[Note: Those of you who read my not-so-secret other blog might see much of this post as familiar. That’s because large parts of this post derive from previous posts. (Come on, it’s a vacation weekend!) There is, however, a fair amount of new content here, too; so if you’ve read these before, I’d urge you to skim past what’s familiar to the new stuff. Have an enjoyable holiday weekend.]
Naturopaths are fake doctors, but they crave the acceptance of real physicians. Whether it’s because they really believe that they are physicians or because, deep down, they know they are fake doctors, I don’t know. Maybe it’s a little of both. Either way, above all their professional organizations strive for legitimacy in the form of being licensed by all 50 states. They even have a goal of having . But it’s more than that. In states where they are already licensed, their goal is to expand their scope of practice to come close to that of real physicians. Basically, naturopaths cosplay real doctors, hoping that the public won’t know the difference. Unfortunately, increasingly, they are correct. Even more unfortunately, as they cosplay real doctors, some of them are also learning to emulate the very worst of real doctors by embracing unproven therapies that can only be considered “natural” with a major stretching of the definition of the word. I’ve already discussed how naturopaths have flocked to “functional medicine,” which combines the worst of two worlds, pure quackery of “professions” like naturopathy and other alternative medicine practitioners with the overtesting and overtreatment of too many areas of conventional medicine pumped up on steroids.
Now, I’ll give you two terms that, when combined, should make you very, very afraid: Naturopaths and stem cells. But before that, let’s talk about naturopaths and their love of cosplaying real doctors.
Naturopaths cosplay real doctors
About a month ago, I took note of a story by the Denver CBS affiliate about ““:
Of course, letting naturopaths refer to themselves as “doctors” or “naturopathic doctors” is bad enough, because most people don’t make that big a distinction between the terms “doctor” and “physician.” Also, I can’t help but note that their favored abbreviation for their degree of “ND” looks and sounds and awful lot like a real physician’s degree of MD, which is why I frequently refer to it as standing for “Not-a-Doctor.” Be that as it may, things are a bit different in Colorado than in a lot of states that license naturopaths. For one thing, there is a law specifically stating that naturopaths cannot refer to themselves as “physicians.” The law came about this way:
The death of Sean Flanagan in 2003 touched off a storm. Ill with cancer, he received treatment from a man who called himself a naturopathic doctor practicing in Wheat Ridge.
Sean’s father David Flanagan told CBS4’S Rick Sallinger three years later about his dismay.
“We’ve got people like Brian O’Connell who can claim to be a doctor and use the word, put it on his scrubs, wear a stethoscope like he’s somebody important,” he said.
Although Flanagan died from cancer, Brian O’Connell’s actions may have sped up his death.
He was sent to prison and legislation was later passed by the state to register naturopathic doctors. In the law one point was made very clear: naturopaths cannot refer to themselves by a key word: “physician.”
I couldn’t remember having heard about this case, so I did a little Googling. It turns out that O’Connell ran Mountain Area Naturopathic Associates. Consistent with what David Flanagan said in the interview above, in his office O’Connell displayed numerous degrees and certifications claiming he was doctor and a naturopath. In an investigation, the Colorado Medical Board found that O’Connell had no license to practice medicine in Colorado and was not certified as any kind of health care worker. It also turned out that O’Connell’s only medical-related “training” had come from a correspondence school in Arkansas called the Herbal Healer academy. As , in 2003 the school’s proprietor Marijah McCain under which she paid $10,000 and was barred from disseminating certificates stating that the holder is an “ND, NMD,” or similar designation that would indicate that the holder is a doctor or physician.
Naturowatch also notes:
- O’Connell told the family that he personally had “cured” many patients suffering from the same type of cancer he had. He also showed them a plastic bag containing an object he claimed was a cancerous tumor removed from a patient and claimed that he had a black salve that would draw cancerous tumors from the body. Flanagan had failed a course of chemotherapy and his cancer was progressing. Also, black salve is not just quackery, but disfiguring quackery. It’s a caustic substance derived from plants that burns.
- The family paid O’Connell $7,400 for “photoluminescence” treatments in which blood was removed from Sean Flanagan’s body, exposed to ultraviolet light, and then returned to the body along with a diluted solution of hydrogen peroxide. Both of these, UV blood irradiation and intravenous hydrogen peroxide, are also quackery. Basically, it’s UV blood irradiation combined with hydrogen peroxide therapy.
