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

Alternatives to the Quack Stuff

Today, I sent the following letter to the Irish Times.

Regarding “Alternatives to the Pink Stuff” published on Tuesday, March 8th.

A chara,

I find it disappointing and disturbing to note that a well renowned and regarded paper would publish what amounts to a puff piece promoting a form of quackery that has been debunked countless times. I refer, of course, to the Alternatives To The Pink Stuff article of March 8th. This article is a shameless promotion of homoeopathy, a non-medical treatment that is regarded as quackery by prominent doctors and scientists around the world. Its claims have been proven groundless time and time again.

We are told that, if a child is unwell, Ni Chinneide would treat them with fast-acting belladonna. Homoeopathic belladonna, aka Deadly Nightshade, is proposed as a cure because taking belladonna will give you a fever. Homoeopathic dilutions render the solution so dilute that it contains nothing but water. I’m not certain which is more laughable as a cure, but I am sure that neither will work.

Ni Chinneide herself says that if a child is in danger, one should see a doctor. Surely if her cures were as legitimate as this article makes out, one would have no need of a doctor?

The letter is in response to an article published on March 8th, called “Alternatives to the Pink Stuff“, and while I would have liked to go into more detail in the letter, I was advised that brevity is the watchword if one wishes to be published. Luckily, I impose no such restrictions here.

I was surprised, and more than a little disappointed to see that the Irish Times, a paper I would have previously regarded as being fairly upstanding, had published what amounts to a promotional puff piece, vaunting homoeopathy as a natural, safe, panacea-style alternative to all those nasty medicines that we stuff into our children.

After an opening paragraph which sets the tone for the article, “Applying the homeopathic, holistic principle of treating the whole person, not just the symptoms, she proposed more individualised methods of temperature control, specifically in childhood illnesses.”, we are introduced to Lee Ni Chinneide, a homoeopath working in the “Elbow Room” clinic in Dublin. Sadly, not two paragraphs in, and the contradictions and apologetic tone come to the fore. We are told that Ni Chinneide would treat a fever with “fast acting belladonna”, a delightful oxymoron. Just previously, however, we are warned that “if a child has suspected meningitis or could be in danger, do not delay seeing a doctor”.

Let’s get down to brass tacks here – either your medicine works, or it doesn’t. You can call it whatever you wish – alternative, natural, homoeopathic – but it all falls into one of two categories; the stuff that works, and the stuff that doesn’t. If fast acting belladonna provides fever relief, and the principles of homoeopathy are sound, then why preface your assertion with a “get out” clause? If homoeopathy worked, then you wouldn’t need to see a doctor if your child was in danger, as there are homoeopathic cures for virtually every ailment (including several purported cures for meningitis, such as belladonna, ferrum phos, bryonia, helleborus, and zincum metallicum). Of course, if one were certain that the medicine being administered was safe, and would cure all ills, then why caveat at all? It is an admission that the cures being administered will cure nothing at all, and that when the fast acting belladonna doesn’t take down the child’s fever, you’ll have to seek real medical help.

I’m not saying that everyone should rush to medicate their children at the slightest hint of a runny nose, but common sense should dictate that when your child has fallen more seriously ill, you should treat them with something more potent than water. Croup, diarrhoea, ear infections, and “tummy upsets”, may be common enough childhood illnesses, but that does not mean that they should be disregarded. Croup can cause rapid, and sometimes lethal, narrowing of the airways. Diarrhoea and “tummy upsets”, if prolonged or frequent, can be indicative of allergies or severe digestive problems which, if left untreated, can lead to the child becoming malnourished. Ear infections, left untreated, can result in ruptured eardrums, hearing loss, and bone infections. While these are undoubtedly the worst examples of complications from common illnesses, they are all possible. If a child begins to exhibit symptoms that indicate that he or she is not succeeding in fighting the infection themselves, and a parent chooses to seek homoeopathic treatment in lieu of real medical treatment, those complications become far more likely.

It goes without saying that all of the homoeopathic remedies mentioned in the article are extremely unlikely to cure anything, since they contain no active ingredients, and many of the purported ingredients have not been proven to be effective even when actually included in medication. Perhaps it needs to be said that, when it comes to children, doctor knows best.


And it continues with a campaign

As a result of my dealings with Boots, and my general attitude toward homoeopathic products, I’ve decided to take a leaf out of the book of the 1023 campaigners in England, and launch a similar campaign here in Ireland. The website for the campaign is now live, and I’d love it if you would all take a look, pass the link on, and consider supporting the campaign.

The reason I’m posting this is twofold – firstly, to let everyone know that the campaign is now starting, and that I need your support, and secondly, to talk a little bit more about why I’m doing it.

