alternative medicine

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It has been announced that advertisements for three supplement brands claiming to treat a range of medical conditions, including autism and ADHD, have been banned in the UK.

A paid-for Facebook advert for Aspire Nutrition in April said: “The secret weapon parents of ASD kids swear by”, while text in the form of a review attributed to “Tara K. Verified Buyer”, read: “This has helped my five-year-old with level two autism so much. “Within the first week his meltdowns decreased by 80%. He is communicating so much better… he is starting to show kindness and empathy to his little sister.” Further text read: “As parents of children with autism, we all share the same dream: to see our children thrive in school.”

Another paid-for Facebook ad in January, for Drop Supplements, stated: “For people with stress, anxiety, brain fog, ADHD … Happy Mind Drops – your new secret adaptogen against stress! Prepare yourself to unleash your true potential and banish your mental barriers.”

A third paid-for Facebook ad for Spectrum Awakening stated: “My five-year-old son Scout is diagnosed with receptive expressive language disorder and sensory disorder. Until I found Spectrum Awakening he could barely put a sentence together with very limited speech and words and lots of jargon.” It went on: “The first supplement we tried was Power and Focus and within the first three days he started using way more words. Within a week he was speaking sentences. I’m absolutely amazed that I can’t wait to order more.”

The Advertising Standards Authority (ASA) found that the claims that each supplement, or substances in them, could help to prevent, treat or cure autism breached regulations after investigations.

Aspire Nutrition said they had stopped sending adverts to UK residents who visited their website and had withdrawn the ad entirely for all audiences after being informed of the complaint. Drop Supplements said their adverts featuring Happy Mind made no direct or implied statements about curing, treating or preventing ailments or diseases. However, the ASA said the advert’s claims would be understood by most consumers as implied claims that the product could prevent, treat or cure human disease. Spectrum Awakening did not respond to the ASA’s inquiries.

The ASA told each firm to ensure their future advertising did not claim that food – in these cases in the form of a supplement – could prevent, treat or cure human disease.


Such work by the ASA is most laudable, in my view. Misleading advertising is endangering the health of consumers thousands of times every day. However, the firms affected by the ASA reprimands are probably not all that worried. In fact, I imagine that they are laughing their heads off:

  • The chances of getting caught for misleading advertising are truly minimal.
  • If they are unlucky and do get caught the punishment is negligible.
  • There is little to stop them re-offending.

It is time that the ASA (and the equivalent organisations in other countries) get more power, more support and more money to effectively go after offenders in such a way that others think twice before breaking advertising rules.

To accuse anyone of an abuse of science is a hefty charge, I know. In the case of proponents of so-called alternative medicine (SCAM) doing science, it is, however, often justified. Let me explain this by using the example of chiropractors (I could have chosen homeopathy, faith heaalers, acupuncturists or almost any other type of SCAM professional, but in recent times it was the chiros who provided the clearest examples of abuse).

Science can be seen as a set of tools that is used to estabish the truth. In therapeutics, science is employed foremost to answer three questions:

  1. Is the therapy plausible?
  2. Is the therapy effective?
  3. Is the therapy safe?

The way to answer them is to falsify the underlying hypotheses, i.e. to demonstrate that:

  1. The therapy is not plausible.
  2. The therapy is not effective.
  3. The therapy is not safe.

Only if rigorous attempts at falsifying these hypotheses have falied can we conclude that:

  1. The therapy is plausible.
  2. The therapy is effective.
  3. The therapy is safe.

I know, this is rather elementary stuff. It is taught during the first lessons of any decent science course. Yet, proponents of SCAM are either not being properly taught or they are immune to even the most basic facts about science. On this blog, we regularly have the opportunity to observe exactly that when we read and are bewildered by the comments made by SCAM proponents. This is often clearest in the case of chiropractors.

  1. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is plausible.
  2. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is effective.
  3. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is safe.

If they conduct research, they set up their investigations in such a way that they confirm their beliefs:

  1. Spinal manipulations are plausible.
  2. Spinal manipulations are effective.
  3. Spinal manipulations are safe.

In other words, they do not try to falsify hypotheses, but they do their very best to confirm them. And this, I am afraid, is nothing other than an abuse of science.


