Naturopathy: An Introduction

Naturopathy—also called naturopathic medicine—is a medical

system that has evolved from a combination of traditional practices
and health care approaches popular in Europe during the 19th
century. Guided by a philosophy that emphasizes the healing power
of nature, naturopathic practitioners now use a variety of traditional
and modern therapies. This fact sheet provides a general overview
of naturopathy and suggests sources for additional information.

Key Points

 People visit naturopathic practitioners for various health-related

purposes, including for primary care.

 Naturopathy focuses on treatments considered by practitioners

to be “natural,” but they may not be without risk.

 Although some of the individual therapies used in naturopathy

have been studied for efficacy and safety, naturopathy as a
general approach to health care has not been widely researched.

 Naturopathic practitioners may vary widely in education and

training, licensing, and treatment preferences.

 Tell your health care providers about any complementary and

alternative practices you use. Give them a full picture of what
you do to manage your health. This will help ensure coordinated
and safe care.

Background

Naturopathy as a whole medical system has its roots in Germany. It

was developed further in the late 19th and early 20th centuries in
the United States, where today it is considered part of
complementary and alternative medicine (CAM).
The word naturopathy comes from Greek and Latin and literally translates as “nature disease.”
A central belief in naturopathy is that nature has a healing power (a principle practitioners call
vis medicatrix naturae). Practitioners view their role as supporting the body’s inherent ability to
maintain and restore health, and prefer to use treatment approaches they consider to be the
most natural and least invasive.

Naturopathy was popularized in the United States by Benedict Lust, who was born in Germany
in the late 1800s. When Lust became seriously ill, he was treated by a priest and healer in
Germany named Sebastian Kneipp. Kneipp’s treatment included hydrotherapy (water
treatments) and the “nature cure” (wholesome diet, gentle exercise, herbal medicines, and
exposure to sun and air).

When Lust moved to the United States at the turn of the 20th century, he began to promote
Kneipp’s treatment approach. He called the approach naturopathy, led the way in developing it
as a medical system, and founded the first naturopathic college and professional association.
In naturopathy’s early years, other therapies were added—for example, homeopathy and
manipulative (hands-on) techniques.

Naturopathy’s popularity in the United States grew in the 1920s and 1930s. Its use began to
decline when drugs (such as antibiotics) and other developments in conventional medicine
moved to the forefront of health care. Naturopathy began to reemerge in the 1970s, with
increased consumer interest in “holistic” health approaches and the founding of new
naturopathic medical colleges. Today, naturopathy is practiced in a number of countries,
including the United States, Canada, Germany, Great Britain, Australia, and New Zealand.

Use in the United States

According to the 2007 National Health Interview Survey, which included a comprehensive
survey of CAM use by Americans, an estimated 729,000 U.S. adults and 237,000 children had
used a naturopathic treatment in the previous year. Although naturopathy was not among the
most commonly used CAM therapies, it was one of six with increases in adult use since the
previous (2002) survey.

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

Underlying Principles

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

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 First do no harm. Try to minimize harmful side effects and avoid suppression of symptoms.

 Physician as teacher. Educate patients and encourage them to take responsibility for their
own health.

 Treat the whole person. Consider all factors (e.g., physical, mental, emotional, spiritual,
genetic, environmental, social) when tailoring treatment to each patient.

 Prevention. Assess risk factors and, in partnership with patients, make appropriate
interventions to prevent illness.

 Healing power of nature. Seek to identify and remove obstacles to the body’s natural
processes for maintaining and restoring health.

 Treat the cause. Focus on the causes of a disease or condition, rather than its symptoms.

Practitioners

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

Naturopathic physicians generally complete a 4-year, graduate-level program at one of the

North American naturopathic medical schools accredited by the Council on Naturopathic
Medical Education, an organization recognized for accreditation purposes by the U.S.
Department of Education.1 Admission requirements generally include a bachelor’s degree and
standard premedical courses. The study program includes basic sciences, naturopathic
therapies and techniques, diagnostic techniques and tests, specialty courses, clinical sciences,
and clinical training. Graduates receive the degree of N.D. (Naturopathic Doctor) or N.M.D.
(Naturopathic Medical Doctor), depending on where the degree is issued. Although
postdoctoral (residency) training is not required, some graduates pursue residency
opportunities.

As of 2010, 15 states,2 the District of Columbia, and two U.S. territories (Puerto Rico and Virgin
Islands) have licensing requirements for naturopathic physicians. In these jurisdictions,
naturopathic physicians must graduate from a 4-year naturopathic medical college and pass

                                                            
1
As of spring 2010, six naturopathic medical schools—four in the United States and two in Canada—were accredited by the Council on
Naturopathic Medical Education, and another U.S. school has been granted candidacy status by the Council. 
2
 Alaska, Arizona, California, Connecticut, Hawaii, Idaho, Kansas, Maine, Minnesota (effective July 2009), Montana, New Hampshire, Oregon,
Utah, Vermont, Washington 

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an examination to receive a license.3 They must also fulfill annual continuing education
requirements. Their scope of practice is defined by law in the state in which they practice (for
example, depending on the state, naturopathic physicians may or may not be allowed to
prescribe drugs, perform minor surgery, practice acupuncture, and/or assist in childbirth).

