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

homeopathy

Alternative practitioners practise highly diverse therapies. They seem to have nothing in common – except perhaps that ALL of them are allegedly stimulating our self-healing powers (and except that most proponents are latently or openly against vaccinations). And it is through these self-healing powers that the treatments in question cure anything and become a true panacea. When questioned what these incredible powers really are, most practitioners would (somewhat vaguely) name the immune system as the responsible mechanism. With this post, I intend to provide a short summary of the evidence on this issue:

Acupuncture: no good evidence to show stimulation of self-healing powers.

Aromatherapy: no good evidence to show stimulation of self-healing powers.

Bioresonance: no good evidence to show stimulation of self-healing powers.

Chiropractic: no good evidence to show stimulation of self-healing powers.

Detox: no good evidence to show stimulation of self-healing powers.

Energy healing: no good evidence to show stimulation of self-healing powers.

Feldenkrais: no good evidence to show stimulation of self-healing powers.

Gua sha: no good evidence to show stimulation of self-healing powers.

Herbal medicine: no good evidence to show stimulation of self-healing powers.

Homeopathy: no good evidence to show stimulation of self-healing powers.

Macrobiotics: no good evidence to show stimulation of self-healing powers.

Naturopathy: no good evidence to show stimulation of self-healing powers.

Osteopathy: no good evidence to show stimulation of self-healing powers.

Power bands: no good evidence to show stimulation of self-healing powers.

Reiki: no good evidence to show stimulation of self-healing powers.

Reflexology: no good evidence to show stimulation of self-healing powers.

Shiatsu: no good evidence to show stimulation of self-healing powers.

Tai chi: no good evidence to show stimulation of self-healing powers.

TCM: no good evidence to show stimulation of self-healing powers.

Vibrational therapy: no good evidence to show stimulation of self-healing powers.


Vaccinations: very good evidence to show stimulation of self-healing powers.


THE END

The Impact Factor (IF) of a journal is a measure reflecting the yearly average number of citations to recent articles published in that journal. It is frequently used as a measure of the importance of a journal within its field; journals with higher impact factors are often deemed to be more important than those with lower ones. The IF for any given year can be calculated as the number of citations, received in that year, of articles published in that journal during the two preceding years, divided by the total number of articles published in that journal during the two preceding years.

press-release celebrated the new IF of the journal ‘HOMEOPATHY’ which has featured on this blog before. I am sure that you all want to share in this joy:

START OF QUOTE

For the second year running there has been an increase in the number of times articles published in the Faculty of Homeopathy’s journal Homeopathy have been cited in articles in other peer-reviewed publications. The figure known as the Impact Factor (IF) has risen from 1.16 to 1.524, which represents a 52% increase in the number of citations.

An IF is used to determine the impact a particular journal has in a given field of research and is therefore widely used as a measure of quality. The latest IF assessment for Homeopathy covers citations during 2017 for articles published in the previous two years (2015 and 2016).

Dr Peter Fisher, Homeopathy’s editor-in-chief, said: “Naturally the editorial team is delighted by this news. This success is due to the quality and international nature of research and other content we publish. So I thank all those who have contributed such high quality papers, maintaining the journal’s position as the world’s foremost publication in the scholarly study of homeopathy. I would particularly like to thank our senior deputy editor, Dr Robert Mathie for all his hard work.”

First published in 1911 as the British Homoeopathic Journal, Homeopathy is the only homeopathic journal indexed by Medline, with over 100,000 full-text downloads per year. In January 2018, publishing responsibilities for the quarterly journal moved to Thieme, an award-winning medical and science publisher.

Greg White, Faculty chief executive, said: “Moving to a new publisher can be difficult, but the decision we took last year is certainly paying dividends. I would therefore like to thank everyone at Thieme for the part they are playing in the journal’s continued success.”

END OF QUOTE

While the champagne corks might be popping in homeopathic circles, I want to try and give some perspective to this celebration.

The IP has rightly been criticised so many times for so many reasons, that it is now not generally considered to be a valuable measure for anything. The main reason for this is that it can be (and is being) manipulated in numerous ways. But even if we accept the IP as a meaningful parameter, we must ask what an IP of 1.5 means and how it compares to other medical journals’ IP.