- The boy developed a blood infection because O’Connell’s wasn’t exactly careful about sterile technique.
O’Connell also injected this hydrogen peroxide solution into a 17-year-old girl, which caused her to go into cardiac arrest. Another patient of O’Connell’s had terminal liver cancer and was told by O’Connell that a “black salve” compound would pull the cancer out of his body. Instead it created open, bleeding wounds that continued until his death, prosecutors said.
In other words, even though he didn’t have the “ND” degree, O’Connell was a typical naturoquack. Ultimately, he was convicted. In 2006, he pleaded guilty to theft, perjury, criminally negligent homicide, practicing medicine without a license, and 3rd degree assault. As a result, he was sentenced to 13 years in prison, which was a salutary outcome which is all too rare when quacks are prosecuted.
As a result of this case, when Colorado passed a law registering—not licensing—naturopaths, the law made it very clear that naturopaths are not allowed to refer to themselves as physicians. Now, I’m not exactly clear on the difference between licensure and registration, but apparently registration provides for a much less rigorous degree of scrutiny of naturopaths than licensure would. Basically, according to Colorado law, naturopaths who have gone to the top tier naturopathy quack academies, like Bastyr University, and as a result have the “ND” degree can call themselves “doctor” but not physician. All other naturopaths are forbidden from calling themselves “doctor” or “physician.” Of course, one wonders why such naturopaths are even allowed to practice, although I suppose that, despite what “NDs” claim, there really isn’t any substantive difference that I’ve ever been able to find in the level of quackery practiced by NDs or non-ND naturopaths. Basically, .
Be that as it may, even though the law expressly forbids it, :
Larry Sarner and Linda Rosa of the Colorado Citizens for Science and Medicine conducted a survey of websites and claim most naturopathic doctors violate the Colorado Medical Practices Act and State Statutes.
Sarner said, “It would be almost hard not to believe they are medical doctors given their own discussions of it.”
Some naturopathic doctors claim they are licensed. They can’t be. The state of Colorado says they are simply registered, which carries less scrutiny.
Of course, at least Colorado doesn’t let naturopaths use the term “physician” to describe themselves. Lots of other states, where naturopaths are licensed and not just registered, do let naturopaths use terms like “naturopathic physician,” the favored term of organized naturopathy. Naturopaths continue to push for this, because they know that language feeds impressions. If they can win the legal right to be called “naturopathic physicians,” chances are that a lot of people won’t know the difference between that and real physicians and that legislators will be more likely to expand their scope of practice to reach their Holy Grail, being considered primary care physicians in all 50 states.
Which would allow more naturopaths to do what the least ethical MDs do already, bringing us to stem cell clinics.
Naturopaths and stem cells
I’ve frequently written about bogus stem cell clinics that use hard sell techniques to sell unproven and expensive “stem cell treatments” to desperate patients. For instance, I deconstructed the story claiming that hockey great Gordie Howe improved so markedly after a severe stroke, thanks to stem cells offered to him for free (because of his celebrity) by a dubious stem cell company (Stemedica) through its Mexican partner (Clínica Santa Clarita). The whole incident basically opened my eyes to just how unethical the for-profit stem cell clinic industry is, as clinics use hard sell techniques more akin to used car salesmen to peddle potentially dangerous therapies even right here in the good ol’ USA. The level of corruption and lack of ethics are truly astounding. Indeed, some stem cell clinics have in getting patients to pay to be on dubious clinical trials that are designed primarily to sell product rather than to answer any sort of scientifically important question.
The problem, of course, is that very few stem cell therapies have compelling evidence for efficacy and safety. Yet that doesn’t stop dubious stem cell clinics all over the country from selling treatments claiming to improve or cure everything from heart disease to lung disease to cancer to even autism, all with minimal evidence that what these clinics are doing can do anything of the sort. That’s why I view it as very much a good thing that the FDA has recently about , a move that’s long overdue. I hope it continues.
