Naturopathic medicine is not any kind of medicine, and its practitioners are nothing short of quacks. I know because I used to be one. Herein lies my story.

 

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Six years ago, I was a quack.

From 2011 until 2014, I was a licensed naturopathic doctor in the United States. Thanks to poor legislation in many states, I could advertise as a primary care physician, write prescriptions, and bill insurance companies. I called myself “Dr. Britt.” In Arizona, I worked outside the health insurance system and catered to a patient population interested in aligning chakras and detoxing with diets and enemas. While I was more drawn to using real medical treatments rather than esoteric therapies, I was happy to be employed by the renowned naturopathic cancer “specialist” who owned the clinic.

I likely would have gone the entirety of my career as a naturopath if I hadn’t unexpectedly found myself in a nerve-rattling situation. I quit after discovering my boss had been importing a non–Food and Drug Administration (FDA) approved drug called Ukrain and administering it to cancer patients (Thielking 2016; Arizona Naturopathic Physicians Medical Board 2015). His patients would get regular intravenous injections of Ukrain despite, in some cases, being discharged by their medical oncologists due to the severity of their disease. Others had chosen him for first line treatment. They flocked to him because his credentials included FABNO (Fellow of the American Board of Naturopathic Oncology).¹

It didn’t strike me as unusual that the packages, containing dozens of old-fashioned glass ampules, were marked with foreign postage. I assumed patients had been given informed consent, as they were spending thousands of dollars on the treatments. We all trusted him. One day the shipments stopped. My boss said, “They were probably confiscated.”

It is potentially a federal crime to give an unapproved medication to patients (Friedman 2018; FDA 2019). Under my boss’s orders, I had assisted with the administration of Ukrain, which is advertised as a natural cancer drug that cures almost any type of cancer and does not harm healthy cells (Nowicky 2019). Although this type of marketing is generally a red flag for a bogus cure, Ukrain does contain compounds that seem to show anti-cancer activity (Ernst and Schmidt 2005). However, it is also associated with life-threatening side effects, such as liver failure, tumor bleeding, and bone marrow toxicity (Boehm et al. 2015; Gansauge et al. 2002; Stickel et al. 2001; Moro et al. 2009). During the time that our patients had been receiving intravenous injections of Ukrain, its manufacturer had been arrested in Austria for charges of fraud—he had been relabeling and continuing to sell expired product (“Ukrainian Chemist” 2015). In 2016, the accused manufacturer was found guilty of serious commercial fraud and sentenced to three and a half years of imprisonment in Vienna, but he has appealed the verdict, and court proceedings are still ongoing (Der Standard 2016).

I learned this information on a Friday. That same weekend, I submitted a complaint to the Arizona Naturopathic Board of Examiners. Monday, I reported the events to the state’s attorney. That afternoon, I confronted my boss and quit. Later that same evening, I received a call from a respected leader in the naturopathic profession. He urged me not to go to the authorities, pleading for me to reconcile with my boss because I was a “naturo-path, after all.”

Was this code for dismissing my ethical duty to report a crime in honor of some kind of great, naturopathic philosophy? From this conversation, I lost my faith. This event forced me to confront the reality that patients whom I had come to deeply care about were being cheated out of money and duped into thinking that a so-called “natural” drug would help or even cure them.

I spent the next few months seeking out information that was scientifically critical of naturopathy and alternative medicine. I began scrutinizing my naturopathic education and training and, in parallel, learning more about evidence, standards of care, and medical ethics. After reading some great books and blogs, sending emails to leaders in the skeptical community—including Dr. Edzard Ernst and Jann Bellamy—and after a lot of tears, I concluded that naturopathic medicine is a scam. I was a fake doctor. How could I have been so wrong?

 

What Is Naturopathy?

Naturopathy is based on magic. Its origins trace back to a late nineteenth-century belief in vitalism (Whorton 2002; Brown 1988). In this worldview, all living beings embody a sort of supernatural energy force that is responsible for making you healthy or sick. Naturopaths refer to this power as the vis (Micozzi 2018). Other systems of pre-modern medicine have similar ideas about healing energies. In traditional Chinese medicine, it is called qi. In Ayurvedic medicine, it is called prana (Tabish 2008).

