17 avril 2021

Association américaine des naturopathes: Médecine naturelle. De vraies solutions.

[1]https://www.researchgate.net/publication/273634914_A_Hierarchy_of_Healing_The_Therapeutic_Order_A_Unifying_Theory
Retour au sommet.

FAQ n ° 20: Comment les docteurs en naturopathie aident-ils à résoudre les problèmes de fertilité et d'infertilité? Voir la version PDF imprimable.

L'AANP et l'INM tiennent à remercier Jaclyn Chasse, Dakota du Nord, pour sa contribution au contenu de cette FAQ.

Si vous et votre partenaire avez du mal à avoir un bébé, vous n'êtes pas seul. Aux États-Unis, un couple sur huit a des difficultés à tomber enceinte ou à rester enceinte. L'infertilité, définie comme une tentative de concevoir pendant un an (ou six mois après l'âge de 35 ans) sans succès, concerne les hommes et les femmes âgés de 15 à 44 ans. De nouvelles données suggèrent que l'infertilité est en augmentation.

Les problèmes de fertilité ont souvent des conséquences physiques, émotionnelles et financières sur un couple. Entre visites répétées chez des endocrinologues de la reproduction, médicaments sur ordonnance, injections d’hormones et laboratoires, essayer d’avoir un bébé peut donner l’impression d’une série de procédures mécaniques épuisantes. Certains couples envisageront des techniques de reproduction telles que l'insémination artificielle, l'insémination intra-utérine et la fécondation in vitro pour réaliser une grossesse. Bien que ces approches puissent être efficaces, elles sont financièrement hors de portée pour de nombreuses familles. Étant donné que les taux de réussite des traitements tels que la FIV se situent entre 13 et 36% chez les femmes de plus de 35 ans, les couples souhaitent optimiser leur santé d’abord pour optimiser leurs résultats. Ils peuvent également s'inquiéter des risques à long terme du traitement antirétroviral pour la santé du bébé. Avec toutes ces variables, les patients se demandent souvent s'ils ont d'autres options.

Formés à traiter toute la personne, les docteurs en naturopathie ont aidé d'innombrables hommes et femmes à résoudre leurs problèmes de fertilité et à concevoir facilement, de manière sûre et à moindre coût. En vue de découvrir ce qui empêche un couple de concevoir, les docteurs en naturopathie s’attaquent autant que possible aux causes sous-jacentes de l’infertilité. Les DS considèrent chaque patient comme un individu unique. Ils guident les couples dans l'amélioration de la fertilité dans le but de concevoir naturellement et d'éviter les interventions lorsque cela est possible. S'attaquant à la santé au-delà de la conception, les ND ont également pour objectif de vous aider à réaliser une grossesse et un bébé en bonne santé.

Identifier les causes sous-jacentes
Les docteurs en naturopathie commencent par évaluer l'ensemble du couple. Les rendez-vous initiaux durent généralement une heure ou plus et comprennent les antécédents familiaux détaillés, les antécédents médicaux, des discussions sur le régime alimentaire, l'activité physique, les expositions environnementales, les habitudes de sommeil et les facteurs de stress psycho-émotionnels pour les deux partenaires. Vous pouvez vous attendre à une conversation sur votre style de vie, votre cycle menstruel et ce que vous avez fait pour essayer de concevoir. Votre ND peut demander des analyses de sang, des examens d'imagerie et des analyses nutritionnelles. Ils creuseront plus profondément si les tests révèlent des signaux d'alarme.

Il existe une grande variété de raisons pour lesquelles un couple peut avoir des difficultés à concevoir. Bien que certains reçoivent un diagnostic des médecins conventionnels, beaucoup souffrent «d'infertilité inexpliquée». Les problèmes de fertilité peuvent être causés par une mauvaise santé des spermatozoïdes (pour les hommes), une qualité médiocre des ovocytes, des déséquilibres hormonaux, y compris des anomalies du cycle (chez les femmes), l'obésité, etc. Un certain nombre de causes profondes sont liées au mode de vie et à des facteurs environnementaux, et les DN sont formés pour rechercher et découvrir ces problèmes sous-jacents.

Il existe de nombreuses modifications de style de vie et de thérapies sûres, naturelles et efficaces qui peuvent traiter ces problèmes, renforcer votre santé globale et augmenter vos chances de devenir enceinte. En raison de leur formation rigoureuse en nutrition clinique, conseils en matière de style de vie, médecine botanique et plus encore, les docteurs en naturopathie sont des experts en matière de mobilisation et de responsabilisation des patients pour qu'ils apportent des changements à leur mode de vie, dont il a été prouvé qu'ils amélioraient les résultats pour la santé.

Soins pré-conception
Il a été démontré que des soins préconceptionnels appropriés amélioraient la fertilité et conduisaient à des résultats plus sains, à la fois pour les couples en phase de conception naturelle et pour ceux qui utilisent la technologie de procréation assistée (ART). Les docteurs en naturopathie travaillent pour vous aider à cultiver un corps sain en premier lieu pour maximiser le succès de la grossesse et nourrir la croissance d'un bébé en bonne santé. Les DS encouragent les couples à prendre quelques mois pour se préparer à la conception. Durant cette période, les ND travaillent avec les couples pour:

  • traiter les problèmes de santé sous-jacents, tels que l'obésité chez les hommes et les femmes
  • optimiser l'alimentation et la nutrition
  • gérer le stress
  • incorporer un soutien complet en oligoéléments
  • optimiser la synchronisation des rapports grâce à l'éducation sur le cycle menstruel
  • Mauvaise qualité d'œuf
    Alors que les obstacles et les traitements liés à la fertilité sont très individuels, la qualité médiocre des œufs est une cause sous-jacente commune aux femmes. La qualité des œufs peut diminuer naturellement avec l’âge ou prématurément. Dans les deux cas, il est essentiel de déterminer le «pourquoi» du déclin. Les causes peuvent être nutritionnelles et hormonales. Des recherches ont démontré que, pour des raisons nutritionnelles, une supplémentation en antioxydants tels que la mélatonine, des vitamines telles que la DHEA et d'autres antioxydants d'origine végétale peut être utile pour améliorer la qualité de l'œuf. Les irrégularités hormonales affectant la qualité des œufs et l'ovulation comprennent l'endométriose et le syndrome des ovaires polykystiques (SOPK). La naturopathie propose de nombreux remèdes pour aider les femmes à remédier à ces déséquilibres, notamment par l'utilisation de thérapies botaniques.

    Mauvaise santé du sperme
    Pour les hommes, la production, la qualité et la motilité du sperme sont souvent au cœur des problèmes de fertilité. Bien que les recommandations individuelles soient adaptées, les docteurs en naturopathie aident à préserver la santé des spermatozoïdes en: 1) optimisant les choix de mode de vie tels que cesser de fumer et limiter la consommation d’alcool; et 2) l'optimisation du régime alimentaire et de la nutrition, y compris la supplémentation en micronutriments tels que le zinc, le L-carnitène, la CoQ10 et en antioxydants tels que le sélénium.

    Améliorer les soins cliniques avec Tender Loving Care (TLC)
    Le voyage vers la grossesse peut ressembler à une montagne russe physique et émotionnelle. Les docteurs en naturopathie fournissent aux patients un niveau élevé de soutien émotionnel et psychologique du début à la fin. L'ajout d'un soutien psychologique et de conseils sympathiques aux soins cliniques se sent non seulement mieux, mais il a également été démontré qu'il améliorait les taux de réussite de la grossesse.

    Retour au sommet.

    Mai 2018 | Comment les docteurs en naturopathie aident-ils les femmes pendant la périménopause? Consultez la version PDF imprimable.

    L'AANP et l'INM tiennent à remercier Tori Hudson, Dakota du Nord, pour ses contributions au contenu de cette FAQ. Une partie du contenu a été publiée pour la première fois dans un article sur le blog de Dr. Hudson.

    On estime que deux millions de femmes américaines atteignent la ménopause chaque année. Mais beaucoup commencent à ressentir une série de symptômes physiques, mentaux et émotionnels bien avant la ménopause (12 mois consécutifs sans menstruation). La période de transition progressive vers les années autres que la reproduction s'appelle la périménopause et se produit généralement entre 40 et 51 ans environ. La périménopause peut être provoquée prématurément par l'ablation chirurgicale des ovaires, la chimiothérapie, la radiothérapie ou certains médicaments antihormonaux. Cette transition, unique pour chaque femme, peut entraîner des symptômes qui nuisent à la qualité de vie. L'évaluation de la santé de l'ensemble du corps et les soins prodigués pendant la périménopause sont essentiels, à la fois pour gérer les symptômes troublants et pour traiter de manière préventive les changements pouvant avoir une incidence sur la santé du cœur, des os et du cerveau.

    Les docteurs en naturopathie agréés prennent le temps d'identifier et de traiter les facteurs génétiques, les antécédents médicaux personnels, les facteurs hormonaux et liés au mode de vie qui ont une incidence sur la périménopause et les changements de santé qui y sont associés chez les femmes. Les ND fournissent un niveau élevé de soutien émotionnel et éducatif. Dans le but de renforcer les bases de la santé d’une femme afin qu’elle puisse se développer pendant la ménopause et vieillir de manière optimale, les MN utilisent un large éventail de modalités de traitement, notamment la nutrition, les nutraceutiques, la médecine botanique, les conseils en matière de mode de vie, la thérapie hormonale et, parfois, la sélection de produits pharmaceutiques.

    Symptômes et changements biologiques sous-jacents
    Pendant la périménopause, les niveaux hormonaux de la femme changent et fluctuent considérablement, ce qui entraîne souvent des modifications dans la structure des menstruations. À mesure que vous devenez ménopausée, les taux d'hormones de reproduction diminuent, ce qui entraîne des taux d'œstrogène et de progestérone insuffisants pour produire les règles. Les symptômes sont variés, imprévisibles et ne sont souvent pas reconnus comme des symptômes de la périménopause. Ils peuvent inclure:

    Périodes irrégulières. À mesure que l'ovulation devient irrégulière, l'intervalle entre les règles peut être plus long ou plus court, votre flux peut être plus léger ou plus lourd et vous pouvez avoir des périodes de spotting ou de sauts aléatoires. Il est important de gérer les saignements excessifs et d'éliminer l'hyperplasie de l'endomètre (lorsque la muqueuse utérine devient trop épaisse).

    Les bouffées de chaleur. Les bouffées de chaleur et les sueurs nocturnes sont courantes, avec une intensité, une longueur et une fréquence variables. Ils peuvent être aggravés par des facteurs liés au mode de vie, notamment l'environnement, la nutrition, le stress, l'alcool et le tabagisme. Il est important de différencier les autres problèmes médicaux des bouffées de chaleur liées à la ménopause, notamment l'hyperthyroïdie, l'anxiété et plus.

    Sécheresse vaginale et amincissement. Une diminution de l'œstrogène peut amener les tissus vaginaux à devenir plus minces, plus secs et moins élastiques, ce qui rend la pénétration vaginale douloureuse. La diminution des œstrogènes peut également vous rendre plus vulnérable aux infections vaginales, aux infections des voies urinaires et à l'incontinence urinaire. Il est important d'éliminer les autres causes de ces symptômes, notamment les tumeurs malignes, les dystrophies vulvaires et les dermatoses, les infections, les allergies et les affections cutanées.

    Changements de peau. Des modifications de la peau commencent à se produire avec des taches brunes, une sécheresse, des ecchymoses faciles et une augmentation des rides. La peau est partiellement composée de collagène et, avec l’âge, le collagène diminue. Au cours des cinq premières années suivant la ménopause, 30% du collagène cutané est perdu.

    Fatigue / troubles du sommeil. Les problèmes de sommeil sont souvent dus à des bouffées de chaleur ou à des sueurs nocturnes, mais le sommeil devient parfois imprévisible, même sans eux.

    Une diminution de la libido et d'autres modifications de la réponse sexuelle sont courantes pendant la périménopause. Les niveaux hormonaux, l'anatomie, la physiologie, les facteurs psychologiques, les facteurs de stress et les problèmes médicaux concomitants sont tous des facteurs potentiels de modification de la fonction sexuelle.

    Dépression, anxiété et / ou sautes d'humeur. La cause de ces symptômes, notamment l’irritabilité accrue et les troubles anxieux / paniques, peut être une perturbation du sommeil associée à des bouffées de chaleur ou d’autres facteurs non liés aux changements hormonaux.

    La perte osseuse est causée par la baisse des taux d'œstrogènes et peut augmenter le risque d'ostéoporose et de fractures osseuses.

    Changer les profils lipidiques. La diminution du taux d'œstrogènes peut entraîner des modifications défavorables du taux de cholestérol dans le sang, notamment une augmentation du cholestérol lié aux lipoprotéines de basse densité (LDL) – le "mauvais" cholestérol – qui contribue à augmenter le risque de maladie cardiaque. Dans le même temps, le cholestérol lié aux lipoprotéines de haute densité (HDL) – le "bon" cholestérol – diminue chez beaucoup de femmes à mesure qu'elles vieillissent.

    Les autres symptômes associés à la périménopause peuvent inclure: modifications de la mémoire et de la cognition, perte de cheveux sur le cuir chevelu, croissance des poils du visage, acné, palpitations, nausées et maux de tête.

    Traitement naturopathique
    En utilisant une approche du corps entier et des thérapies naturelles chaque fois que possible, les MN aident les femmes à traiter les symptômes de la périménopause et à mettre en œuvre une prévention proactive pour optimiser la santé à mesure que le corps vieillit. Les DS passent généralement une à deux heures avec les patientes lors du rendez-vous initial pour recueillir des informations sur les facteurs physiques, mentaux, émotionnels, génétiques, environnementaux, sociaux et autres qui ont une incidence sur la santé de la femme. Les ND appliquent leur formation rigoureuse à la nutrition clinique, aux conseils en matière de mode de vie, à la médecine botanique et nutraceutique et à d’autres modalités de traitement (y compris l’utilisation de produits pharmaceutiques lorsque la licence de l’État le permet) pour fournir une évaluation individualisée et une orientation thérapeutique aux patients, notamment:

  • Les plantes médicinales contenant des phytoestrogènes, tels que le ginseng, le trèfle rouge et le soja, réduisent les bouffées de chaleur, réduisent la sécheresse vaginale, augmentent l'énergie et améliorent l'humeur.
  • Plantes sans phytoestrogènes telles que l'actée à grappes noires et le kava pour réduire les bouffées de chaleur.
  • Suppléments de vitamine D, de calcium et d'autres nutriments pour aider à prévenir l'ostéoporose.
  • Médecine corps-esprit telle que la réduction du stress, la méditation et le yoga pour la dépression légère à modérée, le déclin cognitif et les bouffées de chaleur.
  • Bacopa pour améliorer la mémoire.
  • Des évaluations individuelles et des recommandations sur l'utilisation de plantes, de nutraceutiques, d'hormones bio-identiques, y compris des composés personnalisés, et / ou d'un traitement hormonal classique doivent être effectuées pour chaque femme en fonction de ses symptômes, des facteurs de risque d'ostéoporose / de maladies cardiovasculaires / démences / autres conditions et préférences. Lorsque cela est approprié, les ND sont formés pour utiliser à la fois les options de remplacement d'hormone disponibles de manière conventionnelle et les formulations d'hormones composées spéciales. Leurs conseils, à la fois pour traiter les symptômes de la périménopause et pour renforcer de manière proactive leur état de santé général, ont aidé plus de femmes à vieillir pendant la ménopause.

    Retour au sommet.

    Pourquoi le médecin en tant qu'enseignant est-il un principe de la médecine naturopathique? Mai 2018
    Voir la version PDF imprimable.

    L'AANP & INM aimerait remercier Amy Rothenberg, ND, et Allison Willette, RN, ND, pour leurs commentaires sur cette FAQ.

