MD, PhD, FMedSci, FSB, FRCP, FRCPEd

homeopathy

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Homeopaths have, since about 200 years, insisted that their remedies are efficacious treatments for infectious diseases. As evidence for this notion, they often produce epidemiological data showing that a group of infected patients treated homeopathically had better results than another group treated conventionally. While potentially interesting, such findings never constitute proof, because the two groups might not have been comparable and many other factors could have determined the observed outcome. In fact, these stories are prime examples for the need of rigorously controlled trials when testing the efficacy of medical treatments.

Homeopaths are invariably unable to provide more compelling evidence for their claims. Instead, they repeat, since 200 years, their assumptions over and over again. Are they not aware, I ask myself, that the repetition of a lie does not create a truth?

What their repetition of lies sometimes does create, unfortunately, is some impact on a political level. This website explains it fairly well:

The Public Health Ministry (of Thailand) is thinking of implementing alternative therapy homeopathy in all districts of Sing Buri this year, after a report that it could boost the human’s body immunity to fight dengue fever, an inspector-general at the ministry said.

Homeopathic medicines had been given to Sing Buri volunteer students from kindergarten to lower-secondary level in a 2012-13 trial and it yielded satisfactory results, said Dr Jakkriss Bhumisawasdi, director of the Inspector-General Region for Bureau of Inspection and Evaluation.

The number of dengue fever cases in Sing Buri have gone down, taking its rankings from No 67 in the country (with one death) in 2011 to No 76 in 2012. As there was a nationwide dengue fever outbreak in 2013, Sing Buri reported the country’s lowest prevalence at 44.95 per 100,000 population.

Jakkriss said “homeopathy” was safe and low-cost and had been used in various countries including the United Kingdom, France, Italy, Switzerland, Belgium, the United States, Australia, India and Malaysia.

Pilot project

Next, the system of medicine would be implemented in Region 4 Bureau’s seven other provinces: Nakhon Nayok, Nonthaburi, Pathum Thani, Ayutthaya, Lop Buri, Sara Buri and Ang Thong. If this one district per province pilot project went well, they would consider implementing it across the country, he said.

Sing Buri Hospital paediatrician Dr Wali Suwatthika said the preparation involved dissolving Eupatorium herbal pills in drinking water. Each child would be given 3cc of this tasteless water every three months. The trial, which began in July 2012, covered 4,250 children in Muang district and only four of them developed mild dengue fever in one year, while seven out of the district’s 2,856 remaining kids who didn’t get the medicine had dengue fever, in a more severe condition.

Thailand reported 150,934 dengue fever patients last year, double the previous year’s number, and 133 deaths. As there is no vaccine for dengue fever, the Public Health Ministry used a combination of several measures, including the eradication of mosquito larva incubation grounds and a campaign for people to install mosquito nets.

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So, where is the evidence that homeopathy does anything at all for Dengue patients? The 2012-13 trial referred to above has, as far as I can see, not been published. This probably means that it was not a publishable study at all. The only study available on Medline is this one:

A double-blind, placebo-controlled randomized trial of a homeopathic combination medication for dengue fever was carried out in municipal health clinics in Honduras. Sixty patients who met the case definition of dengue (fever plus two ancillary symptoms) were randomized to receive the homeopathic medication or placebo for 1 week, along with standard conventional analgesic treatment for dengue. The results showed no difference in outcomes between the two groups, including the number of days of fever and pain as well as analgesic use and complication rates. Only three subjects had laboratory confirmed dengue. An interesting sinusoidal curve in reported pain scores was seen in the verum group that might suggest a homeopathic aggravation or a proving. The small sample size makes conclusions difficult, but the results of this study do not suggest that this combination homeopathic remedy is effective for the symptoms that are characteristic of dengue fever.

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The bottom line is simple and depressing: the totality of the best available evidence fails to show that homeopathy is efficacious for Dengue fever (or any other infectious disease). It is irresponsible to claim otherwise.

In real medicine, most doctors view telephone consultations as highly problematic and would use them but in emergency situations or when there is no realistic other choice. Not so in homeopathy! Here telephone consultations are actively promoted my many – many who have a financial interest in it, that is.

Take this press-release, for instance; I have slightly abbreviated the text but abstained from correcting the many mistakes to give you a realistic impression of the high standard of the firm offering it.

