Homeopathy: Extraordinary Claims And Excuses

February 7, 2011 at 7:20 pm (Homeopathy) (, , , , , , , , , , )

Extraordinary claims require extraordinary evidence. Homeopathy makes perhaps the most extraordinary claims of any branch of alternative medicine, yet the extraordinary evidence required for such claims has not been provided. In fact, homeopaths have trouble providing ordinary evidence that their treatments work. What they are quite good at is providing excuses…

Claim 1:

Claim – Homeopathy works

Evidence – Despite being utterly implausible, trials have been conducted (to the dismay of those who feel that testing such obvious nonsense is futile). Large, well-designed trials have found no benefit above placebo. Systematic reviews of well-designed trials have been conducted and there is even a systematic review of systematic reviews. The bottom line? Homeopathy doesn’t work. Homeopathic products are inert.

Excuse #1 – You can’t test homeopathy in a randomised controlled trial, as it is individualised.

The truth – You can test individualised homeopathy using an RCT. Not only is it possible to do this, it has actually been done. In 1991, Kleijnen et al found 14 trials of individualised homeopathy. In 1998, Linde and Melchart conducted a review of randomized controlled trials of individualized homeopathy and found that “when the analysis was restricted to the methodologically best trials no significant effect was seen” (the authors concluded that “The results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing…“). [See also Ben Goldacre‘s comments on individualised homeopathy in the Guardian.]

Excuse #2 – Randomised, placebo-controlled clinical trials of individualised homeopathy fail because placebo effects are substantially higher than in conventional medicine.

The truth – In 13 matched sets the placebo effect in the homeopathic trials was larger than the average placebo effect of the conventional trials, in 12 matched sets it was lower (P=0.39). Additionally, no subgroup analysis yielded any significant difference. Placebo effects in RCTs of individualised homeopathy were not larger than in trials of conventional medicine.

Claim 2:

Claim – Diluting remedies makes them more powerful. Even when they’re so dilute that there is not a single molecule of the ‘active’ ingredient left.

Evidence – This claim contradicts everything from common sense to the laws of physics and chemistry. If dilute remedies were so powerful, then we’d be easily able to observe their effects in properly conducted trials. We can’t. In fact, homeopathy doesn’t work. Highly diluted homeopathic products are not more powerful, they are inert.

Excuse – Never mind the laws of physics. There doesn’t need to be any active ingredient present. Homeopathy works by the memory of water.

The truth – Researchers have found that “liquid water essentially loses the memory of persistent correlations in its structure within 50 fs”. There is some comment here on the ‘memory of water’ and homeopathy:

…the ‘explanations’ on offer seem either to consider that water physics can be reinvented from scratch by replacing decades of careful research with wishful thinking, or they call on impurities to perform the kind of miraculous feats of biomolecular mimicry and replication that chemists have been striving to achieve for many years.

Claim 3:

Claim – Effects of homeopathy cannot be explained by the placebo effect.

Evidence – Homeopathy can be explained by the placebo effect. “…there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo”.

Excuse – Homeopathy works in children and animals, therefore it cannot be placebo.

The truth – There are several possible reasons for the perceived improvements in animals treated with homeopathy, all of which are more likely reasons for the perceived improvement than homeopathy. For example, spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment… and the placebo effect.

I’m not sure why some people believe that placebo effects cannot be produced in children or animals. Not only have those making this argument failed to provide me with evidence that the placebo effect is irrelevant to children and animals, they have also failed to explain the ‘logic’ behind their thinking.

For placebo in animals, there may be an expectation on the part of the owner or vet that the treatment will be beneficial and there may be a conditioning effect on the animal being treated. If Clever Hans could respond to subtle visual clues in order to ‘perform arithmetic’ and pigeons could be trained to recognise a target and peck at it, then is it really so implausible that a cow might respond to the body language of a farmer or vet who was enthusiastically treating the animal with homeopathy? If adult humans can be fooled into thinking that a treatment has made them better, is it really so implausible that the same adult humans can be fooled into thinking a treatment has led to improvements in the symptoms of an animal they are treating?

