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

alternative medicine

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This retrospective audit aimed to assess the clinical effectiveness of telehealth interventions in an out-patient, individualized homeopathy clinical setting for 305 individuals with symptoms of positive or probable COVID-19
by a team of professional homeopaths working together in the United States during spring and summer of
2020.

The audit lasted from March to August 2020. It examined the merits of the initiative considering accessibility, effectiveness, safety, efficiency, and appropriateness of the care model.

Positive intervention outcomes were found in every measure:

  • individual remedy prescriptions (83.4% positive),
  • final outcomes of interventions (76.2% positive),
  • degree of recovery following homeopathic interventions (74.4%).

Additionally, ease of access for a range of users, a high level of safety of the interventions, and efficiency of care and team resources indicated consistently positive outcomes.

The authors concluded that, given the significant strain on conventional healthcare systems during the early stages of the pandemic, the complementary medicine interventions studied here offer important considerations for meeting the demands for COVID-19 acute care with agile and adaptive complementary medicine models.

If one were to look for ridiculously poor studies in the realm of homeopathy, one would be spoilt for choice. Amongst the many such papers, this one would achieve a very high ranking. The investigation is nonsensical in:

  • concept,
  • design,
  • endpoints,
  • write-up,
  • conclusion.

The paper prompts me to ask a few questions (and some answers):

Whoever had the notion that an audit can “assess the clinical effectiveness” of a therapy?

Do the authors even know what an audit is?

What institutions are behind such embarrassingly poor work? They are:

  • ‘HOHM Foundation’, New York,
  • the ‘Academy of Homeopathy Education,
  • HOHM Foundation, Philadelphia.

Which journal publishes such rubbish?

It’s INTEGRATIVE MEDICINE REPORTS, a publication that claims to be a “high-quality open access journal”.

And who sponsors such idiocy?

This study was funded by donations to HOHM Partners and to Homeopathy Help Network by clients and community members.

Say no more!

The BBC has repeatedly misled the public on matters related to so-called alternative medicine (SCAM). Examples include:

Recently the BBC published an article about Ashwagandha. Here it is in its untouched beauty:

Ashwagandha is a herb (Withania somnifera) in the nightshade family, which also includes tomatoes and chilli peppers.  It has been used in traditional Indian medicine (Ayurveda) for thousands of years to make preparations for treating various ailments, from infectious diseases, like tuberculosis, to pain and inflammation, baldness and hiccups. In classic Ayurvedic texts, it’s also described as a ‘mental strength promoter’ (or ‘Balya’).

While lots of research has been done on ashwagandha, studies for specific conditions can be sparser. Perhaps the most recent assessment of its use for stress and anxiety comes from a 2022 review of studies by the Cochrane Collaboration, which is internationally recognised for its high-standard medical reviews. Although the Cochrane researchers were only able to find 12 studies on the subject, which together tested the herb on just 1,002 participants, their findings did suggest that ashwagandha can lower stress and anxiety. The researchers rated the ‘certainty’ of the evidence as ‘low’ and called for more detailed studies, though.

The benefits of ashwagandha are thought to be related to natural steroids called withanolides, but this group includes hundreds of compounds, with tens having been isolated from ashwagandha so far. As with any herbal remedy, the combination of compounds and the exact concoction you get depends on how and where the plant is grown, and how it’s prepared. This means that not all supplements based on the same plant are equal.

Remember, too, that herbal doesn’t mean risk-free. For some people, ashwagandha causes drowsiness and more serious side effects aren’t unknown. It’s best to treat it like a drug and not ‘just’ a herb.

The review cited in the article is this one:

Clinical trial studies revealed conflicting results on the effect of Ashwagandha extract on anxiety and stress. Therefore, we aimed to evaluate the effect of Ashwagandha supplementation on anxiety as well as stress. A systematic search was performed in PubMed/Medline, Scopus, and Google Scholar from inception until December 2021. We included randomized clinical trials (RCTs) that investigate the effect of Ashwagandha extract on anxiety and stress. The overall effect size was pooled by random-effects model and the standardized mean difference (SMD) and 95% confidence interval (CIs) for outcomes were applied. Overall, 12 eligible papers with a total sample size of 1,002 participants and age range between 25 and 48 years were included in the current systematic review and meta-analysis. We found that Ashwagandha supplementation significantly reduced anxiety (SMD: −1.55, 95% CI: −2.37, −0.74; p = .005; I2 = 93.8%) and stress level (SMD: −1.75; 95% CI: −2.29, −1.22; p = .005; I2 = 83.1%) compared to the placebo. Additionally, the non-linear dose–response analysis indicated a favorable effect of Ashwagandha supplementation on anxiety until 12,000 mg/d and stress at dose of 300–600 mg/d. Finally, we identified that the certainty of the evidence was low for both outcomes. The current systematic review and dose–response meta-analysis of RCTs revealed a beneficial effect in both stress and anxiety following Ashwagandha supplementation. However, further high-quality studies are needed to firmly establish the clinical efficacy of the plant.

