anthroposophical medicine
“Crusade Against Naturopathy” (Kreuzzug gegen Naturheilkunde) is the title of a recent article (in German – so, I translated for you) published in ‘MULTIPOLAR‘. It is a defence of – no, not naturopathy – quackery. The authors first defend the indefencible Heilpraktiker. Subsequently, they address what they call ‘The Homeopathy Controversy‘. This is particularly ridiculous because homeopathy is not a form of naturopathy. Yes, it uses some natural materials, but it also employs any synthetic substance that you can think of.
The section on homeopathy contains many more amusing surprises; therefore, I have translated it for you [and added a few numers in square brackets that refer to my brief comments below]:
According to a representative survey conducted by the Allensbach Institute for Public Opinion Research in 2023, 35 per cent of homeopathy users are fully convinced of its effectiveness, while 55 per cent rate it as partially effective. Only nine per cent of respondents described homeopathic medicines as completely ineffective. [1]
Nevertheless, Health Minister Karl Lauterbach announced at the beginning of 2024 that he wanted to abolish homeopathy as a health insurance benefit. Stefan Schmidt-Troschke, paediatrician and managing director of the ‘Gesundheit Aktiv Association’, then launched a petition for the preservation of homeopathic medicines as statutory benefits in statutory health insurance. The petition was signed by more than 200,000 people. In March 2024, the cancellation of homeopathy and anthroposophic medicines as additional statutory benefits was revoked. [2]
Shortly afterwards, in May 2024, the ‘German Medical Assembly’ passed a motion against homeopathy to bring about a total ban for doctors. Dr Marc Hanefeld, official supporter of the ‘Informationsnetzwerk Homöopathie’, was behind the motion. Doctors should be banned from practising homeopathy in future, as well as billing via statutory and private health insurance. [3]
The case of the Charité University Hospital in Berlin shows just how much influence opponents of homeopathy have: for years, the hospital’s website stated ‘that homeopathic medicine can cure or improve even the most serious conditions’. After fierce protests – including from the health journalism portal MedWatch – the statement was removed. [4]
My comments:
- Effectiveness is not something to be quantified by popular votes. Responsible healthcare professionals employ rigorous clinical trials for that purpose.
- Lauterbach caved in because of the pressure from the Green Party and insists that his plans are merely postponed.
- The ‘German Medical Assembly’ decided that the use of homoeopathy in diagnostics and therapy does not constitute rational medicine. German doctors continue to be free to practice homeopathy, if they so wish.
- The notion that ‘homeopathic medicine can cure or improve even the most serious conditions’ is so obviously and dangerously wrong that it had to be corrected. This has little to do with the influence of opponents but is due to the influence of the evidence.
I feel that, if proponents of homeopathy want to save their beloved quackery from the face of the earth, they could at least get their facts right and think of some agruments that are a little less ridiculous.
‘Yes to Life’ is a UK cancer charity that promotes so-called alternative medicine (SCAM). It has featured before on my blog:
Uncharitable charities? The example of ‘YES TO LIFE’
‘Yes to Life’ also runs a radio show:
The Yes to Life Show is presented by Robin Daly, Founder and Chairman of the UK registered charity Yes to Life. Robin set up Yes to Life nearly two decades ago, following the experience of supporting his youngest daughter Bryony through cancer three times. The extraordinary difficulties he found that faced people in finding and obtaining the help they wanted, spurred him into creating a charity to make a difference to this tragic predicament.
Although very familiar with the territory, Robin is not a cancer specialist or any kind of health expert. In presenting the show, he is always looking for a ‘layman’s’ understanding of the complexities of cancer and the issues surrounding it that is accessible to all…
… As we rapidly approach the point where half of us will get cancer, there are some pretty stark questions facing us that the show attempts to throw light on:
- What are we doing wrong?
- Why has the colossal investment in research produced so few answers?
- What are we missing?
- And crucially to all the above – What is cancer?