Here are some IFs of general and specialised medical journals readers of this blog might know:

Annals Int Med: 2016/2017 Impact Factor : 17.135,

BMJ: 2016/2017 Impact Factor : 20.785,

Circulation: 2016/2017 Impact Factor : 19.309,

Diabetes Care: 2016/2017 Impact Factor : 11.857,

Gastroenterology: 2016/2017 Impact Factor : 18.392,

Gut: 2016/2017 Impact Factor : 16.658,

J Clin Oncol: 2016/2017 Impact Factor : 24.008,

Lancet: 2016/2017 Impact Factor : 47.831,

Nature Medicine: 2016/2017 Impact Factor : 29.886,

Plos Medicine: 2016/2017 Impact Factor : 11.862,

Trends Pharm Sci: 2016/2017 Impact Factor : 12.797,

This selection seems to indicate that an IF of 1.5 is modest, to say the least. In turn, this means that the above press-release is perhaps just a little bit on the hypertrophic side.

But, of course, it’s all about homeopathy where, as we all know, LESS IS MORE!

I stumbled over an article entitled ‘The myths of homeopathy: Resounding answers‘. I thought it was great fun, so much so, that I copied it below – not just once but twice. The second time I took the liberty of replacing the little porkies told by homeopaths with the truth.

THE ORIGINAL

Homeopathic medicines are not placebos! Little “pellets” of sugar cannot have an effect!

Of course, the sugar in homeopathic pellets doesn’t have any effect. This is why we also have tablets and drops that contain homeopathic active substances.

The sugar is simply a medium for these active substances. The important element is what has been added to the sugar – the active ingredient!

As homeopathic remedies have very slow action, they cannot be used to treat acute illnesses!

This is incorrect. You can successfully use homeopathy in acute circumstances such as infections, fevers and colds.

Homeopathy seems to be a kind of magic!

Homeopathy is not magic! Homeopathy is a field of medicine that has the capacity to heal, but if course, it has its limits, just like any other medicine, including conventional medicine.

To give you a clear example – it’s unlikely that homeopathy will replace a surgical intervention.

During homeopathic treatment you have to follow a strict diet!

Well, it’s not such a bad thing…but of course, you need to eat healthily and avoid smoking, drinking alcohol and coffee.

In some cases you can’t eat onion or garlic as they contain sulphur, which is a homeopathic remedy in itself. All of these things have little to do with a strict diet.

Diabetes sufferers can’t use homeopathic remedies!

This is not true. The amount of sugar in the pellets is negligible. These homeopathic pellets could even be taken on a daily basis. The foods we eat contain much more sugar, even those that are especially for diabetics.

MY CORRECTED VERSION

Homeopathic medicines are not placebos! Little “pellets” of sugar cannot have an effect!

Of course, the sugar in homeopathic pellets doesn’t have any effect. And the drops added also contain no active substances.

In other words, there is no active ingredient!

As homeopathic remedies have very slow action, they cannot be used to treat acute illnesses!

This is correct. You cannot successfully use homeopathy in acute circumstances such as infections, fevers and colds. In fact, you cannot use it to cure any condition, chronic or acute.

Homeopathy seems to be a kind of magic!

Homeopathy is not magic! It relies on the placebo and other non-specific effects, and that is no magic.

During homeopathic treatment you have to follow a strict diet!

Hahnemann gave very clear instructions to avoid a whole range of things while taking homeopathic remedies – otherwise, they don’t work, he claimed. This is as wrong as everything else Hahnemann said about homeopathy: these remedies don’t work whatever you do.

Diabetes sufferers can’t use homeopathic remedies!

This is not true. The amount of sugar in the pellets is negligible. These homeopathic pellets could even be taken on a daily basis. The foods we eat contain much more sugar, even those that are especially for diabetics. But that does, of course, not mean that diabetics ought to take homeopathic remedies. There is no reason why they should; these remedies are pure placebos.

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Few people reading these lines will be surprised that the ‘resounding answers’ turn out to be resounding lies. And what I above called ‘great fun’, turns out to be a serious deception.

The fascinating thing here is, I think, the way homeopaths try to mislead the public: one seemingly innocent untruth about the ‘active substance’ is used as the basis for an entire house of cards. It tumbles at the slightest attempt to provide the facts. Sadly, many consumers do not know the facts and are therefore prone to fall victim of these resounding lies.

There is perhaps not a law against such lies, but there certainly are moral and ethical principles that must not be violated:

TELLING LIES OF THIS NATURE IS UNETHICAL AND ENDANGERS THE HEALTH OF THOSE WHO DO NOT KNOW THE FACTS.