    Les docteurs en naturopathie suivent six principes directeurs qui servent de plate-forme philosophique à tout ce qu'ils font. Les principes influent sur leur façon de penser à la médecine, sur la manière dont ils prennent des décisions cliniques et, plus important encore, sur la façon dont ils vous traitent en tant que patient. Chaque principe joue un rôle dans l'orientation des docteurs en naturopathie dans le diagnostic et le traitement. Le médecin en tant qu'enseignant est l'un de ces six principes fondamentaux.

    Si vous ne suivez pas toujours les instructions de votre médecin, vous n'êtes pas seul. Des études montrent que le non-respect des recommandations du médecin est une épidémie et que cela peut entraîner un traitement inefficace ou d'autres problèmes de santé. La non-conformité découle souvent du fait que le plan et la stratégie de traitement ne sont pas clairement compris. De nombreux patients ont du mal à comprendre «le langage du médecin» et risquent de ne pas bien comprendre les explications cliniques et les directives de soins.

    Les docteurs en naturopathie autorisés à croire qu'un patient informé est prêt à jouer un rôle actif dans le processus de guérison. Les docteurs en naturopathie travaillent pour expliquer chaque problème de santé que vous avez et chaque approche qui sera utilisée pour aider à le résoudre. Les DS ont pour objectif de répondre à vos questions afin que vous puissiez pleinement comprendre et participer à votre plan thérapeutique.

    La communication avec vous, le patient, est un élément essentiel du travail avec tout docteur en naturopathie. Parce que chaque patient est considéré comme un individu, pas seulement comme un diagnostic, les docteurs en naturopathie accordent la priorité à l'empathie, à la connexion et au partage d'informations pertinentes. Afin d'éduquer et d'informer les patients de manière adéquate, les DS passent souvent une heure ou plus avec les patients lors du premier rendez-vous, par rapport à un rendez-vous moyen de 20 minutes avec un médecin formé de manière conventionnelle.

    Les patients instruits qui comprennent les recommandations de traitement réussissent souvent mieux le traitement et se sentent plus confiants dans leurs choix de soins de santé. Les recherches montrent qu'une meilleure communication et une prise de décision collaborative entre médecins et patients réduisent les coûts des soins de santé.

    En raison de leur orientation vers l’éducation et l’autonomisation des patients, les docteurs en naturopathie conviendront mieux aux personnes qui préfèrent participer activement à leurs soins de santé et qui recherchent une nouvelle perspective sur les soins préventifs et les options de traitement naturel pour améliorer la santé.

    Retour au sommet.

    Comment les docteurs en naturopathie aident-ils à améliorer la santé des hommes? Juin 2018
    Voir la version PDF imprimable.

    Selon une nouvelle étude réalisée à Harvard, cinq changements de mode de vie importants peuvent ajouter jusqu'à 12 ans à la vie d’un homme. Cependant, des habitudes de vie malsaines, des dépistages moins fréquents et un traitement tardif des maladies chroniques évitables font que les hommes meurent à un taux plus élevé que les femmes de causes telles que les maladies cardiaques, le diabète, les accidents et le cancer. En fait, la moitié des hommes américains – qui ont déjà une espérance de vie inférieure à celle des femmes – ne se soucient pas des bilans de santé annuels. Les naturopathes autorisés, qui mettent l’accent sur la médecine préventive et la médecine du mode de vie, peuvent contribuer à remédier à certaines de ces disparités. Une visite avec un ND peut intéresser davantage les hommes qui ont évité les visites chez le médecin car les ND privilégient les approches médicamenteuses naturelles sans ordonnance, se concentrent sur l'éducation des patients et sont formés pour donner aux patients les moyens de modifier leur mode de vie pour une santé optimale. Ils passent plus de temps avec vous lors de vos rendez-vous pour identifier les causes sous-jacentes de vos problèmes de santé et s'attachent à soutenir la capacité innée de votre corps à guérir. Voici quelques domaines clés de la santé masculine où les ND sont spécialisés:

    Cancer de la prostate
    Le cancer de la prostate, qui touche un homme sur six, est mieux traité s'il est détecté tôt. L'éducation sur les facteurs de risque – qui ont un impact lorsque le dépistage régulier doit commencer et à quelle fréquence il doit avoir lieu – est essentielle. Les principaux facteurs de risque sont: être afro-américain, vieillissement, antécédents familiaux de cancer de la prostate, obésité, exposition à certains produits chimiques, régime alimentaire et taux élevés de testostérone. Des études montrent que la prévention fonctionne et que les facteurs liés au mode de vie ont une incidence sur l’incidence et l’agressivité du cancer. Si le cancer de la prostate est diagnostiqué, l’utilisation de méthodes de médecine naturopathique parallèlement aux soins classiques peut aider à améliorer l’efficacité, à réduire les effets secondaires et à prévenir les récidives.

    Dysfonction sexuelle
    La dysfonction sexuelle est une plainte qui amène les hommes dans les cabinets de médecins. Défini comme une incapacité à atteindre ou à maintenir une érection adéquate pour la satisfaction sexuelle des deux partenaires, le dysfonctionnement sexuel peut également être une indication d'autres problèmes de santé. Par exemple, une maladie cardiovasculaire associée à l’athérosclérose provoque l’obstruction des vaisseaux sanguins, ce qui peut entraîner l’impuissance. La dysfonction sexuelle peut également être un symptôme du diabète, lié à une mauvaise circulation sanguine ou à d'autres troubles du système endocrinien. Les effets secondaires des médicaments couramment prescrits tels que les antidépresseurs, les antihistaminiques et les antihypertenseurs peuvent contribuer à la dysfonction sexuelle, de même que la consommation d'alcool et de drogues. Un docteur en naturopathie peut vous aider à comprendre les causes sous-jacentes du dysfonctionnement sexuel et à créer un plan de traitement qui tienne compte de vos facteurs de risque ou de votre pathologie. Les ND utilisent une approche globale du corps, y compris une ordonnance de régime et d'exercice, pour améliorer la circulation. Ils travaillent avec des suppléments naturels et des médicaments botaniques pour lutter contre le dysfonctionnement sexuel.

    Maladie cardiovasculaire La maladie cardiaque, qui reste la principale cause de mortalité chez les hommes américains, est en grande partie évitable si elle est dépistée et traitée tôt. En traitant toute la personne, les docteurs en naturopathie s’attaquent aux facteurs génétiques, environnementaux et comportementaux / de style de vie menant aux maladies cardiovasculaires. En savoir plus dans cette FAQ sur la médecine naturopathique et les maladies cardiaques.

    Diabète
    Le diabète est la sixième cause de décès chez les hommes et une maladie chronique qui a un impact énorme sur la qualité de vie. Les docteurs en naturopathie disposent d’un large éventail de directives et d’une vaste boîte à outils sur laquelle travailler afin d’aider les patients atteints de diabète. Leur formation avancée en nutrition clinique et en médecine comportementale aide les individus à modifier et maintenir leur mode de vie de manière à améliorer ou à inverser la progression de la maladie.

    La douleur chronique
    Les hommes souffrent souvent de douleurs chroniques provenant d’un certain nombre de sources potentielles, notamment les blessures, l’arthrite, la fibromyalgie et d’autres causes. Les docteurs en naturopathie excellent dans les approches non opioïdes de la douleur chronique. En développant des plans de traitement personnalisés de la gestion de la douleur qui incluent des recommandations diététiques, des compléments nutritionnels, des médicaments à base de plantes, une rééducation physique et des approches esprit-corps, les ND collaborent avec les patients pour aider à réduire efficacement la douleur causée par l'inflammation et d'autres causes.

    Une dépression
    La dépression peut être différente chez les hommes et chez les femmes. Par exemple, certains hommes souffrant de dépression peuvent ressentir de la colère ou de l'agressivité à la place ou en plus de la tristesse. Les hommes peuvent parler davantage des symptômes physiques de la dépression tels que la fatigue, les maux de tête ou les modifications de l'appétit. En accordant la priorité à la médecine comportementale, à la nutrition, à la médecine botanique, à l'exercice et aux nutraceutiques sélectionnés ainsi qu'à d'autres approches en médecine naturelle, les docteurs en naturopathie aident les hommes à lutter contre la dépression. Les DS sont également formés aux traitements pharmacologiques couramment prescrits par des médecins formés de manière conventionnelle. Dans certains États, les DS ont autorité pour la gestion des produits pharmaceutiques sur ordonnance. Ils peuvent travailler conjointement avec des spécialistes de la santé mentale conventionnels pour cogérer les soins aux patients.

    Pour les hommes cherchant des soins pour ces plaintes courantes et autres, les docteurs en naturopathie ont des réponses basées sur une formation rigoureuse en nutrition thérapeutique, en médecine comportementale, en médecine botanique et en mettant l'accent sur le traitement des causes sous-jacentes de la maladie.

    Retour au sommet.

    Pourquoi un nombre croissant de médecins travaillent-ils en collaboration avec des docteurs en naturopathie? Juin 2018
    Voir la version PDF imprimable.

    L'AANP et l'INM souhaitent remercier les docteurs Leonard A. Wisneski, FACP et Dave Johnson, MD, FACC pour leur contribution au contenu de cette FAQ.

    Les docteurs en médecine conventionnels constatent que les docteurs en naturopathie ont une éducation, une formation et une approche de la pratique qui améliorent les soins et élargissent les options de traitement pour les patients. Plus précisément:

  • Les ND adoptent une approche globale de la santé. De nombreux facteurs affectent votre santé. Les docteurs en naturopathie prennent le temps d'explorer le plus grand nombre possible de ces facteurs, notamment l'alimentation, le mode de vie, la génétique familiale, les problèmes psycho-émotionnels, spirituels, socio-économiques et environnementaux, etc. Ils passent généralement une heure ou plus avec les patients à un examen initial pour découvrir les causes sous-jacentes des problèmes de santé.
  • Les DS donnent la priorité aux thérapies naturelles. Les docteurs en naturopathie utilisent des traitements peu invasifs chaque fois que cela est possible. La nutrition clinique, la médecine du comportement et du mode de vie et la médecine botanique ne sont que quelques-uns des nombreux traitements que les ND utilisent pour soutenir les processus de restauration de la santé du corps, par opposition à la simple réduction des symptômes. Les docteurs en médecine sont formés à l’utilisation des médicaments sur ordonnance dans les facultés de médecine, mais ils mettent l’accent sur les substances moins toxiques qui favorisent la guérison naturelle. Si leur permis d'État le permet, les ND peuvent prescrire des médicaments si nécessaire. Sinon, ils dirigeront les patients vers un collègue médical et collaboreront avec eux.
  • Les DS reçoivent une formation rigoureuse en nutrition clinique. Les docteurs en naturopathie reconnaissent que la nutrition est la pierre angulaire de la santé. Au cours de leurs études en médecine, les étudiants en ND accomplissent en moyenne 155 heures d’éducation nutritionnelle en classe. Ils fournissent une évaluation nutritionnelle et des conseils individualisés à l'aide de recommandations fondées sur des preuves. Leur expérience approfondie couvre des domaines tels que les macronutriments, les micronutriments, les évaluations diététiques, les types de régimes, le régime alimentaire et la thérapie nutritionnelle, les interactions médicament-supplément, la technologie de la nutrition, etc.
  • Les ND ont suivi une formation avancée en médecine comportementale. Les ND reconnaissent que le mode de vie et l'environnement jouent un rôle essentiel dans votre santé. Un grand pourcentage de maladies chroniques pourraient être évitées par des modifications modifiables du mode de vie. Après avoir suivi plus de 100 heures de formation en médecine comportementale à la faculté de médecine, les ND sont formés à la découverte des problèmes sociaux, culturels, cognitifs, environnementaux et émotionnels qui influent sur votre santé en général. Ils permettent aux patients de faire et de maintenir des changements pour une santé et un bien-être optimaux.
  • Les ND fournissent des soins hautement individualisés. Les DN comprennent qu’il n’existe pas de traitement unique. En utilisant une approche centrée sur le patient, les DS prennent le temps de comprendre vos objectifs de santé et d'explorer les facteurs génétiques, environnementaux et comportementaux / mode de vie qui peuvent constituer des obstacles à une santé optimale. Les docteurs en naturopathie élaborent des plans de traitement parfaitement adaptés à votre état de santé, à vos objectifs et à votre mode de vie.
  • Les DN connaissent bien les approches intégratives et complémentaires. Grâce à leur formation diversifiée sur des modalités thérapeutiques complémentaires, les DS savent quand et comment utiliser les approches intégratives dans le traitement global du patient. Intégrant des traitements tels que l’acupuncture, la médecine corps-esprit, la chiropratique et d’autres disciplines intégratives, les spécialistes de la neuropathie référeront à d’autres praticiens experts selon les besoins / le cas échéant.
  • De plus en plus de personnes recherchent des approches complémentaires, intégratives et globales des soins de santé. Le bien-être, la prévention et la création d'une santé allant au-delà de la gestion des maladies ne sont que quelques-unes des raisons. En réponse, les décideurs politiques bipartites unissent leurs forces pour plaider en faveur d'un modèle de soins de santé intégratif et intégral. Et de nombreux groupes nationaux de médecins reconnaissent maintenant la valeur d'approches complémentaires, proposant de nouvelles directives de traitement pour des problèmes séculaires, tels que la douleur chronique. La naturopathie, qui met l'accent sur la prévention, l'autoguérison et les thérapies naturelles, offre aux patients un choix de soins de santé convaincant pour le corps entier.

    Aujourd'hui, environ 6 000 médecins naturopathes agréés exercent aux États-Unis. Vingt-trois États et territoires américains autorisent actuellement les DS. Éduqués et formés dans des collèges de médecine naturopathique accrédités et diplômés de quatre ans, les ND diagnostiquent, préviennent et traitent les maladies aiguës et chroniques. Ils restaurent et aident à établir une santé optimale. Formés en tant que médecins de soins primaires, les ND peuvent jouer un rôle central dans l’inversion de l’épidémie de maladies chroniques aux États-Unis. De plus en plus, ils travaillent en collaboration avec des médecins conventionnels et sont reconnus comme un élément essentiel de l’équipe de soins de santé d’un patient.

    Un nombre croissant de systèmes de santé de premier plan, d'hôpitaux et de centres de traitement du cancer comptent désormais un ou plusieurs docteurs en naturopathie titulaires d'une licence dans le personnel clinique de leurs installations. Les médecins qui défendent les intérêts des docteurs en naturopathie reconnaissent que les MN peuvent aider à améliorer les résultats pour la santé à moindre coût. Ils font référence aux ND et collaborent avec eux dans les soins primaires et dans des domaines spécialisés tels que le traitement du cancer, la douleur chronique, les maladies gastro-intestinales, le diabète, les maladies cardiaques, etc.

    Retour au sommet.

    Quelle formation avancée les docteurs en naturopathie ont-ils en médecine comportementale? Juillet 2018
    Voir la version PDF imprimable.

    L'AANP et l'INM souhaitent remercier Brad Lichtenstein, ND, BCB, professeur associé et Katie Stage, ND, RH (AHG), directeur de la division thérapeutique du Southwest College of Naturopathic Medicine pour le contenu de la présente FAQ.

    Le comportement individuel est l’un des facteurs les plus importants de votre santé. Votre style de vie et les conditions dans lesquelles vous grandissez, vivez, travaillez et vieillissez façonnez votre bien-être. Outre le régime alimentaire, l'exercice et d'autres comportements liés au mode de vie, des facteurs sociaux, économiques et culturels sont souvent à l'origine de maladies chroniques évitables. En fait, jusqu'à 70% des visites de soins primaires sont motivées par des facteurs psychologiques et / ou sociaux. Mais trop souvent, les fournisseurs de soins primaires ne consacrent pas assez de temps à ces problèmes.

