On
this page:
- What
is homeopathy?
- What
is the history of the discovery and use
of homeopathy?
- What
kind of training do homeopathic
practitioners receive?
- What
do homeopathic practitioners do in
treating patients?
- What
are homeopathic remedies?
- How
does the U.S. Food and Drug
Administration (FDA) regulate
homeopathic remedies?
- Have
any side effects or complications been
reported from the use of homeopathy?
- What
has scientific research found out about
whether homeopathy works?
- Are
there scientific controversies
associated with homeopathy?
- Is
NCCAM funding research on homeopathy?
- For
More Information
- References
- Appendix
I
- Appendix
II
Homeopathy
("home-ee-AH-pah-thy"), also known
as homeopathic medicine, is a form of health
care that developed in Germany and has been
practiced in the United States since the
early 19th century. Homeopathic
practitioners are commonly called
homeopaths. This fact sheet answers some
frequently asked questions on homeopathy and
reviews scientific research on its use and
effectiveness.
Key
Points
- In
homeopathy, a key premise is that every
person has energy called a vital force
or self-healing response. When this
energy is disrupted or imbalanced,
health problems develop. Homeopathy aims
to stimulate the body's own healing
responses.
- Homeopathic
treatment involves giving extremely
small doses of substances that produce
characteristic symptoms of illness in
healthy people when given in larger
doses. This approach is called
"like cures like."
- It is
important to inform all of your health
care providers about any therapy that
you are currently using or considering,
including homeopathic treatment. This is
to help ensure a safe and coordinated
course of care.
Top
1. What is
homeopathy?
The term
homeopathy comes from the Greek words homeo,
meaning similar, and pathos, meaning
suffering or disease. Homeopathy is an
alternative medical system. Alternative
medical systems are built upon complete
systems of theory and practice, and often
have evolved apart from and earlier than the
conventional medical approach used in the
United States.a
Homeopathy takes a different approach from
conventional medicine in diagnosing,
classifying, and treating medical problems.
Key
concepts of homeopathy include:
- Homeopathy
seeks to stimulate the body's defense
mechanisms and processes so as to
prevent or treat illness.
- Treatment
involves giving very small doses of
substances called remedies that,
according to homeopathy, would produce
the same or similar symptoms of illness
in healthy people if they were given in
larger doses.
- Treatment
in homeopathy is individualized
(tailored to each person). Homeopathic
practitioners select remedies according
to a total picture of the patient,
including not only symptoms but
lifestyle, emotional and mental states,
and other factors.
a.
Conventional medicine, as defined by NCCAM,
is medicine as practiced by holders of M.D.
(medical doctor) or D.O. (doctor of
osteopathy) degrees and by their allied
health professionals, such as physical
therapists, psychologists, and registered
nurses. Some conventional medical
practitioners are also practitioners of
complementary and alternative
medicine.
Top
2. What is
the history of the discovery and use of
homeopathy?b
In the late
1700s, Samuel Hahnemann, a physician,
chemist, and linguist in Germany, proposed a
new approach to treating illness. This was
at a time when the most common medical
treatments were harsh, such as bloodletting,c
purging, blistering, and the use of sulfur
and mercury. At the time, there were few
effective medications for treating patients,
and knowledge about their effects was
limited.
Hahnemann
was interested in developing a
less-threatening approach to medicine. The
first major step reportedly was when he was
translating an herbal text and read about a
treatment (cinchona bark) used to cure
malaria. He took some cinchona bark and
observed that, as a healthy person, he
developed symptoms that were very similar to
malaria symptoms. This led Hahnemann to
consider that a substance may create
symptoms that it can also relieve. This
concept is called the "similia
principle" or "like cures
like." The similia principle had a
prior history in medicine, from Hippocrates
in Ancient Greece--who noted, for example,
that recurrent vomiting could be treated
with an emetic (such as ipecacuanha) that
would be expected to make it worse--to folk
medicine.14,15
Another way to view "like cures
like" is that symptoms are part of the
body's attempt to heal itself--for example,
a fever can develop as a result of an immune
response to an infection, and a cough may
help to eliminate mucus--and medication may
be given to support this self-healing
response.
Hahnemann
tested single, pure substances on himself
and, in more dilute forms, on healthy
volunteers. He kept meticulous records of
his experiments and participants' responses,
and he combined these observations with
information from clinical practice, the
known uses of herbs and other medicinal
substances, and toxicology,d
eventually treating the sick and developing
homeopathic clinical practice.