In naturopathy, the vis is manipulated using treatments that are based on food, water, plants, minerals, and physical contact. The mainstay naturopathic therapies are nutrition, hydrotherapy, herbal medicine, spinal manipulation, homeopathy, and traditional Chinese medicine. Some naturopaths utilize methods and substances that are more familiar to modern medicine, including intravenous injections and pharmaceutical drugs.

Today, naturopathy has been rebranded as naturopathic medicine. Naturopaths call themselves naturopathic doctors, or NDs for short. The profession has been somewhat successful in passing itself off as a credible medical specialty that claims to blend the best of both modern and traditional medicine. To get here, naturopaths aggressively and relentlessly lobby for laws to allow them to be licensed as medical practitioners. Almost half of the U.S. states license or regulate naturopaths, and five Canadian provinces regulate naturopathy. Current scopes vary wildly. In Arizona, an ND is considered a “physician” and can prescribe controlled substances and perform minor surgeries. In Alaska, an ND is restricted to providing nutritional advice, counseling, herbs, homeopathy, and physical therapies. Contrary to what naturopaths will tell you, regulating the naturopathic profession does not make the practice of naturopathy safe (Hermes 2017; Hermes 2016b; Weeks 2016).

A licensed ND needs to have graduated from a program accredited by the Council on Naturopathic Medical Education (CNME), which is granted programmatic accrediting status by the U.S. Department of Education. Many—especially NDs—often confuse CNME accreditation with government endorsement. In fact, CNME has accrediting power merely because it meets administrative criteria, not because the naturopathic curriculum is medically validated or scientifically sound. Tellingly, naturopaths accredit their own programs while shielding the process from outsiders.

Based on my experience, accredited naturopathic programs play fast and loose with biomedical science. Much of the curriculum is homeopathy, herbalism, hydrotherapy, craniosacral therapy, chiropractic manipulation, and naturopathic philosophy. In fact, when I started my master’s of science program in Germany, which is ironically the birthplace of naturopathy, I was required to retake science courses, including anatomy, histology, and immunology.

Clinical training is mandated by the CNME to be no less than 850 hours of direct patient care (Council on Naturopathic Medical Education 2016). I reviewed my clinical training handbook and discovered this benchmark is attainable only through accounting tricks. For example, time counted when students reviewed a case with their peers or when we observed advanced ND students perform physical exams.

ND students are not trained in the same standards of care as medical students. It was common to hear instructors clinically discuss a patient’s “vital force” as if this could somehow be detected and improved. Frequently, patients were diagnosed with dubious food allergies,² chronic Lyme disease,³ or adrenal fatigue.⁴ Patients would be prescribed an assortment of herbs and supplements—conveniently sold at the clinic’s dispensary.

A residency is not required for naturopaths to practice any specialty of medicine, including oncology (Association of Accredited Naturopathic Medical Colleges 2019). After a naturopathic student graduates, he or she may move directly into practice after passing a two-part licensing exam that primarily focuses on naturopathic therapies, such as homeopathy and herbs. A small number of NDs voluntarily complete residencies, which are essentially encores of naturopathic clinical training. These positions are typically two years and are sponsored by naturopathic clinics that provide naturopathic treatments, including alternative cancer therapies, in an outpatient setting. It is not uncommon for naturopaths who call themselves “cancer specialists” start practicing directly after passing their licensing exams.

During my time in naturopathic school, students took one lecture course (about twenty classroom hours) in cancer care. In my course at naturopathic school, I was taught that no natural substance has been proven to cure cancer. Despite this disclaimer, it is easy to find naturopaths advertising natural cancer cures.

Sued for Defamation by a Naturopathic Cancer ‘Specialist’

In early 2015, I started blogging at Naturopathic Diaries in an effort to help protect patients and other students from falling prey to naturopathy. I quickly became the naturopathic profession’s number one enemy.

