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The Case for Homeopathy

E. HOMEOPATHY IS SAFE

i. Risks of using pharmaceuticals
ii. Safety of homeopathy
iii. Aggravation of symptoms
iv. Perceived safety of homeopathic medicines by patients
v. Conclusion

Most doctors who have integrated the use of homeopathy into their practices still have occasion to be thankful for the ability to fall back on conventional medicine when their homeopathic skills are not able to assist their patients in the shortest, surest, most gentle way that is available to them and their patients as a result of their multi-facetted training, including surgery and pharmaceuticals.

However, such doctors are also critically aware that pharmaceuticals are not given for their effects, only for their least dangerous side-effects, which often are of use to the patient. In other words, pharmaceuticals do not have effects and side-effects, only side-effects.

There are many publications showing the worrying incidence of ill-health that is caused by pharmaceutical treatment (iatrogenic disease). Vioxx is a well-known example of a pharmaceutical that was initially researched and thought to be safe for use but, after a few years experience was found to cause life-threatening changes in the heart, necessitating its withdrawal from use.

i. Risks of using pharmaceuticals
The Medicines Information Centre of the Department of Pharmacology of the University of Cape Town published an article in the journal Continuing Medical Education (published by the South African Medical Association) in 1999 46, stating that 15% of all hospital patients in the U.S.A. suffered iatrogenic side-effects. On the other side of the Atlantic, up to 5% of all hospital admissions in the U.K. were due to adverse drug reactions (A.D.R.’s) and furthermore 15% of U.K. in-patients had their stay in hospital prolonged by A.D.R.’s.

A meta-analysis of prospective studies measuring the incidence of A.D.R.’s in hospitalised patients in the U.S.A. was published in the Journal of the American Medical Association in 1998 47. This produced the astonishing evidence that A.D.R.’s were the fourth highest cause of death in American hospitals (behind heart disease, cancer and strokes). Around 2,216,000 hospitalised patients had serious ADR’s in 1984 and 106,000 hospitalised patients died from ADR’s.

By contrast, homeopathy has been found to be safe.

ii. Safety of Homeopathy
Doctors at the Royal London Homeopathic Hospital did a world-wide literature review of homeopathic studies published from 1970 – 1995 in which they looked for adverse effects of homeopathic treatment. Whilst they found that 10 clinical trials, 19 case studies and 18 provings reported possible adverse effects, in only 3 reports were these adverse effects deemed to be due to the homeopathic medicine. Of these 3 reports, 2 were ‘proving’ symptoms (a temporary induction of symptoms foreign to the patient, that are consistent with symptoms induced by the homeopathic medicine when tested on healthy patients and that cease when the homeopathic medicine is stopped). The third report concerned a compound medicine, which also contained herbs.

A doctor who practices homeopathy in London, Dr. A. Jain, did a cost-comparison in 100 of his homeopathically-treated patients 48. One of his findings was that none of his patients suffered any side-effects from the homeopathic treatment.

iii. Aggravation of symptoms
Soon after starting homeopathic treatment, patients may experience an initial and temporary aggravation (apparent flare-up or recurrence) of existing or old symptoms. This short-lived phenomenon is considered desirable by many homeopaths.

Proving symptoms may be seen as adjunctive proof of a specific phenomenon associated with taking homeopathic medicine. Indeed, a skeptic of the scientific validity of homeopathy was a co-author of a review of homeopathic randomized controlled trials in which it was suggested that there was no evidence for the phenomenon of homeopathic aggravation. However, the authors of this review acknowledge that many homeopathic trials to date have not routinely collected data on side effects, lessening the validity of this review.

Two studies have confirmed the presence of homeopathic aggravations.

A pilot study of 1,025 homeopathically treated patients in six European countries showed that less than 8% of patients reported a significant aggravation at the beginning of homeopathic treatment and around 25% of patients a slight aggravation of symptoms 35.

A preliminary audit investigating remedy reactions including adverse events in 116 outpatients followed up 6-10 weeks after their first appointment at the Bristol Homeopathic Hospital was published in 2004 49, using the Glasgow Homeopathic Outcome Score. 80% of patients experienced a change in symptoms since starting homeopathic treatment. Overall, 62% of patients noticed an improvement in their symptoms, 18% reported a return of old symptoms and 24% an aggravation of their symptoms (of which 54% were more likely to score +2 = significant change of symptoms in daily life, or +3 = symptomatic improvement had a life-changing effect, on their outcome scores). 11% of patients reported adverse events: this was in response to the question “Do you feel you had any bad reaction to the medicines given at your last appointment?” The tabulated descriptions of these ‘bad reactions’ indicate functional changes only, no pathological responses were noted.

Perceived safety of homeopathic medicines by patients
A study published in 2002 in the European Journal of Pharmacology which showed that homeopathy was the most frequently used ‘unconventional therapy’ in Italy also found that the main reason given for use of ‘unconventional therapies’ was potential toxicity of ‘conventional medicine’ 50.

A study from University College London found that concern about the adverse effects of conventional medicine was the third most important factor that motivated patients to seek ‘complementary’ treatment 51.

Conclusion
Homeopathic medicines are safe in their application. Any negative reactions are usually functional and temporary, rather than pathological or permanent, as can occur with the use of pharmaceuticals. Nevertheless, these functional disturbances, which include the documented phenomenon of ‘aggravation’ of symptoms (adjunctive proof of a specific phenomenon associated with the use of homeopathic medicines) or ‘proving’ symptoms, may be uncomfortable. They are of varying duration, yet invariably dwindle after cessation of the homeopathic medicine, unlike the permanent nature of some side-effects of pharmaceuticals.

High quality homeopathic education is required to minimize the incidence and severity of these temporary functional disturbances.

References

35. Anelli M. et al Homeopathy and health related Quality of Life: a survey in six European countries Homeopathy 2002 91(1):18-21

46. Chanterie A. University of Cape Town Medicines Information Centre, Dept. of Pharmacology
CME 16;10 982

47. Lazarou J. et al. Incidences of adverse drug reactions in hospitalised patients. A meta-analysis of prospective studies. JAMA 1998. 279: 1200-1205

48. Jain A. Does homeopathy reduce the cost of conventional drug prescribing? A study of comparative prescribing costs in General Practice Homeopathy 2003 92:71-76

49. Thompson E. et al. A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice Homeopathy 2004 93(4):203-209

50. Menniti-Ippolito F. et al European Journal of Clinical Pharmacology 2002 58(1): 61-4

51. Vincent C, Furnham A. Why do patients turn to complementary medicine? An empirical study Br J Clin Psychol 1996 35:37-48