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

integrative medicine

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The Academy of Homeopathy Education is a US-based accredited teaching institution offering homeopathy education services to professional and medically licensed homeopathy students. This study reports on clinical outcomes from the teaching clinic from 2020 to 2021.

Data were collected using the patient-generated outcome measure, the Measure Yourself Concerns and Wellbeing (MYCaW). Mean MYCaW values for initial and subsequent consultations were analyzed for the degree of change across the intervention period in 38 clients. Each client listed up to two complaints. MYCaW scores between initial and subsequent consultations were analyzed for the degree of change (delta) across the intervention period.

A total of 95 body system-related symptoms were analyzed for change in intensity following the homeopathic intervention. Statistically significant improvements in the intensity of main symptoms were observed between initial and subsequent follow-ups. The main symptom scores showed a mean change in intensity (delta MYCaW) of −0.79 points (95% confidence interval (CI), −1.29 to −0.29; p = 0.003) at first follow-up, a mean change of −1.67 points (95% CI, −2.34 to −0.99; p = 0.001) at second follow-up compared with the initial visit, and a mean change of −1.93 points (95% CI, −3.0 to −0.86; p = 0.008) at third follow-up compared with the initial visit. For clients with four or more follow-ups, the mean delta MYCaW was −1.57 points (95% CI, −2.86 to −0.28; p = 0.039).

The authors concluded that statistically significant improvements as well as some clinically meaningful changes in symptom intensity were found across a diverse group of individuals with a variety of long-term chronic conditions. The improvement was evident across different body systems and different levels of chronicity. There are limitations to the generalizability of the study due to the research design. Further research and investigation are warranted given the promising results of this work.

There are, of course, not just limits to the generalizability of this study! I’d say there are limits to the interpretation of any of its findings.

What was the cause of the improvements?

Here are just a few questions that I asked myself while reading this paper:

  • Are the guys from the Academy of Homeopathy Education not aware of the fact that even chronic conditions often get better by themselves?
  • Have they heard of the placebo effect?
  • Are they trying to tell us that the patients did not also use conventional treatments for their chronic conditions?
  • What about regression towards the mean?
  • What about social desirability?
  • Why do they think that further research is needed?
  • Are these really results that look ‘promising for homeopathy?

To answer just the last question: No, these findings are in perfect agreement with the fact that highly diluted homeopathic remedies are pure placebos (to be honest, they would even be in agreement with such remedies being mildly harmful).

 

Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy is claimed to be effective, but there is little data on the effect on inflammation and disease activity in RA. The objective of this study was therefore to explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients.

A total of 100 RA patients were randomized into two groups:

  • the naturopathy group (integrated naturopathy interventions with routine medical therapy),
  • the control group (only with routine medical therapy).

Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points.

The results show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003) and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06).

The authors conclused that the findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.

The naturopathic treatments included:

  • acupuncture,
  • hot and cold-water application to the painful joints,
  • sauna baths,
  • enemas,
  • fasting,
  • mud therapy,
  • massage therapy.

The study was designed as an A+B versus B trial. Therefore, it is hardly surprising that subjective endpoints improved. A little more baffling are the changes in objective parameters. These could easily be due to the fasing interventions – there is reasonably sound evidence for such effects. Take this review, for instance:

Fasting is an act of restricting, for a certain length of time, food intake or intake of particular foods, and has been part of religious rituals for centuries. Religions such as Christianity and Islam use this practice as a form of sacrifice, self-discipline, and gratitude. However, in the past decade, fasting has penetrated the mainstream as a diet trend. There are several ways of fasting; existing fast mimicking eating methods promise accelerated weight loss, and many more benefits: lower cholesterol, prevention of type 2 diabetes and a longer lifespan. Even more, it has been proposed that fasting can downregulate the inflammatory process and potentially be used as a treatment regimen for several diseases. Here, we review the effects of fasting on immune and inflammatory pathways. Also, we present current knowledge about the role of fasting in the activity of inflammatory arthritides with a focus on rheumatoid arthritis.