As to whether children can benefit from a placebo effect… Children with drug-resistant partial epilepsy receiving placebo in double-blind RCTs demonstrated significantly greater 50% responder rate than adults, probably reflecting increased placebo and regression to the mean effects.

27 Comments

  1. Mark said,

    excellent post. It honestly can’t be said often enough that homeopathy goes against pretty much all know laws of biology, physics and chemistry.

    cue Nancy Malik’c copy & paste comment in 3, 2, 1…

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  3. Oliver Dowding said,

    You ask….“is it really so implausible that a cow might respond to the body language of a farmer or vet who was enthusiastically treating the animal with homeopathy? If adult humans can be fooled into thinking that a treatment has made them better, is it really so implausible that the same adult humans can be fooled into thinking a treatment has led to improvements in the symptoms of an animal they are treating?”

    If you knew a little bit more about a farm, you’d appreciate that the vast majority of the time the animal doesn’t even see the farmer, herdsman, or stockman treating it, as he or she is down in a milking pit and the animal is looking the other way into its feed trough. Alternatively, they might be treating a baby calf whose sole intention is to resist containment, with little idea of what’s going on! As for those that respond to group treatment, they most definitely aren’t seeing anybody treating them. And believe me, but you won’t want to, when with talking the group being tens of thousands of chickens, for example, I’m fairly certain that the farmer doesn’t go round and have a word with all of them.

    Furthermore, there’s no way that the animal can be responding on a placebo, as it doesn’t know it’s being given something. If you persist in believing that it does know that it’s being treated, then why is it that you don’t promote the giving of a single medication for all animal diseases, on the presumption that they’ll all recover on the placebo presumption.

    As you well know, all conventional medication has specific conditions it is designed to treat, and others upon which the same medication will have no impact at all. In the latter cases, of course, the animal will simply become more poorly, and ultimately die. Nobody would get away with that kind of medication for long, as the animal welfare people would soon summon the offending stockman or farmer into court. Similarly with homoeopathy, the animal is individually assessed, and individually treated, with an individualised remedy, of an individualised potency. This goes some way to explain why undertaking RCT’s on animals is virtually impossible, due to the excessive number of variables. There might be the odd example that you can dredge up, but by and large it’s not feasible.

    So, the answer to your question is, yes, it’s highly implausible that the adult humans can be fooled as you suggest, regardless of what Clever Hans may have done. I appreciate that that’s most disappointing, and that you really don’t want to have to believe this. I’m not expecting you to change your mind! But, again, thank you for asking.

    It’s possible that you might want to visit a farm, and perhaps meet a homoeopathic vet. Much as I would like to be able to supply you with a suitable venue, and somebody prepared to entertain you, I will refer you to http://www.hawl.co.uk where you can make the necessary enquiry. For your information, they are an esteemed organisation, having made it to the finals of the (highly conventionally minded) Farmers Weekly magazine’s “livestock adviser of the year” competition, 2010. They came third, which is incredibly creditable given the circumstances.

    Mark might be waiting for a post from whoever Nancy Malik may be, so perhaps now it’s my turn to wait and see which of the regular posters on here is the first to set about about dismissing what I’ve said………

  4. jdc325 said,

    Hi Oliver,

    Did you pass my email address on to your vet and/or homeopathic product supplier? I’d be happy to hear from them.

    Cheers,
    James.

  5. Oliver Dowding said,

    James, yes, I did. I appreciate you would be.
    Oliver

  6. shpalman said,

    “Homeopathy works by some new science which you old fashioned Newtonian scientists don’t understand” as if quantum physics wasn’t about a century old and far better understood by actual scientists (apart from http://shpalman.livejournal.com/tag/lionel%20milgrom anyway) than it is by homeopaths.

  7. AndrewF said,

    Excuse 3b) The remedy retains the energy signature of the active ingredient, even after it’s gone. This might be a more wishy-washy version of shpalman’s.

  8. Martin said,

    Are they really the widespread/common claims though? The most common I hear anecdotally (recursively) is “It worked for me/a friend” or even “It works for me/a friend”. And then we’re into seperating out confounding factors which can be tricky.

