Updated Edition!
We all have heard of so-called alternative therapies but few of us are aware of the fact that there are also alternative diagnoses. These are diagnoses used regularly by practitioners of so-called alternative medicine (SCAM) that have no basis on science, or – to put it simply – that do not exist. They are nonetheless popular with SCAM practitioners and allegedly cause a wide range of non-specific symptoms such as:
- anxiety,
- brain fog,
- constipation,
- depression,
- dizziness,
- fatigue,
- headaches,
- heart palpitations,
- insomnia,
- irritability,
- muscle and joint pain,
- loss of appetite,
- loss of libido,
- weight gain.
In this series of posts, I will briefly discuss some of these diagnoses and list the treatments that SCAM practitioners might recommend for them.
Adrenal Fatigue
Adrenal fatigue is not the same as adrenal insufficiency or Addison’s disease; it is a term coined by a chiropractor who claimed that the stresses of modern life tire out the adrenal glands. In turn, this phenomenon allegedly leads to generalised weariness.
There is not evidence that this is true, nor that adrenal fatigue even exists. A systematic review of the evidence concluded that “there is no substantiation that adrenal fatigue is an actual medical condition.”
Yet, SCAM practitioners advise to cure adrenal fatigue with a range of dietary supplements (e.g. fish oil, ashwagandha, rhodiola rosea, schisandra and holy basil, licorice, magnesium, various vitamins), special diets, lifestyle adjustments, stress management and many other SCAMs. They all have in common that their effectiveness is not supported by convincing evidence from rigorous clinical trials.
Candidiasis hypersensitivity
Most of us are infected by the fungus Candida albicans without being affected by it in any way. Yet, many SCAM practitioners claim that candidiasis hypersensitivity is a condition that causes symptoms like fatigue, premenstrual tension, gastrointestinal symptoms, and depression and therefore needs treating.
But, candidiasis hypersensitivity does not exist. An RCT concluded that, “in women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo.”
This, however, does not stop SCAM practitioners to recommend numerous forms of SCAM to treat the condition, e.g.: dietary supplements containing probiotics, milk thistle, red thyme, barberry, garlic, or external applications of coconut oil, essential oils of peppermint oil, lavender oil, oregano oil, and tea tree. No sound evidence exists to show that ant of these SCAMs can successfully treat the condition.
Chronic intoxications
Chronic intoxications do ecist, of course. But in the realm of SCAM, they are diagosed for the sole putpose of selling their various ‘detox’ treatments. The alleged rationale is that our bodies are overloaded with all sorts ot harmful substances, for instance, from the environment, from our food, from modern drugs, or from our own metabolism.
To eliminate them, we need to ‘detox’. For that purpose, SCAM practitioners recommend a very wide range of SCAMs; in fact, it is hardly possible to identify a single form of SCAM that is not said to detoxify our bodies. Yet, for none of them is there compelling evidence that it eliminates toxins from our body. Some of the most popular detox regimen include:
- acupuncture;
- CEASE therapy;
- chelation therapy;
- crystal healing;
- cupping;
- detox diets;
- detox supplements;
- gua sha;
- homeopathy;
- homotoxicology;
- Kombucha;
- oil pulling;
- vaginal steaming.
Interim conclusion: non-existing diagnoses are perfect opportunities for SCAM practitioners to rip off gullible patients.
We have repeatedly discussed financial and other fraud by (mostly US chiropractors, e.g.:
- Medicare fraud by chiropractors costs taxpayers millions
- Chiropractor accused of Medicare fraud exceeding $1 million
- A $2.6M Insurance Fraud by Chiropractors and Doctors?
- Fraud and sex offences by chiropractors
- Doctor gets 7-year sentence for multimillion-dollar fraud scheme
- The Dark Side of Chiropractic Care
Many of these cases are impressive in their illegality or even viciousness. Yet, this one takes the biscuit, I think:
It has been reported that a former chiropractor will be spending a long time behind bars following his conviction for running a colossal workers’ compensation fraud that bagged him $150 million over several years. Peyman Heidary has been sentenced to 54 years and 8 months in state prison on April 12, and will also have to shell out more than $23 million in fines, according to the Riverside County District Attorney’s Office.