Homeopaths are not generally known for the reliability of their recommendations. This advice by the UK Society of Homeopaths (SoH) was emailed to me a few days ago (how on earth did they know I was on holiday?). It is just too weird and wonderful – I cannot resist the temptation of showing it to you:

START OF QUOTE

Off on holiday? Whether you’re going abroad or ‘staycationing’, keep these remedies handy to tackle a range of minor ailments. We suggest 30c potencies for all remedies, using every 30- 90 minutes, two or three times depending on the severity of the condition. Always seek medical help for anything more than a minor injury or illness.

Aconite Great for shock, such as from fright, bad news or after having a fall. Also good for the onset of fever after exposure to acute cold, wind or heat.

Apis For bee or wasp stings and any allergic reaction which causes rapid swelling, redness and pain and where the affected area is puffy, white or rosy, feels hot and is better for cold compresses.

Arnica The classic remedy for trauma, injury and bruising. The typical arnica patient will tell you that they are fine but may well be confused or in shock. Also useful for fractures, strains after exertion such as lifting heavy objects and the early stages of a black eye and for jetlag.

Arsenicum This is a great remedy for food poisoning, especially from meat. The person will be very anxious and not easily pacified. The pains are often burning. Vomiting and diarrhoea accompanied by chills, exhaustion, and restless.

Belladonna Great for heatstroke or exhaustion, along with appropriate cooling and rehydration therapy, and for acute fevers or inflammations, which come on suddenly and lead to throbbing pain, redness and swelling. The skin is hot and red and the face flushed but, at the same time, the person can feel chilly and want to be covered.

Ledum This is the first remedy to think of with puncture wounds and for bites and stings which fester. Good for twisted or sprained joints, especially ankles.

Nux Vomica The main remedy for hangover or indigestion from over-eating but also useful for food poisoning in which there is constant retching.

Urtica urens Very useful for skin conditions such as urticaria with raised lumps like nettle rash and great for ‘prickly heat. Urtica can be used for minor burns and scalds as well where pains are stinging, like nettle rash, but not too sore to touch.

END OF QUOTE

I find the list and particularly the comments most revealing. To me, they suggest that homeopathy just do not have a cue. They recommend nonsense for conditions they know nothing about. They do not seem to know what real shock or food poisoning or heat stroke are. They do not seem to appreciate that they can be life-threatening problems. And by stating “Always seek medical help for anything more than a minor injury or illness”, they clearly admit that they are merely jokers of no significance whatsoever.

For what it’s worth, I here give my evidence-based view on the remedies listed:

Aconite No evidence to justify the claims mentioned above.

Apis No evidence to justify the claims mentioned above.

Arnica Some evidence to show that Arnica does not work.

Arsenicum No evidence to justify the claims mentioned above.

Belladonna No evidence to justify the claims mentioned above.

Ledum No evidence to justify the claims mentioned above.

Nux Vomica No evidence to justify the claims mentioned above.

Urtica urens No evidence to justify the claims mentioned above.

Oh, I almost forgot: the SoH is the organisation of ‘professional’ homeopaths in the UK (professional meaning they have no medical training). On their website, they state: “High standards are the cornerstone of the Society of Homeopaths. So we were delighted that our register was accredited by the Professional Standards Authority for Health and Social Care (PSA)  in 2014… This accreditation demonstrates our commitment to high professional standards, to enhancing safety and delivering a better service.”

One does wonder whether killing gullible holidaymakers via bad advice counts as high standards.

This study examined websites of naturopathic clinics and practitioners in the provinces of British Columbia and Alberta, looking for the presence of discourse that may contribute to vaccine hesitancy, and for recommendations for ‘alternatives’ to vaccines or flu shots.

Of the 330 naturopath websites analysed, 40 included vaccine hesitancy discourse and 26 offered vaccine or flu shot alternatives. Using these data, the authors explored the potential impact such statements could have on the phenomenon of vaccine hesitancy.

Next the researchers considered these misrepresentations in the context of Canadian law and policy, and outlined various legal methods of addressing them. They concluded that tightening advertising law, reducing CAM practitioners’ ability to self-regulate, and improving enforcement of existing common and criminal law standards would help limit naturopaths’ ability to spread inaccurate and science-free anti-vaccination and vaccine-hesitant perspectives.

