Wednesday, December 14, 2011

A Real Look: Homeopathy

Before we begin talking about homeopathy, I need to make one quick remark about what we are talking about and what we are not talking about.

Homeopathy is often confused as anything that is natural (herbal medications, etc). This is not true. Homeopathy dates back to the early 1700s and a man named Samuel Hahnemann. The basic principle is that of "like cures like". That is, a substance that causes a symptom in a healthy person will relieve that same symptom in a diseased person. A critical point is that homeopathic remedies are extremely dilute. In fact, homeopaths believe that further dilution (combined with the magical succussion) makes a remedy more potent, not less.

Homeopathy is just plain bad science, and has three strikes against it:

1. It doesn't make sense scientifically.
2. It doesn't work.
3. It kills.

It doesn't make sense scientifically

Homeopaths are deceitful in how they describe their dilutions. They say things like 10X, 200C, 1M. These don't appear to be very dilute, but are in fact so dilute that in most cases none of the original ingredient is even left. For example:

  • A 10X dilution is 1:10. This is a legitimate dilution. The original ingredients are still at a detectable level. This dilution is considered to be a "low potency" homeopathic dilution.
  • A 30C dilution is 1:10030. That's a one followed by 60 zeros. This is a very common homeopathic dilution. However, at this point there are already none of the original ingredients. In fact, to make this dilution you would need only one molecule and a container more than 30,000,000,000 times the size of the Earth.
  • A 200C dilution is 1:100200 . That's a one followed by 400 zeros. Let's put that in perspective: To make this dilution you would need one molecule of the original substance followed by more molecules than exist in the entire universe. But homeopaths don't stop there. Another possible dilution is the "M" dilution.
  • A 1M dilution is 1:1001000 (That's a one followed by 2,000 zeros). I have found homeopathic remedies available at as high as 80M. That's a one followed by 80,000 zeros.

The homeopath's defense
Homeopaths agree that none of the original substance is present in their dilutions. They call upon the magical properties of water memory; the essence of the substance is left in the water. While it is a very "sciencey" sounding explanation, it can't possibly be true. If this type of water memory existed, drinking from any water source would be potentially dangerous (or helpful depending on your ailment), since every water molecule you drink has been in contact with just about every other type of molecule you could imagine. If we attribute the water memory to the specific succussion that homeopaths do the theory still fails; I shake my water bottle as a nervous twitch and I know I'm not the only one.

It doesn't work

I'm a physical chemist. I've studied some very weird things. Maybe homeopathy is just one of those things we can't understand. If it works, then maybe there is something to this water memory idea and we need to change our understanding of the world around us.

The truth doesn't work. I don't mean there aren't groups of people that will risk their reputation, their lives, and even the lives of those they love to defend homeopathy. People take homeopathic remedies and get better. The question is: did they get better because they took the remedy or for some other reason. You are most likely to buy a homeopathic flu remedy1 when you feel the sickest - which is also the time you're most likely to start feeling better. You would have recovered without the sugar pill. On top of this, we are all very susceptible to the placebo effect2. So yes, people take homeopathic remedies and then feel better.

When I say it doesn't work, I mean in a controlled environment when you are studying specifically the question "Does homeopathy work" the answer is no. In study after study homeopathy has been shown to work no better than placebo. Small positive effects have been seen in various studies, but those studies are methodologically flawed in one way or another. Even when these studies are included in a meta-analysis (a study of studies) the results show that homeopathy doesn't work. To quote the conclusion section of that study:
"The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition."
To accent the point that homeopathy doesn't work, there is an offer of $1,000,000 to anyone that can show that homeopathy works. The prize has yet to be claimed.

The homeopath's defense
When confronted with these studies, homeopaths will claim that since homeopathy is not understood by scientists it can't be tested by scientists. This is a logical fallacy (special pleading), but remember the studies aren't testing how homeopathy works. They are looking for any evidence that is has worked and the evidence just isn't there.

Homeopathy kills

If anything I write in this blog will bring controversy, it will be this next subject. It needs to be said, though. Homeopathy kills. Homeopathy kills because it is seen as a viable substitute for real medication when real medication is needed. I really don't care if you want to pay $5 for a box of sugar pills when you have the sniffles because you feel like you get better. I think it's unethical that many homeopathic remedies appear to conceal the fact that they are selling sugar pills. The bigger problem, though, is when homeopathic remedies are given to children in West Africa as the primary treatment for malaria3. But we don't have to look that far from home to find homeopathic remedies that kill. In 2009 the parents of a nine month old baby were charged with manslaughter. The father, a homeopathic physician, ignored a severe case of eczema and instead used only homeopathic remedies. The child died from a bacterial infection that could have been easily treated. This sad story isn't the only example of the dangers of substituting real treatment for sugar pills.

The homeopath's defense
Advocates for homeopathy will claim that homeopathy is superior to allopathic medicine because there are no side effects. The pills are harmless. You could never overdose on a homeopathic remedy. The only claim made by homeopathy that I agree with is there are no side effects - of course as stated before there are no effects either. A favorite quote is one by Mark Twain:
"You may honestly feel grateful that homeopathy survived the attempts of allopaths to destroy it."
Of course, when Mark Twain spoke homeopathy was arguably better than current medical practices. Not because homeopathy was more effective but because doing nothing was better than some of the medical practices of the time (blood-letting, etc).

Now what?

This is the point of the post that I'm supposed to call you to action. Write your congressman, tell your neighbors, etc. I'm not going to do that. In fact, if you have favorite homeopathic remedy that, after reading this, you still want to take before heading to sleep I don't care. I just feel passionate about this subject and it was fun to spend an few hours researching it and writing about it. If you have any comments or questions I'd love to continue a discussion. If you want to argue with me I welcome the debate.

[1] Yes, you can buy it at Walgreen's - and no, they aren't required to tell you you're only buying sugar pills. They can even list something that isn't there as an active ingredient!
[2] Our mind is amazingly efficient at tricking us. This will no doubt be the subject of a later post. 
[3] I don't believe that those involved in the Senya/Tamale Homeopathy Project are acting maliciously or with anything but the best of intentions. I don't think they understand the harm they are almost certainly causing.