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

homeopathy

1 3 4 5 6 7 58

It has been reported that Brazil and India will collaborate in the promotion of quackery! Brazil’s president Jair Bolsonaro and India’s Prime Minister Narendra Modi, have just signed several agreements on collaboration. Agreement 8 is particularly intriguing:

8. Memo of agreement for cooperation in Traditional Medicine and Homeopathy

We seek to promote and develop bilateral cooperation in the field of traditional medicine and homeopathy. The areas of cooperation provided for in the instrument include exchange of experience in teaching regulations, practices, medicines and non-medicine therapies; knowledge promotion, exchange of training for therapists, health professionals, scientists, teaching professionals and students; and development of joint research, besides educational and training programs.

Homeopathy, already a recognized medical specialty in Brazil, is currently offered for free by the Brazilian national healthcare system. Other so-called alternative medicines (SCAMs) employed in the Brazilian healthcare system include:

  • acupuncture,
  • Reiki,
  • spiritual healing,
  • crystal healing,
  • aromatherapy.

Homeopathy and acupuncture are also recognized by the Brazilian Federal Council and both are taught in the most prestigious public Universities, in medical, veterinary, public health and nursing schools.

India has gone one step further by establishing its AYUSH ministry. It registers SCAM practitioners considered ‘indigenous’ by the Indian government under a separate board.  The SCAMs thus regulated are:

  • Ayurveda,
  • Yoga and Naturopathy,
  • Unani and Tibbi,
  • Siddha,
  • Homeopathy.

In India, practitioners are taught some of these subjects as MBBS ( Bachelor of Medicine and Surgery). The graduates are then considered to be ‘doctors’. In Brazil, homeopathy and acupuncture are practiced by medical doctors. Brazilian citizens are thus misled to believe that these SCAMs are evidence-based.

So, what this ‘bilateral co-operation’ is going to achieve? Narendra Nayak (President of the Federation of Indian Rationalist Associations and former Assistant Professor of Biochemistry in Mangalore) and Natalia Pasternak (President of the Instituto Questão de Ciência in São Paulo) are less than optimistic:

Exchange of ‘technology’ of so called ‘psychic surgery’ of  quacks like the late José Arigo, “the surgeon with the rusty knife”, with specialists of gaumutra (urine of India’s allegedly indigenous cows) whose concoction is supposed to be a panacea for 440 diseases? Is Brazil going to export to India the peculiar surgical techniques of the “medium” John of God, recently arrested, not for years of practicing unlicensed medicine and hurting people, but for sexual harassment and rape? Don’t get the wrong message, we are very glad John of God was convicted, and very glad for the brave women who came forward, but we cannot ignore the fact that he was never bothered by the authorities for placing people under his (usually not quite clean) knife.

Since India and Brazil are leaders in sugar production, are they going to support Homeopathy? Also the use of alcohol to produce their tinctures?

Again, we wonder why India and Brazil are going for an alleged system of medicine called homeopathy which is nowhere in the mainstream in the country of its origin -Germany. And why do they embrace it while the rest of the world is pushing back against homeopathy, after several scientific papers, reviews and meta-analyses showed beyond any reasonable doubt that it doesn’t work?

Brazil and India have much in common, both are rising developing economies, with a diverse population, trying to be true to their democratic ideals. Unfortunately, another similarity comes to light: the fact that presently both our countries are governed by rulers that have shown total disregard by scientific knowledge and evidence in many of their public policy decisions.

As heads of organizations that promote science and rational thinking in Brazil and India, we regret the decision of our governments to promote quackery as a legitimate subject of an international agreement.

I feel that individuals and organisations promoting critical thinking in other parts of the world should lend their support to these two courageous people.

It’s not (yet) a global emergency, the WHO have announced. But 26 fatalities have today been reported, and soon we will have thousands of people infected with the new coronavirus, experts predict. A vaccine will take at least a year to become available, and experts are alarmed.

But there is no need for panic!

Let’s just ask our homeopaths for help. They are excellent with curing viral infections!

You don’t believe me? But it must be true; take this website, for instance; its message could not be clearer :

… Homeopathic remedies can help you in fighting viral infections effectively… Homeopathy can be effective for viral infections including influenza-like symptoms, viral coughs and serious viral infections like herpes cold sores and genital herpes… The most common oral homeopathic remedy for herpes outbreaks is Rhus Toxicodendron (Rhus Tox in short), which is an extremely diluted form of poison ivy…

Another website offers more detail:

Conventional drugs do not offer comprehensive treatments for viral infections. Certain viruses like Influenza, HIV, etc. have tendencies to mutate (change) very rapidly, thereby lowering the effectiveness of such medicines. Additionally, viruses quickly develop resistance to these drugs, making the development of preventive medicine somewhat challenging. Conventional medications therefore only provide supportive management and suppression of the symptoms.
Homeopathic treatment for viral infections helps ease the symptoms and also enables the body to heal naturally.

