Evidence-based medicine (EBM) is considered the paradigm in conventional healthcare and has been suggested as the methodology for natural medicine. The underlying foundation of EBM is the randomized controlled trial, which is very valuable in evaluating single treatments for individual diseases. There are randomized controlled trials that suggest that naturopathic treatments, such as botanical medicine, nutritional therapies, acupuncture, and physiotherapy are effective at treating some conditions, such as fibromyalgia, migraine headaches, depression, asthma, hypertension, and type II diabetes.

While randomized control trials are effective at testing single treatments, they may not be the best paradigm to judge the use of multiple treatments in patients with more than one disorder or disease. For this and other reasons, some scientists have suggested that an evidence-based approach should include not only research evidence, but also clinic expertise and patient preferences (Geyman, 1998). For example, riboflavin, a B vitamin, has been proven in a randomized controlled trial to reduce the frequency and duration of migraine headaches when used for three months. Thus a naturopathic physician will often use riboflavin as part of a treatment plan, while also including other treatments based on clinical expertise. These treatments may include the use of omega-3 fatty acids to decrease inflammation or an elimination diet to identify possible food or chemical triggers. Individual patients will have different triggers-for some it could be MSG, for others it could be wheat. Noting individual responses is part of taking patient preferences into consideration.

In short, naturopathic medicine is personalized medicine that does not always lend itself to a strict adherence to treatments based on randomized controlled trials alone. It is essential to test the value of individual treatments, but the actual clinical application is much more complex.

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