Traditional naturopaths, also known simply as “naturopaths,” emphasize naturopathic

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

Other health care providers (such as doctors of medicine, doctors of osteopathy, doctors of
chiropractic, dentists, and nurses) sometimes offer naturopathic treatments and other holistic
therapies, having pursued additional training in these areas. Training programs vary.

Treatment

Naturopathic practitioners use many different treatment modalities. Examples include:

 Nutrition counseling, including dietary changes (such as eating more whole and
unprocessed foods) and use of vitamins, minerals, and other supplements
 Herbal medicines
 Homeopathy
 Hydrotherapy
 Physical medicine, such as therapeutic massage and joint manipulation
 Exercise therapy
 Lifestyle counseling.

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

Efficacy and Safety

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

Some studies have shown a few areas of scientific interest to pursue. For example, a study of
warehouse employees with chronic low-back pain found that naturopathic care was a more

                                                            
3
 In states that license naturopathic physicians, that title as well as “naturopathic doctor” or even “naturopath” may be protected by law for
practitioners who have completed a 4-year naturopathic medical school program. 

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cost-effective approach than standard physiotherapy advice. In another study, postal
employees with chronic low-back pain had significantly greater improvement from
naturopathic care than from standard physiotherapy advice. Researchers have also found
evidence that naturopathic treatment may help improve quality of life in multiple sclerosis
patients. A study of treatment alternatives for patients with temporomandibular (jaw)
disorders found that two whole medical system approaches—naturopathic medicine and
traditional Chinese medicine—both resulted in greater pain reduction than state-of-the-art
conventional care. In assessing the safety of naturopathic care, points to consider include:

 Naturopathy is not a complete substitute for conventional care. Relying exclusively on

naturopathic treatments and avoiding conventional medical care may be harmful or, in
some circumstances (for example, a severe injury or an infection), have serious health
consequences.

 Some beliefs and approaches of naturopathic practitioners are not consistent with
conventional medicine, and their safety may not be supported by scientific evidence. For
example, some practitioners may not recommend childhood vaccinations that are
standard practice in conventional medicine (although a survey of naturopathic physicians
in one state found that some provided childhood immunizations).

 Some therapies used in naturopathy have the potential to be harmful if not used under the
direction of a well-trained practitioner. For example, herbs can cause side effects on their
own and may interact with prescription or over-the-counter medicines or other herbs, and
restrictive or other unconventional diets can be unsafe for some people.

If You Are Thinking About Using Naturopathy

Keep in mind the following points:

 Naturopathy practitioners’ qualifications may vary widely. Find out about the practitioner’s
education and training. Ask whether the practitioner is licensed by the state, and about
any other documented qualifications.

 Tell the practitioner about any medical conditions you have. Ask whether the practitioner
has any specialized training and experience in them.

 Ask about the practitioner’s referral network and make sure the practitioner has
experience coordinating care with other types of medical providers.

 Ask the practitioner about typical out-of-pocket costs and insurance coverage (if any).

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 Tell the practitioner about all drugs (prescription or over-the-counter) and dietary
supplements you are taking. Naturopathic practitioners may use herbal remedies, or may
be licensed to prescribe certain drugs. Avoiding potential interactions is important.

 Tell all of your health care providers about any complementary and alternative practices
you use. Give them a full picture of what you do to manage your health. This will help
ensure coordinated and safe care. For tips about talking with your health care providers
about CAM, see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/.

NCCAM-Funded Research in Naturopathy

Some recent NCCAM-supported projects have been studying:

 A naturopathic dietary approach for type 2 diabetes

 Naturopathic treatments for periodontal (gum) disease
 Naturopathic herbal and dietary approaches to breast cancer prevention.

The NCCAM-funded Naturopathic Medical Research Agenda (NMRA) project brought together
representatives from a broad range of scientific and clinical backgrounds to develop priorities
for scientific exploration of naturopathic medical practices and principles. NMRA
recommendations were published in 2006.

Selected References
Albert DP, Martinez D. The supply of naturopathic physicians in the United States and Canada continues to increase.
Complementary Health Practice Review. 2006;11:120-122.

Baer HA. The sociopolitical status of U.S. naturopathy at the dawn of the 21st century. Medical Anthropology Quarterly.
2001;15(3):329-346.

Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 2007.
CDC National Health Statistics Report #12. 2008.

