Since we last wrote about homeopathy a decade ago, this form of alternative medicine has become more popular than ever—but no less controversial. Originally, homeopathy was based primarily on formulations created and prescribed for an individual. Today, homeopathy is a multi-billion-dollar mass-market business. Its products are widely advertised and sold over the counter in drugstores, often sitting alongside regular medicines, and are also marketed online.
Supporters of homeopathy say it can help treat virtually all diseases, and they often accuse physicians of closed-mindedness and fear of competition. Mainstream medicine looks at homeopathy as nonscientific nonsense, if not an outright scam. Earlier this year the FDA held a public hearing about homeopathic remedies as part of a re-evaluation of its regulation (or rather lack thereof) in light of the booming marketplace for these products and safety concerns. What do we really know about homeopathy?
Homeopathy claims and principles
Homeopathy was developed at the end of the 18th century by Samuel Hahnemann, a German physician who believed that whatever caused disease could also, in infinitesimal doses, cure it: “like cures like.” 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 people turned to homeopathy, says John Swartzberg, MD, chair of the editorial board of BerkeleyWellness.com and the University of California, Berkeley Wellness Letter.
A second traditional 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 receive different treatments.
Another principle is that the more a remedy is diluted, the greater its potency. Homeopathic solutions typically are diluted at least one billion times: one molecule of “remedy” (substances from plants, minerals, or animals) to more than one billion water molecules. The preparations are produced via serial dilution—a solution is diluted by a factor of 10, and then one part is taken and the process repeated again and again—and are labeled as 12X or 24X, for instance, to represent the number of dilutions.
Many preparations are diluted to such unimaginable degrees as one molecule of “medicine” in 1060or even 10400molecules of water (that’s a 1 followed by 400 zeroes), the dilution of Oscillococcinum, a widely marketed “treatment” for flu. The original substances, in effect, disappear in an ocean of water. These mixtures are supposed to be vigorously shaken (“succussed”) in a prescribed manner to potentiate them.
Homeopaths claim that even when the substance is reduced to only one molecule or is lost altogether, its “pattern” or “vital essence” remains in the liquid (or sometimes tablets, ointments, or sugar pellets placed under the tongue) 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 and common sense.
Is It Really Homeopathic?
An increasing number of products labeled homeopathic today are only slightly diluted—which means they could cause side effects or interact with drugs.
Homeopathy: a history
Homeopathy flourished in the nineteenth century, but by around 1900 it was largely displaced by medical practice based on scientific advances such as the germ theory of disease, the development of antiseptic techniques, and the discovery of ether anesthesia. Homeopathy never died out, however, especially in France, Germany, England, and the Netherlands. Many French and British physicians, for instance, include some form of homeopathy in their practice or refer patients to homeopaths. (The British may be influenced by members of the royal family who believe in homeopathy.) Homeopathy is part of the national health care system in some other countries as well.
Here in the United States, in 1938 the Federal Food, Drug, and Cosmetic Act—written in part by a senator who was a homeopath—recognized homeopathic products in the Homeopathic Pharmacopeia as drugs. But most important, the Act exempted the products from the FDA’s “safe and effective” requirements for conventional drugs. This allows homeopathic products to make explicit claims about treating diseases, which dietary supplements may not do. However, only homeopathic products for self-limiting health problems like colds, headaches, or tinnitus, which go away on their own, can be sold over the counter. The small percentage of products claiming to treat serious diseases such as cancer are available only by prescription.
In the 1970s homeopathy started to thrive again in the US, 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 you need only take a short course. Most people, however, use 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 invariably labeled “natural” and are unlikely to have side effects because most are so extremely diluted. Its practitioners tend to spend a lot of time talking to patients and claim to treat the whole person, not just 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,” says Dr. Swartzberg.
Diluting the evidence
During the past two decades various homeopathic remedies for conditions such as allergies, migraines, colds, and diarrhea have been tested in clinical trials. Almost all of the better-designed studies have found that the products work no better than a placebo. In contrast, studies that claim to find benefits tend to be flawed—poorly designed, with a small number of subjects, no comparison group, and subjective outcomes. There have been no published controlled studies on homeopathic treatments for chronic diseases such as cancer, hypertension, or diabetes.
Recently the Australian government’s National Health and Medical Research Council undertook a comprehensive assessment of 176 controlled studies and 57 systematic reviews. It concluded that “there are no health conditions for which there is reliable evidence that homeopathy is effective.”
Even the National Center for Complementary and Integrative Health (part of the National Institutes of Health), which generally supports alternative therapies, says that “there is little evidence to support homeopathy as an effective treatment for any specific condition” and that “several key concepts of homeopathy are inconsistent with fundamental concepts of chemistry and physics.”
Some proponents claim that modern scientific methods can’t explain or evaluate homeopathy. We believe, however, that treatments should be supported by science-based evidence.
Our advice on homeopathy
We don’t recommend homeopathic remedies. If you’re considering taking a homeopathic product, keep these points in mind:
- If you take a homeopathic remedy for a cold, headache, or other minor problem, it may make you feel better because of a placebo effect or simply because the ailment has run its course. The placebo effect occurs when belief in a remedy or in the power of a trusted practitioner actually helps the remedy work and triggers an improvement in symptoms and health, even if the treatment is a dummy pill or sham procedure.
- Don’t take homeopathic remedies in place of proven medical treatments. The biggest risk is that treatment with such products can keep people from getting the medical care they need. Unfortunately, some homeopathic purveyors encourage this by making spurious claims about the ineffectiveness and dangers of medical treatments.
- Don’t fall for claims that “homeopathic immunizations” (also called nosodes) can take the place of standard vaccinations. This is dangerous quackery.
- Many homeopathic products contain nothing more than water or alcohol, so they are very unlikely to harm you. Still, you really can’t be sure what’s in the bottle. For instance, in recent years the FDA has warned about dangers posed by dozens of homeopathic products, either because they contain toxic or allergenic substances or because they can prevent or delay proven treatments. A British systematic review of case reports involving homeopathy over two decades, published in the International Journal of Clinical Practice in 2012, identified more than 1,100 patients who were apparently harmed, but added that adverse effects are likely to be underreported.
- Read labels when buying over-the-counter drugs and watch out for the word “homeopathic” in small print. “Since homeopathic products are often sold on the same shelves as FDA-approved drugs, it’s easy to buy them inadvertently,” Dr. Swartzberg warns.
Published October 13, 2015