Wednesday, June 18, 2008

Review of Scientific Literature on Yoga III

General research on pranayamas

Behanan (1937) reported an increase in oxygen consumption (OC) by 24.5% during ujjayi pranayama and by 18.5% in bhastrika pranayama. Similarly Miles (1964) also measured OC during ujjayi and bhastrika pranayamas and a high frequency yoga breathing called kapalabhati . The OC increased by 32% during ujjayi, 20% during bhastrika and by 14% during kapalabhati. The breath rate decreased by 3 breaths/min following ujjayi, and bhastrika pranayama and an increase of over 4 breaths/min following kapalabhati. In a single subject who practiced ujjayi pranayama at different altitude levels, an increase in OC during ujjayi pranayama by 9% at 520m above sea level was reported (Rao, 1968). An increase of 16% in OC at an altitude of 3800m was also found. Comparisons were made with levels at low altitude.
Bhargava, Gogate & Mascarenhas (1988), studied autonomic responses to breath holding in 20 male healthy volunteers. Breath holding time, heart rate, systolic and diastolic blood pressure, and galvanic skin resistance were recorded when breath was held at different phases of respiration. After initial recordings of the above mentioned parameters, all the subjects practiced nadi-shodhana (alternate nostril breathing) pranayama for a period of 4 weeks. The same parameters were recorded at the end of 4 weeks and the results compared. Baseline heart rate and blood pressure (systolic and diastolic) decreased and were also significantly decreased at breaking point after pranayama breathing. Thus pranayama breathing exercises appear to alter autonomic responses to breath holding probably by increasing vagal tone and decreasing sympathetic discharge. Kumbhak (timed breath holding) is considered as an important phase of the respiratory cycle in pranayama. There are 2 categories of kumbhak viz, short and long kumbhak. Oxygen consumption (OC) was studied using a closed circuit method of breathing through the Benedict-Roth spirometer. Readings were obtained pre, during and post pranayamic breathing period. Results revealed that during the short kumbhak there was a significant increase in OC by 52%, in contrast during long kumbhak there was a significant reduction in OC by 19% (Telles & Desiraju, 1991). In a single subject, heart rate was studied in different types of pranayamas namely, savitri pranayama (SP), nadisuddhi pranayama,(NP), mahatyoga pranayama (MP) and vibhaga pranayama. Ratios of inspiration, kumbhak at the end of inspiration, expiration and kumbhak at the end of expiration differed. Heart rate showed an overall increase during two pranayamas (VP and MP) of the 4 pranayamas, compared to the respective prepranayamic baseline values (Telles & Desiraju , 1992).
A study on middle latency evoked potentials (AEP - MLRs) in subjects practiced ujjayi and bhastrika pranayamas showed that there was an increase in the Na wave amplitude and a decrease in the latency of the Na wave. This is interpreted as a indication of a generalized alteration in information processing at the primary thalamo cortical level during the pranayamas (Telles & Desiraju, 1992). Wood (1993) studied perceptions of physical and mental energy and positive and negative mood states in 71 normal volunteers with ages ranging from 21- 76 years using three different procedures viz, relaxation, visualization and yogic breathing with stretch (pranayamas). He reported that practicing paranayama caused a significant increase in perception of mental and physical energy and feelings of alertness and enthusiasm compared to the other two procedures. Hence, a 30 min program of yogic stretch and breathing exercises which is simple to learn even for the elderly had a markedly `invigorating’ effects on perception of both mental and physical energy and increased high positive mood.

A. Research on uninostril breathing:

The nasal cycle is an ultradian rhythm characterized by alternating patency of the left and right nostrils, with a periodicity of two to eight hours (Keuning, 1968; Shannahoff-Khalsa, 1991). The nasal cycle is controlled by sympathetic/parasympathetic innervation of the nasal mucosa. When sympathetic activity to one side dominates, the result is vaso-constriction and thus decongestion on that side, while the enhanced parasympathetic activity on the other side simultaneously results in congestion (Keuning, 1968; Stocksted, 1953). Hence while the nasal cycle is regulated by the autonomic nervous system, the reverse is also true: the nasal cycle in turn influences the autonomic nervous system. The mechanism for this is as follows: The work by Kristof, Servit & Manas (1981) suggests that the electrographic activity in the cortex is produced by a neural reflex mechanism in the superior nasal meatus. This activating effect could be elicited by air insufflation into the upper nasal cavity without pulmonary exercise. Thus , Stocksted (1953) and Eccles (1978) have proposed that the hypothalamus may be responsible for regulating the cyclical changes in nasal resistance. This lead to further studies on uninostril breathing influencing autonomic status, based on heart rate, plasma catecholamines (Shannahoff-Khalsa & Kennedy 1993, Kennedy, Zeigler & Shannahoff-Khalsa, 1986).
A study done by Backon (1988) shows that right UFNB significantly increases blood glucose levels and left UFNB lowers the blood glucose levels. Similarly studies on intra ocular pressure through the uninostril breathing by Backon, Matamoros & Ticho (1989) showed that right hemisphere activation via left UFNB increases intra ocular pressure by an average of 4.5%, whereas left hemisphere stimulation via right UFNB leads to significant decrease in intra ocular pressure by 25%. On the relationship between the brain rhythm and the nasal cycle the work of Werntz, Bickford, Bloom & Shannahoff-Khalsa (1983) was interesting. They observed an increase in the EEG amplitudes over the hemisphere contralateral to the dominant nostril. Therefore this study suggests that the rhythm alternating cerebral dominance might also be regulated by the autonomic nervous system in a manner similar to the nasal cycle.
Another study by Werntz, Bickford & Shannahoff-Khalsa (1987) on integration of EEG amplitudes and UFNB on 5 subjects who breathed through the more congested nostril for 11-20 min, showed that UFNB produces a relative increase in the EEG amplitudes of the contralateral hemisphere . Correlating EEG changes with functions, a study on spatial and verbal task performance was done on 126 subjects, using breathing through dominant uninostril and forced uninostril breathing (Klein, Pilon, Prosser & Shannahoff-Khalsa, 1986). This showed that there was a tendency for subjects exhibiting baseline right nostril dominance to perform verbal tasks better (relative to spatial performance) than subjects exhibiting left nostril dominance. However there was no effect of forced uninostril breathing on relative verbal and spatial task performance. These results showed that atleast in baseline (not forced breathing) conditions the function of the contralateral hemisphere is enhanced.
It is interesting that an earlier study (Block, Arnott, Quigley & Lynch, 1989) investigated this question correlating performance with gender. Unilateral forced nostril breathing influences spatial and verbal performance in both males and females was studied. In males, they observed that UFNB influences both spatial and verbal tasks ipsilaterally whereas in females, UFNB influenced them contralaterally.
The consistent and selective effect of forced uninostril breathing in normal subjects on the general pattern of EEG activity in the hemispheres suggests the possibility of therapeutic approaches to states of psychopathology where lateralized dysfunction has been shown to occur. Flor-Henry (1983) and others have concluded from numerous studies that schizophrenia is associated with greater left cerebral hemisphere dysfunction and that depression and the other affective disorders are associated with greater right hemisphere dysfunction.
Recently Shannahoff-Khalsa & Beckett (1996) studied the clinical efficacy of yogic techniques in the treatment of 8 adults with obsessive compulsive disorder (OCD) over one year follow up. Left nostril yoga breathing with voluntary nostril manipulation for 31 min was given along with other yoga practices. Five patients were able to complete the study and showed a remarkable improvement in Yale-Brown Obsessive Compulsive scale (Y-BOCS), symptom checklist, Perceived Stress Scale and a significant reduction in medication.