What I am trying to say is this: some modalities used in naturopathy might well be effective in treating certain conditions. In my view, this is, however, no reason for condoning or recommening naturopathy as a whole. Or – to put it bluntly – naturopathy is a weird mixture of pure nonsense and some possibly reasonable interventions.

‘WORLD HOMEOPATHY DAY’ is upon us and the Internet is awash with pro-homeopathy comments, e.g.:

  • World Homeopathy Day is observed annually on April 10th to commemorate the birth anniversary of Samuel Hahnemann, a prominent figure in the development of homeopathy. This day celebrates the principles and practices of homeopathy, an alternative medicinal approach that emphasizes treating ailments by utilizing natural substances and stimulating the body’s inherent healing abilities.
  • The theme for World Homeopathy Day 2024 is ‘Empowering Research, Enhancing Proficiency: A Homeopathy Symposium”. This theme underscores the significance of continuous research in homeopathy and the need to upgrade capability in its training to give better medical care results.

Even slightly less biased sources cannot bring themselves to a more realistic approach, e.g.:

The significance of the World Homeopathy Day is said to be as follows:

  • Raising Awareness: World Homeopathy Day has successfully brought homeopathy to the forefront of public attention, generating dialogue and interest in its principles and practices.
  • Bridging Communities: The Day serves as a platform for bringing together homeopaths, practitioners, researchers, and individuals interested in alternative medicine, fostering collaboration and knowledge exchange.
  • Focus on Education: World Homeopathy Day emphasizes the importance of education and ethical practices within the field, promoting responsible usage and informed choices for individuals seeking homeopathic care.

World Homeopathy Day is about understanding and exploring the potential of this alternative medicine system while keeping an open mind and prioritizing evidence-based healthcare practices.

So, let me try to counter-balance these texts by showing you what my recently published 7 key points about homeopathy tell us:

Homeopathy is popular, particularly in India, Germany, France and parts of South America. It was invented more than 200 years ago and still divides opinions like few other subjects in alternative medicine.

  1. Homeopathy was invented by the German physician, Samuel Hahnemann (1755–1843). At the time, our understanding of the laws of nature was woefully incomplete, and therefore Hahnemann’s ideas seemed less implausible than today. The conventional treatments of this period were often more dangerous than the disease they were supposed to cure. Consequently, homeopathy was repeatedly shown to be superior to ‘allopathy’ (a term coined by Hahnemann to denigrate conventional medicine) and Hahnemann’s treatments were an almost instant, worldwide success.[1]
  2. Many consumers confuse homeopathy with herbal medicine; yet the two are fundamentally different. Herbal medicines are plant extracts that contain potentially active ingredients. Homeopathic remedies are based on plants or any other material and they are typically so dilute that they contain not a single molecule of the substance advertised on the bottle. The most frequently used dilution (homeopaths call them ‘potencies’) is a ‘C30’; a C30-potency has been diluted 30 times at a ratio of 1:100. This means that one drop of the staring material is dissolved in 1 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 drops of diluent (usually a water/alcohol mixture)—and that equates to less than one molecule of the original substance per all the molecules of the universe.
  3. Homeopaths claim that their remedies work via some ‘energy’ or ‘vital force’ and that the process of preparing the homeopathic dilutions (it involves vigorous shaking the mixtures at each dilution step) transfers this ‘energy’ or information from one to the next dilution. They also believe that the process of diluting and agitating their remedies, which they call potentisation, renders them not less or not more potent. Homeopathic remedies are usually prescribed according to the ‘like cures like’ principle: if, for instance, a patient suffers from runny eyes, a homeopath might prescribe a remedy made of onion, because onion make a healthy person’s eyes water. This and all other assumptions of homeopathy contradict the known laws of nature. In other words, we do not fail to comprehend how homeopathy works, but we understand that it cannot work unless the known laws of nature are wrong.
  4. According to Hahnemann’s classical homeopathy, homeopaths are focussed on the symptoms and characteristics of the patient. They conduct a lengthy medical history, and they show little or no interest in a physical examination of their patient or other diagnostic procedures. Once they are confident to have all the information they need, they try to find the optimal homeopathic remedy. This is done by matching the symptoms with the drug pictures of homeopathic remedies. Any homeopathic drug picture is essentially based on what has been noted in homeopathic provings where healthy volunteers take a remedy and monitor all that symptoms, sensations and feelings they experience subsequently. Thus, the optimal homeopathic remedy can be seen as a diagnosis which makes homeopathy also a diagnostic method.[2]
  1. Today, around 500 clinical trials of homeopathy have been published. The totality of this evidence fails to show that homeopathic remedies are more than placebos.[3] Numerous official statements from various countries confirm the absurdity of homeopathy, for instance:
  • “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)
  • “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)
  • “There is no good-quality evidence that homeopathy is effective as a treatment for any health condition” (National Health Service, England)
  1. Yet, many patients undeniably do get better after taking homeopathic remedies. The best evidence available today clearly shows that this improvement is unrelated to the homeopathic remedy per se. It is the result of a lengthy, empathetic, compassionate encounter with a homeopath, a placebo-response or other factors which experts often call ‘context effects’.[4]
  2. Whenever homeopaths advise their patients (as they often do) to forgo effective conventional treatments, they are likely to do harm. This phenomenon is best documented in relation to the advice of many homeopaths against immunisations.[5]
[For references, see the original text]

