Nov 19, 2009
Homeopathy really doesn’t work
A couple of years ago, I re-posted an old article of mine about homeopathy discussing its ludicrous claims, its feeble attempts to provide a scientific explanation for those claims, and basically pointing out that no solid evidence has ever been found that infinitely diluted solutions of spurious ingredients have any more beneficial effect on a patient than a glass of fresh water.
The post got a very late critique from someone in the homeopathy “industry”, so I took each of their points and updated my original post, making it even more robust than it had originally been. Incidentally, that first draft was written originally for a medical magazine and had been checked over by a homeopath and a general practitioner, so it’s not that it hadn’t been in half decent shape to begin with.
One of the big claims that homeopaths make is that there is lots of positive evidence for what they do and that anyone who says there isn’t is being economical with the truth. Well, there are a few clinical trials, that demonstrate something-ish, but lots more that say a very lot about how homeopathy really doesn’t work.
Cochrane Reviews, NHS Choices, etc are great starting points for looking at clinical trials:
Homeopathy for dementia – Summary: “No evidence that homeopathy is effective in treating dementia”.
Homeopathy for ADHD – Conclusion: Overall the results of this review found no evidence of effectiveness for homeopathy for the global symptoms, core symptoms or related outcomes of attention deficit/hyperactivity disorder.
Homeopathy for headache? – Results: There is insufficient evidence to support or refute the use of homeopathy for managing headache; studies published to date are flawed.
Homeopathic medicines for adverse effects of cancer treatments – Conclusion: There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments.
Homeopathy in allergies and respiratory conditions – Conclusion: There is insufficient evidence to judge whether or not homeopathy is useful in the treatment of allergic, ENT and respiratory conditions.
Quackwatch has an interesting summary of homeopathy in which the author points out that homeopathic products “are the only category of quack products legally marketable as drugs.” But, Bandolier has the best comment:
Even ardent proponents of homeopathy who have performed a critical overview conclude that homeopathy ‘should not be substituted for proven therapies’.
This quote is based on a citation of Jonas et al in Annals of Internal Medicine in their critical review of homeopathy in which they state – “There is a lack of conclusive evidence on the effectiveness of homeopathy for most conditions.”
Proponents claim that homeopathy works. They claim that the repeated dilution (effectively infinite dilution to the point where not a single molecule of the original tincture is present in the solution) of an agent that causes particular symptoms will yield a treatment for similar symptoms presented by a patient with some condition or other.
Of course, they also argue that a homeopath does much more than a conventional physician in assessing “holistically” the patient’s state of physical and mental health…but then that suggests that the remedy hinges on bedside manner rather than a physical effect and doesn’t that then imply that the billion-dollar homeopathic over-the-counter remedies won’t work because the patient doesn’t get the pep talk from the practitioner? Anyway, if I were a GP I’d be wholly insulted that I was being accused of not taking care of my patients, just because scientifically it makes more sense to focus…
The homeopathy debate is almost totally one sided, any rational assessment can show that homeopathy is nothing more than quackery. Similar debates surround arguments about other forms of superstition, including the existence of ghosts, ghouls, fairies at the bottom of the garden, perpetual motion machines, and countless other medical panaceas.
Clinical trials have been done, they are generally weak, poorly designed, and when assessed en masse reveal little more than statistical deviations even in those claimed to be the most extensive and strong.
Respectful Insolence recently deconstructed FASEB Journal’s homeopathic deconstruction.
In addition, Bandolier provides a nice summary of homeopathic evidence: “Until large and well conducted randomised trials tell us differently, the conclusion is that homeopathy does not work, and its use instead of remedies of proven effectiveness is not a matter of trivial implication. Members of the public are relieved of much money each year by homeopaths. There’s little evidence they are relieved of any suffering.”
By the way, despite the existence of dozens of homeopathic clinics in Africa, the World Health Organisation (WHO) specifically states that it: “DOES NOT recommend the use of homeopathy for treating HIV, TB, malaria, influenza and infant diarrhoea”.
Jonas WB, Kaptchuk TJ, & Linde K (2003). A critical overview of homeopathy. Annals of internal medicine, 138 (5), 393-9 PMID: 12614092
Baum, M., & Ernst, E. (2009). Should We Maintain an Open Mind about Homeopathy? The American Journal of Medicine, 122 (11), 973-974 DOI: 10.1016/j.amjmed.2009.03.038:
It is considered unethical for modern medical practitioners to sink to this kind of deception that denies the patient his or her autonomy. Secondly, by opening the door to irrational medicine alongside evidence-based medicine, we are poisoning the minds of the public. Finally, if we don’t put a brake on the increasing self-confidence of the homeopathic establishment, they will cease to limit their attention to self-limiting or nonspecific maladies.
I expect this post will get a lot of irrational comments, I don’t intend to enter into personal correspondence, but would hope that readers could discuss the issues here. Should we maintain an open mind about homeopathy? I don’ think so, open your mind too much and your brains are likely to trickle out one homeopathic drip at a time.
>have you seen how much these guys charge just so you can take a sugar pill?
The price/value is another problem – and not only for HP.
but if you are interested see – Boiron Net profit margin.
http://www.google.com/finance?q=EPA:BOI
—————
but my honest opinion – that ethicaly acceptable to use HP
– for example – in case of pregnant women ..
because:
– safety, no alternatives, ( sometimes patient preference )
see acupuncture treatment example :
“Ethical principles of enhancing placebo effects in clinical care”
http://press.thelancet.com/placebo.pdf
“Can a recommendation for a treatment intended to
promote the placebo effect be made without deception
and also without undermining its therapeutic potential?