B. Studies on yoga breathing with nostril manipulation:

Studies by other investigators on uninostril breathing (baseline and forced) have shown that these practices alter various autonomic functions, brain rhythm and performance in hemispheric tasks. With this background studies were carried out on 3 types of pranayamas in which nostril manipulation is voluntary not forced, i.e., right nostril yoga breathing (RNYB) , left nostril yoga breathing (LNYB) and alternate nostril yoga breathing (ANYB), practiced over a month for 27 breath cycles, 4 times a day. Oxygen consumption was significantly higher by 37% in RNYB (Telles, Nagarathna & Nagendra, 1994). Following a month of the LNYB similarly practiced ,there was a significant increase in galvanic skin resistance, which can be interpreted as a relaxing effect with reduced sympathetic nervous system activity. The immediate effect of 45 minutes of RNYB was also found to be sympathetic activating, with increased OC, systolic blood pressure and increased cutaneous vasoconstriction (Telles, Nagarathna & Nagendra, 1996).
In a study on 135 school children all yoga breathing practices (irrespective of nostril manipulation), increased spatial memory scores, suggesting a right hemisphere activating effect (Naveen, Nagarathna, Nagendra & Telles, 1997).
Two other studies planned by the guide, on yoga breathing correlated with hand grip strength and heart rate variability have been detailed below under work done by the candidate in this area. Hand grip strength was studied in 130 school children and was found to increase in both hands, irrespective of the nostril breathed through (Raghuraj, Nagarathna, Nagendra & Telles, 1997).
Heart rate variability spectrum studied in alternate nostril breathing pranayama showed a trend of increase in the high frequency, parasympathetic component (Raghuraj, Ramakrishnan, Nagendra & Telles, 1998).

Bibliography in brief:

· Backon, J. (1998) Changes in blood glucose levels induced by different forced uninostril breathing, a technique which affects both hemisphericity and autonomic activity. Medical Science Research, 16: 1197-99.
· Backon, J., Matamoros, N. & Ticho, U. (1989) Changes in intra ocular pressure induced by different forced nostril breathing, a technique which affects both brain hemisphericity and autonomic activity. Graefe’s Archives of Clinical Experimental Ophthalmology, 227: 575-77.
· Behanan, K.T. (1937) Yoga: A scientific evaluation. New York: Dover Publication Inc.
· Bhargava, R., Gogate, M.G. & Mascarenhas, J.F. (1988) Autonomic responses to breath holding and its variations following pranayama. Indian Journal of Physiology and Pharmacology, 32(4): 257-64.
· Block, R.A., Arnott, D.P., Quigley, B. & Lynch, W.C. (1989) Unilateral nostril breathing influences lateralized cognitive performance. Brain Cognition, 9: 181-90.
· Cacioppo, J.T. & Tassinary, L.G. (1990) Principles of psychophysiology: physical, social and inferential elements. New York: Cambridge University Press.
· Eccles, R. (1978) The central rhythm of nasal cycle. Acta Otolaryngologia. 186: 464-68.
· Flor-Henry, P. (1983) Laterality and disorders of affect. Neurobiological and linguistic aspects of the schizophrenic syndrome. John Wright, P.S.G. (Ed) In: Cerebral basis of psychophysiology. Boston. MA. pp 63-90.
· Gertner, R., Podoshin, L. & Fradis, M. (1984) A simple method of measuring the nasal airway in clinical work. Journal of Laryngology and Otology, 98: 351-55.
· Kennedy, B., Zeigler, M.G. & Shannahoff-Khalsa, D.S. (1986) Alternating lateralization of plasma catecholamines and nasal patency in humans. Life Sciences, 38: 1203-14.
· Keuning, J. (1968) On the nasal cycle. International Journal of Rhinology, 6: 99-136.
· Klein, R., Pilon, D., Prosser, S. & Shannahoff-Khalsa, D.S. (1986) Nasal airflow asymmetries and human performance. Biological Psychology, 23: 127-37.
· Kristof, M., Servit, Z. & Manas, K. (1981) Activating effect of nasal airflow on epileptic electrographic abnormalities in the human EEG. Evidence for the reflex organ of the phenomenon.
* Naveen KV, PhD. National Institute of Naturopathy, Pune sponsored this study.

Review of Scientific Literature on Yoga I

Earliest Scientific Studies

The earliest scientific studies on yoga were conducted by Swami Kuvalayananda (1925). He reported the radiological and pressure changes in the viscera related to the practice of Uddiyana Bandha and Nauli. Later, a pupil of his (K.T. Behanan) carried out a systematic study (Behanan, 1937), on the oxygen consumption during pranayamas and reported an increase in the oxygen consumed, ranging from 12 to 25%, during the practice of Ujjayi, Kapalabhati, and Bhastrika pranayamas.

The ability of certain yogis to exert voluntary control over the heart aroused a spate of interest among scientists. The earliest study (Brosse, 1946), showed a decrease in magnitude of heart potentials and pulse wave, approximately to zero, for several seconds before returning to normal.

Later researchers (Satyanarayanmurthy and Shastry, 1958; Wenger et al., 1961; Ananda and Chhinna, 1961), reported brief periods of weakening or disappearance of heart and radial pulse sounds, associated with retention of breath and considerable muscular tension in the abdomen and thorax, with a closed glottis (i.e., an exaggerated Valsalva maneuver in some form). In another study (Kothari et al., 1973), an interesting and different type of yogic control over the heart was reported. After 29 hours in an underground pit, the normal ECG of the subject was replaced by a straight line, which persisted for the next 5 days. Electrical activity returned about half an hour before the pit was scheduled to be opened. The authors did not give any definite explanation for this phenomenon. Another effect of yogic practice which has been of interest to scientists, is the ability to lower the metabolic requirements, enabling the yoga practitioners to stay in an air tight pit for longer periods than control (non-yoga practitioners) subjects, without signs of distress (Anand et al., 1961).

In the study of Karambelkar et al. (1968), it was found that the oxygen consumption of four subjects in an airtight pit was less than the value predicted on the basis of their basal oxygen consumption. For the subjects with training in pranayama, the reduction in oxygen consumption, was less than for the others. The authors speculated that this might indicate that pranayama practice provides acclimatization to higher carbon dioxide content in the inspired air.

Around 1960, Maharishi Mahesh Yogi introduced Transcendental Meditation (TM) to the western world. The TM technique is taught as a simple practice, and provides an opportunity for scientific research. Robert Keith Wallace in his doctoral thesis (Wallace, 1970) and subsequent published researches (Wallace, 1970, Wallace et al., 1971), reported definite effects in terms of reduced metabolic rate, changes in blood chemistry, increased skin resistance, and a consistent pattern of changes in the EEG.