    Des docteurs en naturopathie agréés, formés pour traiter toute la personne, prennent le temps de s'attaquer aux multiples causes des problèmes de santé. Les rendez-vous sont guidés par l'ordre thérapeutique, une approche naturelle de l'intervention thérapeutique utilisée pour découvrir et évaluer de multiples obstacles à la guérison, notamment des facteurs sociaux, culturels, cognitifs, environnementaux, émotionnels et autres ayant une incidence sur votre santé. Au cours de leurs études en médecine, les ND effectuent en moyenne 150 heures de formation en médecine comportementale. En raison de leur formation rigoureuse, les docteurs en naturopathie vont bien au-delà du traitement des symptômes physiques; ils aident les patients à comprendre et à traiter les schémas sociaux, émotionnels et psychologiques sous-jacents qui influencent la santé.

    Les docteurs en naturopathie sont formés pour utiliser un large éventail de thérapies, notamment des interventions concernant l'alimentation et le mode de vie, la réduction du stress, la psychothérapie et le conseil. Ils disposent des connaissances et de l’expérience nécessaires pour donner aux patients les moyens d’apporter des changements à leur mode de vie qui améliorent la santé et réduisent les coûts de santé.

    La médecine comportementale et le conseil en matière de mode de vie sont enseignés dans une série de cours qui se renforcent mutuellement dans le cadre d’une formation médicale scientifique de quatre ans. Les facultés de médecine naturopathique sont agréées et reconnues par le département de l'éducation des États-Unis. En plus des études en classe, les étudiants en médecine naturopathique peaufinent et appliquent leurs apprentissages dans divers contextes, notamment plus de 1 200 heures de stages en clinique avec des patients. Les domaines de concentration de cours comprennent:

    Interactions patient-médecin, abordant l'écoute centrée sur le patient, l'entretien de motivation et le développement de la relation médecin-patient

    Psychopathologie, mettant l'accent sur les bases biologiques et psychosociales des conditions psychologiques, y compris l'évaluation clinique utilisant les critères du DSM pour le diagnostic des troubles mentaux

    Changement de mode de vie / changement de comportement, y compris les facteurs biologiques et psychologiques, les facteurs de risque et de promotion de la santé, la prise de décision médicale et l'adhésion médicale

    Conseils, y compris traitement médical fondé sur des données probantes et techniques de médecine esprit-corps tels que: pleine conscience, exercice thérapeutique / yoga, biofeedback, relaxation musculaire progressive, respiration artificielle, méditation et visualisation guidée

    Dépendances et troubles, en mettant l'accent sur la nature et le traitement des dépendances, y compris les facteurs neurologiques, biochimiques, cognitifs, émotionnels et sociopolitiques

    Système nerveux et santé mentale, mettant l'accent sur les outils d'évaluation et les thérapies du système nerveux et des affections courantes liées à la santé mentale, utilisant des pratiques factuelles de nutrition, de médecine botanique et de pharmacologie

    Problèmes sociaux et culturels dans les soins de santé, axés sur les déterminants sociaux de la santé et les maladies chroniques, notamment le statut socioéconomique, le soutien social, les caractéristiques socio-démographiques, les inégalités sociales et les facteurs de stress psychosociaux

    Lorsque vous rencontrez un médecin naturopathe, il prend le temps de comprendre vos préoccupations et vos symptômes dans le contexte de votre style de vie, de votre comportement et de votre environnement socioculturel. En examinant les détails de votre régime alimentaire, votre niveau de stress, votre sommeil, votre activité physique et plus encore, ils visent à identifier les causes sous-jacentes de vos problèmes de santé. Les docteurs en naturopathie engagent les patients, étape par étape, à modifier leur mode de vie et leur comportement, et leur permettent de poursuivre ces changements. Ce type d'autonomisation entraîne une plus grande satisfaction du patient, de meilleurs résultats pour la santé et une réduction des coûts. Les DS sont également formés pour savoir quand vous avez besoin de soins de santé mentale plus spécialisés. Ils collaboreront avec des spécialistes de la santé mentale et les consulteront, le cas échéant.

    *** L'utilisation du terme psychothérapie peut varier en fonction de la législation juridictionnelle

    Retour au sommet.

    Qu'est-ce que les docteurs en naturopathie entendent par traiter toute la personne? Juillet 2018
    Voir la version PDF imprimable.

    L'AANP et l'INM tiennent à remercier Amy Rothenberg, ND, pour sa contribution au contenu de cette FAQ.

    Les docteurs en naturopathie (DS) suivent six principes directeurs qui servent de plate-forme philosophique à toute la médecine naturopathique. The principles influence how NDs think about medicine, make clinical decisions, and most importantly, how you are treated as a patient. Treat the whole person is one of these six core principles.

    Multiple factors contribute to your health, including: diet, lifestyle, genetics, psycho-emotional make up, spirituality, socioeconomic position, environmental issues, and more. While most primary care providers are trained to treat the body, few also address matters of the mind and spirit, elements that are equally important. Licensed naturopathic doctors are trained to uncover, evaluate, and address relevant obstacles to healing. They take extra time with patients and provide highly individualized care.

    Guided by the Therapeutic Order, naturopathic doctors focus on identifying the underlying cause(s) of your health concerns and empowering you to engage actively in restoring and managing your own health. Research shows that whole-person care often leads to higher patient satisfaction and improved outcomes.

    Identifying Underlying Causes of Illness
    Sometimes aches and pains, stomach discomfort, trouble sleeping, and numerous other symptoms are indicators of underlying illness. While these symptoms can be reduced or managed, it is more important to understand and treat the root cause, which is the focus of naturopathic medicine. This takes time and comprehensive evaluation encompassing physical, behavioral, emotional, and other key components of your health.

    Providing Individualized Care
    Treating the whole person involves giving each person tailored and personalized therapies specific to their genetics, nutrition status, lifestyle, and capacity for implementing suggestions, not just a set of instructions to follow. In order to assess, educate, and inform patients adequately, NDs often spend one hour or more with patients in an initial appointment, and 30+ minutes in subsequent appointments, compared to an average 20 minute appointment with a conventionally trained physician.

    Addressing Behavior and Lifestyle Factors
    NDs recognize that both psycho-social factors and lifestyle choices are central contributors to illness and chronic disease. Among U.S. adults, 90 percent of Type 2 diabetes, 80 percent of cardiovascular disease, 70 percent of stroke, and 70 percent of colon cancer are potentially preventable by modifiable lifestyle changes. NDs’ rigorous training in areas such as clinical nutrition, behavioral medicine, botanical medicine, and others makes them expert at prescribing and supporting essential, effective, and enduring behavior and lifestyle modifications which impact health outcomes.

    Because of their focus in these areas and others, naturopathic doctors may be a good fit for people looking for a more comprehensive perspective on health concerns, or for a whole-person approach to health care.

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    How do naturopathic doctors help people manage blood pressure? Août 2018
    View the printable PDF version.

    The AANP and the INM would like to acknowledge Kasra Pournadeali, ND, for his contributions to the content of this FAQ.

    Forty-six percent of U.S. adults, and nearly 80 percent of those aged 65 and older have high blood pressure, or hypertension, according to new guidelines from the American Heart Association. High blood pressure, which often occurs without symptoms, boosts the risk of stroke and heart disease. Further, patients diagnosed with high blood pressure are estimated to pay almost $2,000 more in annual healthcare costs than those who have blood pressure in the normal range. While blood pressure medications represent some of the greatest advances in healthcare pharmacology, they have side effects and consequences with long-term use. Whole-body health evaluation and care is vital to identify the underlying cause(s) of high blood pressure, to proactively make changes that can impact overall health, and to minimize reliance on prescription medications when possible.

    Licensed naturopathic doctors (NDs) are trained to evaluate and treat the whole person. They help patients identify the well-known causes of and modifiable risk factors for hypertension, as well as less-examined causes that include vitamin and mineral deficiencies and inflammation.
     What do blood pressure numbers really mean?
    Your blood pressure measurement is made up of two numbers that reflect the different pressures in your blood vessels. The systolic number is the pressure in your vessels when your heart contracts, and the diastolic number is the pressure when your heart is at rest between beats. Numbers greater than the ideal range indicate that your heart is working harder than ideal to pump blood to the rest of your body. Over time, untreated high blood pressure damages the delicate tissues inside blood vessels, in the eyes, brain, heart, and other areas. This can cause blindness, atherosclerosis (clogged arteries), and stroke. High blood pressure can also impact kidney function and in long term and severe cases, cause kidney failure.

    What causes high blood pressure?
    Causes of high blood pressure are different for every person and are often called “risk factors.” Well-known modifiable risk factors include: being overweight or obese, having a sedentary lifestyle, using tobacco, having an unhealthy diet (high in sodium), excessive alcohol usage (more than one drink per day for women and two drinks per day for men), stress, sleep apnea, and diabetes. Non-modifiable risk factors include: age, race, and family history. Other well-known causes of high blood pressure include side effects from certain medications, hormonal imbalances, and kidney disease.

    Naturopathic medicine approach and therapies
    Naturopathic doctors take enough time to identify and address the genetic, environmental, and behavioral/lifestyle factors that raise blood pressure.

    NDs offer a large spectrum of treatments including: clinical nutrition, exercise prescriptions, botanical medicine, behavioral medicine, and, at times, standard medications. Naturopathic doctors work with and refer to other physicians and specialists when indicated.

    Because of their extensive training in clinical nutrition, NDs are well-equipped to help people with diets and nutrition, which is essential. A large body of evidence now supports specific diets in the treatment of high blood pressure.

    Naturopathic doctors provide highly individualized therapies. They follow the Therapeutic Order, leading with minimally invasive therapies that support the body to restore healthy function, whenever possible. Meeting the patient where they are, NDs might recommend dietary approaches, vitamin supplements, exercise training, stress management, or even prescription medications when needed, depending on the unique situation of each patient.  The naturopathic medicine principle of recognizing the healing power of nature always brings NDs back to health-promoting, natural approaches that support the body’s effort to repair itself.

    How to measure your blood pressure at home

  • Find a time when you can rest for several minutes.
  • Use a cuff that will inflate and deflate automatically.
  • Sit comfortably and keep arms at heart level. Take your measurement 2 to 3 times, between 1 and 2 minutes apart. Write the numbers down. If there is something stressful happening, make a note of that, too. Take your recorded measurements to your doctor.
  • Measure twice daily: once in the morning and once in the afternoon/evening, 30 minutes before eating, drinking, or exercising.

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    What do naturopathic doctors mean by first, do no harm? Août 2018
    View the printable PDF version.

    The AANP and INM would like to acknowledge Amy Rothenberg, ND, for her contributions to the content of this FAQ.

    Licensed naturopathic doctors (NDs) follow six guiding principles that serve as a philosophical platform for all of naturopathic medicine. The principles influence how NDs think about medicine, make clinical decisions, and most importantly, how you are treated as a patient. First, do no harm is one of these six core principles.

    Naturopathic doctors follow a hierarchy in patient evaluation and treatment guided by the Therapeutic Order. To do no harm, NDs:

  • Acknowledge and respect the individual's healing process, using the least force necessary to diagnose and treat illness.
  • Avoid, when possible, the harmful suppression of symptoms.
  • Use treatments that minimize the risk of harmful side effects.
  • The body works hard on its own to support recovery from injury and illness. But certain genetic, environmental, and behavioral/lifestyle factors can slow or prevent optimal healing and recovery. Naturopathic doctors spend extra time with patients to identify and remove these obstacles to recovery in order to facilitate healing.

    Therapies are aimed at supporting the body’s health restoring and maintenance processes, as opposed to only reducing symptoms. Naturopathic doctors view symptoms as nature’s attempt to correct imbalances. Consequently, naturopathic treatments are geared toward allowing the body to reestablish balance and heal rather than suppressing symptoms, which can disable the body’s most primary way of communicating that something is wrong.

    Naturopathic doctors choose the gentlest and least-invasive therapies first to achieve the desired outcome for each patient. NDs apply their rigorous training in clinical nutrition, behavioral medicine, botanical medicine, and other natural therapies to provide the most beneficial and least harmful treatments. They are also trained to use pharmacological drugs when necessary. If their state license permits, an ND can prescribe medication as a bridge to manage symptoms while the body repairs itself. If such healing is not possible, naturopathic doctors refer patients to conventional medical colleagues and work collaboratively. For those patients who need to be on medications, naturopathic doctors can help to prevent side effects.

    For example, here’s how a naturopathic doctor would apply first, do no harm to a patient who is diagnosed with gastroesophogeal reflux disease (GERD). The ND would:

  • Carefully examine and adjust the patient’s diet and lifestyle to identify and address behaviors that may be underlying causes for stomach discomfort and heartburn, such as overeating, alcohol consumption, spicy foods, lying down after eating, stress, and more.
  • Use lab tests and other clinical diagnostic approaches to assess the operation of the sphincter muscle and/or address inflammation in the lining of the esophagus, stabilizing these systems with natural supplements if appropriate.
  • Aim to avoid or eliminate the prescription of proton pump inhibitors (PPIs) like Prilosec, which can impair digestion, damage the body’s microbiome, are linked to depression, and other side effects.
  • About 15 million people in the U.S. use PPIs every year, but studies suggest as many as 70 percent do not benefit from the prescription.

    Because of their focus on the most natural, least toxic approaches to health care, naturopathic doctors may be a good fit for people looking for a more comprehensive perspective on health concerns, or for those seeking non-drug therapies.

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    How and why do naturopathic doctors use botanical medicine? Septembre 2018
    View the printable PDF version.

    The AANP and the INM would like to acknowledge Patricia Gaines, ND, and Sheila Kingsbury, ND, for their contributions to the content of this FAQ.
     Botanical medicine, also known as herbal medicine, is the science and practice of using medicinal plants and extracts to improve overall health, support wellness, and treat acute and chronic disease. Many conventional pharmaceutical drugs are derived from plants. Modern botanical medicine combines evidence-based science along with centuries-old experience to provide safe and effective treatments that support the body’s ability to heal.

    A cornerstone of naturopathic medicine, botanical medicine is one of the most effective therapies that licensed naturopathic doctors (NDs) use to gently and safely treat illness while minimizing the risk of harmful side effects. Botanical medicine expands treatment options for patients. Alone or in combination with other naturopathic treatments, botanical medicine can be a safe, appropriate, and effective choice for addressing numerous health concerns ranging from frequent illness to gastrointestinal discomfort to depression, and more. During medical school, NDs complete an average of 130 classroom hours of botanical medicine education.

    Botanical medicine is taught in a series of courses that build upon each other through an ND’s four-year, science-based medical education. Naturopathic medical schools are accredited and are recognized by the United States Department of Education. In addition to classroom study, naturopathic medical students refine and apply learnings in various settings, including over 1,200 hours of clinical rotations with patients.

