I was recently prescribed a Boiron topical cream to alleviate a skin rash condition caused by radiation therapy. The box says, “Calendula Cream…Homeopathic Medicine.”
Since this was prescribed by what I would call a reputable medical facility, NOT of the CAM persuasion (St. Vincent’s Hospital in Green Bay and Sturgeon Bay), I was surprised that they would hand homeopathic preparations to patients, especially since the box said, “…uses have not been evaluated by the FDA.” Do hospitals usually ignore the FDA like this?
Then I noticed, in the “drug facts” section of the box, “1X HPUS-10%.” So the active ingredient, Calendula officinalis (marigold flowers) is present at a 1X dilution, i.e., 1 drop in 10 drops of an inert carrier substance.
So is this homeopathic or not? Wouldn’t a 1:10 ratio of active:inactive be much too high for homeopathy (and therefore ineffective)?
Conversely, wouldn’t a 1:10 dilution be acceptable to “standard” medicine? I have some first-aid preps in my medicine cabinet with a strength of only 1%, yet the box doesn’t say it is homeopathic.
Maybe Boiron (maker of many homeopathic products) is adding it to the label to increase sales to the CAM crowd, and is counting on conventional medicine to ignore the label?
It’s a weird sort of grey area. Calendula has been used as a minor topical remedy for a long time, but there’s very little evidence it has any medicinal properties, and none have been evaluated by the FDA.
Of course, as a natural extract that no one can own a patent on, there’s no profit motive for getting it through FDA approval, so if it did work, we might not know because no one is willing to put in the money to seriously study it.
According to wikipedia, there is at least some evidence of effectiveness specifically for radiation dermatitis, the reason you were prescribed it, and it’s in a concentration that could conceivably do something (if there is in fact something it does) so it’s not 100% woo.
I would read “homeopathic” as “folk medicine” in this case, not as “derived from quantum molecular healing crystals”. Might work. Pretty unlikely to be harmful. Probably keeps most patients from complaining about some minor irritation that’s mostly not very treatable.
Thanks, good advice. I was given another preparation (Aquaphor, active ingredient 41%), not labeled homeopathic, as an alternative. Maybe I’ll try one cream on the left side, the other on the right (not a perfect test, but it’s all I can do).
I certainly didn’t want to stir up trouble, but couldn’t help asking both nurses and doctors, individually, if they had an opinion about the box label. It soon became obvious that they had very little knowledge of what homeopathy was or what the dilution concept meant. About all they could tell me was that they heard the term on occasion. None had noticed it on the box.
That is surprising and fascinating. I figured that anyone in medicine would be well acquainted with such crankery, but I suppose the strongest of the cranks avoid actual medical practitioners in the first place.
Essentially, slapping the word “homeopathic” on the label is a way of providing non-homeopathic (i.e., potentially therapeutic) dosages of certain long-used drugs without having to meet the usual FDA standards. During the writing of one of the bills establishing or changing the authority of the FDA to regulate drugs, a senator who was friendly with the homeopathy establishment wrote a loophole into the act. It was intended to protect homeopaths prescribing very low concentrations of medicine but no requirement for low concentration was written into the law. Sorry, I don’t remember the details. The upshot is that any drug listed in the Homeopathic Pharmacopoeia back then has never been subject to the same sort of scrutiny as other drugs. This is true even when the drugs are provided in much stronger concentrations than practicing homeopaths would prescribe.
When I was in med school (1979-83) we got some firm lectures on what was considered quackery, focusing a lot on the nonsensical basis of both chiropractic and homeopathic theory. However, as ‘alternative’ medicine became embraced by more and more patients, I’m told (hopefully falsely) that such lectures were were de-emphasized. A pity if true. It should have resulted in the opposite.
This is a bit strange, a quick google does show your interpretation is correct, and “1X HPUS-10%.” is not a “homoepathic” remedy per se, its just a 10% Calendula cream:
Why even say that? Herbal medicines are not the same as Homeopathic ones, unlike homeopathy, while there is a lot of made up quackery associated with herbal medicines, there are also some very effective treatments.
Why not just say 10% Calendula cream (or 10g per 100g)
I heard the same thing. IMHO that is what is happening with the Ops’ cream.
