MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

I am indebted to my good friend and long-term admirer Dana Ullman for alerting me to this new (2019) paper. It reports a study aimed to test whether homeopathic medication administration to COPD patients during the influenza-exposure period may help to reduce the frequency of common URTIs.

This prospective, observational, multicenter study was carried out in Cantabria, Spain. Patients with COPD were divided into two groups: group 1 received conventional treatment + homeopathic medication (diluted and dynamized extract of duck liver and heart; Boiron) (OG); group 2 received conventional treatment only (CG). The primary endpoint was the number of URTIs between the 4-5 months follow up (mean 4.72 ± 0.96) from basal to last visit. Secondary endpoints included the duration of URTIs, number and duration of COPD exacerbations, use of COPD drugs, changes in quality of life (QoL), compliance, and adverse events (AEs).

219 patients were analyzed (OG = 109, CG = 110). There was a significant reduction in mean number of URTIs during the follow-up period in OG compared to CG (0.514 ± 0.722 vs. 1.037 ± 1.519, respectively; p = 0.014). Logistic regression analysis showed a 3.3-times higher probability of suffering ≥2 URTI episodes in CG (p = 0.003, n = 72). OG patients having ≥1 URTI also had a significant reduction in mean URTI duration per episode (3.57 ± 2.44 days OG vs. 5.22 ± 4.17 days CG; p = 0.012). There was no significant difference in mean number of exacerbations, mean duration of exacerbations, or QoL between OG and CG. There was a greater decrease in proportion of patients using corticosteroids for exacerbations between baseline and visit 2 in OG compared to CG (22.1% vs. 7.5% fewer respectively, p = 0.005). Exacerbator phenotype patients had a significant decrease in number of URTIs (0.54 ± 0.72 vs. 1.31 ± 1.81; p = 0.011), and fewer COPD exacerbations (0.9 ± 1.3 vs. 1.5 ± 1.7; p = 0.037) in OG vs. CG, respectively.

The authors concluded that homeopathic medication use during the influenza-exposure period may have a beneficial impact at reducing URTIs’ number and duration in COPD patients and at reducing the number of COPD exacerbations in patients with the exacerbator phenotype. Further studies are needed to confirm the effects observed in this study.

Evidently, Dana thinks highly of this new evidence for Boiron’s duck diluted out of existence, markeded as Oscillococcinum. Do we now have to eat out words? Does homeopathy work after all? Has Dana been right all along?

‘fraid not!

Here are just a few of the most obvious flaws of this trial:

  1. It was not an observational study as I understand it.
  2. It followed the infamous A+B versus B design (which never generates a negative result).
  3. As such it did not control for placebo effects.
  4. It cannot achieve its stated aim.
  5. Its statistical analysis seems faulty.
  6. It lacks randomisation which means the 2 groups differed in many undetected ways.
  7. The primary endpoints were assessed by an undisclosed method.

But there is more, much more.

Conflicts of interest:

J.L. Garcia-Rivero has received speaker’s fees from Boiron Laboratories. G. Diaz Saez (the senior author of the trial) was the Medical Director of Boiron Laboratories when the study was carried out and continued to collaborate in the study after leaving this post. A. Viejo Casas has received speaker’s fees from Boiron Laboratories. All authors of this study, except for G. Diaz, received fees for including patients.

Funding:

This work was supported by Boiron Laboratories.

I REST MY CASE

46 Responses to Homeopathy: a new study proves efficacy (according to Dana Ullman)

  • I think I am getting more simple minded as I get older.

    When the paper says “There was a significant reduction in mean number of URTIs during the follow-up period in OG compared to CG (0.514 ± 0.722 vs. 1.037 ± 1.519, respectively; p = 0.014)” does this mean that some people had -0.208 and -0.482 URTI’s respectively?

    How do you have a -ve URTI?

    • I agree that the abstract is rather ambiguous. Elsewhere in the full paper the authors have used ± to refer to the standard deviation of the data, rather than to confidence intervals (which is how you have read it, and everybody else I suspect). However, for data following a normal distribution you would expect the 95% confidence interval to be approximately two standard deviations either side of the mean, which would be even more ridiculous in this case.

      As far as I can tell, the problem is that the data do not follow a normal distribution, which means that the statistical tests that they were using to analyse it are invalid. For instance (from memory – I don’t have the paper in front of me just now) in one of the patient groups, more than half never had a further URTI during the follow-up period, which meant that the median number of infections was zero, and the mean would be strongly influenced by those few patients who had more than one. With this highly skewed data it is meaningless to use the standard deviation, and rather misleading to use the mean. The finding of a potentially negative number of infections ought to have been a clue to the authors that they had got their sums wrong.