Regardless of whether the FDA’s new loving attention to stem cell clinics is sustained or not, yesterday I learned of something very, very disturbing. Let’s just put it this way: What’s scarier than an unregulated, dubious stem cell clinic selling “stem cell”-related “cures” for lots of money? I’ll tell you. It’s an unregulated, dubious stem cell clinic selling “stem cell”-related “cures” for lots of money run by a naturopath cosplaying an interventional radiologist. I kid you not. There’s a clinic in Park City, Utah, the , in which a naturopath is advertising that it offers. The naturopath, , ND (Not-a-Doctor) is :
Stem cells, specifically mesenchymal stem cells (MSCs), have been called “patient-specific drug stores for injured tissues” because of their broad range of healing abilities. MSCs are directly responsible for healing damaged tissues after injury. Upon encountering damaged tissue, they release proteins that decrease inflammation, kill invading microbes, and trigger the growth of new connective tissues and blood vessels. In the case of severe damage and cell death, MSCs have the ability to turn into healthy versions of damaged or destroyed cells that they encounter.
When we take MSCs from your own bone marrow, from your own fat, or from both, concentrate and/or isolate them, and then inject them directly into your problem area, we ‘trick’ your body into thinking that there has been a new injury without actually causing any tissue insult, and you get a second chance at healing. In the case of advanced osteoarthritis where the population of stem cells has been depleted, we are repopulating the area with stem cells, and thereby restoring the body’s natural ability to heal itself.
The only good thing I can say about this is that Docere Clinics don’t claim to be able to treat spinal cord injury, autism, or cancer. Believe me, that isn’t saying much. Because, quite strategically, Docere Clinics does treat all manner of musculoskeletal pain syndromes, some of which stretch the imagination as conditions that would need something like stem cell therapies. For instance, like many “regenerative medicine” stem cell clinics, Docere claims it can treat osteoarthritis and avascular necrosis. It also claims that it can treat back pain of various etiologies and bone spurs. (One wonders why on earth one would need a treatment as expensive and radical as stem cell therapy in order to treat bone spurs.) Ditto carpal tunnel syndrome, whose pathophysiology is pretty well understood and which is treated quite effectively by carpal tunnel release surgery. (I know. I’ve that surgery 15 years ago and it basically cured my carpal tunnel syndrome, other than a minor twinge every now and then.)
Looking at the list, I see no condition for which stem cell therapies have been shown to be efficacious or safe, but I do see conditions that are primarily ones of chronic pain, which means that they are likely to be particularly susceptible to placebo effects. Without rigorously designed randomized, placebo-controlled, double blind clinical trials, it would be very difficult to determine whether any therapy has a significant impact on these conditions. Is there any RCT data supporting what Not-a-Dr. Adelson does? Nope. None of that stops him from doing what naturopaths love to do and (an interventional radiologist, based on his activities) by wearing scrubs in all his videos and pictures on the clinic website:
Dr. Adelson began his training in regenerative injection therapy (prolotherapy) in 1998 while in his final year at The National College of Naturopathic Medicine, in Portland, Oregon after having been cured of a rock-climbing injury with prolotherapy. During his residency program in Integrative Medicine at the Yale/Griffin Hospital in Derby, Connecticut, he volunteered after hours in a large homeless shelter in Bridgeport, Connecticut, providing regenerative injection therapies to the medically underserved while gaining valuable experience. He opened Docere Clinics in Salt Lake City in 2002 and from day one, his practice has been 100% regenerative injection therapies for the treatment of musculoskeletal pain conditions. In 2006 he incorporated platelet rich plasma and ultrasound-guided injection into his armamentarium, in 2010, bone marrow aspirate concentrate and adipose-derived stem cellls, and in 2013, fluoroscopic-guided injection (motion X-ray).
Prolotherapy, of course, has been around a long time but lacks convincing evidence for clinical efficacy. (PRP). Neither have particularly compelling evidence for utility in the conditions for which they are commonly used by both naturopaths and, unfortunately, real doctors. It’s possible that PRP might have an effect in some conditions, but there really isn’t much in the way of decent evidence to show that it does.
But wait! Before I forget to ask it, did you do a double take when you saw that last sentence, wherein a naturopath is using fluoroscopy to guide his injection of stem cells? Just let that sink in a moment. How on earth could he ever be qualified as a naturopathic quack to use fluoroscopy for anything? Get a load of , too:
Of the fluoroscopically-guided injections that we perform, one that stands out is the injection stem cells into the intervertebral disc. Discs are structures that are rich with nerves, but are the least vascularized tissue in the body. The way discs maintain hydration is through movement; as the disc moves, hydration comes from the vertebral bodies (bones) above and below. When we lead sedentary lifestyles or suffer traumatic injuries, the discs can become ‘desiccated’, meaning dehydrated. A dry disc is an extremely painful disc. Being able to inject a dry disc with stem cells is the primary reason we became interested in fluoroscopically-guided injection.
