Naturopathy, defined as a system of alternative medicine based on the theory that disease can be successfully treated or prevented without the use of drugs, is a topic that generates polarising opinions. And every so often a naturopath will make headlines for all the wrong reasons.
This was the case in Sydney in 2018 when naturopath Marilyn Bodnar was sentenced to 14 months jail after a baby with eczema under her care almost died of starvation. Bodnar had advised the baby’s mother, who was exclusively breastfeeding, to go on a raw food diet to rid her body of toxins. When the baby became seriously ill with fever, instead of advising the mother to seek urgent medical attention, Bodnar told the mother to go on a fast and to give the child goat’s milk, which he repeatedly threw up.
Bodnar’s case is not an isolated incident. Babies have died from bacterial meningitis after naturopaths have treated them with echinacea, and teenagers have died from only taking herbs for their asthma.
In sentencing Bodnar, Downing Centre District Court Judge Peter Berman said, “Well-intentioned but seriously misguided advice is …. capable of causing great harm and even death”.
Former naturopath, and author of the blog Naturopathic Diaries, Britt Hermes, says that a danger of naturopathy is that during their training, naturopaths are “tricked” into thinking that they are competent primary care practitioners. “As long as the naturopathic profession continues to assert that naturopaths are trained ‘just like medical doctors’ we are going to have issues,” she writes.
In 2019 the Federal Government banned private health insurers from offering a rebate for naturopathy consultations, using the justification that the modality was deemed to be lacking in adequate scientific evidence.
This move was welcomed by Professor Alastair MacLennan, who is a founding member of the Friends of Science in Medicine. He is a passionate advocate for the need for evidence-based medicine.
“Alternative medicine just means medicine that has not been proven. If it was proven, it would be considered genuine, conventional medicine,” MacLennan said. “Almost all alternative medicines, or practices like acupuncture or chiropractic or naturopathy, rely on something magical that they are doing. But it doesn’t work.”
While some alternative therapies may seem to work initially, this temporary improvement may often be due to the well-known phenomenon of the “placebo effect”.
“There are four main harms of so-called ‘harmless’ therapies,” Professor MacLennan, who was appointed an Officer of the Order of Australia in 2011, said. “One is, they delay you trying to find effective therapy. Two, they are often very expensive. The third is that some of them have side-effects. And finally, there is the disillusionment that leads to depression that occurs when a placebo wears off and hasn’t done what you’d hoped it would do.”
Despite the largely unproven and unregulated nature of alternative therapies, millions of people are still drawn to them. The Royal Australian College of General Practitioners estimates that two thirds of Australians have used complementary and alternative medicine (CAM) at some stage, spending more than $4 billion annually on treatments that have little or no clinical evidence to back them up.
“The alternative therapies industry targets conditions that the medical profession can’t really cure,” MacLennan said.
It is hard to argue that the traditional medical system is without fault. Funding shortages, long hours, bureaucracy and clinician burnout mean the cliché of the uncaring doctor shoving a prescription at a patient, without properly listening to their concerns, can often be true. And almost all alternative practitioners have many cases of patients who have come to them as a last resort after the traditional medical system has failed them.
Claire Dunkley is a nurse consultant who specialises in amino neuro frequency therapy – an alternative treatment using frequency-emitting discs that claims to reduce pain and inflammation in the body by modulating the nervous system. She believes that society’s health issues are negatively influenced by the overwhelming focus on pharmaceutical or surgical modalities, rather than identifying and treating the root cause of the health issue.
“Traditional medicine has its place in acute, traumatic events, but when it comes to chronic disease management, you can’t expect people to get better with only pharmaceuticals,” she said. “The difference between what we [alternative therapists] do, is that we believe that no one person is the same, that no one person has the same ailment for the same reason.”
Dunkley would like to see conventional and alternative medicine working together more to offer the patient a more holistic health approach. “Most of my clients see a gamut of health professionals, so we’re all complementing each other, none of us are better than the other, we all should work together,” she said.
However, many conventional medical practitioners would argue that they already work closely with a range of allied health care professionals including physiotherapists, dietitians and psychologists.
“When you’re dealing with chronic diseases, you need to have a multidisciplinary team working in a holistic way to co-ordinate patient care,” says Melbourne-based general practitioner, and founder of Pop Up GP, Dr Deepak Gaur. “I used to do a lot of work in chronic fatigue syndrome and you’ve got to look at the patient as an individual to understand the condition.”
Gaur says it is very common for patients to use alternative therapies, and he believes honesty is key. “As part of this conversation it is very valuable to understand the level of evidence that is associated with a treatment choice,” he said. “The gold standard is the double blind, randomised controlled trial.”
Acute illnesses and trauma are one thing. But is there a role for the alternative practitioner who may be able to offer more time and empathy for people with chronic conditions?
