Homeopathy is not a "complementary" form of medicine, since it holds principles and practices that are at polar opposites to orthodox medicine.  Homeopathy is a pseudoscience-belief system that was created out of the mind of Samuel Hahnemann, a German physician (1755-1843).  This was a time before modern medicine existed, before germ theory, before purified medicines were available, before causes of diseases were known, and before human anatomy was understood.  Hahnemann developed a set of homeopathic principles based on erroneous conclusions based on his observations of the similarities between the symptoms of diseases and symptoms of the rather toxic medicines and concoctions of the day.  He tried several medicines on himself and others (called "provers") and catalogued the side effects of the medicines.  Then he catalogued diseases and their symptoms.  He noted that some medicines had similar side effects as the symptoms of the medicine, then erroneously reasoned that the specific medicine and the disease must somehow be related. 

 

Thus his first principle of homeopathy was developed- the law of similars that he termed 'let likes be cured by likes'.  He then later came up with the concoction that if a medicine that produced a certain side effect similar to a disease was serially diluted by 1:10 dilutions (termed X) or 1:100 dilutions (termed C), then the bad side effects of the medicine would be eliminated, but that the diluted product would treat the disease.  He further erred in concluding the more dilute the product, the more potent was the final product. He called this "potentiation", and claimed the water had memory of the properties of the original medicine, amplifying the effect the more dilute the substance.  Hahnemann typically used dilutions of 1:100 performed 30 times or 100 to the 30th power expressed mathematically.  This dilution amount is 1 over 1 followed by 60 zeros- or one molecule remaining in an entire ocean of diluent, or no molecules of the active substance remaining in the final treatment used. This extreme dilution was called minimization and this is the second principle of homeopathy.  Each dilution is accompanied by vigorous agitation of the diluted solution ending with a magical striking of the vial Hahnemann called 'succussion".  The third principle of homeopathy is use of a single agent on a patient.  Clearly homeopathic remedies sold in stores today scoff at this since in America, 'more is better', with current homeopathic solutions frequently containing many different diluted substances, each with their own dilution posted as an X or C.  Of course there is no science behind homeopathy, but it has many believers, so they can't all simply be deluded. Hahnemann also developed, as the underpinning of homeopathy, his own theory of disease, called the miasm theory. According to this theory there are three miasms which are responsible for all human disease, and homeopathic remedies are directed towards treating these offending miasms. One of the main "miasms" is venereal disease, that Hahnemann thought to be the cause of most other diseases seen. In fact, in 1828, he claimed all diseases emanated from scabies, a sexually transmitted disease.  Hahnemann claimed he could cure all diseases with homeopathy.  Of course he was a charlatan, but died a wealthy charlatan, being a millionaire at his death. 

​

Homeopathy, like traditional Chinese medicine, is a system of alternative treatment that employs counseling, touch therapy, and homeopathic concoctions.  In order to be a homeopathic practitioner, there are no requirements, no regulation, no licensure, no required training, and no oversight by the state or federal government.  As long as the drugs are listed in the Homeopathic Pharmacoepia of the US (HPUS) from 1938, then the government is strictly hands off homeopathy.  Some practitioners of homeopathy are Naturopathic Doctors but some are nurses, and some are just people with no medical or nursing training at all, but read an article on homeopathy and hung out their shingle. 

​

The goal of a modern homeopathic consultation is to find the “totality of symptoms,” physical, mental, and spiritual. The homeopathic practitioner (frequently a naturopathic doctor, a system of medicine that eschews science) accomplishes this goal by taking a “homeopathic history” which includes questions such as: do you feel sad when you hear piano music, are you excessively tidy, or do you have a chilly personality? This information is combined with the patient’s symptoms and their physical “constitution,” which may depend on such facts as hair color. The homeopath then decides on what single remedy will treat the patient’s “totality.” The remedy is then prescribed, and is usually given in either a single dose or only a few doses.

The principles of homeopathy run contrary to modern science and have never been empirically established.  But homeopathy was very popular in the 1800s and early 1900s in the US with many homeopathic hospitals throughout the US and there were homeopathic medical schools.  Eventually however, homeopathy fell out of favor because it does nothing to actually treat disease, since effectively the only treatment being offered are concoctions containing only water. All homeopathic hospitals in the US closed, not because of the AMA but because of lack of results.

​

The scientific studies of the effectiveness of homeopathy have found for the most part, homeopathy is a fraudulent treatment that does nothing to treat disease. In September 2017, the European Academies Science Advisory Council representing 29 national science academies in Europe (including the Royal Academy of Science in the UK) branded homeopathy "nonsense" and warned the "promotion and use of homeopathic products risks significant harms, through delay in diagnosis. The NHS in Britain has subsequently stopped covering all homeopathic treatments. In order to cash in on homeopathic medicines, many pharmacies, grocery stores, and Walmart offer concoctions of homeopathy, frequently multiple homeopathic medicines in one pill.  The use of homeopathic medicines off the shelf (completely ineffective placebos) without counseling by a "practitioner" (effective in patient satisfaction, validation of patient disease, and helps with psychological derangements) denigrates homeopathy to the nonsense the European council above decries. 

