It is that time of the year again! It is Naturopathic Medicine Week. This year I am very pleased to see that our American cousins have synchronized their Naturopathic Medicine Week with the Canadian.

Every year I update my post on research in whole person Naturopathic medicine. I deliberately exclude studies on single interventions or products, preferring to focus on Naturopathic medical treatment as a whole.

There was not a great deal of difference from the research review last year, but each year seems to bring new advances, which I am immensely grateful for. To begin with, we should discuss Naturopathic regulation globally, something that the World Naturopathic Federation has done wonderfully in the following paper.

To begin with, two reviews of all clinical trials on Naturopathic medicine have been conducted. The first was done in 2015, and found clinical trials on 13 conditions, finding statistically significant results in 10 of them. A second review conducted in 2019 found 33 trials, with Naturopathic medicine being found effective in pain, cardiovascular illness, type 2 diabetes, PCOS, depression and anxiety. A newer review was also performed, specifically in regard to side effects of Naturopathic medicine and surgical practice. The reviewers found a number of potential benefits naturopathic treatment could have in relation to surgery that demand further study, and no reports of serious side effects present. We will examine the clinical trials in different disease categories below.

Naturopathic Medicine in Metabolic disorders and Diabetes

Numerous clinical trials exist showing the effect of whole person naturopathic care on Diabetes. In this study the types of advice provided to Naturopathic Diabetes patients was examined. As well 31% acheives a HbA1c below 7% ( indicating diabetes was under control) and 61% acheived moderate control (HbA1c 6-10%).

A second study by the same authors examined the course of lab measurements in 37 patients, seen over a mean number of 11 visits. Changes in Lab values were -0.65% for HbA1c (p = 0.046), -45 mg/dL for Triglycerides (p = 0.037), -7 mm Hg in Systolic Blood Pressure (p = 0.02), and -5 mm Hg in Diastolic Blood Pressure (p = 0.003).

Another study examined 40 patients with diabetes given conventional and adjunct naturopathic care, and compared with a matched cohort of 329 patients given standard care alone. In the words of the abstract: “At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003). Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005). For clinical outcomes, mean HbA1c decreased by -0.90 % (P = 0.02) in the ANC cohort at 6-months, a -0.51 % mean difference compared to usual care (P = 0.07). Reductions at 12-months were not statistically significant (-0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12)” Please note, that insignificant means that a larger sample is needed to determine whether or not those changes are purely due to the intervention, or due to chance. A larger sample size would determine this.

Another study shows the results of 101 patients with Diabetes given a 3 month course of in patient therapy with Yoga and Naturopathy. In this study “A ‘favourable outcome’ was defined as glycaemic control (glycosylated hemoglobin (HbA_1c) < 7 % or absolute reduction by 1 %) along with at least 50 % reduction in antidiabetes medication at 3 months relative to baseline”. This study found “Of 101 patients with 3-month follow-up data, 65(65 %) achieved a favourable outcome – with 19(19 %) stopping medication while sustaining glycemic control. Factors associated with favourable outcome were baseline HbA_1c and compliance to diet, which showed a significant linear relationship with mean HbA_1c reductions of 0.4 %, 1.1 % and 1.7 % in relation to poor, moderate and excellent dietary compliance respectively.”

In this small prospective cohort Study, Naturopathic and Yoga care was observed to reduce postprandial blood glucose, and Hemoglobin A1C.

Another study shows 176 patients with obesity and diabetes randomized to either standard care, or residential naturopathic care. They found, in the words of the study “reduced PPBG levels (P < 0.001), glycated hemoglobin levels (P < 0.001), and reduced requirement for antidiabetic medications (P < 0.008) in the intervention group compared to controls. The effects were more profound immediately following intervention and lasted up to 6 months from the start of the study”

Naturopathic Medicine in Cardiovascular disease

Numerous trials of Naturopathic Medicine in Cardiovascular disease exist. In one trial 104 subjects with mild to moderate hypertension were treated by various Naturopathic therapies on an in patient basis. From the abstract “After starting nonpharmacological approach of naturopathy and yoga, Systolic blood pressure came down from mean of 139.6 to 129.6 where as it came down from 91.2 to 86.1 for diastolic blood pressure. At the same time favorable effect was also seen in other variables like lipid profile and body weight. At the end of one year out of 57 patients who came for follow-up, 14 cases were found to have blood pressure within normal ranges without any medication over the previous 12 months. ”

