Naturopathy: An Introduction

On this page:

• Key Points
• Background
• Use in the United States
• Underlying Principles
• Treatment
• Efficacy and Safety
• Practitioners
• If You Are Thinking About Using Naturopathy
• NCCAM-Funded Research in Naturopathy
• Selected References
• For More Information

Naturopathy—also called naturopathic medicine—is a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century. Guided by a philosophy that emphasizes the healing power of nature, naturopathic practitioners now use a variety of traditional and modern therapies. This fact sheet provides a general overview of naturopathyA whole medical system that originated in Europe. Naturopathy aims to support the body’s ability to heal itself through the use of dietary and lifestyle changes together with CAM therapies such as herbs, massage, and joint manipulation. and suggests sources for additional information.

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Key Points

• Although some of the individual therapies used in naturopathy have been studied for efficacy and safety, naturopathy as a general approach to health care has not been widely researched.
• “Natural” does not necessarily mean “safe.” Some therapies used in naturopathy, such as herbal supplements and restrictive or unconventional diets, have the potential to be harmful if not used under the direction of a well-trained practitioner.
• Some beliefs and approaches of naturopathic practitioners are not consistent with conventional medicineMedicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals such as physical therapists, psychologists, and registered nurses., and their safety may not be supported by scientific evidence. For example, some practitioners may not recommend childhood vaccinations. The benefits of vaccination in preventing illness and death have been repeatedly proven and greatly outweigh the risks.
• Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

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Background

Naturopathy has its roots in Germany. It was further developed in the late 19th and early 20th centuries in the United States.

The word naturopathy comes from Greek and Latin and literally translates as “nature disease.” A central belief in naturopathy is that nature has a healing power (a principle practitioners call vis medicatrix naturae). Practitioners view their role as supporting the body’s ability to maintain and restore health, and prefer to use treatment approaches they consider to be the most natural and least invasive.

Today, naturopathy is practiced in a number of countries, including the United States, Canada, Germany, Great Britain, Australia, and New Zealand.

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Use in the United States

According to the 2007 National Health Interview Survey, which included a comprehensive survey of the use of complementary health practices by Americans, an estimated 729,000 adults and 237,000 children had used a naturopathic treatment in the previous year.

People visit naturopathic practitioners for various health-related purposes, including primary care, overall well-being, and complementary treatment (used in addition to conventional medical treatment) of chronic illnesses as well as acute conditions such as colds and flu. Many practitioners also provide complementary health care for patients with serious illnesses.

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Underlying Principles

The practice of naturopathy is based on principles that are similar to and consistent with the principles of primary care medicine as practiced by conventional physicians. These include:

• First do no harm. Try to minimize harmful side effects and avoid suppression of symptoms.
• Physician as teacher. Educate patients and encourage them to take responsibility for their own health.
• Treat the whole person. Consider all factors (e.g., physical, mental, emotional, spiritual, genetic, environmental, social) when tailoring treatment to each patient.
• Prevention. Assess risk factors and, in partnership with patients, make appropriate interventions to prevent illness.
• Healing power of nature. Seek to identify and remove obstacles to the body’s natural processes for maintaining and restoring health.
• Treat the cause. Focus on the causes of a disease or condition, rather than its symptoms.

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Treatment

Naturopathic practitioners use many different treatment modalities. Examples include:

• Nutrition counseling, including dietary changes (such as eating more whole and unprocessed foods) and use of vitamins, minerals, and other supplements
• Herbal medicines
• Homeopathy
• Hydrotherapy
• Physical medicine, such as therapeutic massagePressing, rubbing, and moving muscles and other soft tissues of the body, primarily by using the hands and fingers. The aim is to increase the flow of blood and oxygen to the massaged area. and joint manipulation
• Exercise therapy
• Lifestyle counseling.

Some practitioners use other treatments as well or, if appropriate, may refer patients to conventional health care providers.

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Efficacy and Safety

Some of the individual therapies used in naturopathy have been researched for their efficacy, with varying results. The complex treatment approaches that naturopathic physicians often use are challenging to study, and little scientific evidence is currently available on overall effectiveness. Related research is under way but is in the early stages.