START OF QUOTE

Solviva Health is an online treatment initiative based on…  homeopathy. Since homeopathy’s introduction by Samuel Hahnemann in 1796, the popularity of this system is growing day by day [1]. According to World Health Organization, homoeopathy is the second largest system of medicine in the world [1]. India is one among the top nations to adopt this technique of curing and describes it as a natural way of healing. Solviva Health is an online homeopathic treatment platform that interacts with their patients through online initiatives like emails, video conferencing, web chat, telephonic and all other possible communication sources. The main motto of this initiative is to provide medical services not only to the local people of Mohali but also to extend the reach of this quality treatment to rest of India & all across the world. It’s one amongst very few genuine platforms to avail the world class homeopathic medical services without visiting the doctors…

Whenever you need an expert guidance, the doctor is just a phone call away.

The medical team present under SolvivaHealth is well-known personalities in their respective field. The clinic specializes in Allergies, Polycystic ovarian disease, Female disorders, Rheumatoid arthritis, Joint problems & Child disorders. Suppose, “Before a specified team of doctors has to handle a particular case, the patient can check all the doctors’ detail for testimonial verifications, which are available online on the official website.” As per many sources, homeopathic treatment do not have side-effects and one of the safe & reliable way to tackle Allergies, Asthma, Female Disorders which are usually not having any cure in Allopathy… “Solviva Health provides the much awaited first Indian homeopathy online consultancy treatment services, which allows you to get all the precise treatment at the comfort of your home.”

Solviva Health is one of the first of it’s kind in India that offers treatment via online or telephonic interactions between doctors and patients. They have successfully completed 3 years in offering quality homeopathic treatment services with a patient satisfaction rate of 95%.

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I am sure that Hahnemann would be turning in his Parisian grave, if he knew about this. He and most of his followers have always stressed the importance of taking a long and detailed history during an empathetic, personal encounter with the patient.

But there is another important aspect here to consider: telephone consultations are by definition devoid of any physical examination of the patient by the clinician. I know that, generally speaking, homeopaths attach much less importance to physically examining their patients. I always have found this odd and borderline negligent. To omit them completely is no longer borderline but crosses the line into unethical behaviour, I think.

To me, it seems as though Solviva Health (and all the other firms that offer homeopathy by telephone) have found a method of maximising their income, while minimising the already meagre benefit of homeopathy. As we all know, if homeopathy has any positive effects on patients, it is through the personal encounter with an empathetic clinician. Telephone services are likely to be far less effective than fact-to-face consultations at building constructive therapeutic relationships.

Yesterday I received an electronic Christmas card from two homeopathic institutions called ‘Homeopathic Associates and The Homeopathic College’. It read: WISHING YOU THE BEST OF HEALTH AND HAPPINESS FOR THE NEW YEAR!

Naturally I was puzzled, particularly since I had no recollection of ever having been in contact with them. The card was signed by Manfred Mueller, MA, DHM, RSHom(NA), CCH, and I decided to find out more about this man. It turns out that Manfred Mueller developed The Mueller Method or “Extra-Strength Homeopathy” to meet today’s complex chronic conditions, drug induced disorders, vaccine injuries, toxic overload, radiation-induced health problems, cancers, etc.

Now, this sounds interesting, I thought, and read on. Just a few clicks further, Mueller offers his wisdom on homeopathic cancer treatments in a lengthy article entitled ‘Is Homeopathy an Effective Cancer Treatment?

According to Mueller, the answer to his question is a clear yes. I will spare you the torture of reading the entire paper (if you have masochistic tendencies, you can read it via the link I provided above); instead, I will just copy Mueller’s conclusion:

START OF QUAOTE

Laboratory studies in vitro and in vivo show that homeopathic drugs, in addition to having the capacity to reduce the size of tumors and to induce apoptosis, can induce protective and restorative effects. Additionally homeopathic treatment has shown effects when used as a complementary therapy for the effects of conventional cancer treatment. This confirms observations from our own clinical experience as well as that of others that when suitable remedies are selected according to individual indications as well as according to pathology and to cell-line indications and administered in the appropriate doses according to the standard principles of homeopathic posology, homeopathic treatment of cancer can be a highly effective therapy for all kinds of cancers and leukemia as well as for the harmful side effects of conventional treatment. More research is needed to corroborate these clinical observations.