Bibliography in brief:

. Anand, B.K., Chhina, G.S., & Singh, B. (1961). Studies on Shri Ramanand Yogi during his stay in an airtight box. Indian Journal of Medical Research, 49: 82-89.
. Behanan, K.T. (1937). Yoga, A scientific evaluation. Dover Publications Inc.: New York.
. Brosse, T. (1946). A psychophysiological study. Main Currents in Modern Thought, 4: 77-84.
. Karambelkar, P.V., Vinekar, S., & Bhole, M.V. (1968). Study on human subjects staying in an airtight pit. Indian Journal of Medical Research, 56: 1282-1288.
. Kothari, L.K., Bordia, A., & Gupta, O.P. (1973). The yogic claim of voluntary control over the heartbeat: an unusual demonstration. American Heart Journal, 86: 283-284.
. Kuvalayananda, Swami (1925). X-ray experiments on uddiyana and nauli in relation to the position of the colon contents. Yoga Mimamsa, 1: 250-254.
. Satyanarayanmurthy, G.V. and Sastry, P.B. (1958). A preliminary scientific investigation into some of the unusual physiological manifestations acquired as a result of yogic practices in India. Weiner Zeitschrift Fuer Nervenheil Kunde, 15: 239-249.
. Wallace, R.K. (1970). The physiological effects of transcendental meditation: a proposed fourth major state of consciousness. Ph.D. Thesis, University of California, Los Angeles.
. Wallace, R.K., Benson, H., & Wilson, A.F. (1971). A wakeful hypometabolic physiologic state. American Journal of Physiology, 221: 795-799.
. Wenger, M.A., Bagchi, B.K., & Anand, B.K. (1961). Experiments in India on “voluntary” control of the heart and pulse. Circulation, 24: 1319-1325.

* Naveen KV, PhD.
National Institute of Naturopathy, Pune sponsored this study.

Thursday, June 12, 2008

Review of Scientific Literature on Yoga II

General Research on Meditations

Autonomic And Electroencephalographic Studies:

Transcendental meditation was described as a `fourth major state of consciousness’, based on the fact that 6 months to 3 years practice of TM was reported to cause some changes similar to those in sleep, i.e., a decrease in the heart rate and oxygen consumption, and an increase in the level or stability of the electrodermal response. However, there was also an increase in the EEG alpha wave amplitude and regularity, normally seen while awake (Wallace, 1970; Wallace, Benson and Wilson, 1971). A study on autonomic stability in TM practitioners revealed that meditators (compared to non-meditators) were more stable, with respect to rate of GSR habituation, multiple responses of GSR and the spontaneous fluctuation of GSR (Orme-Johnson, 1973). A controlled study by Banquet (1973) on 12 transcendental meditators with 2 years of experience showed increase in alpha amplitude with decreased frequency anteriorly, posterior theta, rhythmic beta waves during deep meditation and synchronization of anterior and posterior channels.

All the above-mentioned studies were on single sessions. In a later study on the EEG changes during TM, Tebecis (1975) showed considerable individual variation between the 2 separate sessions in the EEG patterns during meditation. Lang et al (1979), reported that the 24 hour urinary catecholamines was higher in advanced meditators compared to meditators with less experience. Neither increase in plasma nor adrenaline was found in advanced meditators after meditation preceded by exercise, whereas after another period of physical exercise, following meditation, neither plasma nor adrenaline decreased. Stigsby (1981) demonstrated the EEG pattern during TM different from sleep onset and sleep, but not different from wakefulness and drowsiness.

Contradictory autonomic changes were observed in Zen and Tantric meditations.

One set of studies reported changes suggestive of autonomic activation (Hirai, 1974: Corby et al., 1978), whereas another set of studies reported changes suggestive of autonomic relaxation evident through the reduction in oxygen consumption, decrease in respiratory rate and stable GSR (Sugi and Akutsu, 1968; Akishige, 1968; Elson et al., 1977).

Farrow and Hebert (1982) observed increase in the frequency and length of the breath suspension episodes in TM practitioners compared to controls. They also asked the subjects to indicate the experience of pure consciousness experience (complete quiescent mental state) by pressing an event marking button. The temporal distribution of the button presses was significantly associated to the episodes of breath suspensions, indicating that breath suspension is a physiological correlate of some episodes of experience of pure consciousness. This was substantiated by the results of another study (Fried, 1987) where the breathing pattern and the rate following relaxation with biofeedback-assisted guided imagery resembled the pattern observed in meditators, indicating the importance of breathing rate as an index of hypoarousal. It was observed that heart and breath rates were significantly different as an experienced meditator shifted at will from `single thought’ to `no thought’ state (Telles & Desiraju, 1992). In Brahmakumaris Raja Yoga meditators, there was a group significant increase in heart rate during meditation, while other parameters showed inter and intra individual differences. The heart rate varies with sympathetic and parasympathetic activity and hence no conclusion was made about the effects of this meditation on the autonomic nervous system (Telles & Desiraju, 1993). Senior Om meditators showed a decrease in heart rate along with increased peripheral vascular resistance, interpreted as a sign of mental alertness while being physiologically relaxed (Indian Journal of Physiology and Pharmacology, 1995, 39(4): 418-420).

Travis and Wallace (1997), demonstrated the appearance of skin conductance response, heart rate decceleration and the experience of transcendental consciousness at the onset of respiratory suspensions, with higher phasic autonomic activity at respiratory suspension than at breath holding. These easily measured markers could help focus research on the existence and characteristics of transcendental consciousness. In a separate group of meditators (n = 12, 20 days of meditation experience), there was a decrease in heart and breath rates (similar to the control session) and a decrease in skin resistance in meditation sessions alone (Telles, Nagarathna & Nagendra, 1998). These results also suggest meditation causes alertness with relaxation. A study on another relaxation technique and meditation, combined, called `cyclic meditation’, showed that this practice reduced the oxygen consumption significantly more than an equal period of supine rest (Telles, Reddy, & Nagendra, 2000).

There are two review articles for comprehensive understanding of the neurophysiological correlates of meditation practice (Shapiro, 1982 and Delmonte, 1984). The first one provides physiological and clinical comparisons of meditation with other self-control strategies, emphasizing the “uniqueness” of meditation. The other review by Delmonte highlights the state effects of meditation eventually generalized to become traits, viz, decreased electrocortical arousal, stronger orienting and recovery responses to stressors. He also describes the course of meditation practice i.e., it may begin with left hemisphere activity, which gives way to functioning more characteristically of the right hemisphere. However, in advanced meditation (no thought) both left and right hemisphere activity is suspended or inhibited. Finally, the review states that the inadequate evidence to support the notion of “unique state effects of meditation” is not adequate.

In summary, studies on TM reported mainly reduced sympathetic activity following meditation, though a single report did describe sympathetic activation in TM. Similarly, contradictory autonomic sympathetic changes were reported in Zen and Tantric meditators.

Event Related Evoked Potential Studies In Meditation:

Wandhofer et al. (1976), reported a study on auditory evoked potentials using loud tones and observed lower 12% baseline values of the latencies of the P1, N1 and P2 components in meditators compared to non meditators. However, in the meditators there was no change during meditation compared to the preceding baseline. A later study (Barwood et al., 1978) reported no consistent change in long latency AEP during TM. A study on short latency AEPs by McEvoy (1980) showed a slight modulation in the wave V latency, after meditation.