I do not expect fans of homeopathy to be impressed by my evidence-based assessment of their cult. In fact, just looking what is currently being posted on ‘X’ today about the ‘WORLD HOMEOPATHY DAY’ seems to justify my expectation. Here are the 10 first postings that appeared on my screen about an hour ago:

  1. Today, on #WorldHomeopathyDay, we celebrate the birth anniversary of Dr. Samuel Hahnemann, the founder of homeopathy. Let’s embrace the principles of natural healing and holistic well-being.
  2. On #WorldHomeopathyDay President #DroupadiMurmu to inaugurate 2-day Homeopathic Symposium at Yashobhoomi Convention Centre Dwarka, New Delhi. Organized by Central Council for Research in Homoeopathy (CCRH) based on theme of ‘Empowering Research, Enhancing Proficiency.’
  3. Dr. Ashvini Kumar Dwivedi, Member, Scientific Advisory Board, Central Council for Research in Homeopathy, Ministry of Ayush, Government of India, and #ASSOCHAM Ayush task force member, underlined the significance of #WorldHomeopathyDay, observed on April 10th each year
  4. Today, we celebrate #WorldHomeopathyDay 2024, embracing the gentle healing power of nature.
  5. Happy #WorldHomeopathyDay!  Let’s celebrate the holistic approach to health that homeopathy offers, honoring its contributions to alternative medicine and its focus on individualized care. Here’s to exploring natural remedies and supporting wellness for all! #HolisticHealth
  6. Happy World Homeopathy Day Embracing the gentle yet powerful healing of homeopathy, let’s cherish its holistic essence, promoting balance and well-being worldwide. Here’s to the harmony it brings to mind, body, and spirit.
  7. #WorldHomeopathyDay: President #DroupadiMurmu to inaugurate 2-day Homeopathic Symposium at Yashobhoomi Convention Centre Dwarka, New Delhi. Organized by Central Council for Research in Homoeopathy (CCRH) based on theme of ‘Empowering Research, Enhancing Proficiency.’
  8. Celebrate #WorldHomeopathyDay with us & enter to win these two enlightening reads by renowned homeopath Dr. Mukesh Batra. What inspired you to explore homeopathy? Share your story in the comments section & get a chance to win a copy of #HealWithHomeopathy and #FeelGoodHealGood!
  9. #WorldHomeopathyDay is celebrated on April 10th, promoting awareness of the principles and benefits of homeopathic medicine. It aims to address the whole body, including hereditary predispositions and disease history, and encourages people to pursue homeopathy as a profession.…
  10. On World Homeopathy Day, we celebrate Dr. Samuel Hahnemann, the pioneer of homeopathy. His gentle remedies, made from natural substances, have helped countless people heal without side effects.