    • The standard deviation is just a formula and in this case the number was larger than the mean.

      What it actually means is that the distribution of the number of URTIs in this sample does not fall into a proper bell curve. It was weighted to the high end.

  • “All authors of this study, except for G. Diaz, received fees for including patients”
    I would be interested to know what these fees were. When conducting commercial trials at a non-commercial setting (such as a hospital) it is usual for the sponsors (i.e. the company making the drug or whatever) to make a payment per patient enrolled, in order to cover the additional costs required. The huge amount of work involved in a clinical trial means that additional staff have to be employed (research nurses etc.), and this is a common way of funding them.

    I have already commented on some of the statistical shortcomings of the paper in another thread.

  • Your comments here, indeed none of your comments anywhere provide any evidence that homeopathy ‘doesn’t work’.

    • correct;
      you would also be hard-pressed to find evidence that bungy-jumping does not work for hair-loss.
      the point is that in healthcare, we must go with positive proof. the default position is that, if positive proof is not available, it should be considered ineffective.

    • Dear Mr. Biggins,
      Your comment indicates a fundamental misunderstanding; science cannot DISPROVE supernatural phenomena (e.g. efficacy of homeopathic remedies, existence of gods, ghosts, etc.). The scientific method is not the right tool for such a purpose.
      As an example: no scientist on earth will be able to DISPROVE the existence of fairies, hobgoblins or unicorns.
      The burden of prove is on the person claiming that such a supernatural phenomenon exists.
      And supporters of homeopathy always fail to prove that their claims of efficacy beyond placebo are justified (within the statistical expectation for false positive results), unless the studies are seriously flawed.

      • The following esteemed medical journals have published double-blind and placebo controlled trials showing efficacy of homeopathic medicines: Lancet, BMJ, Chest, Cancer, Rheumatology, Pediatrics Infectious Disease Journal, European Journal of Pediatrics, Journal of Clinical Oncology.

        Please show me that these same journals have proven the existence of faires or unicorns OR consider that you’re creating a false equivalency…or are just super-daft.

        • Dana, Dana, Dana!
          surely you cannot mean that

          • Ed, Ed, Ed,
            Just because you are in DENIAL doesn’t mean that everyone else is.
            And for the record, if you used the same critical analysis of conventional medicine that you give to homeopathy, less than 2% of medical treatments would be found to be effective (and I’m being generous here).

          • are you saying that only 2% of conventional treatments are supported by studies that are more rigorous than this one?
            in this case, it might well be you who is in denial.
            in any case, for someone who has been certified by an US judge in this way, your accusation of denial sounds like a true compliment:
            The Defendant presented the testimony of Gregory Dana Ullman who is a homeopathic practitioner. He outlined the theory of homeopathic treatment and presented his opinion as to the value and effectiveness of homeopathic remedies. The Court found Mr. Ullman’s testimony to be not credible. Mr. Ullman’s bias in favor of homeopathy and against conventional medicine was readily apparent from his testimony. He admitted that he was not an impartial expert but rather is a passionate advocate of homeopathy. He posted on Twitter that he views conventional medicine as witchcraft. He opined that conventional medical science cannot be trusted.
            […]
            Mr. Ullman’s testimony was unhelpful in understanding the purported efficacy of the ingredients of SnoreStop to reduce the symptoms of snoring. Although he is familiar with the theory of homeopathic treatment, his opinions regarding its effectiveness was unsupported and biased. The Court gave no weight to his testimony.

        • Dana

          Indeed they have. And the efficacy they showed was none whatsoever. You’ve waved those studies around previously and had the errors in them explained to you. That memory of yours is becoming a real problem.

          And there’s only one person here creating false equivalencies and that’d be Mrs Ullman’s son. The one who’s standing there with his invisible pants on.

          • Len/Len/Len…just because you or one other psycho here reports on a trial with the defect does NOT make the trial invalid. The journals that I listed previously do not publish rubbish…and in fact, they hold studies on homeopathy to a much higher level of review…and yet, all of these studies found significant and often SUBSTANTIALLY significant results.

            Heck, even the BMJ wrote an editorial acknowledging the allergy/rhinitis/hayfever studies by Reilly, et al. asserting that it is time to acknowledge the efficacy of homeopathy.

