Homeopathic remedies

Claims, Benefits: A kinder and gentler alternative to modern high-tech medicine. Whatever causes disease can also cure it, though all it takes is extremely diluted doses.

Bottom Line: There is no solid scientific evidence that homeopathy works—and no plausible reason to think that it could work.

Full Article, Wellness Letter, February 2006:

Distilling the Truth About Homeopathy

In the 10 years since the Wellness Letter last looked at homeopathy, this form of alternative medicine has become more popular—and more controversial—than ever. Its supporters say homeopathy plays a unique role in the treatment of virtually all diseases, and they often accuse M.D.s of closed-mindedness and greed. Mainstream medicine looks at homeopathy as nonscientific nonsense—if not an outright scam. Just about every year studies on homeopathy appear, and headlines announcing proof that it works alternate with those sounding its death knell. What do we really know about homeopathy?

Claims and principles

Homeopathy (from the Greek homeo, meaning similar, and pathos, meaning suffering) was developed two hundred years ago by Samuel Hahnemann, a German physician who believed that whatever caused disease would also cure it: “like cures like.” For example, his theory was that since cinchona bark (which contains quinine, a known treatment for malaria) produces the symptoms of malaria in a healthy person, quinine in minuscule doses will cure malaria. Homeopathy was an alternative to the harsh “cures” of those days, such as blistering, purging, and bloodletting. In that era, when most doctoring did little or no good, it’s not hard to see why many people turned to homeopathy.

A second homeopathic principle is that an illness is specific to an individual. The choice of remedy is based not only on the symptoms, but also on the patient’s emotional state, lifestyle, and other factors. Thus, two people with the same ailment may well receive different treatments.

Another principle—the hardest for scientific medicine to swallow—is that the more a remedy is diluted, the more potent it is. Homeopathic solutions typically are diluted at least one million times: one molecule of “remedy” to more than one million, or even billion, water molecules. The preparations are produced via serial dilution—a solution is diluted 10 times, and then one part is taken and the process repeated again and again. Some remedies are diluted to such unimaginable degrees as one molecule of “medicine” to 10-60 molecules of water (that’s a 1 followed by 60 zeroes, equal to an ocean of water). The original substance would, in effect, disappear. These mixtures are supposed to be vigorously shaken (“succussed”) in a prescribed manner in order to activate them.

Homeopaths claim that even when the substance is reduced to only one molecule, or lost altogether, its “pattern” or “vital essence” remains in the liquid (or sometimes tablets) and can produce an effect. Of course, the notion that a single molecule, let alone the “memory” of a molecule, could have any effect flies in the face of science as well as common sense.

The rise and fall and rise of homeopathy

Homeopathy flourished in the nineteenth century, but by around 1900 it was largely displaced by medical practice founded on recent scientific advances (notably Pasteur’s germ theory, the development of antiseptic techniques, and the discovery of ether anesthesia) and clinical training. Homeopathy never died out, however, especially in France, Germany, and England. Many French medical doctors include some form of homeopathy in their practice, and some British physicians refer patients to homeopaths (perhaps influenced by members of the royal family who believe in homeopathy). In India, Mexico, and some other countries homeopathy is part of the national health-care system.

Crucial for the future of homeopathy in the U.S., in 1938 the Pure Food and Drug Act (written in part by a Senator who was also a homeopath) specifically exempted homeopathic remedies from meeting the “safe and effective” requirements of the Food and Drug Administration.

The current revival

In the 1970s homeopathy started to thrive again in the U.S., and today there are thousands of practitioners here. Often they are naturopaths, chiropractors, or acupuncturists. Though there are voluntary certification programs, nearly anybody can set up shop as a homeopath—in many states all you need to take is a short course. Arizona, Connecticut, and Nevada license medical doctors for homeopathy, but only a few hundred American M.D.s practice homeopathy. Most often, though, people take homeopathic products on their own, or on the advice of a salesperson in a store, without consulting a practitioner.

Some people are attracted to homeopathy because they see it as a kinder and gentler alternative to modern high-tech medicine. Its preparations are not painful or frightening, are invariably labeled “natural,” and are unlikely to have side effects because they are so extremely diluted. Its practitioners tend to spend a lot of time talking to patients, and claim to treat the person, not the disease. What could be wrong with all that? The fact remains, there is no solid scientific evidence that homeopathy works—and no plausible reason to think that it could work.

Diluting the evidence?

In recent years various homeopathic remedies for conditions such as allergies, migraines, colds, and diarrhea have undergone clinical trials, some claiming positive results. Often these studies were published with great hoopla and then inevitably torn apart by other researchers for good reason (poor study design, small number of subjects, subjective outcomes, and/or results that could not be replicated). Most studies, in fact, have had negative results. There have been no published controlled studies on homeopathic treatments for chronic diseases such as cancer, hypertension, or diabetes.

Several reviews of the overall research on homeopathy have concluded that few studies were well designed. Recently a review in the Lancet concluded that of 110 placebo-controlled studies, the large well-designed trials almost always found that homeopathy worked no better than a placebo. That is, when subjects benefited, it was because of the placebo effect.

The National Center for Complementary and Alternative Medicine says that “the results of individual, controlled clinical trials of homeopathy have been contradictory . . . systematic reviews have not found homeopathy to be a definitively proven treatment for any medical condition.”

Some proponents claim that modern scientific methods can’t explain or evaluate homeopathy. We believe, however, that all treatments should be supported by science-based evidence.

Words to the wise

If you have a chronic disorder and your doctor can’t help you, you can hardly be blamed for seeking alternatives. But stop and think. Are you certain of your diagnosis? Have you sought a second or even third opinion?

We don’t recommend consulting a homeopath or buying homeopathic remedies. But if you do, keep these points in mind:

• Except for the ghostly molecules, homeopathic products may contain nothing more than water or alcohol. Thus they are unlikely to harm you. The FDA has rules about the labeling of homeopathic products, but you really can’t be sure what’s in the bottle.

• Though this goes against a basic principle of homeopathy and is probably rare, some products labeled “homeopathic” are only slightly diluted and thus do contain significant amounts of active ingredients. In that case, there certainly could be side effects. For instance, the FDA has received reports that the cold remedy Zicam, a popular homeopathic nasal gel, contains enough zinc gluconate to cause loss of smell. And there have been documented cases of serious adverse effects caused by inadequately diluted solutions of dangerous chemicals such as arsenic.

• If you take a homeopathic remedy for a cold, headache, or other minor problem, it may make you feel better—most likely because of the placebo effect or simply because the ailment has run its course.

• Do not take homeopathic remedies instead of proven medical treatments, such as drugs to control cholesterol or blood sugar.

• A homeopathic practitioner will almost certainly sell you remedies. The treatment may go on indefinitely, and the costs can add up.

UC Berkeley Wellness Letter, February 2006