Nov 19, 2009

Homeopathy really doesn’t work

Posted in Science at 1:00 pm by David Bradley

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.