Homeopathy treatment for viral infections is steadily gaining popularity as a natural way to deal with viral infections. These medicines help reduce the frequency and intensity of acute symptoms like weakness, fever, body pain, etc. These help with quick recovery. In some cases, they reduce the chances of further complications. Homeopathy treatment for viral infections treats the symptoms not by suppressing them, but by strengthening the immune system. It activates the body’s natural restorative properties by producing symptoms similar to the ones experienced by the patients. This method helps settle underlying internal disturbances in the body. Homeopathy treatment for viral infections also minimizes the weakness and fatigue commonly encountered as an aftermath of the infection.

Viral infections are highly communicable and spread rapidly from one person to another. Homeopathy treatment for viral infections is also preventative and helps reduce the chances of contracting the infection.

Yet another website is equally clear:

For viral ailments with symptoms that are fast and violent, use the following homeopathic remedies: Aconitum and Belladonna.

Aconitum – also known as Devil’s helmet or Queen of All Poisons – is a flowering plant that belongs to the family Ranunculacea. The flowers of this plant are harvested and then processed to treat various ailments, including viral infections.

Belladonna – also known as Deadly Nightshade – is a perennial herbaceous plant – prized for its medicinal benefits. It’s used as a muscle relaxant and pain reliever. The plant contains potent anti-inflammatory properties too. It’s an excellent remedy for viral infections.

What, you are still not convinced? In this case, have a look at what a Devon homeopaths stated only yesterday about the current epidemic:

Panic and anger in Wuhan as China orders city into lockdown.

A Coronavirus is a common virus that causes an infection in your nose, sinuses, or upper throat. Most corona viruses are not dangerous, they can in fact just cause symptoms which look like a mild cold.  Earlier this month though, the World Health Organization identified a new type (2019-nCoV) in China and to date there have been over 500 confirmed cases of this Corona virus with 17 fatalities reported so far this month.  The Media seems to be covering its progress with great relish, causing a lot of panic.

The virus starts with a fever, followed by a dry cough, and then after a week or so this leads to shortness of breath when some patients are hospitalised.  Pneumonia is one complication that can be caused by the virus. Most of the information spread about the virus is gained from these severe cases in hospital.

To protect yourself from any virus, you should boost your own immune symptom with a healthy diet and supplements if necessary.  I recommend the best vitamin C & D supplements you can get.  I also love Fermented Cod Liver Oil and a good Magnesium supplement.  Having homeopathic constitutional treatment is also proven to boost your immune system.

Homeopathic remedies can address every symptom caused by this virus so having an inexpensive homeopathy kit at home is an excellent resource.  I love the First Aid Kit by Helios Pharmacy which also comes with a booklet to guide you on which remedy to choose.  If you have remedies but feel you’re not equipped to use them, get in touch with me and I will send you a free PDF first aid booklet.

Here are a few homeopathic remedies which will be useful to treat viruses such as this one.  If you are confident the remedy is well indicated you need to repeat often in a 30C or 200C until it no longer helps, then move onto another if necessary:

Ferrum-phos: give this at the very first sign of symptoms.  Useful when you just don’t feel well, tired.  Red inflamed eyes, chill with shivering and fever.  Hot, burning eyes.  Worse cold, better rest.

Gelsemium: This is for when your symptoms start to feel more severe, especially if they have come on gradually.  You will feel dull, sluggish, heavy, often with a headache at the back of the neck.  Shivering up and down the spine, aching muscles, burning throat.  Worse cold, better after urination.

Pulsatilla: You will feel Chilly, even in a warm room.  Nose blocked up, bland and thick mucous.  Dry mouth with no thirst.  Changing, shifting symptoms, weepy and sorry for oneself.   You may often have a sore throat or ear ache with viruses.  Worse in a warm room, better in the open air.

Camphora: You will feel very cold, and may have laborious, asthmatic breathing with an accumulation of phlegm in the air tubes, cold, dry skin.  Total exhaustion, with coldness and shivering.  Weak pulse, irritability.  Worse cold.

Phosphorous:  For any virus which affects your lungs.  You may have bloody sputum and crave cold drinks.  Burning, pressure and constriction in the chest; worse lying on the left side or painful side.  Better in company, needing reassurance.