This review is NOT a Cochrane Review; what is more (and more important), it seem rather uncritical.

The BBC article seems to down-play the safety issue related to Ashwagandha. As we have discussed on this blog, Ashwagandha is far from harmless. In fact, Ashwagandha has been shown to be a herb with a high risk of hepatobiliary toxicity as well as heart problems.

So, why does the BBC misinform the public?

Search me.

Manfred Lucha has been Baden-Württemberg’s Minister for Social Affairs, Health and Integration since 12 May 2016. He also is a staunch defender of homeopathy.

Lucha has repeatedly spoken out in favour of maintaining the reimbursement of costs for homeopathy by health insurance companies. He described anthroposophy and homeopathy as the essence of the Green Party. In August 2022, Lucha positioned himself against the Baden-Württemberg Medical Association on the subject of homeopathy. The Association had announced that additional training for doctors in homeopathy would be removed from the medical training catalogue. Health Minister Lucha stated that he still believed in the effectiveness of homeopathy and announced a legal review of the decision, as the Ministry of Health has legal supervision over the Medical Association. Lucha also criticised the plan by Federal Health Minister Karl Lauterbach to no longer allow homeopathic treatments to be paid for by health insurance companies. Finally, it seems safe to assume that Lucha is not amused about the new development about which I reported yesterday.

With so much outspoken engagement in the medical field, one would expect that Lucha has a solid background in evidence-based medicine and science. Yet, one would be mistaken.

After an apprenticeship as a chemical worker, Lucha completed secondary school and trained as a nurse at the Weißenau Psychiatric State Hospital. He went on to gain his university entrance qualification and studied social work. In 2005, he also completed a Master’s degree in ‘Management in Social and Health Care’. He then became the technical director of a community psychiatric centre in Friedrichshafen. Lucha is spokesman for the Bodensee district community psychiatric association and deputy federal chairman of the Federal Working Group of Community Psychiatric Associations.

Any education in evidence-based medicine?

No!

So, why does he feel he knows better than the experts?

I am not sure.

 

PS

Mr. Lucha, if you read these lines, please tell us.

To show my appreciation, I would then send you a copy of the German translation of my book on homeopathy.

The German medical profession is struggling to decide what stance it should take on homeopathy. The evidence is clear: homeopathy is a pure placebo therapy. But there are powerful lobby groups trying to prevent the general acceptance of this conclusion. Now, a further step towards progress has been taken.

After two years of heated debate, the Baden-Württemberg Medical Association, Germany, has decided that further training for doctors in homeopathy will be cancelled. In July 2022, the Assembly of Representatives had already voted in favour of removing homeopathy from the further training regulations in Baden-Württemberg. This move prompted fierce opposition on several levels; the Social Affairs Minister Manfred Lucha (Greens), for instance, called it the ‘absolutely the wrong signal’. Homeopathy is an important part of healthcare for many people, he had claimed.

The treatment of patients in Baden-Württemberg with homeopathy will neither be restricted nor prohibited by this step. Doctors who have already completed the further training programme or are still in the process of doing so will not be affected by the change.

The chamber’s evaluation had concluded that there is no scientific evidence showing that homeopathy is effective for any condition. The German Medical Association had arrived at the same verdict and, already in 2022, it had spoken out in favour of the abolition in 2022.

On this blog, we have regularly discussed the German homeopathy debate and its many twists and turns, e.g.:

I am fairly confident that, in the end, the evidence will prevail, the confusion will disappear, and an agreement with broad support will emerge also in Germany:

THE PLACE FOR HOMEOPATHY IS IN THE MEDICAL HISTORY BOOKS! 

 

 

 

Whooping cough is on the rise in many parts of the world; and it’s far from harmless. It has been reported that 9 infants died from whooping cough in England between November last year and the end of May 2024. Altogether a total of 7599 cases of whooping cough have been confirmed in England this year, with cases continuing to rise from 555 in January to 920 in February.