I think that everyone should have freedom of choice when it comes to their health. The decisions you make can affect the rest of your life dramatically, so it’s important to make the right ones. With so much advertising, it can be a bit tough to siphon out the useful information from all of the advertisement chaff when it comes to healthcare, so many people turn to their pharmacist for advice. And this is really where the problem starts. You could argue that it is someone’s choice to use homoeopathic remedies, and indeed, it is a choice that we should be free to make. But when that choice is made with incomplete or inaccurate information, then it’s not really a choice at all. Unless your pharmacist is specifically telling you that there is nothing in these remedies at all, then you are not making an informed decision.

Another oft-heard argument is that it’s not doing any harm to anyone to have them on sale, or for people to take them. After all, the placebo effect is a demonstrable phenomenon, and surely if that’s enough, we should leave them be? While I would typically refer these people to a number of cases where people have died unnecessarily due to carers withholding conventional medicine in favour of homoeopathic medicine, in this case, I’m going to look a little deeper.

The relationship between patient and pharmacist or doctor is a delicate thing. The doctor/pharmacist relies on the complete honesty of the patient in order to diagnose or treat correctly, and the patient has to trust the doctor/pharmacist enough in order to be completely honest. When this relationship fails, people are wrongly diagnosed and don’t get better. In order for a placebo drug, such as a homoeopathic medicine to work, the doctor/pharmacist has to lie to the patient. They have to say that it is a real medicine, that will cure what ails the patient. Every doctor and pharmacist would have to agree to treat homoeopathic medicine like a giant “emperor’s new clothes” conspiracy, and simply not mention the fact that there’s nothing in it, and lie to the patient if they ask directly. And when the doctor/pharmacist lies to the patient, that delicate bond of honesty and trust is broken.

In addition, it is often forgotten that the placebo effect is not limited to placebo medicines. For example, when you go to a doctor, and they prescribe you with a conventional medicine, the expectation is that you will get better, so you will experience the same placebo effect, along with the conventional treatment. Again, this relies partly on that bond between doctor/pharmacist and patient – the patient has to believe that the doctor/pharmacist is not lying to them and that the medicine will do them good. To return to a world where doctors and pharmacists lie to patients is to take a massive step backwards in the way we look after ourselves, and it shouldn’t be encouraged. In order for doctors and pharmacists to be honest, they need to let people know that there are no active ingredients whatsoever in the homoeopathic remedies that people are purchasing. Currently, this isn’t happening, and people are spending money on useless remedies.

I hope that, by organising this protest, I’ll be able to show some people that there really is nothing in homoeopathy, and that they shouldn’t waste their money on it. And I hope that I can show Boots that we would rather know the truth about our medicines than be lied to. If you agree, I hope that you’ll join me in the demonstration.


It started with an email…

Yesterday, I emailed the Boots customer care address, about homoeopathic products. I did this because I discovered that Boots was selling homoeopathic remedies in their stores in Dublin. The store that I visited was in the Jervis Street shopping centre, and it had prominent displays outside promoting the pharmaceutical advice and products available. I was pretty shocked, then, to find that they were selling useless sugar pills alongside actual effective medication. I was shocked enough that I was prompted to write a quick note, as follows:

To whom it may concern:

On visiting a local Boots store over the weekend, I was shocked and horrified to discover homoeopathic remedies for sale in the store (Jervis Shopping Centre branch). This particular store had a heavy emphasis on the pharmacy side of the business in its advertising, so I would not have expected it to also be selling unproven and essentially fake medicine to people, alongside useful drugs.

Homoeopathic remedies contain no actual substance other than sugar pills and/or water. They are diluted beyond the point where one molecule of the original substance can be in the final product, and that is scientifically proven. I cannot understand, therefore, why you would choose to sell such products alongside legitimate medicines.

On a personal note, I’m extremely disappointed to find that a store which I used to enjoy shopping in is continuing to sell these products.

Today, I received a reply from Boots:

Thank you for taking the time to contact us regarding your concerns over the retail of Homeopathic and Alternative remedies.

At Boots we take our responsibilities as the leading Pharmacy-led Health & Beauty retailer in the UK very seriously and as part of this we?re [sic] committed to providing our customers with a wide range of healthcare products to suit their individual needs.  We know that many people believe in the benefits of complementary medicines and we aim to offer the products we know our customers want.