Bryonia: Excellent in pneumonia or pleurisy, especially when the right side is affected.  There is dryness everywhere, dry tongue, with generally a white coating.  There may be pain when breathing or coughing where the patient wants to hold steady as any movement hurts.  Irritable and thirsty.  Better rest, pressure.  Worse excitement, bright lights, noise, touch, movement.

This is outrageous, you claim? You insist that homeopathy is bunk, that homeopaths behave irrationally and their remedies are pure placebos? Placebos are no good for life-threatening infections! Anyone who says otherwise is deluded and irresponsible, you suggest.

I see, you might have a point.

Think of the time when homeopaths travelled to Liberia to cure Ebola. That was a homeopathic disaster, if there ever was one. Have homeopaths learnt their lesson since then? Clearly not: there are still hundreds of websites and books promoting homeopathy even for the most serious viral diseases. Do homeopaths provide sound evidence for their claims? I can see none.

Maybe that’s why nobody asks homeopaths to help with medical emergencies.

Ever since the government in Bavaria has been misguided enough to agree to a research programme testing whether homeopathy has a role in curtailing the over-use of anti-biotics, the subject of homeopathics as a replacement of antibiotics has been revived.

In this paper, homeopaths describe four female cases with recurrent urinary tract infections. The patients were treated successfully with the homeopathic strategy after several conventional approaches revealed no improvement. The follow-up period was a minimum of 3 years and the frequency of episodes with urinary tract infection as well as of antibiotic treatment was documented. Additionally, the patients were asked to assess the treatment outcome retrospectively in a validated questionnaire.

The treatment resulted in a reduction of urinary tract infections and the need for antibiotics from monthly to less than 3 times a year. Three of the four women had no cystitis and related intake of antibiotics for more than 1.5 years. A relapse of symptoms could be treated efficiently with a repetition of the homeopathic remedy. All subjective outcome assessments resulted positive.

The authors concluded that this case series suggests a possible benefit of individualized homeopathic treatment for female patients with recurrent urinary tract infections. Larger observational studies and controlled investigations are warranted. 

Such articles make me quite angry! They have the potential to mislead many patients and, in extreme cases, might even cost lives.

The ‘possible benefit’ of any treatment cannot be demonstrated with such flimsy case series. It has to be shown in properly controlled clinical trials. The findings of case series are confounded by dozens of variables and tell us next to nothing about cause and effect.

Case series make sense when they explore possible new therapeutic avenues. Homeopathy does certainly not fall into this category. The notion that homeopathics might be an alternative to antibiotics has been tested many times before in different settings, in animals, in humans, it vivo and in vitro. This has never generated convincingly positive findings. To re-address it by reporting uncontrolled cases is not just a nonsense; in my view, it is an unethical attempt to mislead us.

I am beginning to think that a devotion to homeopathy is conducive to telling porkies. When I read texts by homeopaths, I almost invariably discover untruths. Take this article on the popularity of homeopathy, for instance:

Worldwide

  • Worldwide, over 200 million people use homeopathy on a regular basis.1, 2
  • Homeopathy is included in the national health systems of a number of countries e.g. Brazil, Chile, India, Mexico, Pakistan, Switzerland.

India

  • India leads in terms of number of people using homeopathy, with 100 million people depending solely on homeopathy for their medical care.1
  • There are over 200,000 registered homeopathic doctors currently, with approximately 12,000 more being added every year.3

Europe

  • 100 million EU citizens, some 29% of the EU’s population, use homeopathic medicines in their day-to-day healthcare.2
  • Homeopathy is practised in 40 out of 42 European countries.4

UK

  • 10% of people in the UK use homeopathy – an estimated 6 million people.5
  • In Britain, the market for homeopathy is growing at around 20% per year.  In 2007, it was estimated to be worth £38m, and is projected to reach £46m in 2012.6
  • There are ~ 400 doctors in the UK that use homeopathy, regulated by the Faculty of Homeopathy and promoted by the British Homeopathic Association.7
  • There are ~1,500 professional homeopaths (non-medically qualified homeopaths) in the UK,8 regulated by the Society of Homeopaths (65%), Alliance of Registered Homeopaths and Homeopathic Medical Association. They largely operate in private practice outside the NHS.
  • See NHS spending on homeopathy

US

  • According to the National Institutes of Health, over 6 million people in the United States use homeopathy, mainly for self-care of specific health conditions.
  • Of those who use homeopathy, ~1 million are children and over 5 million are adults.9, 10

