History was made in Canada on September 8th, 2010, when prescribing numbers were issued to those naturopathic physicians in British Columbia who passed their Pharmacy Upgrade exams in July. For the past 80 years naturopathic physicians in British Columbia have been working with the various governments over the years to establish a pharmacopeia from which to practice the art of naturopathic medicine. Many ask why would NDs want access to prescription drugs?

Well, over the years NDs have lost the right to use more and more natural substances. You may recall in the 80s when tryptophan, a common amino acid used to treat insomnia, was abruptly taken off the market because it was thought to be toxic, but in fact there was a contaminated batch circulated. It has never returned to the open market and was turned into a prescription drug and the price was quadrupled! Now that NDs have prescribing rights they can once again use this safe and effective remedy if required.

Jane, age 55, has come into the office asking about bio-identical hormones for the treatment of her menopausal symptoms that are no longer controlled with herbal medicines. Her MD prescribed what she thought were bio-identical hormones but still her hormones were out of balance. I explained to her that when I use bio-identical hormones I always start with progesterone alone without any of the estrogens. If after the first month of usage the progesterone (which is NOT Provera) does not help enough then I add the estrogens. What is commonly prescribed is the Tri-Est, which includes the three main estrogens: estrone, estradiol and estriol. Estrone is the strongest and has the most inflammatory nature so the use of this estrogen is avoided by NDs. The Bi-Est combination that I recommend is made up of estradiol and estriol. Once we balanced the estrogens and progesterone dosages for Jane she was much more stable emotionally and physically. We then follow up with yearly salivary testing to make sure the balance is maintained and perhaps in the future the bio-identical hormones may be reduced in dosage or discontinued altogether.

A number of years ago, a patient Laura, age 42, came to me convinced that she still had Lyme even though she had received two weeks of antibiotic treatment. At that time she was able to find another MD who was willing to prescribe antibiotics for an additional three months. She came to me for further treatment and I recommended naturopathic remedies along with the antibiotics she was prescribed. Now that NDs have prescribing rights we will be able to help some of these Lyme patients who may require antibiotic treatment in addition to naturopathic remedies. Getting an accurate Lyme diagnosis in BC, however, still remains a large challenge.

Drugectomies: Did you know that fluoxetine (Prozac) has a half life of 90 hours? What this means is that a dosage of 10 mg of fluoxetine may be effective in the system for more than 2 days. Did you know that 12.5 mg of the water pill Hydrochlorothiazide may be as effective as the 25 mg dosage? These are a few of the gems I learned in the pharmacy course. It will be ever my goal to prescribe the lowest dose possible of any drug for optimal effect and in some cases help people get off medications they may not need to be on. It must be emphasized that this should not be done without the professional help of an MD or ND.

For more information about how pharmacists and doctors are trained to use fewer drugs and lower dosages when possible, listen to the free podcasts available at www.therapeuticseducation.org. For more information on Dr. Ingrid Pincott, refer to the naturopathic physician section of the HANS Wellness Directory at www.hans.org/directory.

Originally published November 10, 2010 in the North Island MidWeek.  Reprinted with permission.

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