Turnera diffusa, known as damiana is a shrub native to southern Texas in the United States, Central America, Mexico, South America, and the Caribbean that produces small, aromatic flowers. Damiana is an ingredient in a traditional Mexican liqueur, which is sometimes used in lieu of triple sec in margaritas. Damiana was included in several 19th-century patent medicines, such as Pemberton’s French Wine Coca. The leaves were omitted from that product’s non-alcoholic counterpart, Coca-Cola.

In folklore, the plant was believed to be an aphrodisiac. I looked for evidence from clinical trials but was unable to find any. However, that does not seem to bother PharmaSGP GmbH which produces a drug called Neradin.

The German advertisement of Neradin tells us that:

Bei sexueller Schwäche wie Erektionsstörungen können auch traditionelle Mittel helfen – ohne die Nebenwirkungen mancher chemischer Potenzmittel. Das pflanzliche Arzneimittel Neradin® nutzt dazu erfolgreich Wirkstoffe der mexikanischen Heilpflanze Damiana (Turnera Diffusa).

Die Vorteile von Neradin® auf einen Blick: Fördert die Potenz des Mannes bei sexueller Schwäche

I translated this into English:

Traditional remedies can also help with sexual weakness such as erectile dysfunction – without the side effects of some chemical sexual enhancers. The herbal medicine Neradin® successfully uses active ingredients from the Mexican medicinal plant Damiana (Turnera Diffusa).

The advantages of Neradin® at a glance: Promotes male potency in case of sexual weakness

The patient information leaflet states that “Niradin is a homeopathic drug” and “one tablet Niradin contains 100mg Turnera Diffusa Trit. D4”.

English language sites concur:

Neradin is a homeopathic medicine. Homeopathy is understood as a regulatory therapy for acute and chronic diseases. The areas of application are derived from the homeopathic drug pictures. The following indications are authorised for this medicinal product: Discomfort caused by sexual weakness

So, what we seem to have here is the following:

  • A pharma firm that advertises a homeopathic product as a herbal drug.
  • A homeopathic remedy that is based on a plant for which there is not a jot of evidence.
  • If there were evidence that the plant helps against erectile dysfunction, its homeopathic dilution would, according to the homeopathic ‘like cures like’ axiom, bring about erectile dysfunction.
  • A dilution (1:10000) that is too low to have any effect, even if it were made of Viagra.

Am I the only one to think that something is not quite right here?

But don’t let it spoil your HAPPY VALENTINE!

18 Responses to A homeopathic remedy marketed “for sexual weakness” should cause erectile dysfunction

  • I’m under the impression that ever more homeopathic products on the market contain minute amounts of substances – maybe because the general public is becoming more aware of the fact that there’s literally nothing in homeopathic dilutions 12C+, and increasingly refuse to believe fairy tales about ‘water memory’ and such.

    By putting in just a few micrograms of whatever they can now claim ‘Hey, look, there’s molecules of active substance in them remedies, there is! – even though those microdoses still don’t do anything (as also addressed above).
    And designating it a ‘homeopathic’ product (instead of ‘herbal product’) is also a clever way to keep (ab)using the legal exemption for homeopathic products with regard to requirements for efficacy and safety.

    And what’s with the image on the package? I’d say that sprouting wings is not exactly what a user would want to happen …

  • I hate (not hate) to break your bubble again…and I hate (not hate) to show your ignorance of homeopathy again…BUT…this medicine is in a very low potency (D4)…and as such, it acts like a botanical medicine. If this medicine was in a higher potency, such as the 30C, 200C, or 1M, then, it would not work to improve erections but might be indicated for priapism.

    I can’t help but sense that you KNOW this but you still write this shit, but then, I guess that is the whole idea of your blog is to just write with enough sciency stuff that people believe you even though you’re a little limp. Just sayin’.

    • Hi Dana; happy Valentine’s Day.
      you don’t need to worry about breaking bubbles – you never do. you merely blow bubbles of hot air.
      we all know that D4 is a low potency. But it is not a low dilution 1: 10 000 means the stuff is far too dilute to have an effect.
      and the confusion about herbal/homeopathic was created by the firm – deliberately, I suspect because they want the cake and eat it.
      thanks for the ‘little limp’ very funny when the subject is erectile dysfunction!

      • Edzard…

        Glad you appreciate my sense of humor. Humor supercedes rationality (IMHO).

        However, if you feel that D4 is too low of a medicine to have physiological effects, how is it that your and my body’s hormones and various biochemicals have known powerful effects on our bodies in doses akin to 10 to the negative 10, 12, 14, and more!

        Biological Activity of Low Concentrations:
        Interleukin-1 for T-cell clone proliferation: 2.5 x 10-18 (18X)
        Platelet-activing factor for decrease of luteinizing hormone somatostatin: 10-17 (17X)
        β-endorphin to modulate natural killer cell activity: 10-18 (18X
        Tumor necrosis factor for synergistic action with various drugs: 10-14 (14X)
        Leukotrienes for release of luteinizing hormone: 10-20 (20X)

        Eskinazi D. Homeopathy re-revisited. Arch Int Med. 1999;159(17):1981–1987.

