homeopathy
“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 In March 2024, the cancellation of homeopathy and anthroposophic medicines as additional statutory benefits was revoked.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.
Homeopathy was founded some two hundred years ago by Dr Samuel Christian Hahnemann. Over time, it has grown to be among the most frequently used forms of alternative medicine in Europe and the USA. It is underpinned by the principle of ‘like cures like’, where highly diluted substances are used for therapeutic purposes, by producing similar symptoms to when the substance is used in healthy people. Many studies have been published on the value of homeopathy in treating diseases such as cancer, depression, psoriasis, allergic rhinitis, asthma, otitis, migraine, neuroses, allergies, joint disease, insomnia, sinusitis, urinary tract infections and acne, to name a few. An international team recently published a “comprehensive review” of the literature on homeopathy and evaluated its effectiveness in clinical practice.
Their conclusions were as follows:
The current evidence supports a positive role for homeopathy in health and wellbeing across a broad range of different diseases in both adult and paediatric populations. However further research to assess its cost-effectiveness and clinical efficacy in larger studies is required. These findings may encourage healthcare providers and policymakers to consider the integration of homeopathic therapies into current medical practice, to provide a greater sense of patient autonomy and improve the consumer experience.
Medicine is dynamic and continues to evolve. Conventional medicine, while backed by the largest body of evidence thus far to support its safety and efficacy, still has its limitations in terms of side effects and subsequent effects on quality of life. This analysis calls for more in-depth assessment of the current research on homeopathy across a larger range of diseases.
And their ‘Key Summary Points’ were:
- While homeopathy is among the most frequently applied forms of alternative medicine, there is a lack of familiarity with this therapeutic modality within everyday medical practice.
- This review examines some of the available evidence in relation to the impact of homeopathy on a variety of common chronic diseases.
- Homeopathy was found to have the potential for symptom improvement in certain diagnoses within the fields of internal medicine, oncology, obstetrics and mental health.
- Although there is a paucity of studies on homeopathy within the context of standard clinical practice, an opportunity exists for further research into its application by utilising conventional study designs.
To understand how the researchers could arrive at these conclusions, we need to have a look at their methodology. This is their full description:
We conducted a literature review to answer the following research questions:
- What is the current knowledge on the use of homeopathy in clinical practice?
- Has the use of homeopathy achieved beneficial results in patients being treated for specific clinical entities?
Results were then appraised in relation to:
- Population: patients using homeopathy, physicians and homeopaths who reported using homeopathic agents in the included studies
- Intervention: homeopathic remedies
- Control: conventional treatment or no treatment
- Outcome: improvement in patients’ conditions (or positive results)
Keywords were searched in respect of homeopathy (homeopathy; formulas, homeopathic; pharmacopoeias, homeopathic; materia medica and vitalism) and clinical practice (complementary and alternative medicine, health). The following search terms were used: (“homeopathy” OR “formulas, homeopathic” OR “pharmacopoeias, homeopathic” OR “materia medica” OR “vitalism”) AND (“health” OR “complementary and alternative medicine”).
Two electronic databases were searched using the search terms homeopathy, cancer therapy, type 2 diabetes, complementary and alternative medicine, COVID-19 and SARS-CoV-2. Material retrieved was examined to omit overlapping results or duplicates. Publications in languages other than English, and those without full texts accessible online, were excluded.
This article is based on previously conducted studies and does not contain any new study with human participants or animals performed by any of the authors.
___________________________
Two crucial things are missing here:
- An adequate description of which articles were included and which were discarded. A look at the reference list discloses that only articles in favour of homeopathy were considered.
- A description of the critical evaluation performed of the included evidence. A look at the text shows that no critical evaluation took place.
Thus this paper turns out to be not a ‘comprehensive review’ but a ‘comprehensive white-wash’ of homeopathy. Using the methodology of the authors it would be easy, for instance, to publish a comprehensive review demonstrating that the earth is flat.
I sugget the journal editors, peer-reviewers and authors of this idiotic paper bow their heads in shame!
It is already 7 years ago that I listed several ‘official verdicts on homeopathy‘, i.e. conclusions drawn by independent, reputable bodies evaluationg the evidence for or against homeopathy:
“The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available”
Russian Academy of Sciences, Russia
“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”
National Health and Medical Research Council, Australia
“These products are not supported by scientific evidence.”