Hahnemann
added two additional elements to homeopathy:
- A
concept that became "potentization,"
which holds that systematically diluting
a substance, with vigorous shaking at
each step of dilution, makes the remedy
more, not less, effective by extracting
the vital essence of the substance. If
dilution continues to a point where the
substance's molecules are gone,
homeopathy holds that the
"memory" of them--that is, the
effects they exerted on the surrounding
water molecules--may still be
therapeutic.
- A
concept that treatment should be
selected based upon a total picture of
an individual and his symptoms, not
solely upon symptoms of a disease.
Homeopaths evaluate not only a person's
physical symptoms but her emotions,
mental states, lifestyle, nutrition, and
other aspects. In homeopathy, different
people with the same symptoms may
receive different homeopathic remedies.
Hans Burch
Gram, a Boston-born doctor, studied
homeopathy in Europe and introduced it into
the United States in 1825. European
immigrants trained in homeopathy also made
the treatment increasingly available in
America. In 1835, the first homeopathic
medical college was established in
Allentown, Pennsylvania. By the turn of the
20th century, 8 percent of all American
medical practitioners were homeopaths, and
there were 20 homeopathic medical colleges
and more than 100 homeopathic hospitals in
the United States.
In the late
19th and early 20th centuries, numerous
medical advances were made, such as the
recognition of the mechanisms of disease;
Pasteur's germ theory; the development of
antiseptic techniques; and the discovery of
ether anesthesia. In addition, a report (the
so-called "Flexner Report") was
released that triggered major changes in
American medical education. Homeopathy was
among the disciplines negatively affected by
these developments. Most homeopathic medical
schools closed down, and by the 1930s others
had converted to conventional medical
schools.
In the
1960s, homeopathy's popularity began to
revive in the United States. According to a
1999 survey of Americans and their health,
over 6 million Americans had used homeopathy
in the preceding 12 months.16
The World Health Organization noted in 1994
that homeopathy had been integrated into the
national health care systems of numerous
countries, including Germany, the United
Kingdom, India, Pakistan, Sri Lanka, and
Mexico.7 Several
schools of practice exist within homeopathy.17
Persons
using homeopathy do so to address a range of
health concerns, from wellness and
prevention to treatment of injuries,
diseases, and conditions. Studies have found
that many people who seek homeopathic care
seek it for help with a chronic medical
condition.18,19,20
Many users of homeopathy treat themselves
with homeopathic products and do not consult
a professional.13
b.
Items 1-13 in the references served as
general sources for this historical
discussion.
c.
Bloodletting was a healing practice used for
many centuries. In bloodletting, incisions
were made in the body to drain a quantity of
blood, in the belief that this would help
drain out the "bad blood" or
sickness.
d.
Toxicology is the science of the effects of
chemicals on human health.
Top
3. What
kind of training do homeopathic
practitioners receive?
In European
countries, training in homeopathy is usually
pursued either as a primary professional
degree completed over 3 to 6 years or as
postgraduate training for doctors.14
In the
United States, training in homeopathy is
offered through diploma programs,
certificate programs, short courses, and
correspondence courses. Also, homeopathic
training is part of medical education in
naturopathy.e
Most homeopathy in the United States is
practiced along with another health care
practice for which the practitioner is
licensed, such as conventional medicine,
naturopathy, chiropractic, dentistry,
acupuncture, or veterinary medicine
(homeopathy is used to treat animals).
Laws about
what is required to practice homeopathy vary
among states. Three states (Connecticut,
Arizona, and Nevada) license medical doctors
specifically for homeopathy.
e.
Naturopathy, also known as naturopathic
medicine, is an alternative medical system
that emphasizes natural healing approaches
(such as herbs, nutrition, and movement or
manipulation of the body). Some elements of
naturopathy are similar to homeopathy, such
as an intent to support the body's own
self-healing response.
Top
4. What do
homeopathic practitioners do in treating
patients?
Typically,
in homeopathy, patients have a lengthy first
visit, during which the provider takes an
in-depth assessment of the patient. This is
used to guide the selection of one or more
homeopathic remedies. During followup
visits, patients report how they are
responding to the remedy or remedies, which
helps the practitioner make decisions about
further treatment.