    Naturopathic Botanical Medicine Curriculum
    Through this rigorous curriculum, naturopathic doctors learn how to choose and effectively prescribe herbal medicines to treat the underlying cause(s) of illness, minimize side effects and drug interactions, and individualize doses and formulations for the maximum therapeutic benefit. Core areas of focus in naturopathic botanical medicine curriculum include:

  • History and current use of Western herbal medicine
  • Herbal properties and actions of plants
  • Herbal constituents (compounds that have medicinal properties), medicinal actions (function in the body), and indications
  • Critical evaluation of literature and research in regard to both efficacy and interactions/contraindications of botanical medicines
  • Optimal extraction and delivery for a variety of plants
  • Botanical prescription writing
  • Organ systems-based botanical medicine formulation and topical application, including: gastrointestinal, respiratory, immune, cardiovascular, ears/eyes/nose/throat, reproductive, urinary, endocrine, musculoskeletal, and nervous systems
  • Choosing, assessing and preparing herbal medicine in various forms including aqueous extracts, tinctures, herbal oils and salves, syrups, capsules, oxymels, poultices, and compresses. This includes evaluating comparable advantages and disadvantages of each type of preparation
  • Dose ranges, contraindications, toxicity, side effects, and interactions
  • Sustainability of herbal medications
  • Effective creation of individualized formulas for patients
  • Translation of labels to determine the purpose and application of over-the- counter herbal products
  • This comprehensive training combined with a focus on treating the whole person—mind, body, and spirit—enables naturopathic doctors to utilize botanical medicine when best suited to effectively treat the patient based on their diagnosis and presentation. By spending extra time to evaluate and diagnose patients and then drawing on a spectrum of therapies including botanical medicine, clinical nutrition, and behavioral and lifestyle medicine, naturopathic doctors tailor comprehensive treatment to each patient, with a close eye on safety.
     Botanical Medicine for Cold and Flu
    Naturopathic doctors individualize botanical medicine treatments for numerous acute and chronic conditions. One example is cold and flu prevention/treatment. More people are seeking alternatives to prescription pharmaceuticals such as antibiotics, which can damage the gut, and to over-the-counter medications such as analgesics, decongestants, and antihistamines, which can suppress the body’s ability to produce antibodies and/or cause unwanted side effects. Examples of safe and effective botanical medicines commonly used by NDs for cold and flu prevention and treatment include:
     Elder (Sambucus)—a flower or berry that can be used as an anti-inflammatory, anti-viral, antioxidant, often used in syrup formGarlic—an anti-microbial herb that can help break up mucus, and is delivered through tinctures, syrups, capsules, or crushed freshThyme—an anti-microbial herb, also an immune stimulant, effective against biofilms, and can also help relax a spastic coughEchinacea—an anti-inflammatory, immune modulating herb that can activate white blood cells to fight infection and also be used for prevention

    While licensed naturopathic doctors are also trained to use pharmaceutical drugs, and can prescribe them where state license permits, they emphasize less toxic substances like botanical medicine that promote natural healing first, following the Therapeutic Order to provide the greatest benefit to patients with the least potential for damage.

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    Why and how do naturopathic doctors focus on prevention? Septembre 2018
    View the printable PDF version.

    The AANP and INM would like to acknowledge Amy Rothenberg, ND, for her contributions to the content of this FAQ.

    Naturopathic doctors (NDs) follow six guiding principles that serve as a philosophical platform for all of naturopathic medicine. The principles influence how NDs think about medicine, make clinical decisions, and most importantly, how you are treated as a patient. Prevention is one of these six core principles.

    Half of all Americans live with at least one chronic disease, like heart disease or diabetes. Chronic conditions are the leading causes of death and disability and a leading driver of health care costs in America. But among U.S. adults, 90 percent of Type 2 diabetes, 80 percent of cardiovascular disease, 70 percent of stroke, and 70 percent of colon cancer are potentially preventable by modifiable lifestyle changes. The right preventive care at every stage of life helps Americans stay healthy, avoid or delay the onset of disease, and keep diseases they already have from becoming worse or debilitating. However, Americans use preventive services at about half the recommended rate.

    Licensed naturopathic doctors (NDs) proactively focus on prevention both to benefit individual patients and to improve public health. Beyond reactively treating disease, naturopathic doctors emphasize and help individuals build optimal health by:

  • Spending extra time with patients to identify the determinants of health and disease
  • Approaching health through the lens of the whole person—body, mind, and spirit
  • Educating about and promoting healthy lifestyle choices
  • Assessing and addressing risk factors and implementing early interventions
  • Determining genetic and hereditary susceptibility to disease
  • Evaluating and addressing environmental and other external impacts on health
  • Determining the impact of social relationships and community on health, and working to improve them, when relevant
  • NDs are educated and trained to use pharmacological drugs when necessary and can prescribe medication to manage symptoms if their state license permits. However, because naturopathic doctors focus on supporting the body’s health restoring and maintenance processes, they offer the gentlest, least toxic, evidence-based treatments first.

    Non-drug approaches offer effective prevention strategies that can improve health outcomes. Studies have found a 40 percent average reduction in LDL (i.e., comparable to statins) in patients who were asked to consume a whole foods plant-based diet low in both fat and refined carbohydrates (along with moderate exercise, meditation/yoga, and social support). In addition, studies have shown that proper testing, treatment, and lifestyle changes such as losing weight, adopting a healthy diet, and physical activity have beneficial effects on people with Type 2 diabetes and are the cornerstones of diabetes prevention for at-risk individuals.

    For those with an established disease that is not going away—such as chronic arthritis or permanent disabilities—naturopathic doctors use prevention strategies to strengthen health and improve quality of life and life expectancy. NDs’ rigorous training in areas such as clinical nutrition, behavioral medicine, botanical medicine, and other natural treatments makes them expert at prescribing and supporting essential, effective, and enduring behavior and lifestyle modifications.

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    How do naturopathic doctors treat anxiety? Octobre 2018
    View the printable PDF version.

    The AANP and INM would like to acknowledge Moira Fitzpatrick PhD, ND, FICPP, CHT, for her contributions to the content of this FAQ.

    40 million adults in America suffer from anxiety, the most commonly diagnosed mental condition in the country. Unique for every person, Generalized Anxiety Disorder (GAD) is often experienced as excessive, uncontrollable worry about a variety of topics in a manner disproportionate to their potentially posed risk. Chronic nervousness, agitation, a restless mind, muscle tension, racing heart, and sleep disturbance are common symptoms.
    Anxiety can have a variety of root causes from genetic to biological to environmental. Common first-line treatments often focus on prescription medications and/or therapy. While pharmaceutical drugs can provide symptom relief, these same drugs often have limited effectiveness. Drugs such as Benzodiazepines can also be highly addictive and can cause unwanted side effects. A growing body of research is uncovering dangers associated with commonly prescribed drug treatments including selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Lexapro, and with benzodiazepines such as Xanax and Ativan.

    Licensed naturopathic doctors (NDs) excel at treating anxiety because they focus on treating the whole person, and on addressing the underlying causes of the condition. NDs have a deep toolbox of evidence-based, natural therapies including clinical nutrition, botanical medicine, and behavioral medicine to draw from.

    Identifying Underlying Causes of Anxiety
    Naturopathic doctors begin by assessing the whole person. Initial appointments often last one hour or more and include a detailed family history, medical history, discussion of diet, physical activity, environmental exposures, sleep patterns, and psycho-emotional stressors. There are a wide variety of underlying causes for anxiety. Naturopathic doctors consider:

    Genetic predisposition— An understanding of genetic markers and pathways contributes to a more precise and personalized approach to treatment. Single Nucleotide Polymorphisms (SNPs) are the most frequent type of mutation. NDs look at patterns in SNPs and see how they affect B vitamins, hormones, nutrients, neurotransmitter production, and breakdown. This information provides foundational support to treatment planning.

    Neurological imbalance—The balance of chemicals in the brain helps control mood and can play an important role in anxiety. Your ND will look for imbalances in serotonin, gamma-aminobutyric acid (GABA), and norepinephrine.

    Digestive/microbiome dysfunction—The microbiome or ‘good germs’ that line your digestive tract play an important role in balancing your nervous, hormonal, and immune systems. Your ND may order a stool analysis test to evaluate the health of your GI tract. You can also expect a detailed discussion of your diet, and potential labs to identify food sensitives and nutritional deficiencies.

    Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis—Your HPA axis is your body’s stress response system. In the face of chronic psychological stress, the adrenal glands excrete an abnormal amount of cortisol in an abnormal rhythm. This can be caused by a number of factors, including blood sugar imbalance, lack of sleep, caffeine, toxins, and allergens. Your ND may order lab testing if this condition is suspected.

    Evidence-Based Naturopathic Medicine Treatments
    Naturopathic doctors provide highly individualized therapies. They are trained in the pharmacological treatments commonly prescribed by conventionally trained MDs, and in some states, have scope for prescription of pharmaceuticals when necessary. When it is necessary to use medications, genetic testing can help determine which medications you will be responsive to with the least side effects. NDs lead with minimally invasive therapies that support the body to restore healthy function. Naturopathic therapies include:

    Improve gut health. Research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection supports the importance of a nutritional and diverse diet, and supplementation with probiotics. NDs have the expertise to balance the microbiome and address food sensitivities and leaky gut thanks to their rigorous training in clinical nutrition.

    Repair and restore with nutritional and botanical supplements. NDs utilize a multitude of evidence-based nutritional and botanical supplements for their calming effects to help reduce the frequency, severity, and duration of generalized anxiety and panic disorders. These treatments are individualized and evaluated carefully for safety in every patient. Effective supplements include: Gamma-aminobutyric acid (or GABA), L-theanine, passionflower, scutellaria lactiflora (skullcap), hops, Piper methysticum (kava), lavender, adaptogens such as Withamnia Somnifera (ashwagandha), lithium orotate, and magnesium.

    Manage stress with behavioral medicine. NDs are trained to evaluate your symptoms in the context of your lifestyle, behavior, and social-cultural environment. By examining the details of your diet, stress level, sleep, physical activity, and more, they can prescribe the most effective, evidence-based behavioral medicine treatments and mind-body medicine techniques. These include mindfulness, therapeutic exercise/yoga, biofeedback, progressive muscle relaxation, breath work, and meditation. For some patients, addressing repressed or current trauma can play a significant role in treating anxiety. Naturopathic doctors who are highly specialized in mental health, such as those certified by the Psychiatric Association of Naturopathic Physicians, can offer energy-based therapies which focus on the release of trauma. These may include hypnotherapy, guided visualization, cranial sacral therapy, and other specialized modalities.

    Optimize lifestyle factors. Because of the extra time they spend getting to know you, NDs uniquely tailor recommendations to optimize lifestyle habits such as sleep, diet, exercise, and reduction of stimulants, all of which play contributing roles in anxiety. 
    NDs may evaluate and utilize additional strategies and therapies for different types of anxiety disorders, including anxiety in perimenopausal women, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, and panic disorder.

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    How do Naturopathic Doctors Treat ADHD? Octobre 2018
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    The AANP and INM would like to acknowledge Paul Herscu, ND, MPH, for his contributions to the content of this FAQ.

    Attention Deficit Hyperactivity Disorder (ADHD) is a chronic, neurobiological condition that affects nine percent of children and four percent of adults in America. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity, and impulsive behavior. Many diagnosed with ADHD also struggle with concurrent states such as low self-esteem, troubled relationships, poor performance in school or work, anxiety, learning disabilities, and other mental, emotional, and behavioral disorders.

    The common first line of treatment for ADHD is medication such as a stimulant (e.g. Adderall, Ritalin) or non-stimulant (e.g. Intuniv, Strattera) for those age six and above. While prescription drugs can be extremely effective addressing symptoms in the short-term, for many, the effects fade after prolonged use. Additionally, these medications may not address underlying causes or concurrent conditions, and frequently cause unwanted side effects including weight and height disturbances, sleep disruption, personality changes, “tics,” and even addiction. The consequences of taking stimulants for years on end have not been fully evaluated in studies, and use during pregnancy is still in debate. These challenges lead many to discontinue medication, seeking complementary or alternative approaches. Whole-person treatment can help address these hurdles.

    Licensed naturopathic doctors (NDs) excel at treating ADHD because they focus on treating the whole person—mind, body, and spirit. Understanding how each person is experiencing their ADHD symptoms and discovering what is most limiting for them is important in the naturopathic approach. NDs have rigorous training in evidence-based treatments that have been shown to address underlying causes while improving ADHD symptoms. These treatments include clinical nutrition, behavioral medicine, and botanical medicine. Depending on the individual, naturopathic treatment can support conventional care, or be a primary treatment.

    Whole Person Whole Patient, Individualized ApproachNaturopathic doctors spend extra time with patients to evaluate the whole person, including: diet, lifestyle, genetics, psycho-emotional makeup, socioeconomic position, environmental issues, and more. They are able to provide patients and their families with a high level of emotional and psychological support. Often, NDs assess multiple body systems including digestive/gastrointestinal (for inflammation), nutritional (for deficiencies or sensitivities), immune, and neurological (neurotransmitter regulation) to get a full picture of the patient's needs. The goal is to identify areas of dysfunction and then develop a plan to restore optimal function. In addition to the physical body, how an individual with ADHD feels mentally and emotionally always influences which therapies are selected. The age of the patient is taken into careful consideration. All of these pieces are taken together when building a comprehensive naturopathic care plan tailored to the patient.

    Evidence-Based Naturopathic Treatments

    Diet and lifestyle changes. Diet plays an enormous role in brain function. An ADHD assessment and treatment plan may include food sensitivity testing to pinpoint and help avoid those foods that are contributing to hyperactivity and distraction. An elimination diet can be effective, where common allergens and foods containing artificial dyes and high levels of salicylates are removed from the diet. A Mediterranean diet, rich in fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil may also be considered. It is also important to make sure blood sugar levels stay balanced through regular protein consumption. Additionally, improving sleep hygiene can play a role in managing ADHD symptoms. Emerging evidence shows that physical exercise, yoga, and time spent in nature can benefit children with ADHD.

    Supplementation. Deficiencies in magnesium, iron, and vitamin-D are associated with ADHD. Research also supports a connection between B-vitamin deficiencies and ADHD symptom severity. NDs evaluate and address these deficits with proper supplementation. Further, numerous studies have demonstrated improvement in symptoms of ADHD through the use of supplemental fish oil. Because a good balance of healthy bacteria in the gastrointestinal system can positively impact brain health, supplementation with probiotics can also help reduce symptoms of ADHD.

    Botanical medicine. Botanical or herbal medicines can help calm the nervous system and address restlessness, anxiety, and irritability associated with ADHD. Bacopa monnieri and Ginseng are just a couple examples of beneficial botanical medicines that NDs utilize. Naturopathic doctors will individualize formulations for patients.

    Behavioral medicine. The American Academy of Pediatrics states that behavioral therapy should be the first step in treating ADHD in pre-school-aged children. Sometimes called behavioral modification, this approach works on resolving specific problematicbehaviors and offers solutions to help prevent them. Cognitive behavioral therapy (CBT) can help children and adults with ADHD overcome difficulties in everyday executive functions that are needed to effectively manage time, organize, and plan in the short term and the long term. CBT can also focus on concurrent and associated symptoms such as anxiety, emotional self-regulation, impulse control, and stress management. Neurofeedback is a therapy that uses real-time EEG data to help train brains to improve focus, impulse control, and other challenges associated with ADHD. A number of studies have shown that neurofeedback can improve certain ADHD symptoms. Naturopathic doctors refer patients to licensed therapists for these therapies as needed.

    ADHD is a complex disorder impacted by numerous genetic, neurological, nutritional, and environmental factors. Whole-person naturopathic medicine strategies can offer patients many benefits.

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    How do naturopathic doctors help prevent cognitive decline?                        November 2018

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    The INM and AANP would like to acknowledge Doni Wilson, ND, Sara Thyr, ND, and Amy Rothenberg, ND, for their contributions to the content of this FAQ.

    As the aging baby boomer generation grows, a growing number of Americans are projected to have dementia and associated cognitive decline. Currently over five million Americans are living with Alzheimer’s, a degenerative brain disease and the most common form of dementia. By 2050 that figure is expected to rise to 14 million, a staggering number of afflicted patients causing overwhelming strain on caregivers and the economy. Licensed naturopathic doctors (NDs) have effective approaches for the prevention of cognitive decline based on rigorous training in therapeutic nutrition, behavioral medicine, botanical medicine, and an emphasis on addressing the underlying causes of disease.What is Cognitive Decline?

    Cognitive decline describes a noticeable and measurable impairment in cognitive abilities, including memory, language, thinking, and judgement. It is characterized by damage to brain cells, specifically, an accumulation of amyloid plaques and neurofibrillary tangles in the brain. This accumulation is influenced by a number of lifestyle, environmental, and genetic factors.

    Risk Factors and Prevention
    Studies have suggested that one-third of dementia cases worldwide could potentially be prevented through better management of health and lifestyle factors. The biggest risk factors for dementia-related cognitive decline outside of age and family history/genetic pre-disposition are heart disease, diabetes, stroke, depression, and stress. Addressing chronic illnesses and lifestyle choices helps reduce the risk of developing dementia. Prevention is a focal point of naturopathic medicine, and NDs have a proven track record of helping patients manage specific chronic health conditions such as heart disease, hypertension, and diabetes.