Sometime in 2016, a webpage misrepresenting my position on naturopathic medicine appeared. The site didn’t post untrue statements about me or say anything negative. But it clearly made it seem as though I was an advocate for naturopathic medicine. I quickly learned that about half a dozen domains using versions of my name had been anonymously registered. Some of these domains forwarded to the websites of the American Association of Naturopathic Physicians and the Association of Accredited Naturopathic Medical Colleges. I called the company hosting the brittmariehermes.com page and asked for the email address associated with the account. Surprisingly, a forthcoming representative gave me an email address at natonco.org, the website for the Naturopathic Cancer Society—of which a naturopath named Colleen Huber is president and founder (Hermes 2016a).

I had never heard of Colleen Huber prior to that moment. When I started to look into Huber, I got really sucked down deep into what felt like a pit of despair. Here is what I learned: Huber’s Naturopathic Cancer Society is a nonprofit organization that previously claimed to help naturopathic patients raise money for alternative cancer therapies (Huber 2016b; Huber 2017a). Huber also owns a naturopathic clinic called Nature Works Best in Arizona, where she treats cancer patients with intravenous baking soda, megadoses of intravenous vitamin C, and a strict sugar-free diet (Huber 2015). Huber advocates against state-of-the-art oncology, especially chemotherapy and radiation, because she thinks these therapies strengthen cancer (Huber 2016a). Huber’s clinic website and charity website previously linked to each other, which provided the impression that a patient of Huber’s could use her charity funds to pay for treatments at Huber’s clinic (Huber 2017b; Huber 2019a).

  Huber is also the secretary and founding member of a naturopathic ethics review board that goes by multiple names. I later learned, according to a writ submitted by Huber’s attorneys, this ethics board approved the cancer research that Huber conducts at her clinic. I should note here that Huber does not use a standardized cancer treatment protocol on her patients (Huber 2015). It all looked sketchy, and truthfully Huber seemed like someone I did not want to legally tangle with. But my views were being misrepresented, and I felt like I needed to act.

  In June 2016, I hired an American lawyer to send Huber and one of her colleagues a cease and desist letter, asking Huber to relinquish the domain names to me. The letter went unanswered. About six months later, I decided to take the fight public.

  In a blog post from December 2016, I laid out my theory for why I thought Huber, or someone in her close orbit, had purchased the domains of my name. I also wrote about her cancer therapies, charity, and so-called cancer research. I was highly skeptical of the relationship between her charity and clinic, and I also questioned the ethics of her research protocol. Nine months after this post, with the help of a German law firm, Huber sent me a cease and desist letter. Huber wanted me to remove the entire blog post about her and to pay her legal fees, because she claimed I had defamed her.

  I hired a German lawyer and responded to this letter. We refused to comply with Huber’s demands. I had not done anything wrong, and I found Huber’s claims ridiculous. I felt strongly that Huber’s treatment methods and research were questionable and that the public was entitled to this information. In September 2017, Huber filed a lawsuit against me in Germany for defamation.

Huber’s Cancer Research

Colleen Huber conducts research out of her clinic and claims to have gathered data on the efficacy of her naturopathic cancer treatments. She characterizes her research as “groundbreaking” and states that “no other clinic has such a high documented success rate” (Huber 2016a; Huber 2019b). Her claimed success rate has varied, but on a recent version of her website, she writes, “85% of patients who completed our metabolic treatments and followed our food plan went into confirmed or assumed remission” (Huber 2019b). Regardless of what exact percentage you go by, these results, if true, would be remarkable and are certainly worth examining. In fact, Huber invites the public to do just that. Below these stats, she writes, “You can verify this data for yourself … . We invite you to take a simple calculator and ‘crunch the numbers,’ to see if you come up with the same percentages that we do” (Huber 2019b).

 

  I did look at the data. And Thomas Mohr, a cancer researcher at the Medical University of Vienna, did crunch the numbers. Mohr calculated an odds ratio of 2:1 (95 percent confidence interval 1.014.40, p<0.05) in favor of state-of-the-art therapy (chemo, radiation, etc.). As Mohr puts it, “Patients under natural care have more than a two-fold higher risk to die” (Hermes 2018).

