QED: Quality Evidence Demonstrated for Homeopathy

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“Ask for Evidence” of Homeopathy because the scientific evidence is vital to good decision-making and optimisation of resources. [click to tweet]

Answers to most of the questions on evidence of homeopathy are available at Scientific Research in Homeopathy In case you are not satisfied with the methodology/results of the research paper, you are requested to contact the authors or the editors of the journal first otherwise you are welcome to ask your questions in the comment section by entering the following data:

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Ask/Claim: Your Question
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You can ask like

  1. The name of the Journals where studies in evidence of homeopathy are published

  2. The kind of studies published in those journals such as basic fundamental research, Super-Avogadro Research, research models, pathogenetic trials, meta-analysis, systematic reviews, double-blind randomised placebo-controlled trials, in vitro, in vivo, etc

  3. The quality of trials such as Jadad score, AMSTAR rating, etc.

  4. The URL link to the full-text of the studies

  5. The articles on applied research in homeopathy for specific clinical conditions

  6. Advice on scientific matters such as how to evaluate the evidence, etc

Remember, this is not a discussion forum but preparing a database, so you are requested to keep your question short and based on your feedback, I may modify my answer to your question.

You will be provided with

Evidence: My Answer 
Reference:

Important Points

1. If you wish to ask for an evidence of homeopathy on twitter, then send me a tweet and use #drnancymalik in your tweets.

  1. If you wish to ask me anything about homeopathy other than the evidence such as principles, concepts, etc, you may ask at Medicine Blog

  2. This campaign of  educating the medical and health professionals, scientific community, patients and to the general public is supported by “VoGS: Voice of Good Science” and “Sense About Medicine“

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20 Comments

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  1. Brian Lynchehaun

    Name: Brian Lynchehaun
    Location: Japan.
    Question: Where are the randomized control studies of homeopathy vs medicine vs placebo (i.e. three groups) with 50 participants (or more) that have been replicated, and their results not undermined by massive methodological flaws?

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    • Dr. Nancy Malik

      Randomised Control Studies with n=50 or more are given below

      HOMEOPATHY SUPERIOR TO CONMED

      Evidence-based Complimentary & Alternative Medicine (Hindawi)
      Homeopathic LM potencies Vs Fluoxetine for Depression (2009)

      Click to access News_2009-09_eCAM_Depression.pdf

      Double-blind Randomised Trial with n=91
      Homeopathy not inferior to fluoxetine (Prozac) but had a better safety profile
      Higher percentage of patients treated with fluoxetine reported troublesome side effects and there was a trend toward greater treatment interruption for adverse effects in the fluoxetine group compared to homeopathy
      Complementary Therapies in Medicine (Elseiver)
      Homeopathy for the prevention of upper respiratory tract infections (2005)
      http://www.ncbi.nlm.nih.gov/pubmed/16338192
      Randomised Controlled Trial with n=169
      The difference in the median number of days with URTI symptoms was statistically significant with 8 days in the homeopathic group and 13 days in the control (conventional) group (p = 0.006).
      Jadad Score=5
      Homeopathy (Elseiver)
      The 2005 meta-analysis of homeopathy: the importance of post-publication data (2008)
      https://docs.google.com/file/d/0B0b69JqzK_44a1JsNHRETmtrYzg/edit
      Meta-Analysis of Randomised Controlled Trials
      Quality of homeopathic Trials is better than of conventional trials for all trials (p=0.03) as well as for smaller trials (p=0.003)

      HOMEOPATHY EQUALS CONMED

      Archives of Otolaryngology- head & Neck Surgery (American Medical Association)
      Homeopathic Vs conventional treatment of vertigo (1998)
      https://docs.google.com/file/d/0B0b69JqzK_44ZmNkYjIzZWYtNmFkZi00NWYxLTg1MjItN2E4ZDUwMmVlZjUz/edit
      Double Blind Randomised Controlled trial with n=119
      Statistical Significant results with homeopathy as well as betahistine

      Forschende Komplementärmedizin und Klassische Naturheilkunde (German ) meaning Research in Complementary and Classical Natural Medicine
      Comparing Luffa compositum-Heel nasal spray with cromolyn sodium spray in the treatment of allergic rhinitis (1999)
      https://docs.google.com/file/d/0B0b69JqzK_44NTY5MDI3MzctNGEwYy00OWE4LThhYjUtYjIyZjExZWMwOTdm/edit?num=50&sort=name&layout=list#
      Double-blind Randomised trial with n=146
      Homeopathic Nasal Spray containing Luffa, Galphimia, Histamine and Sulphur is as efficient and well tolerable as conventional therapy as Cromolyn Sodium

      HOMEOPATHY SUPERIOR TO PLACEBO

      Journal of Clinical Epidemiology
      Conclusions on the effectiveness of homeopathy depend on the set of analyzed trials (2008) http://www.anthromed.org/UploadedDocuments/LuedtkeRuttenJCE08.pdf
      Meta-Analysis of Randomised Controlled Trials
      homeopathy had a significant effect beyond placebo (odds ratio= 0.76) with p=0.039 at 95% CI