Some studies have shown a few areas of scientific interest to pursue. For example, a study of warehouse employees with chronic low-back pain found that naturopathic care was a more cost-effective approach than standard physiotherapy advice. In another study, postal employees with chronic low-back pain had significantly greater improvement from naturopathic care than from standard physiotherapy advice. Researchers have also found evidence that naturopathic treatment may help improve quality of life in multiple sclerosis patients. A study of treatment approaches for patients with temporomandibular (jaw) disorders found that two complementary health practices—naturopathic medicine and traditional Chinese medicine—both resulted in greater pain reduction than state-of-the-art conventional care.

In assessing the safety of naturopathic care, points to consider include:

• Naturopathy is not a complete substitute for conventional care. Relying exclusively on naturopathic treatments and avoiding conventional medical care may be harmful or, in some circumstances (for example, a severe injury or an infection), have serious health consequences.
• Some beliefs and approaches of naturopathic practitioners are not consistent with conventional medicine, and their safety may not be supported by scientific evidence. For example, some practitioners may not recommend childhood vaccinations that are standard practice in conventional medicine (although a survey of naturopathic physicians in one state found that some provided childhood immunizations).
• Some therapies used in naturopathy have the potential to be harmful if not used under the direction of a well-trained practitioner. For example, herbs can cause side effects on their own and may interact with prescription or over-the-counter medicines or other herbs, and restrictive or other unconventional diets can be unsafe for some people.

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Practitioners

In the United States, naturopathy has three general categories of practitioners: naturopathic physicians, traditional naturopaths, and other health care providers who also offer naturopathic services. The titles used by practitioners may vary (for example, both naturopathic physicians and traditional naturopaths sometimes refer to themselves as “naturopathic doctors” or by the abbreviation N.D. or N.M.D.). As of 2000, an estimated 1,500 naturopathic physicians were practicing in the United States; that estimate nearly doubled by 2006. As of 2001, an estimated 3,600 traditional naturopaths were practicing in the United States.

Naturopathic physicians generally complete a 4-year, graduate-level program at one of the North American naturopathic medical schools accredited by the Council on Naturopathic Medical Education, an organization recognized for accreditation purposes by the U.S. Department of Education. Admission requirements generally include a bachelor’s degree and standard premedical courses. The study program includes basic sciences, naturopathic therapies and techniques, diagnostic techniques and tests, specialty courses, clinical sciences, and clinical training. Graduates receive the degree of N.D. (Naturopathic Doctor) or N.M.D. (Naturopathic Medical Doctor), depending on where the degree is issued. Although postdoctoral (residency) training is not required, some graduates pursue residency opportunities.

Some U.S. states and territories have licensing requirements for naturopathic physicians, but others do not. In those jurisdictions that have licensing requirements, naturopathic physicians must graduate from a 4-year naturopathic medical college and pass an examination to receive a license.¹ They must also fulfill annual continuing education requirements. Their scope of practice is defined by law in the state in which they practice (for example, depending on the state, naturopathic physicians may or may not be allowed to prescribe drugs, perform minor surgery, practice acupunctureA family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health., and/or assist in childbirth).

Traditional naturopaths, also known simply as “naturopaths,” emphasize naturopathic approaches to a healthy lifestyle, strengthening and cleansing the body, and noninvasive treatments. They do not use prescription drugs, injections, x-rays, or surgery. Several schools offer training for people who want to become naturopaths, often through distance learning (correspondence or Internet courses). Admission requirements for schools can range from none, to a high school diploma, to specific degrees and coursework. Programs vary in length and content and are not accredited by organizations recognized for accreditation purposes by the U.S. Department of Education. Traditional naturopaths are not subject to licensing.

Other health care providers (such as physicians, osteopathic physicians, chiropractors, dentists, and nurses) sometimes offer naturopathic treatments and other holistic therapies, having pursued additional training in these areas. Training programs vary.

¹ In states that license naturopathic physicians, that title as well as “naturopathic doctor” or even “naturopath” may be protected by law for practitioners who have completed a 4-year naturopathic medical school program.