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The website of Yes to Life Show offers a wide range of previous broadcasts, many featuring individuals who are also familiar to this blog such as Michael Dixon or Elizabeth Thompson. I listened to sections of Elizabeth’s recordings:
I find this recording and many others recordings available on the Yes to Life Show (please do make the effort and listen to some of them!) concerning and at times outright irresponsible and dangerous – no wonder that the Yes to Life Show includes this ‘Disclaimer’:
Please note that all information and content on the UK Health Radio Network and all its radio broadcasts and all its publications and all its websites are provided by the authors, producers, presenters and companies themselves and is only intended as additional information to your general knowledge. As a service to our listeners/readers our programs/content are for general information and entertainment only. The UK Health Radio Network does not recommend, endorse, or object to the views, products or topics expressed or discussed by show hosts or their guests, authors and interviewees. We suggest you always consult with your own professional – personal, medical, financial or legal advisor. So please do not delay or disregard any professional – personal, medical, financial or legal advice received due to something you have heard or read on the UK Health Radio Network.
The UK Health Radio Network makes no warranties or representations of any kind that the services provided on the radio broadcasts or web sites will be uninterrupted, error-free or that the radio broadcasts or web sites, or the servers that hosts the radio broadcasts or web sites are free from viruses or other forms of harmful computer codes. In no event will the UK Health Radio Network, its employees, distributors, advertisers, syndicators or agents be liable for any direct, indirect or consequential damages resulting from the use of this web site. This exclusion and limitation only applies to the extent permitted by law.
So, the show is “for entertainment only”. I can easily see why:
as advice for cancer patients (or carers), it would be outright dangerous!
Mistletoe is a popular so-called alternative medicine (SCAM) often advocated for cancer. It has featured regualarly on this blog:
- A cancer patient died after taking a herbal mixture containing mistletoe
- A systematic analysis of the mistletoe prescriptions used in clinical studies
- Prof Harald Walach reviews mistletoe and arrives at a positive conclusion
- Mistletoe treatment for cancer is useless and should be discouraged
- Mistletoe for cancer: Does it improve patients’ quality of life?
- Mistletoe for cancer: the saga continues
- Mistletoe, a cancer therapy? You must be joking!
- Suzanne Somers has died – another victim of so-called alternative medicine?
Now concerns about the safety of mistletoe therapy have re-surfaced.
One man was diagnosed with a neuroendocrine neoplasia of the terminal ileum that had metastasised diffusely to the liver. The patient also developed symptoms of carcinoid syndrome (flushing, sporadic diarrhoea and bronchospasticity). Somatostatin analogue therapy was started after surgical treatment in 11/2020.
The patient had independently started mistletoe injection therapy. After six weeks, he complained of several localised reactions at the injection sites, each with a very itchy ‘hazelnut-sized’ hardening. He was then advised to halve the mistletoe dose and continue the therapy. However, the local findings did not improv; the physician therefore prescribed a further dose reduction.
As a result, the local findings improved, the patient increased the dose. 30 minutes after the injection of the high dose, he felt an increasing feeling of warmth, tingling, nausea and discomfort, as well as shortness of breath and an urge to defecate. When he went to the toilet, he also experienced visual disturbances and dizziness, and eventually fell unconscious. The emergency doctor called by his wife admitted him to the nearest hospital with the diagnosis of anaphylactic shock. After inpatient diagnostics – with exclusion of a cardiopulmonary event – and successful treatment, the patient was able to leave the hospital on the second day.
Mistletoe therapy has become more popular as a supportive cancer therapy. Therefore, rare but serious to life-threatening side effects should be known to the therapists and patients, the doctors of the patient stress. The most common adverse events of mistletoe therapy are skin reactions at the injection site (pruritus, urticaria, redness ø ≤ 5 cm). One review noted that the rate of serious adverse events from mistletoe therapy was < 1 per cent. According to the above-mentioned guideline, the following are very rare side effects:
- hypersensitivity and anaphylactic reactions,
- intensification of autoimmune reactions,
- local lymphoma infiltrate at the injection site.