The paper listed some poignant examples of vaccine hesitancy discourse:

1) ‘…children are now being given increasing numbers of vaccinations containing potentially harmful derivatives and substances such as mercury, thimerisol [sic], aluminum and formaldehydes. These harmful derivatives can become trapped in our tissues, clogging our filters and diminishing one’s ability of further toxins out.’ — www.evolvenaturopathic.com

2) ‘Vaccines given to children and adults contain mercury and aluminum. Babies are especially susceptible to small amounts of mercury injected directly into their tiny bodies. It is now suspected that the increase in autism and Asperger Syndrome is related to the mercury in childhood vaccinations.’ — www.vancouvernaturopathicclinic.com

3) ‘The conventional Flu Shot is a mixture of 3 strains of flu viruses mixed with a number of chemical preservatives and these strains are based on a prediction of what flu viruses some medical experts think will be the most problematic this season. This is really an impossible prediction to make when we have thousands of different strains of viruses that are continuously mutating.’ — www.advancednaturopathic.com

4) ‘A [sic] epidemiologist researcher from British Columbia, Dr. Danuta Skowronski, published a study earlier this year showing that people who were vaccinated consecutively in 2012, 2013 and 2014 appeared to have a higher risk of being infected with new strains of the flu.’ — www.drtas.ca

5) ‘Increasing evidence suggests that injecting a child with nearly three dozen doses of 10 different viral and bacterial vaccines before the age of five, while the immune system is still developing, can cause chronic immune dysfunction. The most that vaccines can do is lead to an increase in antibodies to a specific disease.’ — www.evolvevitality.com

6) ‘The bugs in question (on the Canadian Vaccine List) can enter our systems and depending on our bodies, our histories, and mostly the bugs’ propensity, they can cause serious harm. There are certainly questionable ingredients in vaccines that have the potential to do the same.’ — www.tharavayali.ca

The authors also considered that, in Canada, a naturopath who recommends homeopathic vaccines or who counsels against conventional vaccination could potentially be criminally negligent. Section 219 of the Criminal Code of Canada [Code] states that ‘[e]very one is criminally negligent who, in doing anything, or in omitting to do anything that it is his duty to do, shows wanton or reckless disregard for the lives or safety of other persons’. Subsection (2) goes on to state that, for the purposes of criminal negligence, ‘duty’ means a duty imposed by law; a legal duty in this context is one arising from statute or from the common law. The Code creates a legal duty for anyone ‘who undertakes to administer surgical or medical treatment to another person or to do any other lawful act that may endanger the life of another person’ to ‘have and to use reasonable knowledge, skill and care in so doing’. This duty is a uniform standard, meaning the requirement of reasonable knowledge, care, and skill is based on the treatment or lawful act in question, not on the level of experience of the person administering it. As such, naturopaths offering services similar to medical doctors will be held to the same standards under the Code.

Criminal negligence occurs due to the ‘failure to direct the mind to a risk of harm which [a] reasonable person would have appreciated’. Fault is premised on the wrongful act involved, rather than the guilty mind of the perpetrator. Naturopaths counseling patients against vaccination are arguably undertaking a lawful act that endangers the life of another person (especially in the case of a young child, elderly individual, or immunocompromised person), breaching s.216 of the Code. In addition, since relevant legal duties include those arising through the common law, naturopaths could alternatively be criminally negligent for failing to satisfy the aforementioned duty of reasonable disclosure inherent to standard of care in tort. In the context of a community with diminished vaccination rates, either failure could be considered wanton or reckless, as it may greatly and needlessly endanger the patient. However, under the standard for criminal negligence, the trier of fact must ‘assess whether the accused’s conduct, in view of his or her perception of the facts, constituted a marked and substantial departure from what would be reasonable in the circumstances’. This is similar to the standard of gross negligence, so ultimately a finding of criminal negligence would require meeting a rather onerous threshold.

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This, of course, is according to Canadian law; but I imagine that the law in other countries must be similar.

Therefore, this is a legal opinion which might be worth considering also outside Canada.

If there is a legal expert amongst my readers, please do post a comment.

I have already posted challenges to homeopaths. For instance, in a previous post, I asked the ‘homeopaths of the world’ to answer a few questions satisfactorily. In return, I promised to no longer doubt their memory of water theory. If they cannot do this, I contended, they should to admit that all their ‘sciency’ theories about the mode of action of highly diluted homeopathic remedies are really quite silly – more silly even than Hahnemann’s idea of a ‘spirit-like’ effect.

