Tonsillitis is a common condition predominantly affecting children and adolescents, presenting as acute, recurrent, or chronic infection. This review evaluated the effectiveness of homeopathy for clinical improvement and recurrence prevention across all tonsillitis presentations.
A team of scientists searched nine databases and four trial registries for randomised controlled trials (RCTs) and non-randomised controlled trials (nRCTs) involving patients of all ages with diagnosed tonsillitis. Studies examining individualised homeopathy (IH) and non-individualised homeopathy (non-IH) were included, compared with an inactive or active control group. Primary outcomes were clinical improvement (symptoms and signs) and recurrence. Secondary outcomes were antibiotic consumption, healthcare utilisation, quality of life, costs, and adverse events. Data extraction, Risk of Bias assessment, and certainty of evidence evaluation (GRADE) followed established methodology.
Five RCTs compared homeopathy with placebo (n=4) or standard care (n=1): one used IH, one used both IH and non-IH, and three used non-IH. Two RCTs examined acute tonsillitis, two examined recurrent tonsillitis, and one examined chronic tonsillitis. Three trials enrolled children, one enrolled adults, and one enrolled a mixed population. Sample sizes ranged from 30 to 256. Substantial heterogeneity across populations, interventions, and outcomes precluded meta-analysis. Individual RCTs showed that, in acute tonsillitis, non-IH achieved short-term symptom improvement. In recurrent tonsillitis, both IH and non-IH were associated with reduced infection recurrence, lower antibiotic consumption, and improved quality of life, with the strongest evidence for a standardised non-IH complex (SilAtro-5-90). In chronic tonsillitis, IH showed delayed but consistent improvements in symptoms, recurrence, healthcare utilisation, and quality of life by 2–3 months, with early outcomes favouring placebo. The certainty of evidence for all outcomes was low. No serious adverse events were reported.
The authors concluded that the evidence from individual trials suggests that both individualised and non-individualised homeopathy may benefit clinical improvement, reduce infection recurrence, reduce antibiotic use, and enhance quality of life in tonsillitis, with no safety concerns reported. However, substantial heterogeneity across studies and methodological limitations restrict the ability to draw definitive conclusions about homeopathy’s effectiveness in patients with tonsillitis. Further well-designed, adequately-powered trials with standardised outcomes and consistent methodological approaches are needed to strengthen the evidence base and enable more robust conclusions.
My critical evaluation of this paper is impeded by the fact that two of its authors were once members of my own team. On the one hand, this might assure me that their review is of a high standard, on the other hand it hinders me to voice harsh criticism. Fortunately, they include their own valid criticism of their project:
One study was a pilot study and therefore not appropriately powered [36] and one was published by a single researcher not following a formal publication protocol or underwent a formal peer-review process [34]. One study used an add-on design [31] which is a recognised methodology in clinical research, not unique to homeopathy, and their limitations regarding attribution of effect are well understood and acknowledged. We do acknowledge the possibility of publication bias and the limitations of a small evidence base. We also note there are issues arising from numerous outcomes, subscales, and repeated time-point analyses, which substantially increases the likelihood of false-positive findings.
Further variability was introduced by unclear definitions of some secondary outcomes and by differences in definitions across studies. Two of the five studies reported on their funding body. One did not receive funding [37] and Palm et al., 2017 [31] was sponsored by Deutsche Homoopathie-Union, DHU-Arzneimittel GmbH & Co. Germany.
They also are open about the funding of their work:
Existing funds held by Homeopathy Research Institute (HRI) – donated by Manchester Homeopathic Clinic Charitable Trust – were donated to University of Bristol to conduct the systematic review. The funders had no involvement in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication.
So, what should we make of their effort? Let me just state this:
If I had to advise them on how to improve their review substantially, I would have suggested they re-phrase their conclusion. I am sure that something like this would have been much more adequate:
Most of the included trials were positive yet, because of substantial heterogeneity and methodological limitations of the primary studies, the evidence collectively fails to show that individualised or non-individualised homeopathy are effective treatments for tonsillitis.