That’s right, Not-a-Dr. Adelson is injecting “stem cells” of unclear provenance into cervical discs because he thinks the stem cells will somehow un-desiccate them and turn the old, atrophied cervical disks to shiny new ones. Here he is, again cosplaying a real interventional radiologist:
Yes, he’s injecting his concoction into cervical and lumbar disks. What could go wrong? Well, there are nerve roots nearby that could be damaged. One can damage the disks themselves. There’s a reason why becoming a board-certified interventional radiologist takes as many years as becoming a surgeon does. Perhaps what’s most disturbing about this is that Not-a-Dr. Adelson trained at Yale’s integrative medicine program. I wonder if our fearless leader Steve Novella knows his school’s quackademic medicine program admits naturopaths. He probably does. This led me to find that the Director of the Yale Adult and Pediatric Integrative Medicine Program is a . Although the Yale/Griffith Hospital integrative medicine program appears to , in its day it did have naturopaths as residents, as evidenced by this advertisement for a , given by one of the naturopath residents.
So does Not-a-Dr. Adelson have any evidence to back up his treatment? Well, he has a TEDx talk:
It’s basically an anecdote about a veteran of the Iraq/Afghanistan wars named Chris who had severe chronic low back pain due to a degenerated L4/L5 disk, suffered as a result of injuries due to his bad luck of being too close to two different IED explosions. Apparently this veteran came to him asking him to inject stem cells into his disc. At about the 1:20 mark, you see how Adelson justifies his unethical actions. He basically portrays the options, but paints the ethical option (not using stem cells) in the worst possible light, as abandoning the patient. He portrays the other best option, enrolling the patient on a clinical trial, in an equally bad light, dismissing it saying that, well, you know, you have to be aware that you might bet a placebo. The next option he jokes about, namely taking the patient to “my offshore stem cell clinic” to treat him. Then, he portrays what he did, using an unproven technique that hasn’t been validated scientifically or in clinical trials on a single patient, as the best option, the heroic option, the “can do” option. He even brags about how doing an autologous stem cell transplant is no different than doing a hair transplant. He also justifies his action by his own “conversion experience” using prolotherapy to treat his shoulder injury from rock climbing. I also learned the name of the surgeon who taught him how to do injections. Not surprisingly, it was a doctor, an orthopedic surgeon, who runs a dubious stem cell clinic in Florida.
Not-a-Dr. Adelson makes the claim that the outcomes were “so much better” than PRP that stem cell treatments “instantly became 100% of my practice,” bragging about how he traveled to various Central and South American stem cell clinics. One man he mentioned was Carlos Cecilio Bratt, MD, who, it turns out, runs a stem cell clinic in Venezuela, and runs what sounds like an assembly line doing stem cell treatments. (One wonders why he hasn’t published his results.) He also went to the infamous Stem Cell Institute in Panama City. He also went to Ecuador. Finally, he found MDs and DOs willing to teach him how to use a C-arm and do fluoroscopy. Naturally, Adelson finished his story by bragging about how much Chris claims his pain has improved and how good his results are.
An unethical naturopathic “clinical trial”
Notice in the last section something that Not-a-Dr. Adelson failed to mention: Clinical trials. He didn’t mention any clinical trials. After doing a little more digging, though, I found that he does actually have ” that he carried out. It’s badly designed and highly unethical clinical trial, but it is a clinical trial. Sort of. Unfortunately, what he doesn’t have is any mention of whether he had institutional review board (IRB) approval to do this dubious unholy mix of a prospective unrandomized trial paired with a retrospective chart review. Worse, he doesn’t have anything resembling real informed consent:
Patients presenting to Docere Clinics in Park City, Utah, between July 15, 2014, and November 15, 2014, who were deemed candidates for autologous stem cell therapy, were asked to choose between being treated with BMAC [bone marrow aspirate concentrate] or SVF/ PRP [stromal vascular fraction suspended in platelet rich plasm]. e conversation can be summarized as follows: “I can do a bone marrow aspiration and treat you with BMAC, with which I have five years of experience and am aware of data supporting its use, or I can do a lipoaspiration and a blood draw and treat you with SVF suspended in PRP, which has the potential to provide us with a far greater yield of stem cells and, theoretically, a superior outcome. However I have little experience with it and there are very few data supporting its use.” Patients then self-selected into the BMAC or the SVF/PRP group.