Studies on Chinese, Qi-Gong meditation showed increased amplitude of I to V components of BAEP during meditation (Guo-Long, Rong-qing, Guo-Zhang & Chi-ming, 1990). In contrast, decreased amplitudes of AEP-MLR and long latency AEP components occurred during meditation, believed to be due to inhibition of neural activity at thalamo-cortical, cortical levels during Qi Gong.

Banquet et al.(1979), compared the meditators with matched controls for reaction time (RT) during a series of visual stimuli. The meditators showed faster RT with less mistakes, and N100 and P200 of larger amplitude and shorter latency. The transient effects were opposite for the 2 groups, i.e., longer RT and larger P300 was observed following meditation while following rest there was no change in RT and decrease in P300. These results explain selective attention capacity and information processing strategies in meditation. Middle latency auditory evoked potentials were studied in senior Om meditators with 5-20 years of meditation experience. As described above, there were differences within and between subjects for the parameters studied. However there was a group significant decrease in the Nb wave latency of middle latency auditory evoked potentials during meditation, suggesting changes at the level of the association cortices (Telles & Desiraju, 1993). Om meditators with 15 days to 12 years of experience of meditation showed opposite direction changes in Na amplitude, an increased amplitude of the Na component of middle latency auditory evoked responses during meditation, suggesting increased activity at mesencephalic-diencephalic levels was seen in experienced meditators (Telles, Nagarathna, Nagendra & Desiraju, 1994).

In summary, Evoked potential studies on meditators, showed that brainstem neural centers, as well as those at thalamic, and primary sensory cortex were involved in meditation.

Studies of cerebral function during meditation using positron emission tomography (PET) and functional magnetic resonance imaging (fMRI):

A positron emission tomography (PET) study (Herzog et al., 1990-91) on meditation showed intraindividual changes in regional cerebral metabolic rate of glucose (rCMRGlc), or regional glucose consumption, when meditation and non-meditation were compared. The ratio of frontal versus occipital rCMRGlc was significantly higher in meditation than in non-meditation, suggesting involvement of frontal cortical areas in meditation. There were also two more recent studies, one using P.E.T., the other using functional magnetic resonance imaging (fMRI).

Studies In Response To External Stimuli:

Two studies (Kasamatsu and Hirai, 1966: Hirai, 1974) on Zen meditators, demonstrated alpha suppression response, a sudden attenuation of alpha waves in response to a stimulus, which did not habituate to repeated click stimuli during Zen meditation whereas controls habituate after the fifth or sixth click. This reflects a “hypersensitivity” of attention during Zen meditation. In contrast, Anand, Chhina & Singh (1961), found that two yogis showed no alpha blocking to diverse stimuli while performing Raja Yoga meditation during which attention is supposedly focused inward (on a sound or word called a “mantra”) and withdrawn from the outside world. These two studies provide an indication that advanced meditators exhibited neurophysiological alterations indicative of their specific state of attention during meditation. There have been two reports of physiological reactions to stimuli during meditation (Wallace, 1970: Banquet, 1973). Both reports were minor parts of larger studies, and two reports directly contradict each other, one finding no response to stimuli and the other finding many responses and a failure to habituate. Becker and Shapiro (1981), replicated the two studies (Anand, et al., 1961: Kasamatsu and Hirai, 1966) on very experienced Zen, Yoga and TM meditators along with the two groups of controls. All five groups were presented with auditory clicks during meditation. EEG alpha suppression and skin conductance response showed clear habituation, which did not differ among groups. They also recorded N100, P200 and P300 components of AEP. Contrary to their expectation there were no difference between groups. They observed non-significant larger intial N100 responses to the clicks which lead to the speculation that enhanced N100 reflects selective attention during meditation. A later report (Heide, 1986), noted a difference in the heart-rate response but not in the electro dermal response evoked by 80 dB tones, when TM practitioners and non-meditators were compared.

In summary, the response of meditators meditating on either an external or internal object, to external stimuli is not conclusively worked out.