Convicted in January of 68 counts including insurance fraud, conspiracy, and money laundering, Heidary’s scheme involved the control of fake health clinics and law firms from 2009 to 2014. He manipulated the workers’ comp system to exploit legitimately injured people and run up unnecessary treatments to inflate insurance billings, according to a Riverside County jury.
District Attorney Mike Hestrin made clear the gravity of Heidary’s exploitation: “The California workers’ compensation system is designed to help injured workers get back on their feet without ruining them financially,” Hestrin stated, adding “Sophisticated criminals like Mr. Heidary don’t just steal money, they take advantage of innocent patients”. The trial also heard from one such patient, Denise Rivera, a worker injured on the job who despite being promised care, was left untreated.
Originally pegged at $98 million, the fraud was ultimately revealed to have caused about $150 million in damages. Judge Charles Koosed, overseeing the sentencing, called out Heidary’s greed, exploiting his detailed knowledge of the workers’ compensation landscape, Judge Koosed noted, “’[Heidary] took advantage of that knowledge based on greed.”
Heidary used the sham law firm to recruit thousands of legitimately injured patients, referring them to his network of clinics to create unnecessary billing. One of the injured workers, Denise Rivera, slipped and fell while working as a certified nurse assistant for special needs children. Ms. Rivera testified that she was recruited into Heidary’s scheme, but never received any effective treatment. “[Heidary’s employees] released me,” Rivera told jurors. “They told me … basically I was okay. My knee was okay.” When asked during the trial if her knee actually was OK, she simply responded, “No.”
___________________________
It will probably not take long for some chiro to post a comment pointing out that dishonest chiropractors are extremely rare exceptions. Most are law-abiding and behave ethically, he/she will insist. It will then be useless, of course, to counter that, in fact, there is plenty of evidence that dishonesty is rife amongst chiropractors and more frequent than with other healthcare professionals. They will not accept that and would like me to withdraw the allegation.
Such arguments often remind me of the Labour politician, Dennis Skinner, who once stated in the UK Parliament: “Half the Tories opposite are crooks.” When the Speaker insisted he should retract this remark, he responded, “OK, half the Tories opposite aren’t crooks.
Prof Michael Frass is the undisputed star amongst researchers of homeopathy. Here are the awards and achievements that he mentions on his website:
- 1994 until 2019Head, Special Outpatient Clinic “Homeopathy in Malignant Diseases”, Department of Internal Medicine I, General Hospital of the City of Vienna
- 1992 until Feb. 2004Director, Intensivstation 13.i2, Klinik für Innere Medizin I
- 1994 until 1998 Medical Director Maimonides Center
- since May 1994Vice President of the “Medical Society for Classical Homeopathy” (ÄKH)
- since Oct. 1995Head of the Working Group for Homeopathy of the ÄKH in Vienna
- since Jan. 1998 Speaker of the ÄKH at training courses
- 1999 – 2012Training Officer of the Austrian Society for Internal and General Intensive Care Medicine (ÖGIAIM)
- 2001 until 2019 Coordinator of the lecture series “Selected chapters and scientific discussion of complementary medicine methods”, Med. Univ. Vienna, VO 560480
- May 2002 – Dec. 2005Director of the Ludwig Boltzmann Institute for Homeopathy
- since June 2003Member of the Scientific Advisory Board of the Vienna International Academy of Holistic Medicine
- 2004 until 2019Expert in Airway Management and Homeopathy in Intensive Care Medicine at the Center of Excellence in Internal Critical Care Medicine (CEMIC).
- 2005 until 2019Coordinator of the free elective “Homeopathy”, Med. Univ. Vienna, VO 562 923
- since June 2005Director, Institute for Homeopathy Research
- 2006 until 2019Member of the planning area + lecturer for the line element “Interdisciplinary Patient Management” (compulsory lecture for medical students)
- since June 2006President of the Austrian Umbrella Association for Medical Holistic Medicine.
- since Nov. 2010Chairman of the Scientific Society for Homeopathy (WissHom)
Many of my readers will remember the case of the Prof. Frass et al study of homeopathy for cancer. On this blog, we have seen several articles about it:
- Michael Frass’ research into homeopathy for cancer: “numerous breaches of scientific integrity”
- An update on the dubious cancer study by Prof Michael Frass et al
- A thorough analysis of Prof M. Frass’ recent homeopathy trial casts serious doubts on its reliability
- Homeopathy prolongs survival of lung cancer patients … Can it be true?
