practice for the individual naturopathic physician (e.g., broken bones, traumatic injuries requiring surgery).
The difficulty many naturopathic physicians experience in attempting to interact with conventional medical doctors stems from misconceptions the medical doctor may
have about naturopathic medicine or from fraudulent naturopathic practitioners. These issues are usually displaced when conventional medical doctors interact with a
well-trained modern naturopathic physician.
PROSPECTS FOR THE FUTURE
To some, naturopathic medicine, as well as the entire concept of natural medicine, appears to be a fad that will soon pass away. However, naturopathic physicians
believe they are at the forefront of a better health care system.
One of the myths about naturopathic medicine is that there is no firm scientific evidence for the use of the natural therapies. However, numerous research studies and
observations have not only backed the validity of diet, nutritional supplements, herbal medicines, detoxification, and physical medicine, but also have lent some
support to more esoteric natural healing treatments,
such as acupuncture, biofeedback, meditation, and homeopathy. In some cases, the scientific investigation has
not only validated the natural measure, but also led to greater understanding of the pathophysiology and healing processes of the practices. In the past 30 years,
there have been advances in understanding about how many natural therapies and compounds work to promote health or treat disease. Research has not lent
support to all naturopathic practices. For example, recent studies on the effect of several naturopathic on the progress of HIV disease have shown no benefit from
such practices. Undoubtedly, other established naturopathic practices will be shown to be ineffective or possibly even harmful as more and better research is
conducted. The naturopathic organizations are committed to conducting those studies and improving naturopathic practices as resources for such research become
available.
Scientific tools exist to assess and evaluate the fundamental principles and therapies of naturopathic medicine. It is becoming more common for conventional
medicine to adopt and endorse a number of age-old naturopathic techniques, such as lifestyle modification, stress reduction, exercise, consuming a whole foods diet,
supplemental nutrients, toxin reduction, and others.
There is a paradigm shift occurring in medicine. What was once scoffed at is now becoming generally accepted as effective. In many cases of common illnesses, the
naturopathic alternative offers significant benefit over standard medical practices. In the future, it is likely that many of the concepts, philosophies, and practices of
naturopathy will be demonstrated.
The naturopathic profession is growing rapidly. The therapeutic and diagnostic skills of practitioners are becoming more sophisticated; licensing is being established
in new states; and public interest is strong. Key to the profession's future is becoming an integral part of the health care system.
C
HAPTER
R
EFERENCES
1.
Cody G. History of naturopathic medicine. In: Pizzorno JE,
Murray MT, eds. A textbook of natural medicine. Seattle, WA: Bastyr University Publications, 1998.
2.
Pizzorno JE, Murray MT, eds. A textbook of natural medicine. Seattle, WA: Bastyr College Publications, 1998.
3.
Dingle JT. The effect of NSAIDs on human articular cartilage glycosaminoglycan synthesis. Eur J Rheumatol Inflamm 1996;16:47–52.
4.
Brandt KD. Effects of nonsteroidal anti-inflammatory drugs on chondrocyte metabolism in vitro and in vivo. Am J Med 1987;83(suppl.5A):29–34.
5.
Shield MJ. Anti-inflammatory drugs and their effects on cartilage synthesis and renal function. Eur J Rheumatol Inflamm 1993;13:7–16.
6.
Brooks PM, Potter SR, Buchanan WW. NSAID and osteoarthritis—help or hindrance. J Rheumatol 1982;9:3–5.
7.
Newman NM, Ling RSM. Acetabular bone destruction related to non-steroidal anti-inflammatory drugs. Lancet 1985;2:11–13.
8.
Noack W, Fischer M, Forster KK, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage 1994;2:51–9.
9.
Vaz AL. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulfate in the management of osteoarthrosis of the knee in out-patients. Curr Med Res Opin
1982;8:145–9.
10.
Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure. Am Heart J 1996;131:1248–1250.
11.
Goa KL, Brogden RN. L-carnitine—a preliminary review of its pharmacokinetics, and its therapeutic use in ischemic cardiac disease and primary and secondary carnitine deficiencies in
relationship to its role in fatty acid metabolism. Drugs 1987;34:1–24.
12.
Mancini M, Rengo F, Lingetti M, et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneim Forsch 1992;42:1101–1104.
13.
Pucciarelli G. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure. Clin Ter 1992;141:379–384.
14.
Hofman-Bang C, Rehnquist N, Swedberg K. Coenzyme Q10 as an adjunctive treatment of congestive heart failure. J Am Coll Cardiol 1992;19:216A.
15.