Homeopathy over almost two decades of its existence has developed more than four hundred remedies for cancer treatment. Only a small fraction have been subjected to scientific study so far. More homeopathic remedies need to be studied to establish if they have any significant action in cancer. Undoubtedly the next big step in homeopathic cancer research must be multiple comprehensive double-blinded, placebo-controlled, randomized clinical trials. To assess the effect of homeopathic treatment in clinical settings, volunteer adult patients who prefer to try homeopathic treatment instead of conventional therapy could be recruited, especially in cases for which no conventional therapy has been shown to be effective.

Many of the researchers conducting studies — cited here but not discussed — on the growing interest in homeopathic cancer treatment have observed that patients are driving the demand for access to homeopathic and other alternative modes of cancer treatment. So long as existing cancer treatment is fraught with danger and low efficacy, it is urgent that the research on and the provision of quality homeopathic cancer treatment be made available for those who wish to try it.

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Amazing! What could be more wrong than this?

But it’s the season of joy and love; so, let’s not go into the embarrassing details of this article. Instead, I feel like returning the curtesy of Mr Mueller’s Christmas card. Therefore, I have decided to post this open ‘Christmas card’ to him:

Dear Mr Mueller,

thank you for your card, the good wishes, and the links you provided to your websites, articles, etc. I only read the one on cancer but was impressed. It is remarkably misguided, unethical and dangerous. Crucially, it has the potential to shorten the lives of many desperate patients. I therefore urge you to desist making your opinions public or from applying them in your clinical practice. I say this not merely because I am concerned about the patients that have the misfortune to fall into your hands, but also to prevent you from getting into trouble for immoral, unethical or unlawful behaviour.

In this spirit, I wish you happiness for the New Year.

Edzard Ernst

HOMEOPATHIC REMEDIES CANNOT POSSIBLY  PLACEBOS BECAUSE THEY WORK IN ANIMALS!

How often have we heard this argument?

And how often have we pointed out that it is wrong on more than one level?

On this blog alone, we have done so here, here, here and here, for instance. But homeopaths and their followers seem to be strangely immune to facts. Presumably, they will therefore also ignore a recent paper that re-confirms what has already been said so often.

This new systematic review assessed the efficacy of homeopathy in cattle, pigs and poultry. Only peer-reviewed publications dealing with homeopathic remedies, which could possibly replace or prevent the use of antibiotics in the case of infective diseases or growth promotion in livestock were included. Search results revealed a total number of 52 trials performed within 48 publications fulfilling the predefined criteria. Twenty-eight trials were in favour of homeopathy, with 26 trials showing a significantly higher efficacy in comparison to a control group, whereas 22 showed no medicinal effect. Cure rates for the treatments with antibiotics, homeopathy or placebo varied to a high degree, while the remedy used did not seem to make a big difference. No study had been repeated under comparable conditions. Consequently, the use of homeopathy cannot claim to have sufficient prognostic validity where efficacy is concerned. When striving for high therapeutic success in treatment, the potential of homeopathy in replacing or reducing antibiotics can only be validated if evidence of efficacy is confirmed by randomised controlled trials under modified conditions.

I think this, together with the previous systematic reviews on the subject, speaks for itself, and there is little to add – except perhaps the bravely outspoken letter by Oliver Kamm in THE TIMES which alludes to the above named paper:

START OF QUOTE

Using highly diluted substances to cure ailments is a better idea than the medieval practices of bloodletting by leeches or administering hemlock as an anaesthetic. That’s the best you can say for homeopathy: it isn’t outright dangerous. As medicine, however, it’s junk. Study after study has confirmed that homeopathic remedies are inert and no more effective than either a placebo or just allowing an illness to run its course.

Now research published in the Veterinary Record concludes that there is insufficient evidence to support the use of homeopathic treatments in livestock, either, as a way to prevent or treat infectious diseases. Two scientists from the university of Kassel in Germany reviewed studies of the effectiveness of homeopathic treatments in cattle, pigs and poultry. They say the “evidence in favour of homeopathy lacks reproducibility and therefore cannot claim to have sufficient prognostic validity”.