            But double-heck, you are much much smarter than the editors of these medical journals, and we should bow down to your intellectual capabilities…or give you a medicine for delusions (or dilutions) of grandeur.

        • Dear Mr. Ullman,
          First: I do not recall that I have addressed you disrespectfully in our previous exchanges, so I don´t see a reason for the aggressive undertone in your comment. I will have to leave it up to you to decide for yourself if I am “super daft”.
          And although you seem to be a “black-or-white” kind of guy, please at least consider the possibility that I could just be “medium-daft”, not “super-daft” if we have different opinions on this matter.

          Second: Publication of a couple of papers that indicate a specific effect of homeopathy in esteemed journals does not prove that homeopathy “works”. Let´s not forget the many, many publications (also published in esteemed journals) indicating the opposite. And, as far as I know, pretty much all the pro-homeopathy papers have been criticized for being flawed. But please correct me if I am wrong, I certainly haven´t read all of them.

          Third: Your belief that homeopathic “nanodoses” exist and can affect e.g. the human body indeed reminds me of a typical supernatural believe.
          Might I ask you: How could it be shown to you that your “nanodose” concept is wrong? Is there any way that you would accept to prove to you that such “nanodoses” do NOT exist? If your answer is no, then your believe is not falsifiable and (as for all unfalsifiable, supernatural claims), you should not trust the idea with any degree of confidence.

          • Sorry…but you’re in the super-daft category because anyone who equates homeopathy with unicorns is super-daft.

            Once again, please show me where any of the previously mentioned journals have published double-blind and placebo-controlled trials on unicorns.

          • Ouch… not even medium-daft, no?! Guess it does take much to fall into your “super-daft” category. Ok then, after we have established this, I will answer your question:

            Yes, I certainly will not find any double-blind and placebo-controlled trials on the existence of unicorns in the journals you mentioned (or any other).
            But I wonder: What does this prove in your opinion?! And… how would a placebo-unicorn look like?!
            One thing is certain: big pharma does not make any money with unicorns, but plenty with selling homeopathic remedies. How convenient that “scientists” employed by these companies (in this case Boiron Laboratories) produce studies that will sell their products. Well, my super-daft mind tells me that this must be a coincidence.

            Now, would you be so kind to answer my question?
            What evidence would convince you that homeopathic “nanodoses” do NOT exist? Can you give just one example?
            Or… is this just something that you “have to believe” is true?

          • Soul And Spirit magazine likes unicorns as healing modalities, Dana.

            http://www.soulandspiritmagazine.com/unleash-unicorn-power-today/

            They also like White Witches who use homeopathy.

            http://www.soulandspiritmagazine.com/11-signs-youre-a-white-witch/

            A quality journal and no mistake.

            Carry on, Dana.

            Oh, and be careful with your dinner tonight. If you eat like you argue you’ll be taking an eye out with your fork.

  • Dear Jashak,

    Accepting both yours and my comments, where do we go next. The impasse always seems to be that a certain kind of trial used in drug manufacture must be applied to homeopathic medicine if it is to be taken seriously. I am inclined to agree that this scientific method can not be satisfactorily applied, although I think some have tried.

    I am left wondering how it is that within three months (and two homeopathic prescriptions) a 32 year old female with polycystic ovaries has reported to me a normalising effect to her menstrual cycle, vastly improved sleep pattern, improved mood, improved energy, worsening of eruptions on fingers and toes and the mysterious complete loss of a toenail. On re-reading the proving of Silica, (the second of the two remedies) I have used I find mention of the effects on fingernails and toenails.

    As homeopaths we too would love to know what is going on too. Me especially.

    • Dear Mr. Biggins,
      regarding your case report, my answer is: no clue what was going on with the woman (I have a degree in molecular biology, not in medicine). From a scientific point of view, I would say the symptoms are unlikely to be connected to a homeopathic treatment, due to the lack of active ingredients.
      If you ask me where to go next, I have a great recommendation for you:
      Have a look at the homepage of the GWUP. They offer 50.000€ to anyone who is able to prove ANY effect of ANY homeopathic treatment with ANY method that the applicant wants to use (see specifics there). Seems more than fair to me, so you should go ahead and grab the free money!
      I wished that someone would offer such a challenge in my field of expertise…

    • Dear Nick,

      “The impasse always seems to be that a certain kind of trial used in drug manufacture must be applied to homeopathic medicine if it is to be taken seriously.”