In France too, cases of whooping cough are rising among all ages, the French health authority has warned, saying vulnerable groups should check their vaccinations are up to date. Cases of the illness – called coqueluche in French – have been rising since the start of 2024, states Santé publique France (SPF). It has called for people to be vigilant.

I have recently argued that this might be not least due to the irresponsible advice of homeopaths. But homeopaths are by no means alone in this.

According to advice from MOTHER EARTH LIVING several natural home remedies help alleviate whooping cough symptoms (as well as cold and flu symptoms) and clear the pertussis infection. A teaspoon of fresh garlic juice taken 2 to 3 times a day is a potent, effective treatment.

A pinch of the Indian curry spice turmeric, taken at least twice a day, relieves whooping cough symptoms and helps clear the bacterial infection. (Odorless garlic and turmeric capsules may not be as effective as fresh ingredients, whose odors can be minimized by chewing fresh mint).

Ginger has antiviral, antibacterial, antiparasitic, antifungal, anti-inflammatory and expectorant properties. It boosts the immune system, warms and induces sweating (which helps push fever and toxins out of the body), and calms coughs and sore throats quickly. It also stimulates appetite, which is important to sick individuals weakened by infection.

____________________

There are numerous further SCAM-sites that give advice to use this or that SCAM. The recommended treatments all have one thing in common: they do not work to prevent or treat whooping cough.

If one member of your family has caught the infection, please do me a favour:

avoid SCAM and see a real doctor.

 

What is it about Reiki that fascinates me?

It must be the exemplary poor science that its proponents use trying to convince us that it is valid.

This randomized controlled trial investigated the effect of Reiki on pain, functional status, and holistic well-being in patients with knee osteoarthritis (OA). The sample consisted of 42 patients.

  • The control group received standardized treatment only.
  • The intervention group received face-to-face Reiki (nine positions; 39 minutes) and distance Reiki on two consecutive days in addition to standardized treatment in addition to standard treatment.

The results show that the Reiki group had lower pain scores than the control group as measured by the Visual Analog Scale (p < .001) and the Western Ontario and McMaster Universities Arthritis Index pain score (p < .001). Those participating in the Reiki group had improved holistic well-being scores specifically for the subscales of Sadness, Perception of Sadness, Spiritual Disruption, Cognitive Awareness, and General mood.

The authors concluded that Reiki is a safe, noninvasive, and cost-effective alternative treatment technique that has the potential to reduce symptoms of pain and improve holistic well-being in patients with knee OA.

So many falsehoods in one sentence!

Is this a new record?

Let’s analyse these conclusions a little, shall we?

  • Reiki is safe: this does not follow from the data because the sample was far too small for assessing rare safety issues, safety was not measured, and half of the Reiki group might have dropped dead a week after the study.
  • Reiki is non-invasive: that might be true.
  • Reiki is cost-effective: cost-effectiveness was not an endpoint; the statement is thus not supported by the data.
  • Reiki reduces the symptoms of pain and improve holistic well-being in patients with knee OA: I disagree! The observed outcomes are much more likely caused by the considerable amount of extra attention and treatment time given to the Reiki group, and the results were entirely unrelated to any specific effects of the therapy.

So, I feel the need for re-phrasing the conclusions as follows:

Reiki is an implausible treatment and the outcomes of this study are unrelated to any alleged specific effects of this therapy.

A new market report predicts that the worldwide market for so-called alternative medicine (SCAM) will grow from $100 billion in 2022 to $438 billion by 2032.

According to the report, the SCAM market is expected to see innovation and expansion through mergers, acquisitions, and partnerships among large companies. Companies that are capitalizing on these trends include health supplement companies, companies that specialize in Ayurvedic health, those that offer TCM solutions, and those that offer more general holistic solutions to health. Major supplement brands include Herb Pharm LLC, Gaia Herbs, NOW Foods, Life Extension, Pure Encapsulations, Douglas Laboratories, Nordic Naturals, Nordic Nutraceuticals, Quality of Life Labs, Nature’s Bounty Co., Valensa International, Herbo Nutra, and Emerson Ecologics.