The study and the suspicion of scientific misconduct it raised eventually resulted in an official complaint by the Viennese Medical School to the authority that deals with suspicions of publication fraud, the ‘Austrian Agency for Scientific Integrity’. It took a very long time, but recently they have published their final on-line summary of their assessment of the case; here is my translation:
Enquiry A 2021/10:
After an Austrian university was informed externally and by name of possible scientific misconduct in a study and the resulting publication, the institution concerned submitted the already publicised suspected case in the field of applied natural sciences to the OeAWI with a request for examination by the Commission.
After establishing sufficient suspicion of various violations of good scientific practice, the Commission declared itself responsible and initiated proceedings. In the course of this, the principal investigator was given the opportunity to submit a written statement and to provide the Commission for Research Integrity Annual Report 2022 material that would help to clarify the facts of the case, which the accused submitted in large quantities.
In a very complex, comprehensive investigation, which required, among other things, the on-site inspection of original documents, the Commission was able to substantiate the suspicion of data falsification, fabrication and manipulation. In a final statement, the study director, who no longer works for the university in question, and the numerous co-authors were informed in detail about the course and results of the commission’s investigation and informed of the recommendations to the university and journal. The Commission recommended that the university concerned should consider investigating its own responsibilities and act accordingly, and that the publication should be withdrawn as a matter of urgency. The journal responsible for the publication was asked to withdraw the publication on the basis of the findings of the investigation.
Nobody who has studied the Frass paper in some detail can be surprised by the verdict. I do applaud the ‘Austrian Agency for Scientific Integrity’ for their work. Yet, I do also have some criticism: health fraud on the scale of Frass can easily costs lives. I find it therefore unacceptable that the verdict took so long to get published.
Even worse is, in my view, the fact that the journal, ‘Oncologist’, is still offering this paper today, albeit with this ‘expression of concern’:
This is an Expression of Concern regarding: Michael Frass, Peter Lechleitner, Christa Gründling, Claudia Pirker, Erwin Grasmuk-Siegl, Julian Domayer, Maximilian Hochmair, Katharina Gaertner, Cornelia Duscheck, Ilse Muchitsch, Christine Marosi, Michael Schumacher, Sabine Zöchbauer-Müller, Raj K. Manchanda, Andrea Schrott, Otto Burghuber, Homeopathic Treatment as an Add-On Therapy May Improve Quality of Life and Prolong Survival in Patients with Non-Small Cell Lung Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Three-Arm, Multicenter Study, The Oncologist, Volume 25, Issue 12, December 2020, Pages e1930–e1955, https://doi.org/10.1002/onco.13548
In August 2022, the journal editors received credible information from the Austrian Agency for Research Integrity about potential data falsification and data manipulation in this article.*** While The Oncologist editorial team investigates and communicates with the corresponding author, the editors are publishing this Expression of Concern to alert readers that, pending the outcome and review of a full investigation, the research results presented may not be reliable.
Cancer patients will thus still read the dangerously misleading conclusions of the Frass fabrication: “Quality of life (QoL) improved significantly in the homeopathy group compared with placebo. In addition, survival was significantly longer in the homeopathy group versus placebo and control. A higher QoL might have contributed to the prolonged survival. The study suggests that homeopathy positively influences not only QoL but also survival. Further studies including other tumor entities are warranted.” And lives of cancer patients remain needlessly at risk. In my view, this is seriously unethical.
***As far as I know, they received credible information from others long before that!
This review updated and extended a previous one on the economic impact of homeopathy. A systematic literature search of the terms ‘cost’ and ‘homeopathy’ from January 2012 to July 2022 was performed in electronic databases. Two independent reviewers checked records, extracted data, and assessed study quality using the Consensus on Health Economic Criteria (CHEC) list.
Six studies were added to 15 from the previous review. Synthesizing both health outcomes and costs showed homeopathic treatment being at least equally effective for less or similar costs than control in 14 of 21 studies. Three studies found improved outcomes at higher costs, two of which showed cost-effectiveness for homeopathy by incremental analysis. One found similar results and three similar outcomes at higher costs for homeopathy. CHEC values ranged between two and 16, with studies before 2009 having lower values (Mean ± SD: 6.7 ± 3.4) than newer studies (9.4 ± 4.3).