Health Canada, Canada
“Homeopathic remedies don’t meet the criteria of evidence based medicine.”
Hungarian Academy of Sciences, Hungary
“The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.”
Swedish Academy of Sciences, Sweden
“We recommend parents and caregivers not give homeopathic teething tablets and gels to children and seek advice from their health care professional for safe alternatives.”
Food and Drug Administration, USA
“There is little evidence to support homeopathy as an effective treatment for any specific condition”
National Centre for Complementary and Integrative Health, USA
“There is no good-quality evidence that homeopathy is effective as a treatment for any health condition”
National Health Service, UK
“Homeopathic remedies perform no better than placebos, and that the principles on which homeopathy is based are “scientifically implausible””
House of Commons Science and Technology Committee, UK
Since then, there have been many more statements from similar organisations (does someone know of a complete list? if so, please let me know). One such statement is from French veterinarians: Avis 2021- 3 sur l’Homéopathie vétérinaire. Aloow me to translate the crucial passages for you:
Opinion 2021- 3 on Veterinary Homeopathy. The Report of a Working Group on Veterinary Homeopathy, an Opinion on Veterinary Homeopathy adopted in the academic session on May 6, 2021. The report ecommends that :
no medical discipline or practice claiming to be a medical discipline should be exempt from the ethical duty of testing its claims;
in this respect, clinical studies on the individual, reconciling scientific rigor and practical constraints, be explored, and in particular the N of 1 trials described in human medicine;
veterinary medicine be defined as evidence-based medicine, and not as allopathic medicine;
it is reaffirmed that veterinary medicine must above all be holistic, and that consequently the label of holistic veterinary medicine cannot be monopolized by particular practices;
homeopathy in veterinary medicine, as in human medicine, is not currently recognized nor can it be claimed as an exclusive veterinary medical activity;
institutional communication provides ongoing information on the scientific approach, evidence-based medicine and complementary medicine, tailored respectively to veterinarians, the general public and, in particular, animal keepers;
veterinary surgeons who, in the absence of recognized scientific proof of the efficacy of homeopathy in particular, wish to pursue this activity, particularly as a complementary medicine, should be fully aware of their increased responsibilities due to the current lack of scientific confirmation of efficacy;
it is possible to use homeopathic preparations, insofar as the medical decision to use a complementary and non-alternative therapy systematically requires informed consent, and does not result in a loss of opportunity by delaying the diagnostic procedure and/or the establishment of a recognized effective treatment;
that, in order to provide the information needed to obtain informed consent, a prescription for a homeopathic preparation should be accompanied, on any suitable medium, by a statement to the effect that, in the current state of knowledge, veterinary homeopathy has a contextual effect;
that the term “homeopathic medicine” be eventually replaced by “homeopathic preparation” in national and European legislation, that labelling state that “the efficacy of the preparation has not been demonstrated in accordance with current standards”, and that homeopathic preparations cannot claim the properties of vaccines or replace them, without incurring criminal sanctions;
in veterinary medicine, no university diploma in homeopathy be awarded by schools and other public establishments, and that training in homeopathy only take place within the framework of training that takes into account the realities of the scientific approach;
as part of their initial training, veterinary schools are places for debate and training in critical thinking, by offering interdisciplinary seminars on non-conventional approaches;
_____________________________
So, the next time someone claims “homeopathy has been proven to work in animals”, let’s show them what the experts think of this notion.
I recently published an article in the German newspaper ‘DIE WELT‘ about the Bavarian Homeopathy trial. My comments did not go down well with the German Association of Homeopathic Doctors (DZVhÄ). Here is their ‘OPEN LETTER’ (my translation) in response to my article (the numbers [in bold brackets refer to my comments below):
Berlin, 11 December 2024: Open letter to Ulf Poschardt, editor-in-chief of the daily newspaper Die Welt, asking whether Prof. Edzard Ernst is really still acceptable as a WELT author. This letter refers to E. Ernst’s article ‘Why a globule study was discontinued’ (DIE WELT, Tuesday, 3 December 2024).