MacLennan believes the answer is no. “I’ve absolutely nothing against massage, relaxation, and good advice about diet and exercise. That’s all common sense. But you don’t need an alternative practitioner for that.”
Nicky Wood, a naturopath based in Tweed Heads with more than 25 years’ experience, adamantly disagrees. She says that naturopathy can play an integral role in supporting someone’s health and wellness goals.
“One of the first things I do when I’m seeing a patient is to remind them that I’m not there to diagnose conditions,” Wood said. “I often say to my patients, ‘I’m a wellness concierge’.”
The most common conditions Wood’s patients are suffering from include digestive conditions, dermatological conditions, chronic fatigue and chronic pain. “I’ll go in and start looking at what we need to do to help,” Wood said. “I see my role as helping move that stalled process forward.”
Wood believes botanical medicine is a value-added way to treat ailments. “We’re able to support general nutrition at a trace minerals and vitamins level,” she said. “It’s a multi-faceted approach.”
Wood says it’s exciting to see when science catches up to something that naturopaths have been doing for years. “We’ve got a lot of folktales and a lot of folklore hints and we’re now starting to see there’s a bit of science emerging behind that, and it’s being applied in laboratory tests,” she said.
Suzanne Wadsworth, 49, has been seeing Wood for the past six months to help manage her chronic lymphatic leukaemia. She claims that the dietary and lifestyle modifications, and the natural supplements that Wood has advised, have helped her to avoid commencing chemotherapy.
“I’m on a modified keto diet made up of leafy greens, vegetables, healthy fats, eggs and seafood and have removed stresses to my body by increasing meditation, rest, and swapping high intensity exercise with yoga, walking and swimming,” said Wadsworth, who lives on the Gold Coast, Queensland. “I also take a lot of supplements including Immunogenics, herbal tonic, Vitamin D, Vitamin C, Gtox, EnergX, NAC and Adaptan.”
Wadsworth credits Wood with helping her deal with emotional triggers that otherwise might send her on an alcohol or food binge.
“I feel like naturopathy addresses my wellness overall and I am learning how to manage my chronic condition,” Wadsworth said. “If the medical system recommends that I have chemo, and I cannot reverse my test results with diet and lifestyle alone, then I will have chemo. But if I can avoid chemo with my own lifestyle choices, I will be very happy.”
It is estimated that up to one quarter of prescription medicines are made from ingredients found from rainforests. And when it comes to a toss-up between a conventional prescription medicine, and a herbal remedy, a doctor speaking to me off-the-record recently said: “Alternative medicine is the medicine that is left over from conventional medicine, because it doesn’t work.”
There is perhaps some truth in that. But it still begs the question: How does a substance, or a treatment for that matter, become a conventional medicine?
“As soon as you set up a carefully controlled experiment, then you can assess some intervention or some herb as either effective or not effective,” medical scientist Professor Jonathan Stone, former executive director of the Bosch Institute, Australia’s leading medical research institute, said. “And if it passes the effectiveness test, it becomes part of the world of science.”
MacLennan has some important advice for those who may be wondering whether their treatment will give them benefit.
“What a lot of people don’t know is that there’s a little clue on the label of each bottle, where it says AUST L or AUST R with a number. The AUST means Australia, and the number is specific to that product. And the key letter is the L or the R. R means registered, or really has been proven to have efficacy and safety for the indication that’s on the label. And these are the ones that are quite legitimate to take. But most of the products are AUST L, and L means listed, but that just means the TGA is aware of them but they have no testing of their efficacy or safety,” he said.
Another tip for people who want to investigate whether their therapy has evidence-based merit is to search for it in the medical databases of the Cochrane Library. “Australia has free access to the Cochrane Library, and you can actually look up everything from appendicectomy to coenzyme Q10 and you can see what trials have been performed,” MacLennan said.
“Always be sceptical if an alternative practitioner has a financial interest in the product you’re being asked to take,” MacLennan said. “Don’t self-medicate. And don’t be gullible. These are some of the things you can do to make sure that what you’re taking is safe and effective.”
Everyone will have a most valuable asset in their life, and that is one’s own health. And it is common sense to maximise that asset through exercise, avoiding smoking, drinking and illicit drugs, maintaining a healthy body weight, and eating a healthy diet. But it is equally important to exercise due diligence when it comes to treatments for your body, whether they be pharmaceutical, “off-label”, surgical or lifestyle modifications. If a proposed treatment has minimal evidence behind it, maintain a healthy scepticism. After all, if something sounds too good to be true, there’s usually a reason why.
Suvi Mahonen is a Surfers Paradise-based journalist. Her work appears in The Australian, the Australian Quarterly, Mamamia and other health and lifestyle publications. Follow her on Facebook, YouTube and online art-selling platform Redbubble.
