Can Homeopathy Be Both a Useless Placebo and Dangerous at the Same Time?April 30, 2013
Let’s look at the science.
Earlier this month we told you about an attack on homeopathic medicines in California courts, one that could threaten the industry.
We also told you about a recent report published in the International Journal of Clinical Practice. That report claimed to do a systematic review of all adverse event reports (AERs) in connection with homeopathy from 1978 to 2010. On the one hand, the report concluded that homeopathy is ineffective because it has no active ingredients, that it is nothing more than a placebo because it has been diluted so much that “the likelihood of a single molecule approaches zero.” On the other hand, the report also concluded that homeopathic preparations caused many dangerous allergic reactions.
We pointed out that you can’t have it both ways—either homeopathic preparations are powerful enough to cause a physiological reaction, or they can’t do anything at all. This is all too typical of what passes for scientific review of homeopathy. Dismiss it any way you can, regardless of fact or logic. If that doesn’t work, then argue that homeopathy is dangerous because it may keep people from visiting a conventional doctor.
We promised to return to the subject of what real evidence there is behind homeopathy. That is a large subject, but here are some scientific studies from the past ten years showing that homeopathy can indeed be effective—far more effective than placebo. These studies, which range from random controlled trials (RCTs, the supposed “gold standard”) to observational studies to meta-analyses, often look at homeopathy as an adjunct to conventional medicine. Here is just a sampling:
- Acute otitis media (when the middle ear gets blocked with fluid and infected with bacteria): a 2012 RCT showed that symptomatic improvement was quicker in the homeopathy group than conventional therapy group, with a much lower antibiotic requirement
- Allergies: a 2012 observational study revealed that homeopathy substantially improved allergy symptoms and conventional medicine dosage could be substantially reduced; a 2013 study listed the effectiveness of different homeopathic treatments for allergies based on the type of allergy
- Asthma: In a study of individualized homeopathic treatment for asthma, there was evidence that it decreased the severity of asthma in children
Other studies show effectiveness of homeopathy for conditions ranging from chicken pox, diarrhea, and in a multi-center observational study, chronic sinusitis. Homeopathy could be an effective treatment for low-grade chronic inflammation, which is the root of many diseases, and as a complement to conventional anti-tubercular treatment (a finding that is especially important as patients are becoming resistant to TB drugs).
Much more research is ongoing despite the abysmal lack of funding for it. At the very least there is promising evidence supporting homeopathy.
So if it works, how does it work?
A homeopathic remedy is an extremely pure, natural substance that has been diluted many times. In large quantities these substances would cause the same symptoms the patient is trying to cure. In tiny, diluted doses, it is not only safe and free from side effects, but it will trigger the body to heal itself. For example, when you chop a red onion, it causes watery eyes and a runny nose in most people. Allium cepa is a remedy created from red onion; in very small doses, Allium cepa doesn’t create those symptoms but instead activates the body’s own mechanism for stopping watery eyes and a runny nose.
As noted in “Immunology and Homeopathy,” an article published in the journal Evidence-Based Complementary and Alternative Medicine, “The profound analogies between homeopathic thought and immunology are due to the fact that the whole of homeopathic theory is substantially based on the principle of regulating endogenous systems of healing, the best known of which is certainly the immune system and its neuroendocrine integrations.”
Around the end of the 19th century, scientists observed that different doses of the same substance can create wildly varying effects in humans. They observed that weak stimuli slightly increase biological responses, medium stimuli markedly raise them, strong ones suppress them, and very strong ones arrest them. This principal, called hormesis, is seen, for example, in medicinal plants: belladonna, in very small doses, has long been used as a pain reliever, muscle relaxer, and anti-inflammatory; in large doses it is extremely toxic. Foxglove (digitalis) helps cardiac arrhythmias in minute dosages, but in large doses can cause heart block and either bradycardia (decreased heart rate) or tachycardia (increased heart rate), depending on the dose and the condition of one’s heart.
The big difference between these practices and homeopathy is the amount of dilution used—and it is here that conventional medicine has such difficulty with it. In homeopathy, the substance (an herb, mineral, or animal product) is crushed and dissolved in a liquid (usually an alcohol and water solution), violently shaken with impact at least 100 times (“succussion,” usually done mechanically), then stored. This is the “mother tincture.” Homeopaths then dilute tinctures further. One part of the tincture to ten parts of the liquid is a 1X dilution (X being the Roman numeral for ten), with another round of succussion. A 2X potency takes one part of the 1X potency and adds it to nine parts of the diluting solution, thus creating a one-to-100 dilution; common potencies used in homeopathic remedies usually begin around 6X, or one part of the original mother tincture to one million parts of the diluting material. By the time you get to a 30X dilution, there is no measurable part of the original substance left.
The precise mechanism of how homeopathy works—why greater and greater dilutions should have more and more power, and why the violent shaking with impact should be so important—is still unknown. This is not really surprising given the lack of funding available to study the question, although some prominent scientists such as Luc Montagnier, the first discoverer of the AIDS virus, is pursuing it.
Despite the lack of formal research funding, homeopathy has always been an observational science, testing and refining a practice until it works better and better. The authors of “Immunology and Homeopathy” (cited above) put it this way: “The two approaches to system regulation—scientific/reductionistic and homeopathic/holistic—are not conflicting, but use different approaches: mainstream pharmacology applies a ‘structural’ analog, which is identified as the molecule binding to specific receptors or enzymes of the target system (if known). Classic homeopathy applies a ‘functional’ analogue, which is identified as the diluted compound that is able to regulate and/or to trigger homeodynamic systems. This kind of functional analogy, based on the similarity of symptoms, can be exploited even if the details of the receptors or the effector enzymes are unknown within the complex homeodynamic networks.”
Conventional medicine is, by and large, solely focused on biochemistry. but living cells and tissues also generate bioelectromagnetic fields, and it is at this level that homeopathy may be working. Every electron in every cell vibrates; so if everything vibrates, it would seem fairly logical that one vibration must affect another. One current hypothesis is that the succussion of the dilution strengthens the vibratory resonance of the substance, even when the physical component of the substance has been removed.
Other hypotheses discuss homeopathy in terms of nanotechnology—or nanopharmacology. The micro-bubbles and the nano-bubbles caused by the succussion may produce microenvironments of higher temperature and pressure. Several studies by chemists and physicists have revealed an increased release of heat from water in which homeopathic medicines are prepared, even when the repeated process of dilutions should suggest that there are no molecules remaining of the original medicinal substance.
In other words, no one knows precisely how homeopathy works. That is the rub. But there is a vast amount of anecdotal evidence that it does, including the experiences of ANH staff, such as an instant cure of trigeminal neuralgia, one of the most painful and difficult conditions to heal, instant cures of infant earaches, teenage allergies, and much more. Scientific studies, undertaken with very little funding because these are not patentable drugs, are now starting to show that it does work—and that it is far safer than FDA-approved drugs.
In the meantime, vicious attacks on homeopathy—in the US and UK and elsewhere—continue, both because it is an affront to conventional medical thought and an economic threat to the patent drug business.