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Homeopathy: A Placebo Effect In 110 Trials
Dec 1, 2009 
Jamie Hale--
Claim: Homeopathy is an effective treatment procedure for various health problems.
Investigation: Samuel Hahnemann, a German physician, developed homeopathy in the late 18th century. He developed homeopathy in response to his dissatisfaction with the conventional medicine of his time. Hahnemann’s homeopathy suggested two key principles. First, he asserted that "like cures like."
In other words, a substance that produces certain symptoms in a healthy person can be used to cure similar symptoms in a sick person. Second, he claimed that smaller and smaller doses of the remedy would be even more effective. Hahnemann diluted the remedies in a process he named "potentization." Hahnemann would take an original natural substance and often dilute it numerous times. Between each dilution, the remedy was shaken. Shaking, supposedly released the healing energy of the remedy (1).
After investigating 107 controlled trials on homeopathy Kleijnen and and colleagues concluded (2) “At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.” Hill & Doyon investigated 40 randomized trials involving homeopathy (3).
The researchers concluded, that in their opinions the evidence did not show homeopathy to be effective. In 1994 the National Council Against Health Fraud advised consumers not to buy homeopathic products or to patronize homeopathic practitioners (4).
In addition they suggested, “basic scientists are urged to be proactive in opposing the marketing of homeopathic remedies because of conflicts with known physical laws. Those who study homeopathic remedies are warned to beware of deceptive practices in addition to applying sound research methodologies.” Shang and colleagues analyzed 110 trials of homoeopathy and 110 conventional medicine trials (5).
The researchers concluded “there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.”
Conclusion: A few studies implicating the positive benefits of homeopathy have appeared in major medical journals. But, the majority of positive studies have appeared in nonscientific journals, have been subject to bias, or poor research design. The overwhelmingly majority of data appearing in scientific journals shows that homeopathy is an ineffective treatment for any clinical condition. There is no good reason to use homeopathic products.
References
1-Wagner M. Is Homeopathy “New Science” or “New Age”? [online] September 18, 2009 http://www.homeowatch.org/articles/wagner.html
2-Kleijnen J, et. al. Clinical Trials of Homeopathy. BMJ 302(6772):316-23 1991
3-Hill C, Doyon F. Review of randomized trials of homeopathy. Rev Epidemiol Sante Publique 38(2):139-47 1990.
4-NCAHF Position Paper on Homeopathy. [online] September 18th, 2009 http://www.ncahf.org/pp/homeop.html
5-Shang A, et. al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 366(9487):726-32 2005.
Coach Jamie Hale is a sports conditioning specialist, fitness author of over 10 books, independent researcher and nutrition consultant. His scientific and critical thinking approach has led him to be nicknamed, “The Fitness Skeptic,” as he is well known for tackling fitness myths and encouraging critical thinking and debate on all matters of diet and exercise.
Jamie Hale is the author of Knowledge and Nonsense: The Science of Nutrition and Exercise and Should I Eat The Yolk: Separating Facts From Myths To Get You Toned, Fit and Healthy (Ulysses Press/ 2010). Visit him online at www.maxcondition.com
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Reader Comments (1)
The mythology that Homeopathy is ineffective or a mere placebo effect is a convenient means of acknowledging the well documented Homeopathic curative effects but then it is immediately disavowed with nonsense about how it is all supposed to be "placebo" effect.
There are several fallacies from such simplistic thinking.
First, the attempt to divert focus from the tens of thousands of MD's and other fully qualified health professionals who have quite successfully adapted and used Homeopathy across a span of two centuries. It is their case histories, clinical analyses and clinical reports, published in Homeopathic medical journals continuously for over a century, that form the real basis of Homeopathy, not some artificial testing methods, originally designed to win approval of side effect ridden dangerous pharmaceuticals and allow their release onto an unsuspecting public until the inevitable bad effects occur followed by a withdrawal of the drug. Are we to believe that legions of well trained expert Drs, and yes even surgeons, were somehow self deluded about this? Not just one but thousands of them? And somehow our armchair sceptics and journalists, never having seen a patient or treated the sick, have it all figured out? So called standard medicine is also based on such case histories, based on the expert reports, analyses and journal articles of its expert MD and surgeon practitioners - not on some double blinded tests performed as though people were lab rats. Seen any double blinded placebo controlled tests for heart surgeries or chemotherapy done on humans? Of course not - so shall we deny these treatments because they are ... unproven? The "evidence" for standard medical treatments come from the same source as for Homeopathy - the expertise of its practitioners and NOT from double blinded pharmacology tests.