      As far as I can see the problem arises because most people don’t understand probability and the behavior of numbers very well. Indeed, most of our intuitions about probability are completely wrong.

      All biological systems, humans included, are subject to a great many influences, most of which cannot be predicted or identified in an individual case, which means, in effect, that there is a strong random element in how they behave. Clinical trials are designed the way they are so that real effects can be separated from random ones. They are also designed to minimise bias, which otherwise gives misleading results. This does not only apply to drug manufacture, but to the assessment of any intervention or treatment.

      Numbers behave the same way whether they are being used to look at the effects of a new drug or of a homeopathic treatment and if you are suggesting otherwise then I would be forced to conclude that you are not very numerate.

      “I am inclined to agree that this scientific method can not be satisfactorily applied”
      This suggests to me that you don’t know what the scientific method is. Essentially it involves testing a hypothesis by attempting to disprove it (or to falsify predictions made by the hypothesis). If it stands up to robust testing then it is provisionally accepted. The scientific method is the best way that we have found to establish an approximation to the truth. There are some areas that are not amenable to science and are instead a matter of faith, but health care is not one of them.

      It seems to me that the scientific method can be applied to homeopathy in at least two ways. The first is to leave aside any considerations of the mechanism of action and simply to look at the effects of treatment, which involves conducting well-designed randomised controlled trials. So far these have failed to show any effects. That such effects do not, in fact, exist seems a better explanation than that the method of investigating them is wrong.

      The second way is to look at the proposed mechanisms whereby homeopathic treatment may have an effect. If an experiment could be designed that showed that such mechanisms existed, then this would invalidate the atomic theory of matter, and indeed much of what we know of physics and most of chemistry. I would imagine that most scientists would be very excited at such a breakthrough in our understanding of Nature, though it would leave engineers with nothing to base their practice on.

      “I am left wondering how it is that within three months (and two homeopathic prescriptions) a 32 year old female with polycystic ovaries has reported to me a normalising effect to her menstrual cycle, vastly improved sleep pattern, improved mood, improved energy, worsening of eruptions on fingers and toes and the mysterious complete loss of a toenail.”
      Any doctor will know that many patients behave in unexpected ways and that very often the available information and current level of understanding cannot give a satisfactory explanation. It is best simply to accept this, rather than to invent an explanation that is plausible (i.e. fitting a favourite model of disease) but wrong. Otherwise you can end up convincing yourself of something that isn’t there, and worse, using it as the basis for treating future patients.

      Having said that, I can think of some quite common reasons for the behaviour of the case that you describe. The history is quite consistent with an episode of depression, improving over the follow-up period of three months (depression markedly affects mood, energy and sleep). I am not sure that three months is long enough to make an accurate assessment of any changes in the menstrual cycle, however, particularly if it is very irregular to begin with (which it commonly is in this condition).

      With regard to the toenails, have you considered that there might be an infection present, such as a fungus, or perhaps Staphylococcus aureus? It is quite simple to send microbiological samples, and in the case of Staph. aureus, a therapeutic trial of flucloxacillin could show a marked improvement within a few days.

      In any case, it is well established that patients tend to report improvements over time almost regardless of how they are treated, due to the placebo effect, due to not wanting to disappoint the person treating them, and due to the mathematical phenomenon of regression to the mean (i.e. for chronic conditions such as PCO they tend to seek help when, by chance, their condition is worse than usual, after which it is more likely to improve than to worsen even more).

      For that matter, how was the diagnosis of polycystic ovaries made? My understanding of homeopathy is that the practitioner treats the combination of symptoms that the patient presents with, rather than a specific diagnosis, and I would be surprised if Hahnemann described polycystic ovaries in his Organon.

      “As homeopaths we too would love to know what is going on too. Me especially.”
      I would recommend studying physics, maths, chemistry and biology to begin with, and then some of the medical sciences such as physiology, biochemistry, pathology, microbiology and statistics.

