We in Michigan are dealing with yet another effort on the part of NDs, which stands for “naturopathic doctors” but more appropriately should mean “not a doctor, to achieve licensure in the form of Michigan HB 4531. As I mentioned when I first learned that HB 4531 was passed by the House Committee on Health Policy and sent to the full House for consideration, it’s a scary, scary bill. Moreover, it’s supported by the Michigan Association of Naturopathic Physicians (MANP), who are taking money from the supplement industry to lobby for this bill’s passage. It’s a bill that would grant NDs a wide scope of practice. Basically, if HB 4531 were to pass, licensed naturopaths would have a scope of practice almost as wide as primary care physicians, such as internists, family practice doctors, and pediatricians. About the only difference would be that NDs would not be allowed to prescribe controlled substances. (Imagine my relief.)

You might wonder why I’m bringing this up again. The reason is simple. Until I know that the bill is dead, any time I write about naturopathic quackery (but I repeat myself), I plan on mentioning HB 4531. If anyone searches for HB 4531 on this blog, he’ll find a whole list of examples of naturopathic quackery. It’s that simple.

Unfortunately, the supply is endless. Fortunately, there is a way to find out how naturopaths discuss medicine when no one’s listening. There’s a private mailing lists that many naturopaths belong to called Naturopathic Chat or NatChat for short. Thanks to an anonymous source going by the ‘nym Naturowhat, we have periodic access to leaks from NatChat. Naturopaths have tried to plug the leak. They’ve talked about moving over to a different platform besides Yahoo! Groups, but for some reason NatChat is still there and remains the basis for my Sh*t naturopaths say series, of which this is the latest installment. In any case, a few days ago, Naturowhat released a thread with the Subject: header homeopathy buffs - bipolar disorder and voices in head.

Before I read a single message, the thought of using homeopathy to treat bipolar disorder alarmed me. Regular readers know that many homeopathic remedies are nothing more than water because they are diluted to the point where it’s unlikely that a single molecule of the original substance, with the belief that the water, thanks to the magic shaking between each serial dilution step, is somehow imbued with the “memory” of the remedy. Of course, as I’ve described so many times before that I’ve forgotten how many, homeopathy is truly The One Quackery To Rule Them All. Worse than that in considering HB 4531, homeopathy is integral to naturopathy. Indeed, you can’t have naturopathy without homeopathy. Homeopathy is a huge part of the curriculum at naturopathy schools, and in states where naturopaths are licensed it’s on the naturopathic licensing exam, known as the NPLEX.

With that in mind, let’s see what a naturopath named Jena Peterson asks:

I have a new patient that is having an acute episode. Diagnosis coming in is bipolar disorder 1. She describes panic attacks, 5 hours sleep per night, and voices in her head constantly. She also describes feeling like the voices or entities are in her body and moving her body, moving her hands for example. PHx of sexual abuse as a child. She has many resources in place currently, but I am hoping to start working on a remedy for her. Any suggestions anyone has would be appreciated; with such unusual symptoms I am hoping to get ideas to narrow down my search.

WTF? She wants to start making a homeopathic remedy for this patient? This patient has bipolar disorder and might be psychotic, given the voices and the delusions of entities controlling her body and moving her hands!

I can sense psychiatrists, psychologists, and anyone with bipolar disorder who are reading this cringing or even gasping in alarm. Bipolar disorder is serious business, especially bipolar I, which involves periods of severe mood episodes from mania to depression. As described by the Depression and Bipolar Support Alliance:

Bipolar I is characterized by one or more manic episodes or mixed episodes (which is when you experience symptoms of both a mania and a depression). Typically a person will experience periods of depression as well. Bipolar I disorder is marked by extreme manic episodes.

For those of you not familiar with bipolar disorder, it involves cycling between a manic phase and a depressive phase, hence its previous name, manic-depressive disorder. During depressive phases, bipolar patients suffer the same symptoms as straight-up depression, to the point where they are at risk for suicide. When they’re in their manic phase, they exhibit elevated mood, poor judgment, hypersexuality, flight of ideas, substance abuse, decreased inhibitions, excessive spending, hyperactivity, and an inflated self-image.

As you can imagine, bipolar patients in their manic phase can get into considerable trouble. As WebMD puts it, people in manic episodes may spend money far beyond their means, have sex with people they wouldn't otherwise, or pursue grandiose, unrealistic plans. In severe manic episodes, a person loses touch with reality. They may become delusional and behave bizarrely. Occasionally, they even get violent. Indeed, I remember when I was rotating on the psychiatry rotation as a medical student, the only time I was ever frightened for my safety was when a bipolar patient became agitated. The guy was huge, strong, and very, very intimidating.

The treatment of bipolar disorder involves medication, including mood stabilizers, possibly mood stabilizing antipsychotics, and possibly antipsychotics. Treating such a serious psychiatric disorder with homeopathic remedies is the same thing as leaving it untreated, with all the attendant complications that can result from not stabilizing their mood and giving them the ability to control his behavior.

Before I move on, I couldn’t resist looking at Peterson’s website, Full Circle Natural Medicine. It didn’t take me long to find a whole lot of pure quackery, including the DAN! Autism treatment protocol, “detox” quackery, cleanses, acupuncture (of course!), and IV nutrients. You get the idea.

So what do Peterson’s fellow naturopaths recommend? Let’s see. Shiva Barton suggests:

Please investigate PANS/PANDAS in this patient. Ask if she has had any antibiotic use or food poisoning/stomach bugs; or strep within the last 6 months. Please do a stool culture to see if there are abnormal bacteria growing. The use of antibiotics raises the risk of panic attack and anxiety by 50% within 6 months of taking them. I've had a few patients recently who have had new onset of panic, anxiety and insomnia post antibiotic use. Improving the biome can be very helpful.

