Myth: Alternative Medicine is not Scientific



I have recently heard several people mention that they think Naturopathy is not evidence based medicine. First off lets define evidence based medicine (EBM)= "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." (Sackett D, 1996)

Evidence is categorized into three levels:

  • Level I: Evidence obtained from at least one properly designed randomized controlled trial.
  • Level II-1: Evidence obtained from well-designed controlled trials without randomization.
  • Level II-2: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.
  • Level II-3: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
  • Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
The myth I would like to dispel is that alternative medicine is not evidence based when in fact it is as evidenced based as conventional medicine. Complimentary Alternative Medicine (CAM) is made up of 30% EBM and conventional medicine is made up of 40% EBM. Many people would be surpise to know there are no positive level I and minimal level II studies of the efficacy for ANY surgery. There was one double blind placebo controled study of knee surgury, half the participants had "fake" kneee surgury, and the study showed those who had the fake surgury had better outcomes then those who had the actually surgery.

There is a 10% difference but when you consider there are 814,000 MDs (according to the AMA) in the country and only 2,000 NDs to provide clinical evidence and the support for alternative medicine research is consideribly less then conventional it is amazing that the gap is not larger.

Places to find CAMand conventional medical research:
For more on EBM visit http://www.hsl.unc.edu/Services/Tutorials/EBM/index.htm

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Well I am picking up my pasture raised trukey on tuesday! And if you don't know where to find your healthy Thanksgiving Feast check out this article on MSNBC on the Healthiest Supper Markets in America.

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Gobble Gobble


Its almost that time again, Turkey Season! I just received notice from my local farmer that he will have my free-range pastoral raised Thanksgiving turkey ready for our big family feast. Ordering a fresh turkey from a local farmer is a great way to add health and wellness to your favorite holiday meal. Buying grass-fed, free-range meats are ensure the healthiest product and support a sustainable future of food.

If a local pastoral raised bird sounds delicious to you, you may need to get your order in very soon. I ordered my Turkey in August! Maybe I was a little excited for fall, but the farmer said he often sells out early. Go to www.eatwild.com to find pastoral farms near you.

My favorite Turkey recipe:

Drunken Turkey

A juicy, spicy recipe that makes a wonderful stock or turkey soup the day after. My favorite part of this recipe is the tradition to begin your Thanksgiving toast when you baste the turkey the first time, thus the second bottle of wine. Everyone gathers round and when the turkey drinks we all toast our gratitude for the year! This recipe can be easily adapted to any size turkey by adjusting the amount of fruit and vegetables.

15 lb Grass fed, free range Turkey, giblets and neck removed, rinse and pat dry
1/2 c Cajun seasoning, ideally find a gluten free, organic brand
1/4 c Eden Foods Organic Tamari, a gluten free soy sauce
1 green apple, cut into large chunks
1 red apple, cut into large chunks
1 orange, quartered
2 lemons, quartered
1 new potato, cut into large chunks
1 old potato, cut into large chunks
1 sweat potato, cut into large chunks
1 yellow onion, peel and quarter
3 large shallots, peel and leave whole
2 heads garlic, peel and leave whole
small bunch grapes, separate from vine
6-8 pads butter
2 bottles favorite hearty red wine, I like Petite Syrah or a Zinfandel

(note: if you do not want to make stock/soup out of veggies and carcass you do not need to peel onion, garlic, and shallots)

Pre-heat oven at 350.

Rinse inside of turkey with a splash of wine. Combine all fruits and veggies in large bowl and toss to mix. Stuff turkey with fruit veggie mix. Set aside extra.

Starting at neck end, carefully slide hand between skin and breast meat to loosen skin. Evenly distribute pads of butter over breast meat under skin. Tuck wing tips under; tie legs together to hold shape. Place turkey on rack set in large roasting pan. Put Cajun seasoning in small bowl and add enough tamari sauce to make into a paste. Rub paste over turkey. Cover only breast area of turkey with sheet of heavy-duty foil. Scatter remaining fruit and veggie mix in pan around turkey.