And then there is the challenge to correctly identify their own remedies. In return, they would even earn the neat sum of Euro 50 000.

So far, none of these challenges have been met. But one must not give up hope!!!

Meanwhile, I have decided to issue another one. Let me explain:

One argument that the ‘defenders of the homeopathic realm’ love and almost invariably use, when someone states that it is time to move on and ban homeopathy to the history books, is this one:

IF WE BANNED HOMEOPATHY FROM OUR CLINICAL ROUTINE, WE WOULD ALSO HAVE TO BAN MANY OF THE TREATMENTS USED IN CONVENTIONAL MEDICINE WHICH ARE EQUALLY POORLY SUPPORTED BY SOUND EVIDENCE FOR EFFICACY.

This looks like a good argument!

I am sure that politicians, journalists, consumers and even many healthcare professionals find it convincing.

We know that lots of conventional treatments are less well supported than many of us would hope or think.

But less well-supported than homeopathy?

Let’s see: Homeopathy has been around for ~200 years. Controlled clinical trials of homeopathy have been conducted since 1835. Today, we have about 500 controlled clinical trials of homeopathy. The totality of these data fails to convincingly demonstrate that homeopathy is more than a placebo.

Are there many other therapies that fulfil these criteria? Personally, I am not aware of such a therapy, and if I did know one, I am fairly certain that I would advocate its elimination from our clinical routine.

But I am, of course, not an expert in all fields of healthcare.

Perhaps such treatments do exist!

I want to find out, and – as always – the burden of proof is with those who use this argument.

Which brings me to my challenge.

I HEREWITH CHALLENGE HOMEOPATHS AND THEIR FOLLOWERS TO NAME THERAPIES THAT ARE AS USELESS AS HOMEOPATHY!

To be clear, they ought to fulfil the following criteria:

  1. The treatment must be about 200 years old (plenty of time for a thorough evaluation).
  2. It should have been extensively tested in about 500 controlled clinical trials.
  3. The totality of this evidence should be negative.
  4. The treatment should be part of the clinical routine and have ardent proponents who insist it should be paid for by public funds.

I hope lots of homeopaths can name lots of such therapies.

Failing this, they should think twice before they use the above argument again.

 

The wishes of a patient do not over-rule medical knowledge!” (Patientenwunsch steht nicht über medizinischem Wissen)

This was one brave conclusion drawn in a discussion about homeopathy during a recent German radio programme. Specifically, the discussion was about the pros and cons of a leading paediatric hospital of the Ludwig Maximilian Universitaet (LMU) Munich offering homeopathy to its patients (they also run a course in homeopathy which we discussed previously).

The wishes of a patient does not over-rule medical knowledge!

This sentence made me think.

Is it correct?

An interesting question with ethical dimensions!

The short answer is NO, I believe..

Patients can always refuse to have a given therapy, if they so wish. Or they might opt for one evidence-based therapy instead of another. And in certain circumstances such wishes may well be completely against the current best medical knowledge.

But this is probably where the dominance of the patient’s wishes over medical knowledge ends — at least, if we only consider wishes paid for by the public purse (otherwise, anyone can, of course, buy almost any rubbish).

And that was not what the above-mentioned discussion was about. It focussed on the arguments by the LMU to justify their offer of homeopathy to sick children. Essentially, they seem to say:

  • We believe in evidence-based medicine (EBM) and are fully dedicated to its principles.
  • We know that homeopathy is not evidence-based.
  • Yet, many of the parents want us to use homeopathy in the treatment of their kids.
  • And the wish of a patient over-rules the medical evidence.

This is, of course, a flawed argument. One cannot subscribe to EBM and, at the same time, administer overt nonsensical, disproven treatments. A patient’s wish does not render a nonsensical treatment evidence-based. If one would follow the LMU logic, one would have to use any idiotic therapy … and could still pride oneself to follow EBM practice. In England, we call this ‘having the cake and eat it’; once you eat the cake, it’s gone and you cannot have it any longer.

What follows is simple: the decision makers at the LMU have been found out with (homeopathically potentised) egg on their faces (for some reason they had this homeopathy enclave for years, it is well-established and, I suspect, even better protected by some people of influence). They quickly tried to find a way out of their dilemma. Unfortunately, they did not think hard enough; the solution to bank on patient choice turns out to be a non-solution.