​

But homeopathy in some cases does actually work for certain people or in biased studies.  So how does it work?  Clearly not in the manner stated by the homeopathic practitioners that depend on defying the laws of physics and chemistry in order to explain the effect.  Below are some of the ways homeopathy does have an effect:

​

1. Placebo effect.  There is around a 20-35% placebo response in medicine.  That is, patients believe the medicine administered will work, therefore it does work, even if there is nothing in the medicine other than water or a filler. Homeopathy strongly depends on the placebo effect.

2. Cyclic or transient diseases treated with homeopathy often resolve with or without treatment.  Homeopathic practitioners frequently take credit for spontaneously improving disease.

3. The homeopathy medicine contains active ingredients that are listed as inert.  For instance, some homeopathy medicines contain oil of Eucalyptus that in itself is an active ingredient.  Frequently creams and salves mislabeled as homeopathy medicine, contains active carrier agents.  

4. Homeopathy medicines are fraudulently containing prescription medicines.  Sometimes manufacturers are unscrupulous, and add prescription drugs to homeopathy medications, much in the same way supplement manufacturers do.  The FDA does not regulate homeopathy manufacturers, only rarely tests their products- even less so than the already rare testing of supplements, therefore no one really knows what these medicines contain. There have been homeopathy medicines for asthma that were found to contain high amounts of corticosteroids, without this fact being divulged on the bottle or package. 

5. Homeopathic medicines are fraudulently mislabeled- not being homeopathic at all.  For instance, Arnicare cream states on the front of the package that it is a "Homeopathic Medicine".  But the Arnica concentration is 7%.  Homeopathic medicines by definition do not contain more than 0.00001% of an active ingredient.  This is clearly fraudulent labeling of a medicine but the FDA does nothing about it. 

6. The liquid in homeopathy washes out the cytokines or toxins.  This is unlikely to be operative unless the homeopathy medicine (effectively pure water) is injected into the spine or into a joint such as Traumeel or Zeel injections.

7. Time spent with patient.  One study showed homeopathic practitioners spent an average of 118 minutes on the initial visit with the patient- far in excess of allopathic medicine.  It has been shown positive outcomes from homeopathy are due to time spent with the patient, and the medications prescribed have no effect. (Rheumatology (Oxford). 2011 Jun;50(6):1070-82).  So in effect, patients are spending their money to tell homeopathic practitioners about their symptoms, and even though the homeopath can do nothing to help, the patients feel satisfied.   

8. Indoctrination.  Homeopathic practitioners spend time convincing patients their art actually does something, and gives counseling with positive feedback.  This active indoctrination into homeopathy strongly plays into the placebo effect.  

9. Catering to the alternative medicine schtick.  There are many reasons why some people seek out homeopathic treatments- intense mistrust in orthodox medicine, perception that homeopathy is safer, seeking a "holistic" practitioner, and a personality type that causes some to gravitate to the fringes in medicine, etc.   It is these patients that accept the premises of homeopathy without question, and therefore results, no matter what they are, are better in their minds than traditional physician approaches. 

10. Counseling.  Even though the homeopathic method uses gibberish in their diagnosis and treatment, the fact they are counseling patients may have some benefit in the treatment of anxiety, depression, and "validating" the patient has some disease, even if the homeopathic diagnosis is wrong.

​

STUDY EVALUATIONS

Since case series, case reports, etc. are strongly biased in homeopathy, only RCTs are included.  In many cases, the RCTs are biased towards homeopathy, due to the comparison being used is the homeopathic system plus indoctrination plus counseling vs simply giving the patient a placebo or comparison medicine.  It is surprising homeopathy does not show stronger results given the inherent bias in some of the RCTs.

​

​

STUDIES SHOWING NO EFFECT OF HOMEOPATHY FOR PAIN   (RCT= randomized controlled trial)

• Iran Red Crescent Med J. 2016 Aug 9;18(9) No effect on menstrual pain (RCT)

• BMJ. 1995 Jun 3;310(6992):1439-42  Homeopathy had no effect on post surgical pain or inflammation (RCT)

• J R Soc Med. 1998 Nov;91(11):579-82 There was no difference between a homeopathic preparation of belladonna and placebo

• Clin J Pain. 1998 Sep;14(3):227-31. No difference between Arnica homeopathic concoction compared with placebo for muscle soreness after long distance running (RCT)

• Br J Sports Med. 1997 Dec;31(4):304-7  Placebo works better than homeopathy for muscle soreness (RCT)

• J R Soc Med. 1997 Feb;90(2):73-8 There was no difference between Arnica homeopathic and placebo for the treatment of post operative pain (RCT)