In a similar trial we see 72 subjects with cardiovascular risk factors receive a three week in patient Naturopathic/yoga treatment, with half receiving treatment, and half not. From the abstract “Compared to waitlist control, subjects in the Intervention group showed significantly (p < 0.05) lower adjusted mean values of systolic blood pressure (140.36 vs. 124.62), diastolic blood pressure (85.28 vs.76.93), fasting blood glucose (142.29 vs. 116.61), postprandial blood glucose (233.2 vs. 172.19), body mass index (33.05 vs. 31.86), total cholesterol(181.61 vs 161.04), LDL cholesterol(107.76 vs 85.72 ),triglycerides (152.8 vs. 131.74), anxiety (6.79 vs 4.98), depression (6.54 vs. 4.45) and somatization symptoms (7.84 vs. 3.56) at 3 weeks following intervention compared to waitlist controls. The intervention group showed significantly higher (p < 0.05) adjusted mean values of current health (29.56 vs 33.31) and prior health (9.67 vs 10.46) on the General Health Perception Questionnaire compared to waitlist controls following intervention.” This trial also found addition beneficial effects on blood glucose, LDL, and trigylcerides.

Another trial shows the results of yogic exercises, vegetarian diet and education on patients with hypertension. Of 80 patients, 79% acheived target blood pressure, 50% acheived this while reducing hypertensive medication by at least 50%. 10% were actually able to completely discontinue medication. There was also a significant differences in body fat, triglycerides and HbA1C as well.

An observational study was conducted in 2011. From the abstract “Patients with both stage 1 and stage 2 HTN appeared to improve during care, with stage 2 patients achieving mean reductions of −26 mmHg (P < .0001) and −11 mmHg (P < .0001) in systolic BP (SBP) and diastolic BP (DBP), respectively. The proportion of patients achieving control (<140/90 mmHg) in both SBP and DBP was increased significantly from 14 to 44% (P < .033), although the statistical significance was not maintained upon correction for multiple comparisons.”

Another trial examined 922 patients recovering from cardiothoracic sugery, 337 of which were given a program of supplements and lifestyle advice, and compared with 585 patients that received standard care. The treatment group required 42% less postoperative inotropic support.

My alma mater, CCNM, recently performed a clinical trial in which 246 postal workers received Naturopathic care (207 completed the study) in addition to normal family medicine from their MD. Lab chemistry was taken before and after Naturopathic care,and their risk of a major cardiovascular even was computed using the Framingham Risk Score method of computing the likelihood of a Cardiovascular event,  and the Adult Risk Panel III to compute the prevalence of metabolic syndrome. One group in the study received Naturopathic care plus normal medical care, and another received only normal medical care. In this study a highly significantly reduced risk of a major cardiovascular event (risk reduction in control group of 10.81, risk in Naturopathic group of 7.74% for a reduction of 3.07%) and a reduction of metabolic syndrome (48.48% control group, 31.58% Naturopathic group for a reduction 16.9%).Naturopathic care in Cardiovascular disease was recently examined in a clinical trial. 246 postal workers received Naturopathic care (207 completed the study) in addition to normal family medicine from their MD. Lab chemistry was taken before and after Naturopathic care,and their risk of a major cardiovascular even was computed using the Framingham Risk Score method of computing the likelihood of a Cardiovascular event,  and the Adult Risk Panel III to compute the prevalence of metabolic syndrome. One group in the study received Naturopathic care plus normal medical care, and another received only normal medical care. In this study a highly significantly reduced risk of a major cardiovascular event (risk reduction in control group of 10.81, risk in Naturopathic group of 7.74% for a reduction of 3.07%) and a reduction of metabolic syndrome (48.48% control group, 31.58% Naturopathic group for a reduction 16.9%).

This data was further analyzed in another paper for the economic impact of Naturopathic treatment. The above trial resulted in (corresponding to a 3.3% decreased risk of a Cardiovascular event) in a savings of $1138 in costs to society and $1187 in employer costs per year of Naturopathic treatment. The cost savings of livelong Naturopathic care that could be speculated on based on this remain staggering.

In response to this trial, this MD in CMAJ endorsed the idea of delegating some aspects of Cardiovascular care from Medical to Naturopathic Doctors. Many MDs would oppose this, but a significant minority of our Allopathic cousins would gladly cooperate with us in patient management.