And how can the average consumer (who may not always be in a position to realize whether a study is reliable or not) tell when such abuse of science is occurring? How can he or she decide who to trust and who not?

A simplest but sadly not fool-proof advice might consist in 2 main points:

  1. Never rely on a single study.
  2. Check whether there is a discrepancy in the results and views of SCAM proponents and independent experts; e.g.:
    • Chiropractors claim one thing, while independent scientists disagree or are unconvinced.
    • Homeopath claim one thing, while independent scientists disagree or are unconvinced.
    • Acupuncturists claim one thing, while independent scientists disagree or are unconvinced.
    • Energy healers claim one thing, while independent scientists disagree or are unconvinced.
    • Naturopaths claim one thing, while independent scientists disagree or are unconvinced.
    • Etc., etc.

In all of those cases, your alarm bells should ring and it might be wise to be cautious and avoid the treatment in question.

Yesterday, I stumbled across this remarkable notice. As it is in German, I took the libery of translating it for you:

Am 6. April 2024 war es wieder soweit: Die ÖGHM und die Schwabe Austria GmbH luden zur Verleihung des mit 4.000,- Euro dotierten Dr. Peithner Preises ein.

Dieses Mal wurde der Forschungspreis für die zwei eingereichte Arbeiten „Recommendations in the design and conduction of randomized controlled trials in human and veterinary homoeopathic medicine“ und „Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine“ an Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni und Petra Weiermayer vergeben.

Wir freuen uns sehr und gratulieren den Preisträger:innen zum verdienten Erfolg. Ein herzliches Dankeschön geht auch an die ÖGHM und die Schwabe Austria, die nicht nur mit diesem traditionellen Forschungspreis die Wissenschaft unterstützt.

Here is my translation:

On 6 April 2024, the time had come again: the ‘Austrian Society for Homeopathic Medicine’ (ÖGHM) and Schwabe Austria GmbH hosted the award ceremony for the Dr Peithner Prize, which is endowed with 4,000 euros.

This time, the research prize was awarded to Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni and Petra Weiermayer for the two submitted papers “Recommendations in the design and conduction of randomised controlled trials in human and veterinary homoeopathic medicine” and “Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine”.

We are delighted and congratulate the prizewinners on their well-deserved success. A big thank you also goes to the ÖGHM and Schwabe Austria, who support science with this traditional research prize.


And where is the irony?

Firstly, homeopaths are not exactly the experts on how to conduct research.

Secondly, there are recommendations and guidelines for conducting clinical research (e.g. here), and there is no reason for homeopathy to not to adopt those.

Thirdly, and most importantly, to award a prize to Michael Frass for telling us how to do research is more than a little ironic. If anything, Frass could teach us a thing or two about how to falsify, fabricate and manipulate research results!

People living with HIV (PLWH) are common users of so-called alternative medicine (SCAM). The main objective of this study was to study the frequency and patterns of SCAM natural products use in a large cohort of PLWH and to identify potential drug–drug interactions (DDIs) and the impact on their antiretroviral treatment (ART) adherence and efficacy.

This was a cross-sectional multicenter survey including 420 PLWH from different Spanish hospitals. Participants completed a face-to-face questionnaire on SCAM consumption and different sociodemographic and clinical data were collected. DDIs between SCAM and ART were identified and classified according to the Liverpool University Database and patient factors related to SCAM consumption were assessed.

In total, 420 participants were included (82.6% male, mean age 47 years); 209 patients (49.8%) were taking at least one SCAM. The most consumed SCAM were:

  • green, black and red tea (n=146, 25.4%),
  • ginger (n=26, 4.5%),
  • fish oil (n=25, 4.4%),
  • cannabis (n=24, 4.2%).

