Current Affairs Science

The time I believed in homoeopathy

I have a confession to make: once upon a time, I believed that a homoeopathic arnica cream magically cured my bruises.

By аз, via Wikimedia Commons

No, no, bear with me. Don’t leave yet, the story ends well…

Some years ago (don’t ask how many), I studied Biology and Computer Science in NUIM. I thought I understood how scientific research worked, and I thought that articles in scientific journals were infallible. I thought that, as long as there was a journal article about a topic, it must be true. When I realised that this wasn’t the case, that all studies were not created equal, that merely being published did not make a study truth, and that the quality of the study (and the journal) mattered, it fundamentally changed how I approached scientific evidence gathering, and how I cemented or debunked beliefs.

While I was in college, I also took up martial arts for the first time. As virtually any martial artist will tell you, it’s nearly impossible to study a martial art without picking up some bumps and bruises, and I was no exception. When I eventually did my first grading, it’s fair to say that I came away with more than a few bruises, particularly on my arms. Normally, this wouldn’t have bothered me, but in this particular case, I was due to be a maid of honour at a wedding only a short time afterwards, and my family weren’t too keen on the idea of my sashaying up the aisle looking like I’d been beating rocks with my forearms.

Lucky for me, then, that I had heard about the miraculous curative properties of arnica from a number of people. I went straight to my local health food store, picked up some cream without a second thought, and dutifully applied it like it was going out of fashion. And come the day of the wedding, why my bruises had faded faster than I thought possible, and I was 100% convinced that the arnica had helped me to do it. Naturally, because I was completely convinced that the arnica cream had made a difference, I told everyone. I extolled the virtues of the cream in my martial arts club, to friends and family, and even online. It was while browsing online that I came across a forum thread that started me down a slippery slope to critical thinking – a thread on a martial arts forum discussing arnica, and some commenters who were adamant that it was nonsense.

When I found this thread, of course, the first thing I thought about was my own experience – I had used arnica, and I was sure it had worked, so surely that was evidence? Of course, I summarised my story and posted it up online, and those commenters told me I was wrong. I googled, and I found a paper or two that posited an explanation for arnica’s effect (that it caused increased blood flow to an area, that it had an effect on capillaries), and posted that, sure that the evidence supported my anecdote. The commenters weren’t convinced, but then, neither was I. I had papers and my story, and they had some papers too, but whatever, it worked and that was that.

Looking back on this, I cringe at how silly I was. I didn’t understand so many of the basics about alternative medicine, so I didn’t understand that there was a fundamental difference between herbal medicine and homoeopathic medicine. I didn’t know that herbal medicines are often poorly regulated, with differing quantities of active ingredient, differing quality, and other similar issues. I didn’t know that homoeopathic medicine involved finding components that allegedly caused the symptoms (10ccs of forearm double block anyone?), and then diluting those components so much that they aren’t even present anymore (ironic, since I had been learning about the practicalities of serial dilution in the lab). I didn’t realise that the papers I presented discussed application of herbal medicine, not homoeopathic, and I didn’t realise that those papers were in poor quality journals, and not properly peer reviewed. I didn’t even know that the cream I was sold contained no active ingredients, and was just an expensive, smelly placebo. To those commenters who worked hard to convince me, I’m sorry. I didn’t realise how wrong I was.

Why am I telling this story now? Because I no longer believe these things, and if I came across my former self, posting her healing anecdote on that forum, I would pick apart the argument with one internet hand tied behind my back. I’m telling this story because I have changed my beliefs, and that is ok. Sometimes, when you believe something for a long time, it’s hard to change that. It’s much easier to ignore evidence than to acknowledge that you were wrong, possibly for months or years. Having egg on your face, realising that your declarations of the effectiveness of arnica were laughable, is really not much fun at all, but in time, instead of being an embarrassing memory, it can become a reminder of how easy it is to be fooled by people who are unscrupulous, a reminder that the information out there is sometimes confusing and conflicting.

But how on earth can anyone figure out what’s what when scientists seem to change their minds every day? People often joke that scientists (as a large, amorphous, faceless science-blob) can’t agree on anything – first red wine causes cancer, then it cures it, then it causes it but only if you drink it while eating or not eating dark chocolate. This notion is used to debunk assertions that climate change is real, that magical urine can’t cure cancer, and that infinitesimally small quantities of compounds are remembered by water but sewage is not. After all, if scientists can’t agree on red wine, how can we trust them about our climate/medicine/children?

The truth is somewhat different – sometimes press-releases present preliminary results as if they were final, verified findings, and then forget to also present the later study which disproves it. Scientists assert a theory, and then test it, and if they find it to be true, they celebrate. But other scientists might find out, after more independent testing, that this was just a freak result. Over time, enough of these results will prove or disprove a theory, and scientists may change their minds about something that they once believed to be true. This isn’t the equivalent of political flip-flopping, or being fickle – this is the scientific process in action. Believe a thing, test that thing, examine all of the evidence, and then, if necessary, believe the confirmed thing (even if it’s different to what you used to believe). Be sceptical of things that seem too good to be true, and be pleasantly surprised if they are.

Science doesn’t always get it right. Sometimes, papers will make it to journals when they never should have passed peer review. Sometimes, bad scientists will lie about results or manipulate data and deceive people. There are still a lot of things that we don’t fully understand, but this doesn’t mean that the scientific community is constantly at war over everything, or that every piece of established knowledge is tenuous, and liable to be disproved at a moment’s notice. On an awful lot of the big stuff, there is agreement. The human genome contains 23 chromosome pairs. Climate change is real. Water doesn’t remember the lavender that was in it 30 dilutions ago. There is no miracle cure for all cancers, being suppressed by big pharma. Some people believe some of these things to be untrue, but they are usually in the minority, however disproportionately loudly they may shout.

