Some herbal preparations can be quite toxic, and excessive fasting or use of enemas can upset the body's balance of fluid and minerals, leading to potentially dangerous consequences such as irregular heartbeat. The greatest hazard, however, is that using naturopathic therapies without any conventional advice could allow a serious medical condition to go undiagnosed and unchecked. Such practitioners have completed four years of graduate-level training at a naturopathic medical college. In the 11 states where they are currently licensed, naturopathic physicians must pass either a national or state-level board examination. Their scope of allowable practice varies from state to state, but generally conforms to their training in the types of therapies described above.
Some states also grant certification in specialties such as natural childbirth or acupuncture.
They are also fond of pointing out that the naturopathic curriculum actually offers more hours of basic biological science than do leading medical schools such as Johns Hopkins and Stanford. According to mainstream MDs, such claims can be misleading. They charge that, despite the use of scientific-sounding terminology, most naturopathic research consists largely of isolated case studies and untested theories. Given the broad range of therapies under the umbrella of naturopathy, no general guideline applies. Dietary modifications to reduce the risk of chronic disease or control food allergies, for example, may need many months to make a significant difference, whereas therapy for an acute condition such as an infection or minor injury should reasonably be expected to produce much faster results.