Dr. Andy

Reflections on medicine and biology among other things

Wednesday, September 14, 2005

Homeopathy

Shockingly, a systematic review in the August 27 Lancet concludes that homeopathy is probably worthless:
Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.
(no free full text but citation is Shang et al. Lancet 2005 366:726)

As an accompanying editorial notes, what is surprising is not the finding, but that we are still having this debate. Of course with a President (and, worse, a Senate majority leader who is both a presidential hopeful and a transplant surgeon) advocating teaching of intelligent design, how much can we expect.

As Vandenbroucke notes in his accompanying editorial (page 691 of same issue):
In 1846, John Forbes compared homoeopathy and allopathy, mostly informally, but also with a few shrewd experiments. He found the results of homoeopathy for certain ailments as good as those of his own treatments. Because he considered the theory of increased potency by greater dilutions “an outrage to human reason”, and therefore any effect of homoeopathy impossible, he proposed that his findings should lead to introspection about the effectiveness of the allopathic medicine of his time.
Unfortunately more than 15o year laters, homeopathy is a billion dollar business. I've always said the great weakness of economics was its assumption of rationality, and the dollars spent on "alternative" health care are about the best refutation of that assumption I can muster.

3 Comments:

At 6:54 PM, Blogger Dymphna said...

The money spent on alternative medicine has more than one cause, but I'll outline my own experience so that perhaps you can some compassion for those who choose not to show up at the local doc.

It is harder and harder to get good, consistent medical care in which some of the cures are not as bad as the disease.

Alternative meds are also cheaper and often less harmful. For years, doctors poo-poohed B6, C and folate for depression. Now NIMH is recommending it -- or so says my psychopharmacologist who rolled his eyes when I first started this regimen some years ago.

Feverfew has been shown in numerous studies in England (double blind blah blah) to be a worthy contender in preventing migraine headaches.

I don't know if homeopathy is a placebo or not but I do know we need more placebos while we continue to unravel the mysteries of human illness.

MSM (Main Stream Medicine) is not always my first choice. Where bacterial infections are concerned, you bet. But for more chronic conditions, I'll continue to experiment. I've had more success that way than I have with MSM tx and rx.

I remember telling my PCP 27 years ago about homocysteine (I'd read about in Atlantic Monthly for heavens' sake) and being dismissed. Got a new PCP...

I was told for years my ulcers were psychogenic until Dr. Marshall came along with his protocol. Remember how ridiculed he was? I was lucky: I got to be in one of his first US studies and haven't had an ulcer since then. BTW, the endoscopy was negative for ulcers but the pain was unreal and my blood tested positive for Helicobacter Pylori.

Having had my share of run-ins with docs, I choose carefully among them. My current PCP is an excellent diagnostician and I really like her. But I go my own way in my tx of fibromyalgia, using a protocol developed by an endocrinologist in CA. It works -- pain is gone using OTC drugs. Before that, being referred to a rheumatologist who prescribed Ultram and assured me is was not addictive, but who otherwise had nothing to offer me was a large waste of time and money.

Homeopathy wouldn't be so widely used if people had better options. But they don't. And for the MSM to look down on them for choosing such remedies is unfortunate and does nothing to improve communication.

 
At 8:19 PM, Blogger Dr. Andy said...

Thanks for your comment.

We are partially going to have to agree to disagree.

I think that you bring up a good point that what we might call mainstream medicine is often wrong. But its advantage is that it has a mechanism to correct its errors. In homeopathy, etc. any errors just continue since there is no way to identify and correct them. I've blogged before that I think one thing a lot of alternative therapies give is time with the practitioner, something mainstream medicine often can't offer

 
At 12:47 PM, Anonymous Anonymous said...

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