Edzard Ernst is a member of the GWUP (Gesellschaft zur Wissenschaftlichen Untersuchung von Parawissenschaften). (1) This organisation within the so-called sceptic movement has set itself the task of pointing out in the health sector that belief in alternative medicine (‘pseudoscience’) prevents more effective therapies from being used. (2) From this point of view alone, Ernst’s polemic against the iHOM study by the Technical University of Munich[1] misses the mark by a mile, as the study design explicitly does not envisage treating patients with recurrent cystitis ‘either with individually selected homeopathic remedies or a placebo’. On the contrary, it provides for all patients to be treated strictly in accordance with the rules of evidence-based medicine if necessary and if the findings are clear, but also to investigate whether concomitant homeopathic treatment could lead to a reduction in the frequency of antibiotic use. It must be assumed that Ernst has read the study design, but either he is deliberately omitting the true aim of the study or he is simply unable to recognise the difference between a study and his personal fight against homeopathy (3). In both cases, he cannot be taken seriously (!) as an expert on scientific issues in the field of medicine, and certainly not in a serious print medium such as WELT.
Health services research shows: Homeopathy can save antibiotics
The members of the Bavarian state parliament, some of whom were cross-party supporters of this study, were clearly aware of the results of healthcare research, according to which homeopathy can help to reduce the use of antibiotics in defined clinical pictures. In France, for example, a large survey (EPI3-MSD cohort study[2]) came to the conclusion that GPs who use homeopathy for respiratory diseases only use around half as many antibiotics as their conventionally working colleagues. (4) To date, however, there have been no studies that have investigated this at the highest scientific level (randomised, double-blind, placebo-controlled). Against the background of increasing antibiotic resistance worldwide, it was therefore neither ‘ignorance on the part of the Bavarian state government’ nor a foreseeable ‘waste of money’ to investigate this option.(5) If you add to this the fact that panel doctors with an additional qualification in ‘homeopathy’ can even get confirmation in black and white from their panel doctors’ association that their antibiotic consumption is below the average for their respective specialist group, then it would be “unethical” – in complete contrast to Ernst’s assessment – not to have attempted this study. (6)
The article shows the ideological ‘blinding’ of Edzard Ernst
It is clear that Mr (7) Ernst’s ideological ‘blinding’ as an exponent of the sceptic movement (8) leads him, consciously or unconsciously, to draw conclusions that are contrary to open-ended science (9). Reducing the use of antibiotics in the fight against the increasing development of resistance is simply a medical necessity, and those who do not or do not want to face up to this task are manoeuvring themselves into scientific obscurity with flimsy interpretations. (10) The fact that there are individual cases (Italy, child, middle ear infection, globules, dead) in which a method was not applied with sufficient care or expertise does not change this. It should be added at this point that there are always examples in the field of conventional medicine where misdiagnoses can lead to complications or even death. In addition, the RKI (Robert Koch Institute) estimates 9,700 deaths[3] due to antimicrobial resistance, and the trend is rising! Against this dramatic backdrop, Mr Ernst’s polemic should actually be out of the question. (11)
One must come to the same conclusion if one scrutinises the meaning of the reference to a ‘series of experiments in the Third Reich’ and a ‘Homeopathy World Congress’ under Nazi rule. The attempt to discredit homeopathy by pointing out the involvement of homeopathically orientated doctors in the Third Reich is well known. (12) Of course, this usually ignores the fact that the doctors convicted of crimes against humanity at the Nuremberg medical trial were exclusively representatives of the scientific medicine of the time. (13)
However, Ernst’s references to the ‘Third Reich’ conceal something else: the ‘Society of Truth-Loving Men’, which studied the effectiveness of homeopathy in 1835, was a Masonic lodge, and although it was a ‘double-blind trial’, it was of course not ‘the first randomised, placebo-controlled double-blind trial in the history of medicine’, as it is accepted and applied today as a scientific experiment with strict ethical and legal regulations. The first such study worthy of its name was not conducted until 1947 (treatment of tuberculosis with streptomycin). (14)
And of course there was the so-called ‘Donner Report’ (after Dr Fritz Donner), which Ernst indirectly refers to and which summarises the results of drug trials in the ‘Third Reich’. The result was indeed not convincing in favour of homeopathy (15), but this report had a not inconsiderable ‘flaw’: it is extremely problematic in terms of source criticism because it was not written until around two decades after the end of the Second World War, and the original documents Donner referred to have not reappeared and must therefore be considered lost. (16)