  Mohr wanted to do a more robust analysis, because, frankly, we believed that the data Huber gathered is inconsistent and of questionable quality. When Mohr removed questionable data, he found that the odds ratio was 10:1 in favor of state-of-the-art therapy, meaning the risk of death with Huber’s therapies appears to be ten times higher compared to those patients who pursue conventional cancer treatments (Hermes 2018).

  In the lawsuit, Huber contested Mohr’s analysis. She felt that it was defamatory for me to publish the results and wanted these statistics removed from my blog. Huber took issue with several other points as well, including me calling her a quack, my characterization of the relationship between her charity and clinic, and the cybersquatting (Hermes 2018).

  On May 24, 2019, the District Court of Kiel, Germany, ruled against Huber. Reading through the judgment, I really felt like the judge understood me and the point of my blog. The judge wrote:

The effectiveness of naturopathic treatment is a highly controversial issue among experts. This is exactly what is intended by the Defendant’s article. It is a concern for information in connection with an issue that is discussed controversially and emotionally in the public. In medicine, in particular, a comprehensive and critical approach is required so even medical laymen can get an idea of different treatments and approaches. By making critical and partly exaggerated statements the Defendant intends to initiate to a discussion about treatments she regards as dubious.

The judge determined my statements were protected speech under Article 5(1) of the German constitution. The deadline has now passed for Huber to appeal, which means Huber cannot sue me again for these points in Germany, nor can she appeal at a later date.

Natural Cancer Therapies Kill

Even though I have won this battle, patients are still at risk of losing. A tragic example of this is Huber’s former associate Rebecca Stephan. I found Rebecca’s story through a GoFundMe page set-up by her sister-in-law (C. Stephan 2017).

In 2016, Rebecca Stephan was diagnosed with mucinous ovarian cancer. She had surgery to remove the tumor and then was hospitalized due to complications. Her oncologist recommended she start chemotherapy right away. However, Stephan and her family didn’t like this treatment plan. She was frail after surgery, and her family worried chemotherapy might kill her. So Stephan began to think about alternatives, writing in a blog post from August 2017: “My husband and I began to look elsewhere for natural treatment options and flew down to see Colleen Huber, NMD, Medical Director of Nature Works Best Cancer Clinic in Tempe, AZ. As soon as I met her I knew this is where I wanted to be treated. Also, the percentages of doing treatment with Doctor Huber were better for me than with my oncologist” (R. Stephan 2017; emphasis added).

Stephan moved her family, including her three kids, from Colorado to Arizona so that she could get weekly intravenous injections of baking soda and vitamins, a strict diet of no sugar, and supplements. Stephan claimed that after just three months of treatment, she was cancer free. She believed Huber’s regimen cured her. Stephan then became the executive director for Huber’s Naturopathic Cancer Society, which, in her own words, is a charitable organization “dedicated to raising funds for those who have cancer.” She seemed keen to help other cancer patients afford the same naturopathic therapies as she did.

The latest update on Stephan’s GoFundMe, from about a year and a half ago, reported that she was not doing well: “Friends it’s with a heavy heart that I tell you Rebecca has cancer again! She is not doing well and the cancer has moved to other parts of her body! She has asked me to get as many people praying for her as we can. She is in a lot of unbearable pain and getting weaker.”

It is important for cancer patients to understand the risks associated with using alternative therapies to treat cancer. The reality is that patients who use alternative therapies to treat cancer are more likely to die. There is clear scientific evidence to back this up. In 2018, Dr. Skyler Johnson and his colleagues at Yale University found that the use of alternative medicine to treat cancer is independently associated with a greater risk of death compared to conventional cancer care (Johnson et al. 2018a).

Later that same year, Johnson and colleagues published more disturbing results. They found that alternative medicine use by cancer patients was associated with refusing at least one component of conventional cancer care, which is not surprising in my opinion, and a two-fold greater risk of death compared with cancer patients who used conventional therapies alone (Johnson et al. 2018b). This may be due to delays in conventional care or refusal of specific therapies. The bottom line is this: If you mix conventional medicine with complementary care, there may be a higher risk of death.

