CLAIMING NATUROPATHY IN 2019 - written by Maedy Colenso

A comprehensive review which looked at the nature of complementary medicine usage within Australia, found it to be commonly utilised by patients with a variety of conditions. This trend is supported by a wealth of evidence on the effectiveness of natural medicines for these conditions.

However, even with this it has been decided that as of 1 April 2019 the government are removing their 30% contribution from health funds for the following modalities:

Alexander Technique, Aromatherapy, Bowen Therapy, Feldenkrais, Herbal Consults, Homeopathy, Kinesiology, Naturopathy, Pilates, Reflexology, Shiatsu and Yoga.

This may come as a surprise,  hence I am writing this article.  Many of our clients are not aware of this 2019 change. My advice, if you do currently claim on naturopathic consultations, is to contact your private health insurance company and clarify how this will impact your future claiming of naturopathy. You may decide to reduce your extras. You may choose to change your insurance agency.

If you are not happy or feel it is unfair write to the government.

With naturopathy, the interesting thing is, you can find lots of evidence of the natural remedies being useful yet how do you actually prove evidence of usefulness in practices of Naturopathy, Medicine or Chinese Medicine. Is it the modalities needing evidence or the remedies. In each of these three listed modalities the practitioners have extensive training and under their professional organisations require continual professional education (CPE). Therefore it seems very unfair that Traditional Chinese Medicine practitioners and Doctors are accepted by the government and naturopathy is not.

The big question. - Is the decision to stop payments to insurance companies a scientific decision made by government or a political one?

The way I see it as a naturopath, you need to be trained well, you need to keep your continual professional education updated and to be in a professional association. In my opinion to be totally honest even with doing this there are good practitioners and ones that are not as good. Just like a good mechanic or good chef. The evidence of a good practitioner lies with the individual practitioner, their knowledge, communication and care of the individual person they are treating. You can research the remedies but there is more than this in fields of Medicine, Chinese Medicine and Naturopathy. How do you really research clinical practice and draw accurate evidence scientifically when there are modalities of lifestyle, communication, listening, intellect, outside thinking, experience, care, personality, guidance, counselling as well as remedies like nutrients, diet, amino acids, minerals, herbs and vitamins to name a few.

I think the public know which professionals they seek for their health advice. They know their needs and will not go to the ones that do not work. Your health should be your choice not the government’s choice.

There is a website called www.yourhealthyourchoice. When I watched and read their website it made me question how the decision to stop payments to private health insurance companies came about:

• Was there any consultation with research experts in the individual modalities?
• Was the group chosen (NTRAC-  Natural Therapy Review Advisory Committee) -  pro or anti complimentary medicine. Was there bias?
• Was there a political agenda and this just a process?
• Is complementary medicine and preventative medicine positive in helping reduce the demands on hospitals and Medicare?
• Were past reviews looked at where benefits of complementary medicine were seen? 
• If the review policy only looked for negative things, was this to  justify the outcome?
• Did they look at original research or only studies in the last 5 years?
• Did they look at research on herbs, vitamins, minerals?
• Were legitimate published studies looked at?
• Were clients of naturopaths spoken to?
• Were any clinical observations seen as evidence and if so how did they choose these clinics?

It does not take long to look into the amount of documented scientific evidence of remedies. Here are a few examples:

• In mental health, Professor Jerome Sarris’s January 2018 systematic review highlights high quality (scientific) evidence for several herbs in the treatment of anxiety (egg passionflower) and depressive disorders (eg saffron).

• For arthritis, the British Medical Journal published a state of the art review in 2017 that included meta-analyses with positive outcomes for both omega-3 fatty acids and turmeric in the reduction of pain and disease activity.

• For cardiovascular disease and diabetes, magnesium supplementation has consistently demonstrated significant improvements in numerous relevant markers such as insulin, glucose, lipids, blood pressure, as well as improved heart function and survival in heart disease patients – all in placebo-controlled trials and meta-analyses.

• A 2014 Frost and Sullivan report predicted the potential healthcare savings to be made if at risk Australians utilised just a handful of natural medicines for the prevention or treatment of key conditions – B vitamins and omega-3 for cardiovascular health; magnesium, calcium and vitamin D for bone health; lutein and zeaxanthin for eye health; and St John’s wort for depression. 

• Peter R Ebeling writes in the National Library of Health NCBI – Vitamin D and Bone Health

• In 2007 Martin KR has studies in the PubMed Journal Nutritional Health Ageing - The chemistry of Silica and its potential health benefits.