    Exercise and Weight Loss

    The role of exercise in prevention and slowing of cognitive decline is always part of the naturopathic medicine prescription. Naturopathic doctors spend extra time with patients and caregivers to find and tailor opportunities for physical activity. Studies confirm that obesity late in life is another risk factor for Alzheimer’s. Naturopathic doctors help address underlying metabolic imbalance to support long- term healthy weight maintenance.

    Diet and Supplementation
    NDs assess and help optimize your diet to decrease inflammation and maintain blood sugar balance. Therapeutic nutrition through food and supplementation are often part of the plan. A number of herbal supplements including curcumin, resveratrol, and Bacopa monnieri have been shown to help reduce inflammation in the brain and support brain health.

    Sleep
    Studies show that insomnia and lack of sleep can increase the risk of Alzheimer’s. Additionally, medications often used to help with insomnia also increase risk of cognitive decline. NDs are experts at resolving sleep issues using natural approaches such as herbal medicine, hydrotherapy, and blue-light blocking goggles.

    Social Interaction
    Treating the whole person, naturopathic doctors also educate and motivate patients to keep up ongoing social interaction, an important factor for both the prevention and slowing of dementia. Emerging research has identified hearing loss as a modifiable risk factor for dementia. Actively wearing aids, to help ease and encourage social interaction, has the potential to delay cognitive decline. You are more at risk for hearing loss if you have diabetes, heart disease, or if you smoke.

    Helping families create, access, and integrate cognitive exercises has also been shown to help prevent dementia. NDs can prescribe such programs, or refer you to and partner with, specialists in that field.

    Stress Reduction
    Naturopathic doctors often recommend mindfulness meditation, and other forms of stress reduction such as gardening, journaling, and listening to music for the prevention of cognitive decline and to enhance memory and quality of life for those already diagnosed.

    Minimizing Reliance on Drugs that Increase Risk
    It is important to remember that memory loss and cognitive decline can be symptoms of other disease processes or drug side effects and may be reversible. A proper diagnosis with a licensed provider is essential before beginning any kind of treatment with conventional and/or naturopathic medicine.

    Some commonly prescribed drugs create additional risk factors for dementia, such as proton pump inhibitors for gastroesophageal reflux (GERD). Naturopathic doctors address GI concerns with natural and lifestyle approaches. Research has also shown that long-term use of Zolpidem (Ambien) one of the most commonly prescribed medications for sleep, is associated with an increased risk of Alzheimer’s.

    While there are no known cures for Alzheimer’s and other forms of dementia, naturopathic medicine offers highly individualized, whole-person prevention strategies.

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    How do naturopathic doctors diagnose and treat Crohn’s disease and ulcerative colitis?           December 2018
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    The AANP and the INM would like to acknowledge Eric Yarnell, ND, for his contributions to the content of this FAQ.

    When diagnosing and treating patients with acute or chronic gastrointestinal (GI) symptoms, licensed naturopathic doctors (NDs) address the whole person—including body, mind, emotions, genetics, environmental exposures, and socio-economic status. NDs employ a variety of diagnostic approaches to pinpoint the underlying causes of distress. Trained rigorously in clinical nutrition, behavioral medicine, botanical medicine, and conventional pharmaceuticals, NDs draw on a broad and deep spectrum of treatments, expanding options for patients with Crohn’s disease and/or ulcerative colitis.

    What are Crohn’s Disease and Ulcerative Colitis?
    Crohn’s disease (CD) and ulcerative colitis (colitis or UC) are the most common disorders in a group of auto-immune GI diseases referred to as inflammatory bowel diseases (IBDs). Crohn’s may develop anywhere in the digestive tract; ulcerative colitis is limited to the large intestine and rectum. Thought to be caused by your body’s immune system having an abnormal reaction to normal bacteria in your intestine, both diseases are chronic, lifelong, and often debilitating. Intestinal pain, dangerous obstructions and blockages, abscesses and ulcers are all possible complications. Acute flare-ups can be triggered by foods, stress, anxiety, depression, or acute infections. Tobacco products can also trigger flares of Crohn’s disease.

    How are Crohn’s and Colitis Diagnosed?
    Crohn’s and ulcerative colitis can be hard to diagnose because symptoms vary from person to person, and are similar to those of other diseases. For example, the most common symptoms of Crohn’s are intense abdominal pain and diarrhea. However, a person with Crohn’s disease can have constipation and diarrhea and sometimes blood in the stool, although some people with constipation will not have any diarrhea or blood in the stool. In addition, the typical symptoms of Crohn’s can be identical to those of small intestinal bacterial overgrowth (SIBO). With ulcerative colitis, symptoms typically include bloody diarrhea, frequently accompanied by abdominal pain and weight loss.

    Given the complexities of Crohn’s and ulcerative colitis, a correct diagnosis is essential to effective treatment. There is no one definitive test for Crohn's disease. Testing is determined by the suspected location, small vs. large bowel. In addition to a comprehensive health history and an in-office exam, a naturopathic doctor may order stool testing to assess gut bacteria, markers of inflammation, and immune markers. NDs may also order blood testing for food sensitivities/allergies, celiac antibodies, folic acid deficiency, and inflammatory indicators such as C-reactive protein.

    Diagnosis usually involves endoscopic or imaging studies in patients with compatible clinical history, and naturopathic doctors refer patients to gastroenterologists for this vital testing.  Colonoscopy is the most appropriate first test for a patient presenting with diarrhea and suspected large bowel CD. Wireless capsule endoscopy is increasingly being used for evaluation of suspected small bowel CD. Imaging studies are generally considered more appropriate for those with abdominal pain and to evaluate the small bowel. These can include upper GI radiography with barium, computed tomography (CT) and computed tomography with enterography (CTE), magnetic resonance imaging (MRI), and magnetic resonance enterography (MRE). Diagnosis can also be supported by specific findings such as perianal skin tags or abdominal tenderness.

    Naturopathic doctors also frequently test fecal calprotectin, an inflammatory substance produced by neutrophil white blood cells. Measuring calprotectin is helpful in establishing that there is inflammation in the lower intestinal tract.

    Individualized Naturopathic Treatment for Crohn’s and Colitis
    Once a patient has been diagnosed with Crohn’s, ulcerative colitis, or other IBDs, a naturopathic doctor will create a tailored treatment plan based on each patient’s individual presenting symptoms understood in context with the patients’ overall health and lifestyle. While there are no well-documented cures for either disease, the goal is to help prevent flare-ups, achieve and maintain remission, and heal as much of the underlying inflammation (even in periods without symptoms) as possible. Specific treatments a naturopathic doctor may recommend include:

  • Elimination/challenge diets or other approaches to reducing food triggers (including elemental diets) to stop and prevent flare-ups
  • Curcumin in tincture, capsule, or whole turmeric powder form to reduce inflammation (however, there are contraindications to the use of turmeric. For instance, turmeric should be avoided in patients who readily form calcium oxalate kidney stones)
  • Probiotics to modulate the immune system and prevent flare-ups
  • Stress reduction by various techniques
  • Artemisia absinthium (wormwood) capsules
  • Because they are lifelong conditions, Crohn’s and ulcerative colitis must be carefully monitored and managed, with more aggressive interventions necessary during flare-ups.  Research shows that a naturopathic medical approach emphasizing diet and other lifestyle changes can be used to successfully manage these conditions. Naturopathic therapies may eliminate the need for prescription drugs (such as prescription anti-inflammatory medications, immune system suppressors, and antibiotics) or surgery, which have the potential to cause more side effects and long-term problems. However, if natural approaches are not successful, naturopathic physicians do not hesitate to prescribe palliative medications (when in state scope of practice) or to refer patients for treatment with various medications, biologic drugs, or surgery. A naturopathic medical approach has the added benefit of focusing on engaging patients in managing their own health—a crucial component of living a long and healthy life with these challenging conditions.

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    How do naturopathic doctors treat hypothyroidism? Janvier 2020
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    Of the 20 million Americans who have thyroid disease, most have hypothyroidism, a condition where the thyroid gland can’t make enough thyroid hormone to keep the body running normally. More common in women than men, hypothyroidism can have a number of genetic, nutritional, and immune-related underlying causes and contributing factors. Licensed naturopathic doctors (NDs) have effective approaches for the treatment of hypothyroidism based on rigorous training in therapeutic nutrition and botanical medicine, and an emphasis on addressing the underlying causes of disease.

    Hypothyroidism: What is it and what are the symptoms?

    The thyroid gland is a butterfly-shaped endocrine gland located in the lower front of the neck. The thyroid’s job is to make hormones which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body make energy, metabolize, regulate temperature, and keeps the brain, heart, muscles, and other organs working as they should. When the body isn’t making enough thyroid hormone, symptoms can include fatigue, weight gain, hair thinning, dry skin, and depression. Low thyroid hormone can also cause more serious symptoms like difficulty sleeping, changes in menstruation, or gastrointestinal symptoms. Because symptoms of hypothyroidism can resemble those of other diseases and vary widely from person to person, patients may not recognize them as a problem warranting exploration or treatment. Experts believe that between 40 and 60 percent of people with thyroid disease do not know they have it.

    Hypothyroidism: Diagnosis

    Typically, blood tests are used in the diagnosis of hypothyroidism. Three measurements are often considered: free thyroxine (T4) and free triiodothyronine (T3), both produced by the thyroid itself, and thyroid-stimulating hormone (TSH, also called thyrotropin), produced by the pituitary gland to regulate the thyroid. While many doctors follow the current TSH reference ranges for diagnosis (0.4 to 5.0mU/L), there is a lot of controversy about what is diagnosable and treatable as hypothyroidism and sub-clinical hypothyroidism (when blood levels of free T3 and free T4 are normal, but the level of thyroid-stimulating hormone is high). A blood test measuring thyroid antibodies anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) is used to confirm or rule out autoimmune thyroid disease causing hypothyroidism.

    Hypothyroidism: Underlying Causes
    Naturopathic doctors treat hypothyroidism from the root of the problem. There are two main types of hypothyroidism, with numerous contributing factors:

    Autoimmune thyroid disease (Hashimoto’s) is the most common cause of hypothyroidism. This is a form of thyroid inflammation caused by the patient's own immune system. Hashimoto’s is five to eight times more common in women than men. Elevated levels of anti-TPO antibodies are found in approximately five percent of adults and 15 percent of older women. Individuals with other autoimmune diseases such as type 1 diabetes, celiac disease, and rheumatoid arthritis have a higher prevalence of autoimmune thyroid disease.

    Central or pituitary hypothyroidism, where the thyroid just isn’t making enough hormone, is often influenced by environmental and nutritional factors including: gastrointestinal system inflammation, vitamin and mineral deficiencies or imbalances, high levels of cortisol (due to prolonged stress or oral steroid use), and/or elevated estrogen. Surgery on the thyroid gland (to remove a goiter or nodule) and/or radioactive iodine treatment (to treat a thyroid nodule, hyperactive thyroid, throat cancer, and cancer of nearby sites) can also cause hypothyroidism.

    Hypothyroidism—Naturopathic Treatments
    The current conventional medical treatment for hypothyroidism is daily thyroid hormone supplementation with synthetic levothyroxine (T4), liothyronine (T3), or natural desiccated thyroid (T4 and T3) to correct low levels. While this treatment can be very effective for some patients, for others with Hashimoto’s taking thyroid hormone alone does not fully address the underlying cause of dysfunction. For some, the medication can create a yo-yo-ing of symptoms while trying to find the correct dosage. Other individuals don’t tolerate or absorb thyroid hormone well.

    Naturopathic doctors are trained in the pharmacological treatments commonly prescribed by conventionally trained MDs, and in some states, prescribe pharmaceuticals when necessary. However, NDs rarely use medication as a standalone treatment.

    If autoimmune disease is the main cause of thyroid dysfunction, NDs work to help control the inflammation and eliminate autoimmune triggers. Working to reduce thyroid antibodies, if possible, is the main goal of treatment. If the thyroid is just not producing enough thyroid hormone, NDs address lifestyle and environmental factors that may be contributing to low production. Although every hypothyroid treatment is carefully individualized, some common natural therapies for hypothyroidism include:

    Diet and Microbiome
    Many nutritional factors play a role in optimizing thyroid function, and the right diet is important to help prevent and manage conditions that can accompany thyroid disease. When it comes to Hashimoto’s and other autoimmune conditions, research shows that one important factor in autoimmune response is chronic, persistent microbiome imbalance and inflammation in the gut. Naturopathic doctors address microbiome dysfunction with nutritional therapies such as probiotics, cultured foods, and diets lower in sugar, starch, and carbohydrates, which help to decrease inflammation and balance immunity. Food allergy panels and/or an elimination diet can help identify food triggers to the autoimmune response for Hashimoto’s. Those with an autoimmune thyroid disorder should also be tested for celiac disease to determine if gluten elimination is needed.

    Supplémentation
    Naturopathic doctors test for common nutrient deficiencies associated with hypothyroidism, and supplement as needed.

  • Vitamin B-12 is very important for thyroid production. It helps improve cellular response to thyroid hormone and boosts energy production in cells to help with fatigue and other symptoms associated with hypothyroidism.
  • Selenium supports efficient thyroid synthesis and metabolism and has been found in studies to reduce thyroid antibody levels in patients with Hashimoto’s.
  • Zinc is beneficial in improving thyroid function and hormone levels and has been shown in studies to have a positive effect on thyroid function in overweight females.
  • Botanical Herbs
    There are several herbs that have been shown to benefit thyroid function, including adaptogens like Ashwagandha, which was shown to improve thyroid function for subclinical hypothyroid patients. Adaptogens are herbs that work on several body functions at once to help balance out dysfunction and regulate metabolic processes. They are used with caution, however, in those with autoimmune thyroid disease as some botanicals can stimulate the immune system response. Other herbs such as gum guggal can be used in all forms of hypothyroidism as they help to convert the inactive form of T4 to the more active form of T3. Any herbal treatment should be approved by a professional trained in herbal medicine to reduce side effects, prevent unwanted drug/herb interactions, and maximize treatment efficacy.

    Regulation of thyroid function can be tricky and requires a whole-person approach. Naturopathic doctors lead with natural therapies that address underlying causes and support the body to restore healthy function.

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    Who ensures the quality of naturopathic medical schools? Janvier 2020

    View the printable PDF version.

    The AANP and INM would like to acknowledge Marianne Marchese, ND, and Daniel Seitz, JD, EdD, for their contributions to the content of this FAQ.

    Accreditation is an external peer review and regulatory process for higher education. Its goal is to ensure high-quality education and training in various disciplines, including medical education, in order to protect the interests of students and the public, and to ensure safe and effective practice. Accreditation is usually carried out by private, non-profit organizations that are “recognized” (i.e., approved) by the U.S. Department of Education.

    How are naturopathic medical schools accredited?

    Naturopathic medical programs that award the naturopathic doctoral degree (ND degree) are accredited by the Council on Naturopathic Medical Education. This process is similar to the accreditation of the Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees, and the U.S. Department of Education recognizes the accrediting agencies that oversee schools granting these three degrees. All three of these degree programs—MD, DO, and ND—must go through a rigorous process of initial accreditation, as well as periodic, ongoing re-accreditation—generally every five to 10 years, depending on the field—to ensure continued high-quality education and training.

    Why is accreditation necessary?

    Accreditation ensures that high educational standards reflecting the needs of a given medical profession have been established and are being met. Additionally, accreditation provides the foundation for practitioner licensing and regulation. Specifically, accreditation signifies that a college or educational program has met or exceeded the standards for:

  • educational quality with respect to mission, goals, and objectives
  • governance, administration, and finance
  • facilities, equipment, resources, faculty, student admissions, performance, and evaluation
  • preclinical and clinical curriculum
  • research and scholarship activity
  • Accreditation ultimately protects consumers and students, providing an assurance that a program has met set educational standards, and that if said standards are not maintained, recourse will be available for the student.

