00:00 – Dr. Girard: Part of our principles include treating the root cause in our patients,
00:04 – treating the whole person, which basically means that we always use individualized medicine.
00:22 – Melissa: This is a much anticipated interview for which we received hundreds of questions, so a big thank you
00:27 – to Dr. Ashley Girard, a naturopathic doctor based in Ontario, Canada, who works with many chronic
00:33 – UTI patients as well as those with other chronic bladder conditions. Thank you so much for joining me.
00:38 – Dr. Girard: Hi Melissa, thank you so much for having me here today. I’ve been really looking forward to
00:43 – speaking with your community and you about chronic UTI and other bladder conditions, and
00:49 – helping to raise awareness about what naturopathic doctors can do to help with
00:56 – this condition. Melissa: And we’re really happy to have you.
01:05 – Before we jump into some of the detailed questions that we’ve got, I’d love if you can provide some oversight into what a naturopathic
01:05 – doctor does, what the approach is, and how it differs to that of western medicine.
01:10 – Dr. Girard: Okay, all right so naturopathic medicine is something that’s practiced differently in
01:16 – different parts of the world. Basically there are regulations in place that are dependent on
01:22 – the country, the province, the state that it’s being practiced in, so it really really
01:29 – depends. A naturopathic doctor, someone calling themselves that, in one country may have a
01:35 – completely different scope of practice, completely different training behind them compared to another
01:41 – location. So in, I can mainly speak to Ontario, so here in Ontario we have a very wide scope.
01:48 – We are considered doctors, we have a college that oversees the profession and keeps
01:55 – patients safe. They set our standards, they allow us to diagnose, run labs. We have additional
02:03 – training that we can choose to do in order to become prescribers which allows us to do
02:10 – a limited list of prescribing, but things like bioidentical hormones, thyroid hormone,
02:17 – as well as certain vitamins and minerals that are considered a prescription. So here in Ontario we
02:23 – have a great scope. We have good oversight and we have a lot to offer patients,
02:31 – so that’s the way it is here. So I encourage your patients always to look up by their area
02:37 – the credentials behind their naturopathic doctor. There are six schools in North America
02:43 – that graduate naturopaths and have and use a regulating body to make sure that their schooling
02:51 – is appropriate for your full-time program. That is usually done after your undergraduate, so there’s
02:57 – there’s lots of testing and making sure that we’re not just getting a
03:03 – weekend course type of thing. Melissa: That’s good to know.
03:06 – Dr. Girard: Yes, yes, which is a bit of an issue in some places.
03:10 – Melissa: I can imagine. Dr. Girard: Yeah, which makes it very confusing for patients because
03:16 – someone will say, “go see a naturopath,” but then that naturopath may have only, like I said, done a few weekend courses.
03:23 – And where they are, that title is not regulated, so anybody can use it.
03:29 – So always look to that first. At the core of naturopathic medicine, we follow six different
03:37 – principles that are at the heart of how we choose to treat patients. Of course there’s first, do
03:46 – no harm. That’s something that’s shared with the conventional medical side, of course, but part of
03:50 – our principles include treating the root cause in our patients, treating the whole person,
03:56 – which basically means that we always use individualized medicine. I get a lot,
04:01 – I get a lot of questions from patients, “well what’s your protocol?” And I always have to tell patients that, no that’s not how a naturopathic doctor is going to approach
04:13 – your care. How I create a treatment plan for one patient is not going to be the same as another,
04:18 – because we are all unique individuals and if we’re not addressing the whole person then we
04:24 – may miss a facet that is going to help them heal, right? Another principle that we follow is to
04:32 – use the healing power of nature. So we believe the body has that innate ability to heal and
04:39 – if we use the right treatments, then we can harness that ability and enhance it and
04:45 – help patients go forward being healthier overall, as opposed to just palliating symptoms
04:51 – with a medication, or even a nutraceutical supplement can also at times palliate.
04:58 – And then another principle that we follow is to prevent disease,
05:02 – right. If we, and this goes hand in hand with the last principle which is doctor as teacher,
05:07 – if we teach our patients the fundamentals of how to live a healthy life and how to take care
05:13 – of their bodies, then they will be able to prevent other diseases from starting as we go through
05:19 – life. So that’s one of the core ways that we approach care. Another way that I talk
05:25 – with a lot of my patients about is, we call it the therapeutic order, and that is a triangle picture.
05:32 – I should have the diagram, but you can look it up, you can search the therapeutic order. And
05:37 – at the bottom of the pyramid is we try to establish those foundations for optimal health,
05:42 – diet, lifestyle, stress, thinking, feeling, how… you know, getting patients to a healthier lifestyle
05:49 – and then from there we’ll try to stimulate those healing mechanisms using our various therapies
05:55 – that we have that we’re trained in to get the body to heal. Maybe it’s missing some
06:00 – ingredients and then we may sometimes have to go to a physical issue, a physical alignment of
06:07 – some sort. This is kind of where physios, chiropractors, osteopaths come into play,
06:12 – and then we may try to palliate if we’re still not getting better
06:15 – with natural products. If that doesn’t work, then pharmaceuticals and then potentially high
06:21 – force interventions like surgical procedures. So we just, we really believe in following that order.