•  Sultan Qaboos University Medical Journal,  April 2004. This report was on the role of Vitamin E in human health and some diseases. It was put together by Saliha Rizvi, Syed T. Raza, Faizal Ahmed, Absar Ahmad, Shania Abbas and Farzana Mahdi

• Evidence to Support the Anti-Cancer Effect of Olive Leaf Extract and Future Directions was published online in August 2016, by Anna Boss, Karen S. Bishop, Gareth Marlow, Matthew P. G. Barnett and Lynette R Ferguson

• Vitamin C is up to ten times more effective at stopping cancer cell growth than pharmaceuticals such as 2-DG, according to scientists in Salford, UK. The research, published in Oncotarget, 2017  is the first evidence that Vitamin C (ascorbic acid) can be used to target and kill cancer stem cells (CSCs), the cells responsible for fuelling fatal tumours. Dr Michael P. Lisanti, Professor of Traditional Medicine at the University of Salford, said: "We have been looking at how to target cancer stem cells with a range of natural substances including silymarin (milk thistle) and CAPE, a honey-bee derivative, but by far the most exciting are the results with Vitamin C.

• The Importance of Magnesium in Clinical Healthcare by Gerry K Schwalfenberg and Stephen J Genius was published online in Sept 2017 in Scientifica. The concept of chronic latent Mg depletion is relatively new, yet deficiency of this required biochemical element has been shown to be an often unrecognised and widespread reality in the modern world. Furthermore, insufficient Mg has been linked to a spectrum of clinical afflictions, a not surprising finding considering the required role of the electrolyte in hundreds of essential biochemical reactions. Mg supplementation in appropriate clinical situations appears to be immensely useful in the management of a number of potentially serious and chronic medical conditions.

• Published online 2016 Oct 23 in the Int J of Endocrinol. Effects of Inositol(s) in Women with PCOS: A systematic review of randomised controlled trials done by Vittorio Unfer, John E Nestler, Zdravko A. Kamenov, Nikos Prapas and Fabio Facchinetti. It has been demonstrated that, in patients affected by PCOS, the metabolism of inositol is dysregulated, highlighting the subtle connection between insulin resistance and inositol deficiency in PCOS patients. Indeed, in women with PCOS, insulin resistance and compensatory hyperinsulinemia due to dysregulation of inositol metabolism may actually be the major underlying cause of the disorder. Various studies have shown the role of D-chiro-Inositol at low dosage in increasing insulin sensitivity and ovulation frequency, as well as in decreasing levels of lipid biomarkers and serum androgen

• Then way back in 1987 Lysine was written about in the Dermatologica by Griffith RS, Walsh DE, Myrmel KH, Thompson RW, Behforooz A. Success of L-lysine therapy in frequently recurrent herpes simplex infection. Treatment and prophylaxis.  L-Lysine appears to be an effective agent for reduction of occurrence, severity and healing time for recurrent HSV infection.

• Then Guilarte TR studied Vitamin B6 and this study was in Nutr Rev 1993.Vitamin B6 and cognitive development: recent research findings from human and animal studies.Numerous studies have suggested that pregnant and lactating women may have dietary intakes of vitamin B6 that are well below the recommended dietary allowance, which may affect the vitamin B6 status of their offspring. This nutrient is an essential cofactor in the developing central nervous system and may influence brain development and cognitive function. Recent work in animal models suggests that vitamin B6 deficiency during gestation and lactation alters the function of N-methyl-D-aspartate receptors, a subtype of receptors of the glutamatergic neurotransmitter system thought to play an important role in learning and memory.

• ZINC and its importance for human health was an intergrative review found in J Res Med Sci in 2013. By Nazanin Roohani, Richard Hurrell, Roya Kelishadi and Rainer Schulin. Supplementation programs are useful for targeting vulnerable population subgroups, which are at a particular high-risk of micronutrient deficiencies

• Krill Oil for Cardiovascular Risk Prevention: Is It for Real? This was published in the Hosp Pharm and published online in 2014. This was studied and co- authored by James M Backes and Patricia A Howard.The potential cardiovascular benefits of dietary omega-3 fatty acids are well documented. For individuals who cannot achieve adequate dietary intake or require higher doses for triglyceride reduction, fish oil supplements are proven to be an effective alternative. For those who are unwilling or unable to tolerate fish oil supplements, krill oil appears to be a safe alternative with the potential for comparative benefits.