The authors concluded that, although results of the CHEC assessment show a positive chronological development, the favorable cost-effectiveness of homeopathic treatments seen in a small number of high-quality studies is undercut by too many examples of methodologically poor research.
I am always impressed by the fantastic and innovative phraseology that some authors are able to publish in order to avaid calling a spade a spade. The findings of the above analysis clearly fail to be positive. So why not say so? Why not honestly conclude something like this:
Our analysis failed to show conclusive evidence that homeopathy is cost effective.
To find an answer to this question, we need not look all that far. The authors’ affiliations give the game away:
- 1Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany.
- 2Medical Scientific Services/Medical Affairs, Deutsche Homöopathie-Union DHU-Arzneimittel GmbH & Co. KG, Karlsruhe, Germany.
- 3Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany.
- 4Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
Another rather funny give-away is the title of the paper: the “…evaluation for…”comes form the authors’ original title (Overview and quality assessment of health economic evaluations for homeopathic therapy: an updated systematic review) and it implies an evaluation in favour of. The correct wording would be “evaluation of”, I think.
I rest my case.
The Academy of Homeopathy Education is a US-based accredited teaching institution offering homeopathy education services to professional and medically licensed homeopathy students. This study reports on clinical outcomes from the teaching clinic from 2020 to 2021.
Data were collected using the patient-generated outcome measure, the Measure Yourself Concerns and Wellbeing (MYCaW). Mean MYCaW values for initial and subsequent consultations were analyzed for the degree of change across the intervention period in 38 clients. Each client listed up to two complaints. MYCaW scores between initial and subsequent consultations were analyzed for the degree of change (delta) across the intervention period.
A total of 95 body system-related symptoms were analyzed for change in intensity following the homeopathic intervention. Statistically significant improvements in the intensity of main symptoms were observed between initial and subsequent follow-ups. The main symptom scores showed a mean change in intensity (delta MYCaW) of −0.79 points (95% confidence interval (CI), −1.29 to −0.29; p = 0.003) at first follow-up, a mean change of −1.67 points (95% CI, −2.34 to −0.99; p = 0.001) at second follow-up compared with the initial visit, and a mean change of −1.93 points (95% CI, −3.0 to −0.86; p = 0.008) at third follow-up compared with the initial visit. For clients with four or more follow-ups, the mean delta MYCaW was −1.57 points (95% CI, −2.86 to −0.28; p = 0.039).
The authors concluded that statistically significant improvements as well as some clinically meaningful changes in symptom intensity were found across a diverse group of individuals with a variety of long-term chronic conditions. The improvement was evident across different body systems and different levels of chronicity. There are limitations to the generalizability of the study due to the research design. Further research and investigation are warranted given the promising results of this work.
There are, of course, not just limits to the generalizability of this study! I’d say there are limits to the interpretation of any of its findings.
What was the cause of the improvements?
Here are just a few questions that I asked myself while reading this paper:
- Are the guys from the Academy of Homeopathy Education not aware of the fact that even chronic conditions often get better by themselves?
- Have they heard of the placebo effect?
- Are they trying to tell us that the patients did not also use conventional treatments for their chronic conditions?
- What about regression towards the mean?
- What about social desirability?
- Why do they think that further research is needed?
- Are these really results that look ‘promising for homeopathy?
To answer just the last question: No, these findings are in perfect agreement with the fact that highly diluted homeopathic remedies are pure placebos (to be honest, they would even be in agreement with such remedies being mildly harmful).
Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy is claimed to be effective, but there is little data on the effect on inflammation and disease activity in RA. The objective of this study was therefore to explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients.
A total of 100 RA patients were randomized into two groups:
- the naturopathy group (integrated naturopathy interventions with routine medical therapy),
- the control group (only with routine medical therapy).
Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points.
The results show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003) and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06).
The authors conclused that the findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.
The naturopathic treatments included:
- acupuncture,
- hot and cold-water application to the painful joints,
- sauna baths,
- enemas,
- fasting,
- mud therapy,
- massage therapy.