Other major players mentioned in the report are:

  • AYUSH Ayurvedic Pte Ltd, Dabur India Ltd., Himalaya Global Holdings Ltd., Banyan Botanicals, and Arya Vaidya Pharmacy offer Ayurvedic health and wellness products while aiming to advance the science behind Ayurveda.
  • Sheng Chang Pharmaceutical Company produces traditional Chinese medicines and herbal products that is one of the largest TCM pharma companies.
  • All and One Medical provides healthcare solutions that combine conventional medicine with complementary and alternative therapies to promote overall wellness and preventive care.
  • The John Schumacher Unity Woods Yoga Center is another that focuses on enhancing physical and mental well-being through the practice of Iyengar Yoga and offers classes and workshops.
  • New Life Chiropractic aims to improve overall health and well-being by providing comprehensive chiropractic care that focuses on spinal health and preventive wellness.
  • The Chicago Body Works offers a range of therapies and treatments designed to enhance physical and mental well-being, including massage and bodywork services.
  • Weleda AG aims to connect people with nature by producing natural organic products that support health, beauty, and overall wellness while practicing sustainability and social responsibility.
  • Quantum-Touch Inc. teaches energy healing techniques that promote physical, emotional, and spiritual health.
  • Spectrum Chemical Manufacturing Corporation focuses on delivering high-quality chemicals and laboratory supplies to support scientific research and innovation across various industries, including health and wellness.

I must admit, I do like these market reports. They never fail to amuse me – for two main reasons:

  1. They are as reliable as reading tea leafs.
  2. The only reliable info they do provide is that the SCAM proponents’ often-voiced argument, “we are very different from BIG PHARMA” is pure nonsense.

Several years ago, I reported on the range of conditions which, according to homeopaths, “respond best to homeopathic treatment” (basically any condition imaginable). To remind you, here is the list again:

ENT and bronchial problems

  • Ear infections,
  • rhinitis,
  • sinusitis,
  • pharyngitis,
  • tonsillitis,
  • tracheitis,
  • bronchitis,
  • asthma.

Digestive problems

  • Stomach complaints
  • acidity,
  • heartburn,
  • fullness,
  • poor digestion,
  • flatulence,
  • duodenal ulcer,
  • diarrhoea,
  • constipation,
  • nausea,
  • vomiting,
  • canker sores.

Cardiovascular problems

Osteoarticular complaints

All types of muscle and/or joint pain due to arthrosis or arthritis:

  • neck pain,
  • shoulder pain,
  • elbow pain,
  • wrist pain,
  • Back pain,
  • sciatica,
  • knee pain,
  • ankle pain,
  • Sprains,
  • contractures etc.

Traumas

Urological disorders

Gynaecological problems

Dermatological problems

  • Eczema, hives,
  • Acne vulgaris, acne rosacea,
  • Recurrent boils, verucas, plantar warts,
  • Molluscum contagiosum,
  • Herpes simple and zoster
  • Psoriasis

Neurological disorders

  • Headaches and migraines.
  • Eye problems
  • Conjunctivitis,
  • blepharitis,
  • styes, dacryocistitis,
  • uveitis.

Behavioural and psychiatric disorders

  • Anxiety,
  • depression,
  • stress,
  • mental fatigue,
  • Pediatric problems,
  • Ear infections,
  • tonsillitis,
  • bronchitis,
  • asthma,
  • diarrhoea,
  • vomiting,
  • skin complaints,
  • canker sores,
  • teething problems,
  • sleep disorders,
  • educational attainment issues,
  • behavioural issues.

Endocrine disorders

  • Obesity,
  • hypothyroidism,
  • hyperthyroidism,
  • Depleted immune defences,
  • Recurrent infections affecting the throat,
  • sinuses, nose, ears,
  • connective tissue, larynx,
  • bronchial tubes,
  • lungs,
  • skin,
  • bladder etc.

Palliative care

For the treatment of the diverse symptoms that appear over the course of the illness. Homeopathy can improve the patient’s general wellbeing and counteract the side effects of other treatments.

These are just a few examples, but the list could be endless – it is important to stress that homeopathy is very effective in pathologies that are difficult to establish or those with contradictory or paradoxical symptoms.

In recurrent illnesses, homeopathic medicines can boost the defences and help to regulate the sufferer’s body in order to prevent further relapses.

Homeopathy is an excellent preventive medicine.

_______________________

You will notice that SCIATICA is on the list.

Would they really be as daft as to use homeopathy for sciatica?