06:27 – Sometimes we have to palliate symptoms a little bit more early because it’s not ethical to leave
06:32 – a patient in a situation where they’re in pain while we wait for their body to
06:39 – start healing, but that goes more into the practice. And yeah, so those are the,
06:49 – that’s how we approach care as naturopaths. And some of the key differences, which you can probably
06:55 – guess based on what I’ve described, is that we try to be more proactive as opposed to reactive.
07:01 – Here in Canada, we have a very reactive system. It’s a free system, but it tends to be more reactive
07:08 – as opposed to establishing those foundations for optimal health. We also treat the patient
07:14 – like they’re the expert of their own body, right. I don’t know how many times I’m gonna hear
07:19 – a patient say, you know, “my doctor said it’s in my head.” That breaks my heart, so
07:26 – that’s not respecting a patient’s innate knowledge about what’s going on in their
07:30 – bodies, so that’s something else that we talk a lot about. And throughout our education,
07:36 – we focus on quality of life, life versus life-saving medicine, and we focus on the
07:45 – physical, mental, emotional, and spiritual health of patients as opposed to just that physical
07:49 – aspect. And we try to listen more than we talk. Melissa: Very important.
07:54 – Dr. Girard: We have longer visits. Very important, very important. Longer visits, I don’t understand how we can provide really thorough
08:04 – medicine with a 10-minute visit here in Canada. It’s, to me, just impossible. I spend lots of time with patients and
08:12 – we just, I just keep learning more facets about their condition that are useful to me and help me
08:18 – determine appropriate treatment plans for them. Yeah, so those are the main qualities
08:25 – that dictate how we decide to treat patients. And then of course we have nutritional medicine,
08:33 – lifestyle medicine, botanical medicine, we’re trained in Chinese medicine and acupuncture.
08:38 – We even get some training in chiropractics and physiotherapy, hydrotherapy, homeopathy,
08:46 – and then other schools have some modalities, we call those modalities,
08:51 – some schools have different modalities and then of course many practitioners go on to learn
08:56 – additional things like IV therapy, ozone therapy, like I mentioned bioidentical hormones, bone
09:03 – therapy, prolotherapy. There’s just so many different options out there too for patients to
09:09 – explore with naturopaths and depending on their individual training. Melissa: That probably makes this next
09:15 – question a bit hard to answer. We got a couple of questions around the safety of naturopathic
09:20 – approaches, but if there are so many modalities, how can you answer or are you able to?
09:25 – Dr. Girard: Well overall, the
09:29 – the profession practices very safely. As I spoke about earlier, you want to find
09:36 – a professional who’s regulated, right, because then there’s a college to hold them accountable
09:40 – if they’re doing anything that would put patients at risk, so that’s the most important thing.
09:46 – Our regulating body reviews everything that we are allowed to be doing as a profession and
09:52 – stipulates how that’s to be done in a safe manner, ensuring patients have informed consent so that they understand what the risks are for any
10:05 – therapy that they decide to take or do. But overall we have a very safe profession compared to
10:14 – pharmaceuticals and surgical interventions. There’s much lower risk in general. Some of the most common
10:21 – side effects that we see with some of the nutraceuticals is GI upset, diarrhea, maybe
10:26 – some dizziness. Some of the herbals can cause a Herxheimer reaction, which is when
10:34 – the body has a die-off reaction, it creates almost flu-like symptoms in a patient and those do have
10:39 – to be monitored carefully. But most interventions are very very well tolerated.
10:46 – Melissa: Okay, that’s good to hear. Are there studies to support a number of these approaches in naturopathy?
10:52 – Dr. Girard: There are. Not necessarily from the way a naturopath might approach the patient
11:00 – with the individualized treatment plan, like I was describing. We have a few studies
11:07 – with that where they had, you know, 60 patients with heart disease and they didn’t even, they
11:15 – weren’t focused on the intervention that was used, they were focused on the fact that a naturopathic
11:21 – doctor did their intake and designed them an individualized treatment plan and then they
11:25 – looked at the outcome to see if they were, you know, what their 10-year heart attack risk was.
11:31 – And overall they see it in those studies that it is a good
11:38 – complement to conventional care. So we don’t have a study like that for approaching urinary cases,
11:44 – but the same principles apply. So in terms of supplements and botanicals, nutraceuticals that
11:54 – are used often with urinary patients, there is lots of research out there to support their use.