    Who oversees accreditation?

    There are three U.S. accrediting agencies for the recognized medical professions. The Liaison Committee on Medical Education (LCME) is the accrediting body for the MD degree. The Commission on Osteopathic College Accreditation (COCA) is the accrediting body for the DO degree. And, as mentioned above, the Council on Naturopathic Medical Education (CNME) is the accrediting body for the ND degree. These three accrediting agencies are recognized by the United States Department of Education (USDE). In some fields, there are accrediting entities that are not recognized by USDE; in some cases, these entities are not legitimate. Thus USDE recognition is an important distinction to be aware of.

    How rigorous is the accreditation process?

    Accreditation is a highly demanding process. Generally, it involves the submission of extensive information and documentation by a school seeking initial or renewed accreditation, followed by two to three days of on-site assessment. The on-site assessment encompasses careful observation and evaluation of many aspects of the school including: facilities, administration, faculty, curriculum, student performance, and more. Members of the on-site review team and of the accrediting bodies are unpaid volunteers, and every effort is taken to ensure that there are no conflicts of interest that may interfere with objectivity. The medical school accrediting agencies are made up of professional members (physicians), institutional members (faculty or administrators of schools), and public members. Some agencies have student representatives as well. The U.S. Department of Education oversees all three medical school accrediting agencies in order to ensure that the accrediting process is thorough, objective, and fair.

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    Do naturopathic doctors prescribe medication? Février 2020

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    The INM and AANP would like to acknowledge Christie Fleetwood, ND, RPh, for her contributions to the content of this FAQ.

    Licensed naturopathic doctors (NDs) are trained as primary care providers to diagnose, prevent, and treat acute and chronic illness. NDs complete rigorous education in pharmaceutical drugs during their four-year, science-based medical education, and they may prescribe medications when indicated as allowed by state regulations. However, naturopathic doctors typically don't prescribe drugs at the first sign of symptoms or trouble. Instead, NDs choose to work with natural, less invasive therapies without strong side effect profiles before reaching for the prescription pad. They support and enhance a patient’s innate capacity for healing with evidence-based therapies such as lifestyle modification, clinical nutrition, botanical medicine, and behavioral medicine, to name a few.

    Pharmacology education and training
    Pharmacology is taught through a series of courses that build upon each other through an ND’s medical education. This training is reinforced through a minimum of 1,200 hours of hands-on, clinical training. Naturopathic medical programs are accredited and are recognized by the United States Department of Education. Pharmacology is an essential part of the Naturopathic Physicians Licensing Examination (NPLEX), the passage of which is required before a doctor of naturopathic medicine can be licensed or regulated by a state/province.

    As part of the pharmacology curriculum, naturopathic doctors learn both medical and clinical pharmacology. They study primary therapeutic uses, mechanisms of action, potential adverse effects, and drug/drug interactions of medicines commonly encountered, including prescription drugs, controlled substances, and over the counter (OTC) medications. Additionally, they learn how to prescribe and manage pharmaceuticals for the most common presenting concerns in primary care medicine.

    While pharmacology coursework is comparable to that taught in conventional medical schools, NDs receive additional training and focus in two important areas:

  • Botanical or herb/drug and supplement/drug interactions. Seventy-five percent of Americans regularly take herbs and dietary supplements, and they don’t always inform their primary care doctor. Naturopathic doctors complete approximately 130 classroom hours of botanical medicine education. This encompasses the science and practice of using medicinal plants and extracts to improve overall health, support wellness, and treat acute and chronic disease. An extensive knowledge of herbs and supplements allows NDs to better help guide patients and prevent harmful interactions.
  • Identification of nutrient depletions caused by long-term use of drugs. Some of the most commonly prescribed or recommended drugs can interfere with or cause deficiencies of vital nutrients with ongoing use. These include medicines prescribed for acid reflux, heartburn, cholesterol, and more. Naturopathic doctors are expert at identifying signs of nutrient depletion, and apply their extensive knowledge of clinical nutrition and botanical medicine to help reverse these harmful side effects.
  • NDs are also trained to identify when and whether a patient is overmedicated, and when prescriptions, OTC medicines, and supplements can be tapered off or discontinued.

    When NDs Use Pharmaceuticals
    Naturopathic doctors prescribe drugs based on available evidence, clinical experience, patient preference, and the Therapeutic Order. They match the patient’s level of health and pathology with the necessary level of intervention. As a principle, naturopathic doctors support and enhance the body’s inherent ability to heal itself. They utilize a deep toolbox of natural therapies to help get a patient healthy enough to heal disease without strong interventions. Yet when a careful assessment of lifestyle, social/emotional factors, physical exam, and/or targeted laboratory testing reveals that the patient is not able to heal with natural therapies, NDs will refer or prescribe appropriate medicine.

    The Therapeutic Order is the framework NDs use to evaluate the patient’s obstacles to healing and to choose therapeutic approaches in the most logical, least invasive ways first. If NDs do prescribe medication, they anticipate and address potential side effects of that medication with natural therapies. For example, if a patient requires antibiotics, which are known to wipe out needed, healthy bacteria in the microbiome in addition to harmful bacteria, NDs may also prescribe probiotic foods or supplements to help keep the GI system in healthy balance.

    Here are two care scenarios when a naturopathic doctor may use pharmacology in addition to natural therapies to treat acute or chronic illness:

  • A hypertensive patient with a comprehensive physical exam showing multiple signs of ongoing vascular damage including swollen ankles, skin discoloration, hair loss, and multiple blood pressure readings of 200 over 120. A detailed intake reveals that the patient’s diet consists largely of fast food and coffee. In this case, the patient requires a high level of intervention to prevent further harm, and the ND is likely to write a prescription for an anti-hypertensive drug, a diuretic, and refer the patient to a cardiologist for further testing. This is in addition to recommending significant lifestyle changes and other natural medicine approaches.
  • A patient is traveling and has left his "rescue inhaler" for asthma at home. He encounters an irritant (e.g. an excessive amount of smoke), and is wheezing and experiencing difficulty breathing. The ND would call in a prescription for an inhaler and work to restore the patient's health with natural approaches when he returns to his hometown.
  • Overall, naturopathic doctors believe that natural medicine and conventional medicine are not mutually exclusive. They recognize that there are times when both approaches can be utilized together for the patient’s benefit.

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    How do naturopathic doctors treat insomnia and other sleep problems? Mars 2020

    View the printable PDF version.

    The AANP and the INM would like to acknowledge Amy Rothenberg, ND, for her contributions to the content of this FAQ.

    If you struggle to fall asleep or stay asleep, you are not alone. Forty percent of American adults get less sleep than the nightly seven hour minimum recommended by the American Academy of Sleep Medicine. Good quality sleep is essential to whole-person health—mind, body, and spirit—and sleep deprivation can increase the risk of chronic disease, impact metabolism and hormone production, worsen cognitive and motor performance, and wreak havoc on your overall health. Licensed naturopathic doctors (NDs) are trained rigorously to identify and treat the numerous underlying causes of insomnia, and to address the psychological and biological impacts of not having enough sleep. With advanced training in therapeutic nutrition, botanical medicine, and behavioral medicine, NDs lead with safe, natural, and effective treatments to restore good sleep.
     Why is sleep important for overall health?
    The right quantity and quality of sleep is necessary to help optimize your mental health, physical health, quality of life, and safety. During sleep, your body is working to support healthy brain function and emotional well-being. While you're sleeping, your brain is forming new pathways to help you learn and remember information. Studies show that a good night's sleep improves learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative. Sleep deficiency has been linked to risk-taking behavior, depression, and suicide.

    Sleep deprivation has been shown to have an adverse effect on heart health. Helping to maintain a healthy balance of the hormones that make you feel hungry or full, sleep affects how your body reacts to insulin, the hormone that controls your blood sugar level. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, hypertension, diabetes, and stroke. Sleep deficiency also increases the risk of obesity. Your immune system relies on sleep to stay healthy, and ongoing sleep deficiency can make it harder for your body to fight common infections. Sleep also plays a role in puberty and fertility, and helps support growth and development in children.

    People who are sleep deficient take longer to finish tasks, have a slower reaction time, and make more mistakes. Studies show that sleep deficiency harms your driving ability as much as, or more than, being drunk.

    What are the underlying causes of insomnia?
    Lifestyle and environmental factors, psychosocial issues, and medical conditions can all influence sleep problems. Naturopathic doctors spend an hour or more assessing the whole person, exploring a wide variety of underlying causes for sleep disruption, including: Nutrition. Alcohol, caffeine, and nicotine may all contribute to insomnia. Refined sugar in desserts, sodas, and simple carbohydrates like white bread and barbecue sauce have also shown negative effects on restful sleep. When, what, and how much you eat can also interfere with your sleep.

    Studies show that partial sleep deprivation alters the gut microbiome. Lower proportions of microbiota (specifically phyla Verrucomicrobia and Lentisphaerae) was associated with poor sleep quality. In simpler terms, this implies that increasing your gut microbiota should help improve your sleep. The easiest way to do this is through diet. Eat foods high in fiber, such as lots of vegetables, legumes, beans, and fruit to help stimulate gut bacteria, or biota, digestion.

    Environment. Noise, light, room temperature, and other environmental irritants often affect sleep. NDs look for and address environmental exposures that may cause irritation, inflammation, and negatively impact Circadian rhythms. Common irritants include pollen, dander, noise, and blue light from phones and screens. Sufficient exposure to full spectrum light outdoors is also important to maximize melatonin production.

    Emotional + psychological causes. The relationship between sleep and mood is complex, because disrupted sleep can lead to emotional changes, clinical depression or anxiety (as well as other psychiatric conditions), but these conditions can also compound or further disrupt sleep. Research shows that people with insomnia have greater levels of depression and anxiety than those who sleep normally.

    Hormone imbalances. Imbalances in serotonin, cortisol, melatonin, estrogen, and testosterone can all contribute to sleep problems. Additionally, individuals with hypothyroidism, a condition where the thyroid gland does not make enough thyroid hormone to keep the body running normally, are also at higher risk of developing insomnia.

    Medication side effects. Medications such as those taken for the common cold and nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma, and depression can cause insomnia. The side effects are often dose-dependent. Other drugs commonly prescribed for sleep problems, such as Ativan, can affect quality of sleep.

    Individualized Naturopathic Treatments for Sleep
    Whole-person treatment is individualized and focused first on lifestyle changes including optimizing diet, environment, and sleep hygiene, removing stimulants, increasing physical activity, and creating routines.

    NDs carefully investigate and address microbiome imbalance with clinical nutrition, including probiotics and fermented foods. When emotional and/or psychological factors are involved, NDs work with patients and mental health professionals to identify and address depression, anxiety, and stress. They utilize behavioral medicine including mindfulness, breathing techniques, and meditation. When appropriate, NDs may prescribe botanical medicine to address stress, anxiety, and depression, including GABA, L-theanine, passionflower, and adaptogens such as Ashwaghanda. They will order lab testing if hormonal imbalances are suspected, and address them with nutraceuticals when possible, including melatonin, glycine, and tryptophan, as appropriate. NDs will also help identify prescription medications that may be negatively impacting sleep and, when possible and in communication with prescribing physicians, support patients reducing or discontinuing such drugs.

    Naturopathic doctors appreciate that insomnia is both the cause the effect of many serious health conditions. By looking at the whole person, addressing underlying causes and supporting your self-healing capacity, naturopathic doctors have many tools to help in the treatment of sleep problems.

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    How Do Naturopathic Doctors Treat Endometriosis?  April, 2020

    View the printable PDF version.

    The AANP and INM would like to acknowledge Marianne Marchese, ND and Amy Rothenberg, ND for their contributions to the content of this FAQ.

    Endometriosis is one of the common yet misunderstood medical conditions, affecting 10-15 percent of women of childbearing age. Licensed naturopathic doctors (NDs) utilize effective diagnostic interventions for discovering underlying causes of endometriosis. Trained extensively in clinical nutrition, botanical medicine, pharmaceuticals, and lifestyle counseling, naturopathic doctors provide patients with various options for a comprehensive treatment plan catered to the patient’s personalized needs.

    Endometriosis: What is it and what are the symptoms?Endometriosis is the presence of endometrial tissue outside the uterus. This uterine tissue is not restricted to the uterus and can be found on the ovaries, fallopian tubes, in the abdominal cavity and in other places throughout the pelvic area. This misplaced uterine tissue responds to monthly hormonal cycles and wreaks havoc in many ways. Depending on where the uterine tissue located symptoms can include painful periods, pain during or after intercourse, persistent lower back and pelvic pain, discomfort during bowel movements or urination, menses lasting longer than seven days, bloating, constipation, and diarrhea or nausea during menstruation. Endometriosis is also a common cause of infertility or endometrial cysts.

    Endometriosis symptoms may include painful periods, persistent lower back and pelvic pain, bloating, constipation, infertility, and more.

    Diagnostic
    Physicians diagnose endometriosis based on findings during a pelvic exam, presenting symptoms, and a thorough medical history. During the pelvic exam, doctors manually palpate the pelvis for abnormalities such as scars behind the uterus or growths on reproductive organs. Pelvic ultrasound and MRI are often ordered to rule out other causes of the patient’s symptoms. Laparoscopy remains the gold standard for the diagnosis of endometriosis.

    Underlying Causes
    While the exact cause of endometriosis is unknown, there are several hypotheses regarding how endometriosis may develop. One possible factor is retrograde menstruation, when the endometrial tissue flows backward, out through the fallopian tubes, and into the abdomen to implant and grow on organs in the pelvis. In addition, endometriosis lesions may arise from Mullerian anomalies that did not correctly differentiate or migrate during fetal development. Other factors such as hormonal imbalance, inflammation, toxic environmental exposures, and immunologic dysfunction may determine why lesions implanted in the pelvic cavity cause symptoms and/or persist. There is also likely a genetic component as endometriosis does run in families.

    Naturopathic Treatment
    Understanding multifaceted causes of endometriosis guides treatment for both acute and long-term challenges. Treatment for endometriosis begins by stimulation of the body’s innate ability to heal through restoring healthy inflammatory response, balancing hormones, and aiding the liver’s ability to break down environmental toxins and naturally occurring estrogens. For some, the treatment of endometriosis will also include surgery performed by a gynecologic surgeon.

    Some factors that may contribute to endometriosis may include genetics, hormonal imbalance, environmental exposures, and immunologic dysfunction. Naturopathic treatment also addresses the whole patient. For many women, endometriosis can cause high levels of stress, often due to pain, difficulty in diagnosis, and the trials associated with an often invisible illness. NDs help treat not just the body, but the symptoms of the mind and spirit too.

    Nutrition
    There are numerous nutritional influences related to endometriosis. Licensed naturopathic doctors often begin with the diet, where patients are able to take an active part in the management and prevention of symptoms. The recommendation of an anti-inflammatory diet is often part of the plan in order to reduce inflammation and help with the balance of estrogen.

    In a study of 500 women, there was a significantly decreased risk of developing endometriosis with higher consumption of fruits and green vegetables. Conversely, an increased risk for endometriosis was associated with high intake of red meat. Foods high in dietary fiber are associated with a healthy balance of microorganisms in the gut flora, where they play a significant role in breaking down estrogens and also reducing inflammation. Studies show that the inclusion of soy with its isoflavones can reduce the proliferation of endometrial cells.

    Naturopathic treatments including nutrition and dietary changes, botanical medicine, and supplementation have been shown to provide relief for endometriosis symptoms.

