On Homeopathy

A question passed by me: Can you provide me with studies about homeopathy? (Substitute any alternative concept for the word "homeopathy.")

There are no valid scientific studies.

There are some studies out there, but they aren’t properly done. It is not provable that homeopathy is effective through science – but doesn’t mean that it doesn’t work for some people. It just means we can’t justify recommending it to be used all the time to work for a certain condition, like a medication would be recommended.

The way I look at it is that there are a multitude of conditions and treatments used commonly, that don’t have science to back them up, but clinically the medical establishment has seen change.

Why? Because medicine is more than science. We use science; especially to figure out if something is harmful or to help classify what part of medicine it fits into.

For many medications we still have no idea how they work, but we use them because we see them work effectively.

This is called Evidence-Based-Medicine – Clinical judgement matched with scientific knowledge & the patient as they present themselves; physically, emotionally and motivationally). If we find out through science that therapies harm, or harm outweighs benefit, or they seem to stop working, then it is vitally important to place more weight on the data.

I don’t think to date we have any data to prove that homeopathy in itself, harms – outside of irresponsible recommendations and negligence of red flags, which is an issue of a physician’s skill and judgement, not the treatment.

Just a few common examples of medicines that are lacking scientific evidence:

1. Using Tetracycline for acne. No one has any idea how it works, how long it will take or why it works for some not others.

2. Tylenol – still don’t know how it stops pain.

3. Lithium – drastically helps bipolar cases. No one has ever figured out why. Its dosage window is tiny, and it’s ridiculously safe when taken in the right dose, but too much is toxic and without it some people fall into bipolar fluxes.

4. B6 & Antihistamines for pregnancy nausea. No one knows how it stops nausea, it doesn’t work for everyone and it works differently in everyone.

Even without science, there is evidence of these all working –   And most clinicians are willing to use these without science, because we see the change in our patients, and there have been years of using it and people feeling better.

Large Scale Evidence is a critical piece of support that homeopathy doesn’t have – because there is no substance to measure and no specific symptom to monitor and no algorithm for prescribing – it is philosophically and fundamentally based on a clinician’s judgement call and experience. This makes the likelihood of prescribing error pretty high, which would make it challenging to collect accurate evidence to either prove or disprove it.

To demonstrate evidence, let’s take darts:

If you start the game with no rules about goals, distance, direction, board size or dart throwers skill – regardless of the end score - you cannot reliably assess for any evidence of whether the darts are functioning as they should, if the board is standard, if the thrower is an amateur, or if anyone even won the game. You need parameters to make conclusions on evidence. 

(p.s. I’ve never played darts. I have no idea if I’ve offended any dart playing experts.)

The science is definitely impossible to show – Because there is literally nothing to measure reliably, and because it’s a feeling that a clinician gets through dialogue and experience and familiarity of the archetypes and symptom pictures. Not really replicable for gathering evidence to show effect.

Not so helpful for a request about studies, but all this is what fuels me in conversations about homeopathy.

Medicine is far too messy for a clear answer. I went into medicine to be in the unknown messiness, balancing the unknown with the known.

I might one day want to indulge in the chase for the knowable through science, but I’ll try not to forget the people who are in the trenches, holding the space, listening carefully, attempting to help the person in front of them actually heal.

I’m hugely respectful of science and I primarily use its capacity to be knowledgable about what I’m doing clinically, but I’m also working with people day-to-day, and sometimes clinging to a science-only philosophy does a disservice to the people who need care in practice.

 

The three laws of medicine (in my view):

1.  No matter how much data we gather, we will never be able to fully understand why our bodies accept and reject certain substances, situations, values, environments.

2. We are all emotionally biased. Science does its best to attempt a removal of bias, but it is a human condition. In fact it’s the only way we can make decisions in life. People who are devoid of emotional/intuitive brain centers (say through a brain injury/accident) cannot make the simplest decisions in daily life. Making decisions is not purely rational – we need emotion to guide us. But it is irresponsible to make decisions purely on intuition or purely on rational information.

3. Whenever people are weak or vulnerable (especially in health), there are always other people looking to capitalize on that fear. Be wary of anything that claims a cure by purchasing products through trusting a practitioner only, without allowing it to run through your own intuitive and rational filter. Both homeopathy and any scientific product can lure patients to drink the koolaid.

We all just have to do our best weighing out the information with our gut feelings and just be ok with the fact that we’ll all probably be duped a few times in life and – ideally we don’t get angry or feel shame about it or defend our choices, and instead take it as a given that sometimes the science is incorrect and sometimes our intuitions guide us astray and our job is to swallow our pride, laugh it off and keep learning.

With this in mind, an answer to a few questions you may have:

Should homeopathy be covered? No

Should people at home have the right to use homeopathy without public lynching? Yes.

Should Health care practitioners be corrected for claiming that homeopathy is evidence based? Yes.

Should Health care practitioners be handcuffed to only evidence-based therapies? No.

How can we build a system where patients feel free to disclose the alternative therapies they are using, without feeling shame or ridicule?

And for patients to be partners with the medical system in their health journey, so if they are advised to be monitored or medicated they trust that their health care practitioner is working in a patient’s best interest, rather than assuming they are avoiding liability or aiming for financial gains.

I don't have an answer, but I’m a fan of education, full disclosure & freedom without harming others.