The study was designed as an A+B versus B trial. Therefore, it is hardly surprising that subjective endpoints improved. A little more baffling are the changes in objective parameters. These could easily be due to the fasing interventions – there is reasonably sound evidence for such effects. Take this review, for instance:
Fasting is an act of restricting, for a certain length of time, food intake or intake of particular foods, and has been part of religious rituals for centuries. Religions such as Christianity and Islam use this practice as a form of sacrifice, self-discipline, and gratitude. However, in the past decade, fasting has penetrated the mainstream as a diet trend. There are several ways of fasting; existing fast mimicking eating methods promise accelerated weight loss, and many more benefits: lower cholesterol, prevention of type 2 diabetes and a longer lifespan. Even more, it has been proposed that fasting can downregulate the inflammatory process and potentially be used as a treatment regimen for several diseases. Here, we review the effects of fasting on immune and inflammatory pathways. Also, we present current knowledge about the role of fasting in the activity of inflammatory arthritides with a focus on rheumatoid arthritis.
What I am trying to say is this: some modalities used in naturopathy might well be effective in treating certain conditions. In my view, this is, however, no reason for condoning or recommening naturopathy as a whole. Or – to put it bluntly – naturopathy is a weird mixture of pure nonsense and some possibly reasonable interventions.
This systematic review and meta-analysis aimed to evaluate the effectiveness of spiritually based interventions on blood pressure (BP) among adults. A systematic search was performed using the PubMed, Scopus, and Cochrane databases to identify studies evaluating spiritual interventions, including:
- meditation,
- transcendental meditation,
- mindfulness meditation,
- yoga,
for high BP among adults up to January 1, 2022.
The inclusion criteria were:
- (a) randomized controlled trials (RCTs),
- (b) studies in English or Persian,
- (c) studies conducted among adults (≥ 18 years),
- (d) studies reporting systolic or diastolic BP.
Given the high heterogeneity of these studies, a random effect model was used to calculate the effect sizes for the RCTs.
In total, the systematic review included 24 studies and the meta-analysis included 23 studies. As some of studies reported two or more outcome measurements, separate estimates of each outcome were extracted for that study (24 datasets). Fifteen trials reported the mean (SD) systolic blood pressure (SBP), and 13 trials reported the mean (SD) diastolic blood pressure (DBP). In addition, 13 studies reported means (SDs) and six trials reported mean changes in DBP. A significant decrease was found in systolic BP following intervention ((WMD (weighted mean difference) = − 7.63 [− 9.61 to − 5.65; P < 0.001]). We observed significant heterogeneity among the studies (I2 = 96.9; P < 0.001). A significant decrease was observed in DBP following the interventions (WMD = − 4.75 [− 6.45 to − 3.05; P < 0.001]).
The authors concluded that spiritually based interventions including meditation and yoga had beneficial effects in reducing both SBP and DBP. Reducing BP can be expected to reduce the risk of cardiovascular diseases.
Q: What do the RCTs of these interventions have in common?
A: They cannot normally be placebo-controlled because no adequate placebos exist for these therapies.
Q: What does that mean?
A: It means that patients could not be blinded and that patient expectations influenced the outcome.
In view of the fact that blood pressure is an endpoint that is extremely sensitive to expectation, I think, the conclusions of this paper might need to be re-formulated:
This analysis confirms that expectation can have beneficial effects in reducing both SBP and DBP. Reducing BP can be expected to reduce the risk of cardiovascular diseases.
‘WORLD HOMEOPATHY DAY’ is upon us and the Internet is awash with pro-homeopathy comments, e.g.:
- World Homeopathy Day is observed annually on April 10th to commemorate the birth anniversary of Samuel Hahnemann, a prominent figure in the development of homeopathy. This day celebrates the principles and practices of homeopathy, an alternative medicinal approach that emphasizes treating ailments by utilizing natural substances and stimulating the body’s inherent healing abilities.
- The theme for World Homeopathy Day 2024 is ‘Empowering Research, Enhancing Proficiency: A Homeopathy Symposium”. This theme underscores the significance of continuous research in homeopathy and the need to upgrade capability in its training to give better medical care results.
Even slightly less biased sources cannot bring themselves to a more realistic approach, e.g.:
The significance of the World Homeopathy Day is said to be as follows:
- Raising Awareness: World Homeopathy Day has successfully brought homeopathy to the forefront of public attention, generating dialogue and interest in its principles and practices.