An ART based on integrase inhibitors was the only factor independently associated with SCAM consumption (OR 1.54, 95% CI 1.04 to 2.26). 50 potential SCAM–ART interactions in 43 (20.6%) patients taking SCAM were identified, being clinically significant in 80% of the cases. SCAM products most frequently involved with a potential significant DDI were supplements containing divalent cations (n=11) and garlic (n=7). No differences in ART efficacy and adherence were observed between patients with and without SCAM consumption.

The authors concluded that almost 50% of patients were taking at least one SCAM product and its use was associated with an integrase inhibitor based ART. One out of every six patients was at risk of presenting with an interaction between a SCAM and their ART, confirming the need to review continuously the use of SCAM as part of the medication review process.

So, the authors found that half of all PLWHs use some form of SCAM (whether I would classify tea as a SCAM is a different question). They also point out that this might put many PLWHs at risk. What I don’t understand is why they do not take the next logical step and ask what the benefits of the SCAMs for PLWHs are.

Allow me to answer this question: they are zero or very close to zero!

And this means that SCAMs generate a risk for PLWHs without creating any meaningful benefit. In other words the risk-benefit balance fails to be positive.

I think that this is an important point which needs to be stressed clearly in the conclusions. Therefore, I suggest to re-formulate them as follows:

Almost 50% of patients were taking at least one SCAM product. One out of every six patients was at risk of presenting with an interaction between a SCAM and their ART. The SCAMs used convey no appreciatable benefit. Therefore, SCAM use fails to generate more good than harm. It follows that responsible healthcare professionals should discurage SCAM use.

This review was aimed at quantifying the proportion attributable to contextual effects of physical therapy interventions for musculoskeletal pain. Randomized placebo-controlled trials evaluating the effect of physical therapy interventions on musculoskeletal pain.

Risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (ROB 2.0). The proportion of physical therapy interventions effect that is explained by contextual effects was calculated, and a quantitative summary of the data from the studies was conducted using the random-effects inverse-variance model (Hartung-Knapp-Sidik-Jonkman method).

Sixty-eight studies were included in the systematic review (total number of participants: n=5,238), and 54 placebo-controlled trials informed our meta-analysis (participants: n=3,793). Physical therapy interventions included:

  • soft tissue techniques,
  • mobilization,
  • manipulation,
  • taping,
  • exercise therapy,
  • dry needling.

Placebo interventions included manual, non-manual interventions, or both.

The results show the following:

  • The type of treatment with the largest proportion not attributable to the specific effects (PCE) for pain intensity assessed immediately after the intervention was mobilization, which represented 87% of the overall treatment effect (PCE = 0.87, 95% CI: 0.54, 1.19).
  • For soft tissue techniques, the PCE was 81% of the overall treatment effect (PCE = 0.81, 95% CI: 0.64, 0.97).
  • For dry needling, the PCE was 75% (PCE = 0.75, 95% CI: 0.36, 1.15).
  • For manipulation techniques the PCE was 74% (PCE = 0.74, 95% CI: 0.33, 1.14).
  • For taping the PCE was 69% of the overall treatment effect (PCE = 0.69, 95% CI: 0.48, 0.89).
  • The smallest proportion not attributable to the specific intervention itself for pain intensity was exercise therapy accounting for 46% of the overall treatment effect (PCE = 0.46, 95% CI: 0.41, 0.52).

The authors concluded that the outcomes of physical therapy interventions for musculoskeletal pain were significantly influenced by contextual effects. Boosting contextual effects consciously to enhance therapeutic outcomes represents an ethical opportunity that could benefit patients.

This sounds as though most of the treatments in question rely mainly on placebo effects. But what about conventional therapies? The authors point out that the PCEs of general medicine and surgery in pain-related conditions are also large. In particular, the overall proportion not attributable to the specific effects of general medicine interventions is high (PCE = 65%), with higher values observed in semi-objective and objective outcomes (PCE = 78 and 94%, respectively) than in subjective outcomes (PCE = 50%).

What does that mean for healthcare routine?

As placebo and other context effects are unreliable, usually short-lived, and not normally affecting the cause of the problem (but merely the symptoms), I would say that those treatments with a very high PCE are of limited value, paticularly if they are also expensive or burdened with risks. Of the treatments studied here, I would – based on the current analysis – avoid the following therapies for pain management:

  • mobilization,
  • soft tissue techniques,
  • dry needling,
  • manipulation,
  • taping.