Over 200 years, homeopaths have failed to substantiate their claims. It may seem bizarre that anyone in the 21st century could take seriously the notion of homeopathic treatments for animals. But that is to reckon without the Prince of Wales and his lifetime enthusiasm for zaniness on science, medicine, aesthetics and linguistics. He once gave a speech declaring himself proud for having been “accused once of being the enemy of the Enlightenment”. A few months ago he stunned a conference of scientists and public officials by disclosing that he uses only homeopathic remedies when treating his cattle and sheep on his country estate at Highgrove.

Prince Charles’s knowledge of science may be a joke but his contributions to public debate aren’t funny. They bestow prestige on atavistic superstitions that have no place in modern healthcare and animal welfare. NHS guidelines are clear there “is no good-quality evidence that homeopathy is effective as a treatment for any health condition”. Likewise in veterinary medicine. Out of more than 20,000 vets licensed in the UK, around 50 practise homeopathy. That is 50 too many. The same is true of the roughly 500 farmers who employ homeopathy. They can’t even claim a placebo effect as the animals are unaware of their purported medical treatment.

Yet the quacks are undaunted. The British Association of Homeopathic Veterinary Surgeons even claims success in curing dogs of cancer through homeopathy. This is nonsense — and if it persuades farmers and pet owners to forgo evidence-based treatments, it’s also wanton cruelty. It’s past time to shut these people down.”

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Actually, the exact quote was slightly different: What we’re dealing with here is the big lie, being perpetrated by corrupt government officials on the payroll of Pharma” (the bold lettering is from the original). It comes from the pen of  who has featured on this blog before (see also here).

Strong words indeed! But not as strong as those of the title of his new article: BRING THE CRIMINALS TO JUSTICE. What were they directed against? They were in protest against the recent rulings of the British Advertising Standards Authority and the American FCT  out-lawing the advertising of bogus claims for homeopathy.

Alan V Schmukler continues his article as follows: “It’s time to hold these people accountable. There are laws in every country against officials taking bribes and malfeasance in office. Write to your legislators and demand that they investigate and bring these criminals to justice. Send them the links to hundreds of homeopathy studies, including disease prevention with homeopathy, at the end of this article.   Tell them that the regulatory agencies are protecting Pharma profits, not the public.

Meanwhile, let us insist that pharmaceutical drugs be labeled honestly, like this:

“This drug was tested by the same company that profits from it, and which company has been fined millions of dollars in the past for lying about test results. This drug does not cure any medical condition, but only suppresses symptoms which may ultimately make the patient sicker. This drug has already  killed or injured X  number of people.”

There are not many homeopaths who can render me speechless; I have been used to a lot. But this man almost did. Almost!

After recovering my self-control, all I want to say to this is: THANK YOU ALAN V SCMUKLER! Not only have you made me laugh harder than when I last watched ‘Faulty Towers’, but, more importantly, you have shown us how deluded some (or could this be ‘all’?) of the leading homeopaths really are.

PS

Alan, if you read this, perhaps you want to have a look a this post.

Yes, to a large extend, quacks make a living by advertising lies. A paper just published confirms our worst fears.

This survey was aimed at identifying the frequency and qualitative characteristics of marketing claims made by Canadian chiropractors, naturopaths, homeopaths and acupuncturists relating to the diagnosis and treatment of allergy and asthma.

A total of 392 chiropractic, naturopathic, homeopathic and acupuncture clinic websites were located in 10 of the largest metropolitan areas in Canada. The main outcome measures were: mention of allergy, sensitivity or asthma, claim of ability to diagnose allergy, sensitivity or asthma, claim of ability to treat allergy, sensitivity or asthma, and claim of allergy, sensitivity or asthma treatment efficacy. Tests and treatments promoted were noted as qualitative examples.

The results show that naturopath clinic websites had the highest rates of advertising at least one of diagnosis, treatment or efficacy for allergy or sensitivity (85%) and asthma (64%), followed by acupuncturists (68% and 53%, respectively), homeopaths (60% and 54%) and chiropractors (33% and 38%). Search results from Vancouver were most likely to advertise at least one of diagnosis, treatment or efficacy for allergy or sensitivity (72.5%) and asthma (62.5%), and results from London, Ontario were least likely (50% and 40%, respectively). Of the interventions advertised, few are scientifically supported; the majority lack evidence of efficacy, and some are potentially harmful.

