More than 600 doctors and students convened at the Oregon Convention Center on August 15-17 for the 2019 American Association of Naturopathic Physicians (AANP) conference. This is the largest annual gathering of licensed naturopathic physicians and students in the United States.
Aside from the usual excitement of reuniting and learning from colleagues, this year, participants had an even bigger reason to celebrate: 2019 marked 100 years of licensure for naturopathic doctors in the United States.
In recognition of the 100th anniversary of the profession, the theme of the 2019 AANP conference was “Celebrating the Past, Present, and Future of Naturopathic Medicine.”
Vitalism to Vision: 3 Keynote Speeches
Senior Health Policy Researcher at RAND Corporation and a respected leader in integrative medicine research, Ian Coulter, kicked off the conference. His keynote speech highlighted vitalism as a guiding principle of naturopathic practice.
“Vitalism is part of your DNA,” Coulter said to a packed room. “To throw it away would be a downright shame.”
The topic of vitalism—and how it fits into the practice of modern naturopathic medicine—continued in the presentations, breakout sessions, and hallways over the ensuing days of the conference.
The second keynote represented the “present” of naturopathic medicine. A panel of 4 naturopathic doctors at different stages of practice discussed how they approach the treatment of asthma.
The conversation revealed that the everyday practice of naturopathic medicine manifests in dramatically different ways. Whereas some doctors rely more on guidelines, flowcharts, and protocols, others focus more on nature cure—or stimulating the innate ability of each patient to heal.
Following the panel discussion, executive director of the AANP, Laura Farr, made a short yet meaningful statement. “It isn’t vitalism versus reductionism,” said Farr. “It's both ... and. We are stronger as a profession when we embrace and incorporate the diversity of different world views.”
Clem Bezold of the Institute for Alternative Futures delivered the final keynote of the conference. Bezold inspired attendees to take a visionary approach and to “know your inheritance and your legacy” as a way to bring the naturopathic profession into future success.
Conference Pearls for Clinical Practice
Featuring more than 47 speakers and 40 breakout sessions, the 2019 AANP conference had continuing education opportunities for naturopathic doctors at all stages of clinical practice.
Maurice Werness, ND, an attendee who has been practicing in North Carolina for 27 years, firmly believes in the benefit of coming together as a profession. “We don’t learn medicine from books,” said Werness. “We transmit it from doctor to doctor and generation to generation.”
The next generation of doctors in attendance seemed to agree. Ren Bedasbad, ND, LAc, of Bend, OR, has 5 years of clinical practice under his belt. “It’s impossible in our busy practice to deeply research every single condition and patient,” said Bedasbad. “There just isn’t time.”
Bedasbad said that he gets excellent results with his patients by relying on the tools in his naturopathic toolbox, but “there is always more to learn.” He saw value in the conference because he “gleaned countless clinical pearls” that he could “take back and implement with current patients as soon as next week.”
While there is no way to capture all the knowledge that was shared and transmitted in the dozens of sessions at the conference, here are some brief clinical pearls:
- Dementia (Sarah Thyr, ND). Research has shown that Lion’s Mane may improve function in mild cognitive impairment (MCI), resveratrol can slow the progression of MCI to dementia, and citicoline may benefit people with mild or moderate Alzheimer disease. A study published in March of 2018 showed that a highly absorbable form of curcumin decreased amyloid plaques after supplementation for 18 months.1
- Endocannabinoids (Steve Ottersberg). Endocannabinoids are derived from essential fatty acids, and a 2011 study found that nutritional omega-3 deficiency “abolishes” endocannabinoid-mediated neuronal functions.2 Docosahexaenoic acid may be the most significant dietary determinant of endocannabinoid function.
- Estrogen Metabolism (Carrie Jones, ND). Di-indole-methane (DIM) promotes the conversion of estrogens E1 and E2 into 2-OH-E1 by the cytochrome P450 enzyme, CYP1A1. DIM is an excellent supplement to boost phase I metabolism of estrogen, but be warned: DIM could aggravate symptoms in women who already have low circulating estrogen levels.
- Heart Disease (Decker Weiss, NMD, FASA). Elevated epinephrine levels indicate acute inflammation, whereas elevated norepinephrine levels indicate chronic inflammation. Neurotransmitter levels may give some indication of inflammatory status and allow for early interventions.3
- Hypothyroid (Richard Mauer, ND). Whereas hypothyroid is often treated as a primary disease, Mauer proposed that it is usually secondary to another imbalance—especially insulin resistance.4 He discussed laboratory reference ranges as well as nutrients needed for thyroid function, including iodine, selenium, zinc, and vanadium.
