Homeopathy

Eleanor Bates
Tinsley Harrison Society
November 8, 2005

Complementary and
Alternative Medicine

Traditional Alternative
Medicine

Acupuncture
Ayurveda
Homeopathy
Naturopathy
Chinese/Oriental

Mind-Body Interventions

Biologically Based
Therapies

Dietary Supplements
Herbal Medicine

Manipulative and BodyBased Methods

Chiropractics
Massage

Cognitive Behavioral Therapy

Meditation
Energy Therapies
Biofeedback
Electromagnetic Therapy
Hypnosis
Prayer
Art, Music, Dance

Complementary and
Alternative Medicine

36% of adults are using some form

of CAM
CAM is used greater by
Women
People with higher educational levels
People who have been hospitalized in
the past year
Former smokers

Regulation

The National Center for

Complementary and Alternative
Medicine (NCCAM) is the Federal
Government's lead agency for
scientific research on CAM.
Homeopathy is regulated by the US
Food and Drug Administration (FDA).

Required to list indications, ingredients,

dilutions, and instructions for safe use

History of Homeopathy

Late 1700s developed in Germany

by Samuel Hahnemann
1825 Introduced in the US by
Hans Burch Gram
1835 1st homeopathic medical college
Allentown, Pennsylvania
By the turn of the 20th century, 8 % of all
American medical practitioners were
homeopaths, and there were 20 homeopathic
medical colleges and more than 100 homeopathic
hospitals in the United States.
Negatively affected by medical advances,
including recognition of the mechanisms of
disease and antiseptic techniques

Homeopathy

Homeo (similar) and pathos (suffering)

Principle of Similars: Any substance that

can create symptoms in a healthy person can
be used to treat similar symptoms in a sick
person.

Principle of Potentization: Diluting a

substance, with vigorous shaking at each
step of dilution, makes the remedy more, not
less, effective by extracting the vital essence
of the substance.

Mechanism

Water molecules
are thought to form
clusters that may
be unique to the
original substance
that was dissolved.
Samal and
Geckeler
discovered an
inverse
relationship
between the
aggregate size and
concentration of
the solutes.

On dilution, spherical
clusters appeared,
which were seen to
aggregate in steps
resulting in a size
increase with
decreasing
concentration.

Samal S and Geckeler KE. Chem Commun 2001; 2224-25.

Treatment

Mostly derived from natural substances that

come from plants, minerals, or animals
Used to treat acute and chronic illnesses, as
well as to prevent diseases

Used most often to treat arthritis, asthma, colds,

flu, and allergies

The choice of medicine is based on a persons

total symptom picture.

Homeopathic Pharmacopoeia of the United

States contains guidelines for homeopathic
remedies.

Treatment

Follow-up on problem in 2-6 weeks after

start of the treatment
Patients may experience homeopathic
aggravation.
Doses are repeated as necessary, and
treatment is discontinued upon resolution of
the problem.
Remedies may be changed as the condition
and the associated symptoms change.
Changes to diet and lifestyle are often
recommended, as well.

Safety

Endrezzi et al. studied adverse drug

events related to homeopathic encounters
in 335 follow-up visits in 181 patients.
9 (2.68%) adverse reactions were
reported.
No medical therapy was required to treat
any of the adverse events.
Adverse events exist, but are rare and not
severe.
Endrizzi C et al. Homeopathy 2005; 94: 233-240.

Does it Work?
Results of controlled trials
have been contradictory.

Not placebo

Witt et al. compared conventional treatment v

homeopathy.
Patient assessment:
Greater improvement
after homeopathic versus
conventional treatment

Physician assessment:
More favorable for
children who had
received homeopathic
treatment

Witt C et al. Comp Ther Med 2005; 13: 79-86.

Quality of life:
Physical component score increased in
homeopathically treated patients
Mental component no significant difference

Witt C et al. Comp Ther Med 2005; 13: 79-86.

Not placebo

89 studies

26 studies of higher
quality

OR 2.45 (2.05-2.93)
in favor of
homeopathy

OR 1.66 (1.33-2.08)

Homeopathy not
completely due to
placebo
Insufficient evidence
that any single type
of homeopathic
treatment is clearly
effective in any one
clinical condition

Not placebo

Linde et al. revisited their initial study

(1997).
Higher quality studies tended to yield less
positive results.

All studies: OR 2.45 (2.05-2.93)

Jadad > 3: OR 1.81(1.41-2.32) 28% decrease
IVS > 5: OR 1.97 (1.50-2.59) 22% decrease
Jadad > 3 AND IVS > 5: OR 1.72 30%
decrease

likely that our meta-analysis at least

overestimated the effects of homeopathic
treatments.
Linde K et al. J Clin Epidemiol 1999; 52; 631-36.

Linde K et al. J Clin Epidemiol 1999; 52; 631-36.

Placebo

Shang et al. compared trials of

homeopathy with those of conventional
medicine and estimated treatment effects.
They found no convincing evidence that
homeopathy was superior to placebo

Whereas, for conventional medicine, a

significant difference was found.

OR 0.88 (0.65-1.19)

OR 0.58 (0.39-0.85)

Clinical effects of homeopathy are placebo

effects.
Shang A et al. Lancet 2005; 366: 726-32.

Conclusions

Although trials of homeopathic treatment

have not yet provided a definitive answer,
there are many reports of clinical benefit.
In addition, dismissal of homeopathy by
practicing clinicians may increase the
likelihood that patients will not
communicate about integrative remedies.
If homeopathy appears to be helpful and
safe, then scientifically valid explanations
or proofs of this alternative system of
medicine may not be necessary.

Resources

http://nccam.nih.gov/
Endrizzi C, Rossi E, Crudeli L, Garibaldi D. Harm in homeopathy:
Aggravations, adverse drug events or medication errors? Homeopathy
2005; 94: 233-240.
Frye, JC. Herbal and homeopathic medicine: Understanding the
difference. Seminars in Integrative Medicine 2003; 1: 158-66.
Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB.
Are the clinical effects of homeopathy placebo effects? A meta-analysis of
placebo-controlled trials. Lancet 1997; 350: 834-43.
Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jomas WB. Impact
of study quality on outcome in placebo-controlled trials of homeopathy. J
Clin Epidemiol 1999; 52; 631-36.
Samal S and Geckeler KE. Unexpected solute aggregation in water on
dilution. Chem Commun 2001; 2224-25.
Shang A, Huwiler-Mntener K, Nartey L, Jni P, Drig S, Sterne JAC,
Pewsner D, Egger M. Are the clinical effects of homeopathy placebo
effects? Comparitive study of placebo-controlled trials of homeopathy and
allopathy. Lancet 2005; 366: 726-32.
Vickers A and Zollman C. ABC of complementary medicine: Homeopathy.
BMJ 1999; 319: 1115-18.
Witt C, Keil T, Dagmar S, Roll S, Vance W, Wegscheider K, Willich SN.
Outcome and costs of homeopathic and conventional treatment
strategies: A comparative cohort study in patients with chronic disorders.
Comp Ther Med 2005; 13: 79-86.