Bibliography (in brief):
· Akishige, Y. (1968). A historical survey of the psychological studies in Zen. Kyushu psychological studies, V, Bulletin of the faculty of Literature of Kyushu University 11: 1-56.
· Anand, B.K., Chhina, G.S. AND Singh, B. (1961). Some aspects of electroencephalographic studies on yogis. Electroencephalography and Clinical Neurophysiology 13: 452 - 456.
· Banquet, J-P. (1973). Spectral analysis of the EEG in meditation. Electroencephalography and Clinical Neurophysiology 35: 143-151.
· Barwood, T.J., Empson, J.A.C., Lister, S.G. and Tilley, A.J. (1978). Auditory evoked potentials and Transcendental meditation. Electroencephalography and Clinical Neurophysiology 45: 671-673.
· Banquet, J.P., Bourzeix, J.C. AND Lesevre, N. (1979). Evoked potentials and vigilance induced during the course of choice reaction time tests. Review of Electroencephalography and Neurophysiology 9(3): 221-227.
· Becker, D.E. and Shapiro, D. (1981). Physiological responses to clicks during Zen, Yoga and TM meditation. Psychophysiology 8: 694-699.
· Cacioppo, J.T. and Tassinary, L.G. (1991). Principles of psychophysiology: physical, social and inferential elements. New York: Cambridge University Press.
· Corby, J.C., Roth, W.T., Zarcone, V.P. and Kopell, B.S. (1978). Psychophysiological correlates of the practice of Tantric yoga meditation. Archives of General Psychiatry 35: 571-577.
· Delmonte, M.M. (1984). Electrocortical activity and related phenomena associated with meditation practice: a literature review. International Journal of Neuroscience 24(3-4): 217-231.
· Elson, B.D., Hauri, P. and Cunis, D. (1977). Physiological changes in yoga meditation. Psychophysiology 14: 52-57.
· Farrow, J.T. and Herbert, J.R. (1982). Breath suspension during the transcendental meditation technique. Psychosomatic Medicine 44(2): 133-153.
· Fried, R. (1987). Relaxation with biofeedback-assisted guided imagery: the importance of breathing rate as an index of hypoarousal. Biofeedback and Self-Regulation 12(4): 273-279.
· Guo-long L., Rong-qung, C., Guo-zhang, L. and Chi-Ming, H. (1990). Changes in brainstem and cortical auditory potentials during Qi-Gong meditation. American Journal of Chinese Medicine 18(3-4): 95-103.
· Heide, F.J. (1986). Psychophysiological responsiveness to auditory stimulation during Transcendental meditation. Psychophysiology 23: 71-75.
· Hirai, T. (1974). Psychophysiology of Zen. Tokyo: Igaku Shoin, 36-43.
· Herzog, H., Lele, V.R., Kuwert, T., Langen, K-J, Kops, E.R. and Felnendegen, L.E. (1990-91). Changed pattern of regional glucose metabolism during yoga meditative relaxation. Neuropsychobiology 23: 182-187.
· Kasamatsu, A. and Hirai, T. (1966). An electroencephalographic study on the Zen meditation (Zazen). Folio Psychiatry Neurology Japonica 20: 315-336.
· Lang, R., Dehof, K., Meurer, K.A., and Kaufmann, W. (1979). Sympathetic activity and Transcendental meditation. Journal of Neural Transmission 44: 117-135.
· McEvoy, T.M., Frumkin, L.R. and Harkins, S.W. (1980). Effects of meditation on brainstem auditory evoked potentials. International Journal of Neuroscience 10: 165-170.
· Naveen, K.V., Srinivas, R., Nirmala, K.S., Nagendra, H.R. and Telles, S. (1997). Middle latency auditory evoked potentials in congenitally blind and normal sighted subjects. International Journal of Neuroscience 90 (1-2): 105-111.
· Naveen, K.V., Srinivas, R., Nirmala, K.S., Nagarathna, R., Nagendra, H.R. and Telles, S. (1998). Differences between congenitally blind and normal sighted subjects in the P1 component of middle latency auditory evoked potentials. Perceptual and Motor Skills 86: 1192-1194.
· Naveen, K.V., Srinivas, R., Nagarathna, R. and Telles, S. (2000). Yoga for the rehabilitation of socially disadvantaged and visually impaired subjects. In: D. Majumdar and W. Selwamurthy (Eds.). Advances in Ergonomics, Occupational Health, Safety, and Environment. New Delhi: New Age International Publishers. Pp. 204-208.
· Naveen, K.V., Nagendra, H.R., Garner, C. & Telles, S. (1999). Transcranial Doppler sonography in different physiological test conditions, Neurology India, 47: 249.
· Orme-Johnson, D.W. (1973). Autonomic stability and Transcendental meditation. Psychosomatic Medicine 35: 341-349.
· Raghuraj, P., Ramakrishanan, A.G., Nagendra, H.R. and Telles, S. (1998). Effect of two selected yogic breathing techniques on heart rate variability. Indian Journal of Physiology and Pharmacology 42(4): 467-472.
· Roy, M. and Steproe, A. (1991). The inhibition of cardiovascular responses to mental stress following aerobic exercise. Psychophysiology 28: 689 - 699.
· Shapiro, D.H. Jr. (1982). Overview: clinical and physiological comparison of meditation with other self-control strategies. American Journal of Psychiatry 139(3): 267-274.
· Stigsby, B., Rodenberg, J.C. and Moth, H.B. (1981). Electroencephalographic findings during mantra meditation (Transcendental meditation). A controlled, quantitative study of experienced meditators. Electroencephalography and Clinical Neurophysiology 51: 434-442.
· Sugi, Y. and Akutsu, K. (1968). Studies on respiration and energy-metabolism during sitting in Zazen. Research Journal of Physical Education 12: 190-206.
· Tebecis, A.K. (1975). A controlled study of the EEG during Transcendental meditation: Comparison with hypnosis. Folia Psychiatrica et Neurologica 29: 305-313.
· Telles, S. and Desiraju, T. (1992) Heart rate and respiratory changes accompanying yogic conditions of single thought and thoughtless states. Indian Journal of Physiology and Pharmacology 36(4): 293-294.
· Telles, S., Joseph, C., Venkatesh, S. and Desiraju, T. (1992). Alteration of auditory middle latency evoked potentials during yogic consciously regulated breathing and attentive state of mind. International Journal of psychophysiology 15: 147-152.
· Telles, S. and Desiraju, T. (1993). Recording of auditory middle latency evoked potentials during the practice of meditation with the syllable `OM’. Indian Journal of Medical research 98 [B]: 237-239.
· Telles, S., Nagarathna, R. and Nagendra, H.R. (1995). Autonomic changes during `OM’ meditation. Indian Journal of Physiology and Pharmacology 39(4): 418-420.
· Telles, S. Nagarathna, R., Nagendra, H.R. & Desiraju, T. (1994). Alterations in auditory middle latency evoked potentials during meditation on a meaningful syllable `OM’. International Journal of Neuroscience 76: 87-93.
· Telles, S., Nagarathna, R. and Nagendra, H.R. (1996). Physiological measures of right nostril breathing. The Journal of Alternative and Complementary Medicine 2(4): 479 - 484.
· Telles, S., Nagarathna, R. & Nagendra, H.R. (1998). Autonomic changes while mentally repeating two syllables – one meaningful and the other neutral. Indian Journal of Physiology and Pharmacology 42 (1): 57-63.
· Telles, S., Reddy, S.K. & Nagendra, H.R. (2000). Oxygen consumption and respiration following two yoga relaxation techniques. Applied Psychophysiology and Biofeedback 25(4): 221-227.
· Wallace, R.K. (1970). Physiological effects of Transcendental Meditation. Science 167: 1751-1754.
· Wallace, R.K., Benson, H. and Wilson, A.F. (1971). A wakeful hypometabolic physiologic state. American Journal of Physiology 221: 795-799.Wandhofer, A., Kobal, G. and Plattig, K.H. (1976). Latenzverleurung mensclicher auditoris chevozierter Hirnpotentiale bei Transzendentaler Meditation. Zeitschrift EEG -EMG 7: 99-103.

* Naveen KV, PhD. National Institute of Naturopathy, Pune, sponsored this study.

Online Naturopathy Library of rare books

The Naturopathic Medicine Historical Collection (NMHC) is a collection of books from the 19th and 20th centuries that exemplify some of the literature of alternative medicine practice in its heyday. This literature is important for historical reasons, and also because much of its content is still relevant for naturopathic physicians and other alternative medicine practitioners today. In this first iteration, the NMHC is a collaborative pilot project of the National College of Naturopathic Medicine library and the Oregon Health & Science University library. The pilot project was funded by the Institute of Museum and Library Services through the Library Services and Technology Act.


The materials presented in the NMHC were gathered from the rare book collection of the National College of Naturopathic Medicine and the archives of the Oregon Health & Science University. The collection initially consists of approximately 2,500 page images from 11 different monographs.

View the listings here-

Sunday, June 8, 2008

Scientific Weight Loss Program

Why conventional Weight Loss Programs fail?

Most weight loss programs fail because they do not remove the underlying causes of obesity, and because the program is not individualized to the person's unique needs.

Naturopathic physicians specialize in treatment of factors which inhibit weight loss including: specific dietary counseling, promoting proper digestion, restoring compromised liver function, promoting proper thyroid metabolism, identifying nutrient deficiencies, treating food allergies, treating insulin resistance, detoxification, and treatment of intestinal imbalances.

Conventional Weight Loss Treatment for Obesity/ Overweight:

. Diet usually consisting of a decrease in calories and change in dietary habits.
. Exercise.
. Behavioral therapy (includes many commercial weight loss programs).
. Drugs including appetite suppressants and stimulants.
. Surgery. The most common operations- vertical banded gastroplasty and gastric bypass, radically reduce stomach volume. There are a variety of nutrient deficiencies that may occur as a result of these procedures.

Why Some Weight Loss Programs Fail?