If, like Mr Ernst, one sets out in search of arguments against homeopathy and goes back more than half a century (17), then it would also be fair and obvious to mention that the homeopathic medical profession commissioned the Institute for the History of Medicine of the Robert Bosch Foundation years ago to scientifically investigate the role of homeopathic doctors during National Socialism (Mildenberger 2016[4]). The result: to quote Mr Ernst from a different context, there is no more ‘dirt on their sleeves’ than with other professional and socially relevant groups. (18)
Edzard Ernst ignores the current state of homeopathic research
‘Sugar pellets are the basis of many homeopathic treatments. However, all previous research (19) has shown that their effect does not exist.’ This statement by Edzard Ernst is simply wrong! The current state of research is described by the University of Bern as follows: ‘Summarising the current state of preclinical and clinical research, it can be concluded that homeopathic preparations show specific effects that differ from placebo when they are used appropriately…’[5]. (20)
But Ernst could have come up with the idea of comparing the quality of old studies with the current meta-analyses up to a systematic review of six such meta-analyses (Hamre and Kiene, 2023[6]). But he didn’t! If he had, he would have had to admit that the quality and rigour of the latest scientific homeopathy research need not shy away from comparison with studies in conventional medicine. (21)
Based on positive study results, additional homeopathic treatment was included as a treatment option in the medical S3 guideline ‘Complementary medicine in the treatment of oncological patients’[7] in 2021. Ernst also deliberately ignores this treatment recommendation from scientific medical societies. (22)
Edzard Ernst is part of a sceptic association and not the international research community
As an activist of the GWUP (23), Ernst is known for the fact that he has not been scientifically active for a long time (24), but regularly tries to discredit those scientists who conduct research into complementary medical procedures. (25) This uncollegial behaviour has meant that Ernst has not been invited to speak at international scientific research congresses on integrative and complementary medicine for a long time. (26) Agitation, however, is no substitute for a fact-based exchange, but prevents dialogue, in this specific case about the meaning of the Bavarian state government’s commitment. Furthermore, polemics do not contribute in the slightest to coming even a small step closer to a solution to the obvious problem of increasing antibiotic resistance (27). As a reputable print medium, WELT is therefore advised to distance itself from Mr Ernst and his comments or to dismiss him.
[1] https://www.ihom.nephrologie.med/de#iHOM-Studie
[2] https://www.dzvhae.de/homoeopathische-arzneimittel-antibiotika-notstand/epi3laser_study_de-18/
[3] https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2022/06_2022.html
[4] https://www.wallstein-verlag.de/9783835318793-der-deutsche-zentralverein-homoeopathischer-aerzte-im-nationalsozialismus.html
[5] https://www.ikim.unibe.ch/forschung/uebersichten_zum_stand_der_forschung/homoeopathie/index_ger.html
[6] https://pubmed.ncbi.nlm.nih.gov/37805577/
[7] https://register.awmf.org/de/leitlinien/detail/032-055OL
_____________________________________
- If you want to demonstrate how well informed you are, it is always a good idea to start with a falsehood: I left the GWUP about a year ago, a move that created considerable huhah in Germany.
- Wrong again: “The GWUP has set itself the task of promoting science and scientific thinking.”
- My description of the study did not mention that homeopathy was to be used as an add-on. I thought this was obvious (not least because otherwise the study would have not been ethical) but I gladly admit it was my mistake to not spell this out for those who are slow on the uptake.
- These studies merely show that homeopaths tend to prescribe less antiiotics, and the quoted French study was so convincing that the French government promptly ceased the reimbursement of homeopathy.
- I would still argue that my comment is entirely correct here.
- The notion that it might be unethical not to study homeopathy in expensive clinical trials flies in the face of medical ethics.
- Have I been demoted?
- I probably should be flattered to be called an ‘exponend for the skeptic movement’; however, this is far from what I am. I am simply a scientist trying his best to inform the public responsibly.
- In my WELT article, I point out that virtually every respectable panel worldwide looking at the evidence has concluded that homeopathy is a dangerous nonsense. Does that not suggest that my conclusions might be more accurate than those of homeopaths?
- I am all for rigorous research into the over-prescribing of antibiotics, antibiotic resistance, etc. – so much so that I would have used the Euro 800 000 not for the nonsensical homeopathy study but for that purpose.