        Unless your body is primarily working via an elaborate placebo effect!?

        • Dana, sweety: I wrote, “1: 10 000 means the stuff is far too dilute to have an effect”.
          Do you think that “the stuff”, Turnera diffusa, is a hormone, neurotransmitter, etc.?
          It’s a plant that is in popular use that needs to be employed in high concentration.
          It’s not powerful – if not all the Mexican margarita consumers would be dead.
          Sorry to disappoint you but you should stop digging when you are in a hole.

        • @Dana Ullman

          … how is it that your and my body’s hormones and various biochemicals have known powerful effects on our bodies in doses akin to 10 to the negative 10, 12, 14, and more!

          That is because hormones and other signalling molecules are highly specific proteins that have evolved in tandem with matching receptors.
          There are some substances from outside that can interfere with this signalling mechanism in specific way, mostly toxins and psychotropic substances. One example is botulinum toxin, which prevents the release of acetylcholin at muscular axon terminals, effectively paralysing the muscle, in nanogram dosages.
          Another example is LSD, which binds to certain receptors in the brain, causing strong hallucinogenic effects with just a couple of dozen micrograms.
          These substances are however pretty rare – which is to be expected, as their inter-species biological activity almost certainly came about by pure chance.

          If you wish to propose this receptor-driven model of homeopathy, then this has several consequences:
          – You will first have to show that those homeopathic substances indeed have the claimed effects. So far, not a single homeopathic substance has been proven effective in any consistent, independently repeatable manner. If you can’t demonstrate any effects in the first place, then it is plain silly to to go looking for mechanisms of those non-existent effects. In the above case, it must be demonstrated that the ‘remedy’ indeed helps with erectile dysfunction, preferably in a randomized controlled trial(*).
          – You would have to demonstrate the existence of special receptors for every single homeopathic remedy that you claim works this way. What’s more: those receptors must somehow be linked to the condition in question.
          – Homeopathy would necessarily have to abandon all of their inert dilutions (12C+) which still make up the vast majority of homeopathic ‘remedies’.
          – Homeopathy would have to abandon almost the complete Materia Medica and Repertory, as these interconnected lists of symptoms and ‘remedies’ are for the most part nonsense.
          – Homeopathy would have to abandon ‘remedies’ that are already ubiquitous in our body (e.g. diluted table salt), which means that minute additional doses can’t have any effect.
          – Homeopathy would have to abandon the most basic principles, i.e. the ‘law of similars’ (as it is not compatible with the receptor-driven model) and the ‘law of infinitesimals’ (as even receptor-driven actions will diminish and eventually stop at higher dilutions).
          – Ultimately, homeopathy should in fact be abandoned fully, as receptor-driven mechanisms of action can be much better addressed by modern pharmaceutical means than by a rather more haphazard process of diluting and shaking by people who have no knowledge about medicine in general and pharmacology in particular.

          Given the above, perhaps you might consider taking up an education in endocrinology or perhaps molecular biology? There’s certainly more future in those subjects than there is in homeopathy …

          *: Most certainly NOT a homeopathic ‘proving’.

          • Richard…you make me laugh…thanx.

            I am glad that you admit that super-duper small doses can and will have powerful effects…and not just those substances that are in our body…and I’m glad that you noted that other substances can do so too.

            Did you somehow forget that homeopaths do not use nanodoses of just anything? They use nanodoses of whatever medicinal agent happens to CAUSE the specific syndrome of symptoms that the sick person is experiencing. For those of us who believe in evolution (and who don’t just give lip-service to this belief), our symptoms are actually our body’s effort to survive. By using a medicinal agent that mimics this wisdom, a nanodose enables an immunological response by being able to sift through cellular membranes and blood-brain barriers.

          • @Dana Ullman

            Richard…you make me laugh…thanx.

            All the same here, so we’re off to a great start!

            [Homeopaths] use nanodoses of whatever medicinal agent happens to CAUSE the specific syndrome of symptoms that the sick person is experiencing.

            Yes, I know, and I find it hard to believe that there are still people out there who believe this long-obsolete nonsense. It simply doesn’t make sense from a medical or even scientific point of view.
            In virtually all cases, medical science knows why certain substances cause certain effects in undiluted form. Those effects diminish with higher dilutions, and at a certain point (usually at your ‘nanodose’ level), nothing happens any more. End of story.

            For those of us who believe in evolution (and who don’t just give lip-service to this belief), our symptoms are actually our body’s effort to survive.

            I’m not certain what evolution has to do with this, but OK. Yes, for instance irritating agents could mean that something is harmful, and thus should be avoided. So avoid it, period. And again: end of story.

            By using a medicinal agent that mimics this wisdom …

            Um, this is not exactly wisdom, but a universal biological principle that is so basic that even amoebas ‘know’ it, and move away from higher concentrations of harmful agents.

