Walk down the children’s medicine aisle at any drug store, and you can’t help but encounter all kinds of homeopathic remedies. They are touted as all-natural, great tasting, and non-medicated. And even better, they claim to relieve a variety of symptoms–without any harmful side effects. The packaging makes them sound fantastic. But what’s in the bottle? What exactly does “homeopathic” mean, anyway? It’s actually a very specific term, and one that you should probably understand before you spend any more money on it.
I’ll preface this discussion by saying that homeopathy and science-based medicine differ on a very fundamental level. I’m writing from the perspective of a physician who believes in the ability of science to help us understand how the world works, and to demonstrate which treatments are effective or ineffective; from that perspective, it’s very difficult to reconcile homeopathy. You may have a different perspective, and feel free to disagree with me, but be sure you understand what you’re choosing to believe.
Homeopathy is a field that was developed in the early 1800’s by Samuel Hahnemann, a German physician who had given up his practice because he felt that medicine (as it was practiced at the time) often did more harm than good. In certain instances, I tend to agree with him on that.
My sense of duty would not easily allow me to treat the unknown pathological state of my suffering brethren with these unknown medicines. The thought of becoming in this way a murderer or malefactor towards the life of my fellow human beings was most terrible to me, so terrible and disturbing that I wholly gave up my practice in the first years of my married life.
Hahneman’s hiatus from medicine didn’t last long. He found work translating medical texts into German, and one day happened upon a description of the use of cinchona in the treatment of malaria. He didn’t have malaria, but he decided to try a little cinchona for himself to see what it would do. And he was amazed to discover that the symptoms he experienced were similar to those of patients suffering from malaria. From this experience, and from the knowledge that cinchona was the only known treatment for malaria, he concluded that substances that cause certain symptoms in healthy people can treat those same symptoms in sick people–or, more succinctly, “like cures like.” This became the basis for his theory of homeopathy, which literally means “same suffering.” He went on from there to try many other substances, carefully documenting the unpleasant symptoms they caused.
To be fair, Hahnemann was at the distinct disadvantage of practicing medicine in an era before the germ theory of disease had really taken hold, and certainly before anyone knew what caused malaria. He was dissatisfied with the quality of the current medical system, and he was looking for a better solution. I can’t fault him for his attempt. And cinchona bark really does treat malaria. The modern science-based explanation for this is the bark from the cinchona tree contains quinine, a naturally-occurring compound that both kills the parasite that causes malaria and also happens to treat the pain and fever that accompany the infection. That’s not a bad combination, and quinine is still used on occasion today.
But remember, Hahnemann wasn’t in the business of doing harm, so he couldn’t go around writing prescriptions for a medicine that made people feel like they had malaria. He decided–pretty rationally–that diluting the solution made sense. But (here’s where it gets a little harder for me to believe) the dilution has to be performed in a specific way, called “succussion.” The substance is first mixed with water or alcohol, then diluted in a specific ratio–typically 1:10 or 1:100–with more of the same liquid, striking or vigorously shaking the vial after each step. And unlike conventional medicines, where a higher dose yields a greater response, homeopathic medicines are believed to become more potent with each dilution.
I’m going to back up and review two very important differences between homeopathy and science based medicine. These two principles of homeopathy contradict everything we understand about the physical universe:
- Symptoms are treated not by giving a medicine that counteracts them, but by giving a substance that causes them. For example, if you have a headache and a fever, a homeopath would prescribe treatment with a substance known to cause headaches and fevers (probably without considering the diagnosis of meningitis). If your baby spits up a lot, the homeopathic prescription would be for a substance that causes vomiting.
- The more times you dilute a homeopathic medicine, the more effective it is believed to become. In medicine, we believe exactly the opposite; typically, a medication does more to relieve symptoms if you give a higher dose of the medication. At some point, the maximum dose is limited by undesired side effects (which isn’t a problem with homeopathy because the “active” ingredient no longer exists…I’ll get to that).