This evidence is all here. I have to assume that Huber is ignoring it, perhaps because she is profiting off vulnerable cancer patients. She uses her own research and statistics to set up a bubble where she can convince patients to get potentially dangerous alternative therapies.

Thanking the International Skeptical Community

This defamation lawsuit has accomplished a few important things. First, it demonstrated the strength and the unity of the international skeptic community. Eran Segev of Australian Skeptics Inc. spearheaded a fundraiser to raise the money needed to cover my legal bills. Skeptics from around the world donated, and we raised over 100,000 euros. Over 50,000 euros was donated in just the first nine days of the campaign. I will not be out any money for this lawsuit. The legal fees that I was awarded from winning the lawsuit have been deposited back into this fund. Leftover money is being held for future cases in which skeptics are being legally bullied. We hope to establish an international permanent legal fund for cases like mine, in which the plaintiff would not be able to afford to defend themselves in court.

Without the financial and emotional support of this community, I might have given into Huber’s demands. There was no way I could afford my legal fees, which were originally estimated by my lawyer to be about 50,000 euros. What I have learned from this experience is that skeptics are not lone wolves. We are a protective, and very clever, pack. I am very lucky and very proud to be part of this family.

Second, this lawsuit exemplified the Streisand effect. Huber chose to personally attack me. In doing so, she amplified the attention on her dubious cancer research, charity, and treatments. The international press picked up the story. This lawsuit was written about, and Huber’s actions were criticized all over the world.

  This media attention also boosted my profile. The highlight of this attention was receiving the John Maddox Prize for my advocacy (see SI, March/April 2019). I want to especially thank Prof. Chris French and Dr. Chris Peters for nominating me for this award.

Finally, I think going through this lawsuit will help patients make informed and better choices regarding their cancer care. Hopefully Rebecca Stephan’s story is a warning for other cancer patients. Since the lawsuit, Huber has edited the information presented on her charity and clinic websites. Huber now has a very stern disclosure statement on her clinic’s homepage, in which she warns future patients that they may not have favorable results from her treatments.

Indeed, beware the naturopathic cancer quack.

 

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Notes

1. Fellow of the American Board of Naturopathic Oncology (FABNO) is awarded by the American Board of Naturopathic Oncology (ABNO). The ABNO claims that the FABNO title is similar to board certification in oncology. To be eligible to sit for the FABNO exam, a naturopathic doctor must complete a two-year naturopathic residency in cancer care, submit medical cases for review by naturopathic examiners, and complete fifty continuing education credits approved by ABNO (Oncology Association of Naturopathic Physicians 2015). These qualifications are less stringent than those for medical doctors (American Board of Internal Medicine 2019).
2. Naturopaths commonly use IgG food allergy test panels to diagnose and treat symptoms that seem to be associated with foods. However, these tests are clinically invalid. Their use may lead to false diagnoses and unnecessary treatment (Moore 2019; Gavura 2018). To learn more, please visit the American Academy of Allergy, Asthma and Immunology webpage at www.aaaai.org.
3. Chronic Lyme disease (CLD) is a term commonly used to describe wide-ranging symptoms in people with various illnesses. These patients do not necessarily have clinical evidence of previous Lyme disease. The term is generally not accepted by the conventional medical community. Naturopathic practitioners frequently diagnosis CLD and treat patients using intravenous injections, ozone, supplements, and long-term antibiotics. None of these therapies is recommended to treat CLD (Baker 2010; Feder et al. 2007). To learn more, please visit the National Institute of Allergy and Infectious Diseases webpage at www.niaid.nih.gov.
4. Adrenal fatigue is a term used by naturopathic and alternative medicine providers to describe a condition in which the adrenal glands are over-worked and run-down and, therefore, unable to work properly, resulting in excessive fatigue. This is a common alt-med diagnosis for highly stressed individuals. Scientific evidence to support the idea of adrenal fatigue is lacking, and the conventional medical community generally does not use this terminology (Felson 2019; Shah and Greenberger 2012). To learn more, please visit WebMD’s webpage on adrenal fatigue at https://www.webmd.com/a-to-z-guides/adrenal-fatigue-is-it-real#1.

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