References

  1. Prasad R. Homoeopathy booming in India. Lancet, 2007; 370:1679-80 | Full Text
  2. Homeopathic medicinal products. Commission report to the European Parliament and the Council on the application of Directives 92/73 and 92/74 | Full Text
  3. Ghosh AK. A short history of the development of homeopathy in India. Homeopathy, 2010;99(2):130-6 | PubMed
  4. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, 2001 | Full Text
  5. Professor Woods of the MHRA, response to Q211, House of Commons Science and Technology Committee hearing of evidence in preparation of Evidence Check 2: Homeopathy report (London: The Stationery Office Limited, 2010) | Full Text
  6. Mintel, Complementary Medicines, April 2007 | Link
  7. Faculty of Homeopathy | Link
  8. Society of Homeopaths | Link
  9. Black LI, et al. Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012. National Health Statistics Reports, 2015; 78: February | Link
  10. Clarke TC, et al. Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002–2012. National Health Statistics Reports, 2015; 79: February | Link

Contrast this with the (as far as I know) only systematic review on the subject:

Aim: To systematically review surveys of 12-month prevalence of homeopathy use by the general population worldwide.

Methods: Studies were identified via database searches to October 2015. Study quality was assessed using a six-item tool. All estimates were in the context of a survey which also reported prevalence of any complementary and alternative medicine use.

Results: A total of 36 surveys were included. Of these, 67% met four of six quality criteria. Twelve-month prevalence of treatment by a homeopath was reported in 24 surveys of adults (median 1.5%, range 0.2-8.2%). Estimates for children were similar to those for adults. Rates in the USA, UK, Australia and Canada all ranged from 0.2% to 2.9% and remained stable over the years surveyed (1986-2012). Twelve-month prevalence of all use of homeopathy (purchase of over-the-counter homeopathic medicines and treatment by a homeopath) was reported in 10 surveys of adults (median 3.9%, range 0.7-9.8%) while a further 11 surveys which did not define the type of homeopathy use reported similar data. Rates in the USA and Australia ranged from 1.7% to 4.4% and remained stable over the years surveyed. The highest use was reported by a survey in Switzerland where homeopathy is covered by mandatory health insurance.

Conclusions: This review summarises 12-month prevalence of homeopathy use from surveys conducted in eleven countries (USA, UK, Australia, Israel, Canada, Switzerland, Norway, Germany, South Korea, Japan and Singapore). Each year a small but significant percentage of these general populations use homeopathy. This includes visits to homeopaths as well as purchase of over-the-counter homeopathic medicines.

Spot some discrepancies?

I wonder why the author (no name was provided) failed to cite the systematic review (it was published by pro-homeopathy researchers in a journal which they surely know – it’s called ‘Homeopathy’!). Perhaps because he/she writes for the ‘Homeopathy Research Institute‘. This organisation states that the HRI is an innovative international charity created to address the need for high quality scientific research in homeopathy. The charity was founded by physicist, Dr Alexander Tournier, who previously worked as an independent researcher for Cancer Research UK, conducting interdisciplinary research at the boundaries between mathematics, physics and biology.

The HRI also claims that the evidence suggests that homeopathy could provide solutions to many of the challenges facing us today – from overuse of antibiotics to spiraling healthcare budgets…

You see, now it all makes sense!

An enthusiast of homeopathy recently posted an overview of systematic reviews of homeopathy concluding that the data we do have point towards homeopathy as having an effect greater than that of placebo:

In recent decades, homeopathy has been examined via a number of clinical trials, the number of which now allow meta-analysis. As we can see from the study findings, the type of homeopathy research (ie, individualized vs non-individualized, placebo-controlled vs non-placebo-controlled) can have a strong influence on the results, although trial quality also has a strong effect.

All meta-analyses performed in at least a somewhat open and rigorous manner have found statistically significant effects. This suggests that homeopathy has a greater-than-placebo effect, or at least a strong trend in that direction, when using data from the totality of homeopathy research, or from individualized, placebo-controlled trials. The meta-analyses with questionable methodology, one of which is undergoing government investigation for academic irregularities, have produced negative results, which have been demonstrated to be a direct result of their exclusion of vast swathes of the homeopathic clinical trial literature (based on arbitrary and unexplained criteria), as well as of their failure to differentiate – as Mathie has done – different types of homeopathic research.

The clinical data are flawed. Issues with methodology used in homeopathy RCTs, combined with a lack of research funding, have produced a lack of high-quality trials and data. However, the data we do have point towards homeopathy as having an effect greater than that of placebo.