- Microbial Endocrine System (Guy Citrin, ND). Gut bacteria modulate circulating hormone levels, control the stress response, modulate estrogen dominance, and influence inflammation. Gut restoration involves several steps but can include prebiotics, probiotics, and amino acids. A 2017 study found that spore-forming probiotics reduced serum endotoxin by 42% and improved other biomarkers of health.5
- Pediatric Nature Exposure and Mental Health (Lauren McKinney Mandych). Four students from the Canadian College of Naturopathic Medicine presented a review of 6 studies on nature exposure and mental health in children. They concluded with a recommendation that children spend a minimum of 30 minutes and preferably 60 minutes outside every day.6
- Prescriptions and Naturopathic Medicine (Jacob Schor, ND, FABNO). Schor presented an extensive review of research detailing natural substances that can influence similar mechanisms and pathways as prescription drugs. Among these were vanillin, curcumin, and vitamin C and berberine.7-9
In addition to clinical topics, some sessions focused more on mentorship and practice growth. Trevor Cates, ND, presented on growing your online presence. A panel of 4 doctors discussed ways to use the ND degree outside of clinical practice. Amy Rothenberg, ND, facilitated a media training about writing for the profession. And Michelle Simon, PhD, ND, of the Institute for Natural Medicine, proposed a role for naturopathic doctors in community health centers.
The Journey from Past to Present
In recognition of the 100th anniversary of naturopathic licensure in the United States, conference organizers transformed the vendor exhibit hall into a journey through time. Upon entering the 60 thousand square-foot exhibit hall, attendees could follow footsteps on the floor to discover an exhibit tracing the history of naturopathic medicine.
The roots of naturopathic medicine extend back to ancient times, but the profession in the United States has only been established over the last century. In 1919, Washington became the first state to license naturopathic physicians. There are now 22 licensed states, with New Mexico and Idaho becoming the most recently licensed in the spring of 2019.
Created by the Foundations of Naturopathic Medicine project, a version of the timeline from the AANP exhibit hall can be found at Foundationsproject.com.
More Chances to Learn
All of the presentations and sessions at the 2019 AANP conference were recorded. Videos, audios, and notes from the meeting are available to purchase from Onsite Recording here.
The 2020 AANP conference will be hosted outside of Denver at the Westin Westminster on July 9-11. As that date approaches, details will become available from the American Association of Naturopathic Physicians.
- Small GW, Siddarth P, Li Z, et al. Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial. Am J Geriatr Psychiatry. 2018;26(3):266-277. Free full text.
- Lafourcade M, Larrieu T, Mato S, et al. Nutritional omega-3 deficiency abolishes endocannabinoid-mediated neuronal functions. Nat Neurosci. 2011;14(3):345-350.
- Pongratz G, Straub RH. The sympathetic nervous response in inflammation. Arthritis Res Ther. 2014;16(6):504. Free full text.
- Maratou E, Hadjidakis DJ, Peppa M, et al. Studies of insulin resistance in patients with clinical and subclinical hyperthyroidism. Eur J Endocrinol. 2010;163(4):625-630. Free full text.
- McFarlin BK, Henning AL, Bowman EM, Gary MA, Carbajal KM. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World J Gastrointest Pathophysiol. 2017;8(3):117-126. Free full text.
- Barton J, Pretty J. What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol. 2010;44(10):3947-3955.
- Iannuzzi C, Borriello M, Irace G, Cammarota M, Di Maro A, Sirangelo I. Vanillin affects amyloid aggregation and non-enzymatic glycation in Human Insulin. Sci Rep. 2017 Nov 8;7(1):15086. doi: 10.1038/s41598-017-15503-5. Free full text.
- Abusnina A, Keravis T, Zhou Q, Justiniano H, Lobstein A, Lugnier C. Tumour growth inhibition and anti-angiogenic effects using curcumin correspond to combined PDE2 and PDE4 inhibition. Thromb Haemost. 2015;113(2):319-328.
- De Francesco EM, Bonuccelli G, Maggiolini M, Sotgia F, Lisanti MP. Vitamin C and Doxycycline: A synthetic lethal combination therapy targeting metabolic flexibility in cancer stem cells (CSCs). Oncotarget. 2017;8(40):67269-67286. Free full text.