. Not being realistic about the time that it takes for permanent healthy weight loss. Expect your dietary and exercise changes to be lifelong habits. Plan to take 24-36 months to attain your ideal weight.
. Failure to identify contributing factors in weight gain
. Wrong dietary plan
. Inability to burn total calories being consumed
. Water retention
. Constipation
. Poor digestion
. Poor liver function
. Poor carbohydrate metabolism
. Deficiency of essential nutrients needed for normal metabolism
. Food sensitivities
. Toxicity stored in fat tissue
. Mental/emotional issues. Mental and emotional issues in our lives affect our eating habits and our relationship with food. For many people, it is necessary to address this component of health in order to attain permanent weight loss.

Natural Approaches for Permanent Weight Loss

Naturopathic medicine provides natural, safe, and effective options for a healthy diet and lifestyle which promotes permanent weight loss.

Change your approach to Weight-Loss
. Throw your scale out. Do not weigh yourself. Gauge your weight loss by the change in your clothes, your body and your feeling.
. Make the goal be achieving and maintaining balance in your life. Balance your food, work, home, self, exercise, reactions to life and emotions.
. Work the program diligently for 24-36 months and expect consistent small results. A monthly 2 lb. weight loss equals 72 pounds in 36 months. This is a slow evolving experience, not a crash program. Have patience.
. Never give up. Successfully living a healthy lifestyle requires persistence over a long period of time. It gets easier but you’ll be working at it for the rest of your life. You don’t just arrive and that is it. It is like brushing your teeth; it calls for attention on a daily basis.
. Surround yourself with people who support you and your goals rather than undermine you.
. Regularly do something in your life that you love.

Dietary plan/ Nutritional Considerations
Never use a low calorie diet again. This is not a diet. Banish the word from your vocabulary. Choose to live a particular way that includes a moderate amount of good clean food, regular exercise, relaxation, fun, time for yourself and caring for yourself and others.

Atkins Diet...Zone Diet…Low Fat Diet… They all share a common flaw: a "one size fits all" approach. Naturopathic physicians can work with you to determine the lifetime eating plan that is right for you which will promote overall health as well as permanent weight loss.

Difficulties losing weight are often related to deficiencies in nutrients which are necessary for proper metabolism. If fats can’t be broken down properly, weight loss is difficult or impossible.

. Nutrients such as B-vitamins, lipoic acid, iron, magnesium, manganese, chromium, L-carnitine and Co-enzyme Q-10 are essential for proper metabolism of fats and carbohydrates.
. Nutrients necessary for proper thyroid function include tyrosine, iodine, selenium, zinc, and copper.
. Food cravings and insulin resistance can also be due to nutrient deficiencies.

Exercise helps reduce weight. Research shows that frequency of exercise is the most important factor in weight loss. Duration of exercise is the second most important factor.

Exercise has important benefits:
Increases lean body mass, which automatically increases your metabolism - muscle tissue has a higher metabolic rate (burns more calories) than adipose (fat) tissue.Improves mood, improves sleep, improves balance and coordination, lowers blood sugar, improves insulin sensitivity, improves immune system function, improves circulation, lowers blood pressure, lowers LDL (“bad”) cholesterol, raises HDL (“good”) cholesterol and overall significantly reduces the risk of heart disease. Consult an expert before starting any exercise program who will advise you what based on your physiological condition what kind of exercise would be best for you.

Stress Management
If you have hormonal imbalances that are caused by chronic stress, stress management will help with weight loss. It is often necessary to take a hard look at how one reacts to stress from mental/emotional issues in one’s life and how to resolve/manage/change these responses to be more healthy.

Saturday, June 7, 2008

Principles of Naturopathy

Naturopathic medicine is dedicated to the study of nature’s healing powers. It is as old as healing itself and as new as today’s medical breakthroughs. It is a dynamic philosophy as well as a profession that recognizes the interconnection and interdependence of all living things. It utilizes the most natural, least invasive therapies to treat illness and to promote wellness by viewing the body as an integrated whole.

Naturopathic medicine is defined by principles rather than by methods or modalities. Above all, it honors the body’s innate wisdom to heal. Naturopathic physicians practice the six fundamental principles of naturopathic medicine:

The Healing Power of Nature
Vis Mediatrix Naturae

Trust in the body’s inherent wisdom to heal itself. Naturopathic medicine recognizes an inherent self-healing process in the person that is ordered and intelligent. Naturopathic physicians act to identify and remove obstacles to healing and recovery, and to facilitate and augment this inherent self-healing process.

Identify and Treat the Causes
Tolle Causam

Look beyond the symptoms to the underlying cause. The naturopathic physician seeks to identify and remove the underlying causes of illness, rather that to merely eliminate or suppress symptoms.

First Do No Harm
Primum No Nocere

Utilize the most natural and least invasive therapies. Naturopathic physicians follow three precepts to avoid harming the patient:
. Utilize methods and medical substances which minimize the risk of harmful side effects, using the least force necessary to diagnose and treat.
. Avoid the harmful suppression of symptoms.
. Acknowledge, respect and work with the individual’s self-healing process.

Doctor as Teacher

Educate patients in the steps to achieving and maintaining health. The Original meaning of the word 'Doctor' is teacher. Naturopathic physicians educate their patients and encourage self-responsibility for health. They also recognize and employ the therapeutic potential of the doctor-patient relationship.

Treat the Whole Person
Tolle Totum

Health and Disease are conditions of whole organism, a WHOLE involving the complex interaction of many factors. Naturopathic physicians treat each patient by taking into account individual physical, mental, emotional, spiritual, genetic, environmental, social and other factors. This requires a comprehensive approach to Diagnosis and Treatment.


Focus on overall health, wellness and disease prevention. Naturopathic physicians emphasize the prevention of disease — assessing risk factors, heredity and susceptibility to disease and making appropriate interventions in partnership with their patients to prevent illness.

Friday, June 6, 2008

Love is Real Medicine- Dr Dean Ornish's article!

People who survive a heart attack often describe it as a wake-up call. But for a 61 year old executive I met recently, it was much more than that. This man was in the midst of a divorce when he was stricken last spring, and he had fallen out of touch with friends and family members. The Executive’s doctor, unaware of the strife in his life, counseled him to change his diet, start exercising and quit smoking. He also prescribed drugs to lower cholesterol and blood pressure. It was sound advice, but in combing the medical literature, the patient discovered that he needed to do more. Studies suggested that his risk of dying within six months would be four times greater if he remained depressed and lonely. So he joined a support group and reordered his priorities, placing relationships at the top of the list instead of bottom. His health has improved steadily since then, and so has his outlook on life. In fact he now describes his heart attack as the best that ever happened to him. “yes, my arteries are more open”, he says. “but even more important, I am more open”.

Medicine today focuses primarily on drugs and surgery, genes and germs, microbes and molecules. Yet love and intimacy are at the root of what makes us sick and what makes us well. If a new medication had the same impact, failure to prescribe it would be malpractice. Connections with other people affect not only the quality of our lives but also our survival. Study after study find that people who feel lonely are many a times more likely to to get cardiovascular disease than those who have a strong sense of connection and community. I'm not aware of any other factor in medicine- not diet, not exercise, not genetics, not drugs, not surgery- that has a greater impact on our quality of life, incidence of illness and premature death.