- Bridging Communities: The Day serves as a platform for bringing together homeopaths, practitioners, researchers, and individuals interested in alternative medicine, fostering collaboration and knowledge exchange.
- Focus on Education: World Homeopathy Day emphasizes the importance of education and ethical practices within the field, promoting responsible usage and informed choices for individuals seeking homeopathic care.
World Homeopathy Day is about understanding and exploring the potential of this alternative medicine system while keeping an open mind and prioritizing evidence-based healthcare practices.
So, let me try to counter-balance these texts by showing you what my recently published 7 key points about homeopathy tell us:
Homeopathy is popular, particularly in India, Germany, France and parts of South America. It was invented more than 200 years ago and still divides opinions like few other subjects in alternative medicine.
- Homeopathy was invented by the German physician, Samuel Hahnemann (1755–1843). At the time, our understanding of the laws of nature was woefully incomplete, and therefore Hahnemann’s ideas seemed less implausible than today. The conventional treatments of this period were often more dangerous than the disease they were supposed to cure. Consequently, homeopathy was repeatedly shown to be superior to ‘allopathy’ (a term coined by Hahnemann to denigrate conventional medicine) and Hahnemann’s treatments were an almost instant, worldwide success.[1]
- Many consumers confuse homeopathy with herbal medicine; yet the two are fundamentally different. Herbal medicines are plant extracts that contain potentially active ingredients. Homeopathic remedies are based on plants or any other material and they are typically so dilute that they contain not a single molecule of the substance advertised on the bottle. The most frequently used dilution (homeopaths call them ‘potencies’) is a ‘C30’; a C30-potency has been diluted 30 times at a ratio of 1:100. This means that one drop of the staring material is dissolved in 1 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 drops of diluent (usually a water/alcohol mixture)—and that equates to less than one molecule of the original substance per all the molecules of the universe.
- Homeopaths claim that their remedies work via some ‘energy’ or ‘vital force’ and that the process of preparing the homeopathic dilutions (it involves vigorous shaking the mixtures at each dilution step) transfers this ‘energy’ or information from one to the next dilution. They also believe that the process of diluting and agitating their remedies, which they call potentisation, renders them not less or not more potent. Homeopathic remedies are usually prescribed according to the ‘like cures like’ principle: if, for instance, a patient suffers from runny eyes, a homeopath might prescribe a remedy made of onion, because onion make a healthy person’s eyes water. This and all other assumptions of homeopathy contradict the known laws of nature. In other words, we do not fail to comprehend how homeopathy works, but we understand that it cannot work unless the known laws of nature are wrong.
- According to Hahnemann’s classical homeopathy, homeopaths are focussed on the symptoms and characteristics of the patient. They conduct a lengthy medical history, and they show little or no interest in a physical examination of their patient or other diagnostic procedures. Once they are confident to have all the information they need, they try to find the optimal homeopathic remedy. This is done by matching the symptoms with the drug pictures of homeopathic remedies. Any homeopathic drug picture is essentially based on what has been noted in homeopathic provings where healthy volunteers take a remedy and monitor all that symptoms, sensations and feelings they experience subsequently. Thus, the optimal homeopathic remedy can be seen as a diagnosis which makes homeopathy also a diagnostic method.[2]
- Today, around 500 clinical trials of homeopathy have been published. The totality of this evidence fails to show that homeopathic remedies are more than placebos.[3] Numerous official statements from various countries confirm the absurdity of homeopathy, for instance:
- “The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available” (Russian Academy of Sciences, Russia)
- “Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.” (National Health and Medical Research Council, Australia)
- “Homeopathic remedies don’t meet the criteria of evidence-based medicine.” (Hungarian Academy of Sciences, Hungary)
- “The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.” (Swedish Academy of Sciences, Sweden)
- “There is no good-quality evidence that homeopathy is effective as a treatment for any health condition” (National Health Service, England)
- Yet, many patients undeniably do get better after taking homeopathic remedies. The best evidence available today clearly shows that this improvement is unrelated to the homeopathic remedy per se. It is the result of a lengthy, empathetic, compassionate encounter with a homeopath, a placebo-response or other factors which experts often call ‘context effects’.[4]
- Whenever homeopaths advise their patients (as they often do) to forgo effective conventional treatments, they are likely to do harm. This phenomenon is best documented in relation to the advice of many homeopaths against immunisations.[5]
I do not expect fans of homeopathy to be impressed by my evidence-based assessment of their cult. In fact, just looking what is currently being posted on ‘X’ today about the ‘WORLD HOMEOPATHY DAY’ seems to justify my expectation. Here are the 10 first postings that appeared on my screen about an hour ago:
- Today, on #WorldHomeopathyDay, we celebrate the birth anniversary of Dr. Samuel Hahnemann, the founder of homeopathy. Let’s embrace the principles of natural healing and holistic well-being.
