Before I get to the meat of this article… Hi, I’m Dr. Rachael O’Connell, your intrepid writer! I’m a naturopathic doctor, licensed in Oregon, registered in Pennsylvania, and working in the unlicensed state of Ohio! My husband and I moved here from Oregon in 2024 so I could bring my skills, expertise, and compassionate natural healthcare to this region! On Sunday, January 4th, 2026, I got to meet and talk to an amazing host of lovely community members and fellow natural health and wellness providers. So, since there’s some new subscribers, I thought this was all worth mentioning!

Many people ask me, “so, what do you do?” And in a nutshell, I help people improve their health and lives through focusing on the foundations of what makes humans healthier longterm. This is somewhat difficult to define, but if you read on, the therapeutic order of naturopathic medicine is a helpful philosophy for understanding exactly how we NDs can help. So, check out the graphic, and then read below the examples of how this can be applied.

For this example, I’m going to choose one of the most common conditions I help people with, type 2 diabetes or insulin resistance. For the correct order of operations, we start from the bottom of this pyramid in the diagram above.

1. Determinants of Health: Establish the foundation for optimum health. With this, we need foundations, as it says! This includes the basics of whole-food nutrition, great sleep hygiene for good restoration, daily movement based on ability, plenty of clean water for hydration, a community, spiritual, or religious practice to connect and restore personal significance and connection, occupying green spaces like parks or forests, and a stress relief practice such as meditation, prayer, or talking with a friend or taking care of a pet.
2. Stimulate Self-Healing. This can take many forms, and it can be more condition specific. For insulin resistance, we need the gut, stomach, pancreas, liver, and gallbladder to work better. Extended fasting is an excellent way to stimulate self-healing through autophagy, which means “self-eating” where the cells of the whole body start to delete all the broken, damaged cells, and get rid of metabolic waste, give the digestive system a big rest, and make new, better, healthier cells, including those of all of the organs mentioned above. By removing food (not water, please drink water with salt when fasting), the body is stimulated to renew!
3. Aid Damaged Organs: Support and restore weakened systems. With metabolic diseases, digestion can be a major problem, and the pancreas and gallbladder have to do their part to help with good digestion and nutrient absorption. We can add something simple like a digestive support supplement that increases stomach acid, bile flow, and enzyme activity, such as my favorite, Protocol for Life Balance brand’s Enzymes HCL.
4. Restore Structural Integrity in the Body: Address physical alignment. This is where massage therapy, chiropractic, Chinese medicine and acupuncture, and physical therapy shine. Visceral massage and/or Rolfing can help with digestive issues through hands-on manipulation of the soft tissues in the gut, stomach, ribcage, and supporting structures, so that digestion is more comfortable and fluid. Yoga can also be a wonderful addition to get more lymphatic flow and blood circulation, which help with waste removal and hormone balance. These therapies reduce stress too, which helps tremendously in blood sugar response.
5. Natural Symptom Relief. This is fairly self-explanatory. I often see sleep disturbance in insulin resistance and, while this supplement does help with the symptom of sleep disturbance, it is also healing and restorative metabolically. Glycine, an amino acid, which comes from natural protein, is a super safe supplement that I give for helping with sleep onset, but it reduces the need to urinate in the night, which is common in insulin resistance and diabetes. A helpful herb called Berberine can help to recalibrate the gut bacteria and bring blood sugar into a more normal range, but without severe side effects seen in pharmaceuticals like Metformin.
6. Synthetic Symptom Relief. This is where we get more suppressing and exit the natural realm, but medications can be used as good tools as needed, for the shortest time needed, at the lowest effective dose, to aid in the outcome. Metformin is a good example of a medication that can bring blood sugar into a more normal range, but it is a prescription that needs monitoring by a prescriber and it comes with side effects like diarrhea. However, this medication is one of the safer ones, with a long track record, so it’s a good example for our purposes here.
7. High Force Interventions: Suppress pathology. This can include pharmaceutical prescriptions, surgeries, and chemotherapies, and it is the last resort, but it can be necessary to preserve life in certain instances. In diabetes management (rather than reversal), providers will start with meds that lower blood sugar by increasing pancreatic insulin output, without changing the diet. This causes a new problem where the pancreatic cells that make insulin can burn out, leading to the addition of insulin injections. When this is ongoing for a long period of time, many complications occur because of the over-reliance on insulin. Long story short, These interventions help, but should not be a replacement for everything that comes before it.

With that, hopefully you see where naturopathic therapeutic order changes the game in how we work with common health conditions. If you have more questions about how I can help you or a loved one with a chronic health condition, please go to my contact page to set up an appointment for a free 15 min phone consultation to see if we’re a good fit!

As always, this article is for information purposes only and not a replacement for a doctor-patient relationship. If you are having a medical emergency, please go to the nearest emergency department or dial 9-1-1. Please consult your physician before changing anything about your nutrition or lifestyle and before starting any new supplement. Thanks!