By and large, these are also the conclusions drawn from various other strands of evidence that we have repeatedly discussed in previous posts.

This retrospective cohort study investigated the effect of reflexology on immunological parameters of people living with HIV (PLWH). All patients who received at least one reflexology treatment were included and compared with the group of PLWH who were not treated with reflexology. Measured parameters included CD4 count, CD4%, CD8 count, CD8%, CD4/CD8 ratio, and HIV viral load (VL). Changes in these parameters before and after the treatment were compared with changes in two consecutive measurements in the control group.

In total, 74 patients who received reflexology treatments were matched by age and sex to 144 controls. There was a male predominance of 86% in both groups. Patients in the control group were slightly older, with a median age of 45 versus 43 in the treatment group (p = 0.022). The median baseline CD4 count (730 vs. 795, p = 0.187) and CD8 count (890 vs. 832, p = 0.32) did not differ between the groups. Baseline CD4% tended to be lower in the treatment group (34% vs. 36%, p = 0.058), CD8% was higher in the treatment group (40% vs. 38%, p = 0.03), and the
CD4/CD8 ratio was lower in the treatment group (0.8 vs. 1, p = 0.002).

After therapy, there was a significantly higher increase in CD4, CD4%, and CD4/CD8 in the treatment group (p = 0.006, 0.0004, <0.001, respectively), whereas CD8% decreased significantly and CD8 tended to decrease in the treatment group (p < 0.001, 0.054, respectively).

The authors concluded that reflexology showed a positive impact on the immunological parameters of PLWH.

Who on earth conceives such a study?

Who funds such offensive rubbish?

Who publishes it?

We may well ask these questions, because the paper is pure nonsense!

The authors are very clear about their conviction that the observed differences were caused by the reflexology treatment. They don’t even discuss other options. Yet, there are several plausible explanations that have nothing to do with reflexology.

The patients in the control group originate from the hospital’s register from the time before reflexology had been introduced in the standard care package. Thus these patients differ in numerous ways from those of the experimental group. To name just one possibility, these patients were treated at a time when the treatment of PLWH was less sophicticated and thus had worse outcomes.

The two patient groups are clearly not comparable! This is also shown by the data published in the paper. So why compare them?

The only sensible conclusion of this paper is in my view:

In an effort to prove that their SCAM works, enthusiasts without research expertise often go to great lengths. As a result they mislead us all and do a great disservice to science and medicine.

Post-COVID-19 fatigue is becoming increasingly common as the pandemic evolves. Plenty of so-called alternative medicines (SCAMs) are on offer, including homeopathy. But is homeopathy really helpful?

This trial attempted to identify the preliminary evidence of the efficacy of individualized homeopathic medicines (IHMs) against placebos in the treatment of post-COVID-19 fatigue in adults.

A 3-month, single-blind, randomized, placebo-controlled, parallel-arm trial was conducted at the outpatient department of The Calcutta Homoeopathic Medical College and Hospital, India. Sixty participants were randomized in a 1:1 ratio to receive either IHMs (n = 30) or identical-looking placebos (n = 30). The primary and secondary outcome measures were the Fatigue Assessment Scale (FAS) and Outcome in Relation to Impact on Daily Living (ORIDL), respectively, measured every month, for up to 3 months. Comparative analysis was carried out on the intention-to-treat sample to detect group differences.

Group differences in both the primary (FAS total: F1, 58 = 14.356, p &lt; 0.001) and secondary outcomes (ORIDL: F1, 58 = 210.986, p &lt; 0.001) after 3 months favored IHMs against placebos. Lycopodium clavatum (11.7%), sulfur (11.7%), Arsenicum album (10%), and Thuja occidentalis (10%) were the most frequently indicated medicines. No harm, unintended effects, homeopathic aggravations, or any serious adverse events were reported from either of the groups.