I therefore suggest they get in line with the role of a University hospital, with today’s medical thinking and medical ethics. This would mean re-considering their homeopathy course as well as their inclusion of homeopathy in publicly-funded routine care.

An announcement by the UK Society of Homeopaths caught my attention. Here it is in its full and unabbreviated beauty:

START OF ANNOUNCEMENT

Homeopaths are being urged to contribute to an inquiry exploring ways to tackle a looming public health crisis threatened by ‘superbugs’ – bacteria resistant to antibiotics and other antimicrobial drugs.

The Commons Select Committee on Health and Social Care is inviting evidence for its investigation into the progress made by the government so far in responding to the challenge.

The two angles it is exploring are:

  • What results have been delivered by the current UK strategy on antimicrobial resistance (AMR), launched in 2013?
  • Key actions and priorities for the government’s next AMR strategy, due to be published at the end of 2018.

The Society of Homeopaths is putting together a submission and is asking members to submit their own evidence to the inquiry of using homeopathic alternatives to antimicrobials.

According to the inquiry background papers, antimicrobial resistance – in which bacteria have evolved into ‘superbugs’,  resistant to drugs devised to kill them – is a “significant and increasing threat” to public health in the UK and globally. EU data indicates that it is responsible for 700,000 deaths a year worldwide and at least 50,000 in the US and Europe.

The death toll could reach 10m people a year by 2050 if the rise in resistance is not headed off, it is estimated.

Society Chief Executive Mark Taylor said: “Our members know a great deal about the alternatives to antibiotics through their own practice and knowledge. This is a timely inquiry from the Health and Social Care Committee to assess the success of the existing strategy and an opportunity to make the case again for fresh thinking on this pressing public health challenge.”

END OF ANNOUNCEMENT

Yes, of course!

We have a crisis of antibiotic resistance.

Who is going to offer the solution?

THE HOMEOPATHS!!!

How?

They are going to treat us all with homeopathic remedies when the superbugs strike.

And the result?

No more crisis.

How come?

Because they have turned it into a catastrophe!!!

It has been reported that, between 1 January 2018 and 31 May 2018, there have been 587 laboratory confirmed measles cases in England. They were reported in most areas with London (213), the South East (128), West Midlands (81), South West (62), and Yorkshire/Humberside (53). Young people and adults who missed out on MMR vaccine when they were younger and some under-vaccinated communities have been particularly affected.

Public Health England (PHE) local health protection teams are working closely with the NHS and local authorities to raise awareness with health professionals and local communities. Anyone who is not sure if they are fully vaccinated should check with their GP practice who can advise them.

Dr Mary Ramsay, Head of Immunisation at PHE, said:

“The measles outbreaks we are currently seeing in England are linked to ongoing large outbreaks in Europe. The majority of cases we are seeing are in teenagers and young adults who missed out on their MMR vaccine when they were children. Anyone who missed out on their MMR vaccine in the past or are unsure if they had 2 doses should contact their GP practice to catch-up. This serves as an important reminder for parents to take up the offer of MMR vaccination for their children at 1 year of age and as a pre-school booster at 3 years and 4 months of age. We’d also encourage people to ensure they are up to date with their MMR vaccine before travelling to countries with ongoing measles outbreaks. The UK recently achieved WHO measles elimination status and so the overall risk of measles to the UK population is low, however, we will continue to see cases in unimmunised individuals and limited onward spread can occur in communities with low MMR coverage and in age groups with very close mixing.”

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And what has this to do with alternative medicine?

More than meets the eye, I fear.

The low vaccination rates are obviously related to Wakefield’s fraudulent notions of a link between MMR-vaccinations and autism. Such notions were keenly lapped up by the SCAM-community and are still being trumpeted into the ears of parents across the UK. As I have discussed many times, lay-homeopaths are at the forefront of this anti-vaccination campaign. But sadly the phenomenon is not confined to homeopaths nor to the UK; many alternative practitioners across the globe are advising their patients against vaccinations, e. g.:

Considering these facts, I wish Dr Mary Ramsay, Head of Immunisation at PHE, would have had the courage to add to her statement: IT IS HIGH TIME THAT ALTERNATIVE PRACTITIONERS DO MORE THAN A MEEK LIP SERVICE TO THE FACT THAT VACCINATIONS SAVE LIVES.