Boon HS, Cherkin DC, Erro J, et al. Practice patterns of naturopathic physicians: results from a random survey of licensed
practitioners in two U.S. states. BMC Complementary and Alternative Medicine. 2004;4:14.

Dunne N, Benda W, Kim L, et al. Naturopathic medicine: what can patients expect? Journal of Family Practice. 2005;54(12):
1067-1072.

Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of Internal
Medicine. 2002;137(12):965-973.

Herman PM, Szczurko O, Cooley K, et al. Cost-effectiveness of naturopathic care for chronic low back pain. Alternative Therapies in
Health and Medicine. 2008;14(2):32–39.

Hough HJ, Dower C, O’Neil EH. Profile of a Profession: Naturopathic Practice. The Center for the Health Professions, University of
California, San Francisco Web site. 2001. Accessed at http://www.futurehealth.ucsf.edu/pdf_files/naturo2.pdf on April 23, 2009.

Myers T. Introduction to Naturopathic and Classical Chinese Medicine. National College of Natural Medicine Web site. 2005. Accessed
at http://www.ncnm.edu/about/BriefHxNDCCM.pdf on April 23, 2009.

Naturopathic medicine. Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on April 21, 2009.

Parkman CA. Issues in credentialing CAM providers. Case Manager. 2004;15(4):24-27.

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Ritenbaugh C, Hammerschlag R, Calabrese C, et al. A pilot whole systems clinical trial of traditional Chinese medicine and
naturopathic medicine for the treatment of temporomandibular disorders. Journal of Alternative and Complementary Medicine.
2008;14(5):475-487.

Shankar K, Liao LP. Traditional systems of medicine. Physical Medicine and Rehabilitation Clinics of North America. 2004;15(4):725-747.

Shinto L, Calabrese C, Morris C, et al. A randomized pilot study of naturopathic medicine in multiple sclerosis. Journal of
Alternative and Complementary Medicine. 2008;14(5):489-496.

Smith MJ, Logan AC. Naturopathy. Medical Clinics of North America. 2002;86(1):173-184.

Standish LJ, Calabrese C, Snider P. The naturopathic medical research agenda: the future and foundation of naturopathic
medical science. Journal of Alternative and Complementary Medicine. 2006;12(3):341-345.

Szczurko O, Cooley K, Busse JW, et al. Naturopathic care for chronic low back pain: a randomized trial. PLoS One. 2007;2(9):e919.

U.S. Department of Labor. Dictionary of Occupational Titles (4th Ed., Rev. 1991). 079.101-014, Doctor, Naturopathic. U.S. Department
of Labor Web site. Accessed at http://www.oalj.Dol.Gov/PUBLIC/DOT/REFERENCES/DOT01B.HTM on April 23, 2009.

Weber W, Taylor JA, McCarty RL, et al. Frequency and characteristics of pediatric and adolescent visits in naturopathic medical
practice. Pediatrics. 2007;120(1):e142-e146.

For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications
and searches of Federal databases of scientific and medical literature. The Clearinghouse does
not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site: nccam.nih.gov
E-mail: [email protected]

PubMed®

A service of the National Library of Medicine (NLM), PubMed contains publication information
and (in most cases) brief summaries of articles from scientific and medical journals. CAM on
PubMed®, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses
on the topic of CAM.

Web site: www.ncbi.nlm.nih.gov/entrez

CAM on PubMed®: nccam.nih.gov/research/camonpubmed/

ClinicalTrials.gov

ClinicalTrials.gov is a database of information on federally and privately supported clinical

trials (research studies in people) for a wide range of diseases and conditions. It is sponsored
by the National Institutes of Health and the U.S. Food and Drug Administration.

Web site: www.clinicaltrials.gov

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Research Portfolio Online Reporting Tool (RePORT)

RePORT is a database of information on federally funded scientific and medical research

projects being conducted at research institutions.

Web site: http://projectreporter.nih.gov/reporter.cfm

Acknowledgments

NCCAM thanks the following people for their technical expertise and review of the content
update of this publication: Ali Ather, N.D., M.P.H., Prevention Research Center, Yale University
School of Medicine; Carlo Calabrese, N.D., M.P.H., Helfgott Research Institute, National College
of Natural Medicine; Suzanna Zick, N.D., M.P.H., University of Michigan Health System; and
Wendy Weber, N.D., NCCAM. Dr. Calabrese, Dr. Zick, and Dr. Weber also reviewed the original
publication, as did Leanna Standish, N.D., Ph.D., Bastyr University.

This publication is not copyrighted and is in the public domain.

Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute
for the medical expertise and advice of your primary health care provider. We encourage
you to discuss any decisions about treatment or care with your health care provider. The
mention of any product, service, or therapy is not an endorsement by NCCAM.

National Institutes of Health

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U.S. Department of Health and Human Services

D372
Created April 2007
Updated July 2010