Naturopathic Medicine combines modern medical knowledge and diagnostic techniques with traditional healing arts. It’s a system of medicine that treats the patient as a unique individual with complex genetics, biochemistry, health histories and lived experiences, all of which affect physical health and emotional wellbeing.
I was drawn to Naturopathic Medicine because Naturopathic Doctors take time to spend with their patients. They are not beholden to the conventional medical system which severely limits the length of visits, and the number of concerns a patient is allowed to address at any given appointment. More and more patients are being told to come back later if they want to discuss something outside the scope of the seven minutes that they have been allotted.
Naturopathic Education and Licensure
Naturopathic Doctors (ND) attend one of seven accredited doctoral programs in the US and Canada. The program of study starts with two years of basic sciences, such as Anatomy and Physiology, Biochemistry, and Microbiology, along with courses on Nutrition, Botanical Medicine, Acupuncture, and Homeopathy. After passing the first round of board exams (NPLEX), students spend half of their time the classroom in more specialized medical courses and expanding their knowledge of the Naturopathic healing arts. The other half of their time is spent in clinic or out in the community studying under NDs, Medical Doctors, Doctors of Osteopathic Medicine, and Doctors of Chiropractic. Upon completion of a second set of NPLEX board exams and fulfilling state by state requirements, a Naturopathic Doctor is licensed and can practice.
Currently, 22 states and the District of Columbia license Naturopathic Doctors, while nine states have bills filed or pending for 2020. In Connecticut, NDs are fully licensed physicians, who can order laboratory testing, perform physical examinations, make diagnoses and design treatment plans, but are unable to write prescriptions for medications. Licensing has become more widespread in recent years because it distinguishes licensed Naturopathic Doctors who attend 4-year medical programs from unlicensed ‘naturopaths’ who may attend a months-long correspondence course.
What to Expect
When I see a patient for the first time, the goal is to gather as much information as possible about their current concerns, health history, medication history, family history, lifestyle, diet and exercise habits, sleep patterns, stress levels and stress coping strategies, exposure to toxins or molds, injuries and surgeries, history of infections such as Lyme Disease, other tick-borne diseases and viruses, and vaccination history.
Every patient is counseled on diet, exercise, sleep and stress reduction, laying the groundwork for success once the full treatment plan is introduced. I will then order laboratory testing, both through conventional labs and specialty labs. The patient may receive some combination of specialized nutrient testing, food allergy testing, stool testing, hormone testing, and testing for the presence of toxins or molds.
When all the laboratory results are in, we go over them in detail, and establish a treatment plan with goals and expectations for treatment. We follow up periodically to assess progress through symptom progression and follow-up laboratory testing, and make changes to the treatment plan as necessary.
When to Seek out a Naturopathic Doctor
Patients will seek out my care for a variety of reasons. One is that they are relatively healthy, but have a nagging concern they want to address, or are looking to get to a higher level of health. The second, much larger group, are people who have health issues that have not been adequately addressed by conventional medicine. Those issues tend to be digestive (heartburn/indigestion, gas/bloating/diarrhea, irritable bowel), hormonal (thyroid/adrenal imbalance, menstrual irregularities, low testosterone in men), or inflammation (auto-immune diseases, tick-borne diseases (TBD)).
Lyme Disease and tick-borne co-infections make up a large proportion of my practice. Some patients are aware of having Chronic Lyme disease which hasn’t resolved with conventional anti-biotic treatment. Others have been diagnosed with Chronic Fatigue Syndrome, Fibromyalgia, or an auto-immune disease, when in fact the underlying cause is really an infection with Lyme or another TBD. The TBD patient presents a unique challenge, because Lyme and TBDs cause multi-systemic inflammation with typical (joint pains, fatigue, headaches, fevers) and atypical (hormonal disruption, bladder dysfunction, anxiety/depression, digestive issues, etc.) presentations. Treatment of Lyme disease and TBDs requires proper assessment of how the infections are affecting the body, and personalizing treatment based on that assessment.
Lyme disease is not a one-size-fits-all approach. In a perfect world, the person bitten by a tick would have found that tick attached, would be started on antibiotics and herbal adjunctive treatment immediately, tested properly, and would achieve full resolution of the infection within weeks. In the real world, about half of ticks go unnoticed, an even smaller percentage of people develop the telltale bullseye rash, testing is done too soon (or not done at all), co-infections complicate the symptoms and compromise the effectiveness of treatment, and the person ends up suffering much more than they should have.
The confluence of atypical symptoms, misdiagnosis, and delayed or non-existent treatment sets patients up for a long road when it comes to treating TBDs months to years to decades later. There are also challenges inherent to long-term antibiotic treatment, which compromises the immune system and wreaks havoc on the microbiome, the healthy community of bacteria that live in our digestive tract.
Treating Lyme and TBD
In contrast to the conventional antibiotic route, I prefer an herbal approach. The herbs chosen, based on the work of herbalist Stephen Harrod Buhner, are tailored specifically to the infections present, which can include Lyme Disease, Babesia, Bartonella, Ehrlichiosis, Anaplasmosis, Mycoplasma Pneumoniae, Chlamydia species, Epstein Barr Virus, and others. The starting point for any treatment protocol is to bring down the specific types of inflammation those pathogens stimulate in the body. Anti-biotic herbs are chosen on the types of infections found. The benefit of antibiotic herbs over medications, is that antibiotic medications have one mode of action, or one strategy for killing pathogens. The flaw of this approach is that Lyme disease in particular has developed multiple strategies to evade antibiotic treatment.
Borrelia Burgdoferi, the bacteria that causes Lyme Disease, has the ability to change its genetic expression as its environment changes. The bacteria can respond to changes in temperature, pH, nutrient content, and changes in the host’s defense.
Most concerning, the Lyme bacteria has shown a better ability than other infections to resist antibiotic treatment. Under pressure from antibiotics or environmental changes the Lyme spirochete, the common corkscrew shape, can change to a less mobile round body (cyst form) and other forms, making it less susceptible to antibiotics. After antibiotic treatment has ceased, the round bodies can revert back to the spirochete form. Even in the round body form, Borrelia is still able to infect the host, and reversion to the spirochete form helps explains the high frequency of antibiotic treatment failure.
Borrelia Burgdorferi can also form colonies or biofilms in response to pressures, making it more difficult to eradicate. Biofilms, which are formed by most bacteria, are sticky tangles of sugars and other substances that provide protection and community, facilitating the transfer of oxygen and nutrients, and making individual bacteria less susceptible to treatment.
Herbal treatments on the other hand, work synergistically to kill the infections, modulate the immune system, and support the overall health of the body.
The last piece of the puzzle in treating TBDs is addressing factors that contribute to the severity, or delay resolution of the infections. This is where comprehensive laboratory testing and lifestyle medicine comes in. Are there nutritional deficiencies, gut dysbiosis and inflammation, heavy metal or mold toxicities that need to be addressed? Are there obstacles like biofilms, lack of sleep, stress, the standard American diet, lack of movement, and impaired detoxification pathways impeding our progress? A skilled practitioner will work with their patients to set them up for successful treatment.