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does naturopathy offer a lifeline for our burned-out health system?

in a time when many canadians don't have access to a medical doctor, naturopathic doctors can help fill the void and ensure that the cycle of care remains intact.

by robin roberts

jan 10 2023

6 minute read

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most canadians aren't open with their docs about supplements

the canadian association of naturopathic doctors (cand) describes naturopathic medicine as a blend of modern scientific knowledge and traditional and natural forms of medicine. getty

when ron downie’s sister, carrie, was undergoing treatment for blood cancer, he felt he was in a unique position to help. as manager of a vitamin and supplement store in abbotsford, b.c., he had several customers, also grappling with cancer, who told him they were thriving on a type of mushroom used in traditional chinese medicine called turkey tail ( coriolus versicolor ). he suggested carrie try the funny sounding fungus, which is said to be packed with antioxidants that enhance the immune system. after several weeks, he says, her blood work was so good that even her doctors were “blown away.”

natural remedies are on the rise

downie, who says he had little experience with health supplements before entering the field, learned fast, not only for his sister’s benefit, but for his customers’.

“on my third shift, a person came in dealing with the after-effects of kidney dialysis,” he says. “another was dealing with after-effects of chemotherapy, and another was just diagnosed with cancer. it hit me that this is more than just selling people protein shakes. i needed to take this seriously because there are serious people with serious problems coming in the door.”

more people seeking supplemental support

according to a study conducted in 2016 by the think tank fraser institute, more than three-quarters (79 per cent) of canadians had used at least one alternative therapy over the course of their lives. a 2015 canadian community health survey showed 38 per cent of men and 53 per cent of women overall used vitamin and mineral supplements. and a previous u.s. study reported that those rates among cancer patients shot up as high as 81 per cent. all the more reason that any advice and recommendations come from a licensed and regulated health-care professional, such as a naturopathic doctor (nd).

what is naturopathic medicine?

the canadian association of naturopathic doctors (cand) describes naturopathic medicine as a blend of modern scientific knowledge and traditional and natural forms of medicine and encompasses everything from acupuncture, traditional chinese medicine, hydrotherapy, homeopathy, botanical medicine and clinical nutrition.

“if someone is undergoing conventional cancer treatment, we’re there to support them by helping improve their quality-of-life symptoms,” says dr. mark fontes, naturopathic doctor at insight naturopathic clinic in toronto and chair of cand. “[that includes] improving sleep and appetite, reducing muscle pain [through] dietary interventions, herbal medicine, targeted supplements, minerals and vitamins. “we’re highly trained in managing chronic disease, from inflammatory bowel disease, to lyme disease, chronic pain, digestive and hormonal concerns.”

fontes says naturopathic doctors work collaboratively with major hospitals, family doctors and oncologists to offer supportive care before, during and after conventional medical treatment.

“it’s about individualized care,” says fontes. “we might see five patients with an acute viral infection or migraine, and they’re not all going to leave with the same plan, depending on their current health status and medical history.”

patients not always forthcoming about supplement use

fontes says there are nearly 3,000 naturopathic doctors practising across canada — a number that’s growing. and since millions of canadians are without a primary care physician, he says nds can help bridge the gap.

“we help identify any concerning symptoms,” says fontes. “we can assess and triage, [and determine if] a person needs further medical care beyond what we provide. we can also order blood work. we are well-trained professionals who are regulated and have evidence to inform our decisions. we ensure, first and foremost, that everything we prescribe and recommend is safe in combination with any medication to ensure there’s no interaction.”

but ensuring no interaction is no easy feat if medical doctors are unaware of what vitamins and supplements their patients are taking alongside their pharmaceutical prescriptions. in 2020, mcmaster university’s faculty of health sciences released results of a survey that found 99 per cent of respondents used natural health products, and 46 per cent were using them together with prescription medications. of those using the natural health products, 42 per cent did not tell their doctors.

“the three most common reasons patients don’t disclose their use of these products was, one, that their doctor will view it negatively; two, that physicians don’t deal in this area so they don’t understand what the indications or uses are; and three, it wasn’t relevant, that these are natural products and natural products can’t be harmful,” says dr. jason busse, researcher and associate professor at mcmaster, and senior author of the survey.

st. john’s wort, ginkgo biloba two examples of supplements with serious interactions

but these products can indeed be harmful, in some cases seriously, if used in conjunction with some prescription medications. as examples, busse points to st. john’s wort, a common herbal supplement used to treat symptoms of depression. taken alongside cardiovascular medications such as digoxin, he says, can increase the risk of stroke or heart attack.

“there’s also evidence to suggest that st. john’s wort might decrease the effectiveness of antidepressant medication because the two can be processed through similar metabolic pathways,” he says.

busse also cites ginkgo biloba, a popular supplement that claims to reduce inflammation and boost brain function. but used jointly with non-steroidal anti-inflammatory drugs, it can increase risk of bleeding. another example is evening primrose oil — sold as a treatment for symptoms of eczema, pms or diabetic neuropathy — which can cause seizures if taken with certain antipsychotic medications.

regulations for natural products different from medications

fontes says nds work with professional grade companies that provide the research behind their products.

“every natural health product (nhp) on the market is approved by health canada through the natural and non-prescription health products directorate (nnhpd),” he says. “we consult with them; we have full trust in that process.

it’s different than prescription medications, says busse, which have rigorous studies behind them.

“there may be harms associated with taking prescription medications but studies will hopefully give reassurances that the overall benefit exceeds the harm,” he says, adding that there are also strict quality control standards for what has to be in those products which is governed by good manufacturing practice . “natural health products don’t have to prove any of the benefits that are ascribed, they simply have to prove they’re not overtly harmful.” (health canada also regulates natural health products and their labelling, which is more rigorous than that of the u.s., says fontes.)

as for better communication between doctor and patient about supplement use, busse says that their study showed one of the greatest predictors of whether or not a patient was willing to disclose their use of natural health products to be whether their physician asked about it.

“if we can encourage physicians to ask [these questions] then i think rates of disclosure will go up dramatically,” he says.

fontes agrees. “especially in the supportive cancer care world, a large percentage of patients are taking some form of vitamin or mineral supplement, and a large portion of those patients are not telling their medical doctors and oncologists. we need to bridge that gap so everyone is on the same page and moving toward the same goal, which is better patient care and outcome.”

as for carrie’s use of turkey tail, her blood work today is not as good as it was six months ago, despite consistency with her diet and exercise. and while downie acknowledges that he has heard from countless people about the benefits they have experienced taking the supplement, he also believes that it’s not the only thing that makes positive change happen. also playing a role is the combination of different lifestyle and diet choices, as well as the fact that no one person experiences recovery the same way.

“it’s important that people understand that every person is different and will get different results,” he says.

robin roberts is a vancouver-based writer.

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robin roberts

does naturopathy offer a lifeline for our burned-out health system?