homeopathy

[JillGat]

The National Institute of Health (NIH)has a branch that tests “alternative” medicines.

[elelle]

It was an issue last year at the aforementioned medicinal herbal conference that not one herbal study proposed by any of the long practicing herbalists, many who are graduates of the Medical Herbalist program in Exeter, England, was accepted by the NIH. Herbalists are trying hard to get funding for scientific studies, but there is a barrier. An ethnobotanist I greatly admire is Dr. James Duke; someone with all the proper scientific credentials and a 30 year career with the USDA, who has butted heads with the NIH for many years on proper funding of herbal studies. He’s a scientist first, but the politics of funding have left him with less than sweet words for the system. Perhaps in the past two years it’s changed. I’ll check.

[system]

Originally posted by jab1:
You’re right and I apologize to Sue right now. (I have not yet read anything below Melin’s post.)

Thank-you, Jack. We all say things we later regret. This is water under the bridge, and forgotten.

• Sue

[system]

Brief review:

slythe posted:

This is allopathic medicine vs. naturopathic medicine. This is REAL medicine that is testable and tested vs. FAKE medicine that is at best an unknown quantity, and at worst a danger to people.

I answered:

Since naturopathic medicine has been practiced for thousands of years, I fail to see that it is an unknown quantity. Of unproven efficacy, yes, I’ll agree.

David B chose to take my first sentence out of context, and criticize it thusly:

Sue said:

Since naturopathic medicine has been practiced for thousands of years, I fail to see that it is an unknown quantity.

Astrology has been practiced for thousands of years. So what?

So what? So astrology is not an unknown quantity, either, is what. Being a known quantity, by virtue of being around for thousands of years, simply means that knowledge about it exists. It does not mean that the theories behind the body of knowledge are validated. It does not mean that the applications of that knowledge achieve the desired effect, but you know, I believe my statement about naturopathic medicine being of unproven efficacy acknowledges that (when is not omitted). It does not mean that everyone possesses that knowledge; it simply means that knowledge about naturopathic medicine is out there for anyone to acquire, should they choose to invest the time & effort to do so.

If you want an example of an unknown quantity that is, perhaps, being incorporated into allopathic practice a little too fast, I would suggest gene therapy might be a candidate. Here we have an almost opposite picture compared with alternative modalities. We have extensive knowledge about the effects of a defective gene, and extensive technological know-how about how to get normal copies of that gene into cells, but no observational experience about unintended effects of the the gene being added to cells, or of the technology/viruses used to do this. At least one death appears directly attributable to gene therapy; sloppy work, omitted safety checks, and poor documentation created a major scare recently in which it was feared that dozens of children were exposed to HIV & Hepatitis C from their participation in gene therapy trials.

I also posted:

The primary danger from alternative medicine comes when it is practiced in back alleys (like abortions 30 years ago), or when the medical establishment becomes so confrontational about it that patients are reluctant to share information about herbal or homeopathic remedies they are taking.

David responded:

I don’t think that is the primary danger. The primary danger is that people will actually believe this crap and use it instead of actual medicine.

This is, of course, a non-issue in Germany & other countries in which a false dichotomy does not exist which forces patients to choose between allopathic & alternative medicines. When patients are able to talk to their physicians about all of their concerns & receive support & advice when they do seek to use alternative modalities, they are much more more likely to seek help from their physicians FIRST when new problems develop.

Or that they will use it thinking it has no side effects, and even if they tell their doctors their doctors won’t know about any side effects because there haven’t been any decent scientific studies done (obviously, we’re moving away from homeopathy and into “herbals” here, since homeopathy can’t have side effects because it has no effect of any type). The last “REALLity Check” column (a media review column) I wrote for our newsletter discussed a number of recent news items dealing with herbals. There were the high levels of PCBs in shark liver oil, the cancer patients who use herbals and have them interfere with the cancer treatments, the finding that St. John’s Wort interferes with anti-rejection drugs for heart transplant patients and anti-HIV drugs as well. Since then I found several other articles about other similar problems (don’t have them handy).

Maybe you consider all of this a symptom of the “back room” problem. I consider it a symptom of unscientific practices.

The solution, of course, is not to label practitioners of alternative modalities as frauds, or to label people who seek help from them as fools, but to find ways to fund studies to answer these unresolved issues.