Let’s look at a modern example: Hyland’s Kids’ Kit: Homeopathic Medicine Every Parent Needs (their claim, not mine). I’ve linked to it so you can see where I’m getting my information, but please don’t buy it–at least until you finish reading this article. This kit contains 30X preparations of the following homeopathic “medicines”:
- Aconitum Napellus– a very pretty purple flower (seen in the image above) that has been used in the past to poison the tips of spears and execute criminals. It causes quite a few unpleasant symptoms before it kills you in a couple hours by stopping your heart.
- Arnica Montana– a not-quite-so-pretty yellow flower that, if ingested, can cause severe gastrointestinal bleeding.
- Belladonna– a plant that grows little black berries. Eat a couple of them, and you’ll die. Oh, and the leaves are poisonous, too. It’s one of the ingredients in Hyland’s Teething Tablets (a very common homeopathic remedy for teething), and the cause of a major safety concern a few years back.
- Chamomilla– a rather boring-looking white and yellow flower that is far less harmful than the plants above. Often used in herbal teas to promote sleep and treat various types of abdominal problems. In very large amounts, can cause nausea and vomiting.
- Ferrum Phosphoricum– also known as ferric phosphate (FePO4), a naturally occurring mineral–also known as [gasp] a chemical. (I use the term “chemical” ironically here because many people are so afraid of chemicals without realizing that everything–including your baby and her homemade, organic, GMO-free baby food–consists entirely of chemicals.)
- Hepar Sulphuris Calcareum– also known as calcium sulfide (CaS), another chemical. It has a few potential health risks: skin or eye irritation, cough, headache, vomiting, diarrhea, dizziness, muscle cramps, coma, seizures, respiratory depression, and death. Just a few.
So you can see, homeopathic remedies start with some pretty dangerous substances. But again, the preparations are diluted. Highly diluted. So much so, in fact, that there’s none of the original substance present. As I said before, all the ingredients in our example are present in 30X preparations. What that means is that it has been diluted in a 1:10 ratio 30 times. I’m not sure how much of the original substance goes into the first vial, but I doubt it’s very much. I’ll be generous (probably quite generous) and say that it fills 10% of the vial. Here’s what happens when you keep diluting:
- Vial 1: 1:10
- Vial 2: 1:100
- Vial 3: 1:1,000
- Vial 4: 1:10,000 (I’ll skip ahead now…)
- Vial 30: 1:1,000,000,000,000,000,000,000,000,000,000
So if there is to be even one molecule of the original substance in vial number 30 [there’s a lot of math here…divide by Avogadro’s number…look up molar mass of water because it’s been a while…], you would need to use vials that hold about 7,900 gallons each, just to end up with one molecule. And remember, I was being generous. Assuming that the guy who makes these preparations for Hyland’s does his job right (which he sometimes doesn’t), it’s safe to say that none of the ingredients listed on the label are actually present in the little white tablets. But that’s ok, because that’s not how homeopathy works (so they say). There’s some theory about “water memory” and the substance leaving an “imprint” on the water molecules that defies the laws of physics and chemistry…I don’t really get it. Homeopaths don’t understand it either. And they can’t prove it–probably because it doesn’t exist.
So in the end, you’re left with a vial of water or alcohol (with some supposed healing properties) which is then combined with milk powder, sugar, honey, or some other base and marketed to cure your ailments or those of your children. Anecdotally, you’ll hear plenty of stories about how effective homeopathy can be. You probably have a friend who uses it for her baby, or maybe you’ve tried it yourself. The problem with anecdotal evidence is that there’s no way to know if the symptoms got better because of the treatment, or if they would have gone away on their own. The placebo response can be impressive, and without comparing a treatment to placebo, it’s hard to say how effective it truly is. Another consideration is that the “inactive ingredients” in homeopathic medicines may actually be helpful. For example, the honey in homeopathic cough syrup may have some benefit all by itself. Add to that the fact that many symptoms in children are short-lived and would go away even without treatment, and stories about how your friend’s sister’s baby’s colic got better with homeopathic gripe water are pretty much meaningless.