      Complementary Therapies in Medicine (Elseiver)
      Arnica for inflammation after knee surgery
      https://www.sciencedirect.com/science/article/pii/S0965229906000410 (2006)
      Double-Blind Randomised Placebo Controlled trial with n=226

      British Medical Journal
      Clinical Trials of Homeopathy (1991)

      Click to access bmj00112-0022.pdf

      Meta-Analysis of Controlled Trials
      77% of 105 studies show homeopathy to be superior to placebo

      Journal of Psychosomatic Research
      Efficacy of homeopathic treatment for chronic fatigue syndrome (2004)
      http://www.ncbi.nlm.nih.gov/pubmed/15016577
      Triple-Blind Study with n=92
      Weak but equivocal evidence that the effects of homeopathic medicine are superior to placebo

      Journal of Clinical Gastroenterology
      Homeopathy for post-operative ileus (1997)
      http://www.ncbi.nlm.nih.gov/pubmed/9451677
      Meta Analysis (6 trials, 776 patients)
      Statistically significant (p < 0.05) weighted mean difference in favor of homeopathy (compared to placebo)

      Wiener Medizinische Wochenschrift
      Homeopathic Galphimia glauca for hay fever (1997)
      http://www.ncbi.nlm.nih.gov/pubmed/9381725
      Meta-analysis of controlled trials (11 trials)
      Significant superiority of Galphimia glauca over placebo is demonstrated

      There are more studies showing homeopathy to be superior to placebo. But I must stop here.

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  2. Francis

    The best conclusion in favour of homeopathy from any reputable journal on that list is weak evidence which warrants higher quality trials. And it has been shown that the higher the quality of a trial, the more likely it is to show that homeopathy is not any more effective than placebo (http://www.ncbi.nlm.nih.gov/pubmed/10391656). An example of high-quality research would be the Cochrane reviews which do not have any evidence supporting homeopathy (http://www.ncbi.nlm.nih.gov/pubmed/20402610)

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    • Dr. Nancy Malik

      The reputation/quality of a journal is measured in term of its “impact factor” and indexing services.
      The quality of trials can be evaluated by Jadad score, AMSTAR rating, Oxford scale, etc.

      Cochrane Review
      Homeopathic medicines for adverse effects of cancer treatments (2010)
      http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004845.pub2/full
      8 Randomised Controlled Trials with n=664
      Homeopathic medicines for the prevention or treatment of adverse effects of chemotherapy, radiotherapy, and menopausal symptoms caused by hormonal therapies or oestrogen withdrawal.
      “Compared with trolamine, calendula reduced the incidence of acute dermatitis of grade two or above in women undergoing radiotherapy for breast cancer in one clinical trial involving 254 participants.”
      “Based on a single trial involving 32 participants, one particular homeopathic combination (Traumeel S – a proprietary complex homeopathic medicine) appears to show promise in the treatment of chemotherapy-induced stomatitis.”

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  3. Marc

    Name: Marc
    Location: Canada
    Question: How does a homeopath distinguish between a properly-made homeopathic preparation, and a preparation where the person making it forgot to add the active ingredient in the first step?

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    • Dr. Nancy Malik

      Homeopathic medicines are prepared by a pharmaceutical process of potentisation. It involves preparation of a liquid base substance (called Mother Tincture) from adding the original active ingredient in a hydro-alcoholic (double distilled de-mineralisd water-95% pure medicinal extra-neutral ethanol mixed in a particular ratio) solution or sugar of milk (lactose) if it is insoluble, successive serial dilution and succussion/trituration of the mixture after each dilution.
      The presence of an active ingredient upto 200c potency can be tested using Transmission Electron Microscopy, electron diffraction and Inductively-coupled Plasma-atomic Emission Spectroscopy as shown in the paper https://docs.google.com/file/d/0B0b69JqzK_44Y2FmMzRjYTUtYWFiYi00ODA4LThlYzctZGYxMDhkMDM1NmVk/edit?pli=1 (2010)

      The techniques used to distinguish high dilutions (above 12c/23x/LM4 potency) of homeopathic medicines from the solvent/controls are Fourier transform Infrared Spectroscopy, Bio-Electro-graphy and Ultra-violet Spectroscopy, and are available from year 2003 onward. Before that I am not aware of any studies, if any, to distinguish homeopathic medicines from the solvent/controls.

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  4. Etienne

    Etienne
    Belgium
    Could you in simple terms describe methodology for dose-finding and safety studies in Homeopathy?

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    • Dr. Nancy Malik

      The patient is as sensitive to the medicine as to the disease. If the medicine chosen for the cure of the disease is used in large quantities or in too crude a form then we can actually make the symptoms worse i.e an aggravation of the patient’s condition/disease and might injure the body.

      So, the ‘similar’ remedy must be given in minimum (smallest possible) dose which is sufficient to stimulate the vitality and evoke a natural healing response to bring about the necessary curative change in a patient.

