Friday, October 2, 2009

A Few Notes About Homeopathy

A while back I posted "Scam artists Offer Fake Flu "Immunization" and it's legal." and it, like most the content on my blog, languished in obscurity. Then a true believer in homeopathy posted a rather comical reply where they tried to defend a methodology based on 200 year old misinformation about the human body. I started writing a response and it grew into the post below.

Defining Terms

"Medicine" can be broadly divided into two categories. Science based and mythology based.

Science based medicine, also known as evidence based medicine, relies upon research, clinical trials and the overall advancement of knowledge to progress. Treatments and recommendations change over time as we learn more about the human body and the cause of disease. A few hundred years ago if you went to a doctor with a digestive complaint you were likely to be told that your humors were out of balance. Today your doctor is able to examine you, talk to you about your symptoms, run tests when necessary and prescribe a personalized treatment program based upon about 100 years of modern medicine. Modern medicine is far more likely to actually work.

The advances of science based medicine can be clearly demonstrated by comparing the infant mortality rates and overall health of, for example, stone age tribes in undeveloped portions of the modern world to the average citizens of France, Japan or the USA. Modern medicine makes us healthier. Brian Dunning goes into more detail on Skeptoid in "Natural Hygiene: Health Without Medicine (or Wisdom)"

Mythology based medicine however is a bit different. At some point some kook comes up with a set of rules and treatments. Those "treatments" are then passed on with little to no modification. One easy way to spot a mythology based medicine is that it changes very little, if at all, when new information is introduced.

Homeopathy is one of those sad, pathetic remnants of the days when little accurate information was known about the human body. I could go into a long discussion about what homeopathy is and how it differs from herbal or science based medicine but more articulate people have already done that for me:

Podcasts, web sites and videos where you can learn more:

James Randi explains the history, theory and the "4 rules of homeopathy" part 1

James Randi explains the history, theory and the "4 rules of homeopathy" part 2

Here be Dragons, an introduction to critical thinking

James Randi takes on "Head-On" the homeopathic headache "treatment."

QuackCast 3. Homeopathic Theory Of all the kinds of available, Homeopathy has to be the most retarded. And thats saying something. Listen and see why.

QuackCast 4. Homeopathy Clinical Trials. Clinical trials of homeopathy are of poor quality and treat self limited diseases. The better the study, the less well homeopathy does. In the best meta analysis to date, it is concluded that homeopathy doesn't work. Duh.

QuackCast 12. How to Identify Quackery and Homeopathic Horrors. Seven rules of thumb to identify quackery, with examples. Also more on the potential dangers of homeopathy.

The Skeptics dictionary definition of Homeopathy

Homeopathy: Pure Water or Pure Nonsense?Most homeopathy users believe that it's some kind of herbal remedy. Is it?

What's the harm in homeopathy?
Homeopathy is a practice created by Samuel Hahnemann that believes that incredibly minute quantities of substances dissolved in water can have powerful effects. Here are 437 people who were harmed by someone not thinking critically.

Homeopathy: The Ultimate Fake Homeopathic "remedies" enjoy a unique status in the health marketplace: They are the only category of quack products legally marketable as drugs. This situation is the result of two circumstances. First, the 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded through Congress by a homeopathic physician who was a senator, recognizes as drugs all substances included in the Homeopathic Pharmacopeia of the United States. Second, the FDA has not held homeopathic products to the same standards as other drugs. Today they are marketed in health-food stores, in pharmacies, in practitioner offices, by multilevel distributors, through the mail, and on the Internet.

This of course is jut the tip of the iceberg.

Searching for the Research

I've spent a good deal of time trying to find a homeopathy study that met the following criteria:

1. Double or triple blind
2. Placebo controlled
3. Had a large sample size
4. Showed an effect larger than placebo and the study's margin of error.
5. An objective measurement of clinical effectiveness, as opposed to a subjective one.
6. Rigorous methodology.

I haven't found any.

I've found a lot of garbage. I found small pilot studies of less than 50 people. I saw "positive results" that were so small that the study's margin of error made them indistinguishable from placebo. The simple fact is the more competently conducted the study, the smaller the result gets for homeopathy.

Now, Rene David can call me "simply ignorant" until the cows come home, but that won't change the fact that I have actual science on my side and Rene is relying upon mythology and anecdotes. I have the facts, Rene has wishful thinking and a misguided faith in nonsense. I'd love it if Rene could provide me with a few studies that met the six criteria I outlined above. In the past I've asked homeopaths for actual research that indicated efficacy. What I got were the titles of dozens of small studies showing tiny effects, none of which met the criteria I'd requested.

Where Zicam fits in

The closest anyone came was to mention Zicam, which is a "2C" dilution. The "2" means it's been diluted twice. The "C" means each dilution was 1 part source material to ten parts water. A 1C dilution would therefore be a 10% solution and a 2C dilution would be 1%. As a point of reference Household bleach is a 5.25% dilution of sodium hypochlorite (NaOCI) and a few tablespoons of that is enough to kill the bacteria in 5 gallons of water. Depending on the compound, 1% can be well in the range of a clinical dosage. Calling Zicam a homeopathic remedy is pure marketing.

The more common "X" designation on homeopathic remedies means it was diluted to 1 part per 100. this means a 1X dilution is a 1% solution. By the time you get to the 30X and 200X dilutions used for many homeopathic remedies, you could drink an entire Olympic swimming pool of the "treatment" and never encounter a single molecule of the original ingredient. The Mentalist James Randi will often start demonstrations by taking and entire bottle of homeopathic sleeping pills.


The bottom line is, homeopathy is bunk. The people claiming otherwise are relying upon shoddy "research" and outdated fantasies about how the human body works. I'm sure most homeopaths are convinced that there's actual science behind their cute little mythology. I suspect most of them are sincere in placing 200 year old misinformation ahead of modern medicine. That doesn't change the fact that they're wrong. Homeopathy is, at best, a placebo. Relying upon a placebo in place of actual medicine can kill you.

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