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How Do Naturopathic Doctors Prevent and Treat Heart Disease?

Heart Disease Basics

Heart disease, the leading killer for both men and women in the U.S., is largely preventable if caught and treated early. Naturopathic doctors (NDs) excel at preventing and treating cardiovascular disease because they focus on identifying the underlying causes of disease and empowering patients to make enduring lifestyle changes to restore and maintain their health.

A study investigating the effects of lifestyle changes in patients with atherosclerosis (the buildup of fatty, cholesterol-rich plaque in the arteries) found that after only one year of following lifestyle recommendations, about 80% of participants were able bring about plaque regression and avoid surgery without the use of lipid lowering agents.[1]

Whole Person Care

Trained to treat the whole person, naturopathic doctors address the genetic, environmental, and behavioral/lifestyle factors that lead to cardiovascular disease. While treatment approaches are individualized to each patient, here are six key focuses for naturopathic prevention and treatment of heart disease:

1. Comprehensive intake to identify risk factors and underlying causes.

Root causes of heart disease often show up as warning signs in other bodily systems, and many times they are the result of chronic inflammation in the body.[2] Chronic inflammation can arise from poor diet, a sedentary lifestyle, stress, autoimmune disease, food allergies, and many other sources. Inside arteries, inflammation helps kick off atherosclerosis, which narrows the arteries and increases the risk they’ll become blocked. This can lead to heart attacks and certain types of strokes.[3]

Naturopathic doctors spend 1-2 hours with patients in an initial appointment, and a good portion of this time is dedicated to identifying sources of inflammation. Trained to be “inflammation hunters,” NDs perform a methodical review of your major bodily systems (skin, digestion, joints, respiratory, etc.). They will also ask detailed questions about your diet and physical activity, and discuss your main stressors and coping strategies.

Naturopathic doctors look carefully for conditions such as insomnia, fatigue, and depression[4] because they are all serious risks for both heart disease and heart attack. These conditions deplete vital neurotransmitters, such as serotonin, that are essential for good endothelial (blood vessel) health. Your doctor will individualize treatment with an emphasis on natural agents, such as clinical nutrition, botanical medicine and counseling. Naturopathic doctors avoid the use of non-steroidal anti-inflammatory drugs (NSAIDs) if possible. NSAIDs such as ibuprofen have been associated with heart attacks[5] and heart failure[6].

2. Targeted labs for a clear picture of what’s happening inside your body.

Naturopathic doctors will match diagnostic lab tests to learnings from your intake in order to determine what is causing your symptoms. Just as the intake is a detailed interview process, so are labs an in-depth series of questions to your body. They will be individualized, and may include the following:

  • Lipid panel that includes oxidized LDL (the primary type of cholesterol found in plaques), inflammatory markers, autoimmune markers, and lipoprotein particle analysis
  • Full glucose panel
  • Comprehensive neurotransmitter profile

3. Management of vital signs with medications as needed.

Naturopathic doctors follow the Therapeutic Order, a set of guidelines for clinical decision making that prioritizes minimally invasive therapies to support the body to repair itself. Because of this, NDs lead with natural treatments. However, they are also trained to use pharmacological drugs when necessary.

If their state license permits, NDs can prescribe medications such as diuretics, beta-blockers, and ACE inhibitors as a bridge to manage symptoms of chronic inflammation or cardiovascular disease (e.g. hypertension), until the body repairs itself. If not, they will refer patients to and collaborate with a conventional medical colleague.

Naturopathic doctors will help you balance potential unwanted side effects of these medications with natural protocols that can correct them. The goal is to reduce or eliminate reliance on medications in the long-term by addressing the root cause(s) of heart disease.

4. Optimizing gastrointestinal function.

The gastrointestinal (GI) tract is a common source of inflammation in the body. Gut flora are living microorganisms that provide a wall of protection between your digestive tract and your blood stream. When the flora in your digestive tract are not in balance, you risk developing localized inflammation. This can lead to alterations in intestinal permeability (leaky gut) which can contribute to heart disease.[7]

Naturopathic doctors help repair the GI tract using their extensive training in diet and clinical nutrition. Restoring proper PH, balancing flora, correcting leaky gut and constipation–linked with a higher risk of dying from cardiovascular disease[8]–are focal points of naturopathic GI treatment.