Consider, for example, the case of a clinician who
recommends acupuncture treatment for a patient with
chronic low back pain who has not been helped by
standard medical therapy. Aware of the results of the
recent acupuncture trials, this clinician thinks that
acupuncture might work by promoting a placebo
response. The clinician might provide the following
disclosure to the patient: “I recommend that you try
acupuncture. Several large studies have shown that
traditional acupuncture is not better than fake
acupuncture treatment, but that both of these produce
substantially greater symptom improvement in patients
with chronic low back pain compared with those
patients who receive no treatment or conventional
medical therapy. Although the specific type of needling
does not seem to make any difference, it is possible that
acupuncture works by a psychological mechanism that
promotes self-healing, known as the placebo effect”. At
face value, this disclosure seems honest. A patient who
received this disclosure and subsequently got better
after undergoing acupuncture might nonetheless
develop a false belief about why it worked. This does
not mean, however, that the patient has been deceived
by his or her clinician.”
——————–
I beleive in integrating of conventional and holistic care tends.
and all HP doctors should have education in conventional medicine.
———————
so IMHO – HP medicine – is not BS .
- and it promotes self-healing ….
see: http://www.google.com/search?q=critics+evidence+based+medicine
Yes, yes, placebo blah, blah, blah…have you seen how much these guys charge just so you can take a sugar pill?
>But, homeopathy is 100% BS (no dilution).
The problem is not so simple ..
- see : “placebo paradox”, – it may be unethical to use a placebo, but also unethical “not to use something that heals”
- placebo effect – is normal – and not problem ..
see:
Biological, clinical, and ethical advances of placebo effects
Damien G Finniss, Ted J Kaptchuk, Franklin Miller, Fabrizio Benedetti
http://press.thelancet.com/placebo.pdf
”
Laboratory evidence supports the existence of several
placebo mechanisms and placebo effects in both healthy
volunteers and patients with a variety of medical
conditions. Furthermore, clinically relevant evidence
shows that placebo effects can have meaningful
therapeutic effects, because of their long magnitude
and duration, in different patient populations. Although
substantial progress has been made in understanding
placebo effects, much laboratory and translational
clinical trial research remains to be done, with the
ultimate aim of harnessing placebo effects to improve
patient care.”
-So what can Clinical Evidence tell us about the state of our current knowledge?
11% Benefical
23% Likely to be benefical
7% Trade-off between benefits and harms
5% Unlikely to be beenfical
3% Likely to be ineffective or harmful
51% Unknown effectiveness
http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp
———
and if you are interested in CAM – you have to see :
http://ecam.oxfordjournals.org/cgi/search?fulltext=homeopathy&x=0&y=0
http://ecam.oxfordjournals.org/cgi/content/full/3/3/293
———–
I beleive in “evidence hierarchy,” [ safety, effectiveness, strength of evidence, alternatives, and patient preference. ]
“The real difference between conventional and holistic care tends to be less about evidence, and more about priorities. In holistic care, the priority is relief of symptoms whether or not there is a known disease to treat. That is a laudable principle. So, too, is respect for scientific evidence”
http://www.davidkatzmd.com/admin/archives/Holistic%20Care.Times.10-28-07.doc
——–
I’m sorry Rajiv, but just because something has been around for a long time doesn’t make it right, think: trepanning, blood letting, humours, chi, chakras…all BS. But, homeopathy has not been around that long anyway, just a couple of centuries. I have not discounted other allopathic approaches entirely, given that 40% of scrip medicines have a herbal origin, how could I? But, homeopathy is 100% BS (no dilution).
Hi David,
I have been going through your posts and I observed that you were typically picking on Homeopathy but not giving any other alternative as to which form of medicine we should rely on. I am still not convinced. Please tell me what type of medicine do you support.
I guess you should respect all forms of medicines. It wouldn’t have been existing for so long if it was all BS.
Now let me tell you about my experiences. My cousin is diabetic and he tried all conventional medicines but it didnt help. He became thinner and weaker everyday. To let you know his bigger brother and sister in law are also doctors. But nothing actually helped him until he went to a homeopath. It helped him regain his health with a good control over his sugars. Call it placebo or whatever.
My nephew(my brother’s son) who is 5 has never ever been to a doctor or hospital since his birth but all my 3 sister’s son’s and daughters frequent hospitals even though they use conventional medicines(allopathy). We have been using “diluted” medicines of homeopathy which I guess works very well. Call it placebo or whatever.
I had an acute throat infection and had consulted one of my friend who is a doctor. He gave me 6-7 different medicines (one strong Antibiotic, one he said was for stomach, one was paracetamol of anti allergen,a gurgling solution-others i forgot). It did fine and cost me 300 bucks. It came back again after 1-2 months. This time he suggested a stronger antibiotic. I was about to get the medicines when my father suggested I should try homeopathy. Then after a 30 bucks diluted syrup the infection went away in 3-5 days. Miracle!! Isnt it. All thanks to Placebo.
See I don’t say it is the best or you should discard allopathy or other forms of medicine. But you should learn to appreciate and choose wisely from these different types of medicines.
To the core I was also anti-homeopathic, but in time I have learnt to respect it. You cannot prove its effectiveness through science but it is effective. I have seen cases of severe skin infections and disorder cured by homeopathy which allopathic medicines couldn’t do. Talk to those patients who tried all forms of tests and medicines and have visited almost all reputed skin clinics and couldn’t find a cure but was cured by homeopathy and enlighten them with your science theory and see what reaction you get.
To be honest ill also talk about some failures I saw as well. My sister is asthmatic and my father and his homeopath friend tried all possible treatment but couldnt cure her attacks. We had to finally turn to allopathy for her relief. This is what we should do.
Rather than blabbing about what we can prove or what we cannot, we should discuss what type of medicine is effective on which kind of diseases and share our good experiences. Everyone has a right to choose.
It should not be about believing in it religiously but believing by experience.
Regards