[Legend to figure above: Percentage of alternative medicine clinic websites advertising at least one of diagnosis, treatment or efficacy for allergy/sensitivity or asthma. Presenting the data in this way demonstrates that the Canadian naturopath, homeopath and acupuncturist websites studied have >50% rates of making at least one health-related claim for both allergy/sensitivity and asthma.]

The authors concluded that the majority of alternative healthcare clinics studied advertised interventions for allergy and asthma. Many offerings are unproven. A policy response may be warranted in order to safeguard the public interest.

In the discussion section, the authors state: “These claims raise ethical issues, because evidence in support of many of the tests and treatments identified on the websites studied is lacking. For example, food-specific IgG testing was commonly advertised, despite the fact that the Canadian Society of Allergy and Clinical Immunology has recommended not to use this test due to the absence of a body of research supporting it. Live blood analysis, vega/electrodiagnostic testing, intravenous vitamin C, probiotics, homeopathic allergy remedies and several other tests and treatments offered all lack substantial scientific evidence of efficacy. Some of the proposed treatments are so absurd that they lack even the most basic scientific plausibility, such as ionic foot bath detoxification…

Perhaps most concerning is the fact that several proposed treatments for allergy, sensitivity or asthma are potentially harmful. These include intravenous hydrogen peroxide, spinal manipulation and possibly others. Furthermore, a negative effect of the use of invalid and inaccurate allergy testing is the likelihood that such testing will lead to alterations and exclusions in diets, which can subsequently result in malnutrition and other physiological problems…”

This survey originates from Canada, and one might argue that elsewhere the situation is not quite as bad. However, I would doubt it; on the contrary, I would not be surprised to learn that, in some other countries, it is even worse.

Several national regulators have, at long last, become aware of the dangers of advertising of outright quackery. Consequently, some measures are now beginning to be taken against it. I would nevertheless argue that these actions are far too slow and by no means sufficiently effective.

We easily forget that asthma, for instance, is a potentially life-threatening disease. Advertising of bogus claims is therefore  much more than a forgivable exaggeration aimed at maximising the income of alternative practitioners – it is a serious threat to public health.

We must insist that regulators protect us from such quackery and prevent the serious harm it can do.

The common cold is one of the indications for which homeopathy is deemed to be effective… by homeopaths that is! Non-homeopaths are understandably critical about this claim, not least because there is no good evidence for it. But, hold on, there is a new study which might change all this.

This study was recently published in COMPLEMENTARY THERAPIES IN MEDICINE which is supposed to be one of the better journals in this area. According to its authors, it was conducted “to determine if a homeopathic syrup was effective in treating cold symptoms in preschool children.” Children diagnosed with an upper respiratory tract infection were randomized to receive a commercial homeopathic cold syrup containing allium cepa 6X, hepar sulf calc 12X, natrum muriaticum 6X, phosphorous 12X, pulsatilla 6X, sulphur 12X, and hydrastasis 6X or placebo. Parents administered the study medication as needed for 3 days. The primary outcome was change in symptoms one hour after each dose. Parents also assessed the severity of each of the symptoms of runny nose, cough, congestion and sneezing at baseline and twice daily for 3 days, using a 4-point rating scale. A composite cold score was calculated by combining the values for each of the four symptoms. Among 261 eligible participants, data on 957 doses of study medication in 154 children were analyzed. There was no significant difference in improvement one hour after the dose for any symptom between the two groups. Analysis of twice daily data on the severity of cold symptoms compared to baseline values found that improvements in sneezing, cough and the composite cold score were significantly greater at both the first and second assessments among those receiving the cold syrup compared to placebo recipients.

The authors concluded that the homeopathic syrup appeared to be effective in reducing the severity of cold symptoms in the first day after beginning treatment.

