Sunday, March 15, 2015

Effectiveness of homeopathy for various conditions

Homeopathy is a part of complementary and alternative medicine (CAM) that is an undeniable component of the healthcare industry in the United States.  A nationwide government survey from 2007 estimated that U.S. adults spent approximately $33.9 billion out-of-pocket on CAM.  Of this, $3.1 billion was spent on homeopathic medicine (compare this to $14.8 billion spent on natural products (nonvitamins and nonminerals) and $47.6 billion which was spent on prescription medications)1.  For more of an explanation of what homeopathy is with an example, see below. 


NHMRC Information Paper2

A recent study from the National Health and Medical Research Council in Australia reviewed the evidence of the effectiveness of homeopathy in the treatment of a number of conditions.  This was not a randomized controlled trial but rather a systematic review of systematic reviews.  They used a standardized approach to evaluate the data from systematic reviews (though they considered the data from the individual trial level, not just the overall conclusion), guidelines and reports from other countries, and information submitted from homeopathy interest groups and the public.

Trials were only evaluated if they compared homeopathy with either no treatment or with effective standard treatment.  They did not look at studies that only examined laboratory outcomes, studied animals, studied humans without a specific condition (so no prevention studies), or homeopathy vaccines.


Results

Based on the evidence from 176 individual studies covering 61 health conditions, the authors concluded that there were no conditions that had reliable evidence for homeopathy being effective.  There were no good-quality, well-designed studies with enough participants to demonstrate homeopathy being more effective than placebo or equal to a standard effective treatment.

  • For roughly half of the conditions, there was only one study each and they had poor-quality, unknown quality, or too few participants too be reliable
  • For roughly a quarter of the conditions, there were some studies with favorable conditions for homeopathy, but none were considered reliable
  • For 13 health conditions, homeopathy was specifically found to be not more effective than placebo in either all or the large majority of reliable studies.  These conditions include:
    • Asthma
    • Anxiety or stress-related conditions
    • Diarrhea in children
    • Headache and migraine
    • Muscle soreness
    • Postoperative ileus
    • Premenstrual syndrome
    • Upper respiratory tract infections (ie. colds)
    • Warts

What exactly is homeopathy?

Homeopathy is a type of complementary and alternative medicine that is essentially based on two premises.

  1. A substance that may cause symptoms in a healthy person can be used to alleviate those same symptoms in a person using very small doses ('like cures like')
  2. Highly diluted amounts of a substance may retain some 'memory' of the original substance
To prepare a homeopathic medicine, a substance (can be a plant, animal, mineral, or chemical product) is usually serially diluted and struck against a hard surface or the hand between dilutions.  Dilutions frequently reduce the concentration 100-fold and are performed so many times that it's likely that not even a single molecule of the original substance remains in the diluent.  For example, one study took a sample of hepatitis C virus and diluted it 100-fold, thirty times (yes, that's 10-60 the concentration of the original) and then checked for the presence of hepatitis C virus (for which there was none) and then gave the final concentration to healthy volunteers.3


Take home points:

  • There is no reliable evidence of homeopathy's effectiveness in treating a wide range of health conditions
  • The purpose of the above analysis was to study effectiveness and safety was not analyzed (so adverse events may be an additional concern)


References:
1.  Nahin RL, Barnes PM, Stussman BJ, et al.  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
2.  National Health and Medical Research Council.  2015.  NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions.  Canberra: National Health and Medical Research Council; 2015.
3.  Shah R. Hepatitis C nosode: The preparation and homeopathic pathogenetic trial.  Homeopathy  2013;102(3):207-14.

photo by National Center for Complementary and Alternative Medicine, NIH, DHHS

5 comments:

  1. This comment has been removed by a blog administrator.

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  2. It allows them the freedom to make decisions based on their cultural and moral beliefs. This is essential for non-discriminatory health care. Ways to prevent herpes outbreaks

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  3. The post is somewhat a question to the efficacy of homeopathy treatment. But it works on the principple of "Like cures Like" that looks promising more than hypothetical. For example a A substance which can cause symptoms in a healthy person can, in homeopathy's non toxic micro doses, stimulate cure in others suffering with similar symptoms regardless of the cause

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