Then, he changed the protocol:
During this period and during preliminary follow-up with patients, I began to notice a trend that many SVF/ PRP patients reported higher satisfaction than those in the BMAC group, but the remainder were experiencing no improvement at all. Beginning November 16, 2014, I began offering patients SVF prepared as described above but suspended in BMAC rather than PRP, hypothesizing that the combination could offer the consistency of BMAC with the augmented outcomes of SVF.
This is half-assed, “make it up as you go along” clinical research at its most dubious. Adelson then looked at his outcomes using a retrospective survey. Basically, everyone appears to have done roughly the same. Given that there wasn’t a hint of a whiff of a statistical analysis or power calculation, that’s basically all that can be said. As for the lack of IRB involvement, Adelson appears to be taking advantage of the fact that the IRB requirement, strictly speaking, only applies to human subjects research funded by the federal government, carried out at an institution (e.g., a university) that receives federal funding, or when a clinical trial is being done as the basis to seek FDA approval. True, some states have their own laws requiring that any research inside their borders have IRB approval according to the Common Rule, but I don’t know if Utah is one of them.
Not surprisingly, Adelson seems utterly oblivious to what we already know about invasive surgical procedures: There can be a significant placebo effect any time you inject anything into the spine or discs. I like to use the example of vertebroplasty for lumbar spine fractures due to osteoporosis. It’s been shown convincingly in at least a couple of good randomized, placebo-controlled trials to be no better than placebo. The usage of vertebroplasty has even declined as a result, albeit not nearly as much as it should have. (Yes, doctors sometimes share something in common with not-a-doctors; the unwillingness to give up treatments that science has shown to be ineffective.) Without a good RCT, it’s impossible to tell if Not-a-Dr. Adelson is getting the results he gets due to placebo effects or not. Yet he just cruises along, using an unproven therapy. Worse, who knows what Adelson is actually injecting? He’s described his technique for isolating stem cells, but one thing I see lacking is any characterization of the cells to demonstrate that they are what he claims they are. I also see a lack of followup images to demonstrate that the concoctions injected into the discs have had any effect at all biologically in rehydrating and renewing them. Basically, Adelson’s clinical “evidence” is a joke, and a bad one at that. Yet, Docere Clinics continue to offer the treatment, and even to current patients who refer new patients. Capitalism!
But how can this be legal? Apparently, in Utah, it is. Britt Hermes ed the Utah Division of Occupational and Professional Licensing and received this reply:
Naturopath Harry Adelson who harvests and injects stem cells (using fluoroscopy!) got the approval of Utah authorities.
This is bullshit.
— Britt Marie Hermes (@NaturoDiaries)
Yes, in Utah, naturopathic quacks can basically do anything, science be damned. Or so it would seem.
Beyond Utah naturopaths
Unfortunately, Not-a-Dr. Adelson is not alone among naturopaths in embracing stem cell quackery. There are quite a few naturopaths out there offering prolotherapy and a variety of stem cell therapies, just like unethical MDs do. All I had to do was to Google “stem cells” and “naturopathy” to find a number of examples. For instance, the Stem Cell Rejuvenation Center in Phoenix is run by Not-a-Drs. , who to use stem cells derived from adipose tissue or isolated from bone marrow to treat autism, amyotrophic lateral sclerosis (Lou Gehrig’s disease), cerebral palsy, degenerative disc disease, heart disease, muscular dystrophy, Parkinson’s disease, stroke, spinal cord injuries, and, of course, erectile dysfunction, of $7,100 for either adipose or bone marrow-derived stem cell treatments or the deal of $9,600 for both. What a bargain for something that hasn’t been shown to work in clinical trials! And how on earth are naturopaths allowed to do bone marrow biopsies and liposuction to gather the marrow and adipose tissue, respectively upon which to work their woo? Well, in Arizona, minor surgery is .
Elsewhere in Arizona, also offer “stem cell therapy”:
This incredible advancement in natural healing means that stem cells can be harvested from a patient’s fatty tissue and reintroduced into that patient’s body. These stem cells have the ability to travel to areas of the body that have damaged tissues. The stem cells can then either instigate healing or actually transform into the type of cells needed to repair an injured area. The possible benefits of this kind of treatment are staggering!