There can be no argument with this conclusion, aside from possible new data emerging. Anyone who disputes this is going against the existing set of the highest-quality evidence on homeopathy.

His overview is based on the following publications:

Kleijnen, 19911 All types of homeopathy (eg, single remedy vs combination). Methodological quality assessed; 105 trials. Results: Positive trend, regardless of type of homeopathy; 81 trials were positive, 24 showed no effect.
Linde, 19972 All types of homeopathy. Out of 185 trials, 119 met inclusion criteria; 89 of these had extractable data. Results: OR = 2.45 (95% CI 2.05-2.93).
Ernst, 19983 Individualized homeopathy; 5 trials determined to be high-quality. Results: OR = 0.
Linde, 19985 Individualized homeopathy; 32 trials, 19 of which had extractable data. Results: OR = 1.62 for all trials (95% CI 1.17-2.23). Only high-quality trials produced no significant trend.
Cucherat, 20009 All types of homeopathy; 118 trials, 16 of which met inclusion criteria. Used unusual method of combining p values. Results: All trials = p< 0.000036. Less than 10% dropouts: p<0.084; less than 5% dropouts (higher standards than most trials considered reliable): p<0.08 (non-significant).
Shang, 200511 All types of homeopathy; only 8 trials selected from 21 high-quality trials of 110 selected with unusual criteria. Results: OR = 0.88 (0.65-1.19). Result strongly disputed by statisticians.
Mathie, 201413 Individualized homeopathy; of the analysis pooled data from 22 higher-quality, individualized, double-blind RCTs. Results: OR = 1.53 (1.22-1.91) for all trials pooled; OR = 1.93 (1.16-3.38) for the 3 reliable trials.
NHMRC, 201516 Out of 176 studies, 171 were excluded, leaving only 5 for the study. Investigators used unprecedented methods, did not combine data, and are currently under investigation for outcome shopping. Results: Negative results.
Mathie, 201720 Non-individualized homeopathy; very few higher-quality trials. Results: For 54 trials with extractable data, SMD = -0.33 (-0.44, -0.21). When these were adjusted for publication bias, SMD = -0.16 (-0.46,-0.09). The 3 high-quality trials had non-significant results: SMD = -0.18 (-0.46, +0.09).
Mathie, 201821 Individualized, other-than-placebo-controlled trials; 11 trials found, 8 with extractable data. Results: 4 heterogeneous comparative trials showed a non-significant difference. One trial in this group was positive. Three heterogeneous trials with additive homeopathy showed a statistically significant SMD. No definitive conclusion possible due to trial heterogeneity, poor quality, and low number of trials.
Mathie, 201922 Non-individualized, other-than-placebo-controlled trials; 17 RCTs found, 14 with high risk of bias. Results: Significant heterogeneity prevented much comparison; 3 comparable trials showed a non-significant SMD.

Apart from getting the wrong end of the stick when interpreting the results of these papers (see for instance here, and here), there are other rather embarrassing flaws in this overview:

  1. Many older systematic reviews were omitted (including about 10 of my own papers). This is relevant because the author of the above review went beck until 1991 to find the reviews he included.
  2. Several new papers were missing as well. This is relevant because the author evidently included reviews up to 2019. Here are the key passages from the conclusions of some of them:

homoeopathy as a whole may be considered as a placebo treatment.

We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions. Our results suggest that p-curve can accurately detect when sets of statistically significant results lack evidential value.

We found no evidence to support the efficacy of homeopathic medicinal products

no firm conclusions regarding the effectiveness and safety of homeopathy for the treatment of IBS can be drawn.

Due to both qualitative and quantitative inadequacies, proofs supporting individualized homeopathy remained inconclusive.

… the use of homeopathy currently cannot claim to have sufficient prognostic validity where efficacy is concerned.

I am, of course, not saying that this overview amounts to anything like a systematic review. It merely gives you a flavour how trustworthy proponents of homeopathy are when they pretend to provide us with an objective evaluation of the best available evidence.

A 2020 review entitled ‘Prevention, Treatment and Management of Tuberculosis through Combinational Approaches of Different Indian Systems of Medicine’ stated that recent research suggests that Homeopathic treatment along with the antibiotics synergise the effect of antibiotics while reaching to its site of action. This is a surprising finding, if there ever was one. Therefore, I looked a bit closer with a view of determining what the original data were that led to this conclusion.