    Also… slightly leary about assuming laws of physics tell us if something can or cannot work; evidence trumps theory. Of course a lot of theory is well established, so we should be suspicious of contradictory evidence, but not dismissive of it.

    It’s not that there is no evidence for the efficacy of homeopathy. There is plenty, but it’s not very good, especially when weighed against everything else that we think we know.

  9. Caroline said,

    Why are homeopaths so keen on this ‘better than placebo’ argument anyway?

    All they’re saying, really is ‘better than nothing’ except that the scientific consensus is that it’s not.

    And you know what, homeopaths? Animals and kids have healing abilities too – some of them get better anyway.

  10. Oliver Dowding said,

    Caroline…..”some of them get better anyway”………….what percentage do you have in mind for animals? what percentage for each category? i.e. horses, farm animals, companion animals? what percentage for children? To what age do you consider this – various age bands? Can the baby work it out as well as the teenager? What happens to the rest?

  11. Caroline said,

    Oliver why do I need to categorize by type of animal or age of child? All living beings have evolved ways of dealing with disease. It doesn’t always work, that’s why we have doctors and hospitals, but most people and animals can fight most diseases – often without even being aware of it.

    EG I know my body can recover from the cold I’ve got at the moment. I may resort to medication to alleviate a headache or soothe my throat but I’m under no illusions that those will cure me. I will survive – without sugar pills.

  12. AndyD said,

    Oliver, I’m confused by these statements…

    “…the group being tens of thousands of chickens, for example, I’m fairly certain that the farmer doesn’t go round and have a word with all of them.”

    “Similarly with homoeopathy, the animal is individually assessed, and individually treated, with an individualised remedy, of an individualised potency”

    Which is it? Can homeopathy be generically administered or must it be individualised?

  13. Michael Ringland said,

    Oh! Oliver Dowding, how could you be so wrong…
    “all conventional medication has specific conditions it is designed to treat, and others upon which the same medication will have no impact at all. In the latter cases, of course, the animal will simply become more poorly, and ultimately die. Nobody would get away with that kind of medication for long, as the animal welfare people would soon summon the offending stockman or farmer into court.”

    In my elderly mothers case, she was “treated” by a homeopath/naturopath for blood in her urine. I found out this was the case and almost demanded she have (western medical) tests. It proved to be bladder cancer. Do I chase the homeopath and crucify them in our court system? No, I move on with a heavy heart rather than re-live the grief. I think as far as the homeopath is concerned mum is cured, because she has not returned for more potion.
    It is pointless arguing with people who “believe” in a therapy, its like arguing the impossibility of christ rising from the dead with a catholic bishop – it is the belief in ourselves as “healers” that is a problem…as a physiotherapist I believe in the numbers of increased joint range of movement – in those cases “I heal”, in others – where maybe joint range decreases “the patient didn’t respond” I can accept my failure, but I need something more rational than “energy water” before I can charge for a professional service.

  14. astrologerthe said,

    Thinking on the basis of how it could work rather than being dismissive: predicting how a solution will behave & the rates of diffusion are complex, probability of finding a “molecule” in the final solution. I’d be interested in results of radioactive isotopes labeling of said active ingredients and monitoring through a dilution process. Any light passing through the solution has the potential to form a ”free radical” that in theory could start a chain reaction. There will probably be dissolved oxygen in the water also leading to perhaps a “gaseous” state theory. I’m thinking aloud here. Personally I have not and would not consider trying homeopathy in its current form but something perhaps related to it.

  15. jdc325 said,

    “Thinking on the basis of how it could work rather than being dismissive…”

    @astrologerthe – surely attempting to think of a basis for how homeopathy could work is a waste of time given that we already know it doesn’t? Not only is homeopathy utterly implausible, but it has also failed tests. The best available evidence shows that homeopathy is an inert treatment.