- On #WorldHomeopathyDay President #DroupadiMurmu to inaugurate 2-day Homeopathic Symposium at Yashobhoomi Convention Centre Dwarka, New Delhi. Organized by Central Council for Research in Homoeopathy (CCRH) based on theme of ‘Empowering Research, Enhancing Proficiency.’
- Dr. Ashvini Kumar Dwivedi, Member, Scientific Advisory Board, Central Council for Research in Homeopathy, Ministry of Ayush, Government of India, and #ASSOCHAM Ayush task force member, underlined the significance of #WorldHomeopathyDay, observed on April 10th each year
- Today, we celebrate #WorldHomeopathyDay 2024, embracing the gentle healing power of nature.
- Happy #WorldHomeopathyDay! Let’s celebrate the holistic approach to health that homeopathy offers, honoring its contributions to alternative medicine and its focus on individualized care. Here’s to exploring natural remedies and supporting wellness for all! #HolisticHealth
- Happy World Homeopathy Day Embracing the gentle yet powerful healing of homeopathy, let’s cherish its holistic essence, promoting balance and well-being worldwide. Here’s to the harmony it brings to mind, body, and spirit.
- #WorldHomeopathyDay: President #DroupadiMurmu to inaugurate 2-day Homeopathic Symposium at Yashobhoomi Convention Centre Dwarka, New Delhi. Organized by Central Council for Research in Homoeopathy (CCRH) based on theme of ‘Empowering Research, Enhancing Proficiency.’
- Celebrate #WorldHomeopathyDay with us & enter to win these two enlightening reads by renowned homeopath Dr. Mukesh Batra. What inspired you to explore homeopathy? Share your story in the comments section & get a chance to win a copy of #HealWithHomeopathy and #FeelGoodHealGood!
- #WorldHomeopathyDay is celebrated on April 10th, promoting awareness of the principles and benefits of homeopathic medicine. It aims to address the whole body, including hereditary predispositions and disease history, and encourages people to pursue homeopathy as a profession.…
- On World Homeopathy Day, we celebrate Dr. Samuel Hahnemann, the pioneer of homeopathy. His gentle remedies, made from natural substances, have helped countless people heal without side effects.
_______________________
In view of this volume of pure BS, I encourage everyone to post (here, or on ‘X’, or elsewhere) some evidence-based comments on homeopathy, Hahnemann and the ‘World Homeopathy Day’.
Let me make a start:
Homeopaths are as deluded as their remedies are diluted
Pre-diabetes is a significant public health problem worldwide. India has a very high rate of progression from pre-diabetes to diabetes, 75-78 per thousand persons per year.
The objective of this study was to test the efficacy of individualized homeopathic medicinal products (HMPs) against placebos in preventing the progression from pre-diabetes to diabetes. It was designed as a ix-month, double-blind, randomized (1:1), two parallel arms, placebo-controlled trial.
Sixty participants with pre-diabetes were treated either with:
- HMPs plus yoga therapy (YT; n = 30)
- or with identical-looking placebos plus YT (n = 30).
Pre-diabetes was defined as elevated fasting blood glucose (FBS) of 100-125 mg/dL, glycated hemoglobin (HbA1c) value of 5.7-6.4%, and/or an elevated blood glucose level 2 hrs. after an oral glucose tolerance test (OGTT) of 140-199 mg/dL (ICD-10-R73.03).
The primary efficacy endpoint was the proportion of participants progressing from pre-diabetes to diabetes, measured after three and six months. Secondary outcomes comprised of fasting blood glucose (FBS), oral glucose tolerance test (OGTT), glycated hemoglobin percentage (HbA1c%), lipid profile, liver enzymes (alanine transaminase, aspartate transaminase), urea and creatinine, and Measure Yourself Medical Outcome Profile version 2 (MYMOP-2); all measured after 3 and 6 months.