Here is the unaltered section on homeopathy from the review:

Homeopathy is a special, organic, holistic medicine process which activates the healing responses of the body without any known contraindications or common side effects. In his book Organon of Medicine, aka Organon of Healing Art, the founder of Homeopathy, Samuel Hahnemann, developed these principles. Homoeopathy does not have holistic treatment and hence is incapable of curing TB because of homeopathic portions of water, which is not enough to treat TB, but recent research suggests the use of homeopathic treatment along with the antibiotics, which results in synergising the effect of antibiotics while reaching to its site of action. As standard MDR-TB medicines are second-generation antibiotics taken for 24–27 months, thus, apart from conventional treatment, homeopathy in MDR-TB tends to improve outcome. Hence, it increases the bioavailability of the isoniazid and rifampicin, which resulted in the reduction of tuberculosis therapy. This study has been proving by analysing following parameters as below:

There was no significant difference in smear conversion from positive to negative at 95 % CI between homeopathy (H) and individualised standard treatment regimen (SR) + placebo (P). However, the conversion culture conversion from positive to negative in SR + H was seen in 29 (48.3 %) patients and 23 (38.3 %) patients in SR + P group (p = 0.269) (ITT) and 27 (55.1 %); 21 (42.8 %), p = 0.225 (PP) implying that as compared to SR + P group, culture conversion in SR + H group was more by 10 %. So the difference, although favourable to the SR + H group is not statistically significant as shown in table 4.

All patients had far advanced lung disease as evident from the extensive infiltration, cavitation ns and fibrosis/collapse. Chest X-ray (CXR) were further assessed using RAT (Radiological Assessment Tool), examples of one case rated as + 5 and one case as _4. Significant improvements were seen statistically in CXR in the SR + H 37 (61.7 %); as compared to SR + P 20 (33.3 %), p = 0.002 at 95 % CI (ITT). Homeopathy system having all possibility to enhance the treatment and management of the TB [13].

To be clear: there is no further mention or discussion of homeopathy in this paper. The above-quoted section (its multiple falsehoods are so obvious that I probably don’t need to mention them here) is thus the only evidence provided for backing up the claim that Homeopathic treatment along with the antibiotics synergise the effect of antibiotics while reaching to its site of action. I fail to see how the information provided supports the claim. Moreover, I am not aware of any sound evidence that would support the claim that homeopathy acts synergistically to antibiotics.

In the reference list, I found one of my own articles cited as reference 13 (see above). It refers to this article: Ernst E. A systematic review of systematic reviews of homeopathy. Dr J Clin Pharmacol 2002; 54: 577–582. Here is its abstract:

Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.

I fail to see how my paper backs up the very odd sentence: Homeopathy system having all possibility to enhance the treatment and management of the TB.

This is much more than sloppiness. In fact, it is one of the clearest cases of scientific misconduct I have ever come across. What is more, if its message would get adopted, it has the potential to do considerable harm. The authors of the paper in question, Priyanka Sharma , Ramesh K. Goyal,  and Mukesh Nandave, declared no conflicts of interest; their affiliation is provided as ‘Departments of Pharmacology and Toxicology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India’. The journal that published their review is ‘Drug Research‘, a publication which I always had thought was reputable.

I am not sure what I should do next.

Any advice?

‘HOMEOPATHY360’ are fiercely decided to defend homeopathy, no matter what. They state that we promise to stand by your side always to fight against the critical attacks on Homeopathy… Therefore, I was not really surprised when, a couple of days ago, I received an email by them urging me to support US homeopaths against the threat by the FDA. Here is part of this correspondence:

… If you want to know more about the FDA’s proposed new rules for homeopathic medicines, here’s a summary of the most important points:

  • The new rules, if adopted, will allow the FDA to withdraw even properly manufactured and labeled homeopathic medicines from the marketplace. This is puzzling because these have never posed any sort of safety concern according to an initial review of public FDA records by Americans for Homeopathy Choice.
  • It is clear that the FDA intends to use this authority and has even mentioned specific medicines such as Belladonna, Nux vomica and Lachesis muta in its public statements regarding enforcement.
  • The authority for this kind of assault on homeopathy will result from the declaration by the FDA that all homeopathic medicines are “new drugs.” We all know this is nonsense. Homeopathic medicines have been around for 200 years.
  • But this nonsense declaration means that under U.S. law all homeopathic remedies will become technically “illegal” and subject to withdrawal from the marketplace. If the FDA just thinks there is a problem with a homeopathic medicine, it can withdraw it forever without conducting any sort of investigation.
  • Since the agency has already said that it thinks that Belladonna, Nux vomica, Lachesis muta and several other remedies are dangerous, we can anticipate that it will try to remove them from the marketplace as soon as its new rules are adopted.
  • But, it won’t be possible for Americans to get remedies that are banned sent to them from abroad. The FDA will simply stop these remedies at the border.