Recent studies have demonstrated that sociopolitical attitudes partially explain variance in (SARS-CoV-2) vaccine hesitancy and uptake. Other attitudes, such as those towards esoteric beliefs, so-called alternative medicine (SCAM), and religion, have also been proposed. However, pertinent studies provide limited direction for public health efforts, as the impact of such attitudes has been tested in isolation or on different outcomes. Moreover, related associations between SARS-CoV-2 immunization drivers as well as views towards other modes of immunization (e.g., routine pediatric immunization), remain unclear.
Based on a sample of ~7400 survey participants (Germany), where esoteric belief systems and SCAM (Waldorf, homeopathy) are rather prevalent, and controlling for other sociological factors, this study found that:
- individuals with positive attitudes towards Waldorf education and homeopathy are significantly less likely to have received a (further) dose of SARS-CoV-2 vaccine compared to those with positive views of mainstream medicine;
- for the former, immunization decisions are primarily driven by external pressures, and for the latter overwhelmingly by voluntary considerations;
- attitudes influencing adult SARS-CoV-2 vaccine uptake similarly influence views towards routine pediatric immunization.
The authors concluded that their findings provide significant evidence informing a more nuanced design of public health and communication campaigns, and pertinent policies.
As the authors of this study point out, the attitudes towards mainstream medicine remained the single most influential factor for vaccine uptake. Individuals who viewed mainstream medicine highly favorably, received on average an estimated 1.48 (p < 0.001) more doses of SARS-CoV-2 vaccine than those who held very negative views. In contrast, those who viewed homeopathy highly positively received on average 0.51 (p < 0.001) fewer doses than those who viewed homeopathy highly negatively.
Regarding religious denominations, individuals self-classifying as Roman-Catholic or Protestant received on average 0.17 (p < 0.001) and 0.15 (p < 0.001) more vaccine doses than those self-classifying as non-denominational. The associations between other denominations and vaccine doses were statistically insignificant.
While these associations have been observed before or at least seem logical to me (and we discusses them frequently on this blog), one finding is, I think new (albeit not surprising, in my view): Supporters of the right-wing populist AfD received 1.37 (p < 0.001) fewer vaccine doses than the reference category Christian democrats.
So, does that in essence mean that the typical (German) vaccination hesitant person votes extereme right and loves SCAM?
This study sought to identify if an Neonatal Intensive Care Unit (NICU) integrating complementary medicine has low antibiotic prescribing.
The researchers conducted a retrospective analysis at the level-2 NICU of the Filderklinik, an integrative medicine hospital in Southern Germany, to compare antibiotic use locally and internationally; to compare neonates with suspected infection, managed with and without antibiotics; and to describe use and safety of complementary medicinal products.
Among 7778 live births, 1086 neonates were hospitalized between 2014 and 2017. Two hundred forty-six were diagnosed with suspected or confirmed infection, their median gestational age was 40.3 weeks (range 29-42), 3.25% had a birthweight <2500 g, 176 were treated with antibiotics for a median duration of 4 days, 6 had culture-proven infection (0.77 per 1000 live births), and 2.26% of live births were started on antibiotics. A total of 866 antibiotic treatment days corresponded to 111 antibiotic days per 1000 live births and 8.8 antibiotic days per 100 hospital days. Neonates managed with antibiotics more often had fever and abnormal laboratory parameters than those managed without. Complementary medicinal products comprising 71 different natural substances were used, no side effect or adverse event were described. A subanalysis using the inclusion criteria of a recent analysis of 13 networks in Europe, North America, and Australia confirmed this cohort to be among the lowest prescribing networks.
The authors concluded that antibiotic use was low in this NICU in both local and international comparison, while the disease burden was in the mid-range, confirming an association between integrative medicine practice and low antibiotic prescribing in newborns. Complementary medicinal products were widely used and well tolerated.