In part, this is because people who are lonely are more likely to engage in self-destructive behaviors. Getting through the day becomes more important than living a long life when you have no one else to live for. As one patient told me, “ I have got 20 friends in this pack of cigarettes. They are always for me. You want to take away my 20 friends? What are you going to give me instead?” Other patients take refuge in food, alcohol or drugs: “When I feel lonely, I eat a lot of fat, it coats my nerves and numbs the pain”. But, loneliness is not just a barrier to fitness. Even when you eat right, exercise and avoid smoking, it increases your risk of early death.

Fortunately, love protects your heart in ways that we don’t completely understand. In one study at Yale, men and women who felt the most loved and supported had substantially less blockage in their coronary arteries. Similarly, researchers from Case Western Reserve University studied almost 10000 married men and found that those who answered “yes” to this simple question- “does your wife show you her love?”- had significantly less angina (chest pain). And when researchers at Duke surveyed men and women with heart disease, those who were single and lacked confidants were three times as likely to have died after five years. In all three studies, the protective effects of love were independent of other risk factors.

Awareness is the first step in healing. When we understand the connection between how we live and how long we live, it’s easier to make different choices. Instead of viewing the time we spend with friends and family as luxuries, we can see that these relationships are among the most powerful determinants of our well being and survival. We are hard-wired to help each other. Science is documenting the healing values of love, intimacy, community, compassion, forgiveness, altruism and service-values that are part of almost all spiritual traditions as well as many secular ones. Seen in this context, being unselfish maybe the most self-serving approach to life, for it helps free both the giver and recipient from suffering, disease and premature death. Rediscovering the wisdom of love and compassion may help us survive at a time when an increasingly balkanized world so badly needs it.

· Dr Dean Ornish, a Clinical Professor at the University of California, San Fransisco, is founder and president of the Preventive Medicine Research Institute. His books include “Love and Survival” and “Dr Dean Ornish’s Program for Reversing Heart Disease”. For more information go to or
· Courtesy- Newsweek

Naturopathy Licensing in USA

Guidelines for foreign trained Naturopaths in USA

In the United States, health care practitioners are licensed by the state they practice in; consequently, there is no one set of rules or steps toward licensure that will apply to all state licensing requirements. A requirement common to all licensing jurisdictions is that the applicant must have passed the Naturopathic Physicians Licensing Exam (NPLEX). In order to be eligible to sit for NPLEX, an applicant must document a naturopathic medical education from (or equivalent to that of) the post-graduate degree programs of the approved North American naturopathic medical colleges.

As of May, 2000 no foreign trained practitioner has presented documentation of a naturopathic medical education from an institution outside of the US or Canada which successfully demonstrates academic and clinical courses equivalent to the standards of North American naturopathic medical schools. Therefore, the North American Board of Naturopathic Examiners has not yet approved any foreign trained practitioner to sit for the NPLEX, and no state licensing board has granted a license to practice to any candidate not educated in an approved North American naturopathic medical college.

The following information is provided to assist foreign trained practitioners in beginning their research about licensure requirements. We urge you to be sure to collect and verify all your information directly from officials in the state(s) where you are interested in practicing.
Licensure is dictated by each states' statutes. Most states require the following:

1. The applicant be a graduate of an accredited naturopathic medical school.
2. The medical education should be a four-year post-graduate level program; that is, the equivalent of four, 36-week academic years.
3. The applicant must have passing scores on the Naturopathic Physicians Licensing Exam.
4. The applicant must also have passing scores on any add-on exams particular to that state. For example, Jurisprudence, Acupuncture or Homeopathy may be required.

States that license naturopathic physicians are:
Alaska, Arizona, Connecticut, Florida, Hawaii, Kansas, Maine, Montana, New Hampshire, Oregon, Washington, Utah, and Vermont in addition to Puerto Rico and the U.S. Virgin Islands.

In unlicensed states:
• No statutes regulate or define the profession
• Practitioners cannot use the public designation doctor or physician.
• Practitioners cannot diagnose or prescribe without the risk of being charged with violating the medical practice act, or practicing medicine without a license.

International Credential Evaluation Services:
In preparing documentation to present to a college admissions committee or to a state licensing agency, it is recommended that foreign trained applicants provide professionally translated transcripts to one of these services for evaluation. Untranslated or illegible documentation will not be accepted for evaluation by the agencies below, the state licensing agencies, or any college admissions office.

Academic Credentials Evaluation Institute, Inc.
P.O.Box 6908
Beverly Hills, CA 90212
(310) 559-0578
(310) 204-2842

American Education Research Corporation
P.O.Box 996
West Covins, CA 91793-0996
(818) 339-4404
(818) 339-9081

Educational Credential Evaluators, Inc
P.O. Box 92970
Milwaukee, WI 53202
(414) 289-3400
(414) 289-3411

Foundation for International Services, Inc.
Queen Anne Square, Ste. 503
200 West Mercer St
Seattle, WA 98119-3958
(206) 298-0171
(206) 298-0173

World Education Services, Inc
P.O.Box 745
Old Chelsea Station
New York, NY 10113-0745
(212) 966-6311
(212) 966-6395

NPLEX (Naturopathic Physicians Licensing Examination)

NPLEX is the standard examination used by all licensing jurisdictions for Naturopathic physicians in North America. It includes 5 basic science exams (anatomy, physiology, pathology, biochemistry, microbiology and immunology), which are taken after the first 2 years of medical school. The clinical science examinations are taken following graduation after the 4th year of school. They include: clinical and physical diagnosis, laboratory diagnosis and diagnostic imaging, botanical medicine, pharmacology, nutrition, physical medicine, homeopathy, minor surgery, psychology and lifestyle counseling, and emergency medicine. Individual jurisdictions may give additional examinations in jurisprudence and acupuncture.

NPLEX has announced the creation of a new organization: the North American Board of Naturopathic Examiners (NABNE). NPLEX will retain its role as the producer of a transnational board licensing examination; the NPLEX Board has been restructured so that exam development will be its sole focus. The NABNE will take on the role of gathering input from the various constituencies involved in the profession (jurisdictions, schools, associations, etc.). In addition, the NABNE will begin two new functions. First the NABNE will be the point of application for students and candidates who want to take the NPLEX. NABNE will review credentials to make certain that applicants meet the criteria for examination. Second, the NABNE will set up testing centers in the U.S. and Canada for administration of the exams. The impetus for creating the NABNE stems primarily from the desire to maintain high standards within the profession. The first function (approving candidates to sit for the exams) will ensure that the NPLEX exams are taken only by candidates who have been appropriately trained at accredited naturopathic medical colleges. The second function (administering the NPLEX exams) will ensure that the exams are administered without bias and are kept secure. The NABNE Board will be responsive to the input of an advisory committee comprised of appointees from the jurisdictions, the schools, the Council on Naturopathic Medical Education (CNME), the Federation of Naturopathic Physicians Licensing Authorities (FNPLA), and the national associations, as well as several public members. Input from the Advisory Committee will be critical for setting examining standards and for coordinating the effort. As currently proposed, applicants will apply to the NABNE to take the NPLEX Basic Science Exams. The NABNE will ensure that the applicant meets the standards set with input from the Advisory Committee and if everything is complete, will send exam booklets to the exam administration site of choice for that applicant. The NABNE will arrange all examination sites and proctors. NPLEX will score the exams, and NABNE will send score reports directly to the examinees.