Roast turkey 30 minutes; baste with ½ cup wine. Begin the 1st toast! Continue roasting turkey for 1 1/2 hours, basting with 1/2 cup wine every 30 minutes. Remove foil from over turkey breast. Continue to roast turkey until golden brown and thermometer inserted into thickest part of thigh registers 180°F, basting with pan juices every 20 minutes, about 1 hour longer. Transfer turkey to platter. Tent loosely with foil; let stand 20 minutes.

Serve, enjoy, and give thanks!

For stock save all bones, pan drippings, and stuffing mix. I like to put them all in a stockpot the night of the dinner and cover with water and put in my fridge to cook the next day. When ready to prepare heat up stockpot to a boil turn down and simmer 12-24 hours. Strain and make soup or save as a wonderful rich and spicy turkey stock.

Sarah Marshall is a candidate to graduate as a Naturopathic Doctor in June 2009. She is currently practicing as a medical intern at the Natural Health Center Portland, OR. If you would like to schedule and appointment for a personalized health consultation with her call (503) 552-1551.

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A Healthy Holloween


A few times a year you may find it pretty hard to maintain a healthy diet. Halloween is one that can cause a lot of strife, especially between kids and their parents. There are many creative alternatives to help prevent kids coming home with a bag of candy that weighs as much as they do from eating it all. My favorite is the HALLOWEEN FAIRY.

The kids can still go out and trick or treat and then they leave their bag of goodies for the Halloween fairy. I believe she is the second cousin to the Tooth Fairy and is related by marriage to the Easter Bunny. In the morning the kids wake to find a new toy or some other exciting surprise in place of their bag of candy. I have many friends with young children who have told me their kids are far more interested in the new toy then they ever were with the candy. Result: Happy Healthy kids!

The last step is to get the candy out of the house lest YOU become tempted to put a dent in the stores. You can take it to work and "sick" it on your co-workers or do the world a favor and throw it out.

Sarah Marshall is a candidate to graduate as a Naturopathic Doctor in June 2009. She is currently practicing as a medical intern at the Natural Health Center Portland, OR. If you would like to schedule and appointment for a personalized health consultation with her call (503) 552-1551.

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Going Gluten Free


While watching TV last night (yes, I do that sometimes) I came across a show on the history of wheat. What was the most remarkable was the amount of processing wheat goes through before it makes it to our plates. As many of you may already know wheat or gluten intolerance is a growing phenomenon in our world with an estimated 50-70% of the population of the US undiagnosed with gluten enteropathy.

There are many theories regarding why we have become allergic to a grain that has been a staple in out diet for so long. I have read extensively on the subject and to get into the details of the debate would be a daunting task for a blog. One thing that became apparent watching the show last night is that the way we process our food isn't helping. Processing wheat enable extended shelf life so it may be shipped long distances and sit on grocery store shelf has not only reduced the nutrient content it extends the time from the field to our dinner plate. That time allows for the rancidification of the end product that we eat adding to the oxidative damage in our body and contributing to systemic inflammation. Inflammation is a huge component in all chronic disease.

There is much more to this topic but I would like to provide some resources for those of us who are avoiding wheat and all other gluten containing grains.

Gluten free resources:

For those of you in or near Portland, OR here is a list of coffee shops, bakeries, and restaurants that offer GF opptions:

  • Blog on GF resources in Portland, OR: http://www.graindamaged.blogspot.com/
  • Grolla Restaurant - 2930 NE Killingsworth St, Portland, OR - (503) 493-9521
  • Corbett Fish House - 5901 SW Corbett Ave, Portland, OR - (503) 246-4434
  • Lemongrass - 1705 NE Couch St, Portland, OR - (503) 231-5780
  • Acapulco's Southwest Gold - 7800 SW Capitol Hwy, Portland, OR - (503) 244-0771
  • Andina Restaurant - 1314 NW Glisan St, Portland, OR - (503) 228-9535
  • PF Chang's China Bistro - 1139 NW Couch St, Portland, OR - (503) 432-4000
  • Mississippi Pizza Pub - 3552 N Mississippi Ave, Portland, OR - (503) 288-3231
  • Carafe - 200 SW Market St, Portland, OR - (503) 248-0004
  • Piece of Cake - 8306 SE 17th Ave, Portland, OR - (503) 234-9445
  • Papa Haydn - 715 NW 23rd Ave, Portland, OR - (503) 228-7317
  • The Coffee Plant: Note that The Coffee Plant has two locations but only this one is gluten free. It is right next to Corbett Fish House so you can really celebrate gluten free in this area. 5915 SW Corbett Ave, Portland, OR - (503) 293-3280
  • The Garlic Jim’s Pizza Chain recently introduced gluten free pizza in all its outlets in the Portland/Vancouver area. Click here to read a press release on that subject. Click on the pizza chain’s name for it locations.
  • New Cascadia Traditional GF artisan bakery http://www.newcascadiatraditional.com/ NW Glisan St. between NW 21st and NW 22nd Ave.
Sarah Marshall is a candidate to graduate as a Naturopathic Doctor in June 2009. She is currently practicing as a medical intern at the Natural Health Center Portland, OR. If you would like to schedule and appointment for a personalized health consultation with her call (503) 552-1551.

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Telling It Like It Is

One of the most challenging parts of my job working with patients is giving bad news. I had three separate occasions of this just yesterday. I am not really talking about delivering a difficult diagnosis, although that is certainly hard. What I find even more difficult is explaining that the cause of our symptoms rarely begin when the symptoms begin. I have written before about the cause of our symptoms being very deep in our bodies (read I Treat People). If your condition is truly an acute condition then this is not the case. In acute cases the cause is clear and the reaction is immediate. However, 98% of what walks in my clinic door is not actually acute.

Acute VS Chronic

An acute illness is simply and bluntly defined as something you get, get over quickly and completely, or you die. That's it. Those are the options. If you get something and it mostly goes away, or lingers a long time, or seems to come back again and again, then what you are dealing with is a much bigger and deeper issue. There is some sort of chronic illness involved.

There is little to no difference in the effectiveness of Naturopathic treatments for acute and chornic illnesses except, here is the kicker, TIME.


In today's hustle and bustle world we want things gone and we want them gone now. However, in the case of chronic illness, this isn't possible. Taking things to cover up symptoms may make you feel better for a while but eventually that illness will rear its ugly head again, usually in a worse and less ignorable way. If optimum health is what you seek and you truly want to move towards cure it most certainly can be done, in time.

Last night I had to look a women deeply in pain into her eyes and say, "This isn't going to get better any time soon, but it is going to get better." Those are tough words to hear and tougher words to deliver, especially as a student doctor who wishes she could wave a magic wand and pull all suffering from those around her. That is beyond my ability and it is not my job. I am a facilitator of a healing process that only my patients can initiate and maintain. I am a coach, a cheerleader, a teacher, and a friend.

The healer is YOU.

With time miraculous levels of health and well being are most certainly possible.

Sarah Marshall is a candidate to graduate as a Naturopathic Doctor in June 2009. She is currently practicing as a medical intern at the Natural Health Center Portland, OR. If you would like to schedule and appointment for a personalized health consultation with her call (503) 552-1551.

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A few Questions


I want you to answer a question for me. I know this seems silly but work with me here. How would you light a dark room? This is not a trick question. List five ways you could light a dark room.



Got them?



Good. I came up with: open a window, turn on a light, light a candle, open a door, take off the roof.

One more question. What do all these things have in common, besides being ways to light a dark room?

Answer: They are all things you have to DO.

Your state of health can be compared to the brightness in a room. Maybe your room has French doors that open to an ocean view. If so, good for you! My room could use some lightening up. Some of you may realize your room needs a lot of light.

You can not take away disease any more than you can take away darkness. You have to add health. You have to DO things to add health not just take things.

As a Naturopathic student in our clinic I see a lot of different ways to work with people. While there are many roads to wellness, the people I see get better faster are those who take an active role in their health.

What can you do? Read my article Top 10 Things to DO for your health for ideas.

Sarah Marshall is a candidate to graduate as a Naturopathic Doctor in June 2009. She is currently practicing as a medical intern at the Natural Health Center Portland, OR. If you would like to schedule and appointment for a personalized health consultation with her call (503) 552-1551.

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