Once upon a time, in a land not so very far away, this scientist believed in homoeopathy. She hoped that it would work, and was amazed to find out that it did, which only made her believe all the more. Then, her alarm clock rang, and she awoke from her slumber to a world where belief doesn’t trump evidence (or lack thereof), and all was well.

Current Affairs

Girl Not Against Fluoride

The CDC (Centre for Disease Control) lists water fluoridation as one of the ten great public health achievements of the 20th Century. Today, Dublin City Council will vote on whether to remove fluoride from our water supply, and when they do, it will not be because the CDC or the WHO have changed their mind about fluoridation, or because new and compelling information makes it the only choice. It will be because people who believe in angel healing, homeopathy, and chemtrails, have somehow gained the ability to influence public policy.

It never ceases to amaze me that, in matter of public health, the debate is more often informed by people who believe everything they read on the internet. Celebrities with a cause-du-jour and an audience are given more time and attention than scientists, doctors, or even just people who understand basic chemistry, and realise that not all scientific papers were created equal. It leads to invented medical scandals (such as the disproven MMR autism link), and poor decisions (such as the one the council may make tonight), and it’s really past time that it stopped.

The past few weeks have seen a number of claims made about fluoride, and I’ve been doing my best to counter them with evidence as they’ve appeared. Here are some of the most common issues presented to me every time I post a tweet using the word fluoride.

Is fluoride damaging our health?

In brief, all of the best evidence says no. Dental fluorosis is the most common side effect from fluoridated water, and it is almost always solely cosmetic. Lots of claims have been made about fluoride affecting brain development, affecting IQ, affecting bone growth – and all of these claims just don’t really apply to water fluoridation. Studies which claim to show adverse effects of fluoride are typically using concentrations of fluoride far higher than what is permitted in our water supply, and the concentration in our water supply is monitored. In high concentrations, fluoride absolutely can cause significant health problems, but these concentrations are hundreds of times more than what is currently in our water supply.

What about these countries that don’t fluoridate?

There are lots of reasons that a country may not fluoridate their water. In some cases, it is because they fluoridate alternatives, such as milk or salt (e.g. Germany, Switzerland). In other cases, it is because their water is naturally fluoridated (e.g. France, Argentina, Mexico, and many more). In still more cases, it is because the government has decided to approach dental health in a different way. No countries have yet decided to ban fluoridation because the angels told them it was a form of mind control, although Ireland seems to be teetering on the brink of gaining this dubious title.

This country doesn’t fluoridate, and their dental health is fine. What gives?

Systematic reviews (large studies which look at all of the data available) have concluded that water fluoridation results in a fewer children presenting with cavities, decreased decay, fewer missing teeth, and have concluded that it is responsible for significant cavity prevention across the population. But dental health is not a single point issue – many factors affect dental health, and water fluoridation is just one of them. Countries which have excellent dental health without fluoridation also typically have very robust dental health programs, providing free or inexpensive dental care for children, ensuring that they see dentists regularly, thus keeping the cavities down without fluoride.

More studies have also shown that dental health is highly linked to socio-economic status – in other words, families who cannot afford regular dental care, and do not have it provided for them by the state, tend to have more dental problems. Without fluoridation (and given no alternative), these families are disproportionately affected.

Water fluoridation is not a silver bullet for dental health problems, but without a dental health system which allows equal access to effective care (through school programs, subsidised or free care, etc.), it is one of the best solutions we have. Removing water fluoridation without implementing one or more solid alternatives is a recipe for disaster.

It should be my choice to fluoridate. I don’t approve of mass medication.

The mass medication issue is a tricky one, and like a lot of ethical issues, it is far from black and white. You could argue that a government has a responsibility to protect the health of its people, and that it should provide dental health care to do so (because poor dental health affects many areas of an individual’s life). And many people believe that it would be better if a government provided this through improved dental care system, and I’m inclined to agree. Where that cannot be provided, however, what is a government to do? Fluoride has been shown to help dental health, and if you agree that a government has a responsibility to do its best for the health, life, and wellbeing of its people, shouldn’t they use it?

Mass medication is an ethical dilemma– even if it is shown to benefit people, and cause little or no harm. It is a debate that needs much consideration, but it is a debate that deserves better than scaremongering tactics, false information, and outright lies.

(Edit: 1/10/14 – edited to add some some supporting info: in a 1965 court case, the Supreme Court decided that water fluoridation did not constitute mass medication. The term is inaccurate, and designed to scare people, and used here only because it is the term that will be used most often by those who oppose fluoridation. Water fluoridation is water treatment, not mass medication.)

The fluoride debate is an emotive issue, and because of this, it will probably continue to be controversial. The controversy, however, merely makes it even more important that our politicians do not bow to pressure from scare-tactic groups and appeals to emotion, but decide based on the best available evidence. And that evidence is pretty clear – just ask the WHO, the CDC, the ADA…

My name is Jennifer Keane. I studied at Maynooth University where I was awarded my BSc, and then at the Open University, where I received my MSc. I’m passionate about the truth, about science, and about education. I’m the Girl Not Against Fluoride. I won’t pose in my underwear, but I do have my very own superhero costume. It is my graduation robes, because I am qualified.