• Sue

[system]

elelle posts:

The FDA has been trying to reach a system of quality control for herbal substances. The biggest hurdle is the fact that since herbals are unpatentable, the expensive process of testing cannot be recouped by a manufacturer. To my mind, the answer would be to institute a less expensive, but no less rigorous, set of standards.

Loren Pechtal responds to this:

How could you maintain the rigorousness of current testing and yet lower the cost to something that could be supported from the herbal community???

One concept would be to power* these studies for safety only. (*power here means including enough subjects to have a 95% or better chance of finding a difference if one truly exists. It would take many more patients and many more $'s to perform good quality efficacy studies) Additionally, since these products are already in widespread use, the current Phase I/II/III system in place for pharmaceuticals could reasonably be consolidated into a single phase.

elelle adds:

As to the efficacy of herbal substances, there is now a huge boom in research in the United States. Many scientific studies have already been done in Germany, resulting in the Commission E Monographs, available in English. As to why German science isn’t accepted in the US, perhaps Sue can elucidate.

Sorry. I know the science. This is politics…

elelle continues:

The Center for the Study of Natural Products is a recent addition to the University of Mississippi, and is doing hardcore research, at the cellular level, of medicinal herbs. If they don’t have any potential, I doubt this would have been undertaken. The staff pharmacognocists also do fieldwork with “folk” herbalists in order to gain knowledge and direction of use.

I think that we are at a point in time when healing treatments outside the current structure are being integrated. If an herb has had an effective use, we can now analyze and find out why it works. This technology wasn’t available when the Big Split between synthetic and natural substances happened. We now have the means to begin an understanding, and hopefully can utilize it in order to provide the best available treatment for the ills that plague us all.

Thanks for the information, elelle. I’m really glad to hear that some serious studies are in the pipeline.

• Sue

[Camilla]

I love a good attack on nonsense as much as the next cynical bastard, but I wish people wouldn’t waste so much time on the implausibility of homeopathy. Water with memory? Of course it’s implausible. But believers can and will go on and on about how it is only implausible from “your narrow little viewpoint” or something to that effect. I prefer good, solid, scientific tests. Try it scientifically. Prove to all, believers and non, that homeopathic concoctions are no more effective than water administered with equal aplomb. Then make sure the government treats it like any other proven quackery should be treated.

I also love the story Paul Lee told about the double-blind experiment conducted secretly by pharmacy employees in Denmark. I just hope it doesn’t give any ideas to proponents of homeopathy or other forms of faith healing. Substituting water for water is fine, and I’d like to see it tried with holy water, too. But I wouldn’t want anyone killed by people substituting, for example, sugar tablets and prayer for someone’s very real and effective heart medication.

By the way, many moons ago I was thumbing through the ads in the back of a men’s porn magazine and was quite amused to see several “aphrodisiacs” advertised with lines like “Genuine Placebo!” and “Experience the Placebo Effect!” Maybe that’s how we should label homeopathic medicines.

[David_B]

Several things:

1. We have obviously moved away from homeopathy and into a more general realm of alternative medicine. Does anybody here think homeopathy works? If not, should we take this discussion elsewhere? (Not a big deal, just wondering.)

2. Elelle – While the FDA may be trying to do some things with herbals, the main problem is that Congress took away their power to properly deal with them (and other “supplements”) because of the vitamin industry lobby. Funny how they have enough money to bribe Congress into giving them special dispensation, but don’t have enough money for proper testing. (Yes, I know, lots of other groups bribe Congress too – in that they are not alone.)

3. Jill said:

The National Institute of Health (NIH)has a branch that tests “alternative” medicines.

And if only they would do it properly, I’d be all for it (in fact, when it was created, I was all for it, in the hopes it would be done right). But the first director of the Office of Alt. Med. resigned because of pressure to come up with positive things to say about alt. med. (instead of sticking to the science). The current director throws away science willy-nilly in pursuit of alt. med. I’m sure most of you heard about their statement on acupuncture. Well, it’s quoted like hell by the media, but the problem is that it wasn’t science. I won’t hash through all the details again here, but instead will post a link to an article I wrote about it at the time it happened. Note the way they spent time at the conference criticizing the very bases of science that they should be trying to use to prove their methods!
http://www.reall.org/newsletter/v05/n11/reallity-check.html

[David_B]

Whoops. Forgot number 4:

Sue said:

This is, of course, a non-issue in Germany & other countries in which a false dichotomy does not exist which forces patients to choose between allopathic & alternative medicines.