      • Dear Dr. Money-Kyrle,
        I would like to make two comments on your statement „ (…) Essentially it [the scientific method] involves testing a hypothesis by attempting to disprove it (or to falsify predictions made by the hypothesis).”
        1. You point out an important aspect: any hypothesis that science CAN be used to investigate MUST have the quality to be falsifiable. This means that science is not the right tool to investigate EVERY POSSIBLE claim/hypothesis people come up with.
        Hypotheses like “gods/unicorns/fairies etc. exist” or “homeopathy works” are too unspecific to be falsifiable; therefore they cannot be tested scientifically.
        However, SPECIFIC, FALSIFIABLE claims of efficacy of homeopathic remedies beyond placebo HAVE been tested numerous times, and (as has been pointed out many times by Prof. Ernst and others), these tests fail to provide robust evidence to support this claim, if testing was done diligently.
        2. I think it is not advisable to use the phrase that scientist try to “disprove” a hypothesis. I think it is better to say that scientist “test” a hypothesis.
        Testing should always be free from any bias, so you should not attempt to prove or disprove anything.
        Scientist should aim to design and setup an experiment as objectively as possible and then collect and analyse the data. If the data do NOT support the hypothesis, this does not mean that the hypothesis is disproven; it just means that your confidence level that the hypothesis is true should be lowered. In other words: The degree of confidence that a claim is true should be in accordance with the amount of evidence that supports the claim.

        So one might ask: if the healing power of homeopathy (or any other supernatural claim) has not been “disproven”, is it reasonable to believe in it? In my opinion: no.
        In the case of homeopathy, many well designed clinical trials have shown no effect beyond placebo and furthermore, no rational mode of action exists that would be in agreement with our current understanding of nature and the physical laws of our universe.
        Therefore, the level of confidence in homeopathy should be close to zero and I consider application for any health condition as extremely unreasonable.

    • The impasse always seems to be that a certain kind of trial used in drug manufacture must be applied to homeopathic medicine if it is to be taken seriously

      All a controlled trial does is to detect differences in outcome. If you claim that controlled trials are not a suitable test of homoeopathy, you are claiming that homoeopathy doesn’t make a difference.

      • I never said that controlled trials are not a suitable test for homeopathy. Never ever.

        I simply said that good science requires appropriate usage of homeopathic medicines. Just as antibiotics cannot be used for ALL infections, homeopathic medicine require, except in rare circumstances, an individualized usage that matches the symptoms of the sick person with the medicinal substances toxicology. When that happens, the human body has a hypersensitivity to the medicinal agent and its nanodose augment immune and defensive responses.

        • this is largely fantasy!
          1) there is a whole branch of homeopathy that does not require individualisation; it’s often called clinical homeopathy [from my book: While ‘classical homeopathy’ relies on individualised prescribing according to the ‘like cures like’ principle and selects the optimal remedy for each patient based on the findings from provings, clinical homeopathy resembles more the way drugs are prescribed in conventional medicine; it selects the appropriate remedy according to the condition of the patient, while largely disregarding the ‘like cure like’ principle.
          However, clinical and classical homeopathy are not mutually exclusive; in fact, there is considerable overlap between the two approaches, and they are often used in parallel by the same clinician. In other words, if the symptoms of a patient reveal a very clear indication for a certain homeopathic remedy, clinical homeopathy is used even by classical homeopaths. For instance, Arnica is considered a clear indication for cuts and bruised; so is Coffea for insomnia, Drosera for cough, Opium for constipation etc., and these remedies would be employed regularly by classical homeopaths.
          Clinical homeopathy is also used by many non-homeopaths as well as by consumers when they self-prescribe. It does not require an understanding any of the principles of homeopathy nor its fine details. Moreover, clinical homeopathy is also the predominant approach in veterinary homeopathy]
          2) If it were true that individualised homeopathy ‘augments immune and defensive responses’, as you say, one would be able to quantify these responses. there is no good evidence that such reactions ever occur after individualised, highly diluted remedies.

          • Now we KNOW that Eddy was not a good student of homeopathy.

            Coffea is NOT given to even a MAJORITY of people with insomnia, nor is Opium given to a majority of people with constipation, nor is Drosera given to a majority of people with a cough.

            Eddy, you flunked out of homeopathic school (you never graduated!), and your ignorance is now on display (again).

            Thanx for the evidence…and YOU appreciate “evidence.”

          • … or is it not Dana – I love when he, as an old friend, calls me ‘Eddy’ – who has flunked homeopathy-school by stating that only in ‘rare circumstances’ do homeopaths not individualise. this is just wrong!
            and perhaps he even flunked school much before that; he does not seem to be very good at simple reading tasks either: I never stated that there remedies are given to the MAJORITY of cases.
            or perhaps I am mistaken; all this could, of course, also be the expression of the man’s severe delusional state.
            GET SOME PROFESSIONAL HELP DANA!