Naturopathic Medicine for Musculoskeletal Conditions

Multiple trials have been conducted on the treatment of musculoskeletal pain. One was conducted by CCNM on the Naturopathic treatment of rotator cuff tendonitis was recently published. In it, a group of postal workers with diagnosed rotator cuff tendontis received either a standard set of physiotherapy exercises to do on their own (an approach not unlike that which many MDs in family practice will use before a physiotherapy referral) as well as a matched placebo. Pain was measured using Shoulder pain and disability index scores, visual analogue pain score, Short form 36, and MYMOP. 87% of participants completed 8 weeks of treatment, SPADI scores decreased by 54.5% (p<0.0001) in the Naturopathic care group and 18% (p<0.0241) in the Exercise group. All measures showed significant differences in favor of Naturopathic care, with SPADI showing a difference probability of <0.0001 and no major adverse outcomes reported.

In a similar trial 75 postal employees with back pain greater than 6 weeks duration were given either Naturopathic medicine or standardized exercises ( again similar to what they might recieve at an MD practice) for 12 weeks. Progress was measured using the Oswestry disability questionaire, as well as the SF-36, lower back range of motion, weight loss and BMI. 92% completed at least 8 weeks of treatment. Back pain reduced significantly in the Naturopathic group (-6.92 on Oswestry, p<0.0001) and all other measure improved significantly as well.

The above trial was analyzed for economic impact. In the analysis, employees experienced 9.4 more perfect health days and reduced societal ( read employer) costs of $1212 per participant over the course of the study. The intervention cost $154 per day, compared with lost productivity costs of $178 per day, representing a return on investment of7.9%. Individuals participating saved $1096 each. Again this was from a single course of treatment. Imagine the cost savings applied society wide, particularly in countries like Canada with socialized medicine.

Another trial was performed comparing conventional and naturopathic treatment of back pain, using the Oswestry score. Very little difference was noted overall, but a superior outcome for naturopathic care was noted in women.

One poster presented an observational study of 221 patients treated with naturopathic therapies across a wide range of diagnoses such as fibromyalgia, rheumatoid arthritis, low back pain and chronic neck pain. According to the abstract “Mean VAS decreased by 15.1 from 60.7+23.0 (T1) to 45.6+26.2 (T5) (p<0.0001, two-sided t-test), with highest improvement for low back pain (decrease of 17.5) and no differentiation for multi-morbidity (n=46 with, n=55 without). SF-36 physical and mental component scores improved significantly from 40.0+12.2 to 44.3+12.5 and from 29.6+8.2 to 32.9+10.5, respectively (p<0.0001 for each).

Another pilot study compared 160 women comparing conventional care, naturopathic medicine and chinese medicine in the treatment of TMJ disorders. From the abstract “CM and NM demonstrated significantly greater in-treatment reductions for worst facial pain compared to SC (adjusted regression analysis; higher negative values indicate greater improvement, = -1.11 +/- 0.43, p = 0.010 and -1.02 +/- 0.45, p = 0.025 for TCM and NM, respectively, compared to SC) and at 3 months post-treatment (-1.07 +/- 0.51, p = 0.037 and -1.27 +/- 0.54, p = 0.019 for TCM and NM versus SC, respectively). Additionally, TCM provided significantly greater decreases in average pain than SC; NM provided significantly greater decreases than SC or TCM in TMD-related psychosocial interference”.

One final study was conducted on chiropractice, acupuncture and naturopathic medicine on pain, showing significant reductions in all groups.

Naturopathic Medicine for Mood Disorders

Several trials have examined the efficacy in Naturopathic medicine for mental health conditions. One trial, conducted my my alma mater CCNM, compared Naturopathic care or standardized psychotherapy for the treatment of generalized anxiety, finding a significant difference in favor of Naturopathic medicine.

Another study was conducted on patients with anxiety and depression using Naturopathic medicine as primary therapy. In the words of the abstract “The overall improvement in symptoms of depression and anxiety was highly significant (p < 0.0001) when comparing the group’s average initial screener scores to their average final screener scores for both depression (16.4 vs. 8.6) and anxiety (12.4 vs. 7.2). The response rate, as measured by a 50% decrease in scores, for those with initial scores ≥10 was 58.6% for depression (PHQ-9) and 50% for anxiety (GAD-7). ”

A small Australian trial shows some preliminary results in improving mood and decreasing anxiety though small sample size prevented definite conclusions. A second small case series found a number of bipolar patients who were, with naturopathic therapy, able to reduce or eliminat medication, with mood stability continuing.

Naturopathic medicine for Asthma

Another small Indian study showed significant improvements in PEFR, VC, FVC, FEV1, FEV/FEC%, MVV< ESR and Absolute Eosinophil count in Asthma patients undergoing a Naturopathic and Yogic treatment regimen.