Morisco C, Trimarco B, Condorelli M. Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig
1993;71(Suppl.8):S134–136.
16.
Baggio E, Gandini R, Plancher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol
Aspects Med 1994;15(Suppl.):S287–294.
17.
Pelletier KR. A review and analysis of the health and cost-effective outcome of comprehensive health promotion and disease promotion at the worksite: 1991–1993 update. Am J Health
Promotion 1993;8:50–61.
18.
Mansfield LE, Vaughan TR, Waller ST, et al. Food allergy and adult migraine: double- blind and mediator confirmation of an allergic etiology. Ann Allergy 1985;55:126–129.
19.
Carter CM, Egger J, Soothill JF. A dietary management of severe childhood migraine. Hum Nutr: Appl Nutr 1985;39A:294–303.
20.
Hughes EC, Gott PS, Weinstein RC, Binggeli R. Migraine: a diagnostic test for etiology of food sensitivity by a nutritionally supported fast and confirmed by long-term report. Ann Allergy
1985;55:28–32.
21.
Egger J, Carter CM, Wilson J, et al. Is migraine food allergy? Lancet 1983;2:865–869.
22.
Monro J, Brostoff J, Carini C, Zilkha K. Food allergy in migraine. Lancet 1980;2:1–4.
23.
Grant ECG. Food allergies and migraine. Lancet 1979;1:966–969.
24.
Mazzotta G, et al. Electromyographical ischemic test and intracellular and extracellular magnesium concentration in migraine and tension-type headache patients. Headache 1996;36:357–361.
25.
Swanson DR. Migraine and magnesium: eleven neglected connections. Perspect Biol Med 1988;31:526–557.
26.
Ramadan NM, Halvorson H, Vande-Linde A, et al. Low brain magnesium in migraine. Headache 1989;29:590–593.
27.
Gallai V, Sarchielli P, Morucci P, et al. Magnesium content of mononuclear blood cells in migraine patients. Headache 1994;34:160–165.
28.
Pfaffenrath V, Wessely P, Meyer C, et al. Magnesium in the prophylaxis of migraine—a double-blind placebo-controlled study. Cephalalgia 1996;16:436–440.
29.
Peikert A, Wilimzig C,
Kohne-Volland R, et al. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study.
Cephalalgia 1996;16:257–263.
30.
Galland LD, Baker SM, McLellan RK. Magnesium deficiency in the pathogenesis of mitral valve prolapse. Magnesium 1986;5:165–174.
31.
Johnson ES, Kadam NP, Hylands DM, et al. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J 1985;291:569–573.
32.
Murphy JJ, Heptinstall S, Mitchell JRA. Ran-domized double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 1988;2:189–192.
33.
Barsby RWJ, Salan U, Knight BW, Hoult JRS. Feverfew and vascular smooth muscle: extracts from fresh and dried plants show opposing pharmacological profiles, dependent upon
sesquiterpene lactone content. Planta Medica 1993;59:20–25.
34.
Heptinstall S, Awang DV, Dawson BA, et al. Parthenolide content and bioactivity of feverfew (
Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew
products. J Pharm Pharmacol 1992;44:391–395.
35.
Bush IM. Zinc and the prostate. Presented at the annual meeting of the AMA, 1974.
36.
Fahim M, Fahim Z, Der R, Harman J. Zinc treatment for the reduction of hyperplasia of the prostate. Fed Proc 1976;35:361.
37.
Leake A, Chrisholm GD, Busuttil A, Habib FK. Subcellular distribution of zinc in the benign and malignant human prostate: evidence for a direct zinc androgen interaction. Acta Endocrinol
1984;105:281–288.
38.
Zaichick VY, Sviridova TV, Zaickick SV, et al. Zinc concentration in human prostatic fluid: normal, chronic prostatitis, adenoma and cancer. Int Urol Nephrol 1996;28:687–694.
39.
Leake A, Chisholm GD, Habib FK. The effect of zinc on the 5-alpha-reduction of testosterone by the hyperplastic human prostate gland. J Steroid Biochem 1984;20:651–655.
40.
Wallae AM, Grant JK. Effect of zinc on androgen metabolism in the human hyperplastic prostate. Biochem Soc Trans 1975;3:540–542.
41.
Judd AM, MacLeod RM, Login IS. Zinc acutely, selectively and reversibly inhibits pituitary prolactin secretion. Brain Res 1984;294:190–192.
42.
Hart JP, Cooper WL. Vitamin F in the treatment of prostatic hyperplasia. Report Number 1, Lee Foundation for Nutritional Research, Milwaukee, WI, 1941.