The proportion of participants converted from pre-diabetics to diabetics (n/N; n = diabetics, N = prediabetics) was significantly less in the verum group than control: HbA1C% (month 3: verum – 2/30 versus control – 11/30, p = 0.003; month 6: 3/30 vs. 2/30, p = 0.008), OGTT (month 3: 0/30 vs. 8/30, p = 0.015; month 6: 0/30 vs. 1/30, p = 0.008), but not according to FBS (month 3: 1/30 vs. 1/30, p = 0.779; month 6: 1/30 vs. 3/30, p = 0.469). Several secondary outcomes also revealed significant improvements in the verum group than in placebo: HbA1C% (p < 0.001), OGTT (p = 0.001), serum ALT (p = 0.031), creatinine (p = 0.012), and MYMOP-2 profile scores (p < 0.001). Sulphur, Bryonia alba, and Thuja occidentalis were the most frequently indicated medicines. Thus, HMPs outperformed placebos by successfully preventing the progression of pre-diabetes to diabetes.
The authors concluded that HMPs with YT produced significantly better effects than placebos plus YT with moderate to large effect sizes. Overall, HMPs outperformed placebos by successfully preventing the progression of pre-diabetes to diabetes.
This is an odd study with very odd results; it begs several questions and comments, e.g.:
- If the aim was to test the efficacy of individualized homeopathic medicinal products (HMPs) against placebos in preventing the progression from pre-diabetes to diabetes, why add yoga as a treatment?
- What were the influences of other factors such as diet and life-style, and were these the same in both groups?
- The sample size seems far too small for such firm conclusions.
- What might be the alleged mechanism of action?
- Why not publish such a study that has allegedly important results in one of the many established journals dealing with diabetes?
I fear that this trial is merely one in the long list of poor quality, false-positive homeopathy studies that are currently emerging from India. I predict that the findings will not even be taken seriously enough to be submitted to a replication by established diabetes researchers.
This study evaluated and compared the effectiveness of Reiki and Qi-gong therapy techniques in improving diabetic patients’ negative emotional states. This quas-experimental research design was carried out at the National Institute of Diabetes and Endocrinology’s Hospital in Cairo, Egypt. It included 200 Type 2 diabetes patients randomized into two equal groups, one for Qigong and one for Reiki techniques. A self-administered questionnaire with a standardized tool (Depression Anxiety Stress Scales [DASS[) was used in data collection. The intervention programs were administered in the form of instructional guidelines through eight sessions for each group.
The results showed that the two study groups had similar socio-demographic characteristics. After implementation of the intervention, most patients in the two groups were having no anxiety, no depression, and no stress. Statistically significant improvements were seen in all three parameters in both groups (p<0.001). The multivariate analysis identified the study intervention as the main statistically significant independent negative predictor of the patients’ scores of anxiety, depression, and stress. Reiki technique was also a statistically significant independent negative predictor of these scores.
The authors conclused that both Reiki and Qi-gong therapy techniques were effective in improving diabetic patients’ negative emotional states of anxiety, depression, and stress, with slight superiority of the Reiki technique. The inclusion of these techniques in the management plans of Type-2 diabetic patients is recommended.
This is an excellent example of how NOT to design a clinical trial!
- If your aim is to test the efficacy of Reiki, conduct a trial of Reiki versus sham-Reiki.
- If your aim is to test the efficacy of Qi-gong, conduct a trial of Qi-gong versus sham-Qi-gong.
- If you compare two therapies in one trial, one has to be of proven and undoubted efficacy.
- Comparing two treatments of unproven efficacy cannot normally lead to a meaningful result.
- It is like trying to solve a mathematical equasion with two unknowns.
- A study that cannot produce a meaningful result is a waste of resorces.
- It arguably also is a neglect of research ethics.
- Even if we disregarded all these flaws and problems, recommending therapies for routine use on the basis of one single study is irresponsible nonsense.
All this is truly elementary and should be known by any researcher (not to mention research supervisor). Yet, in the realm of so-called alternative medicine (SCAM), it needs to be stressed over and over again. The ‘National Institute of Diabetes and Endocrinology’s Hospital in Cairo’ (and all other institutions that produce such shameful pseudoscience) urgently need to get their act together:
you are doing nobody a favour!