These are just a few examples I looked at however there are many more. I am fully aware that there is so much more research and funding needed for complementary medicine research. There is always ongoing learning in regards to health advancements. Take the whole genetics and the advancing knowledge of genes and nutrients,  I am so excited to be sharing this with our clients. The good news is research is now incorporated in the naturopathic degree which is fantastic for the future and professionalism of naturopathy. 

Beyond the prescribing of natural medicines, Naturopaths are key proponents of the comprehensive lifestyle interventions needed to help chronic conditions. Dietary change, stress reduction and exercise are key therapies recommended by Naturopaths, all backed by a large body of evidence, and essential for the prevention and treatment of lifestyle-related conditions such as cardiovascular disease, obesity, diabetes and dementia. One example of this, in Australia, where approximately 63% of the population are overweight or obese, it has been shown that, only one third or less of these and/or hypertensive patients receive lifestyle advice from their GP. I really enjoy working with some really great GPs. The doctors are so busy that having the support of complementary healthcare practitioners can only be a bonus to the client who needs experts in the implementation of lifestyle medicine. With longer consultations, complementary healthcare practitioners are able to engage with and coach their clients.

Chronic diseases require a significant amount of self-management on the patient’s behalf, therefore empowering a person can be key to effective management. In doing so, patients develop a greater understanding of the impact of their behaviours on their health, make informed choices/decisions to achieve their health goals, and stay committed when challenges arise.

In Switzerland, they had similar government suggestions but with people power it was over turned. 

MAYBE AUSTRALIANS WILL NEED TO VOTE WITH THEIR CHOICES. LET THE GOVERNMENT AND THE PRIVATE HEALTH INSURANCES KNOW HOW YOU FEEL 

IT IS YOUR HEALTH AND YOUR CHOICE

In the CAMELOT study of 2015 Australians with cardiovascular disease or diabetes, 43% had used complementary medicine in the last 12 months. 

Naturopaths are one of the top four most commonly consulted healthcare Practitioners in Australia, alongside massage therapists, chiropractors and acupuncturists. For those seeking out complementary medicine, key reasons provided include unsatisfactory results as well as side effects from conventional therapy. Patients also report choosing natural medicine due to its ability to be used as preventative medicine, providing a sense of self-control and self-determination over their own health, and the comprehensive approach to their individual health considerations.

In a time when most countries of the world are heading towards a chronic disease healthcare crisis you would think individuals who are proactively seeking and engaging with preventative healthcare Practitioners would be supported and encouraged in their choices or efforts. It would be nice if the government’s response to any perceived lack of evidence was by supporting continued research into complementary medicine. 

  SOME LAST POINTS 
IN REGARD TO THE PROPOSED CHANGES

• The changes limit the rights of patients to choose healthcare which they feel is most appropriate for them. Thousands of people find relief and improved wellbeing through their use of natural therapies every week in Australia. These changes will impact their ability to access these services as required. Currently over 70% of Australian adults use over-the-counter complementary medicine products, one-third of Australians use complementary medicine therapies including naturopathy. Furthermore, 42% of complementary medicine users take these medicines to address national priority health conditions.

• The natural medicine industry is built on 25,000 small businesses, which contributes $4.2bn to the Australian economy and employs 36,441 people. Thousands more tax-payers are employed in the wider education, manufacturing, wholesale, supply and retail network. This includes 82 TGA approved manufacturing sites and 13,600 high-skilled jobs. If the proposal goes ahead demand will be affected. Natural medicine small businesses, educators and manufacturers could lose business, or even shut down, which would impact local jobs.

• Natural medicine is a preventative long-term strategy that will reduce the financial burden on the Australian economy. Natural therapies are crucial to the preventative health strategy of Australia and will significantly reduce the burden on the public health system.  Rather than opting for more expensive medical procedures up-front, planned wellness strategies like naturopaths offer, can potentially save the healthcare system on hospital and medical costs in the long run.

• Maybe the government should encourage the individuals trying to improve their health so they are not a burden to hospitals and Medicare. Maybe preventative health and even exercise programs should be a tax deduction and definitely claimable if the individual has private health benefits. 

Thank you for you continual support of our work here at Possum Hollow Natural Health Clinic.  

Ref: Marla Cunningham BHSc(CompMed), DipHSc(HerbMed)- Metagenics Health world. 

Ref - www.yourhealthyourchoice

Ref – swissinfo.ch