Another Indian study we see the results of a one month in patient regimen on 159 bronchial asthma patients. From the abstract “The paired sample t test results showed significant increase in the Forced Vital Capacity and Forced Expiratory Volume from the date of admission up to 6th month (P < 0.0035) post Bonferroni correction. Maximum Voluntary Ventilation significantly increased from admission till the date of discharge (P < 0.0035) and Peak Expiratory Flow Rate significantly increased from admission till the 36th month of follow-up (P < 0.0035), post Bonferroni correction.”

In another study, patient outcomes from Naturopathic and Allopathic medical practices were compared in the treatment of menopausal symptoms. Consistent with other research, Naturopathic patients reported higher income, lower rates of smoking, higher rates of exercise, but interestingly, greater rates of fatigue, insomnia and hot flashes. Both patient groups resulted in improvements in anxiety, hot flashes, vaginal dryness and menstrual changes. Significantly better results were found in insomnia and fatigue.

Naturopathic medicine in other Chronic Conditions

Naturopathic medicine has been studied in a wide variety of other conditions. One German study on in patient treatment showed significant improvement in quality of life, though with rheumatic patients showing a different improvement profile. Another feasibility trial examined one housing complex. The results showed “After 12 months, effect sizes ≥0.3 were observed for activities of daily living on the NOSGER-Activities of Daily Living subscale (0.53), Barthel Index (0.30), Qualidem total sum score (0.39), Profile of Wellbeing (0.36), NOSGER-Impaired Social Behavior (0.47), and NOSGER-Depressed Mood subscales (0.40). Smaller or no effects were observed for all other outcomes. The intervention itself was found to be feasible, but elaborate and time consuming. ”

An observational study on 5278 patients with a wide variety of concerns for 12 months. From the abstract”Complaints had persisted for 6 years (median). The intensity of the main complaint decreased from 59+/-25 by an average of 25 points at discharge (19 points at 6-month follow-up) corresponding to an effect size of 0.86 (0.62 at 6-month follow-up). At 6-month follow-up about half of the patients showed a clinically relevant improvement of quality of life (SF-36 sum scores increased by >or=5 points). Intake of drugs was reduced,the number of days off work had decreased after rehabilitation. ”

Another small observational trial showed 49 patients with an average  of 57.14% improvement in presenting symptoms and 34.69 percent improvement in overall wellbeing over three years.

An observational trial was conducted in menopausal patients. From the results ” In univariate analyses, patients treated with naturopathy for menopausal symptoms reported higher monthly incomes ($1848.00 versus $853.60), were less likely to be smokers (11.4% versus 41.9%), exercised more frequently, and reported higher frequencies of decreased energy (41.8% versus 24.4%), insomnia (57.0% versus 33.1%), and hot flashes (69.6% versus 55.6%) at baseline than those who received conventional treatment. In multivariate analyses, patients treated with naturopathy were approximately seven times more likely than conventionally treated patients to report improvement for insomnia (odds ratio [OR], 6.77; 95% confidence interval [CI], 1.71, 26.63) and decreased energy (OR, 6.55; 95% CI, 0.96, 44.74). Naturopathy patients reported improvement for anxiety (OR, 1.27; 95% CI, 0.63, 2.56), hot flashes (OR, 1.40; 95% CI, 0.68, 2.88), menstrual changes (OR, 0.98; 95% CI, 0.43, 2.24), and vaginal dryness (OR, 0.91; 95% CI, 0.21, 3.96) about as frequently as patients who were treated conventionally. ”

In a retrospective review of patients with Hepatitis C who were treated with a comprehensive naturopathic protocol. Of 14 patients that had not undergone interferon therapy, 7 had a greater than 25% decrease in ALT, a measure of liver inflammation. The average reduction in ALT was 35 U/L (p=0.026)

Another trial on 20 patients with HIV on standard antiretroviral medications treated with Naturopathic interventions (IG) and compared with 20 matched patients (CG) from the results “: After the end of 6 month, the IG showed significant changes CD4 cell count (p=3.96E-05). The CG also showed a significant improvement in CD4 cell counts (p= 0.024) but not of the same magnitude as of IG. An independent t-test between the groups has shown that the IG was more significant (p=0.047). ”

One study was done on patients with Autism, 67 patients ranging from 3-58 years were given supplementation, with additional naturopathic treatments, such as enzymes, carnitine, epsom salts baths and a diet free of gluten, casein and soy. Lab results show a significant improvement of blood nutrient levels, and nonverbal IQ and autism symptoms also significantly improved.