  16. beetlbot said,

    Mental conditioning (placebo effect) of the immune system has been clearly and scientifically demonstrated in animals. The classic experiment in mice was to give injections of an temporary immunosuppressive drug at the same time as a sweetener was added to the water, this was repeated several times until finally just adding sweetener to the water caused immunosuppression.
    You can certainly be conditioned to have a physiological response to a placebo. A bottle of water given by a very empathic homeopath might make a suggestible patient feel better by the placebo effect, the same bottle given by a doctor who warned the patient that it might have side effects of nausea and diarrhea can cause nausea and diarrhea by the nocebo effect ( look it up).
    Re: Animals, I would suggest that Oliver reviews the articles on how cattle recognize people by their clothes and their body language. Ask any farmer if his animals prefer one vet over another.

  17. Oliver Dowding said,

    @Andy D. Both were equally effectively, when the disease and remedies have been correctly matched.

    @beetlbot. I have read these articles in the past. My animals never mastered the ability to speak, and so I don’t know which vet or herdsman they may have preferred. I should also point out that they were almost always treated through the course of an illness by a number of different people. As I have said before, they also don’t have the ability to deceive, create trickery with words, or be general smart asses. Cows really aren’t particularly clever, and their baby calves even less so.

    The remedy administered was not given by the vet. It was not given at the time of the vet visit in most instances. I refer you to previous posts, where I clearly indicated that the herdsman administering the remedy is in the milking pit, at the time when most remedies were administered, and the cow is in her stall facing away from the herdsman and totally unaware of whether he is milking her, giving her a remedy. Therefore, your supposition is not relevant.

    The cows must be most frustrating for you, in that such huge numbers of animals repeatedly respond positively to homoeopathy, and that perhaps none of us know the exact mechanism by which the response occurs, but respond that they’d surely do. Time after time after time…………..

  18. astrologerthe said,

    Jdc325 – in response to your comment on my comment:

    I don’t really give a toss if Homeopathy doesn’t work, “failed treatment”. I was mainly interested in some science involved within homeopathy as I expressed within my comment. I would be “wasting my time” continuing any discussion as you appear obsessed with your condemnation & disrespected my earlier comment.

  19. Science Wooseum update « Purely a figment of your imagination said,

    […] As was carefully pointed out in the original post, it is not that the Science Museum chooses to talk about alt med that is the problem. The problem is the way in which it is presented; in terms of the content. For more on this, I recommend DC’s post in particular. On why homeopathy is not medicine, jdc posts. […]

  20. Mel Anderson said,

    I found this topic and site through badscienceblogs.net. This has just been suspended – any ideas why?

  21. jdc325 said,

    Hi Mel,

    I saw something on twitter about badscienceblogs.net – think someone is working on it.

    There are currently probs with bdscienceblogs site due to crap hosts and some technology issues. Being looked into and hope to revamp soon.

    Linky.

    Hopefully it will be back up and running soon!

  22. jace said,

    might as well be arguing over religion. it’s not about science. it’s about belief and you cannot quantify belief, nor argue with it. it isn’t a rational thing, it’s not based in anything physical or observable and therefore all attempts to interact with it on the level of rationality will simply fail.

    i think the best thing to do is to continue offering information to counter “uninformation” in the hopes that people will find their way. you can email a link to your mom but you can’t make her read it, you know? ;-)

  23. Homeopathy for Cows « Stuff And Nonsense said,

    […] It’s a kind of magic. Homeopaths make extraordinary claims, but their claims are not supported by the available evidence. Some homeopaths have attempted to explain away this inconvenient evidence with extraordinary excuses. […]

  24. Krebiozen said,

    There’s some good reading on the Veterinary Voodoo website on this subject. This page struck me as particularly apposite:
    http://www.vetpath.co.uk/voodoo/case4.html

  25. Astrology « Stuff And Nonsense said,

    […] I wrote about homeopathic excuses, arguing that it was possible for there to be a placebo effect in animals, someone actually spent […]

  26. girishtvajjampur said,

    homeopathy works in many cases effectively

  27. Chris said,

    “homeopathy works in many cases effectively”

    Show the randomly controlled trial on rodents that it works for rabies.

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