    Botanical medicine
    Botanical medicine has been shown to provide relief for some endometriosis patients, including:

  • Vitex (Chaste Tree) has traditionally been used as a treatment for hormone imbalances in women, causing estrogen to be less available to stimulate endometrial tissue growth. Motherwort gently soothes cramps and pain during times of extreme discomfort in the uterus and other lower abdominal regions. As a mild sedative, motherwort helps with needed relaxation during menstrual cramps.
  • Rosmarinus officinalis (Rosemary) has been researched as a strong anti-inflammatory herb and can be helpful for those with endometriosis pain.
  • Curcumin has also been shown to reduce estradiol which helps to reduce endometriosis symptoms.
  • Flax seeds with their anti-inflammatory impact and their capacity to reduce inflammation are also recommended.
  • Pycnogenol derived from Pine Bark has been studied and shows the capacity to reduce many of the painful symptoms of endometriosis.
  • Green tea has also shown promising results in the treatment of endometriosis.
  • Supplémentation
    Another natural treatment for endometriosis may include supplementation such as:

    Treating endometriosis can be challenging and requires a whole-patient approach encouraged by naturopathic doctors. Natural therapies that address the root cause can lead to appropriate treatments to support the body in restoring optimal function.

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    How Do Licensed Naturopathic Doctors Address Seasonal Allergies?   May, 2020

    View the printable PDF version.

    Seasonal allergies can impact everything from energy level to sinus congestion and for many patients, allergy season is a dreaded annual ritual. Licensed naturopathic doctors address allergies by treating the underlying causes of allergic reaction and by supporting the body’s inherent healing capacity. Main approaches used include therapeutic nutrition, botanical medicine, and lifestyle modification. In many areas spring seasonal allergies can begin in February and last until the early summer.

    Definition of an allergy
    An allergy occurs when the immune system reacts to an allergen as if it were a dangerous bacteria or virus. An “allergen” is typically defined as a “usually harmless substance capable of triggering a response that starts in the immune system and results in an allergic reaction.”

    During an allergic response, the body immediately begins producing “immunoglobulin E” antibodies, or IgE. These specific antibodies release chemicals like histamine that are designed to protect the body from allergens like pollen, mold, and dust. This histamine production is what ultimately leads to the annoying symptoms that plague us during pollen season: itchy eyes, runny nose, coughing, and more.

    An allergy occurs when the immune system reacts to an allergen as if it were a dangerous bacteria or virus.Seasonal allergies are typically plant-based. In the United States, spring allergies are usually associated with tree pollen, which can be combined with mold in a rainy season. Tropical climates often have grass pollen that can cause symptoms, while fall allergies have a strong association with ragweed blooms.Three-quarters of people who are allergic to pollen are also allergic to ragweed, a plant that grows in the United States, especially in Eastern and Midwestern regions. Symptoms of a ragweed allergy are similar to pollen allergies with sneezing, stuffy or runny nose, itchy eyes, trouble sleeping.

    What is oral allergy syndrome?
    Those with allergies to ragweed may also be sensitive to some foods like cantaloupe, bananas, chamomile tea, sunflower seeds, zucchini, and cucumbers can also cause symptoms in a phenomenon called oral allergy syndrome. There is a similar connection between birch allergies and stone fruit like apricots, cherries, peaches, plums – anything with a hard seed or pit. These symptoms can also be affected by seasonal pollen in the air and plants.

    What are some ways that naturopathic medicine can help during allergy season?
    A naturopathic doctor will ask you in-depth questions about your diet and digestive system. Understanding the role of the microbiome in helping balance immune function is essential. Research underscores the idea that a basic probiotic supplement along with the addition of fermented and cultured food helps create a more robust and diverse microbiome, which in turn helps to calm immune system response and reduce allergy symptoms. Supporting gut function is vital and increasing beneficial bacteria is key.

    Several herbs act as natural antihistamines and can help reduce allergy symptoms without attendant side effects often associated with OTC and prescription medication. A few of the most studied herbs recommended by naturopathic doctors include:

     There are a number of nutritional supplements that offer springtime allergy relief.

  • Quercetin, found in onions, shallots, and citrus fruits, is a natural antioxidant with several anti- allergy properties including inhibition of histamine release and decrease of pro-inflammatory messengers.
  • NAC (N-acetyl cysteine) is an antioxidant that supports the breaking up of mucus, making it an effective tool to help clear congestion. These both work well with antihistamine agents.
  • Acupuncture has also been shown to be an effective tool for helping those with seasonal allergies. A neti pot or other nasal sprays are good options to flush the nasal passage, where dirt and pollen are easily trapped. Flushing the nasal passages can reduce symptoms (i.e. coughing, sneezing, watery eyes), though it is important not to flush in excess, as this can wash away the healthy flora in the nasal cavity. With a neti pot, make sure you always use distilled water, not tap water.

    Natural allergy remedies can take time to reach full efficacy. Some patients experience success taking over-the-counter medication for a short time while natural approaches take full effect.

    Should allergy season be a reason to avoid outdoor activity?
    Naturopathic doctors will want you to continue to enjoy the outdoors. Limit your pollen exposure by first checking the weather. There will be local information provided on pollen levels; if the pollen count is particularly high on a certain day or time, save that long walk for later. A pollen count is usually higher at noon and afternoon. Pollution can also affect outdoor activity, as chemical pollutants can interact with pollen grains.

    When exercising outdoors, consider wearing a mask so you don’t breathe in excess pollen.
    Upon returning indoors, take a shower and wash all outdoor clothes to reduce continued exposure. Pollen sticks to clothes and hair, even when not visible.

    Long-term use of OTC medication may cause complications
    Americans spend billions of dollars every year on over-the-counter (OTC) medications including common products for allergy relief. For those who are elderly or have chronic health conditions, OTC medication may cause serious reactions or issues with other medication taken.

    In a 2015 article published in JAMA Internal Medicine, researchers describe a link between dementia and long-term use of anticholinergic drugs including antihistamines like Diphenhydramine and Loratadine. In this large study researchers saw participants who used anticholinergic drugs were more likely to develop dementia, and dementia risk increased with the cumulative dose.

    As part of pharmacology training in naturopathic medical school, naturopathic doctors learn primary therapeutic uses, mechanisms of action, potential adverse effects, and drug interactions, including over- the-counter allergy medication. There are numerous effective agents to help prevent and treat seasonal allergies. A licensed naturopathic doctor can help you create a whole-person individualized plan to help reduce both reliance on both over-the-counter and prescription medication as well as the troubling symptoms of seasonal allergy.

    The AANP and the INM would like to acknowledge Chrysanthi Kazantzis, ND, MS (Dr. Kaz), for her contributions to the content of this FAQ.

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    How do naturopathic doctors use precision medicine? Juin 2020
    View the printable PDF version. ​The INM and AANP would like to acknowledge Peter D’Adamo, ND, for his contributions to the content of this FAQ.

    What if you could accurately predict your health risks, know what lifestyle changes may prevent you from getting sick, and have treatments tailored to your unique genetic, microbiome, and metabolic profile? This is precision medicine, defined by The National Institutes of Health as an “emerging health care model for disease treatment and prevention strategies that takes into account each person’s genetic variations, environment and lifestyle.”

    Though still an emerging area of diagnosis and treatment the goal of precision medicine is to help clinicians deliver “the right treatments, at the right time, every time to the right person” utilizing new tools, knowledge, and therapies. Recent advances in genetic testing and targeted therapeutics are helping to make precision medicine possible for conditions such as breast cancer, skin cancer, colorectal cancer, leukemia, lymphoma, ovarian cancer, pancreatic cancer, rheumatoid arthritis, and lupus, largely with targeted pharmaceutical drugs. A small but growing number of licensed naturopathic doctors (NDs) are also utilizing such sophisticated bioinformatics data combined with innovative analytic tools and extensive knowledge of natural medicine to help personalize the most effective natural, non-drug treatments for patients with a range of health risks and conditions.
     Why do some naturopathic doctors utilize precision medicine?
    Licensed naturopathic doctors (NDs) diagnose, prevent, and treat acute and chronic illness. Focused on identifying and treating the underlying causes of illness, NDs address the whole person and lead with natural treatments when possible. While many patients improve through committing themselves to lifestyle and environmental changes and pharmaceutical treatments if and when needed, some do not. Addressing the whole person, NDs may dig deeper to gather more information about individual factors that contribute to health and disease including genes, the microbiome, and the metabolic environment (aka metabolome). Utilizing this information, NDs qualified in using precision medicine can help patients figure out which foods they should eat or avoid, which type of physical exercise they are most likely to benefit from, and which supplements they need to take to address deficiencies or imbalances, all based on what best suits the individual’s particular biological makeup.
     How does precision medicine work?Human DNA is about 99.5% identical from person to person. However, there are small differences that make each person unique. Single nucleotide polymorphisms, or SNPs, are the most common type of human genetic variation. Each SNP represents a variation within a single DNA building block. Most SNPs do not impact a person’s health or development.
    However, studies have shown that SNPs that may help predict an individual’s susceptibility to environmental toxins, the response to certain medications, as well as risk of certain diseases. CLIA certified labs such as 23andme are making it easier and more affordable for people to analyze their genetic data and obtain a personalized report on hundreds of thousands of SNPs. These reports identify SNPs related to late-onset Alzheimer’s disease, Parkinson’s disease, alpha-1 antitrypsin deficiency, celiac disease, hereditary hemochromatosis, hereditary thrombophilia, and age-related macular degeneration. The number of people getting DNA reports has been doubling every year since 2010.

    In one such application, Opus23, a sophisticated suite of software developed by a licensed naturopathic doctor, an individual’s raw genetic data can be analyzed alongside data about their microbiome (or the genetic makeup of the microorganisms of the gut), and even their metabolically active molecules (metabolome) to provide deeper insight into their health needs. This information can then be cross-referenced against databases of naturopathic treatments–based on and hyperlinked to PubMed published studies–to help pinpoint preventative and therapeutic actions mostly likely to benefit that individual. These targeted therapies include specific lifestyle changes and particular forms of vitamins, herbs, and nutrients.

    By using low impact substances to address a health issue multidimensionally, NDs can increase the efficacy of treatment without an increase in side effects. They also utilize precision medicine advanced bioinformatics tools to predict pharmacological genomic interactions.
     How does precision medicine work with naturopathic medicine?
    Precision medicine has numerous applications for patients in naturopathic medicine. Here is a specific example.

    Anxiété. A patient managing anxiety for years with pharmaceutical medication was not getting sufficient results. Her naturopathic doctor analyzed her DNA and pinpointed variations in her genes responsible for making and breaking down neurotransmitters (e.g. dopamine, serotonin, and adrenaline). He determined that an excessive quantity of adrenaline was being produced, and these high levels weren’t being properly broken down. Because most neurotransmitters are made in the digestive tract and travel to the brain, the ND recognized a need to reduce inflammation in her digestive system. After three months of treatment with natural ingredients cysteamine and Withania somniferia and a genetically determined personalized diet, the patient gained control of her anxiety and is no longer dependent on drugs.

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    What do naturopathic doctors do to treat toxin exposure? Juin 2020
    View the printable PDF version.

    What is Environmental Medicine?
    Environmental medicine (EM) is a relatively new branch of medicine that explores how the environment interacts with the human body – especially the physical, mental, and emotional responses to environmental factors. Environmental medicine dovetails with other branches of medicine including toxicology, industrial medicine, and public health. EM uses a holistic, systems-wide based model to evaluate how various toxins, pollutants, chemicals, and microbes may be compromising the body.

    Those working in environmental medicine leverage the concept of cumulative toxic load – low- level exposure and interaction with various substances in food, water, air, homes, and communities – over time that may compromise fundamental systems which maintain overall wellness and support healthy aging. This field explores the link between the environment and the documented rise in chronic illnesses like cancer, metabolic, neurological, and endocrine disorders.

    Where do toxins come from?

    In the age of industrialization and modern society, pollutants, chemicals, and toxins are commonly encountered in daily life and range from pollutants that come through the atmosphere to packaging and consumed food. Several examples of chemicals and pollutants are listed below.

    Aliments
    Persistent organic pollutants (POPs) Organophosphates (OCPs)
    Pesticides: various herbicides, glyphosate Xenobiotics: Plastics, bisphenol A (BPA) Metals: Aluminum, arsenic, cadmium, mercury Alcohol
    Eau
    Microorganisms Disinfectants: Chlorine Metals: Lead
    Organic Chemicals
    Air
    Mold Mycotoxins
    Polycyclic aromatic hydrocarbons (PAHs) Perfluorocarbons (PFCs)
    Volatile organic compounds (VOCs) Particulate matter
    Ozone
    Carbon monoxide
    Sulfur and nitrogen oxides
    Des produits
    Parabens Phthalates Metals: aluminum

    Naturopathic doctors understand that no two people are alike due to genetic biochemical individuality. Based on this principle and utilizing a patient-centered approach, naturopathic doctors evaluate how each person’s environmental exposure may be influencing their foundations of health. In addition to toxic load, an ND evaluates genetic variations, nutrient deficiencies, stressors, dietary choices, microbiome status, vitality, and associated conditions that may influence how a patient responds to toxins.

    Given that chronic illness is typically caused by many factors, it is important to identify which toxins or elements in the environment are interacting within the body. Many of the above-named chemicals have a direct effect on a variety of tissues, leading to a potential cycle of oxidative stress inflammation. A number of environmental toxins have also been associated with endocrine disruption. Research to date alludes to the inflammation as the key driver of metabolic, neurologic, endocrine, and cellular malfunction leading to a rise in obesity, neurodegenerative disease, autoimmune conditions, reproductive disorders, and cancer.

    How naturopathic doctors evaluate a patient who has many symptoms of toxic exposure?

    While assessing if the environment is contributing or causing a specific illness, a naturopathic doctor (ND) begins with a thorough case history, sometimes using a comprehensive environment – a targeted questionnaire that helps identify signs of toxic overload. Several questions are asked to help identify what chemicals are involved in the timing of exposure is consistent with symptom development, and what systems in the body are compromised by the possible exposure. For example, if a patient began complaining of an increase in allergies, brain fog, headaches, and skin rashes upon moving into an old modular home located in a humid area, a naturopathic doctor may be suspecting mold contamination and compromised lung, immune, and neurological function.

    In addition, there are various specialty laboratory tests available to practitioners. To identify toxic load, advanced laboratory testing may be necessary, including serum or urine testing, which assesses for metals, mold derivatives, solvent metabolites, and organophosphate metabolism. To work up specific systems implicated by environmental exposure, a doctor may explore microbiome testing, hormone testing, organic acid testing, micronutrient panels, genetic panels, and oxidative stress markers before implementing a targeted treatment plan.

    What treatments are available in environmental medicine?

    Naturopathic doctors work through the therapeutic order while treating patients. Given environmental medicine can be so complex and multi-modal, the primary factor in treatment is to identify the source and remove it. Avoidance alone can make a notable difference in apatient’s symptoms. Next, targeted therapeutics depends on the individual’s genetic make-up, biochemical, and metabolic needs. Treatment may include:

    Supporting functional genetics with added vitamins, nutraceuticals, and lifestyle changes.

  • Certain genetic variations in our detoxification pathways have been shown to require added support in their function with specific minerals or stimulation through botanicals that influence antioxidants.
  • Single Nucleotide Polymorphisms (SNPs) are also continuously being transcribed through our DNA, and new research has found that moderate exercise is capable of controlling the genetic expression of unfavorable genes.
  • Supporting liver detoxification with botanicals, protein, and vitamins.

  • Phase 1 and phase 2 detoxification require a broad series of B vitamins, bioflavonoids, sulfur metabolites, protein, and fat-soluble vitamins.
  • Botanicals such as milk thistle have been shown in various clinical studies to increase cellular glutathione, the body’s primary antioxidant, in addition to strengthening antioxidant defense systems.
  • Dietary modification including the increase of cruciferous vegetables such as Brussels sprouts, broccoli, and kale.
  • Increasing system-wide antioxidants with green tea, N-acetyl cysteine, anthocyanins, polyphenols, and citrus bioflavonoids.
  • Supporting elimination pathways through the gut and skin.