5. Addressing endothelial dysfunction.

The endothelium is the inner lining of your blood vessels. It is considered one of the largest organs in your body, and plays an important role in maintaining good heart health.[9] If the endothelium is not functioning optimally, you have an increased risk of arterial inflammation and plaque build-up, which can lead to heart attack or stroke.[10] Endothelial dysfunction is caused by lifestyle factors including tobacco use, obesity, age, hypertension, hyperlipidemia, physical inactivity, and poor diet.

A focus of naturopathic medicine is empowering patients to make lifestyle changes in order to achieve optimal health. Your doctor will work with you to restore normal endothelial function using a combination of lifestyle modification, botanical medicine[11],12, and/or clinical nutrients [13],[14],[15].

6. Motivating physical activity.

Exercise is linked to improvements in numerous cardiovascular risk factors such as obesity[16], depression[17], inflammation[18], diabetes[19], and more. Naturopathic doctors believe it is their duty to inspire patients to exercise, rather than just give them guidelines. Because of the extra time they spend getting to know your lifestyle and support systems, they are often able to give you creative and personalized recommendations for physical activity that you can not only implement, but also sustain.

  1. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. 1990;336:129–133. Accessed October 17, 2017 http://www.thelancet.com/journals/lancet/article/PII0140-6736(90)91656-U/abstract
  2. Willerson, James T. M.D.;Ridker, Paul M. M.D. MPH Inflammation as Cardiovascular risk factor, 2004 American Heart Association, http://circ.ahajournals.org/content/109/21_suppl_1/II-2
  3. http://www.heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp#.WlTw_pM-cWp
  4. Litchman JH, et al. Depression and coronary heart disease: Recommendations for screening, referral and treatment. Circulation, Oct 21 2008. 118(17):1768-1775.
  5. Bally M, Dendukuri N, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ.2017;357.
  6. Arfè A, Scotti L, Varas-Lorenzo C, et al. Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ.2016;354:i4857.
  7. https://consultqd.clevelandclinic.org/2014/11/gut-flora-and-heart-health-a-new-novel-pathway/
  8. Honkura K, Tomata Y, Sugiyama K, et al. Defecation frequency and cardiovascular disease mortality in Japan: The Ohsaki cohort study. Atherosclerosis. 2016;246:251-256.
  9. Widmer, R. Jay and Lerman, A. Endothelial dysfunction and cardiovascular disease. Glob Cardiol Sci Pract. 2014; 2014(3): 291–308.
  10. Ganz P, Hsue PY. Endothelial dysfunction in coronary heart disease is more than a systemic process. Eur Heart J. 2013;34(27):2025-2027.
  11. Peters W, Drüppel V, Kusche-Vihrog K, et al. Nanomechanics and sodium permeability of endothelial surface layer modulated by hawthorn extract WS 1442. PLoS One. 2012;7(1):e29972.
  12. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 2013;6:275-284.
  13. Heinisch BB, Francesconi M, Mittermayer F, et al. Alpha-lipoic acid improves vascular endothelial function in patients with type 2 diabetes: a placebo-controlled randomized trial. Eur J Clin Invest. 2010;40(2):148-154.
  14. Gao L,Mao Q, Cao J, et al. Effects of coenzyme Q10 on vascular endothelial function in humans: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012;221(2):311-316.
  15. Shechter M,Sharir M, Labrador MJ, et al Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000;102(19):2353-2358.
  16. Eckel RH. Obesity and heart disease: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation.1997;96(9):3248-3250.
  17. Mead GE, Morley W, Campbell P, et al. Exercise for depression. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD0044366.
  18. Ford ES. Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology. 2002;13(5):561-568.
  19. Parlikar U. Tight blood sugar control in type 2 diabetes linked to fewer heart attacks and strokes. June 4, 2015. Harvard Health Publications. Available at: https://www.health.harvard.edu/blog/tight-blood-sugar-control-in-type-2-diabetes-linked-to-fewer-heart-attacks-and-strokes-201506048059. Accessed August 4, 2017.
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INM's team is made up of naturopathic doctors and health journalists.

Institute for Natural Medicine

Institute for Natural Medicine

INM's team is made up of naturopathic doctors and health journalists.
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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHC) a consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.