Our Pharmacists are trained healthcare professionals and are on hand to offer advice on the safe use of complementary medicines. The Royal Pharmaceutical Society of Great Britain issues guidance to pharmacists on the correct selling of homoeopathy, which our pharmacists adhere to. We would support the call for scientific research and evidence gathering on the efficacy of homoeopathic medicines as this would help our patients and customers make informed choices about using homoeopathic medicines

We take the concerns of all of our customers very seriously and we thank you for the time you have taken to give us this feedback.  Please be assured that I have shared your comments with our Healthcare and Pharmacy teams.

Yours sincerely

Boots Customer Care

I would hope that, in the light of the recent 10.23 demonstrations, Boots would be receiving many emails complaining about their sale of homoeopathic products, so I expect that the reply is a standardised form letter by now. What their letter says is that, even if they are aware that the products are useless and pointless, they believe people want to buy them, and so they have no problem selling them. I do have a problem with a brand that is so associated with healthcare selling products which are not only ineffective, but which could well damage people if taken instead of conventional medicine when sick.

It is my opinion that it’s not enough to merely support the call for research while also profiting from the sale of useless pills and tinctures. Hundreds of studies have already been done on a wide range of homoeopathic remedies, and the results are almost unilaterally negative. Why ignore those studies in favour of future research, when the evidence is already there? The answer: profit.

I think it’s dangerous and misleading for a healthcare professional to recommend or advise on the use of homoeopathic remedies, as it lends credibility to a completely incredulous field. The only advice that “trained healthcare professionals” should give about homoeopathic remedies is “don’t take them”.

So, with the above in mind, I replied to Boots:


Thank you for your prompt reply.

My concern is precisely that Boots is considered a leading pharmacy, and that many people would turn to staff in store for health advice. If the advice given to them includes advice about homoeopathic remedies, then it undermines the advice that is being given.

Homoeopathic remedies contain no active ingredients whatsoever. Most remedies are sold at 30C dilution, which equates to 10 to the power of 60 dilution, or 1 part of the molecule in 1000000000000000000000000000000000000000000000000000000000000 parts of water. This means, essentially, that it is physically impossible for even a single molecule of the original substance to be present in the final product. What you are selling, as medicine, is essentially sugar pills with drops of water added. When people eschew conventional medicine in favour of homoeopathic remedies, there can be disastrous consequences. I refer you, for example, to the recent case of Thomas, Manju, and Gloria Sam.Gloria Sam was an infant who suffered from severe eczema. Rather than use the conventional medicine and creams which were recommended by their healthcare professional, her parents, Thomas and Manju Sam, chose to turn to a homoeopathic healthcare professional. As a result, Gloria’s condition continued to deteriorate rapidly. By the time the child was seen by a conventional medical professional, a doctor she was so ill that they had to immediately put her on morphine simply to manage the pain. Due to systemic infections, and a total lack of legitimate care, she died after 3 days in the hospital. This is a death that could have easily been prevented had the parents followed the advice of their healthcare professional. This case is just an example of the kind of thing that will continue to happen for as long as large institutions, such as Boots, are seen to support homoeopathy as a legitimate and effective choice when it comes to dealing with health problems.

Unless your healthcare professionals are informing people that no active ingredients are present in the homoeopathic remedies, and that they will have no effect on their health, then you are not helping them to make informed choices. Making an informed choice can only happen when all of the information laid out is correct.

I implore you to reconsider your support of homoeopathic medicine, to examine the evidence which has already shown that these medicines are ineffective, and to help your customers make a truly informed choice.

With all of the above in mind, I have decided to organise a ten23 event (mass homoeopathy overdose) in Ireland. I will set a date, and I would ask that any people who wish to join in get in touch with me at jkeane [at] zenbuffy [dot] com.
Watch this space for further updates on the correspondence with Boots, and on the upcoming ten23 event in Ireland.

A little knowledge is a dangerous thing

I used to think that the above quote was a little odd. I mean, surely knowledge is a thing to be shared, and the gaining of knowledge, something to be encouraged. I think I understand it now though. Knowledge, full and complete, is a wonderful thing. A little knowledge, however, really is a dangerous thing…

As an example, I present another fine article from that favourite of mine, the Daily Mail. The article deals with a planned protest of sorts by a group called 10.23. Members of the group plan to “overdose” on homoeopathic medicines in protest at Boots’ continued endorsement and sale of homoeopathic remedies. The Daily Mail article is sadly riddled with errors, and is attributed to a generic “Daily Mail Reporter”, who appears to have as poor an understanding of the subject matter as the many people who commented on the article itself. On reading the article, it’s clear that the author did very little research before writing (hardly surprising) and instead simply threw in a few names of “homoeopathic” products that he or she knew of. However, the products that are mentioned are not homoeopathic products at all – they’re herbal products.