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In view of this volume of pure BS, I encourage everyone to post (here, or on ‘X’, or elsewhere) some evidence-based comments on homeopathy, Hahnemann and the ‘World Homeopathy Day’.

Let me make a start:

Homeopaths are as deluded as their remedies are diluted

In spite of the safety and efficiency of the COVID-19 vaccines and the many promotion efforts of political and expert authorities, a fair portion of the population remained hesitant if not opposed to vaccination. Public debate and the available literature point to the possible role of people’s attitudes towards medical institutions as well as their preference for so-called alternative medicine (SCAM) on their motivations and intentions to be vaccinated. Other potential ideological factors are beliefs about environmental laissez-faire and divine providence insofar as they encourage people to let the pandemic unfold without human interference.

In three cross-sectional samples (total N = 8214), collected at successive moments during the Belgian vaccination campaign, the present research examines the distal role of these psychological and ideological factors on vaccination intentions via motivational processes.

  • Study 1 gauges the relation between trust in medical institutions and preference for SCAM on intentions to get vaccinated via motivations.
  • Study 2 examines the role of beliefs in the desirability of letting nature take its course (‘environmental laissez-faire beliefs’) on vaccination intention via motivations.
  • Study 3 tests whether people’s adherence to environmental laissez-faire and beliefs about divine providence are linked to their motivations for vaccination via trust in the medical institutions and SCAM.

The results show that adherence to SCAM has a deleterious effect on vaccination intentions, whereas trust in medical institutions has a positive effect. Both ideological factors pertaining to external control are only moderately related, with environmental laissez-faire beliefs having stronger effects on SCAM, medical trust and vaccination motivations.

The evidence of an association between SCAM and willingness to get vaccinated is undeniable. On this blog, we have discussed it repeatedly, e.g.:

But what exactly is the nature of this association?

  • Does SCAM-use predispose to vaccination hesitancy?
  • Does Vaccination hesitancy predispose to SCAM use?
  • Is both true?

After reading all this research that has emerged on the subject, I get the impression that we are mostly dealing here with a cross-correlation where a certain mind-set of being

  • prone to conspiracy theories,
  • anti-establishment,
  • anti-science,
  • irrational,
  • of low intelligence,
  • unable of critical thinking,
  • etc., etc,

determines both the SCAM-use and the vaccination hesitancy.

 

It does not happen often, but when it does, it should be aknowledged. I am speaking of papers from chiropractors that make sense. If you are interested in chiropractic, I do encourage you to read the articles of which I will here only present bits of the conclusions:

Part 1

The chiropractic profession is weighed down by the burden of historical theories regarding spinal manipulative therapy (SMT), which, for some in the profession, have all the characteristics of dogmatic articles of faith. In our opinion, the unlimited scope of practice, which is still advocated by some chiropractors, and which has not been met with unequivocal political rejection, an over-reliance on SMT in the management of MSK disorders, and an over-emphasis on the technical intricacies of SMT represent weaknesses within chiropractic. We argue that these are obstacles to professional development and the major causes of professional stagnation both intellectually and in the market place.

We also discussed what we consider to be threats to the chiropractic profession. Science, the impact of EBM, and accountability to authorities and third party-payers all pose threats to the traditional chiropractic paradigm and, thus, to those within the profession, who practice within such a paradigm. In the marketplace, competition from other professions that provide care of patients with MSK disorders, including SMT, and are better positioned to be integrated into the wider health-care system/market represent a threat. Moreover, finally, the internal schism in chiropractic represents a threat to professional development, as it prevents the profession moving forward in unison with a coherent external message.

We have described those weaknesses and threats, knowing full well, that we do so from our perspective of chiropractic as EBM with a limited MSK scope of practice, i.e. from outside the subluxation frame of reference.