- Do I detect a bit of the ‘Tu quoque’ fallacy here?
- I mentioned the project not primarily because I wanted to discredit homeopathy, but mostly because it was the largest research project ever conducted in homeopathy. Omitting it in a review of the history would have been wrong.
- The Nuremberg Doctors Tribunal tried barely more than a handfull of physicians, while, in total, hundreds had committed crimes agaimst humanity.
- The 1835 study was a placebo-controlled, randomised study; the streptomycin trial was the first to be generally aknowledged.
- From all we know, the results were devastatingly negative, not just “not convincingly in favour”.
- The original files of the project disappeared in the hands of homeopaths after WWII.
- No, I did a review of the history, for which puropose it is inevitable to go back in time.
- Do I detect more ‘Tu quoque’ fallacy here?
- Mea culpa: I should have written: “all previous credible research”.
- Yes, we recently discussed the current state of research on my blog.
- And we also discussed this review; in neither instance were we impressed!
- The guidelines had to rely on the Frass study which has since been disclosed as fraudulent.
- When you issue a falsehood, it is best to repeat it; only then you can make sure to discredit yourself completely.
- And when you tell one lie, you might as well tell a few more (a simple Medline search would have told them that I am ‘research-active’ to the present day!)
- I have often noticed that homeopaths find it tough to accept or even deal with criticism; they thus often prefer to interpret it as a personal attack and discreditation.
- Yes, why not? It’s fun to add yet another falsehood to the hilarious mix of lies and ad hominem attacks!
- A comment in a newspaper cannot possibly find “a solution to the obvious problem of increasing antibiotic resistance”. This has to be found with rigorous research – something homeopaths would not recognise if it bit them in their behinds.
I am, of course, not surprised that the German homeopath did not like my article. Yet, I am truly amazed by their emarrassingly poor (but highly amusing) arguments against me and my comments. I had hoestly thought they had more sense.
Homeopathy is ‘First-Line-Medicine’ – at least this is what a German pro-homeopathy website recently proclaimed. The notion, it informs us, is based on EU law.
But is that true?
Does the ‘Regulation (EU) 2018/848 of the European Parliament and of the Council on organic production (…)’ really recommend homeopathy for treating animals?
This is what the EU law states (my translation from a German original):
‘Diseases shall be treated immediately to avoid animal suffering; chemically-synthesised allopathic veterinary medicinal products, including antibiotics, may be administered, if necessary, under strict conditions and under the responsibility of a veterinarian, when treatment with phytotherapeutic, homeopathic and other remedies is inappropriate … phytotherapeutic and homeopathic preparations are preferable to chemically synthesised allopathic veterinary medicinal products, including antibiotics, provided that their therapeutic effect is guaranteed for the species concerned and the disease to be treated’.
Let’s analyse the text and find out what it really means. It states that:
- Vets should treat suffering animal without delay.
- They should use conventional therapies when homeopathy is inappropriate.
- Homeopathics are preferable, if their therapeutic effect is guaranteed for the species concerned and the disease to be treated.
So, homeopathy is recommended under two important and well-defined conditions:
- They have to be appropriate.
- They have to be proven to be effective.
It is amply clear that homeopathy has not been proven to be effective in any condition that afflicts animals. As this is so, homeopathics are evidently inappropriate.
But why, does the EU make it so complicated?
I don’t know the answer to this question but suspect that there was plenty of lobbying going on, and they had to find a phraseology that apeases the homeopaths and their industry.
- 85 were controlled trials;
- 79 of these were randomized.
There were many areas where the quality of the studies could be improved. About two-thirds of the 85 controlled trials had either high (42 percent) or unclear (24 percent) risk of bias according to internationally recognized standards for internal validity.
Of the 14 observational (cohort) studies, over one-third did not control for important confounders in the outcome analyses. Regarding external validity, adherence was reported in less than a third of studies (n=31). Forty percent of studies (79% of observational studies) did not report on safety. Regarding model validity, fewer than two-thirds of the studies were consistent with homeopathic principles.