          • The individual remedy play is such a cop out. Coffee is indeed given to the majority of patients with insomnia. Most people just walk into the store and scan the Boiron display or ask the clerk. Of course supporters claim a hit when the coffee is reported to work, even if “the hands and feet are not excessively cold.”

        • “Except in rare circumstances”

          What? Like joint and muscle pain, anal fissures, ringworm, acne, traumatic brain injury and lots more according to the many non-individualised remedies you hawk on your website, Dana? Hardly rare.

          • I know some clinicians who never individualise the homeopathic remedies they prescribe.

          • Skeptics of homeopathy are such fun to watch. With their bluster, their arrogance, and their ignorance, they are like a mosquito at a nudist camp…there is so much to bite and no intelligence to do so.

            Those “user-friendly” homeopathic products are for people who are not trained in homeopathy and who do not know how to individualize the correct remedy…and so, homeopathic companies place mixtures of several remedies in order to increase the chances of a therapeutically beneficial effect.

            Arrogance and ignorance are BAD combo for people who idealize a healthy and good scientific attitude. Needless to say, I’m skeptical of these skeptics.

          • Why not create a homeopathic drug that contains all the ingredients permitted for OTC use by HPUS? It could cure all known minor self-limiting conditions, couldn’t it?

          • If only you knew a credible expert in homeopathy who you could ask to come here and comment, Dana…

          • “Except in rare circumstances”

            So, Dana, by your own words, these non-individualised remedies are unlikely to work.

            Or they ARE likely to work, thus homeopathy doesn’t really need to be individualised. You just lob a cocktail of remedies at the mark – sorry – patient.

            You can’t have it both ways, Dana.

            You and logic aren’t even on nodding terms.

      • Maybe the homeopaths would like Big Pharma to be allowed to sell their products only having provided anecdotes as ‘evidence’?

  • A friend of mine recently looked at successful trials of homeopathic dilution.

    The results are about what you would expect….

    “Methods
    Homeopathic ultramolecular dilutions are medicinal preparations with active substances diluted beyond Avogadro’s number. Such dilute mixtures are unlikely to contain a single molecule of an active substance. We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions.

    Results
    P-curve accurately rejected the evidential value of significant results obtained in placebo-controlled clinical trials of ultramolecular dilutions. Robustness testing using alternate p-values yielded similar results.”

    Reisman S, Balboul M, Jones T. 2019. P-curve accurately rejects evidence for homeopathic ultramolecular dilutions. PeerJ 7:e6318

    • “Since Southam and Erlich’s paper, thousands of other examples of compounds exhibiting hormetic effects have been documented. Some of these are well-recognized components of our diet–including trace metals, alcohol and caffeine–recognized to be essential or healthful at low doses, but detrimental or toxic at high doses.”

      In biochemistry, small amounts of coffee make you alert, and large amounts of coffee cause seizures.

      In homeopathy, small amounts of coffee make you alert, and no coffee at all makes you sleepy.

    • I’ve just had a look at that link. The author takes the phenomenon of hormesis (a biphasic response to a toxin or other stress) and runs with it.

      There are a number of factual errors. For instance the author states that survivors of atomic blasts outside the blast radius had a reduced incidence of cancer – as far as I know most of the relevant data comes from Hiroshima and Nagasaki, where 250,000 were killed outright by the blast, burns or radiation, and another 250,000 received a significant dose of radiation but were not killed. After forty years of follow-up there were 300 excess cancers in this group over and above what would be expected. This tells us that that this risk of cancer from radiation exposure is a lot less than most people’s perception, but nevertheless there is a risk.

      Many of the examples he gives of hormesis are of something that has a beneficial effect at low doses (such as sunlight enabling us to make vitamin D) and a harmful effect at higher doses (such as sunburn and a risk of melanoma). This is true of virtually all drugs, which have the desired effect at therapeutic doses but are toxic in overdose, though this doesn’t really fit my understanding of the definition of hormesis.

      The author then gives acquired immunity as another example of hormesis, which really is stretching the definition.

      Nietsche said “What does not kill me makes me stronger”, but while that may be true of life experiences, it is unsafe to extrapolate from philosophy to physiology.

      • It’s possibly also worth mentioning that the beneficial effects associated with hormesis occur at low but measurable concentrations of test substances. Not concentrations when the substances have been diluted out of existence in the solution!

        • And that homoeopathic remedies are presumed to produce the same effects they do in ‘provings’, not the opposite effects. Provings are routinely carried out using the diluted remedies, as prescribed in aphorism 128 of the Organon. Hormesis is irrelevant.

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