The authors concluded that IHMs produced significantly better effects than placebos in the treatment of post-COVID-19 fatigue in adults. Definitive robust trials may be undertaken to confirm the findings.

A glance at the authors’ affiliations is, I think, revealing:

  • 1Department of Organon of Medicine and Homeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, India.
  • 2Department of Pathology and Microbiology, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, India.
  • 3The Calcutta Homoeopathic Medical College and Hospital, Kolkata, India.
  • 4Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, India.
  • 5Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, India.

We are currently being bombarded with false-positive homeopathy trials from India. Why am I sure that the trial is false-positive? Well, I am not sure, of course. But I have suspicions:

  1. Homeopathy is not a plausible form of SCAM.
  2. The most reliable studies fail to show that is is more than a placebo.
  3. The journal that published this paper is 3rd class; if the findings were valid, they would get published in one of the top science journals.
  4. The authors were clearly biased and even admitted as much; they stated that they wanted “to identify the preliminary evidence of the efficacy” of IHM. But this is not how unbiased researcher conduct clinical trials. Such investigations are for testing hypotheses and not for identifying effects.
  5. Most importantly, the trial design is flawed. Even the authors realize this, and the 1st sentence of the conclusions should therefore have been far less definitive.

And what are the main flaws?

As far as I can see they were:

  • The sample size was to small for a far-reaching conclusion.
  • The study was not double blind. In other words the therapists had the opportunity to exert their influence on the patient to produce the desired outcome. Occam’s Razor demands that we assume this to be the real explanation of the positive effects observed here.

In view of all this, I suggest to change the conclusions as follows:

IHMs produced significantly better effects than placebos in the treatment of post-COVID-19 fatigue in adults which most likely is not due to the efficacy of the treatment applied but to the residual bias not controlled for in this study.

This study aimed to investigate the clinical effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention to prevent the recurrence of low back pain.

WalkBack was a two-armed, randomised clinical trial, which recruited adults (aged 18 years or older) from across Australia who had recently recovered from an episode of non-specific low back pain that was not attributed to a specific diagnosis, and which lasted for at least 24 h. Participants were randomly assigned to an individualised, progressive walking and education intervention facilitated by six sessions with a physiotherapist across 6 months or to a no treatment control group (1:1). The randomisation schedule comprised randomly permuted blocks of 4, 6, and 8 and was stratified by history of more than two previous episodes of low back pain and referral method. Physiotherapists and participants were not masked to allocation. Participants were followed for a minimum of 12 months and a maximum of 36 months, depending on the date of enrolment. The primary outcome was days to the first recurrence of an activity-limiting episode of low back pain, collected in the intention-to-treat population via monthly self-report. Cost-effectiveness was evaluated from the societal perspective and expressed as incremental cost per quality-adjusted life-year (QALY) gained. The trial was prospectively registered (ACTRN12619001134112)

Between Sept 23, 2019, and June 10, 2022, 3206 potential participants were screened for eligibility, 2505 (78%) were excluded, and 701 were randomly assigned (351 to the intervention group and 350 to the no treatment control group). Most participants were female (565 [81%] of 701) and the mean age of participants was 54 years (SD 12). The intervention was effective in preventing an episode of activity-limiting low back pain (hazard ratio 0·72 [95% CI 0·60–0·85], p=0·0002). The median days to a recurrence was 208 days (95% CI 149–295) in the intervention group and 112 days (89–140) in the control group. The incremental cost per QALY gained was AU$7802, giving a 94% probability that the intervention was cost-effective at a willingness-to-pay threshold of $28 000. Although the total number of participants experiencing at least one adverse event over 12 months was similar between the intervention and control groups (183 [52%] of 351 and 190 [54%] of 350, respectively, p=0·60), there was a greater number of adverse events related to the lower extremities in the intervention group than in the control group (100 in the intervention group and 54 in the control group).

The authors concluded that an individualised, progressive walking and education intervention significantly reduced low back pain recurrence. This accessible, scalable, and safe intervention could affect how low back pain is managed.