Another study examines Polycystic ovarian syndrome patients who had undergone a Naturopathic and Yogic regimen for 12 weeks. 25 patients were given the intervention, while 25 others were placed on a wait list. Significant changes were observed in ovarian morphology and body measurements.A second trial of PCOs was also conducted on 101 women who were given either lifetyle advice, or lifestyle advice plus herbal therapy. “At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3-42.6, p < 0.01) compared with controls, estimated as a large effect (η_p² = 0.11). Other significant improvements were found for body mass index (p < 0.01); insulin (p = 0.02) and luteinizing hormone (p = 0.04); blood pressure (p = 0.01); quality of life (p < 0.01); depression, anxiety and stress (p < 0.01); and pregnancy rates (p = 0.01).”

A pilot study was with MS patients. 45 patients were randomized to either usual care, usual care plus MS education, or usual care plus naturopathic care. There were no significant differences between the groups, but a nonsignificant trend in favor of naturopathic medicine in general health, timed walk and neurological impairment. These results would likely have been significant in a slightly larger trial.

Naturopathic Medicine and Cancer

This study shows a trial of 116 patients with stage II and stage III adenocarcinoma of the colon, randomized to standard treatment (counselling and chemotherapy) and to Standard therapy plus natuorpathic medicine, yoga, and dietary management. The trial found statistical improvements in Carcinoembryonic antigen and hemoglobin and psychological attributes such as anxiety, depression, symptom severity, and Functional Living Index: Cancer (FLIC) were found to be significantly improved.

Another trial of 101 individuals focused on the survival of patients diagnosed with hepatocellular carcinoma treated with any number of 12 naturopathic agents. From the abstract ” Initial treatment was with 2.6 ± 0.8 agents (range 2-4). Overall, patients were treated with 3.7 ± 1.2 agents (range 2-7). There was a significant correlation between number of agents administered and survival (P < .0001). Patients treated with ≥4 agents survived significantly longer than patients treated with ≤3 agents (40.2 vs 6.4 months, P < .0001). This difference could not be attributed to statistically significant differences in severity of liver disease or tumor stage, delay in treatment, previous treatment, concurrent nondrug treatment, or censoring effects. The greatest effect was seen in patients treated with at least 4 agents that included Cordyceps sinensis. This prolonged survival was without toxic side effects and appeared to potentiate the survival benefit of conventional therapy. ”

Recent Indian research has focused on a number of areas of integration of Naturopathic medicine and conventional care. This paper reviews the multiple ways many Naturopathic agents can aid in modulating cell signalling pathways in cancer. Another paper shows a similar conclusion, with Natural compounds showing great promise in decreasing resistance to one method of cell self destruction in cancers.

Demographics and Morbidity of Naturopathic Patients

Much recent research has focused on the types of patients Naturopathic Doctors see. In one recent study a survey of 300483 visits to a Naturopathic teaching clinic was examined. It was found that Naturopathic clinics saw a similar range of problems to other primary care practices, that patients paid out of pocket more (unsurprisingly) and that Naturopathic clinics offered discounted care far more often.

Another recent study discussed characteristics of Pediatric patients coming to CCNM, a Naturopathic college in Toronto. Furthermore, a cross section of Naturopathic patients as a whole at CCNM was done, showing the incredibly wide variety of issues people come to Naturopathic Doctors with.

Another study was done on the morbidity profiles of patients for Naturopaths in India, showing a very wide variety of ages attending. The diseases presenting tended to be chronic and multisystematic “followed by Obesity, Diabetes Mellitus, Hypertension, Arthritis, and Back pain”.

Naturopathic Medicine in Public Health

Another fascinating direction of research has emerged in the applications of Public health models of research to Naturopathic care, rather than more allopathic models a potential research enterprise with much potential. Another study measured the characteristics of rural Naturopathic practice in Australia, showing the important role played by naturopaths in the provision of underserved rural populations. Another study showed a high level of patient and staff satisfaction resulting from integration of Naturopathic medicine into an acute care hospital.

Perhaps most intriguingly in our survey of research is this paper, published in the Indian Journal of Medical Ethics. India is in the slow process of constructing a healthcare system of Universal coverage (often jokingly termed Modicare after the Indian Prime Minister Narendera Modi). Unlike in Countries such as Canada which have  long traditions of public medicine that were built during the low point of Holistic medicine, in the 1960s, India likely will be including all systems of medicine in it’s public scheme, along with allopathic care. AYUSH is the term in India used for such systems, including Ayurveda, Therapeutic Yoga, Unani, Sidda, Homeopathy and Naturopathy. The above mentioned paper examined the AYUSH systems in light of a report on the Principles of Universal Care produced by the Planning Commission of India. In that paper, the authors conclude that not only does AYUSH meet the standards the India government wishes to see in it’s Universal system, they would actually further it’s goals more effectively in many cases than Allopathic care alone would be able to.