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If You Are Thinking About Using Naturopathy

Keep in mind the following points:

• Naturopathy practitioners’ qualifications may vary widely. Find out about the practitioner’s education and training. Ask whether the practitioner is licensed by the state, and about any other documented qualifications.
• Tell the practitioner about any medical conditions you have. Ask whether the practitioner has any specialized training and experience in them.
• Ask about the practitioner’s referral network and make sure the practitioner has experience coordinating care with other types of medical providers.
• Ask the practitioner about typical out-of-pocket costs and insurance coverage (if any).
• Tell the practitioner about all medications (prescription or over-the-counter) and dietary supplements you are taking. Naturopathic practitioners may use herbal remedies, or may be licensed to prescribe certain drugs. Avoiding potential interactions is important.
• Tell all of your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary and alternative medicineA group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine., see NCCAM’s Time to Talk campaign.

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NCCAM-Funded Research in Naturopathy

Some recent NCCAM-supported projects have been studying:

• A naturopathic dietary approach for type 2 diabetes
• Naturopathic treatments for periodontal (gum) disease
• Naturopathic herbal and dietary approaches for breast cancer prevention.

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Selected References

• Albert DP, Martinez D. The supply of naturopathic physicians in the United States and Canada continues to increase. Complementary Health Practice Review. 2006;11:120–122.
• Baer HA. The sociopolitical status of U.S. naturopathy at the dawn of the 21st century. Medical Anthropology Quarterly. 2001;15(3):329–346.
• Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 2007. CDC National Health Statistics Report #12. 2008.
• Boon HS, Cherkin DC, Erro J, et al. Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two U.S. states. BMC Complementary and Alternative Medicine. 2004;4:14.
• Dunne N, Benda W, Kim L, et al. Naturopathic medicine: what can patients expect? Journal of Family Practice. 2005;54(12):1067–1072.
• Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of Internal Medicine. 2002;137(12):965–973.
• Herman PM, Szczurko O, Cooley K, et al. Cost-effectiveness of naturopathic care for chronic low back pain. Alternative Therapies in Health and Medicine. 2008;14(2):32–39.
• Hough HJ, Dower C, O’Neil EH. Profile of a Profession: Naturopathic Practice. The Center for the Health Professions, University of California, San Francisco Web site. 2001. Accessed at www.futurehealth.ucsf.edu/Content/29/2001-09_Profile_of_a_Profession_Naturopathic_Practice.pdf (320KB PDF) on April 23, 2009.
• Myers T. Introduction to Naturopathic and Classical Chinese Medicine. National College of Natural Medicine Web site. 2005. Accessed at www.ncnm.edu/about/BriefHxNDCCM.pdf (215KB PDF) on April 23, 2009.
• Parkman CA. Issues in credentialing CAM providers. Case Manager. 2004;15(4):24–27.
• Ritenbaugh C, Hammerschlag R, Calabrese C, et al. A pilot whole systems clinical trial of traditional Chinese medicine and naturopathic medicine for the treatment of temporomandibular disorders. Journal of Alternative and Complementary Medicine. 2008;14(5):475–487.
• Shankar K, Liao LP. Traditional systems of medicine. Physical Medicine and Rehabilitation Clinics of North America. 2004;15(4):725–747.
• Shinto L, Calabrese C, Morris C, et al. A randomized pilot study of naturopathic medicine in multiple sclerosis. Journal of Alternative and Complementary Medicine. 2008;14(5):489–496.
• Smith MJ, Logan AC. Naturopathy. Medical Clinics of North America. 2002;86(1):173–184.
• Standish LJ, Calabrese C, Snider P. The naturopathic medical research agenda: the future and foundation of naturopathic medical science. Journal of Alternative and Complementary Medicine. 2006;12(3):341–345.
• Szczurko O, Cooley K, Busse JW, et al. Naturopathic care for chronic low back pain: a randomized trial. PLoS One. 2007;2(9):e919.
• U.S. Department of Labor. Dictionary of Occupational Titles (4th Ed., Rev. 1991). 079.101-014, Doctor, Naturopathic. U.S. Department of Labor Web site. Accessed at www.oalj.Dol.Gov/PUBLIC/DOT/REFERENCES/DOT01B.HTM on April 23, 2009.
• Weber W, Taylor JA, McCarty RL, et al. Frequency and characteristics of pediatric and adolescent visits in naturopathic medical practice. Pediatrics. 2007;120(1):e142–e146.

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