• Br Homeopath J. 2000 Jan;89(1):4-7. Statistically no difference in effect of homeopathy vs placebo for migraine treatment (RCT)

• Z Rheumatol. 2000 Oct;59(5):321-9 No difference between placebo and blood plus formica rufa intramuscular injections for ankylosing spondylitis pain (RCT)

• Rheumatology (Oxford). 2001 Sep;40(9):1052-5.  No difference in outcomes for rheumatoid arthritis placebo vs homeopathy, except pain scores were better in the placebo group (RCT)

• J R Soc Med. 2003 Feb;96(2):60-5. There was no difference between placebo and homeopathy (Arnica pills) for pain or bruising after carpal tunnel surgery (RCT)

• Forsch Komplementarmed Klass Naturheilkd. 2003 Oct;10(5):242-7. No statistical difference in pain or swelling with placebo vs homeopathy oral "globules" for varicose vein surgery (RCT)

• Complement Ther Med. 2006 Dec;14(4):237-46. Epub 2006 Oct 13  Two out of three clinical trials showed no improvement in post op knee swelling after arthroscopy when using arnica vs placebo (RCT)

• Br J Clin Pharmacol. 2008 Feb;65(2):180-7 Homeopathy was no better than placebo in knee ligament reconstruction pain or function or in reduction of analgesics  (RCT)

• Rheumatology (Oxford). 2011 Jun;50(6):1070-82 Homeopathic consultation but not homeopathic medicines are useful in treating rheumatoid arthritis  (RCT)

• BMC Clin Pharmacol. 2010 Apr 12;10:9.  Homeopathic medicine for bunion surgery was not superior to placebo (RCT)

• Homeopathy. 2016 Feb;105(1):66-70. There was no difference between pentazocine and homeopathic medicine for labor pain.

• J Evid Based Complementary Altern Med. 2015 Jul;20(3):186-91 Homeopathy was not superior to placebo in the treatment of osteoarthritis

​

SYSTEMATIC REVIEWS OF HOMEOPATHY FOR MULTIPLE USES

• J Pain Symptom Manage. 1999 Nov;18(5):353-7. 3 trials showed homeopathy ineffective while one trial suggested it might be effective in the prevention of migraines and headaches

• Med J Aust. 2010 Apr 19;192(8):458-60  Homeopathy has no effect beyond placebo

• Sleep Med Rev. 2010 Oct;14(5):329-37 Homeopathy has no effect on insomnia

• BMJ Clin Evid. 2011 May 26;2011 There is insufficient evidence to support homeopathy in chronic fatigue syndrome

• Br J Dermatol. 2012 Jun;166(6):1170-2. Homeopathy is ineffective in eczema treatment

• Cochrane Database Syst Rev. 2007 Oct 17 Homeopathy has no effect in ADHD treatment

​

​

STUDIES SHOWING POSITIVE EFFECT OF HOMEOPATHY FOR PAIN

• Br Homeopath J. 2001 Jan;90(1):21-8 Spiroflor gel was equal to capsaicin gel in pain relief for the treatment of low back pain (RCT)  [Carrier material in homeopathic gel may have had positive effect]

• Rheumatology (Oxford). 2000 Jul;39(7):714-9. Homeopathic gel was as effective as NSAID gel for treatment of pain of osteoarthritis of the knee [Carrier material in homeopathic gel may have had positive effect]

• Homeopathy. 2003 Oct;92(4):187-9  Pooled studies (statistically invalidates conclusions) found Arnica helps reduce muscle pain more than placebo after a marathon p=0.04 (a very marginal level of significance).  "Pills of Arnica", 5 pills were given before each race to each participant (invalidates the minimalization principle of homeopathy)

• Rheumatology (Oxford). 2004 May;43(5):577-82. Epub 2004 Jan 20. Individualized homeopathy vs placebo improved tender point count and pain, quality of life, depression, and global health in patients with fibromyalgia  (RCT- but the homeopathy was the system of homeopathy including extensive time spent with the patient and counseling, not simply the medicine)

• Homeopathy. 2007 Jan;96(1):17-21. Arnica for post-tonsillectomy pain found there was a clinically small but statistically significant reduction in pain compared to placebo. Of note is that it did not change post op analgesic requirements  (RCT)

• Explore (NY). 2005 Nov;1(6):446-52. Traumeel ointment was not inferior to NSAID ointment/creams for tendinopathy pain (RCT) [Carrier material in homeopathic ointment may have had positive effect]

• Homeopathy. 2009 Apr;98(2):77-82 Homeopathy produced significant improvement in function in fibromyalgia patients with a small improvement in pain. [Consistent with psychological counseling effect]

​

LAB STUDIES

• Explore (NY). 2007 Jan-Feb;3(1):16-22. Zeel, a combination of homeopathic medicines that by definition violates Hahnemann's third principle of homeopathy, has demonstrated laboratory reduction in inflammation and swelling