Scientifically speaking, the theory of homeopathy doesn’t make any sense at all, and I have a hard time buying it–although they’d love to sell it to me. And as far as evidence goes, the support for homeopathy is homeo-pathetic; it’s never been shown to be effective…for anything. The limited studies that have made homeopathy look attractive were fraught with methodological flaws–lacking important features like randomization, placebo control, blinding, appropriate sample size, etc.
So as far as being an effective treatment, homeopathy hasn’t really proven itself. But is it dangerous? Probably not directly. As I said before, although the original substances used can be quite dangerous, the preparations are so dilute that it’s quite unlikely that a single molecule of the original substance will make it into the bottle. And while the financial cost isn’t trivial (nearly $3 billion/year in the US), the true danger of homeopathy comes when it replaces proven medical treatments for dangerous diseases. A brief internet search will reveal claims that homeopathy will cure cancer, improve your mood, cure your child’s ADHD, or make your diabetes go away. But by replacing treatments that have been shown to help with these problems, homeopathy can cause significant indirect harm.
Perhaps the best example of this is “homeopathic vaccines.” Also known as “nosodes,” these products are prepared from the bodily fluids (spit, snot, blood, pus, etc.) of diseased humans or animals, and processed in a similar manner to the one I described above until none of the original product remains. Gross, right? But also totally ineffective. And the worst part is that they are marketed as an alternative to “conventional vaccines” which have dramatically reduced the incidence of many significant infections and saved literally millions of lives, with adverse reactions that are incredibly rare. As an aside, it’s interesting that the same crowd that touts homeopathic remedies that are made from poisonous plants and infected bodily fluids will argue against vaccines by listing all the “toxic ingredients” that are present for a clear purpose and in infinitesimally small doses. Ironic.
To be clear, I’m not saying “natural” remedies from plants and herbs can’t be beneficial. Just from the plant belladonna that I discussed above, we’ve derived several important and effective drugs–scopolamine (useful for nausea and motion sickness), hyoscyamine (beneficial for abdominal pain), and atropine (which I’ve used multiple times in the ICU). But when a natural substance is found to have a beneficial effect, it is tested, regulated and produced in a way to ensure that the dose you want is the dose you get–because they can be fatal in excess. The other question about herbal treatments is whether the bottle you purchase actually contains the product on the label. Often it does not. And you can imagine that in homeopathy, where the bottle doesn’t even claim to contain any of the presumably active ingredient, testing and regulating these products would be impossible. Those people who are skeptical of pharmaceutical companies and vaccine manufacturers may want to take a harder look at the alternatives they choose–it seems likely to me that plenty of unscrupulous entrepreneurs could make a fortune selling “homeopathic” products while skipping the complex production process entirely.
When it comes to homeopathy, less is more. None is even better. If you want to use medicine, use real medicine. If you don’t want to use medicine for minor illnesses, don’t–the vast majority of pediatric symptoms go away on their own. Instead of spending your money on this stuff, start saving for your kid’s college. Again, feel free to disagree–but if you choose to give homeopathy a chance, forget everything you just read. It will work better if you believe.
A note about comments: A few readers have expressed displeasure that their comments were not displayed below. Sometimes, when discussing topics like homeopathy (or vaccines), people choose to turn an open and constructive conversation into an opportunity to promote their own agendas. Don’t believe me?
This is the Twitter profile of one of the commenters below–with identifying information removed, because I’m not looking to make it personal. It’s interesting to me to note that this person’s response to the [supposed] benefits of homeopathy is not to advocate for its use, or to warn of the [supposed] dangers of conventional medicine. It’s to heckle those who happen to disagree. I don’t understand.
While I don’t mind people disagreeing with me, I will not tolerate this type of attitude. I will be moderating all comments from this point on, and will delete any comments that I feel to be argumentative, off-topic, baseless, insulting, or otherwise inappropriate. Does this create bias? Absolutely. The same bias that I admitted at the beginning of this post–that I’m a physician looking at the topic with a scientific perspective. There are plenty of websites out there that provide the opposite perspective, and I invite you to visit them. They aren’t hard to find.
I continue to invite constructive comments, sincere questions, and respectful disagreement (please forgive the delay in approving them). But if your purpose is to “generally annoy” me, this isn’t the place.