            … a nanodose enables an immunological response by being able to sift through cellular membranes and blood-brain barriers.

            And this is where you stop making sense.
            First, and once again: the vast majority of homeopathic products do not contain ‘nanodoses’, they contain zero doses. So we can do away with that part of homeopathy, right?
            Second, and as I explained, there are only few foreign substances that still have an effect in nanodoses. To the best of my knowledge, none of those are used in homeopathy – even highly poisonous strychnine or Nux Vomica has no effect any more in doses of less than about 0.1 milligram – still several orders of magnitude more than your ‘nanodoses’.
            The substances that are used in homeopathy may sometimes have an effect in undiluted form, but even that is just as often not the case, at least not until we’re talking about huge amounts (e.g. table salt).
            But let’s look at for instance the humble onion, or Allium Cepa. Homeopaths claim that because it causes our eyes to water when cut, it is effective in relieving symptoms such as a runny nose in homeopathic dilutions. Which is not the case.
            Onions have a defence mechanism by which damaged cells release a particular stinging aerosol compound, which causes irritation of the eyes and (if ingested) mucous membranes. When this substance is diluted to ‘nanodose’ level or beyond, it simply ceases to have an effect at a certain point. It does NOT have any new effects – least of all effects that counteract irritation or runny noses or whatever.
            And no, it also does not ‘enable an immunological response’, and it most certainly does not ‘sift through cellular membranes’ or the blood-brain barrier. All this is completely made-up nonsense. If you ingest a nanodose of onion extract, any remaining active substance is most likely broken down in the digestive tract and absorbed as a (minute amount of) nutrient. There is no evidence whatsoever that it somehow has any pharmacological effects.

            But feel free to come up with good scientific evidence supporting your remarkable claims here, and I might change my mind after all. I won’t be holding my breath though.

            But hey, thanks for the laugh anyway 🙂

          • Nice story, Mr. Ullman – just unfortunate that you do not have evidence that would confirm any part of it (e.g. that shaken water could be a medicinal agent of any sort, the existence of nanodoses in highly diluted homeopathic remedies, any immunological responses caused by these remedies and effects on cell membranes etc.).
            I have to admit that I am quite intrigued by your comments on this blog and often wonder if there is anything in the world that could raise doubts in your mind that homeopathy really works.
            As a skeptic, I sometimes try to imagine how it might feel to be so absolutely certain to know the truth – about any aspect of the world, especially with so little evidence. Same applies to religious fundamentalists, which are also just baffling to me.

        • @Dana

          Thank you for your reply. It proves that you have no idea about natural sciences (namely chemistry, physics and biology). But how should you have any idea with a MPH and as a certified homeopath, sorry witch doctor. Real knowledge is only a hindrance in your job.

        • Wonderful, Dana

          You demonstrate once again your blinkered ignorance. It is explained to you how and why. You wave your hands and laugh.

          This is why, again, you and your opinions are of no significance. You change nothing, You shout and spout and stamp and wave and scream and ….

          You are ignored.

          You are of no significance. Whatsoever.

          It’s wonderful to watch.

        • Mr Ullman, previously in this Blog you asserted that “only fools or liars” doubted that it was possible to distinguish homeopathic water from other water. Can you now please name a laboratory that can do this?

          FIFTY-FIFTH time of asking…..

    • @Dana Ullman
      I recall that several years back, you took exception to a personal insult from me – at which point I apologized, and henceforth refrained from ad-hominems, keeping discussions as much as possible factual and non-personal (barring one or two jokes that you seemed to appreciate as well – even though those jokes were in fact prompted by what could be interpreted as hate speech from your side).

      Perhaps the time has come for you to extend the same courtesy yourself to the people here – especially when unprovoked, such as in this case?

      Thank you in advance.

    • Hi Dana, obviously you are not familiar with the curious manufacture of homeopathic remedies. It is not a D4 dilution or D4 potency . its a D4-Trituration; another variant to produce homeopathic remedies.

  • So Dana, you think homeopathy uses nano doses of whatever CAUSES the relevant syndrome the ‘remedy’ is intended to treat.

    What syndrome exactly is it that Berlin Wall causes? Would that not depend on whether you were an east Berliner anxious to escape, a soviet dictator wishing to contain, an East German fearful of western invasion, a west German longing to see separated relatives….

    Oh hang on. If the Berlin Wall causes some unspecified syndrome does that mean any wall can? My house has walls so should I be taking homeopathic solutions of my wall just to be safe?

  • Amazing that anyone can be so brave and brazen as to defend and “explain” homeopathy in broad daylight without blushing. Obviously it works among less educated audiences to pass this fraud as “science” to believe in ( = pay for), but here, on Dr. Ernst’s blog???

  • It’s interesting that the model they used for the product shot, looks relatively young and very healthy. If a healthy-looking male of that age is having problems of erectile dysfunction, there ought to be thorough examination in case of a serious medical or psychological problem.

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