I have often suggested that somone does a study to assess the usage of meat products in a vegetarian restaurant. I am sure it would generate resuts that are at least as meaningful as the ones reported by the team of anthroposophic geniuses responsible for this paper. Here are their affiliations:
- 1ARCIM Institute, Filderstadt, Germany.
- 2Department of Pediatrics, Filderklinik, Filderstadt, Germany.
- 3Department of Neonatology, University Hospital Tübingen, Tübingen, Germany.
- 4Center for Integrative Pediatrics, Fribourg Cantonal Hospital, Fribourg, Switzerland.
- 5Department of Community Health, Fribourg University, Fribourg, Switzerland.
- 6Institute of Precision Medicine, University Furtwangen, Furtwangen, Germany.
Say no more!
This Phase IV randomized, double-blind, placebo-controlled clinical trial was “designed to demonstrate the efficacy and safety of the product Neurodoron (Kalium phosporicum comp., KPC) in patients with neurasthenia”.
The study was conducted in an outpatient German trial site. Women and men aged 18 and above were randomized to receive either KPC or placebo if they reported typical symptoms of neurasthenia and a severe psychiatric disorder could be excluded. The primary objectives were a reduction in characteristic symptoms of nervous exhaustion and perceived stress as well as improvement in general health status after 6 weeks of treatment.
In total, 204 patients underwent screening, 78 were randomized in each treatment group, and 77 patients each received treatment (intention-to-treat (ITT) population = 154 patients). For none of the primary efficacy variables, an advantage in favor of KPC could be demonstrated in the pre-specified analysis (p-values between 0.505-0.773, Student’s t-test). In a post-hoc analysis of intra-individual differences after 6 weeks treatment, a significant advantage of KPC vs. placebo was shown for characteristic symptoms of nervous exhaustion (irritability (p = 0.020); nervousness (p = 0.045), Student’s t-test). Adverse event (AE) rates were similar between treatment groups, in both groups six AEs were assessed as causally related to treatment (severity mild or moderate). No AE resulted in discontinuation of treatment.
The authors concluded that the trial treatment was well tolerated with only a few and minor AEs reported, confirming the markedly good safety of KPC. A significant improvement of neurasthenia was seen for the total study population at the end of the treatment period. Superiority of KPC vs. placebo could not be demonstrated with the pre-specified analysis with regards to a sum score of 12 typical symptoms, perceived stress, or general health status. However, the explorative post-hoc analysis revealed that KPC is superior to placebo in the characteristic symptoms irritability and nervousness. KPC could therefore be a beneficial treatment option for symptomatic relief of neurasthenia.
The very first thing one notices is the aim of the study. According to its authors, it was “designed to demonstrate the efficacy and safety of the product Neurodoron (Kalium phosporicum comp., KPC) in patients with neurasthenia“. Any group of researchers that is unaware of the fact that clinical trials are for TESTING and not for DEMONSTRATING should, in my view, be sent straight back to school. And while they are at it, they might as well take with them the editor of the journal as well as the peer-reviewers of the paper.
As it happens, I have published a post about Neurodoron before. Here is a short section from it:
Stress is associated with a multitude of physical and psychological health impairments. To tackle these health disorders, over-the-counter (OTC) products like Neurodoron® are popular since they are considered safe and tolerable. One tablet of this anthroposophic remedy contains the following active ingredients:
83.3 mg Aurum metallicum praeparatum trituration (trit.) D10,
83.3 mg Kalium phosphoricicum trit. D6,
8.3 mg Ferrum-Quarz trit. D2.
Experience reports and first studies indicate that Neurodoron® is efficient in the treatment of stress-associated health symptoms…
Apart from its above-mentioned aim, the new study is remarkable in one further aspect: in its conclusion, it makes a big deal out of the ‘good news’ that Neurodoron safe. As the trial was not designed to test safety, this can only be seen as an attempt to hide (as well as possible) the fact that the remedy turned out to be ineffective.