Is homeopathy effective for specific conditions? The FACULTY OF HOMEOPATHY (FoH, the professional organisation of UK doctor homeopaths) say YES. In support of this bold statement, they cite a total of 35 systematic reviews of homeopathy with a focus on specific clinical areas. “Nine of these 35 reviews presented conclusions that were positive for homeopathy”, they claim. Here they are:

Allergies and upper respiratory tract infections 8,9
Childhood diarrhoea 10
Post-operative ileus 11
Rheumatic diseases 12
Seasonal allergic rhinitis (hay fever) 13–15
Vertigo 16

And here are the references (I took the liberty of adding my comments in blod):

8. Bornhöft G, Wolf U, Ammon K, et al. Effectiveness, safety and cost-effectiveness of homeopathy in general practice – summarized health technology assessment. Forschende Komplementärmedizin, 2006; 13 Suppl 2: 19–29.

This is the infamous ‘Swiss report‘ which, nowadays, only homeopaths take seriously.

9. Bellavite P, Ortolani R, Pontarollo F, et al. Immunology and homeopathy. 4. Clinical studies – Part 1. Evidence-based Complementary and Alternative Medicine: eCAM, 2006; 3: 293–301.

This is not a systematic review as it lacks any critical assessment of the primary data and includes observational studies and even case series.

10. Jacobs J, Jonas WB, Jimenez-Perez M, Crothers D. Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. Pediatric Infectious Disease Journal, 2003; 22: 229–234.

This is a meta-analysis by Jennifer Jacobs (who recently featured on this blog) of 3 studies by Jennifer Jacobs; hardly convincing I’d say.

11. Barnes J, Resch K-L, Ernst E. Homeopathy for postoperative ileus? A meta-analysis. Journal of Clinical Gastroenterology, 1997; 25: 628–633.

This is my own paper! It concluded that “several caveats preclude a definitive judgment.”

12. Jonas WB, Linde K, Ramirez G. Homeopathy and rheumatic disease. Rheumatic Disease Clinics of North America, 2000; 26: 117–123.

This is not a systematic review; here is the (unabridged) abstract:

Despite a growing interest in uncovering the basic mechanisms of arthritis, medical treatment remains symptomatic. Current medical treatments do not consistently halt the long-term progression of these diseases, and surgery may still be needed to restore mechanical function in large joints. Patients with rheumatic syndromes often seek alternative therapies, with homeopathy being one of the most frequent. Homeopathy is one of the most frequently used complementary therapies worldwide.

Proper systematic reviews fail to show that homeopathy is an effective treatment for rheumatic conditions (see for instance here and here).

13. Wiesenauer M, Lüdtke R. A meta-analysis of the homeopathic treatment of pollinosis with Galphimia glauca. Forschende Komplementärmedizin und Klassische Naturheilkunde, 1996; 3: 230–236.

This is a meta-analysis by Wiesenauer of trials conducted by Wiesenauer.

My own, more recent analysis of these data arrived at a considerably less favourable conclusion: “… three of the four currently available placebo-controlled RCTs of homeopathic Galphimia glauca (GG) suggest this therapy is an effective symptomatic treatment for hay fever. There are, however, important caveats. Most essentially, independent replication would be required before GG can be considered for the routine treatment of hay fever. (Focus on Alternative and Complementary Therapies September 2011 16(3))

14. Taylor MA, Reilly D, Llewellyn-Jones RH, et al. Randomised controlled trials of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. British Medical Journal, 2000; 321: 471–476.

This is a meta-analysis by David Reilly of 4 RCTs which were all conducted by David Reilly. This attracted heavy criticism; see here and here, for instance.

15. Bellavite P, Ortolani R, Pontarollo F, et al. Immunology and homeopathy. 4. Clinical studies – Part 2. Evidence-based Complementary and Alternative Medicine: eCAM, 2006; 3: 397–409.

This is not a systematic review as it lacks any critical assessment of the primary data and includes observational studies and even case series.

16. Schneider B, Klein P, Weiser M. Treatment of vertigo with a homeopathic complex remedy compared with usual treatments: a meta-analysis of clinical trials. Arzneimittelforschung, 2005; 55: 23–29.

This is a meta-analysis of 2 (!) RCTs and 2 observational studies of ‘Vertigoheel’, a preparation which is not a homeopathic but a homotoxicologic remedy (it does not follow the ‘like cures like’ assumption of homeopathy) . Moreover, this product contains pharmacologically active substances (and nobody doubts that active substances can have effects).

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So, positive evidence from 9 systematic reviews in 6 specific clinical areas?

I let you answer this question.

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