Taking Charge of Your Health

Hi, guys, I’m Dr. Talia Marcheggiani and I’m
recording to you guys from my clinic in Bloor West Village and today I’m going to talk about
some myths about naturopathic medicine, especially regarding our relationship with conventional
medicine and medications and, in order to talk to you about that, I want to talk to
you about something called the Therapeutic Order. So the therapeutic order is from our traditional
roots in the formation of the profession of naturopathic medicine. This is one of our philosophical ideas about
how to treat somebody that comes in our door and how people should be treated in terms
of the medicine that we practice. And this is a 7-step process, or a hierarchy,
of what our treatment goals are for seeing somebody. And the reason that I’m relating the Therapeutic
Order to medications is because one of the steps in this hierarchy of the Therapeutic
Order is pharmaceutical medication. And so I feel that, in naturopathic medicine,
most of us, and certainly in our philosophy, in regards to medication, it’s not that we
don’t agree with medication or surgery or conventional treatments, it’s our agreement
about when they’re implemented and it’s also about our efforts to treat patients before
the need for surgery or medications arises. And so, the Therapeutic Order is a system
of interventions and we go from lower-force interventions to higher force interventions
and the first step in the Therapeutic Order is to remove obstacles to health. So, anytime someone walks into my office,
and is displaying certain symptoms, I’m always looking for, what are the obstacles that their
body is facing when it’s trying to achieve its optimal state of health and wellness. Our bodies have evolved over 300 billion years,
from whatever our common ancestor was, that first created life, we’re this result of a
lineage of survivors, if we’re here on the planet today. And so our bodies have evolved amazing mechanisms
to preserve our health and well-being to ensure that our genes are carried on to future generations. So when somebody is coming in in the initial
stages of disease, and so this may manifest for you as just this subclinical feeling of
“imbalance”, for lack of a better word, there’s often an obstacle in the way. And a big obstacle that often presents itself
in my patients’ lives is stress. That’s one that’s huge and that’s the reason
that I talk about it so often. Another is toxic burden from our environment. Things like pesticides, plastics, smog pollutants
in our air, in our water, in our food, that can also cause an obstacle to health or just
give our bodies some extra things it has to deal with that divert it from its job of making
us feel and look our best. And another thing, of course, is diet that’s
inadequate, that’s not providing us the nutrients that we need or a diet that’s providing us
with anti-nutrients, so it’s preventing us from absorbing the vitamins, the minerals
and the macronutrients that we need to function optimally. And some naturopathic doctors will focus on
the energetic aspect, the spiritual aspect. So, is the person in front of them pursuing
a meaningful life, do they feel satisfied with their work, are they satisfied with their
relationships. So, anytime one of these major pillars of
our health is lacking that can also present an obstacle to us feeling our best. And oftentimes the obstacle is a mental-emotional
one, even if the symptoms that are manifesting are physical. So, another video that explains this is my
wheel of balance video in talking about stress and when I work with mental health, a stage
to mental health promotion is emotional wellness, which is why I use that term so often, rather
than focusing on eradicating or eliminating or managing symptoms of mental “illness”—and
I prefer to say mental health conditions, rather than mental illness—how can we improve
our emotional wellness, how can we improve our mental wellness, as opposed to focusing
on disease. Most naturopathic doctors will focus on this
level, this will be inherent in our philosophy we’re always going to be looking for what
the obstacles are that are in the way of our patients’ achieving symptom-free lives or
a life of low or no symptoms, and a life of abundant wellness and energy, and healthy
weight management and healthy mood and all of the things that indicate robust health. This will always be inherent in our philosophy. The second step in the Therapeutic Order is
to stimulate the Vis, so this is the “vis medicatrix naturae”, which is Latin for the
healing power of nature, which may seem a little bit woo woo to some people, but you
can think of the Vis as metabolism or homeostasis, and this is the idea that our body is primed
for optimal health, and our body is always striving to maintain balance. And there’s this idea in naturopathic philosophy
that sometimes this inherent energetic mechanism that causes life and all living beings, that
sometimes it needs to be stimulated and oftentimes the therapies to do this are more in the energetic