  • Stimulating the liver in detoxification can become troublesome without focusing on elimination pathways, so optimizing bowel and kidney function is key to a successful detoxification program.
  • Focus on adequate water intake for proper kidney elimination may be recommended along with therapeutics that address overall gut health such as colonics, castor oil packs, and/ or high fiber diets.
  • Sauna/infrared saunas are found to stimulate detoxification and clearance of toxic metals through the skin.
  • Facilitating environmental change in the home.

  • Water filtration systems for drinking and shower water.
  • Air purification filters (such as HVAC or house plants), especially for those in urban areas.
  • Reduction in carpet surface area. Carpets are known to store various pollutants from the air in homes.
  • Clean paint to prevent lead off-gases from being absorbed through the respiratory tract.
  • Preventing other toxins from impacting the body in the future.

  • Strengthening the microbiome with broad-spectrum probiotics, fermented foods, and stress modification.
  • Improving the gut epithelial lining with proteins and minerals such as glutamine or zinc carnosine, which are shown to maintain a healthy inflammatory response, support the gut immune system, and prevent “leaky gut.”
  • Exchanging personal and household care products to be paraben and phthalate free.
  • Opting for organic, cleanly washed produce and either wild caught or grass fed, hormone free meat/fish.
  • With modern advancements in biotechnology and advanced therapeutics, many naturopathic doctors are trained and specialize in and promote detoxification in a controlled setting. Such treatments are done under medical supervision.

    As society continues to evolve, the care for nature and our environment is becoming more popular. There are now many ways patients can be proactive about their environment using resources from the Environmental Working Group and understanding the Dirty Dozen, downloading apps like Think Dirty, and following health blogs that educate about DIY tactics for creating a healthy home environment.

    While our environment is ever changing and nearly impossible to avoid complete exposure to pollutants, chemicals, and toxins, seeking out the advice of a licensed naturopathic doctor can help you understand the way your body is responding to your environment and lifestyle, and help support your system in order to maintain optimal function and prevent chronic disease.

    Additional References:

  • Murray MT, Pizzorno JE. The encyclopedia of natural medicine. Rev. 3rd ed. New York: Atria Books; 2012. x, 1219 p. p. 109-130.
  • Pizzorno JE. Total wellness: improve your health by understanding the body's healing systems. Rocklin, CA: Prima Publishing; 1996. xi, 419 p. p. 87-162. Crinnion W, Pizzorno JE. Clinical environmental medicine: identification and natural treatment of diseases caused by common pollutants. St. Louis, Missouri: Elsevier Inc.; 2020. p. p.
  • Bijlsma N, Cohen MM. Expert clinician's perspectives on environmental medicine and toxicant assessment in clinical practice. Environ Health Prev Med. 2018;23(1):19.
  • Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med. 2014;5(12):1487-1499.
  • Herr C, Otterbach I, Nowak D, Hornberg C, Eikmann T, Wiesmuller GA. Clinical environmental medicine. Dtsch Arztebl Int. 2008;105(30):523-531.
  • Lampe JW. Diet, genetic polymorphisms, detoxification, and health risks. Altern Ther Health Med. 2007;13(2):S108-111.
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    How do naturopathic doctors promote healthy aging?   July 2020

    View the printable PDF version. The AANP and the INM would like to acknowledge Michelle Simon, PhD, ND, for her contributions to the content of this FAQ.

    Expected lifespan at birth is declining – and steadily so. The last time the United States experienced such a long and sustained decline was a century ago during World War I when an influenza pandemic crossed the country. According to the Centers for Disease Control and Prevention (CDC), in 2017, average life expectancy in the U.S. was 78.6 years, one tenth below the previous year. And the trend does not seem to be a global issue. Life expectancy at birth in Europe is stable, even increasing, clocking in at 81 years in 2016.

    In addition to a decrease in life expectancy at birth, age-specific death rates increased in the
    U.S. for age groups including 25-34, 35-44, and 85+. The leading causes of death in the U.S. remained the same in a year-over-year comparison, indicating a lack of progress in treating heart disease, cancer, unintentional injuries, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, influenza, pneumonia, kidney disease, and suicide.

    How are naturopathic doctors uniquely positioned to promote healthy aging?

    Aging is a natural process. It can be accelerated or impeded depending on diet, nutrition status, and lifestyle. Naturopathic doctors (NDs) specialize in delivering actionable information to patients by offering personalized treatment plans. Licensed NDs are experts in natural medicine, which may be the best way to support the natural aging process.

    Naturopathic doctors emphasize the prevention of disease, helping to cut down on health care costs later in life. In addition, licensed NDs working in the primary care setting provide a deep understanding of patient care and treat each individual for their unique concerns.

    What are the biggest health concerns related to aging?

    Aging is negatively affected when physical ailments or lack of energy prevent an individual from being active. Some signs of aging include trouble sleeping, weight gain, especially around the middle, and loss of muscle mass. Starting at age 30, people can lose as much as five percent of muscle mass per decade of life.

    Cardiovascular risk

    For some patients, hypertension (high blood pressure) comes from inactivity and weight gain. A tendency for diabetes arises from poor dietary choices, stress, and inactivity. Likewise, cardiovascular disorders also arise from inactivity and stress, as well as depression.

    Cognitive health

    A healthy body is best accompanied by a healthy mind, and cognitive decline is also a troubling symptom that may come with aging. In 2003, experts estimated that as many as 5.1 million Americans 65 years of age or older could have Alzheimer’s disease. That number is expected to grow to 13.2 million by 2050. A 2012 article published in The BMJ reported that cognitive decline can begin as early as age 45. And in a 2013 article published in the Bulletin of the World Health Organization, researchers described cognitive impairment as a chronic condition that is a “precursor to dementia” in as many as one-third of all dementia cases. Genetics may be an uncontrollable factor for cognitive decline, but taking an active role in your diet, and emphasizing prevention and natural treatment of common chronic ailments helps prevent cognitive decline. Naturopathic doctors help support patients to obtain a healthy weight and physical fitness. One important fact is that decreasing obesity lowers the risk for cognitive decline.

    Bone and joint health

    Losses in bone density and joint fluid are common complaints individuals experience as they age. Osteoporosis is the most common type of bone disease affecting at least 50 percent of all women aged 50 and older and also can pose a significant problem in aging men.

    Bone density loss occurs as bones lose calcium and other important minerals. Limbs become brittle and break more easily. Diminished cartilage and calcification in joints – often the hips, knees, and fingers – is an essentially universal problem in aging adults, with most adults experiencing at least minor arthritis. Fluid loss is partially responsible for the loss of height with aging. Discs between spinal vertebrae become thinner, vertebrae lose bone density, and the spinal column compresses. In addition, foot arches may become less distinct.

    Risks of multiple pharmaceuticals

    At least one-third of older adults between the ages of 75 and 85 take at least five prescription medications, a phenomenon called “polypharmacy.” Many medications prescribed are given to address the side effects of other prescriptions. Older adults are paying more for their healthcare and are at a greater risk for negative side effects, dangerous drug interactions, non-adherence due to complicated medication regimens, and an overall decrease in functionality.

    What are the aging differences between males and females?

    Women lose muscle mass earlier than men, but women typically live longer than men and are more likely to reach the centenarian mark. Menopause causes women to experience a more rapid hormonal change versus the gradual change felt by men.

    These rapid changes experienced by women are responsible for the unique symptoms of menopause which can exacerbate bone density loss with age and increase the risk of breaking bones. Varying amounts of hormone production during menopause can also lead to weight gain, moodiness or depression, sleeping problems, hot flashes, and pain during sex.

    While men do not experience the rapid hormonal changes that characterize menopause, the gradual change in hormone levels men do have is associated with some health effects like reduced testicular tissue mass, gradual decrease of testosterone increased risk of erectile dysfunction enlarged prostate gland (this affects 90 percent of men older than 80 years).

    What are some modifiable factors to increase bone, joint, and muscle health?

    Exercise is the most important intervention to help increase the health of bones, joints, and muscles. Humans are meant to move. Exercise does not need to be marathon-running or competitive Olympic weightlifting. Even just three rounds of 20-second stair climbing three times per week can make a difference in cardiovascular health for untrained women. A 2017 Osteoporosis International study found that physical exercise positively influences muscle mass and muscle function in individuals 60 and older, most evidently by improving gait speed, balance, and other tests of physical performance. For people who are too frail for rigorous workouts or even walking, standing on one foot offers an alternative way to support bone health. Even for those who exercise routinely, a few minutes on one foot helps promote core strength and balance. (Caution – as balance problems are also an important factor in the again process, standing on one foot is not recommended for those with existing balance issues, or who may be at risk of falls.)

    A 2017 Oncotarget study found that regular physical activity is associated with longer telomere lengths. Telomeres cap the ends of chromosomes, structures that package human DNA. Preserving telomere length preserves genetic information and a functional cell division process, which could reduce cellular aging and decrease the risk of age-related conditions such as cancer, heart disease, obesity, diabetes, chronic pain, and stress. How can we promote cognitive health in older age?

    Astaxanthin is a supplement with recent research supporting muscle endurance and strength in older individuals.

    Supporting a healthy body with a healthy mind

    Naturopathic doctors prescribe supplements including curcumin, resveratrol, and bacopa monnieri as a way of optimizing brain health. Creating healthy sleep habits and reducing stress are also considered beneficial in the fight against cognitive decline. Naturopathic doctors have an opportunity to help prevent degenerative conditions.

    Other research supports the use of a multifactorial, individualized approach to cognitive decline which includes addressing the gut microbiome, heavy metal levels, neurotransmitters, and mitochondrial health. Understanding a patient’s genetic predisposition to particular risk factors for cognitive decline helps NDs develop a personalized approach to treatment.

    NDs also support the positive role of work and community connections to prevent and address cognitive decline. Regular social activity has been shown to improve cognitive stimulation. NDs are equipped to help patients and their families identify appropriate programs to help in cases of cognitive decline and dementia.

    How do dietary needs change with age?

    Stomach acid levels typically decrease with age, altering digestive capacity. One result can be diminished absorption of nutrients such as B12, calcium, iron, and magnesium.

    Caloric needs decrease with age as a function of lower muscle mass and activity levels, but this proves detrimental to the accompanying increased need for specific nutrients. Maintaining this balance of optimal nutrition can be difficult for people as they age. Licensed naturopathic doctors can assist with targeted nutritional interventions.

    As described above, menopause is often a time when bone density begins to diminish, leading to osteoporosis. One reason is the lowering of hormone levels that promote bone health.
    Nutritional recommendations focused on bone health is advisable. Vitamins K, C, and D along with magnesium and calcium are helpful nutrients for bone health.

    By addressing genetic propensity and lifestyle factors, naturopathic doctors can help you review the kinds of health challenges you might encounter and can make recommendations about modifiable risk factors in order to prevent or slow the aging issues. Prevention is always easier than treatment and having a naturopathic doctor on your team can be a wise investment in your healthy aging.

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    How do naturopathic doctors diagnose and treat diastasis recti?  July 2020
    View the printable PDF version.

    Postpartum physical health is an area that is often under-addressed in women’s health. The female body goes through many changes during pregnancy and not all of these changes immediately reverse, or reverse at all, after birth. A significant portion of mothers experience pain months after birth, which may linger without proper muscle rehabilitation and treatment. Muscle areas involved often include the large muscle groups of the abdomen and/or back. Diastasis recti (DR) is a condition describing a separation between the left and right side of the muscles that cover the abdomen called the rectus abdominis muscles, which are often referred to as the “six-pack” muscles. DR is a common result of dysfunctional adaptation of the abdominal muscles to an increase in intra-abdominal pressure, such as in pregnancy.

    Understanding diastasis recti

    A 2016 study found that from a study group of 300 women between 19 and 40 years old, 33 percent experienced DR by 21 weeks of pregnancy, 60 percent by 6 weeks after giving birth, 45 percent at 6 months after birth, and 33 percent at one year after birth. Potential risk factors for DR include:

  • Older age
  • Giving birth more than once
  • Giving birth via cesarean section
  • Gaining more than the expected amount of weight during pregnancy
  • High birth weight
  • DR is a sign of body misalignment, a weakened core, and misdirected pressure into the abdomen. Women with DR often experience symptoms as a result of weakened abdominal muscles after pregnancy, such as:

  • Continuing to look pregnant after giving birth; looking constantly bloated
  • Cone-shaped belly when laying on back
  • Painful sex
  • Pelvic pain
  • Incontinence
  • Back and knee pain
  • Higher risk of injury in back, pelvis, and knees
  • Pelvic muscle and tissue weakening
  • How is diastasis recti diagnosed?

    DR is not commonly diagnosed or discussed, and often women do not notice the signs of DR until past the standard six-week checkup after giving birth. Many women do not realize that the changes they notice in their body are because of DR, as opposed to common pregnancy weight gain. The American College of Obstetricians and Gynecologists notes that 6-week follow-up visits may be lacking in comprehensive postpartum care, and that postpartum women may need more consistent and frequent follow-ups for several months.

    A healthcare practitioner like a licensed naturopathic doctor (ND) can diagnose DR through a detailed interview including a physical exam that feels for the separation of rectus abdominis muscles.

    Why choose naturopathic care?

    NDs understand and respect the unique postpartum body changes of pregnancy which can include DR. By addressing the whole person and not just the immediate condition, NDs utilize skills in understanding body mechanics and alignment to diagnose where DR patterns have been established and offer solutions for improving functionality in the abdominal muscles.

    DR is one of many physical complaints that may be experienced during postpartum recovery. Some NDs have additional training in pelvic floor rehabilitation that involves internal exams as well as reprogramming movement and breathing patterns. They can also offer exercises to provide support for physical complaints like backache and muscle and joint pain.

    How is diastasis recti treated?

    NDs focus on addressing dysfunctional movement and breathing patterns, use therapeutic nutrition, and may perform or recommend bodywork for patients with DR.

    Mouvement

    The first priority in addressing movement is to correct movement patterns like walking, sitting, standing, and sitting, and breathing patterns that may be leading to excessive intra-abdominal pressure. In treating DR, NDs will also assign appropriate core exercises to strengthen the connective tissue and abdominal muscles. Exercise during the antenatal period reduced the presence of diastasis of the rectus abdominis muscle by 35 percent. These exercises take the place of crunches, sit-ups, and planks, which can exacerbate DR.

    NDs might also tell patients to:

  • Avoid wearing high-heeled shoes
  • Increase fiber and water intake to maintain regular bowel movements and to prevent the need for straining.
  • Some women may use compression wraps in an attempt to retrain core muscles and prevent DR, but NDs stress that “belly binding” after birth will only relieve symptoms – not the condition as a whole – and will only work temporarily. NDs instead focus on correcting the underlying problem to rebuild core strength and functional movement.

    Nutrition

    For patients with DR, NDs recommend supporting tissue repair and collagen production using a combination of diet and nutrient supplementation to maintain optimal levels of protein, essential fatty acids, zinc, iron, and vitamins C, A, and B. Bone broth and collagen powders may be suggested.

    Bodywork

    In addition to implementing changes in physical activity and nutrition practice, NDs might recommend bodywork therapist such as:

  • Craniosacral therapy: noninvasive manipulation of soft tissues and fascia, as well as relief of compression of bones in the head, lower back, and spinal column
  • Internal pelvic floor therapy: physical therapy that may help relieve DR symptoms like incontinence and painful sex; a trained physical therapist works externally and internally to relax pelvic muscles
  • Mental Health

    While mental health may not be a direct contributor to DR itself, it’s important to always recognize the effect that physical changes can have on mental health after pregnancy. Naturopathic doctors understand the mind-body connection to help successfully treat postpartum patients.

    Diastasis recti is a frequently experienced, but often under-addressed physical condition that is common after pregnancy. Treating this condition is an important part of addressing the whole patient and promoting maternal health. Your naturopathic doctor can support your postpartum journey with whole-body comprehensive care.
     The AANP and the INM would like to acknowledge Morgan MacDermott, ND, for her contributions to the content of this FAQ. Find more from Dr. MacDermott @MilkMedicine

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    Association américaine des naturopathes: Médecine naturelle. De vraies solutions.
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