A newer paper has also been published advocating for the inclusion of Naturopathy and Yoga for it’s expertise in treating the burden of non communicable disease.

Finally, there is a free documentary showing Naturopathic medicine being practiced in India, to fully scope, in in-patient facilities. I encourage you to watch it. It is my hope that the example of India in medical equality and non discrimination will be followed by Canada and other Western countries, giving all citizens the potential for access to the benefits of Naturopathic Treatment.

https://www.youtube.com/watch?v=AezmON6hZVk

This is an updated version of a previously published blog post I wrote on the topic of my opposition to Fluoride being added to Calgary’s water supply. With the upcoming plebiscite on the issue scheduled for the October 2021 civic election, and the large amount of fresh research on the topic, I decided to update the blog.

Calgary successfully removed Fluoride from the water in 2011, on the basis of the need for costly plant upgrades to continue, and the rights of individuals to not be medicated against their will, as well as attention to the fact the Fluoride is not a substitute for dental care for poor children, which would be far more effective in preventing dental decay. The funding used to fluoridate water was redirected instead into a program of dental care for low income children.

The catalyst for this reconsideration seems to be a study from the University of Calgary study by Mclaren et al. In this study they compared the number of cavities in grade two schoolchildren between Calgary, which stopped Fluoridation, and Edmonton, which continued it. The study was done in 2013-14, and a similar study in 2004-5 was used a control. The study results are displayed in graphical form to the right:

Now, this would seem to be quite an open and shut case. However, As recently discussed by Neurath et al in another article, this survey was however, somewhat odd in using older 2004-5 data, instead of a more recent 2009-10 survey of dental health in Calgary. This 2009-10 survey was performed using the same methods, in fact being intended to be compared to the 2004-5 study, and it gives some remarkable results, as shown in the figure to the left (taken from page 3 of Neurath et al’s paper, and gratefully acknowledged).

From Neurath’s data we can see that the vast majority of change in dental decay rates occurred before the cessation of fluoridation in the city. The rate of dental decay between 2009-10 and 2013-14 in fact, while showing an upward trend, were not statistically significantly different. Neurath also criticized Mclaren for equating Calgary and Edmonton, as Edmonton has always had considerably poorer health than Calgary, and at baseline Edmonton’s tooth decay rate was 73% higher, for reasons that are not clear, making comparisons between the two of limited value. There was also some potential for selection bias in the 2013-14 dental survey, and subgroup analysis, restricting analysis to children with at least one cavity in fact are even less persuasive than the all inclusive data, as shown in the figure to the right, again gratefully acknowledged as being taken from Neurath et al.

This paper was responded to by Mclaren who stated that the 2009-10 data were excluded due to the lack of a comparison survey in Edmonton, and due to the 2010 paper’s focus on whole tooth, rather than tooth surface data, and dispute several other factors in Neurath’s analysis.

Regardless of this, it can be seen that the case for fluoridation based on this single paper in Calgary is not particularly strong. Calgary and Edmonton ( and indeed most of the first world) is in the midst of a vast increase in dental decay, likely mediated by changes in diet. Fluoridation however, like all interventions on the human body, does not exclusively affect one organ to the exclusion of others. Fluoridation has systematic effects on the human body, outside of the teeth, and these must be taken into account.

A small subset of patients have reported clinically a negative effect on their thyroids from fluoridated water. Some research has examined this phenomenon and found no particular association between TSH levels and urinary Fluoride excretion. Aside from the issues of using TSH alone instead of a full range of thyroid lab values, other research has examined this phenomenon in light of the patients iodine status. In patients with lower Iodine status, according to this research, TSH increases, indicating an adverse effect on thyroid hormone secretion. As we can see from this data from statscan, a considerable percentage of Canadians have poor iodine status, and may have thyroid function lowered by water Fluoridation, particularly in inland areas such as Calgary, which tend to have lower iodine status.

Fluoridation of water was also associated in one study with lower rates of eye cancer, and in another with lower rates of kidney stones and bladder cancer.

