Since this is the World Homeopathy Awareness Week, I might be spending more time on this particular well of credulity. I will also re-post my piece from last year’s WHAW. But today, I’ll be talking about Melanie Grimes, a homeopath who writes for HealthNews as a health “expert”. The irony though is painful -you will soon see that if “expert” was to be used in the same sentence as Melanie, then that would be: “Melanie Grimes is the exact opposite of a health expert“. So let’s start the fun, shall we?

I had a look at 3-4 of her articles^*, and I can assure you they are filled with fallacious arguments of the worst kind; a very bad understanding of modern scientific research; misrepresentation or outright ignorance of the relevant scientific literature; and propagation of very dangerous homeopathic beliefs as to what their pet therapy can treat (from cancer to diabetes, it’s all there).

Starting with her piece on this year’s WHAW (starting slowly with some common stuff):

Homeopathy provides an effective and gently way to treat allergies. Using potentized medicines, homeopaths prescribe minute doses to treat both the acute reaction to allergens, as well as the cause.

I hope you have spotted that subtle piece of misinformation: “minute doses”. It’s not minute doses actually. It’s non-existent doses usually. The most common potencies of homeopathic remedies are 12C and above -a dilution so high that no molecule from the original substance remains in the remedy!

But the most interesting claim is that homeopathy is effective for allergies. In fact, this is a very common claim of homeopaths but is there any evidence to back it up? Readers of this blog already know the answer: no.

A quick search in PubMed brings up some relevant reviews [1][2][3], none of them recommending homeopathy (or CAM in general) for diagnosing or treating allergies. Quoting from “Systematic review of complementary and alternative medicine for rhinitis and asthma”[1]:

Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns. Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence. [emphasis mine]

From “Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials”[2] from our favorite Prof. Edzard Ernst:

CONCLUSION: The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.

And finally, from “Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases”[3] which is a bit more generic and looked at various CAM treatments^**:

Looking at the literature, the majority of clinical trials with CAMS are of low methodological quality, thus difficult to interpret. There are very few studies performed in a rigorously controlled fashion, and those studies provided inconclusive results. In asthma, none of the CAM have thus far been proved more effective than placebo or equally effective as standard treatments. Some herbal products, containing active principles, have displayed some clinical effect, but the herbal remedies are usually not standardised and not quantified, thus carry the risk of toxic effects or interactions. None of the alternative diagnostic techniques (electrodermal testing, kinesiology, leukocytotoxic test, iridology, hair analysis) have been proved able to distinguish between healthy and allergic subjects or to diagnose sensitizations. Therefore these tests must not be used, since they can lead to delayed or incorrect diagnosis and therapy. [emphasis mine]

But Melanie is not bothered by actual research. She has already reached her conclusions -and these are not going to change no matter how much scientific evidence are presented to her…

Homeopathy provides valuable first aid, when treating acute and life-threatening allergic reactions.

If promoting an unproven modality for life-threatening situations is not criminal advice, then I don’t know what is. I am a huge proponent of free speech, but such pieces of writing are extremely dangerous and potentially lethal. The public has neither the expertise to spot such misinformation nor the time and energy to examine and qualify such claims.

But Melanie’s most concentrated woo comes in the last paragraph, really.

The exact mechanism of homeopathic drug therapy has not yet been discovered, due to the minute nature of the substances in the highly potentized medicines. This has led some scientists to speak out against homeopathy. Current breakthroughs in quantum physics and the memory of water are shedding light on the unique pathway that homeopathy provides. Modern research techniques, including double-blind studies, are proving the efficacy of this science.

Ah yes. Quantum Mechanics. The explanation for everything that defies physical laws (i.e. homeopathy). And that little red herring over there: “scientists speak out because the mechanism has not been discovered”. What an amazing understatement! In reality, scientists speak out for a vast number of legitimate reasons: all homeopathic principles go against well established science (like cures like, high dilutions etc); the vast majority of meta-analyses and reviews show that homeopathy is a placebo; in 200 years there has been no advancement or modification in homeopathy practice (pretty much like all religions); and finally, promoting unproven treatments is highly unethical and dangerous.

