What Is Homeopathy? And Why Shouldn't Doctors Recommend It To Their Patients?

Snake Oil
Homeopathy is nothing but smoke and mirrors. Photo Courtesy of Shutterstock

It’s a debate that’s been raging on since Dr. Samuel Hahnemann, a 19th century German physician, first coined the term in 1807: Should health care professionals recommend homeopathy to their patients?

Earlier this Tuesday, the debate was renewed once again within the pages of the British Journal of Medicine, as Dr. Peter Fisher, Director of Research at the Royal London Hospital for Integrated Medicine, took on Dr. Edzard Ernst, Emeritus Professor at the University of Exeter.

As defined by Fisher, homeopathy, a type of complementary and alternative medicine (CAM), is “part of a family of toxicological and pharmacological phenomena” that are “characterised by secondary, reverse, or paradoxical reactions to drugs or toxins as a function of dose or time or both.” More plainly, it is the central theory that all illness can be treated by identifying the symptoms of a sufferer and offering them a diluted solution of a substance, usually obtained from "natural" sources like plants and minerals, that is known to cause those exact same symptoms in larger doses — a philosophy summarized by the mantra of “like cures like”. The diluted solution is often placed onto an otherwise inactive sugar pill.   

As Ernst repeatedly emphasizes though, such a theory would require the very laws of nature to be invalidated, since the “active” substance utilized in a homeopathic treatment is usually diluted to the point of nonexistence.

How diluted? Well, according to the math crunched by a 2012 Popular Science article, a person would need to ingest 10,380 pills of the popular homeopathic flu remedy Oscillococcinum, processed from duck liver, in order to ingest one single molecule of the original substance. Should you be curious enough to try that experiment out for yourself, many homeopathic treatments can be found over the counter in major pharmacy chains like CVS.

Ernst concludes that “homeopathy’s mode of action has no rational explanations.” For his part, Fisher offers up speculative research on nanoparticles which he even admits is of “little clinical relevance.”

Stepping in front of the impossible elephant in the room, Fisher makes the case that while we might not understand the physics of homeopathy, there is, regardless, some evidence showing that it works. He cites a review commissioned by the Swiss federal government that concluded homeopathy is “probably” useful in the treatment of upper respiratory tract infections and allergies, as well as research showing that general practitioners who use both homeopathy and conventional medicine in their practice have better patient outcomes.

Ernst, on the other hand, fully acknowledges that there have been published studies which support homeopathy’s effectiveness — weak, poorly conducted, and easily biased studies.

“[U]ncontrolled studies almost invariably yield positive findings,” he wrote, ”whereas this is not true for the most rigorous of the 250 or so controlled clinical trials.” To Ernst, once a CAM practitioner himself, that reality only points to one possibility: that “highly dilute homeopathic remedies are indistinguishable from placebos.”

It’s a conclusion most recently shored up by a review of more than 1,800 studies conducted by the National Health and Medical Research Council (NHMRC) in Australia this past March. “Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective,” they wrote.

Unlike placebos though, homeopathic remedies are given under the presumption that they will be useful, possibly scaring patients away from more conventional treatments, such as immunizations. It’s a scenario that Ernst says has left some people dead, and deprived others of the proper health care they deserve.

“[C]linicians administering treatments that are effective with compassion and empathy will also generate a placebo response -- with the additional benefit of a specific therapeutic response,” he wrote. And it will keep them away from medical hucksters who have advocated homeopathy for illnesses like HIV, malaria and, as Ernst references, even Ebola.

While Ernst doesn’t wish to strip away the ability for patients to choose the treatment options that they want, he does emphasize the need for medical professionals to be honest about homeopathy’s track record. “Therefore, it seems unreasonable, even unethical, for health care professionals to recommend its use,” he concluded.

Couldn’t say it better myself.


Source: Ernst E, Fisher P. Should doctors recommend homeopathy? BMJ. 2015.

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