- Iris Bell, M.D., Ph.D., University of Arizona College of Medicine (Retired) and Sonoran University of Health Sciences;
- Dan Cherkin, Ph.D., Osher Center for Integrative Health, Department of Family Medicine, University of Washington;
- Roger Chou, M.D., Department of Medical Informatics & Clinical Epidemiology and Department of Medicine, Oregon Health & Science University;
- Katharina Gaertner, MBBS, Research Faculty of Health, University Witten/Herdecke;
- Klaus Linde, M.D., Ph.D., Scientific Coordinator, Technische Universität München, Institute of General Practice and Health Services Research;
- Alexander Tournier, Ph.D., Homeopathy Research Institute and Institute of Complementary and Integrative Medicine, University of Bern;
- Esther van der Werf, M.Sc., Ph.D., Clinical Research Lead, Homeopathy Research Institute, and Honorary Senior Lecturer, Primary Care Infection, Bristol Medical School, University of Bristol;
- Harald Walach, Ph.D., CHSInstitute.
Two very obvious things should be noted about this panel:
- There are not 9 but only 8 members.
- Almost all are individuals who are pro-homeopathy, and no informed critic of homeopathy was invited.
The latter fact seems important. Anyone who has worked with panels knowns that one can pre-determine the outcome of the deliberations by the choice of the members.
The panel essentially concluded that homeopathic research could be substantially improved. Considering its highly biased composition, this is remarkable. It means that, in fact,
HOMEOPATHIC RESEARCH IS DISMAL.
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition affecting children
and adults, characterized by symptoms of inattention, hyperactivity, and impulsivity. Despite the effectiveness of conventional treatments, such as stimulants, side effects drive interest in alternative therapies like homeopathy. This systematic review was aimed at determining the effectiveness of homeopathy as a treatment for ADHD.
A comprehensive search of PubMed, SCOPUS, and Google Scholar was conducted to identify clinical studies evaluating homeopathic treatments for ADHD. After applying selection criteria, eight studies were reviewed, consisting of randomized controlled trials, comparative studies, randomized open-label Pilot study, and clinical trials, were included in the final review.
The results suggest that some homeopathic treatments showed potential in reducing ADHD symptoms, particularly inattention and hyperactivity.
The authors concluded that homeopathy, particularly individualized treatment, shows promise as an adjunct or alternative treatment for ADHD, especially for those children whose caregivers seek alternatives to stimulant medications. Studies report that homeopathic treatment can significantly improve ADHD symptoms in some children, particularly when the correct remedy is identified. However, the evidence is mixed, with several studies showing improvements that may be attributable to the consultation process rather than the remedy itself. Given the increasing interest in Complementary and Alternative Medicine (CAM) among parents of children with ADHD, homeopathy may provide a valuable therapeutic option. Nevertheless, larger, more rigorous trials are required to confirm these findings and establish clear guidelines for its use in clinical practice. The potential for homeopathy to serve as an adjunct to conventional treatments, especially for younger patients or those intolerant to stimulants, remains an area worthy of further exploration.
What journal publishes such misleading drivel? It’s the African Journal of biomedical Research. No, I also had never heard of it! And who are the authors of this paper, their titles and affiliations? Here they are:
- Professor & HOD, Department of Anatomy, Dr. D.Y. Patil Homoeopathic Medical College & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India,
- Professor & HOD, Department of Homoeopathic Pharmacy, Dr. D.Y. Patil Homoeopathic Medical College &
Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India, - Department of Homoeopathic Pharmacy, Dr. D.Y. Patil Homoeopathic Medical College & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India,
- Department of Homoeopathic Pharmacy, Dr. D.Y. Patil Homoeopathic Medical College & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India,
- Principal, Professor & HOD, Department of Forensic Medicine and Toxicology, Dr. D.Y. Patil Homoeopathic
Medical College & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune,
Maharashtra, India.
Five guys with the same name?
No, one chap with 5 rather pomopous titles!
And what is wrong with this ‘systematic review’?
Everything!
It has almost none of the qualities that render a paper a systematic review. Foremost, it does not account for the quality of the primary studies – the most reliable show no effect!
Therefore, I’d like to re-phrase and shorten the conclusions as follows:
There is no reliable evidence to shoe that homeopathy is effective for ADHD.