We recognize that for those who look at SMT from the perspective of traditional, subluxation-based chiropractic, things will look very different: What we identify as weaknesses may be seen by others as the pillars of chiropractic practice, and what we see as threats could appear as just peripheral and ephemeral distractions to the enduring core of chiropractic ideas. Such is the character of the schism at the heart of chiropractic.

None-the-less, having described what we identify as serious weaknesses and threats arising from the profession’s relationship to SMT, it has not escaped our attention that it also gives rise to several strengths, which serve the profession and its patients well. In turn, it follows that a number of opportunities are presenting themselves for the future of SMT and chiropractic.

Part 2

The onus is now on the chiropractic profession itself to redefine its raison d’être in a way that plays to those strengths and delivers in terms of the needs of patients and the wider healthcare system/market. We suggest chiropractors embrace and cultivate a role as coordinators of long-term and broad-focused management of musculoskeletal disorders. We make specific recommendations about how the profession, from individual clinicians to political organizations, can promote such a development.

___________________________

For readers in a hurry:

Progress is an inevitable threat to obsolete and useless practices of any kind. In that, chiropractic is no exception.

The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:

There are three types of health professionals who offer naturopathic treatment:

  • Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
  • Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
  • Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.

At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.

Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.

… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…

ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”

… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.

…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.

________________

The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:

Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.

A recent post of mine started an interesting discussion about the research of the NCCIH. Richard Rasker made the following comment:

The NCCIH was initially established as the Office for Alternative Medicine (OAM) for mostly the same reason that Edzard’s department at Exeter was founded, i.e. to study alternative modalities, and determine once and for all which ones were effective and which ones weren’t. Unfortunately, OAM and its subsequent incarnations were taken over by SCAM proponents almost right away, with its core mission changed into validating (NOT ‘studying’) SCAM modalities – a small but crucial difference that will all but guarantee that even long-obsolete and totally ineffective quackery will continue to be ‘researched’ and promoted.

So what’s the score now, after more than 30 years and well over 4 billion dollars in taxpayers’ money? How many SCAM modalities have they managed to ‘validate’, i.e. definitively proven to be effective? The answer is: none, for all intents and purposes. Even their research into herbal medicine – one of the most effective (or should I say: least ineffective) SCAMs out there – is best described as woefully lacking. Their list of herbs and plants names just 55 species of plants, and the individual descriptions are mostly to the tune of ‘a lot of research was done, but we can’t say anything definite’.

I think I can contribute meaningfully to this important comment and topic. Several years ago, my Exeter team – together with several other researches – systematically reviewed the NCCIH (formerly NCCAM)-sponsored clinical trials. Specifically, we focussed on 4 different subject areas. Here are the conclusions of our articles reporting the findings:

      1. ACUPUNCTURE

Seven RCTs had a low risk of bias. Numerous methodological shortcomings were identified. Many NCCAM-funded RCTs of acupuncture have important limitations. These findings might improve future studies of acupuncture and could be considered in the ongoing debate regarding NCCAM-funding. [Focus on Alternative and Complementary Therapies Volume 17(1) March 2012 15–21]

       2. HERBAL MEDICINE

This independent assessment revealed a plethora of serious concerns related to NCCAM studies of herbal medicine. [Perfusion 2011; 24: 89-102]

       3. ENERGY MEDICINE

In conclusion, the NCCAM-funded RCTs of energy medicine are prime examples of misguided investments into research. In our opinion, NCCAM should not be funding poor-quality studies of implausible practices. The impact of any future studies of energy medicine would be negligible or even detrimental. [Focus on Alternative and Complementary Therapies Volume 16(2) June 2011 106–109 ]

       4. CHIROPRACTIC

In conclusion, our review demonstrates that several RCTs of chiropractic have been funded by the NCCAM. It raises numerous concerns in relation to these studies; in particular, it suggests that many of these studies are seriously flawed. [https://www.ncbi.nlm.nih.gov/pubmed/21207089]

The overall conclusion that comes to my mind is this:

The NCCIH has managed to spend more money on SCAM research than any other institution in the world (in the 20 years that I ran the Exeter research unit, we spent around £2 million in total). The NCCIH has wasted precious funds on plenty of dubious studies; arguably, this is unethical. It has misappropriated its role from testing to validating SCAMs. And it has validated none.