Second, as mentioned above, in order for ALL of Homeopathy to be mere placebo effect, are we to believe that, somehow, tens of thousands of doctors, some of the finest medical minds of their day and of the present, could not tell a real cure from a placebo effect and could not tell if their patient had improved, sometimes even had their lives saved, by the Homeopathic? I don't think so - either Homeopathy works or medical experts have been subject to the greatest and longest running hoax in the history of medicine. The patients whose lives were saved, their doctors and those willing to think for a moment instead of getting caught up in the "woo" and "magic" accusations know otherwise. And NO, you don't need to know the exact method or mechanism - people took aspirin for decades and nobody knew exactly how it worked until a Nobel prize winning discovery finally explained it.
Third, another attack against Homeopathy, which encourages attempts to dismiss it as mere placebo, argues that it is scientifically impossible for high dilutions, in which all molecules of the curative substance have been diluted away, to have any effect whatever. Never mind that this ignores the numerous low dilutions. Unfortunately for this viewpoint, experiments by pharmacology researchers such as M. Ennis, (Inflammation Research vol 53, p181) clearly showed that such high dilutions can and do cause biological effects as though the missing molecules were still present. The experiment has been repeated with the same results and remains the subject of research. The fact that some armchair pseudo-sceptics make claims about how this all violate the "laws" of science is in itself completely unscientific. Likewise, Nobel prize winner Dr. Brian Josephson, chided those who would dismiss Homeopathy with "superficial thinking" on such grounds. (see his web site at the link "Is Homeopathy Nonsense and Why it May Not Be).
Conclusion: The sweeping conclusion that this author makes, on the basis of statements made by people who presume to know all the laws of science, even the undiscovered ones, is fallacious. As people eventually find out after trying Homeopathy in desperation when standard drugs fail, Homeopathy can and does succeed, sometimes remarkably quickly in curing or improving a wide variety of conditions, both chronic and acute.
Addendum:
A journal article,in the Lancet's 2005 "End (sic) of Homeopathy" issue, which emphasized its analysis of Homeopathy trials and concluded that it was no better than placebo based on an analysis of those trials was widely reported to be based on hundreds of trials. In fact, after throwing out many of the well done Homeoapthy trials that had positive results by various exclusionary tactics, the entire conclusion was based on 8 (eight!!) trials. A recent Journal of Clinical Epidemiology article refuted the conclusions of the Lancet "placebo" article.
Lüdtke R, Rutten ALB. The conclusion on the effectiveness of
homeopathy highly depend on the set of analysed trials. Journal of
Clinical Epidemiology, 2008.
doi:10.1016/j.jclinepi.2008.06.015
Rutten ALB, Stolper CF. The 2005 meta-analysis of homeopathy: analysis
of postpublication data. Homeopathy, 2008.
doi:10.1016/j.homp.2008.09.008.
Results
"The quality of trials of homeopathy was better than of conventional
trials. Regarding smaller trials, homeopathy accounted for 14 out of
83 and conventional medicine 2 out of 78 good quality trials with n <
100. There was selective inclusion of unpublished trials only for
homeopathy. Quality was assessed differently from previous analyses.
Selecting subgroups on sample size and quality caused incomplete
matching of homeopathy and conventional trials. Cut-off values for
larger trials differed between homeopathy and conventional medicine
without plausible reason. Sensitivity analyses for the influence of
heterogeneity and the cut-off value for ‘larger higher quality
studies’ were missing. Homeopathy is not effective for muscle soreness
after long distance running, OR = 1.30 (95% CI 0.96–1.76). The subset
of homeopathy trials on which the conclusion was based was
heterogeneous, comprising 8 trials on 8 different indications, and was
not matched on indication with those of conventional medicine.
Essential data were missing in the original paper."
Conclusion
"Re-analysis of Shang's post-publication data did not support the
conclusion that homeopathy is a placebo effect. "
(quoted from Lüdtke R,The 2005 meta-analysis of homeopathy: analysis
of postpublication data. Homeopathy, 2008. doi:10.1016/j.homp.
2008.09.008.)
Not mentioned either in this article nor in the Lancet 2005 article, was a 1994 study of Homeopathy trials, published in the Lancet which concluded that Homeopathy did perform significantly better than placebo.
Regarding the movement towards pre-empting all of medicine on the entirely clinical double blinded "evidence", see the following comments touching on all these issues, of interest to all, from a recent memorandum of Dr. Lionel Milgrom:
http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm0402.htm