Because the FDA has yet to approve this therapy, it cannot be said that stem cells are used specifically for the treatment of any disease. However, empirical evidence shows that this therapy is beneficial to people who suffer from many different illnesses, such as:
- Neurological diseases
- Chronic joint pain
- Autoimmune conditions
- Heart disease
- Pulmonary issues
How nice. It’s basically a quack Miranda warning for their stem cell facility, , run by two of the naturopaths there, Not-a-Dr. Jason Porter and Not-a-Dr. Julie Keiffer. Wait, didn’t I just say that Keiffer works at the Stem Cell Rejuvenation Center, too? Wow. More cosplaying of real doctors, she must work at two different practices and out of two different stem cell centers. The ones listed on her website include East Valley Naturopathic Doctors, Valley Medical Weight Loss, and Peace Wellness Center, which appear to be where she sees patients. On her website, she for the following purposes:
For Hair loss and hair thinning, PRP is injected into the scalp to stimulate the hair follicle strength. In addition to injections, Micropen™ with PRP topically assists with the stimulation of the hair follicle.
For sexual enhancement, the O-Shot® procedure for women and the Priapus Shot ® procedure for men, delivers PRP into the genitalia which may enhance sensitivity, strength and possibly size for men. For more detailed information refer to Patient Resources for links to desired sites.
I could go on, but you get the idea. I’ve found naturopaths offering dubious stem cell therapies in , , , , and all over. It’s apparently becoming such a thing that actual MDs running dubious stem cell clinics are feeling threatened. For instance, here is Dr. Chris Centeno asking, “” His answer is no, for many reasons that are correct:
Much has been made by naturopaths that their training is now equivalent to that of an MD or DO physician. However, some of the issues that came up in the recent board discussion were reports of naturopaths missing common medical side effects of spinal injections, like a dural leak. In fact, naturopaths were not even able to understand that this was a possible complication of the spinal injection procedure they performed. So how is it possible with all of the hours that naturopaths claim they train that they’re not able to conceptualize or catch a simple and common complication of spinal injection? The reason is contained in a simple statement made by one of our fellows.
A few weeks ago, we had a patient who needed to be checked for a postprocedure infection. I couldn’t see the patient, so I had one of our two fellows check him out. While all of the data looked like the patient didn’t have an infection, what the fellow told me verbally was important. He said that the patient “didn’t look toxic.” What the fellow meant was that after training in a large university medical center where he saw many patients who were infected and toxic, or “sick,” and many who were not, he was using that experience filtered through the large neural network in his head to rule out a pattern of patient characteristics that he had associated with patients who were sick, or toxic. These may be the paleness of the skin, a glassy look in their eyes, how they interact, and so on. Every MD or DO who trained in a large university medical center knows what that fellow meant. The issue with naturopaths, chiropractors, and acupuncturists is that they don’t train in these settings. So when they learn how to perform procedures that may injure patients and make them “toxic,” they have no way of knowing, despite many weekend courses, how a sick patient presents. Why? Most of their training is on well patients with chronic problems, like pain or irritable bowel disease or allergies, not on ill patients undergoing surgery in the hospital.
Of course, Dr. Centeno is doing the very same thing naturopaths are doing; so, even as I agreed with everything he said above and more, it was hard for me not to get the impression as I read the article that that it was far more about turf protection than it is about actually protecting patients. Dr. Centeno almost certainly views these naturopaths as muscling in on his action, which threatens him. Even as I agreed with what he wrote about naturopaths, I couldn’t help but think that he’s no better and in fact might be worse than the naturopaths doing stem cell therapy. After all, he has the training to know better, but apparently does not (or chooses not to). He’s decided to forego all that pesky rigorous science and, instead of doing proper clinical trials, to forge right ahead selling his treatments using and . In this, he has a lot in common with the naturopaths he denigrates.
In the end, naturopaths go where the ducks are, where the quacking is the loudest. It doesn’t matter if it’s really “natural” or not. After all, in functional medicine what is “natural” about doing batteries of blood tests for dozens of hormones, nutrients, and other factors and then providing supplements and intravenous therapies to “correct” them all? What is “natural” about extracting fat and doing all sorts of manipulations to isolate individual cell types or doing bone marrow biopsies and isolating the stem cells, then reinjecting them? Of course, then there’s the issue of whether what is being injected are really “stem cells” at all, which in many cases is highly doubtful given the lack of rigorous descriptions of the protocols used to isolate the stem cells. Stem cell clinics have become a profit train for unethical real doctors. Given that naturopaths cosplay doctors, it’s not surprising that they’d cosplay the unethical ones too and jump on the profit bandwagon.