Rigorous clinical trials of excercise therapy are difficult to conceive and conduct because of a range of methodological issues. For instance, there is no obvious placebo and thus it is hardly possible to control for placebo effects. Nonetheless, the benefits of exercise therapy for back pain is undoubted. As previously discussed on this blog, a recent systematic review concluded that “the relative benefit of individualized exercise therapy on chronic low back pain compared to other active treatments is approximately 38% which is of clinical importance.”

I have always been convinced of the health benefits of excercise. In fact, 40 years ago, when I did my inaugural lecture at the University of Munich (LMU), excercise was its topic and I concluded that, if exercise were a pharmaceutical product, it would out-sell any drug. The new study only confirms my view. It adds to our knowledge by suggesting that exercise also reduces the risk of recurrences.

Forget about spinal manipulation, acupuncture, etc., despite the undeniable weaknesses in the evidence, exercise is by far the most promissing treatment for back pain

This study tested the efficacy and safety of individualized homeopathic medicines (IHMs) in treating hemorrhoids compared with placebo. The double-blind, randomized (1:1), two parallel arms, placebo-controlled trial was conducted at the surgery outpatient department of the State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India.

Patients were 140 women and men, aged between 18 and 65 years, with a diagnosis of primary hemorrhoids grades I-III for at least 3 months. Excluded were the patients with grade IV hemorrhoids, anal fissure, and fistula, hypertrophic anal papillae, inflammatory bowel disease, coagulation disorders, rectal malignancies, obstructed portal circulation, patients requiring immediate surgical intervention, and vulnerable samples.

Patients were randomized to Group 1 (n = 70; IHMs plus concomitant care; verum) and Group 2 (n = 70; placebos plus concomitant care; control). Primary-the anorectal symptom severity and quality-of-life (ARSSQoL) questionnaire, and secondary-the EuroQol 5-dimensions 5-levels (EQ-5D-5L) questionnaire and EQ visual analogue scale (VAS); all of them were measured at baseline, and every month, up to 3 months.

Out of the 140 randomized patients, 122 were protocol compliant. Intention-to-treat sample (n = 140) was analyzed. The level of significance was set at p < 0.05 two tailed. Statistically significant between-group differences were elicited in the ARSSQoL total (Mann-Whitney U [MWU]: 1227.0, p < 0.001) and EQ-5D-5L VAS (MWU: 1228.0, p = 0.001) favoring homeopathy against placebos. Sulfur was the most frequently prescribed medicine. No harm or serious adverse events were reported from either of the groups.

The authors concluded that IHMs demonstrated superior results over placebo in the short-term treatment of hemorrhoids of grades I-III. The findings are promising, but need to be substantiated by further phase 3 trials.

Yes, I know: it is not easy to keep a straight face when reading such a paper. And the task is not made easier when considering the affiliations of its authors:

  • 1East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, Under Department of Health & Family Welfare, Government of West Bengal, India, South 24 Parganas, India.
  • 2Department of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, India.
  • 3Department of AYUSH, Government of Uttar Pradesh, Lucknow, India.
  • 4State National Homoeopathic Medical College and Hospital, Lucknow, India.
  • 5Department of Materia Medica, State National Homoeopathic Medical College and Hospital, Lucknow, India.
  • 6Department of Pathology & Microbiology, D. N. De Homoeopathic Medical College & Hospital, Government of West Bengal, Kolkata, India.
  • 7Department of Pathology & Microbiology, Mahesh Bhattacharyya Homoeopathic Medical College & Hospital, Government of West Bengal, Howrah, India.
  • 8Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, India.

Let’s nevertheless ask three serious questions:

  1. According to classical homeopathy, for a cure, one needs a remedy that, when given to a healthy volunteer, causes the symptom one wants to treat. So, does sulfur etc.cause the symptoms of hemorrhoids?
  2. According to classical homeopathy, the remedy is supposed to cure the condition, not alleviate the symptoms. Is that what the results show?
  3. Is it plausible that homeopathy can have any effects on hemorrhoids?

I am confident that the answers are: no, no and no.

And this leads me to ask my final question: do we believe these findings?

I let you answer this one!

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