Why would researchers try to distract the reader from the main message of their work? The answer might lie in the affiliation of two of the authors: Clinical Research, Weleda AG, Schwäbisch Gmünd, Germany.
Acute tonsillitis, which includes tonsillopharyngitis, is a common condition, particularly in childhood. It is mostly caused by a viral infection. Symptomatic treatment is of high importance. But which treatment is effective and which isn’t?
For this expert consensus, 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprised 5 survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.
Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). The panel felt that AM was an adequate therapy for acute tonsillitis.
The authors of this paper concluded that the clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.
I found it hard to decide whether to cry or to laugh while reading this paper.
Experience in anthroposophic paediatric medicine does not make anyone an expert in anything other than BS.
Expert consensus and clinical guidelines are not conducted by assembling a few people who all are in favour of a certain therapy while ignoring the scientific evidence.
AM for acute tonsillitis in children is nonsense, whatever these pseudo-experts claim.
Imagine we run a Delphi process with a few long-standing members of ‘the flat earth society’ and ask them to tell us about the shape of the earth …
…I rest my case.
I have to admit that I came across the ‘ARCIM’ (Academic Research in Complementary and Integrative Medicine) Institute only yesterday when writing the post about Buteyko. Naturally, the institution interested me, and I tried to find out more about it. As pointed out previously, the aim of the ARCIM research institute, founded in 2010, is to research complementary and integrative medicine, in particular anthroposophic medicine, on a scientific basis according to rigorous scientific standards established by the Equator Network criteria (http://www.equator-network.org/).
On the ARCIM’s website we furthermore learn that:
- ARCIM exists since 2010.
- Consists of a team of 8 co-workers.
- Its director is the physician Jan Vagedes.
- Who have published a sizable amount of papers.
- Is funded by the following sponsors: Federal Ministry of Education and Research (BMBF), Mahle-Foundation (Mahle Stiftung), Software AG (Software AG), DAMUS-DONATA e.V.
- Is located in the buildings of the ‘Filderclinic’.
This begs, I think, several questions:
Why is the Federal Ministry of Education and Research sponsoring the ARCIM?
As anthroposophical medicine is based on concepts that fly in the face of science, this seems a legitimate question. Sadly, I have no answer to it.
What is the ‘Filderclinic’?
The Filderklinik in Filderstadt-Bonlanden is one of six anthroposophically orientated hospitals in Germany. It is operated by the non-profit organisation Filderklinik gGmbH. The main founders of the Filderklinik, which has existed since 1975, were Hermann and Ernst Mahle, the founders of the Mahle Group. The Mahle-Stiftung GmbH is the main shareholder and also the largest sponsor of Filderklinik gGmbH. The hospital employs around 915 staff and has 300 beds.
Who is Jan Vagedes?
Jan Vagedes is a specialist for paediatrics and adolescent medicine, neonatology and a doctor for anthroposophic medicine. He studied in and graduated from the LMU in Munich (my alma mater) in 1997. He is the Founder and Scientific Director of the ARCIM Institute, a research associate at the University Children’s Hospital Tübingen, and Head of paediatrics and adolescent medicine at the Filderclinic.
He has no ‘habilitation’ (PhD and in Germany precondition for a professorship). Medline currently lists 42 articles in his name most of which are in 3rd class journals. His first Medline-listed article is dated 2012. As the ARCIM was established in 2010, this means that, when he was appointed as its ‘scientific director’, he had exactly zero published science to his name.
Why did he get the job?
I have absolutely no idea?
(If you know more than I do, I’d be grateful to hear about it.)
The Austrian ‘Initiative für Wissenschaftliche Medizin‘ (Initiative for Scientific Medicine) did a great job by summarizing the non-scientific training events dedicated to pseudomedicine organized, supported or promoted by the ‘Österreichische Akademie der Ärzte‘ (Austrian Academy of Physicians), a partner of the Austrian Medical Association. They sorted them by date in descending order, listing the DFP points (points required for postgraduate education) awarded and the link to each specific event. The content of the programme of such events, if available, is also often “interesting”. The pseudomedicine methods are provided with links to psiram.com, where these methods are described in more detail.