As long as I can remember, the ‘Austrian ‘Chamber of Veterinarian Medicine’ (CVM) has been a staunch supporter of homeopathy. If anyone doubts this statement, he/she should perhaps have a look at the three courses the CVM offered during the last month alone:
| Datum | PLZ, Ort | Titel |
|---|---|---|
| 05.11.2024 | 123 online | Vortragsreihe Teil 1 – Allgemeine Homöopathie |
| 19.11.2024 | 123 online | Vortragsreihe Teil 2- Allgemeine Homöopathie |
| 23.11.2024 | 9313 St. Georgen am Längsee | EAVH-Grundausbildung Veterinärhomöopathie Modul 11 |
It thus stands to reason that the CVM has been nominated for this year’s satirical award “Goldenes Brett vorm Kopf” (Golden Plank in Front of the Head). You might remember that I reported about this rather hilarious award before when in 2017, it was given to the ‘German Association of Doctor-Homeopaths’
Sadly, the CVM seems somewhat displeased with the nomination and argues that homeopathy is ‘a legally recognised speciality in veterinary practice, and training to become a veterinarian homeopath is an officially recognised and legally enshrined specialisation’. In addition, the CVM insists that the Austrian Supreme Court has ‘clarified in several judgements that homeopathy cannot be classified as pseudoscience’.
Moreover, the CVM rejects the claim that it threatened critics of homeopathywith legal action and states that it attaches ‘great importance to upholding professional ethics’ and considers ‘collegiality, respect and the avoidance of exposure’ to be key principles.
On the CVM’s website, we also find the following statement (my translation):
“Homeopathy has been used worldwide for more than 200 years. Since then, it has not only proven its worth in the treatment of humans, but has also been successfully used in livestock and domestic animal husbandry.”
The people in charge of the CVM are evidently not keen readers of my blog. If they had shown a little interest in the actual evidence, they would have realised that veterinary homeopathy is bogus that often borders on animal abuse, e.g.:
- Veterinary homeopathy is without effect … but not without risk.
- Post hoc ergo homeopathy – the sad story of homeopathically mistreated penguins
- Homeopathy for canine oral papillomatosis: a ‘proof’ that homeopathy works?
- SCAM for animals. Part 1: homeopathy
- Good news regarding homeopathy for animals: RCVS POSITION ON CAM
- Homeopathy for bovine mastitis? HOW MUCH MORE EVIDENCE IS NEEDED BEFORE HOMEOPATHS ABANDON THEIR BOGUS CLAIM?
- A new RCT tests homeopathy in cats … and the results are unsurprisingly negative
- And again: no good evidence that homeopathy works in animals
- Homeopathy as a way of reducing antibiotic use in livestock ?
- Homeopathy works for animals – so it can’t be a placebo!
- So-called alternative medicine (SCAM) for animals is not evidence-based and borders on animal abuse
- Homeopathic Arnica more than trebles the length of analgesia in dogs – SHOULD WE BELIEVE IT?
The final winner of the ‘award’ will be announced at the award ceremony on Monday (2 December) in Vienna. We will see whether the CVM is victorious in obtaining this year’s award. There is – as always – fierce competition. For my part, I feel that merely the CVM’s reaction to getting nominated renders them a well-deserving winner.
Fingers crossed!
THE TIMES recently published an interview with (my ex-friend) Michael Dixon, a person who has featured regularly on this blog. Here is a short passage relevant to our many discussions about homeopathy:
“Can I say on the record I’ve never studied homeopathy,” he says. “I’ve never even offered homeopathy. What I have done is said that if patients feel they’ve benefited from homeopathy, what’s the problem?”
The problem, scientists would argue, is that homeopathy undermines trust in real, evidence-based medicine. Homeopathic remedies are made by diluting active ingredients in water, often so that none of the original substance remains. Homeopathy has been banned on the NHS since 2017, because it is “at best a placebo”.
For Dixon, however, this “trench warfare” divide between alternative and conventional medicine is too binary. Even if something is scientifically impossible, as long as it helps his patients that is all that matters, Dixon says. “Many years ago, a Christian faith healer started seeing some of my patients. She made a lot of them better. I didn’t care a damn if it’s placebo — they got better,” he says.
While he thinks homeopathy can serve a purpose on the NHS, he draws a line at the “madness of some of the more wayward complementary practitioners” who will argue for using homeopathy to vaccinate children. “I would always advocate against anyone going for complementary medicine if there’s good evidence-based conventional medicine.”