It’s not a “false dichotomy.” As the retired editor of (I think) JAMA said, (I’m paraphrasing 'cus I don’t have the exact quote handy): There’s no such thing as alternative medicine. There’s only medicine that works and medicine that doesn’t.

Homeopathy doesn’t. Some herbs might, but we need proper scientific studies to find out. The placebo effect, without a doubt, works and should be further studied. Hand-waving about how science might not be able to be applied in certain alt. med. areas doesn’t work.

[JillGat]

Originally posted by elelle:
**It was an issue last year at the aforementioned medicinal herbal conference that not one herbal study proposed by any of the long practicing herbalists, many who are graduates of the Medical Herbalist program in Exeter, England, was accepted by the NIH. Herbalists are trying hard to get funding for scientific studies, but there is a barrier. An ethnobotanist I greatly admire is Dr. James Duke; someone with all the proper scientific credentials and a 30 year career with the USDA, who has butted heads with the NIH for many years on proper funding of herbal studies. He’s a scientist first, but the politics of funding have left him with less than sweet words for the system. Perhaps in the past two years it’s changed. I’ll check. **

It’s really important that herbal remedies be thoroughly tested - not only to find out how they work and if they are effective, but also to discover contra-indications and interactions with other drugs. We now have signs in our HIV clinics, advising patients to let their doctors know if they are taking any complementary remedies. It was recently discovered that St. John’s Wort can reduce the effectiveness of Crixivan, a commonly used HIV drug, by 50%. This is enough for drug resistance to occur!

Jill

[JillGat]

[[The current director throws away science willy-nilly in pursuit of alt. med. I’m sure most of you heard about their statement on acupuncture. Well, it’s quoted like hell by the media, but the problem is that it wasn’t science.]]

Well, Cecil has a column coming out about acupuncture in a couple of weeks, so this should be fun.
Jill

[jab1]

Cecil Adams vs. acupuncture. Wish I’d asked that one.

---

When all else fails, ask Cecil.

[JillGat]

You already asked a great one, Jab. It will be online next week.
Jill

[David_B]

Let’s see. What other quack therapies can we ask Cecil about?

Aromatherapy? That one really stinks.

Old-fashioned chiropractic? That’s sure not all it’s cracked up to be.

Ear candling? I’ve been hearing a lot about that.

Faith healing? Believe it or not, they still rake in the dough.

Iridology? I’ve been seeing references to that lately.

Etc.

[Irishman]

Camilla stated:

I prefer good, solid, scientific tests. Try it scientifically. Prove to all, believers and non, that homeopathic concoctions are no more effective than water administered with equal aplomb. Then make sure the government treats it like any other proven quackery should be treated.

While I applaud your support of scientific evidence to prove a point, you have this backwards. It is not up to science to show homeopathetic ( :)) is not real by clinical trials. It is up to the claimants to prove that it does have an effect. Though I suppose one could run the tests with the intention of showing clinically it doesn’t work by “trying to prove it”. The point is the people who claim it works have the burden to prove that it does. The people who don’t accept that it works are fine to point to well-understood scientific principles that run counter to the possible effectivity, and use that as a basis for non-acceptance without further proof. They have scientific evidence - the laws of chemistry (concentration, molarity, etc).

David B asked:

1. We have obviously moved away from homeopathy and into a more general realm of alternative medicine. Does anybody here think homeopathy works? If not, should we take this discussion elsewhere? (Not a big deal, just wondering.)

It does seem this thread might be better suited to GD.

Ear candling? I’ve been hearing a lot about that.

Psssst. Funny, but http://www.straightdope.com/columns/950310.html http://www.straightdope.com/columns/950421.html

[David_B]

I was waiting for a prescription in a drug store the other day, and came across a pamphlet for homeopathic remedies. I wanted to share a little bit with everybody.