The problem is that homoeopathic remedies and herbal remedies are not the same thing, and to imply that they are leads to confusion and, at worst, damage. A herbal remedy consists of dried, powdered, or otherwise prepared plant, mineral, etc parts and extracts, formed into pills, powders, liquids, etc. There are many herbal remedies for sale in Boots and in other health food shops. And there have been a number of studies that have shown that some herbal remedies can have beneficial effects on the conditions that they are supposed to treat. However, like “conventional” medicine, these herbal remedies are not without their side effects. Perhaps the most well known example of this is St. John’s Wort. This, to reaffirm the point, is a herbal, not a homoeopathic, remedy. St. John’s Wort (or Hypericum perforatum) is a small yellow flowered plant that is considered a noxious and toxic weed in many countries. It has been traditionally used to treat depression. Recent clinical studies have shown that it can be effective in cases of mild to moderate depression. However, clinical studies have also shown that the side effects of St. John’s Wort are many and varied, and it can interact with a number of prescription drugs, such as contraceptive pills, antiretrovirals, immunosuppressants, etc., making them less effective. So, like many over the counter medications, it has been shown to have both benefits and side effects. And like anything that you plan to take that may potentially effect your health, you would be well advised to consult a doctor (a real doctor) before taking it.

So, why isn’t it the same as homoeopathy? Well, when you buy St. John’s Wort over the counter, as a herbal remedy, what you are buying is part of the plant, processed and made into tablets or a similar delivery method. The tablet that you receive will have a defined amount of the plant in it. The same cannot be said of homoeopathic remedies, due to the nature of their creation.

Homoepoathic remedies are often based on a theory originally put forward by Samuel Hahnemann in 1796. The theory states that you should treat like with like – i.e. if you can find a compound which, when taken, causes the symptoms of malaria, then you will be able to cure malaria in an ill patient using this compound. The theory also states that the more diluted a preparation is, the more potent it is. The act of striking the preparation after each dilution (known as succussion) makes the mixture more potent. In Hahnemann’s time, knowledge of molecular chemistry was poor, so it was not unreasonable for him to assume that anything could be diluted infinitely and still contain some of the original chemical. However, the same excuse is not applicable to the people who now practice homoeopathy. Hahnemann advocated a dilution of 30C for almost everything – that is a dilution of 10 to the power of 60, or 1 part of the molecule in 1000000000000000000000000000000000000000000000000000000000000 parts of water. Modern science tells us that, using Hahnemann’s “C” scale of dilutions, that no trace of the original molecule is likely to be found at anything higher than a 12C dilution. Many homoeopathic remedies use dilutions even higher than advocated by Hahnemann, such as the infamous Oscilliococcinum homoeopathic flu remedy, which is diluted at 10 to the power of 400. As it is thought that there are only 10 to the power of 80 atoms in the whole universe, Oscilliococcinum would require several more universes (10 to the power of 320 universes, in fact) to even have a single molecule of the original substance in the final dilution. With those numbers in mind, you will hopefully see that it is extremely unlikely that a finished homoeopathic product (in the form of sugar pill or fluid) will likely contain absolutely none of the original molecule that it perports to contain.

This is the crucial difference between herbal medicine and homoeopathy, and it is a difference that the author of this article, and many of the people who left comments, have missed. Herbal medicinal products may actually contain some part of the plant they come from. Homoeopathic remedies are so unlikely to contain some part of what they originally came from as to be utterly laughable.

To those commenters, and the author, who spoke of the group members overdosing on things like St. John’s Wort and belladonna, you are sadly mistaken, and your little knowledge on the subject will go a long way to fuelling the misunderstanding and mistaken beliefs surrounding alternative medicines.  If the group truly choose only homeopathic remedies to overdose on, then they are in no danger at all. They will merely be swallowing water, possibly flavoured or coloured (such as in Rescue Remedy), or sugar pills. Unless an unfortunate member manages to drown whilst swallowing the remedies, I don’t expect that any medical treatment will be necessary in the aftermath. I expect that the members of the group will have done more than enough research to be aware of the difference between the medicines, as they seem well informed.

I do hope that others reading the article, and deciding to demonstrate the same way, do some research first. To swallow several hundred tablets of 30C nux vom. will be very unlikely to cause you harm. To swallow several hundred tablets of St. John’s Wort could very well leave you quite ill.

And so we return to my original point – a little knowledge is, indeed, a dangerous thing. A little knowledge, in the case of this author, has lead to a confusion between two very different kinds of alternative medicine, and one that could lead to trouble for a lot of people. As a journalist, it’s your duty to know what you are telling people and to make sure it is accurate. “Daily Mail Reporter”, whoever you may be, I’m sorry to say that you have failed.