PS

As some of the above-cited papers are not easily accessible, I offer to send copies to interested individuals on request.

Millions of US adults use so-called alternative medicine (SCAM). In 2012, 55 million adults spent $28.3 billion on SCAMs, comparable to 9% of total out-of-pocket health care expenditures. A recent analysis conducted by the US National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH) suggests a substantial increase in the overall use of SCAM by American adults from 2002 to 2022. The paper published in the Journal of the American Medical Association, highlights a surge in the use of SCAM particularly for pain management.

Data from the 2002, 2012, and 2022 National Health Interview Surveys (NHISs) were employed to evaluate changes in the use of 7 SCAMs:

  1. yoga,
  2. meditation,
  3. massage therapy,
  4. chiropractic,
  5. acupuncture,
  6. naturopathy,
  7. guided imagery/progressive muscle relaxation.

The key findings include:

  • The percentage of individuals who reported using at least one of the SCAMs increased from 19.2% in 2002 to 36.7% in 2022.
  • The use of yoga, meditation, and massage therapy experienced the most significant growth.
  • Use of yoga increased from 5% in 2002 to 16% in 2022.
  • Meditation became the most popular SCAM in 2022, with an increase from 7.5% in 2002 to 17.3% in 2022.
  • Acupuncture saw an increase from 1% in 2002 to 2.2% in 2022.
  • The smallest rise was noted for chiropractic, from 79 to 86%

The analyses also suggested a rise in the proportion of US adults using SCAMs specifically for pain management. Among participants using any SCAM, the percentage reporting use for pain management increased from 42% in 2002 to 49% in 2022.

Limitations of the survey include:

  • decreasing NHIS response rates over time,
  • possible recall bias,
  • cross-sectional data,
  • differences in the wording of the surveys.

The NCCIH researchers like such surveys and tend to put a positive spin on them, i.e. SCAM is becoming more and more popular because it is supported by better and better evidence. Therefore, SCAM should be available to everyone who wants is.

But, of course, the spin could also turn in the opposite direction, i.e. the risk/benefit balance for most SCAMs is either negative or uncertain, and their cost-benefit remains unclear – as seen regularly on this blog. Therefore, the fact that SCAM seems to be getting more popular is of increasing concern. In particular, more consideration ought to be given to the indirect risks of SCAM (think, for instance, only of the influence SCAM practitioners have on the vaccination rates) that we often discuss here but that the NCCIH conveniently tends to ignore.

If I had a £ for each time I was asked during the last few days whether King Charles is going to treat his cancer with homeopathy, I would have my pockets full of cash. The question seems reasonable because he has been singing the praise of homeopathy for decades. But, as I have pointed out previously, he is unlikely to use homeopathy or any other unproven cancer cure; on the contrary he will certainly receive the most effective therapies available today.

In any case, the homeopathic treatment of cancer is currently a most popular topic. As if on command, an article appeared on my screen that promises to address the subject:

“Homoeopathy and Cancer – An Alternative Approach towards the path of Healing”

Here is the abstract of this remarkable paper:

Homoeopathy is a holistic system of medicine rooted on the principle of “Similia Similibus Curentur”. It has gained attention for its potential therapeutic benefits. It offers a holistic approach that addresses both the physical symptoms and emotional well-being of individuals. While this alternative approach of healing has been explored in various health contexts, a notable gap remains in understanding its application in the realm of cancer care. This review seeks to fill this void by exploring the broader landscape of homoeopathy’s principles and applications. Through a critical examination of existing research and evidence, it aims to offer valuable insights into the potential role of homoeopathy as a complementary approach in cancer care and symptomatic relief. This review underscores the need for further research and a more nuanced understanding of homoeopathy’s place in healthcare, particularly in the context of cancer patients and their well-being.

I am sure you are as impressed as I am and keen to learn more. In the article itself, the authors offer some brand-new, cutting-edge science to back up their views:

According to Samuel Hahnemann, “When a person is ill, it is originally merely the spirit-like, autonomic life force (life principle), which is always there in the organism, that is mistuned by the dynamic effect of a morbific agent inimical to life.Only the life principle, tuned incorrectly to such an anomalyis capable of causing irregular functions the body. Cancer may initially be treated as a one-sided disease because the expanded pathology weakens the Vital Force. According to Hahnemann, “Diseases that seem to have just a few symptoms are called one-sided because only one or two prominent symptoms are indicated. This makes these diseases, which primarily fall under the category of chronic diseases, harder to cure. According to Arthur Hill Grimmer, the biggest challenge in treating advanced cancer cases is getting therapeutic individualization of symptoms. Even with all the typical symptoms, it is quite difficult to create a potent homoeopathic prescription. Burnett considered both the characteristic aspects of the patient as well as the ‘action’ or‘organ affinity’ of the remedy he prescribed.

Eventually, the authors (who are affiliated with prestigeous institutions: Rajasthan Ayurved University, Jodhpur; Swasthya Kalyan Homoeopathic Medical College & Research Centre, Jaipur) arrive at the following conclusion:

In the scientific literature, homoeopathy’s use in the treatment of cancer is still largely unexplored. Pioneers have offered intriguing perspectives on disease origins and treatment challenges. The miasmatic perspective offers a distinctive approach that emphasises individualised strategies based on symptoms and characteristics. Some studies suggest an improvement in quality of life of the individuals suffering from cancer. In the dynamic landscape of cancer treatment, more studies are warranted to enhance the scope of holistic, patient-centered care through homoeopathy.

Yes, homeopathy is a joke. This paper (and the many similar publications out there) could thus be intensely funny – except for the fact that these charlatans are playing with the lives of many vulnerable and desperate patients. I sincerely hope Charles manages to stay well clear of homeopathy and its irresponsible practitioners which clearly is one precondition for making a full recovery.

Yestderday, it was announced that King Charles has cancer. He had been in hospital for surgery for his enlarged prostate. Initially, the news was positive, as it was confirmed not to be prostate cancer. However, during the investigations, a cancer was discovered that apparently is unrelated to the prostate. Since the announcement, many journalists and other people have written to me asking what I think about it and what treatment Charles is likely to receive. I therefore decided to write a short post about the matter.

As a physician and human being I am very sorry whenever I hear that anyone has fallen ill, particularly if the condition is serious and potentially life-threatening. That this includes Charles goes without saying. Equally it is self-evident that I wish that all goes well for him, that the treatment he reportedly has already started is not too arduous, that he keeps in good spirit, that he has empathetic support from all his family and recovers quickly and fully.

Charles will, I am sure, have the best treatment anyone could wish for. Will he use so-called alternative medicine (SCAM), for example, the Gerson therapy, one of the SCAMs he once promoted as a cure of cancer? Of course not! He will receive the most effective, evidence-based care that is currently available. Will he thus not try any SCAM at all? I am confident that he will use SCAM wisely, namely not as a cure but as a supportive measure. In my book on this very subject, I go through all the relevant evidence and conclude that, while SCAM is most certainly not a cancer cure, it can have a place in supportive cancer care. Depending on the symptoms that develop during and after the conventional treatments, certain SCAMs can, according to fairly sound evidence, be helpful in improving wellness and quality of life.

Going through a battle against cancer is often a most humbling experience. Therefore, I am hopeful that, as he recovers from his ordeal, Charles will see that modern medicine – he once described it as being out of balance like the leaning tower of Pisa – is not just effective, empathetic and caring but also not nearly as unbalanced and unholistic as he often proclaimed it to be. In that sense, the experience might reform our king, and – who knows? – he might, after all, turn out to be not the self-proclaimed enemy but a true friend of the Enlightenment.

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