So, restricting ourselves to the period of 20 years (2003-2023) and merely looking at a selection of all possible so-called alternative medicine (SCAM), we find in this treasure trove of quackery the following:
- Anthroposophic medicine – 218 events
- Homeopathy – 1 708 events
- Orthomolecular medicine – 645 events
- Neural therapy – 864 events
- TCM diagnostics – 1214 events
In total, thousands SCAM events were organized, supported or promoted by the Academy, and I am not aware of any national physicians’ organization that has done anywhere near as much for quackery.
On their website, the Austrian Academy of Physicians state that they were founded by the Austrian Medical Association as a non-profit organisation with the aim of promoting and further developing medical education in Austria… The aim is to lead the way in medical education issues in order to achieve continuous improvement in the medical profession. For the Academy, continuing medical education is an essential component of medical quality improvement…
This may sound alright but, in my view, it raises several questions, e,g,:
- Does the Academy believe that continuous improvement in the medical profession can be achieved by promoting, organizing or conducting such a huge amount of courses in quackery?
- Do they not know that this is the exact opposite of medical quality improvement?
- Are they aware of their ethical responsibility?
- Do they know that the promotion of quackery puts patients at risk?
- Have they heard of evidence-based education?
It is easy to criticize but less obvious to improve. In case the people responsible for postgraduate education at the Academy want to discuss these issues with me, I would therefore be delighted to do so, for instance, via a series of evidence-based lectures on SCAM.
he German press reported yesterday that the country’s Health Minister Karl Lauterbach plans to remove homeopathic treatments from the benefits catalog of statutory health insurance companies. “Services that have no medically verifiable benefit should not be financed from contribution funds,” states a recommendation paper by the minister. “For this reason, we will remove the option for health insurance companies to include homeopathic and anthroposophic services in their statutes, thereby avoiding unnecessary expenditure by health insurance companies.” However, private supplementary insurance should still be possible.
Lauterbach had already announced last year that he would review the funding of homeopathic treatments. “Although homeopathy is not significant in terms of expenditure, it has no place in a science-based healthcare policy,” the SPD politician told “Der Spiegel” last October. The measure would save merely a maximum of ten million Euros. This is because firstly not all health insurance companies offer the option to reimburse homeopathy, and secondly, because not that many Germans use homeopathy.
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Before I was joined about a decade ago by a group of excellent and effective skeptics, I seemed to be a lone, lost voice in Germany cautioning against the misunderstanding that homeopathy and anthroposophical medicine were backed by evidence. Thus, you probably think that I am rejoicing at this spectacular success. At first glance, it does indeed seem to be great news for those who support evidence-based medicine. But sadly, I also have second thoughts.
We should, I think, be concerned that Lauterbach intends to leave homeopathic and anthroposophical remedies reimbursible via private supplementary insurance. Most Germans have such insurance which means that, despite Lauterbach’s grand announcement, very little will probably change. Homeopathy and anthroposophic medicine, both pure placebo therapies, will still be able to pretend to be real medicine.
Moreover, we should be concerned about Lauterbach’s reasoning. It is, of course, laudable to point out that homeopathic and anthroposophic remedies are not demonstrably effective. But clearly, this is only half of the truth. The full truth is that they are based on totally ridiculous assumptions, that, in other words, they fly in the face of science. Only if we manage to get this message across, will we inform the public responsibly, in my view.
A total ban then? No, personally, I don’t want to ban homeopathic or anthroposophical remedies. If someone loves esoteric nonsense or placebos, he/she should, in my view, be able to buy them. But he/she should use their own money for the purchase. We should remember that wasting notoriously scarce public funds from either statutory or private health insurances is not just uneconomical but foremost unethical.