I could tell you more, but what I’ve told you so far should convince you that we ought to help the American homeopathy community defeat these unreasonable and misinformed rules. The rules simply do not reflect the realities of homeopathic medicines, namely, that they are nontoxic, mild, effective and have few, if any, side-effects. And, homeopaths use them in ways that individualize treatment. That this is the best way to treat patients was discovered by Samuel Hahnemann 200 years ago.

The enemies of homeopathy are everywhere and they appear to be stepping up their attacks. That’s why the world homeopathy community must work together to stand up to them…

_________________________________________________________________

I have reported about the FDA initiatives on homeopathy before. In 2015, they started it with a public hearing. Since then, the FDA also issued several warnings to manufacturers who were putting consumers at risk (see, for instance, here, here, and here).

What the FDA seem to be trying to do is nothing else but meeting their ethical, moral and legal responsibility vis a vis consumer safety. Homeopathy has had a free ride for far too long. It is high time that this sector joins the 21st century.

The above quote, with its bonanza of bogus claims and falsehoods, shows the urgency of this task. The defenders of homeopathy seem to live on a different planet where rationality, facts and evidence can easily be over-ruled by creed, dogma and wishful thinking. If homeopaths want their trade to join the realm of real medicine they need, at the very minimum, to show with sound evidence:

  1. that their remedies generate more good than harm,
  2. that they adhere to acceptable quality standards.

Failing this – and so far, homeopaths not only failed at this task but continue bombarding us with an incessant flow of bogus and dangerous claims – homeopathics cannot be considered to be medicines, and homeopaths cannot be called responsible healthcare professionals. It is high time to stop turning a blind eye to the double standards that have been applied for 200 years.

Hurray, homeopaths have a new study to be jubilant about!

But how far can we trust its findings?

Let’s have a look.

The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct to non-surgical periodontal therapy (NSPT) in individuals with type 2 diabetes (DMII) and chronic periodontitis (CP). Eighty individuals with CP and DM II participated in this randomized, double-blind, placebo-controlled study. They were randomly divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo, while the TG received placebos. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment.

Both groups showed significant improvement throughout the study for most of the parameters studied, but TG presented a significative gain of clinical attachment at 1 and 12 months compared to CG. Mean glucose and glycated haemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significant further reduction of these parameters in TG, as compared to CG.

The authors concluded that homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.

Over the years, I have learnt how to ‘sniff out’ studies that are odd. This is one of them, I fear; it smells strangely ‘fishy’.

Here are some of the reasons why I remain sceptical:

  1. There does not seem to be an approval by an ethics committee.
  2. I also could also not find any mention of informed consent.
  3. There is no mention of conflicts of interest
  4. Neither is the source of funding disclosed.
  5. There were zero drop-outs which I find hard to believe.
  6. The trial started in 2013, but was published only recently.
  7. The treatment with homeopathy lacks biological plausibility.
  8. The authors conducted > 50 tests for statistical significance without correcting for multiple testing.
  9. The clinical relevance of the findings is unclear.

Even if we accepted the results of this study, we would require at least one independent replication before we allow them to influence our clinical practice.

Are you hungover today? you will be pleased to hear that so-called alternative medicine (SCAM) has a lot to offer – at least this is what its enthusiasts think.

Homeopaths swear by Nux Vomica as the first remedy to think of with hangover headaches, but it is also excellent for headaches from overwork, indigestion headaches and headaches accompanying constipation. Use it when your headache is worse when you cough or bend down, and headaches that aggravate when you move your eyes. If you have overeaten and drunk too much alcohol, you may also feel nauseous and want to vomit to make yourself feel better but find you cannot. If this describes your symptoms then Nux Vomica is the remedy for you.

When I worked as a homeopath, I and others often tried this treatment – it never worked. More importantly, there is not a jot of evidence that it does.

Some people recommend artichoke extract. I say: forget it. Here is why:

BACKGROUND:

Extract of globe artichoke (Cynara scolymus) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms. However, few rigorous clinical trials have assessed the effects of artichoke extract, and none has examined the effects in relation to hangovers. We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover.

METHODS:

We recruited healthy adult volunteers between 18 and 65 years of age to participate in a randomized double-blind crossover trial. Participants received either 3 capsules of commercially available standardized artichoke extract or indistinguishable, inert placebo capsules immediately before and after alcohol exposure. After a 1-week washout period the volunteers received the opposite treatment. Participants predefined the type and amount of alcoholic beverage that would give them a hangover and ate the same meal before commencing alcohol consumption on the 2 study days. The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions. Secondary outcome measures were differences between the interventions in scores using a mood profile questionnaire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure.