realm. So things like homeopathy and acupuncture
and hydrotherapy as well, so using water and various temperatures to increase metabolism,
hormonal balance, homeostatic balance and blood flow, so those are all scientific terms
for what I think the Vis attempts to describe. So, I tend also to use diet in this realm
and herbs. I believe that herbs, and there’s some research
for this, some evidence that herbs are modulating, that herbs, as opposed to drugs, kind of seek
where things are lacking and they balance our hormonal milieu, our hormonal landscape,
more than a medication, which is man-made and an example of this is that some people
supplementing with straight vitamin A experienced some negative outcomes in large studies that
were done. But if you eat foods that are high in vitamin
A, those negative symptoms from vitamin A supplementation seem to balance themselves
out and that’s because there are some nutrients present in vitamin and nutrient-rich foods
that we haven’t discovered yet and that seem to act synergistically with other chemicals,
natural chemicals, that are present in those foods. And so, by taking nature into our bodies through
forest bathing, so physically being in nature, or through the consumption of plants and natural
substances, I believe that we receive some of those messages from nature. And I can get into this in future videos. I find that herbs have intelligence behind
them. And that’s not necessarily woo-woo or pseudoscientific,
there’s some research for sure that show that herbs modulate through their anti-inflammatory
effects, their anti-oxidant effects, and their hormone-balancing effects, in ways that pharmaceuticals
don’t do to the same extent. So, these two stages, when patients are coming
in and we’re focusing our treatment, we’re removing obstacles and stimulating the body’s
capacity to heal and you can think about this. If you break a bone, we’re definitely going
to remove the obstacle, which is whatever broke the bone in the first place, and then
we’re going to promote the body’s ability to heal. It’s not conventional medicine that heals
the bone, we simply align the bone so that it can fuse together. It’s the body that heals it. So, we’d be promoting the healing of that
tissue with some of the nutrients that the body needs. So this can be applied no matter how serious
the medical condition, but definitely it will always be implicit in our treatment plans
and how we look at the body. And sometimes that’s enough, if somebody is
just coming in with a general feeling of imbalance or, you know, someone who’s coming in with
a good state of health, without a loss of apparent symptoms that just wants to manage
their health in general, then we’ll kind of stop there, but we might teach you some ways
to detoxify, to encourage a healthy diet, and the healthy consumption of health-promoting
foods and we’ll let you sort of maintain that on your own. But what often happens is that people are
coming in, because we’ve been taught in our culture in North America and Canada, especially,
to come in and seek medical care when we’re feeling ill, a lot of the time people will
come in with some kind of issue, so some specific symptoms, and oftentimes these symptoms are
apparent or located within one organ system. And so the third step in the Therapeutic Order
is to strengthen weakened systems. So this might be somebody who’s coming in
a liver issue and this may be a diagnosed issue, or based on their symptoms, we’re noticing
some impairment in the liver in general. And so we take treatment a step further and
we start to focus on actually repairing the tissues that are present in the liver and
so we’ll be using some, perhaps, liver detoxification, some more intense diets, so diets that are
geared more to therapeutics, and using some herbs and nutrients to clean out the liver. We can also use some of our energetics, at
this stage, acupuncture, homeopathy, hydrotherapy, self-care practices, and we’ll definitely
be removing obstacles to cure, so high-sugar diets, or overconsumption of alcohol, or a
high toxic burden. We’ll be looking at those things as well,
but we’re also taking it a step further and specifically focusing on the liver in this
case. And this is something that I see most of in
my practice, is people coming in with hormonal imbalance, with a mental health condition,
with digestive issues, skin issues, hair falling out, and so we’re ordering labs, we’re targeting
specific organ systems, and we’re, maybe not necessarily putting these symptoms into a
diagnostic category, that would be diagnosed by a conventional doctor, so sometimes these
are still subclinical, but there’s definitely symptoms present, people are suffering and
they’re noticing a change and they’re probably have already sought help with their medical
doctor and maybe were told everything was fine, or maybe they received a diagnosis. The 4th stage in the Therapeutic Order is
to correct structural integrity. So, if our posture, if our alignment is off,
then our health is not going to work properly, there’s not going to be proper nerve conduction,
there won’t be proper circulation, there won’t be proper functioning of our organ systems. If our rib cage is collapsed, we won’t be
breathing properly and we won’t be oxygenating our tissues. If our pelvis is out of alignment we won’t
experience proper digestion and digestive regulation. And I often refer out for this stage, I might
refer to an osteopath or a chiropractor, or a physiotherapist or massage therapist. I might so some acupuncture myself, but typically
for structural correction, I’ll refer to another practitioner and I myself see a massage therapist,
chiropractor, osteopath and do quite a bit of hydrotherapy and work on aligning my body
through yoga and things like that because of its importance and just general health
maintenance. While this is the 4th stage in the Therapeutic
Order, I often recommend that it be implemented as some kind of healthcare strategy that focuses
on structural integrity be implemented early on or as a maintenance, especially because
we’re so sedentary and we spend so much time in front of our computers and often engage
in repetitive exercise. Working on structural integrity management
is so important. The 5th stage in the Therapeutic Order is
the use of natural substances to restore and regenerate. And so this is a little bit like symptom management,
if you can imagine that. The objective of naturopathic medicine is
not necessarily to fix a specific disease, which is often confusing, because we have
a very disease-focused healthcare system, not necessarily a health-focused one. And so we’re sort of indoctrinated into this
view that if you don’t have a diagnosis that you’re healthy, or that health is the absence
of symptoms, which is certainly not the philosophy of the world health organization who believes
that health is a mixture of our mental and spiritual and emotional and physical wellbeing
and not simply the absence of disease, however we do have a sickcare system rather than a
healthcare system, and so we’re educated not to go to the emergency room or your family
doctor unless you feel like it’s serious enough to warrant a diagnosis and, if it’s not, then
you’re often sent home and told everything’s fine. And patients will always come in having told
me that their labs are fine. And they are, they’re fine in the framework
of not requiring a diagnosis, or pointing to necessary pathology, but they’re certainly
not fine in the sense that not things that we can improve on and that are not giving
us warning signals of what could come in the future. We often focus on disease prevention and healing
the body rather than focusing on the symptoms or the pathology. We’re looking for the underlying cause. However, sometimes we get far enough along
that we do need to manage symptoms, otherwise people aren’t going to notice benefit. And, so, further along the disease process,
further along the naturopathic order we need to reach. To manage the diseases. These are a little bit higher-force interventions,
rather than sort of encouraging tissue repair, like we were doing in the 3rd stage of the
Therapeutic Order, now we’re focusing more on managing symptoms, managing inflammation
through herbs that are going to calm it down quickly, and detoxify quickly, and we’re going
to manage headaches with herbs, that are just generally anti-inflammatory. So we’re going to be looking at symptom-management. And so a lot of the time we’ll do that in
conjunction with the other 4 stages of the Therapeutic Order, but this time there is
a heavy focus on keeping symptoms under control for better quality of life and to move the
needle further. And the 6th step of the Therapeutic Order
is similar to the 5th, except we’re using pharmacological devices and so it’s not that
we’re against pharmacology and medications in naturopathic medicine, at all, we simply
want to encourage patients to come and see us before things get to the point where you
require medications and I certainly believe and I think even many conventional practitioners
agree with me on this, that medications are probably too widely prescribed or over-prescribed. And this may be that there are no other solutions
and, as a clinician, you want to help the person sitting in front of you and aren’t
really sure how to go about that. So somebody comes in to your office who has
depression and you’re going to reach for the selective-serotonin reuptake inhibitor, the
SSRI, the Prozac or Cipralex, you’re not going to tend to risk using herbs or focusing on
diet or digestion or those kind of things, you’re going to use this “proven method” and
you’re going to implement that right away, whereas my philosophy would be to, depending
on how serious the case is, to implement other interventions and make sure that our terrain
is being treated, that we’ve removed some obstacles to cure, we’ve encouraged spiritual
and life-meaning pursuits and we’re stimulating the body’s own healing mechanisms and anti-inflammatory
mechanisms, and that maybe we’re directly targeting the brain with some nutrients and
some vitamins and that we’re making sure structural integrity is there, and that we’re even using
some herbs to manage depression because we know that St. John’s Wort works very similarly
to an anti-depressant in terms of its efficacy. And then, if those things are not working
or not having enough of an impact, then we might talk about an SSRI, depending on how
severe the case is. And I say this not to create a stigma around
medication use at all. Every single body is different and everybody’s
going to need a different treatment concoction and it’s never going to be just one treatment
or very rarely will it just be one panacea, no matter how much we wish that there were,
it’s going to be a few things that we need to implement to help manage our own health,
so that’s when we’ll reach for the pharmaceuticals, when the natural treatments are not having
enough of an impact, or the disease process has progressed far enough. And then the last is the use of high-force
interventions, so surgery, radiation and chemotherapy. When you’re diagnosed with cancer, then it’s
definitely appropriate to do radiation and chemo or to excise the tumour, or if there’s
joint degeneration to the extent that it can’t further be repaired, and you can’t sort of
prevent it any longer, because you’ve reached the point where the cartilage in your joint
is damaged, then a joint replacement is appropriate. It’s not that we’re against these things either,
it’s that we believe in trying as hard as we can to prevent them from being necessary. But when appropriate, they’re definitely a
gift that we have in our culture and the time that we live in that we can use these kinds
of things to improve our quality of life and to get us back on track in terms of our health. And so very rarely will I see somebody who
requires this stage of intervention, even naturopaths that work with cancer, their focus
is not to treat cancer with natural therapies but to support the whole patient and to improve
the outcomes of the high-force interventions, often an obstacle to healing from cancer is
that patients aren’t able to finish their course of chemo due to the side effects, and
so a lot of the natural therapies can help boost the efficacy of the medication and reduce
the side effects and make patients feel better, so that they’re able to complete their treatment
and then have better outcomes. So, at these two, the last two stages, where
we’re using medications and high-force interventions, natural medicine is working to support the
terrain and to support the body, through the therapies, through the side effects and to
also encourage the therapies to work better. And just to recap, the stages of the Therapeutic
Order are first, number one, remove the obstacles to health, number two, stimulate the Vis Medicatrix
Naturae, or stimulate homeostasis, improve our body’s self-healing mechanisms through
applying nutrients, or looking at energetics, or using herbs to balance our systems and
promote proper hormone balance. And the third is to strengthen weakened organ
systems, focusing on one organ that may be the culprit in causing symptoms in particular,
and really using nutrients that target that organ and the tissues that that organ has. Number four is to correct structural integrity,
creating proper alignment and healing the musculoskeletal system through things like
chiropractic medicine, osteopathy, massage therapy, even hydrotherapy and acupuncture,
doing exercise like yoga as well fits under there. And number five is to use natural substances
to restore and regenerate, so this is using natural substances to work directly with symptoms,
to promote healing, but in patients that are further along the road to pathology and maybe
already have a diagnosis of some health condition. And number six is to use pharmaco-substances
to halt progressive pathology, so these are palliating, they’re stopping disease, they’re
treating somebody who is either not responding enough or whose disease has progressed far
enough that natural therapies are no longer strong enough. And then the seventh stage of the Therapeutic
Order is to use high-force invasive modalities, such as surgery, radiation and chemotherapy
and, again, these are removing the disease. Often that stage is usually life or death
situations, we’re working to remove what’s causing a danger to our body and to our ability
to survive. And so naturopathic medicine cover this whole
spectrum. We have therapies that cover the whole spectrum
of these stages and we’re working to treat the whole person not focusing on the disease
or the symptoms, but looking at the person in front of us, and taking into account their
lifestyle their preferences, their unique individuality and genetic expression and individual
expression. My name is Dr. Talia Marcheggiani, I’m a naturopathic
doctor and I work at Bloor West Wellness in Bloor West Village in Toronto. Take care.

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