“Unlike most homeopathic tablets, which have the medication sprayed on the surface where it can easily be rubbed off affecting the efficacy of the dose you take, XXXXX’s tablets are manufactured using a state-of-the-art production process in whic the medication permeates the entire tablet, insuring that you receive the entire dosage.”

Hmmm. Wouldn’t you want to receive a lesser dosage, so it would be more powerful, or something? And it’s great to hear they have a state-of-the-art system for making sugar pills.

They also have a section labeled, “About Homeopathy” – among the things they say there are: “Homeopathy is founded on the Law of Similars. This law is credited to Hippocrates, the Father of Western Medicine, and is in use today in conventional (allopathic) medicine.”

Excuse me? I have never heard the Law of Similars associated with Hippocrates. But even if it was (after all, Hioppocrates lived a long time ago), I want to know where they get this bullshit about it being used in conventional medicine today. If it were in use in conventional medicine, why would we need to have homeopathy?

Interestingly, in that same section, they talk about how conventional non-prescription medicines “have helped you by masking the symptoms of your illness to make you feel better, but they have not helped to restore your body to its normal, healthy balance.” But then all of their homeopathic remedies note that they are “For the temporary relief of” various symptoms that go along with cold, flu, insomnia, or whatever. Hmmm. If it’s supposed to be putting your body back in balance, why is it only for temporary relief? Sounds like masking the symptoms to me… And, of course, unless they’re claiming this stuff can kill viruses, I’d love to know how it helps against colds, etc.

Oh, and of course it touts its lack of side effects, which, as I’ve already noted earlier in this thread, isn’t terribly surprising because it doesn’t have any effects at all!

[JillGat]

I’m keeping this thread here, because others who have read the column on Homeopathy will start a new one if I move this. There is a column on acupuncture coming out soon, too, and a similar discussion will come out of that one.
Jill

[Icerigger]

I have an idea for a new product, “Homeopathic Gasoline.” With the current increase in oil prices this may be our salvation. Think of it, 1000:1 dilutions common in many homeopathic “remedies” could make a gallon of gas last all year. I can’t wait to try it in my car. I will report the results!

[David_B]

Sorry, Jill, didn’t mean to imply this thread should be moved – just that if others wanted to debate alt. med. in general, we might be taking this thread off on a tangent. Then again, there really don’t seem to be any folks here who are interested in defending homeopathy (though I got an e-mail from somebody who saw this thread and called me a “bigot” and said I was “ignorant” for pointing out the huge problems with homeopathy.

The e-mail also said the writer had “seen it work countless times.” As usual with alt. med. promoters, he doesn’t seem to understand that the only way to investigate this type of thing is with double-blind scientific studies, not anecdotal accounts of “Gee, it worked for my Aunt Martha!”

But I guess this person would rather send e-mails to complain than try to defend their claims on the Message Board.

[JillGat]

[[But I guess this person would rather send e-mails to complain than try to defend their claims on the Message Board.]]

I am sorry that most proponents of homeopathy don’t feel comfortable entering - or continuing to contribute to - this debate. There must be some out there who believe that there are other ways to identify the efficacy of medicines besides case/control studies, and other scientific methods and can articulate their rationale. I’m hoping they’ll pipe up when we take on acupuncture.

[David_B]

Jill said:

I am sorry that most proponents of homeopathy don’t feel comfortable entering - or continuing to contribute to - this debate.

Honestly, I don’t know that it’s a matter of them not feeling comfortable. It’s just easier for them. Think about it – the guy sends me a nasty e-mail calling me a bigot for not believing in homeopathy. If he did that here, I’d have pointed out that bigotry is a ridiculous accusation in this case, and explain exactly why. Then I’d point out that his anecdotal accounts don’t mean much because of the placebo effect, etc. Then I’d ask him to back up his claims. All in all, we would expect him to prove what he says. I’ve learned through many varied experiences that some people just can’t handle that.

There must be some out there who believe that there are other ways to identify the efficacy of medicines besides case/control studies, and other scientific methods and can articulate their rationale. I’m hoping they’ll pipe up when we take on acupuncture.

I wouldn’t hold my breath if I were you. I predict a similar response to this. Oh, and they will cite the NIH/OAM report about how wonderful acupuncture is, and then ignore my follow-up pointing out all the problems with said report. So say my psychic powers.