctors that disagree with the science behind a given bodily condition or treatment. So, you might want to think twice about asking such a question because it is flawed when medical science doesn’t always agree with itself.

  13. Kris says:

    First of all, the comment that follows is not necessarily aimed at naturopathy, but more at the question, “Do you think medical science is wrong?” Even among board-certified doctors, there is often much disagreement about medical science. You can always find two doctors that disagree with the science behind a given bodily condition or treatment. So, you might want to think twice about asking such a question because it is flawed when medical science doesn’t always agree with itself.

    • Henk says:

      Naturopaths never argue science. Its a fact of life that naturopaths are ignorant of science!

      • Kris says:

        So you’ve talked to each and every one of them? Nice generalization.

        • Henk says:

          That is what is called a logical fallacy. This is the second that I reply to.

          Naturopaths practicing naturopathy discuss notions of force and energy that have never been measured yet they can detect them. This is scientifically unsupportable. It is not science. None of the “weapons” in the naturopaths arsenal are effective in any way except the wallet vacuum constant.

          To start on naturopathy being scientifically valid one has to remove all (useless) practice guff and examine their base claim. Is energy suported by an immune system? what energy? Why is it manipulated/how is it manipulated?

          Since the rise of naturopathy, this has never been adressed by naturopaths. The only support is minimal placebo hypothesis testing (I am a fair bit harsher on EB than Brian is). There is no scientific based medicine in this regard (wrt naturopathy) as there is no science or medicine.

          Naturopathy is in that regard the same as all vitalogy; acupuncture, homeopathy, chiropracty, and bullshido.

          Chiropracty has split into disparate groups denying or supporting subluxation “theory ” (I prefer garble). Those who support it are continuing scientific frauds and those who deny it are contining to practice a discarded philosophy (I prefer woospeak) and hence becoming knowing frauds.

          All four reach out amongst each other for ridiculous comparisons to quantum physics.

          Apparently witches now do as well if Monster talk ep 1# 2012 is to be believed.

          Whats worse is that pseudo science is practiced as a religion forcing notional luddism on its adherents, hypochondria amongst perfectly healthy people.

          There may not be a god in these notions (of which I am not entirely unconvinced) but there are certainly icons and beacons of “zealot stupidity”. I find it amasing that mattress sales persons can be elevated to practicing DN overnight in this country and nobody seems to notice,

          Our medical system here pays for these leeches on society

          Please do a bit of science. Please be a bit slower in not answering charge.

          • Henk says:

            and a truly magical quote to boot….

            “Vitalism—the insistence that there is some big, mysterious extra ingredient in all living things—turns out to have been not a deep insight but a failure of imagination.” –Daniel Dennett

        • Henk says:

          Errata! herbs are plants that may (or not) contain pharmacological compounds.

          Phytochemists are the sort of scientists that conduct research into herbs (and plants and possibly fungi.

          Adressing Kris’ question directly;

          “Do you think medical science is wrong?” Even among board-certified doctors, there is often much disagreement about medical science. You can always find two doctors that disagree with the science behind a given bodily condition or treatment.

          Medical science is nowhere near as complete nor elegant as we would like it to be. Doctors who practice medicine may indeed from time to time use very poor inputs from sources external to medicine (these quite often end up struck off or malpractice).

          Doctors carrying out research into scientific methodologies that may apply to them are called researchers. This gets published.

          If two doctors are arguing “medical science” they hopefully and very likely are arguing technique.

          Seeing the question was loaded in that light. Vitalogists arguing science is a misnomer in the phrase.

    • “Medical science is incomplete therefore homeopathy works” does not fly. Nor does it answer the question.

      • Kris says:

        If you remember my original comment, I said that it was not aimed at naturopathy (or homeopathy) specifically, but the validity of such an argument in general. Therefore, I did not say, “Medical science is incomplete therefore homeopathy works”. I do understand your argument as it relates to the topic at hand and even agree with it. I was merely preparing the person asking the question for a possible response.

    • Vincent Najger says:

      There will always be differences between personal opinions………that doesn’t invalidate the science though.

  14. Henk says:

    that altenrate medicine works is a personal subjective view. When it presents science it will be opinion.

    Sadly,far too many scientists beat them to the punch with new compounds from nature. The vitalists are stuck with their screwy ideas nable to move forward.

    The best study so far was one that Edzard Ernst carried out on st Johns wort. Sadly its wildly invalidated by drop out rates, general terms of efficacy and…its only a meta analysis of fairly disparate studies.

    Since 1937 that means…no successes

    • Vincent Najger says:

      I agree with you Henk…..”There will always be differences between personal opinions………that doesn’t invalidate the science though.”…. that comment was actually meant for Kris. I have no idea why it posted there.

      • Henk v says:

        The peak body for natural and cams is NCCAMs… Brian may be up on its current funding (after all Americans pay for it with their tax dollars.

        Clearly when perusing the monographs, there are cases for them to have to quote the current science. In every case they have to quote that there is no supporting science but they have studies current or completed or funded on these issues.

        Sadly, the completed studies seem to lose their out put when reviewing their studies findings.

        Its embarrassing enough to them that not a single natural remedy under their aeigis has never shown to be a valid modality but…the funded studies never being completed/submitted and reported on their pages is an indictment of all practitioners and researchers and modalities that contribute to CAMs.

        Stephen Novella is correct to refer to these as SCAMs. Not only correct but fully supported by science.

        Truly if scams had 100 valid therapies you’d call them a coven. But not to have one?????

        SCAMs, throw your degrees away, go back and use it as a cred towards a biology technicians cert/Dip and go into the lab and remember the glory days when verifiable was a non applicable term.

        How much can an honest days work for an honest day’s pay cost when you are doing real science in a team led by…a scientist?

  15. Henk v in the "bat cave" watching the niners v saints AGAIN! says:

    That science beats alternate methodologies makes perfect sense. If a remedy is shown to be valid using science then it becomes science. If its shown to be invalid its still science.

    If its guessed at and philosophised its called alternate research. Of the 100′s of journals that carry such research the results are still at placebo or uselessly close to it. This has resulted in a new rise of quack psychology called placebo medicine.

    Its the spectacular failure of people to actually look up studies and do the simple math that is galling.

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