Apart from
- the hilarious implication that a faith healer is NOT a “wayward practitioner”,
- the fact that, as far as I know, nobody ever claimed that Dixon studied homeopathy,
- the fact that Dixon does not understand what, according to scientists, the problems with homeopathy are,
his statements seem very empathetic at first glance.
Dixon’s key argument – if patients feel they’ve benefited from homeopathy, why not prescribe it – is an often-voiced notion. But that does not make it correct!
A physician’s duty is not primarily to please the patient. His/her duty foremost is to behave responsibly and to treat patients in the most effective way. And this includes, in a case where the patient feels to have benefitted from a useless or dangerous treatment, to inform the patient about the current best evidence. To me, this is obvious, to others, including Dixon, it seems not. Let me therefore ask you, the reader of these lines: what is the right way to act as a GP?
SCENARIO DIXON
Patient wants a treatment that is far from optimal and claims to have experienced benefit from it. The GP feels this is enough reason to prescribe it, despite plenty of evidence that shows the treatment in question has at best a placebo effect. Thus the doctor agrees to his/her patient taking homeopathy.
SCENARIO ERNST
Patient wants a treatment that is far from optimal and claims to have experienced benefit from it. The doctor takes some time to explain the the therapy is not effective and that, for the patient’s condition, there are treatments that would be better suited. The patient reluctantly agrees and the doctor prescribes a therapy that is backed by sound evidence (in case the patient resists, he/she is invited to see another doctor).
I admit that risking to lose a patient to another colleague is not an attractive prospect, particularly if the patient happens to be your King. But nobody ever said that medicine was easy – and it certainly is not a supermarket were customers can pick and choose as they please.
What do you think?
The Bavarian homeopathy study has been aborted!
As I posted in 2019, the Bavarian government has given the go-ahead to a major study of homeopathy.
The study was aimed at clarifying whether the use of homeopathic remedies can reduce the use of antibiotics in humans and animals. The vote was carried because of the CDU delegates being in favour. The debate of the project was, however, controversial. Critics stressed that, at best, the study is superfluous and pointed out that the project is negligent because it implies that homeopathics might be effective, whereas the evidence shows the opposite. A SPD delegate stated that he is ‘open moth’, homeopathy works because of the doctor-patient contact and not because of its remedies which are pure placebos. The project was tabled because some people had worried about antibiotic resistance and felt that homeopathy might be an answer. Some CSU delegates stated that in ENT medicine, there is evidence that homeopathics can reduce the use of antibiotics. Even in cases of severe sepsis, there was good evidence, they claimed.
The FRANKFURTER ALLGEMEINE just reported more details about this remarkable project and its failure to produce meaningful results:
The double-blind, placebo-controlled RCT carried out at the Technical University of Munich examined women with regular urinary tract infections – all were to be given antibiotics or ibuprofen if necessary. Around 120 of the women were to receive either placebo or individually selected globules as a preventative measure. Differences were to be measured by whether infections occurred less frequently in the globule group and whether antibiotics were necessary.
The results should have been available a long time ago. However, as the lead-investigator of the study, nephrologist Lutz Renders, has now revealed that the study has apparently come to nothing. ‘The study has cancelled recruitment because the required number of test subjects could not have been reached within a reasonable period of time,’ he explains. Only the women who have already been included will now be followed up until the beginning of 2025.
‘Of the 200 or so women who registered, around 40 were found to have urinary tract infections’, says Renders, ‘so that they could be included in the study. It is a pity that the actual aim of the study was not achieved, as it is possible that something could be learnt about urinary tract infections in general from the extensive examinations of the women. I don’t have much to do with homeopathy,’ says Renders.
Georg Schmidt, head of the ethics committee at the Technical University of Munich, says that the committee found it ‘extremely difficult’ to authorise the study at all. ‘We had a heated discussion along the lines that you can’t compare nothing with nothing. We all agreed that homeopathy is ineffective.’ The commission decided to ensure that the risk of a false-positive result is as low as possible – the statistics have been tightened up for this purpose’.
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The notion that a definitive test of homeopathy is needed seems to beset German govenments from time to time – the last such initiative occurred during the Third Reich. Perhaps, one day, even politicians will understand that, on the scientific level, the discussion about homeopathy is now well and truly over, and that no more money needs to be wasted on it?