      The minimum dose may be different for different people based on patient’s sensitivity. The greater the sensitivity to a substance, the smaller the dose required. This smallness is to be optimal, that is, effectively the amount by which the medicine exceeds the strength of the disease. Hahnemann said, “Only pure experiments, careful observation of the arousability of each patient, and correct experience can determine this in each particular case.” (aphorism 278).

      Some of the papers regarding safety studies in homeopathy
      1. Forschende Komplementarmedizin (German) meaning Research in Complimentary Medicine
      Effectiveness, Safety and Cost-Effectiveness of Homeopathy in General Practice (2006) https://docs.google.com/file/d/0B0b69JqzK_44MGVlZmY0YWItMGZmNS00Y2RhLWFlYjYtNDY3ZDNlNzU3YTk2/edit?pli=1

      2. British Homoeopathic Journal
      Efficacy and safety of a homeopathic gel Spiroflor SRL in the treatment of acute low back pain (2001)
      SRL (Symphytum, RhusTox, Ledum Pal) is equally effective as Cremor Capsici Compositus FNA but has better safety profile
      Double-blind Randomised Trial with n=21

      3. Evidence-based Complimentary & Alternative Medicine (Hindawi)
      Homeopathic LM potencies Vs Fluoxetine for Depression (2009)

      Click to access News_2009-09_eCAM_Depression.pdf

      Homeopathy not inferior to fluoxetine (Prozac) but had a better safety profile. Higher percentage of patients treated with fluoxetine reported troublesome side effects and there was a trend toward greater treatment interruption for adverse effects in the fluoxetine group compared to homeopathy
      Double-blind Randomised Trial with n=91

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      • Etienne

        “Hahnemann said, “Only pure experiments, careful observation of the arousability of each patient, and correct experience can determine this in each particular case.” (aphorism 278)”
        So the rational behind this is based on Hahnemann’s statements (1755 – 1843). In that perspective, we could throw away all the science and rely on Harvey (1578-1657) to do surgery. How does that make sense?

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        • Dr. Nancy Malik

          Newton’s law of gravitation published on 5 July 1687. So should we reject and throw away science just because it was published more than 300 years back? How does that make sense?

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  5. Drew

    In the previous comment I described specific (and under the circumstances very reasonable) evidence which would change my mind about homeopathy.

    What evidence would you need to see to change your mind about homeopathy?

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    • Dr. Nancy Malik

      As long as there are positive studies in evidence of homeopathy, I am happy to demonstrate it’s effectiveness to medical and health professionals, scientific community, patients and to the general public. If those positive studies are retracted by authors/editors/journals, I am happy to change my mind.

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      • Drew

        There are quite a few papers out there that have never been retracted. That doesn’t mean that things like ESP, Cold Fusion or N-rays are good science. They would have become “mainstream” science if everyone who tried to replicate the experiment was able to obtain the same result.

        You would EXPECT some positive results if you tested ANY intervention. If a roomful of people rolled 2 dice you’d expect SOME of them to get 2 sixes. Doesn’t mean they’ll be able to repeat that feat.

        Like I’ve said to you before: the null hypothesis of any experiment is that there is no effect. Until positive results for homeopathy are reproduced by people who do not make a living from it the null hypothesis stands.

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  6. Drew

    Hi Nancy,

    can you provide references (in journals which are preferably not peer reviewed by professional homeopaths) for a positive, double-blinded RCT of a specific homeopathic treatment which has shown similarly positive results when independently replicated?

    Just two links – the original study and its independent replication.

    Many thanks,
    Drew

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  7. Dr. Nancy Malik

    Q What do you consider to be the best clinical evidence supporting the efficacy of homeopathy for any indication?
    A http://www.legatum.sk/en:misc:talk-saine-novella-question01

    Q Can you provide a peer reviewed, randomized, blinded trial that has been duplicated at least once and appears in a mainstream journal of any specific homeopathic remedy that has been shown to be beneficial in any specific disease?
    A http://www.legatum.sk/en:misc:talk-qa-schwarcz-saine

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    • Brian Lynchehaun

      “Unfortunately, the best clinical evidence for homeopathy has not been fully and properly evaluated, as most of its evidence is still lying dormant in its vast literature, in case reports, cohort studies, official reports from boards of health, hospitals, insurance companies and state prisons, orphanages and mental asylums.”

      Cutting through the long nonsensical preamble: there isn’t any evidence.

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  9. Dr. Nancy Malik

    pseudo-s(k)eptic: “I don’t understand how homeopathic medicine works, so it can’t work”
    They still believe the earth is flat.
    Evidence for homeopathy piles up. 298 studies in 114 journals upto the end of the year 2010.
    You gave pseudoskeptics the evidence. They remain in denial. They say it’s the wrong type.
    They need to be more creative in their denialism.
    What convincing evidence would skeptics need to see to change their mind about homeopathy?
    For them the problem is not that it doesn’t work,the problem is that it does.

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