Wait, WTF?

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term describes a subset of children and adolescents who have Obsessive Compulsive Disorder (OCD) whose symptoms worsen following a strep infection. PANS is a newer term that describes acute OCD cases and stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It includes all cases of abrupt onset OCD, not just those associated with streptococcal infections.

Here’s a hint. Bipolar disorder is NOT OCD. Seriously, it’s not. Whatever Barton is smoking, I want some. Actually, no I don’t. You never know what it might be laced with.

Another homeopath, J. Claire Green, had another recommendation:

With respect Jena, I suggest you refer this patient to someone who specializes in constitutional prescriptions. I have been practicing homeopathy and doing advance study in this area for 25 years, and I would hesitate to take on a difficult case like this.

OK, first I saw the term “constitutional prescribing” and realized that I didn’t know what that meant. Yes, even after 11 years of blogging and 18 years debunking various alternative medicine quackeries, I had never heard of this term. Live and learn. So, what is constitutional prescribing? I checked out various homeopathy sites and discovered:

Constitutional prescribing is treatment based on the whole person – that is the mentals, generals and particulars. Some methods also include a miasmatic interpretation. In the case of Homeopathic Facial Analysis (HFA) the miasmatic dominance of both patient and remedy must match to include all aspects of totality. The miasm is interpreted from facial structure while the totality is taken from repertorisation of symptoms with emphasis on generals. The way constitutional prescribing is applied throughout the profession can be sorted into various categories – essence is a broad term that implies the “heart” or totality of the person is being taken into account and is a subcategory of constitutional prescribing

Again, WTF? I know what miasmas are. Miasmas are basically “bad air,” and represent a pre-germ theory concept that disease can result from “bad air.” Yes, it’s basically a prescientific idea that existed before Louis Pasteur figured out how bacteria can cause disease. No wonder homeopaths find it compelling. But what is homeopathic face analysis. As hard as it is to believe, I had never heard of such a thing before. So, I asked almighty Google and found this:

HFA embraces Hahnemannian principles and extends upon them by including the analysis of facial features to find each patient's dominant miasm. A miasm is interpreted as a defense mechanism which is determined by an internal energy as based on Hahnemann's three primary miasms. HFA transfers the concept of a miasm from a disease to an energetic force that is enabled during times of stress to protect the host. However like all organic systems when the host is too stressed the defense mechanism will fail resulting in chronic illness. When a homeopathic remedy (healing energy) is introduced to the system an energetic rebalance and healing occurs. To initiate this process the remedy must have two aspects in common with the inbalanced and stressed system. Totality of symptoms

Defense mechanism (underlying energetic response to stress or miasm) Totality is determined through repertorisation.

The defense system (miasm) is determined by the facial structure.

As a long time Star Trek fan, I’m familiar with a term known as “technobabble,” which describes impressive, scientific-sounding verbiage that is ultimately nonsensical. Star Trek: The Next Generation, in particular, was notorious for technobabble. Well, what we have above is woo babble. It makes zero sense, but it sure sounds impressive.

Naturopathy is quackery. The very fact that homeopathy is a major part of the education of naturopaths to the point that it it is included on the NPLEX. In fact, if you want to get an idea of just how deluded naturopaths are, consider this question from the NPLEX, presented courtesy of Britt Hermes:

PATIENT: 8-year-old male PRESENTATION: The anxious mother of the patient calls you at 11:30 p.m. because the child has developed a loud barking cough that has been preventing him from sleeping. She became frightened when she observed that he is struggling to breathe. You hear the child’s cough in the background. Onset of the cough was several hours ago, after he played outside in the cold wind; she had noticed that he had a runny nose the day before. VITAL SIGNS: His temperature is 101.5° F (38.6° C), heart rate is 120 bpm, and respiratory rate is 60/min and gasping. 1. What is the first thing you should ask the mother? a. “Has he been vomiting?”

b. “Does his neck seem rigid?”

c. “Is there a rash on his abdomen?”

d. “What is his breathing like between coughs?” 2. Which of the following homeopathic preparations would best address his clinical presentation? a. spongia tosta

b. aconitum napellus

c. cuprum metallicum

d. drosera rotundifolia

As Ms. Hermes notes, the case above sounds very much like croup. Croup can range from relatively mild to serious enough to be life-threatening. I have no idea which of these homeopathic nostrums would “best address his clinical presentation.” No, wait. I do: None of them. If the child has signs of difficulty breathing or swallowing, the correct treatment is a trip to the emergency room and might even included inhaled epinephrine and/or steroids to keep the inflamed airway from closing. Guess what? This child has just such signs. A respiratory rate of 60 is way too high for an eight year old by more than a factor of two. Indeed, a respiratory rate of 60 suggests impending respiratory failure. It's a medical emergency that mandates a trip to the ER pronto. (In fact, I'd probably call an ambulance rather than chancing a respiratory arrest during the car ride to the nearest ER, as paramedics would have the equipment and training to deal with it.) Treating such a child with homeopathic remedies could result in the child’s death, just as treating bipolar disorder with homeopathic remedies, whether “constitutionally prescribed” or not, could lead to death or at least severe consequences from untreated manic phase.

Resources for mental health care in Michigan are poor enough. We don’t need a bunch of quacks treating patients with bipolar disorder and other psychiatric conditions with magic water, any more than we need them treating children with potentially serious illnesses with the same. Naturopaths are quacks and should not be licensed in Michigan—or anywhere else.