But that very last sentence is the definition of distortion and misrepresentation: “modern research proves homeopathy”! Following the link, we land on another of Melanie’s “expert” posts: “Research Supporting Homeopathy“… I am not going to spend much time on this one as it is the typical cherry picking, distortion, and misrepresentation of scientific evidence at its finest! Melanie mentions some century-old studies, before getting into the modern era of research, where surprisingly she only mentions Linde’s 1997 meta-analysis!

In 1997, K. Linde and W. Jonas, directors of the Alternative Medicine Evaluation Department of the National Institute of Health, co-signed a meta-analysis which evaluated 186 clinical trials on homeopathic therapies. Among the 105 trials whose results could be interpreted, 81 presented positive results, while homeopathy did not have a positive effect in 24 others. The authors concluded that, “the results of this meta-analysis are incompatible with the hypothesis that the clinical effects of homeopathy are due exclusively to a placebo effect.”

Anyone with an interest in homeopathy should know at least two things: 1) Linde himself has reconsidered his conclusions based on follow-up research that showed publication bias was likely to have affected the 1997 outcome; and 2) Linde’s is not the only modern meta-analysis! But is the only clearly positive one. What does that tell you about Melanie’s (and other homeopaths) honesty?

This cherry-picking and misinformation can only be explained in one of two ways: Melanie doesn’t know about all the other meta-analyses that were either inconclusive or negative; or Melanie knows about those but has chosen not to mention them. In the first case, she is definitely not an expert, and her ignorance on the subject is profound. In the latter case, she is simply dishonest and misinforms the public deliberately. You take your pick. But in both cases she is not qualified or suitable to discuss health issues in the public domain.

However, the problem with the homeopathic community is not Melanie of course. The vast majority of homeopaths act like this, including the Homeopath to the Queen, Peter Fisher, who made the same “mistake” (?) with Linde’s research in response to Ben Goldacre’s criticism [4]. So you can see it’s pervasive.

The other problem is the total lack of internal criticism in the community: no one ever complains about dangerous advice another homeopath gives out; no one complains when another homeopath misrepresents scientific research; and no one complains when another homeopath tries to explain his practice using fairy tales, life forces, and centuries-old disproven ideas.

How can a supposedly scientific field advance under these conditions? It takes real scientists in the field that follow the evidence wherever they lead, not blinded by their personal presumptions. Scientists like Prof. Edzar Ernst, who practiced a number of alternative modalities, critically evaluated them, and decided that most of them are inefficient (first of all homeopathy of course). Scientists like Klaus Linde, who had the courage to review his own conclusion when further research cast doubt over it. Definitely not people like Melanie Grimes, people unaware of the literature, willing to withhold and distort evidence, with a profound misunderstanding of modern research techniques, and good amounts of scientific ignorance…

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Footnotes:

1. * Why am I discussing some arbitrary homeopath writer? Because she is not one of a kind (unfortunately) and the kind of misinformation you will witness (either deliberate or not) is very common when promoting alternative treatments [↩]
2. ** I have to object here (as I have done before) to the inclusion of herbs under the CAM umbrella. First of all, in contrast to homeopathy, herbs actually contain active ingredients and have documented clinical effects. Second, when herbs are found to have a positive influence in a condition, they will usually go through the normal pharma production cycle of rigorous testing, efficacy and safety, dosage standardization etc. before they hit the market -i.e. they become mainstream medicine, for the sole reason that they work [↩]

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References:

1. Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J., "Systematic review of complementary and alternative medicine for rhinitis and asthma," in the Journal of Allergy and Clinical Immunology, 2006 May, v 117(5), pp 1054-62 [↩] [↩]
2. Altunç U, Pittler MH, Ernst E, "Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials," Mayo Clinic Proceedings, 2007 Jan, vol 82(1), pp 69-75 [↩] [↩]
3. Passalacqua G, Compalati E, Schiappoli M, Senna G., "Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases," Monaldi Archives for Chest Disease, 2005 Mar, vol 63(1), pp 47-54 [↩] [↩]
4. B Goldacre, "Benefits and risks of homoeopathy", Lancet 370 (2007), pp. 1672–1673 [↩]