Not only that, they would even conduct a study on the subject. Here is this recently published trial:

Objectives: Sciatica is a debilitating condition that causes pain in its distribution or in the lumbosacral nerve root that is connected to it. Although there are claims that homeopathy can reduce sciatica pain, systematic scientific proof is currently lacking. The objective of the trial was to determine whether individualized homeopathic medicines (IHMs) were as effective as identical-looking placebos in treating sciatica pain. Design: This is a double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. Setting: The study was conducted at Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, West Bengal, India. Subjects: Sixty participants with sciatica pain were included in this study. Interventions: Verum (n = 30; IHMs plus concomitant care) versus control (n = 30; placebos plus concomitant care). Outcome measures: Primary-Sciatica Bothersome Index (SBI) and Sciatica Frequency Index (SFI) scores and secondary-Roland Morris Pain and Disability Questionnaire (RMPDQ), Short Form McGill Pain Questionnaire (SF-MPQ), and Oswestry Low Back Pain Questionnaire (OLBPQ) scores: all of them were measured at baseline, and every month, up to 3 months. Results: Intention-to-treat sample (n = 60) was analyzed. Group differences were examined by two-way (split-half) repeated measure analysis of variance, primarily accounting for between groups and time interactions, and additionally, by unpaired t tests comparing the estimates obtained individually every month. The level of significance was set at p < 0.025 and <0.05 two tailed for the primary and secondary outcomes, respectively. Group differences could not achieve significance in SBI (p = 0.044), SFI (p = 0.080), and RMPDQ scores (p = 0.134), but were significant for SF-MPQ (p = 0.007) and OLBPQ (p = 0.036). Gnaphalium polycephalum (n = 6; 10%) was the most frequently prescribed medicine. No harm, serious adverse events, or intercurrent illnesses were recorded in either of the groups. Conclusions: The primary outcome failed to demonstrate evidently that homeopathy was effective beyond placebo, and the trial remained inconclusive. Independent replications are warranted to confirm the findings.

So, homeopathy does not work for sciatica.

Surprise, surprise!

Why not?

Simple: because homeopathy does not work for any condition.

Some papers on homeopathy are bad, others are very bad and others again create a new dimension of bad. Here is an example of the latter category (Research, Society and Development, v. 13, n. 7, e1413746050, 2024
(CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v13i7.46050 ):

Objective: To research, through literature review, the use of homeopathy as an alternative treatment for many pathologies involved in dentistry field. Methodology: online searches using databases available at PUBMED Central and VHL/BIREME. Other platforms such as Web of Science, Science Direct and Google Academy. Results: Our search resulted in 25 articles. Conclusion: Despite the mysticism that surrounds it, the use of homeopathic medicines in dental treatments is, in fact, a scientifically proven alternative treatment, which helps in various pre and post surgical procedures, which has a low financial cost and great effectiveness, enabling a contribution to dental care. Scientific study in this area requires more research and clinical evidence, so that this practice is more widespread and used by dental surgeons, in addition to the application of homeopathy as a discipline in dentistry.

But that’s merely the abstract. Perhaps the article itself offers some convincing evidence. See for yourself; here is the only section of the paper that provides something akin to evidence:

In dentistry, homeopathic remedies have been proposed for a variety of conditions including oral ulcers, sialorrhea (excessive salivation), neuralgia, temporomandibular joint disorders (TMJ), xerostomia (dry mouth), lichen planus, bruxism (teeth grinding), minor acute illnesses, chronic pathologies, atypical facial pain, burning mouth syndrome, postoperative osteitis, and anxiety related to dental treatment (Steinchler, 2015; Fischer, 2005). They are often used as adjuncts to conventional treatments, especially in cases where traditional approaches have failed or are contraindicated (Amaral, 2021).

Homeopathic medicines for these conditions come in various forms such as tablets, pills, drops, liquids, granules, and creams (Darby, 2011). Some are designed to dissolve on or under the tongue for quick absorption. The instructions typically advise placing the medicine directly in the mouth, where it can be sucked or chewed to facilitate absorption (Darby, 2011).

The use of homeopathic remedies in dentistry offers several potential benefits, including cost-effectiveness, versatility across different dental specialties (such as orthodontics, stomatology, endodontics, pediatric dentistry, periodontics, and surgery), relative efficacy, safety, and ease of use (Eleutério, 2011; Mendonça, 2022; Almeida et al., 2023). This makes them a valuable option in integrative dental care, where they can complement conventional treatments and provide additional therapeutic options for patients.

______________________

As the Brazilian authors of the article fail to say it, allow me to do so:

The place of homeopathy in dentistry is nowhere! There is no reliable evidence that homeopathy is effective for any of the conditions listed above.

PS

This paper is nonetheless notable: it is certainly amongst the worst I have seen for a very long time.

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.

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