The most contentious issue however remains the effect of Fluoride on children’s intelligence. A number of research studies have been done suggesting a strong correlation between Dental fluorosis and lowered IQ in Children. (see here, for a study on this topic in Bagalkot, and here for another done in Lucknow). In one metanalysis in 2012 Choi et all found an inverse association with Fluoride levels on water and children’s IQ, that is a higher levels of fluoride correlated with a lower IQ. This study has been criticized for including studies that looked at both Iodine and Fluoride status, as well as relying on naturally occurring levels of fluoride, rather than artificially supplemented by water fluoridation as well as other confounders, such as the association of water Fluoride with Arsenic contamination, and inability to determine the exact level of fluoride consumption when relying on general water concentrations. One such study, can be seen here, although it was not included in the 2012 metaanalysis. Another, grading children into high, medium and low Fluoride areas found the same negative correlation.

So, several more studies were done using much more precise measures. One in Mexico measured the urine concentration of Fluoride in pregnant women, and correlated it to their children’s cognitive test scores at age 4 and 6-12. This study found significant associations with higher Fluoride urine levels and lower performance on these cognitive tests resulting in a loss of roughly 6.13 loss in IQ for every 1mg/L increase in maternal fluoride excretion. Another study was performed using similar methods in Canada, finding a loss of 4.5 IQ points in boys for every 1mg/L, but none for girls. These last two studies overcame many of the specific problems with the 2012 metanalysis and seem to confirm the findings. To put this effect into context, high childhood lead exposure correlates with a 1.61 point loss of IQ in adulthood, and when this was found out, the result was international banning of leaded gasoline, paint and glazes. This reduction in lead in the 1970s is also hypothesized to be behind the decline in violent crime seen in the 1990s, again, with an IQ point drop that is approximately 1/3 that shown from fluoride.

Echoing the above research,and the emphasis on boys being more vulnerable to negative health outcomes from Fluoridation, another study in Mexico was performed based on urinary Fluoride excretion showing a later age of puberty in boys with higher Fluoride exposure.

More recent research has been performed examining the effect of exposure after birth, as well as confirming the effects of prenatal exposure. A Canadian study of 398 mother child pairs were analyzed for tap water fluoridation and childhood IQ. An increase of 0.5mg/ml correlated with a 9.3-6.2 point IQ drop. Even controlling for maternal exposure to fluoridated water, both breastfed infants and formula fed infants demonstrated lower IQs. A 0.5mg increase in fluoride intake in breastfed infants corresponded with an 8.8 point decrease in IQ.

Another study differentiated the effect of exposure to childhood IQ at different points in childhood development, prenatal exposure only, postnatal exposure, control, and both pre and postnatal. Mean IQ in children exposed to excessive fluoride during pregnancy was significantly lower, and they had a 51.1% decreased chance of excellent intelligence compared with children without excess exposure at any time (acknowledging of course the flawed and ethnocentric nature of IQ). For all children, urinary fluoride excretion above 1.7mg/L was negatively associated with IQ. In children without prenatal exposure, each 1mg/L increase in urinary fluoride was associated with a reduced IQ score of 11.4.

Also recently, some speculation has emerged the Fluoridation in water sources, particularly in combination with aluminum exposure in utero may predispose individuals to develop autism. The evidence behind this hypothesis has not yet been thoroughly examined however.

Conclusions:

The above data do present a complex picture. The general literature, and I personally, accepts that increasing the level of Fluoride in water decreases dental cavities. However, Fluoride also has a complex and negative effect on Childhood intelligence, likely lowering the IQ of children of mothers exposed to high fluoride exposure by 4-6 points per extra mg/L of maternal fluoride excretion. As well, post pregnancy exposure does also seem to reduce IQ. A 0.5mg increase in fluoride intake in breastfed infants corresponded with an 8.8 point decrease in IQ.

To put this into context, the mass exposure of children to leaded paint and gasoline, which was hypothesized to be behind the Lead-Crime effect, showed an approximately 1.6 point IQ drop.

As well, as we can see with more complete data, while Calgary is experiencing an increase in dental cavities in children, this is likely due to much more complex factors than just the removal of Fluoridation from the cities water supply, as the majority of the increase, and possibly all of it, occurred before Fluoride was actually removed.

Fluoride itself is also extremely difficult to remove from water, requiring complex Reverse Osmosis equipment to fully remove. Other additives to water with negative health outcomes, such as Chlorine (associated with certain types of Cancers and disruption of the gut Microbiome) are not relevant, as chlorine is easily removed by inexpensive water filters, within reach of nearly all Calgarians, and the certain benefits of removing water borne pathogens from the water supply that Chlorine provides.