Where to start? There are so many problems with this study that I find it difficult to chose the most crucial ones:

  • The study had a clearly defined primary endpoint; it was not affected by the homeopathic treatment which doubtlessly makes the study a negative trial. The only correct conclusion therefore is that THE HOMEOPATHIC SYRUP FAILED TO AFFECT THE PRIMARY OUTCOME MEASURE OF THIS STUDY. THEREFORE THE TRIAL DID NOT PRODUCE ANY EVIDENCE TO ASSUME THAT THE EXPERIMENTAL TREATMENT WAS EFFICACIOUS.
  • I don’t think that many of the primary or secondary outcome measures are validated or reliable.
  • All the positive results reported in the abstract and the article relate to secondary endpoints which are purely explanatory by nature. They should, in my view, not be mentioned in the conclusions at all.
  • The fact that some results turned out to be positive can be explained by the fact that the investigators ran dozens of tests for statistical significance which means that, by simple chance, some will turn out to produce a positive result.
  • A further explanation for the seemingly positive results might be the fact disclosed in the text of the article that the children in the homeopathy group received more conventional drugs than those in the placebo group.
  • Whatever the reason for these positive results, they certainly had nothing to do with the homeopathic syrup.
  • The study was funded by the company producing the syrup and for which one of the authors was employed as a consultant. This might be an explanation for the abominably poor science. In other words, this paper is not an exercise in testing a hypothesis but one in marketing.

While I might forgive the company for trying to maximise their sales figures, I do find it harder to forgive the authors, reviewers and editors for publishing such overtly false conclusions. In my view, they are all guilty of scientific misconduct.

Yes, this post might come as a surprise to some.

And no, I am not changing sides in the debate in the debate about homeopathy.

But I have long felt that, when sceptics criticise homeopathy, they often wrong-foot themselves by using arguments which are not entirely correct.

Here I want to list seven of them (more details can be found here):

Homeopathy is one single, well-defined entity

During the last 200 years, many different variations of Hahnemann’s classical homeopathy have emerged, for instance clinical homeopathy, complex homeopathy and isopathy. Strictly speaking, they should be differentiated, and it is not correct to generalise across all of them.

In the 200-years’ history of homeopathy, homeopaths have done no good at all

Hahnemann and his followers can be credited with considerable achievements. Foremost, they realised that, 200 years ago, most of the conventional treatments in common use were not just useless but often outright dangerous. Their criticism of ‘heroic medicine’ helped to initiate crucial reforms and to improve health care for the benefit of millions.

No theories to explain how homeopathy might work have ever been put forward

There are several theories which might go some way in explaining how homeopathy works. But all of them are currently just theories, and none provides a full explanation as to the mechanism of action of highly diluted remedies. Yet, to claim that homeopathy is totally implausible might be a counter-productive exaggeration.

There is nothing in it

Many sceptics claim that homeopathic remedies are devoid of active ingredients. Yet, not all homeopathic remedies are highly diluted; some can contain pharmacologically active compounds for affecting human health. These preparations cannot therefore be classified as implausible.

There is no credible evidence at all that might support homeopathy

Several well-conducted clinical studies of homeopathy with positive results have been published. It is therefore not true to claim that there is no good trial evidence at all to support homeopathy. The much better point sceptics should make is that the totality of the reliable evidence fails to show that highly dilute homeopathic remedies are more effective than placebos.

Homeopaths aim at deceiving their patients because they have nothing to offer to them

It would be wrong to claim that all homeopaths aim at deceiving their patients, and it would be misleading to say that homeopaths have nothing to offer to their patients. Many patients of homeopaths primarily treasure the long, compassionate consultations that homeopaths have with their patients and see the homeopathic remedy as secondary. Seen from this perspective, homeopaths do offer something that many patients value highly.

Patients who use homeopathy must be stupid

It would be arrogant, insulting and counter-productive to claim that everyone who uses homeopathy is stupid. Patients consult homeopaths mostly because they have needs which are not met by conventional medicine but which they feel taken care of by homeopathy. Seen from this perspective, the current popularity of homeopathy in some countries is a poignant criticism of conventional medicine. To dismiss it a stupidity means missing a chance to learn an important lesson and to improve mainstream health care.

I know, my stance here can easily get misunderstood (see for instance some of the comments here). But please don’t get me wrong, I am not saying that homeopathy is a useful therapy, nor am I suggesting that we should not criticise it or stop public funding for it. All that I am trying to convey here is this: when we criticise homeopathy, we ought to make sure our arguments are factually correct – if not, we only give ammunition to our opponents.

In a nutshell: I don’t wish to undermine our arguments, but want them to be more effective.

 

 

The Scotsman reported that David Tredinnick, the somewhat feeble-minded Tory MP for Bosworth, has been at it again. Apparently he said that many of his constituents are only alive today because they have been treated with alternative medicine.