11 Responses to Homeopathy for tonsillitis?
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Was it even ethical for these researchers to accept funding to undertake a “study” of something of which there is already a scientific consensus that it cannot work? (beyond placebo of course, that should be taken as read)
Given one could have predicted in advance that the review would inevitably conclude that further “well-designed, adequately-powered trials” are needed, would it have been more ethical for these researchers to advise that these funds would be better used to fund such a trial?
Did the researchers consider that regardless of the outcome, its very publication can be used as propaganda by proponents of a treatment that cannot work?
Gad, oh really? You actually claim that the “science is settled” on homeopathy?! Gad, how uninformed you are on these issues…
There are literally hundreds of positive trials, including works in the Lancet, BMJ, Pediatrics, European Journal of Pediatrics, Pediatrics Infectious Diseases Journal, Cancer, Rheumatology, Chest, PlosOne, and on and on.
Even Chatgpt acknowledges that this IS compelling scientific explanations for homeopathic nanodoses: https://danaullman.substack.com/p/are-there-plausible-scientific-explanations
PLUS
https://danaullman.substack.com/p/dialogue-with-chatgpt-on-compelling
Dear Dana
1. Fantastic,
I didn’t know when ChatGPT has become the authority on evidence 😅.
2. There might be hundreds of positive trials, but most of those are either underpowered, or high risk of bias.
2. Sharing own writings also doesn’t necessarily establishes credibility.
Whooops…you obviously chose to NOT read what ChatGPT wrote…
As for my writings, I referenced my writings that were published in an Oxford University Press journal.
That said, you’ll need to close your eyes more tightly to blind yourself from this 21st century that is providing increasing evidence for the theoretical, basic science, and clinical evidence for homeopathy and nanopharmacology.
Dose Response is a Sage journal. It has a pitiful impact factor of 2.4. They publish any old shit, as demonstrated so ably by yourself. That article is from 2021. Has anyone paid it any attention?
Nope.
Only in your fantasy world. Nobody gives a shit outside of your circle-jerk of inconsequential water-shaking halfwits.
And I’ll ask you again, Dana. Find me an article on homeopathy in a nanopharmacology journal. You won’t be able to. Because no such journal would dream of publishing one. Because homeopathy isn’t nanopharmacology anywhere outside of your own demented and delusional fantasies. When will you learn, Dana?
Never.
@Dana Ullman
Yes. But why don’t you ask your beloved AI this question?
“Is the science settled on homeopathy?”
I’ll leave it to you to do the honorable thing and tell us the answer that you got.
Um, not quite. I looked up all randomized double-blinded clinical homeopathy trials on PubMed, and I found 106 positive trials, and 121 negative trials. When I exclude pilot studies and crazy nonsense such as provings, we’re left with less than a hundred positive RCT’s. In 230 years.
Less than one of these per year. I wouldn’t exactly call that compelling evidence.
Well, yes, of course. ChatGPT is not a scientist. It simply regurgitates whatever if can find on the Internet and is statistically most likely to answer the question. And since you and a handful of others have been more or less the only ones vociferously promulgating this nanobabble for at least 35 years now(*), that is what ChatGPT comes up with. So this ‘evidence’ is in fact 100% made up by you, without any actual scientific evidence to support it. Sure, we have a handful of studies showing nanoparticles in homeopathic preparations, but those studies a) don’t explain how those nanoparticles got there, and usually ignore the possibility of sloppy production and contamination, and b) don’t give any evidence how nanoparticles are actually influencing cells and organs. Another problem is that most homeopathic preparations (at least the ones used in India) contain random chemicals that may or may not have effects. Yet the water-shaking clowns doing the research never acknowledge this problem, and simply assume that they’re working with a preparation containing only the expected substances.
There are of course many more problems with this whole nanobabble nonsense. I already showed you that it can’t possibly work for table salt and other highly soluble common chemicals (e.g. phosphates, nitrates, sulfates). Then there is the question why it only works when water-shaking clowns are involved, but not when those same nanoparticles are created by real scientists in a chemistry lab, without any dilute-and-shake rituals. And of course our world is already full of nanoparticles. Why don’t those have any effects at all? And of course homeopathic preparations contain all sorts of random impurities, in concentrations that are thousands or even millions of times higher than the intended substance. Why don’t those substances – many of which are ‘potentized’ along with the intended substance – do anything?
