About this video:
In this video Dr. Litchy-Miller, ND explains the Therapeutic Order of Naturopathic Medicine.

Question: Naturopathic doctors have several therapies and tools in their toolbox to help meet a patient's healthcare goals. When someone shows up with a healthcare issue or goal to a naturopathic doctor, what is their course of treatment? How do they decide which therapy to use and why?

Dr. Margaret Litchy-Miller, ND, explains:

The first system we use is the Six principles of Naturopathic Medicine. These are explained in the following video. The next system is called the Therapeutic Order. And you can think of this as a stairway, and as you're going up that stairway you're going to go one step at a time right? 

1. Foundations of Good Health:

So thinking about it that way first step we take in treating a patient is we're going to treat what we call the Foundations of Health. Foundations of Health include diet, lifestyle, sleep, exercise, stress. Everything that's in your daily life. Everything that you need to survive. So I need to establish what is going on there, where could we make some tweaks that could stimulate the body in a way to heal itself so that we don't have to go to other measures. So we're going to talk about that at every visit for sure. How are we going to change that? 

2. Support Physiological Function:

The next step would be more of a treatment protocol, and that is going to look like botanical medicine and supporting or maintaining physiological function. We're going to discuss the possible use of homeopathy. Homeopathy is another way, a gentle, effective non-toxic way, to stimulate the body's ability to heal. And then we're going to talk about possible supplementation.

3. Correct Physiological Function:
So the next step we go to Orthomolecular Therapy. This is where I wanted to talk about the difference between two and three, okay? Because three we're using supplements to correct physiological function. This is a difference between level 2 in supporting or maintaining physiological function, and this is the difference between nutraceutical therapy and supplementation. So when we're supplementing, we're giving the body what it needs insofar as vitamins and minerals that you are not needing through your diet. I have yet to find a person that can meet all those recommendations through their diet even though they're very strict and they eat very well. So that's when we're adding in these vitamins and minerals. So that's supplementation. Nutriceuticals is pharmaceutical grade supplementation. So this is going to be higher dosages to correct physiological function, and this is where a naturopathic doctor can be useful because this needs to be monitored although these are vitamins and minerals they are medicine and they need to be treated as such. It's important that you're under the care of a doctor or a naturopathic doctor that understands how these work. They need to understand the type and level that they're being given, and then they also need to understand when to discontinue them. How do we know when to stop this? How do we know when to bring it down? So that's very important. 

4: Bodywork:

Then we go to level four. Now we're getting a little bit more invasive because now we're talking about bodywork. We're talking about adding a chiropractor in to correct structural integrity we're also talking about adding something called craniosacral therapy which is the practice that I do in my office. That can help correct the nervous system and kind of reset it and set that button so that it is again functioning properly. Soft tissue work, those types of things.

5. Prescription drugs and antibiotics (Work with an MD):

Now level 5 we're getting to some pharmaceuticals. We're getting to some antibiotics. We're getting into prescriptions. This is where I may refer to an MD.

6. Saving the most invasive interventions for last - Surgery, Chemo, radiation, Suppressive drugs.

And then the top of the level here is where we're getting to surgical procedures, chemotherapy, radiation, and suppressive drug. This is when you are coming in, and you have cancer, and we need to get some invasive procedures going to beat the cancer. Another example would be if I'm in a car accident I'm going to want to see an MD because they're going to be trained in all these surgical procedures that I don't have enough training to perform. But if I were coming to a doctor with a chronic problem, this is where I think a naturopathic doctor is a great option. Because they're going to go through the systems to determine where is the chronic problem stemming from. This is where we see true healing, okay? So I hope that is enough information for you to understand the basics of a therapeutic order and the six principles that we practice as naturopathic doctors. Thank you.

Key take away:
The Naturopathic Doctor follows the following steps to ensure the best healing for their patients:

1. Establish and practice a good foundation for health - Understanding the patient's lifestyle and life goals and establish basics such as diet, exercise, nutrition to help meet these goals. The important thing is helping to do it in a way so that the patient can easily incorporate that into their life.

2. Support Physiological Function: Using Botanicals, homeopathic and Supplements help body meet its daily nutrition requirements so it can function optimally.

3. Correct Physiological Function: Correct any physiological functions using ortho-molecular therapy and nutraceuticals. Knowing how to administer these, monitoring body functions and knowing when to stop is very important.

4. Prescription drugs and antibiotics.  Working with an MD to help with stronger interventions.

5. Saving the most invasive procedures as a last resort - Chemo, Surgery, Radiation, etc.

Trailhead Health Tip:
Your naturopathic doctor will always try a softer, least invasive intervention before attempting the more aggressive intervention methods. They will almost always start with understanding you and your lifestyle and establishing a good foundation of health. In the Naturopathic world, Natural therapies will be tried first.