Licensing Boards need no longer be involved with the approval or administration process for the Basic Science Exams. At graduation from an approved school, eligible candidates will again apply to the NABNE to be approved to take the Clinical exams; the NABNE will send exam booklets to the candidate's exam site of choice (again arranged and proctored by the NABNE). NPLEX will score the exams, NABNE will send score reports directly to the candidates, and will then send transcripts of the candidate's Basic Science and Clinical exam scores to the jurisdiction where the candidate wants to be licensed.

Please note, the NABNE is NOT a licensing board, the jurisdictions still hold all authority for investigating the credentials of and approving candidates for licensure. The NABNE is an examining board, responsible only for the examination process. This is similar to the model followed in many other health care professions including the National Board of Medical Examiners and the National Board of Chiropractic Examiners where applicants apply to a central agency for examination. We see it as a very positive step both to reduce confusion among applicants regarding where they should apply to take the NPLEX, and to reduce work by the jurisdictions in terms of time that will no longer be spent in approving the applicants to sit for, and administering the exams.

Contact Information for CNME:

Daniel Seitz, J.D., M.A.T.
Executive Director
Council on Naturopathic Medical Education
P.O. Box 178Great Barrington,
MA 01230
Tel.: 413-528-8877
Fax: 413-528-8880

A candidate should contact individual licensing/regulatory authorities for the most up-to-date and accurate information regarding their specific requirements for licensure/registration.

AlaskaDivision of Corporations, Bus. & Prof. Licensing Naturopathic Section
P.O. Box 110806
Juneau AK 99811-0806
Phone: 907-465-2695Fax: 907-465-2974

David Richmond, N.D.
Alberta Association of Naturopathic Physicians
P.O. Box 21142 665 - 8th Street,
S.W. Calgary AB T2P 4H5
Phone: 403-266-2446 Fax: 780-459-5621

Gail Anthony
NPBoMEx 1400 West Washington,
Suite 230 Phoenix AZ 85007
Phone: 602-542-8242Fax: 602-542-3093

British ColumbiaDebbie Ferreira
CNPBC 1698 W. 6th Ave.
Vancouver BC V6J 1R3
Phone: 604-688-8236Fax: 604-688-8476

Bureau of Naturopathic Medicine
1625 North Market Blvd., Suite S-209
Sacramento CA 95834
Phone: 916-574- 7991 Fax: 916-574-8645

Connecticut Department of Public Health Practitioner Licensing and Investigations Section Physician Licensure - Naturopathic
410 Capitol Avenue MS #12
APPHartford CT 06134-0308
Phone: 860-509-8377Fax: 860-509-8457

District of ColumbiaDepartment of Health
Health Professional Licensing Administration
Naturopathic Registration
717 14th Street, N.W. Suite 600
Washington DC 20005
Phone: 877-672-2174Fax: 202-727-8471

Naturopathic Licensing Board
P.O. Box 3469
Honolulu HI 96801
Phone: 808-586-3000Fax: 808-586-1345

IdahoIdaho State Board of Naturopathic Medical Examiners
Bureau of Occupational Licenses
1109 Main Street, Suite 220Boise
ID 83702-5642
Phone: 208-334-3233Fax: 208-334-3945

KansasKaty Lenahan, Licensing Administrator
Kansas Board of Healing Arts235 S.
Topeka BoulevardTopeka KS 66603
Phone: 785-296-8563Fax: 785-296-0852

Jeri BettsDept. of Prof. & Fin. Reg.,
Off. of Licensing & Reg.Board of Complementary Health Care Providers
#35 State House Station
Augusta ME 04333
Phone: 207-624-8603Fax: 207-624-8637

Dr. Deidre Jasper, N.D.
Manitoba Naturopathic Association
P.O. Box 2339 Station MainWinnipeg,
Manitoba R3C 4A6
Phone: 204-947-0381

Cheryl Brandt
Board of Alternative Health Care
P.O. Box 200513
Helena MT 59620-0513
Phone: 406-841-2394 Fax: 406-841-2305

New Hampshire
Connie Beliveau
NH DHHS Office of Program Support
Board of Naturopathic Examiners
129 Pleasant Street, Brown Building
Concord NH 03301-3857
Phone: 603-271-0853Fax: 603-271-5590

Lyle Clark
BDDT - Naturopathy
112 Adelaide St.,
EastToronto ON M5C 1K9
Phone: 416-866-8383 Fax: 416-866-2175

Anne Walsh
Oregon Board of Naturopathic Examiners
800 N.E. Oregon Street, Suite 407
Portland OR 97232
Phone: 971-673-0193Fax: 971-673-0226

Puerto Rico
Dra. Milva Vega Garcia
Junta Examinadora Doctores in Naturopatiac/o Sonia Maysonet Cotto
Call Box 10200
San Juan PR 00908
Phone: 787-725-4904E-
Email: or

Wendy Present-Jahn, N.D.
Saskatchewan Assoc. of Naturopathic Physicians
82 Markwell Dr. Regina SK S4X 1K3
Phone: 306-543-4880

UtahDiana Baker
Div. of Occupational & Professional Licensing
160 East 300 South
P.O. Box 146741
Salt Lake City UT 84114-6741
Phone: 801-530-6179Fax: 801-530-6511

Loris Rollins
VT Office of Professional Regulation
National Life Building, North, FL2
Montpelier VT 05620-3402
Phone: 802-828-2191Fax: 802-828-2465E-

Susan GraggWA DOH - Naturopathy Program
P.O. Box 47866 Olympia WA 98504-7866
Phone: 360-236-4941Fax: 360-236-2406

Options to consider:

1. The recommended route is to apply to one of the accredited naturopathic medical colleges as an advanced standing student, and transfer applicable academic credits from your previous education. An admissions committee will determine the specific program requirements (meaning academic courses and/or clinical preceptor-ship) needed in order to be granted the naturopathic medical degree from that institution. The details of such a program must be crafted to satisfy the criteria for the college degree, the NPLEX and the state board exam requirements. Proficiency in English medical/scientific terminology is essential. There is no other route that will guarantee your application for licensure will be favorably considered.

2. Document your education, supplying for instance very specific and complete course content descriptions, faculty credentials and academic credit hour equivalents, and submit these with a request for consideration as an applicant to the North American Board of Naturopathic Examiners. That credentialing body will then evaluate your documentation and if it is determined to represent an equivalent education, allow you to sit for the NPLEX. If you pass the NPLEX, any state you apply to for licensure will also evaluate your documentation in a separate process, in order to determine eligibility for licensure in that jurisdiction. This is a lengthy and individualized process, which no foreign trained practitioner has, as of May 2000, successfully completed. North American Council on Naturopathic Medical Education (CNME) trains primary care physicians, and the course content and length of study in programs outside the US and Canada tend not to be sufficiently similar.

3. Forego licensure and simply affiliate with a licensed physician, practicing under his/her supervision.

* Source-
1. American Association of Naturopathic Physicians, Washington, DC.
2. North American Board of Naturopathic Examiners, Portland, Oregan
3. Council on Naturopathic Medical Education, Canada