RESULTS:

Fifteen volunteers participated in the study. The mean number (and standard deviation) of alcohol units (each unit being 7.9 g, or 10 mL, of ethanol) consumed during treatment with artichoke extract and placebo was 10.7 (3.1) and 10.5 (2.4) respectively, equivalent to 1.2 (0.3) and 1.2 (0.2) g of alcohol per kilogram body weight. The volume of nonalcoholic drink consumed and the duration of sleep were similar during the artichoke extract and placebo interventions. None of the outcome measures differed significantly between interventions. Adverse events were rare and were mild and transient.

INTERPRETATION:

Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover. Larger studies are required to confirm these findings.

Is there anything else you might want to try? I am afraid the answer is NO. Here is our systematic review on the subject:

OBJECTIVE:

To assess the clinical evidence on the effectiveness of any medical intervention for preventing or treating alcohol hangover.

DATA SOURCES:

Systematic searches on Medline, Embase, Amed, Cochrane Central, the National Research Register (UK), and ClincalTrials.gov (USA); hand searches of conference proceedings and bibliographies; contact with experts and manufacturers of commercial preparations. Language of publication was not restricted.

STUDY SELECTION AND DATA EXTRACTION:

All randomised controlled trials of any medical intervention for preventing or treating alcohol hangover were included. Trials were considered if they were placebo controlled or controlled against a comparator intervention. Titles and abstracts of identified articles were read and hard copies were obtained. The selection of studies, data extraction, and validation were done independently by two reviewers. The Jadad score was used to evaluate methodological quality.

RESULTS:

Fifteen potentially relevant trials were identified. Seven publications failed to meet all inclusion criteria. Eight randomised controlled trials assessing eight different interventions were reviewed. The agents tested were propranolol, tropisetron, tolfenamic acid, fructose or glucose, and the dietary supplements Borago officinalis (borage), Cynara scolymus (artichoke), Opuntia ficus-indica (prickly pear), and a yeast based preparation. All studies were double blind. Significant intergroup differences for overall symptom scores and individual symptoms were reported only for tolfenamic acid, gamma linolenic acid from B officinalis, and a yeast based preparation.

CONCLUSION:

No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.

Yes, it’s true, the only sound advice is moderation!

In the true Christmas spirit, I decided that I will give away presents to fans of homeopathy.

Here is the deal:

It is almost 2 years now that I asked all homeopaths, particularly those who believe that homeopathy works because it is ‘nano-medicine’, to answer the questions below:

  1. How (by what mechanism) does a nano-particle of coffee, for instance, affect the sleep centre in the brain to make the patient sleep? Or how does a nano-particle of the Berlin Wall or a duck liver affect anything at all in the human body? 
  2. Most homeopathic remedies are consumed not as liquids but as ‘globuli’, i. e.  tiny little pills made of lactose. They are prepared by spraying the liquid remedy on to them. The liquid subsequently evaporates. How is it that the information allegedly retained in the liquid does not evaporate with the diluent?
  3. The diluent usually is a water-alcohol mixture which inevitably contains impurities. In fact, a liquid C12 remedy contains dimensions more impurities than homeopathic stock. These impurities have, of course, also been vigorously shaken, i. e. potentised. How can we explain that their ‘potency’ has not been beefed up at each dilution step? Would this not necessitate a process where only some molecules in the diluent are agitated, while all the others remain absolutely still? How can we explain this concept?
  4. Some stock used in homeopathy is insoluble (for instance Berlin Wall). Such stock is not diluted but its concentration in the remedy is initially lowered by a process called ‘trituration’, a process which consists in grinding the source material in another solid material, usually lactose. Assuming that potentisation works in the way homeopaths think, how is information transferred from one solid material to another during trituration?
  5. Everything we drink is based on water containing molecules that have been inadvertently potentised in nature a million times and therefore should have hugely powerful effects on our bodies. How is it that we experience none of these effects each time we drink?

So far, I have not received any answers that stand up to scrutiny. Therefore, I now offer a present, free book on homeopathy,

to anyone who can provide a rational, scientifically sound answer to at least one of these questions. Just post your reply in the comments section. If it fulfils the above criteria, I will contact you, ask you for your postal address, and send you a free copy of my book.

MERRY CHRISTMAS!

1 3 4 5 6 7 58
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories