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1. WHAT IS IT?
4. IS IT SAFE?
WHAT IS IT?
Homeopathy is an alternative medical practice that is based upon a belief system which centres on the principle of “like cures like” . This principle suggests that if a given substance causes particular physical symptoms, that substance can be used in small quantities to treat diseases which present with similar symptoms. For example, if a particular herb causes diarrhea when taken by a healthy person, that herb can be used – in very low concentrations – to treat diarrhea. Likewise, onions can cause a person’s eyes to water and nose to run – therefore, when highly diluted, onion extracts can be used to treat hay fever (which presents with similar symptoms) .
A key aspect of homeopathy is the dilution process. When homeopathic preparations are made, the original “active” substance is typically diluted in water to the point that none of the original substance is actually present [1-3]. In the homeopathic belief system, this process defines a preparation’s strength, such that more diluted (i.e. lower concentration) preparations are believed to be stronger medicines . For example, “oscillococcinum” is a popular homeopathic remedy that is marketed for the treatment of flu-like symptoms and is created by diluting duck liver and heart in water to a concentration of 200C (“C” is a measure of concentration used by homeopaths) [see below]. In practical terms, this is equivalent to adding 1 part duck to 10^400 parts water (10^400 = 1 followed by 400 zeroes = 10000000000000000000… [total of 400 zeroes]). To put this in perspective, the number of particles in the known universe is only 10^80. Hence, in order to dilute one particle of duck to 200C, it would require more molecules of water than are present in the universe. In other words, most homeopathic dilutions are essentially pure water.
DOES IT WORK?
No. There is no reliable evidence that homeopathy is effective for the treatment of any health condition.
WHAT'S THE EVIDENCE?
Quick Definition: "Systematic Review"
A systematic review (and/or “meta-analysis”) is a scientific study that examines the agreement between many clinical trials. Instead of looking at a single study, systematic reviews attempt to analyse the totality of evidence related to a topic. By doing so, the true answer to a given question can be more accurately estimated. For example, a single study might indicate that a particular treatment is effective, leading readers to believe that this treatment works. However, what if three other studies conclude that the same treatment does not work? A systematic review might analyse the data from all four of these trials and conclude (correctly) that the totality of the evidence indicates that the treatment does not work (3 say no, only 1 says yes). The relative importance of each study is determined by things like study size (number of participants – more is better), chance for bias, consistency of measurements, and many others.
Because of their strength, systematic reviews are generally considered one of the highest standards of evidence. However, they are also not perfect, and are subject to the quality of the contributing clinical studies. Hence, if only low-quality studies are used, low-quality results will emerge (a.k.a. “garbage in, garbage out”).
Clinical Studies of Homeopathy
Systematic reviews of clinical studies of homeopathy demonstrate that there is no reliable evidence to support the use of homeopathy for the treatment of any health condition [2, 4-7].
In 2015, a comprehensive analysis of 57 systematic reviews of homeopathy (representing 176 individual clinical studies that assessed 61 different health conditions) was conducted by the Australian Government’s National Health and Medical Research Council (NHMRC). This analysis concluded that there are “no health conditions for which there is reliable evidence that homeopathy is effective” . Based on these findings, the NHMRC went on to warn the public against the use of homeopathy, stating:
“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. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.” .
Similarly, an evidence review by the United Kingdom House of Commons’ Science and Technology Committee concluded in 2010 that “systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos” and thus should not be endorsed or funded by their publicly-administered healthcare system .
A systematic review of Cochrane systematic reviews (Cochrane reviews are generally considered to be highly reliable standards of evidence in medicine) made similar conclusions: current Cochrane analyses of homeopathy demonstrate no difference between homeopathic medicines and non-homeopathic sugar pills (placebo) .
The same conclusions can be found in multiple other systematic reviews and analyses [e.g. references 2, 7].
IS IT SAFE?
Given the fact that most homeopathic remedies are essentially pure water, they are generally considered to be relatively safe. However, some adverse effects have still been reported and are likely due to problems with inappropriate preparation, contamination, or allergic reactions .
Of perhaps more concern, however, are the indirect harms that may result from homeopathy use. Specifically, if patients choose to avoid or delay medically necessary (and evidence-based) treatments because they have decided to use homeopathy instead, serious harm (or death) can result . This is especially concerning in the cases of disease prevention (e.g. vaccination) and serious illnesses. For example, if parents choose ineffective homeopathic ‘vaccines’ (known as ‘nosodes’) in place of standard vaccination for their children, they may leave their children and the public vulnerable to vaccine-preventable diseases .
Likewise, the delay or avoidance of treatment for serious illnesses (such as cancer, severe infections, severe depression, etc.) by using homeopathy as a substitute for evidence-based therapies can lead to serious harm or death. . This type of harm has been documented for homeopathy and other natural health practices [8, 10-12].
HOW MUCH DOES IT COST?
While costs for individual therapies vary, homeopathy represents a multi-billion dollar industry. In the United States alone, consumers spend at least $3.1 billion (USD) per year on homeopathic treatments and services (2007 data) . The implication: consumers are spending billions of dollars every year on ineffective treatments.
Spending on homeopathy in a few countries:
TOO LONG; DIDN'T READ!
There is no reliable evidence that homeopathy is effective for the treatment of any health condition. Simply put: homeopathy does not work.
1) Vickers A, Zollman C. ABC of complementary medicine: Homeopathy. BMJ. 1999;319(7217):1115–1118. doi:10.1136/bmj.319.7217.1115.
2) Ernst E. A systematic review of systematic reviews of homeopathy. British Journal of Clinical Pharmacology. 2002;54(6):577–582. doi:10.1046/j.1365-2125.2002.01699.x.
3) Loudon I. A brief history of homeopathy. Journal of the Royal Society of Medicine. 2006;99(12):607–610. doi:10.1258/jrsm.99.12.607.
4) National Health and Medical Research Council. NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions. Canberra: National Health and Medical Research Council. 2015. Available at: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cam02a_information_paper.pdf
5) House of Commons Science and Technology Committee. Evidence Check 2: Homeopathy. House of Commons London: The Stationary Office Limited. 2010. Available at: http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf
6) Ernst E. Homeopathy: What does the “best” evidence tell us? The Medical Journal of Australia. 2010;192(8):458–60. http://www.ncbi.nlm.nih.gov/pubmed/20402610.
7) Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet. 2005;366(9487):726–732. doi:10.1016/s0140-6736(05)67177-2.
8) Posadzki P, Alotaibi A, Ernst E. Adverse effects of homeopathy: A systematic review of published case reports and case series. International Journal of Clinical Practice. 2012;66(12):1178–1188. doi:10.1111/ijcp.12026.
9) Rieder M, Robinson J. “Nosodes” are no substitute for vaccines. Paediatrics & child health. 2015;20(4):219–22. http://www.ncbi.nlm.nih.gov/pubmed/26038642.
10) Joseph K, Vrouwe S, Kamruzzaman A, et al. Outcome analysis of breast cancer patients who declined evidence-based treatment. World Journal of Surgical Oncology. 2012;10(1):118. doi:10.1186/1477-7819-10-118.
11) Han E, Johnson N, DelaMelena T, Glissmeyer M, Steinbock K. Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes. Annals of Surgical Oncology. 2011;18(4):912–916. doi:10.1245/s10434-010-1487-0.
12) Davis GE, Bryson CL, Yueh B, McDonell MB, Micek MA, Fihn SD. Treatment delay associated with alternative medicine use among veterans with head and neck cancer. Head & Neck. 2006;28(10):926–931. doi:10.1002/hed.20420.
13) Nahin RL, Barnes PM, Stussman BJ, and Bloom B. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. National health statistics reports; no 18. Hyattsville, MD: National Center for Health Statistics. 2009. Available at: http://www.cdc.gov/nchs/data/nhsr/nhsr018.pdf
14) Ipsos Public Affairs (for Health Canada). Natural Health Product Tracking Survey – 2010 Final Report. Ottawa: Ipsos Public Affairs. 2011. Available at: http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2011/135-09/report.pdf
15) World Health Organization (WHO) Safety issues in the preparation of homeopathic medicines. Geneva: WHO Press. 2009. Available at: http://www.who.int/medicines/areas/traditional/prephomeopathic/en/