Homeopathy Is No More Medicinal Than Water, Study Finds

In a recent post for The BMJ, Paul Glasziou, a doctor and professor at Australia’s Bond University, didn’t hold back when summarizing the results of his sprawling systematic review of homeopathic medicine.

“Still no evidence for homeopathy,” he begins.

Homeopathy is purported to be a form of “alternative medicine” that proponents say can treat a range of illnesses and medical conditions. Though it’s been around for many years, it’s never gained acceptance in the mainstream medical community.

Glasziou didn’t come to his conclusions about homeopathy hastily. While he began his investigations skeptically, he was open-minded about what he would find when examining dozens of studies on the effects of homeopathic treatments.

But he found that he lost interest in the subject, “after looking at the 57 systematic reviews (on 68 conditions) which contained 176 individual studies and finding no discernible convincing effects beyond placebo.”

Homeopathic practices

The expansiveness of the study is almost as impressive as the range of purported homeopathic cures. Proponents of the practice argue that homeopathy can treat conditions including infertility, depression, digestive problems, heart disease, epilepsy, insomnia, eczema, arthritis, and autoimmune disorders, among others.

How exactly is homeopathy supposed to work? Centered on the principle that "like cures like," homeopathic treatments are based around an active ingredient that causes symptoms similar to those the treatment is supposed to relieve. This ingredient is then diluted in water repeatedly, until there is little or nothing left of the original ingredient.

So if you're suffering from insomnia, a homeopath might recommend a solution derived using an infinitesimal amount of caffeine. Or if you have seasonal allergies, you might be given a treatment made from diluted pollen.

The idea is that in the process of dilution, the water retains a "memory" of the initial trace ingredient, and this transforms the solution into an effective treatment. Supposedly, the more the treatment is diluted, the more effective it becomes.

Homeopathic practices are not uniform and can vary between practitioners. Many homeopaths claim that they try to treat patients holistically, designing and modifying treatments to individual patients, which they argue gives them an advantage over conventional medicine.

Glasziou points out that medical science has often produced surprising results, so he was open to the idea of homeopathy. But in study after study, he found no reason to believe that homeopathy was more effective than a sugar pill at treating any medical conditions.

When asked for comment on this story, Allison Teitelbaum, Executive Director of the National Center for Homeopathy, responded by saying homeopathy is a “safe, gentle, and natural system” for treating symptoms and restoring a body to health.

She continued, “It has been used successfully for the last 200 years by over 250 million people worldwide. It has a laudable and extensively documented clinical record and there are literally hundreds of high quality, peer-reviewed basic science, pre-clinical, and clinical studies showing its efficacy.”

Looking at the research

On the center’s website, links are provided to 14 research papers purporting to provide evidence for homeopathy. Several of these, however, are published in journals that exclusively publish material about homeopathy or alternative medicines, and are not generally recognized as reliable medical journals. Several others are published in mainstream publications.

One paper, published in the well-respect Lancet, did conclude, “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. ” However, in the very next line, the authors write, “We found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition.”

In other words, the study found this: Maybe it works, maybe it doesn't.

(And remember, this is a paper that the center links to in support of its treatments.)

Other research similarly had problems:

• A study of homeopathic treatments for chronic conditions consisting of nearly 4,000 patients did find significant improvements over the allotted time period. However, the study does not appear to have had a control group, so we can’t conclude that these effects were due to the homeopathic treatments, the placebo effect, or some other cause entirely.
• One study showed some effects of homeopathy on the treatment of traumatic brain injury. However, this study had a small sample size and the authors admitted the need for larger-scale confirmation. No such studies appear to have been done.
• Perhaps the most impressive piece of evidence was a study that looked at homeopathic treatments for diarrhea, finding significant results in a seemingly well-designed experiment. However, a follow-up study years later led by the same researcher, this time with a larger sample size, found no significant effect. The World Health Organization has specifically recommended that homeopathic treatments not be used for treating diarrhea and flu in infants.

These are exactly the kinds of studies Glasziou looked at in his systematic review of the evidence of homeopathy. Many other systematic reviews have found homeopathic remedies to perform no better than placebos for a range of conditions, and other researchers have noted extensive methodological flaws in much of the positive research of homeopathy.

Though most of the problems with these studies suggest that homeopathy may be inert rather than actively harmful, the World Health Organization has raised concerns about safety issues in the preparation of homeopathic remedies. Others point out that it could be dangerous if people rely on homeopathy instead of more effective treatments, if limited health care funds are spent on unproven techniques, or if the preponderance of dubious treatment methods weakens trust in conventional health care.

Teitelbaum and the National Center for Homeopathy offered no response to Glasziou’s comments or his review’s conclusions.

The critics

James Randi, an outspoken critic of homeopathy, frequently demonstrates his confidence that homeopathic treatments are completely inert by publicly “overdosing” on handfuls of homeopathic sleeping pills. Were homeopathic sleeping pills effective, we would assume taking so many would be highly dangerous. Watch a video of Randi’s stunt below (spoiler: he’s fine!):

(Note: Readers should consult a physician regarding the proper dose of any medications.)

Michael Shermer, the founding publisher of Skeptic magazine, pointed out that the idea that water might have some kind of medicinal "memory" property is unfounded. “From a scientific perspective, we know that that’s not possible,” he said.

“The [water] molecules have been floating around somewhere else before they were put in contact with the ‘healing substance,’ whatever it is,” he continued. “Even if it were possible, why doesn’t water remember all the other stuff it has come in contact with?”

If the science is so clear on these points, why do some people take homeopathy so seriously? Homeopathy is a very popular form of alternative medicine, which in 2013 was a $38 billion industry.

“Our minds are designed to pay really close attention to anecdotes, not statistical analysis, demographic studies, and epidemiological research,” Shermer argues. “Those are all new inventions by science to really ferret out cause and effect relationships,”

So when we hear someone say they took a homeopathic pill and their headache went away, we’re more inclined to just believe this first person account rather than look for systematic studies like Glasziou’s. And especially when it comes to very subjective sensations like pain or depression, which may fluctuate in intensity on their own, it’s very easy to attribute any positive changes to an ineffective treatment.

Alternative vs. mainstream medicine

Homeopaths may also benefit from widespread distrust of the pharmaceutical industry. This distrust can cause people to put their faith in alternatives to conventional medical treatments.

“There are a hundred other alternative medical modalities that people make equal claims to by anecdote alone. So there’s nothing special about homeopathy,” said Shermer.

But what really concerns Shermer is the risks of using alternative medicines in place of proven methods for treating serious diseases. Homeopathic treatments or other forms of alternative medicine may seem appealing when compared to pharmaceuticals with difficult side effects. But if the alternative treatment is unproven, there’s a very high risk that the underlying condition will worsen.

In some cases, these risks may include the risk of death for very vulnerable people. As The Guardian reported in October 2014, homeopaths offered their services during the Ebola crisis in west Africa. Homeopathy clinics offering services for people suffering from AIDS, malaria, and tuberculosis already existed across the continent.

If these centers are offering unproven care in place of evidence-based treatments for these diseases, the lives and health of many people could be at risk.

“It’s fine with me if we just test anything to see if it works,” Shermer said. “In that sense, there’s no alternative medicine, there’s just science-based medicine and everything else that hasn’t been tested yet.”

“And if it works, go ahead and incorporate it into medicine.”

Photo Credit: Richard Craig