But far more important is that you should FIRST show us that homeopathy actually works, i.e. that a 12C+ homeopathic preparation has consistent, robust and arbitrarily repeatable effects, and ONLY THEN is it sensible to look into HOW it may work. There is not a single homeopathic preparation showing strong effects whenever it is tested.
What you are doing can be summed up in one word: pseudoscience.
*: Still without any signs of acceptance by mainstream science, of course – just like the rest of homeopathy.
Dear Edzard
I know that you have recently tried to make a distinction between ‘clinical homeopathy’ and ‘individualised homeopathy’ for the treatment of a specific medical condition. It is a nonsense distinction. Homeopathy that is intended to treat a specific medical condition is ‘clinical homeopathy’ whether it is ‘individualised or not ‘individualised’.
I have attached Samuel Hahnemann’s Materia Medica Pura Volume 1 for you to search for a ‘proving’ where Hahnemann cites a remedy as a homeopathic treatment ‘for tonsillitis’.
If you don’t find a reference in Volume 1, I will provide you with a the link to Volume 2.
Good luck in your search Dr. Ernst.
https://archive.org/details/64310340RX1.nlm.nih.gov/page/n7/mode/2up
However, looking closely at the biostatistics and methodology, there are a few critical mechanical issues that readers should be aware of before citing the findings. First, aggregating Individualised Homeopathy (IH) with standardized, non-individualised (non-IH) complexes guarantees the extreme clinical heterogeneity that ultimately precluded meta-analysis here.
the narrative descriptions of the statistical findings routinely fail to align with the reported values. For example, the authors describe the Furuta (2007) trial as demonstrating “less recurrence with the H (IH + non-IH) group compared to placebo”. However, the provided statistical data shows a Risk Ratio of 0.40 with a 95% Confidence Interval crossing the line of no effect (0.15 to 1.07), resulting in a non-significant p-value of 0.07. A statistically non-significant finding cannot be declaratively reported as demonstrating “less recurrence”; standard conventions dictate it must be framed using language reflecting this uncertainty, such as noting the intervention “may result in little to no difference.”
More concerning is the execution of the GRADE framework. Outcomes derived from trials correctly assessed as having an overall “High” Risk of Bias were uniformly rated as having “Low” certainty. When you penalize a “High” RoB trial again for imprecision due to small sample sizes, standard GRADE math mandates a downgrade to “Very Low” certainty. Maintaining an artificial “Low” floor elevates the perceived strength of the weakest evidence. Additionally, it is a standard methodological requirement to include safety and adverse events in a Summary of Findings table to show a balanced benefit-to-harm profile, yet they were entirely omitted from the GRADE table here.
What is your opinion Edzard?
Maybe in a few years time Edzard will post on a published meta-analysis of all the meta-analyses on homeopathy. So an umbrella review or a meta meta analysis. Great but all we will probably get is a call for more ‘well-designed, adequately-powered trials’ by the authors with Edzard deconstructing it all.
Then in many years time we will get the meta meta meta analysis or the umbrella review of all the umbrella reviews and then the call for more ‘well-designed, adequately-powered trials’ with Edzard still deconstructing it all although by then Edzard may have cut down his blog posting massively to a mere prolific.
Well a homeopathee of my age can’t wait 50 more years of this so i just continue acting on my anecdotes giving my-self informed consent to use homeopathy.
in the post that you are referring to, I deconstructed nothing. I merely reformulated the conclusions so that they fit to the data presented in the review.
Yes you are correct. Silly of me not to run my post through God first. So Chat GPT did give me an answer which was that your post was a structured reinterpretation or standardization, not a deconstruction.
Serves me right and this is a bit disappointing but a 20ml dose of Rescue Remedy might help provide some non EBM temporary relief, if that is ok with the informed choice police.