Here is a cite i found:
The treatment options available for the management of most types of wounds are both diverse and contentious. One agent that has been utilized for centuries for the treatment of dermatological disorders and possesses a number of pharmacological actions that are conducive to wound healing is Calendula officinalis, or pot marigold. To assess the effect of Calendula on wound healing, a systematic review of the literature was conducted. The search was limited to randomized controlled trials that used topically administered monopreparations of Calendula officinalis for wounds of any type. Although 6 trials were identified, only 1 trial was of good quality; hence, the statistical pooling of results was not appropriate. Therefore, a narrative review of these studies was conducted indicating that there is only weak evidence to support the topical administration of Calendula in acute and chronic wounds. Undoubtedly, further investigation is needed to establish whether Calendula has a place in mainstream wound care.
Thanks for joining the discussion, QtM. I was hoping you would spot my thread.
The senator mentioned by bibliophage was probably Orin Hatch, from Utah. He was most responsible for allowing anything labelled “supplements” to be sold without FDA approval.
I don’t want my docs, nurses, and assistants to get mad at me, so I’m not pressing the issue, but I am appalled at their apparent lack of knowledge of the crank or at least questionable medical practice field. I suppose they have more than enough to keep them busy, and it’s just not a high-priority item.
Agreed. At all levels we should be rejecting this stuff. A few years ago when our kid had a cough, a friend brought some cough syrup to us. Homeopathic. Not her fault. She just failed to read the fine print. The problem is that the designers make the package look almost identical to the real stuff and the damn drug store stocks it on the shelf next to the actual medicine.
This is particularly heinous in my mind. Pharmacies will mix homeopathic junk right in with OTC meds. Sadly, too much OTC stuff is less than helpful too, but most OTC has some testing behind it showing it is safe and possibly effective.
Found it. The act I was referring to was the Federal Food, Drug, and Cosmetic Act (1938) and the senator who inserted the loophole was Royal S. Copeland who was himself a homeopath. Under the act, homeopathic medicines are not entirely unregulated, but subject to a lesser degree of regulation. Among other things, the act says
It’s not a lack of knowledge, they know full well about those fields. Professional standards keep them from badmouthing them. As long as what you are suggesting you are going to do isn’t known to be harmful they don’t want to risk their therapeutic relationship with you by appearing confrontational or disparaging. It would be very different if you were saying you were quitting radiation treatments in favor of local applications of that ointment. I’m a nurse, with years of wound-healing care under my belt: I’d advise going with the Aquaphor.
All I can say is that in my internationally-distributed cancer support group, all of us had recommendations for the Boiron calendula topical no matter what the bent of our medical centers. I found it much more helpful than Aquaphor and it soothed a lot of discomfort. YMMV.
I didn’t like Aquaphor because it stuck really well, to the point where I use it on my rear end when have (fortunately) rare diarrhea issues. It DOES.NOT.WASH.OFF. It has to wear off!
My rad onc recommended 1% hydrocortisone, and that worked well enough for me.
If a reputable practice is recommending calendula for radiation-affected skin, don’t hesitate to use it. (I’m a pharmacist, BTW.) I personally don’t like seeing homeopathic remedies shelved next to tried-and-true ones myself.
A number of medical centers along with individual practitioners have begun marketing woo including homeopathy, because it’s perceived by patients as “holistic” and makes more money for hospitals and MDs that push it.
A 1X product is not homeopathic and obviously its users would far more likely be susceptible to side effects than with a 30X dilution lacking a single molecule of “active” substance. I doubt the FDA would view slapping a homeopathic label on a non-homeopathic product as protecting the manufacturer from agency oversight.
“First person experience” is another way of saying anecdotes. A decent starting point for investigation, but not a reliable way of determining if a drug works.
Unlike QtM, I don’t recall any med school lectures about woo, whether in pharmacology class or other settings. At a minimum, med students need training in how to spot worthless hype, whether for woo meds or pharmaceuticals.
Sometimes when you get prescription generics, they use the manufacturer who has product available. In most cases people don’t care (I’ve only had one where one manufacturer was clearly superior). I wonder if this is the case that in this particular instance, a source was this non-homeopathic product labeled as such?
Though medical professionals aren’t always the most immune to woo.
CVS banned cigarettes, a health success! No movement on this crap, I spend 15 minutes(!) once trying to figure out which children’s cough syrup actually works. I went with Zarbee’s which has “natural” sounding language but didn’t seem to have dilution info.
Part of the sticking power of homeopathy I think is that people don’t know what it is (magic water) and think it’s the same as naturopathy, which at least makes logical sense even if it becomes allopathy eventually if it works.