The cost of Fluoridation in a city that increasingly burdened by a shrinking tax base, particularly when Fluoridation is difficult to remove from the water and will have a strong adverse effect on intelligence in children, is not in the public interest of Calgary. The problem of increased dental cavities would best be solved by public coverage of dental medicine (which should be included in an expanded medicare system along with Naturopathic, Chiropractic, Traditional Chinese, and other medicines).

Hi Everyone.

I have decided to release a trituration of Bison bison hair. You can access it here.

I release it now, in the 21st hour of the 21st day in the 21st year of the 21st century in the spirit of reconiliation. I have come to this information on the basis of trituration, with no connection to any indigenous lineage, but I release hoping that the world may find some use for this information, and such lineages perhaps may find it of interest.

I hope you all enjoy it.

Hi Everyone!

I hope you all are enjoying your holidays.

Over the last few weeks I have undertaken a course of training in Mold related illness by Dr. Jill Crista, ND. I recently completed the course, and am now listed on their directory of mold literate NDs. I look forward to offering patients this additional level of care. I encourage anyone interested to examine my web page on Mold illness, or to take Dr. Crista’s free course on identifying whether mold is a problem in your life.

I have also created a new course, based on my recent triturations of a series of nosodes within what I term The Redox Miasm. This course is a preview of what I hope to do for every miasm, of which I have identified eight, once my course of research on the nosodes is complete. I shall keep you all informed of my progress.

I will likely be redoing my publications page in the next few weeks, separating papers from books (which even I have trouble keeping track of in their profusion), and setting up a separate teachings page, to keep things better organized. I do hope to finally release my book on mammals early in the new year. The manuscript is nearly complete, and once editing is finished, I do anticipate a speedy publication.

Happy New year to you all!

Hello Everyone!

I wish to wish everyone the Merriest of Christmases, and the Happiest of Holidays and New years!

I am incredibly grateful to have you all in my lives. I look forward to a much better year together in 2021!

Hi Everyone.

As many of you know, I utilize the Carroll method of food intolerance evaluation, which learned from Dr. Jared Zeff, ND, VNMI, and Dr. Letitia Dick-Kronenberg, ND, VNMI Shown in the photograph to the right.

I explain to every patient why I prefer this method, as well as some of it’s history. I have written a web page on this method, but many patients have alo been requesting a video on this method. As such I decided to make one! It is below, and I hope that you enjoy it.

The video is posted on my Youtube channel, I hope anyone who likes my videos likes them and subscribes to my channel. I post regular videos there, and have been posting my meditation series, which I will write about when complete!

Anyway, here is the food intolerance video. I hope you enjoy it!

Hi Everyone!

So it’s been a really busy summer for me. Everyone at clinic has fallen into the groove of a post Covid world, which now does, because of the city bylaw, include mandatory masks during visits. I myself had one potential exposure outside of clinic (which turned out to not be positive after all), which required me to cancel all appointments for a few days. Thank you to everyone who rescheduled.

As always I cannot guarantee that such things won’t need to occur again. I am very grateful to all of my patients who stick with me, despite any needed schedule changes.

I’ve been taking advantage of the covid boom of online training by taking courses that had previously required long distance travel. One course in particular which I have had great fun with is on acupuncture for trauma, a technique developed in Germany that seems to aid in the identification and processing of traumatic experiences through a combination of ear acupuncture and flower essences. I FINALLY got all the supplies, and so began practicing the technique. I have to say, I am finding great success with it, both in terms of psychological health and in terms of freeing up the vitality to work on other physical, mental or emotional problems the person may have, unconnected to any particular trauma.

If you would like to experience this, please do book in for an acupuncture session!

I’ve also begun a meditation blog on my Youtube channel. I upload about 1 session per week. I’ve been focusing on flowers and plants lately, but likely will focus on other topics soon. You can find this playlist by clicking here. I hope you all enjoy it!

And finally, it’s August, and we’re all trying to beat the heat, especially in clinic! Like many of you, I don’t have air conditioning, and am boiling. But I thought I would share a technique that got me through summer in Toronto when I was in school, without air conditioning. The technique is simple. Dunk a t-shirt in tepid water and put it on. It will cool you for about an hour, and will also stimulate your healing processes, in general.

Anyway, I hope you all are having a delightful summer!

Much love!

Dr. Paul

Image Credit: Cornelisus383. https://commons.wikimedia.org/wiki/File:Yoga_Meditation_Pos-410px.png