Tredennick recently urged ministers to spend more NHS money on alternative therapies such as homeopathy and acupuncture to treat patients. It seems to me that, for him and other quackery promoters, evidence and science are issues beyond comprehension. Mr Tredinnick also disclosed the fact that he received acupuncture at a Chinese medical clinic just before the Commons debate on cancer strategy – a regular treatment he credits with keeping him healthy.

Tredennick told his fellow MPs: “I was talking there to practitioners about what they are able to do for cancer patients, and there is actually a very long list of types of cancer that can be treated using traditional Chinese herbal medicine.“ One, cervical cancer, two, non-Hodkins lymphoma, three, HIV, four, colon cancer, five… six, breast cancer, seven, prostate cancer. And so the list goes on. “I have in my constituency several constituents who I believe are alive today because they have used Chinese medicine.“ And the reason for that is what it does is it strengthens your system, and it strengthens the immune system, and it is very effective after cancer treatment. It deals with particular symptoms.”

This is by no means the first outburst of quackery-promotion by the Right Honourable Gentleman. I have a whole selection of quotes from him which I sometimes use for amusing my audience during public lectures. Because amusing he is; Tredennick seems to be utterly devoid of rational thought when it comes to the subject of alternative medicine, and often his statements make for comedy gold. This time, however, he might be sailing closer to the wind than he perhaps realizes: Under English law, it is an offence to claim that any treatment can cure cancer, I believe.

We all had to learn to laugh about unethical and dangerous nonsense the ‘Tredennicks of this world’ regularly claim about alternative medicine. Laughing is the only solution for coping with such idiocy, I am afrid. If we don’t laugh, we have to consider taking it seriously – and this is a truly frightening prospect, particularly considering that this guy actually sits in parliament and has the power to influence our lives.

This randomized, double-blind study evaluated the efficacy of a homeopathic treatment in preventing excessive weight gain during pregnancy in overweight or obese women who were suspected of having a common mental disorder. For the homeopathic group (n=62), 9 homeopathic remedies were pre-selected: (1) Pulsatilla nigricans, (2) Sepia succus, (3) Lycopodium clavatum, (4) sulphur, (5) Lachesis trigonocephalus, (6) Nux vomica, (7) Calcarea carbonica, (8) phosphorus; and (9) Conium maculatum. From those 9 drugs, one was prioritized for administration for each participant. After the first appointment, a re-selection or selection of a new, more appropriate drug occurred, using the list of preselected drugs. The dosage was 6 drops orally 2 ×/day, in the morning and at night, on 4 consecutive days each week, with an interval of 3 d between doses, up until the next appointment medical appointment. The control group (n=72) took placebos. Both groups also received a diet orientation.

Weight change during pregnancy was defined as the difference between the body mass index (BMI) at the initial evaluation and that recorded at the final evaluation, adjusted for 40 weeks of gestation. In addition, the APGAR index in the newborn  (a measure of the health of the baby) was evaluated. The mean variation between baseline BMI and BMI at week 40 of gestation was +4.95 kg/m2 in the control group and +5.05 kg/m2 in the homeopathy group. The difference between the two groups was not significant. APGAR 10 at 5 min (59.6% in the homeopathy group and 36.4% in the control group) was statistically significant (P = .016).

The authors concluded that homeopathy does not appear to prevent excessive body mass gain in pregnant women who are overweight or obese and suspected of having a common mental disorder. Homeopathy did not change the APGAR score to modified clinical attention at delivery room. However, the evidence observed at APGAR 10 at minute 5 suggests that  homeopathy had a modulating effect on the vitality of newborns, warranting further studies designed to investigate it.

I have seen many odd studies in my time, but this must be one of the oddest?

  • What is the rationale for assuming that homeopathy might affect body weight?
  • Why take pregnant women with a weight problem who were suspected of having a common mental disorder?
  • Why try to turn a clearly negative result into a finding that is (at least partly) positive?

The last point seems the most important one to me. The primary outcome measure of this study (weight gain) was clearly defined and was not affected by the therapy. Yet the authors feel it justified to add to their conclusions that homeopathy had a modulating effect on the vitality of newborns (almost certainly nothing but a chance finding).

Are they for real?

I suppose they are: they are real pseudo-scientific promoters of quackery!

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