43.
Scott WW. The lipids of the prostatic fluid, seminal plasma and enlarged prostate gland of man. J Urol 1945;53:712–718.
44.
Boyd EM, Berry NE. Prostatic hypertrophy as part of a generalized metabolic disease. Evidence of the presence of a lipopenia. J Urol 1939;41:406–411.
45.
Chyou PH, Nomura AM, Stemmermann GN, et al.
A prospective study of alcohol, diet, and other lifestyle factors in relation to obstructive uropathy. Prostate 1993;22:253–264.
46.
Berges RR, Windeler H, Trampisch HJ, et al. Randomized, placebo-controlled, double-blind clinical trial of beta- sitosterol in patients with benign prostatic hyperplasia. Lancet
1995;345:1529–1532.
47.
Morton MS, Griffiths K, Blacklock N. The preventive role of diet in prostatic disease. Br J Urol 1996;77:481–493.
48.
Boccafoschi S, Annoscia S. Comparison of
Serenoa repens extract with placebo by controlled clinical trial in patients with prostatic adenomatosis. Urologia 1983;50:1257–1268.
49.
Cirillo-Marucco E, Pagliarulo A, Tritto G, et al. Extract of
Serenoa repens (Permixon
R
) in the early treatment of prostatic hypertrophy. Urologia 1983;5:1269–1277.
50.
Tripodi V, Giancaspro M, Pascarella M, et al. Treatment of prostatic hypertrophy with
Serenoa repens extract. Med Praxis 1983;4:41–46.
51.
Champlault G, Patel JC, Bonnard AM. A double-blind trial of an extract of the plant
Serenoa repens in benign prostatic hyperplasia. Br J Clin Pharmacol 1984;18:461–462.
52.
Mattei FM, Capone M, Acconcia A.
Serenoa repens extract in the medical treatment of benign prostatic hypertrophy. Urologia 1988;55:547–552.
53.
Braeckman J. The extract of
Serenoa repens in the treatment of benign prostatic hyperplasia: a multi-center open study. Curr Ther Res 1994;55:776–785.
54.
Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS89. Phytomed 1996;3:105–111.
55.
Gottlieb SS, Baruch L, Kukin ML, et al. Prognostic importance of serum magnesium concentration in patients with congestive heart failure. J Am Coll Cardiol 1990;16:827–831.
56.
Gottlieb SS. Importance of magnesium in congestive heart failure. Am J Cardiol 1989;63:39G–42G.
57.
Chen MF, Chen LT, Gold M, et al. Plasma and erythrocyte thiamin concentration in geriatric outpatients. J Am Coll Nutr 1996;15:231–236.
58.
Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure. Am Heart J 1996;131:1248–1250.
59.
Goa KL, Brogden RN. L-carnitine—a preliminary review of its pharmacokinetics, and its therapeutic use in ischemic cardiac disease and primary and secondary carnitine deficiencies in
relationship to its role in fatty acid metabolism. Drugs 1987;34:1–24.
60.
Mancini M, Rengo F, Lingetti M, et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneim Forsch 1992;42:1101–1104.
61.
Pucciarelli G, Masturi M, Latte S, et al. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure. Clin Ter 1992;141:379–384.
62.
Ishiyama T, Morita Y, Toyama S, et al. A clinical study of the effect of coenzyme Q on congestive heart failure. Jpn Heart J 1976;17:32.
63.
Hofman-Bang C, Rehnquist N, Swedberg K. Coenzyme Q
10
as an adjunctive treatment of congestive heart failure. J Am Coll Cardiol 1992;19:216A.
64.
O'Conolly VM, Jansen W, Bernhoft G, et al. Treatment of cardiac performance (NYHA stages I to II) in advanced age with standardized crataegus extract. Fortschr Med 1986;104:805–808.
65.
Leuchtgens H. Crataegus Special Extract WS 1442 in NYHA II heart failure. A placebo controlled randomized double-blind study. Fortschr Med 1993;111:352–354.
66.
Schmidt U, Kuhn U, Ploch M, et al. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed
1994;1:17–24.
67.
American Western Life Insurance.
San Francisco, CA, 1994.
68.
Oojendijk WT, Mackenback JP, Limberger HHB. What is better? An investigation into the use and satisfaction with complementary and official medicine in the Netherlands. Netherlands
Institute of Preventive Medicine and Technical Industrial
Organization, 1980.
69.
Bergner P. Safety, effectiveness, and cost effectiveness in naturopathic medicine. Seattle, WA: American Association of Naturopathic Physicians, 1991.