Top
5. What
are homeopathic remedies?
Most
homeopathic remedies are derived from
natural substances that come from plants,
minerals, or animals. A remedy is prepared
by diluting the substance in a series of
steps (as discussed in Question
2). Homeopathy asserts that this process
can maintain a substance's healing
properties regardless of how many times it
has been diluted. Many homeopathic remedies
are so highly diluted that not one molecule
of the original natural substance remains.12,21
Remedies are sold in liquid, pellet, and
tablet forms.
Top
6. How
does the U.S. Food and Drug Administration
(FDA) regulate homeopathic remedies?
Because of
their long use in the United States, the
U.S. Congress passed a law in 1938 declaring
that homeopathic remedies are to be
regulated by the FDA in the same manner as
nonprescription, over-the-counter (OTC)
drugs, which means that they can be
purchased without a physician's
prescription. Today, although conventional
prescription drugs and new OTC drugs must
undergo thorough testing and review by the
FDA for safety and effectiveness before they
can be sold, this requirement does not apply
to homeopathic remedies.
Remedies
are required to meet certain legal standards
for strength, quality, purity, and
packaging. In 1988, the FDA required that
all homeopathic remedies list the
indications for their use (i.e., the medical
problems to be treated) on the label.22,23
The FDA also requires the label to list
ingredients, dilutions, and instructions for
safe use.
The
guidelines for homeopathic remedies are
found in an official guide, the Homeopathic
Pharmacopoeia of the United States,
which is authored by a nongovernmental,
nonprofit organization of industry
representatives and homeopathic experts.24
The Pharmacopoeia also includes
provisions for testing new remedies and
verifying their clinical effectiveness.
Remedies on the market before 1962 have been
accepted into the Homeopathic
Pharmacopoeia of the United States based
on historical use, rather than scientific
evidence from clinical trials.
Top
7. Have
any side effects or complications been
reported from the use of homeopathy?
The FDA has
learned of a few reports of illness
associated with the use of homeopathic
remedies. However, the FDA reviewed these
reports and decided that the remedies were
not likely to be the cause, because of the
high dilutions.3
Here is
some general information that has been
reported about risks and side effects in
homeopathy:
- Homeopathic
medicines in high dilutions, taken under
the supervision of trained
professionals, are considered safe and
unlikely to cause severe adverse
reactions.25
- Some
patients report feeling worse for a
brief period of time after starting
homeopathic remedies. Homeopaths
interpret this as the body temporarily
stimulating symptoms while it makes an
effort to restore health.
- Liquid
homeopathic remedies can contain alcohol
and are permitted to have higher levels
of alcohol than conventional drugs for
adults. This may be of concern to some
consumers. However, no adverse effects
from the alcohol levels have been
reported either to the FDA or in the
scientific literature.3
- Homeopathic
remedies are not known to interfere with
conventional drugs; however, if you are
considering using homeopathic remedies,
you should discuss this with your health
care provider. If you have more than one
provider, discuss it with each one.
As with all
medicinal products, a person taking a
homeopathic remedy is best advised to:
- Contact
his health care provider if his symptoms
continue unimproved for more than 5
days.
- Keep the
remedy out of the reach of children.
- Consult
a health care provider before using the
product if the user is a woman who is
pregnant or nursing a baby.
Top
8. What
has scientific research found out about
whether homeopathy works?
This
section summarizes results from (1)
individual clinical trials (research studies
in people) and (2) broad analyses of groups
of clinical trials.
The results
of individual, controlled clinical trials of
homeopathy have been contradictory. In some
trials, homeopathy appeared to be no more
helpful than a placebo; in other studies,
some benefits were seen that the researchers
believed were greater than one would expect
from a placebo.f
Appendix I details
findings from clinical trials.
Systematic
reviews and meta-analyses take a broader
look at collections of a set of results from
clinical trials.g
Recent examples of these types of analyses
are detailed in Appendix II.
In sum, systematic reviews have not found
homeopathy to be a definitively proven
treatment for any medical condition. Two
groups of authors listed in Appendix
II found some positive evidence in the
groups of studies they examined, and they
did not find this evidence to be explainable
completely as placebo effects (a third group
found 1 out of 16 trials to have some added
effect relative to placebo). Each author or
group of authors criticized the quality of
evidence in the studies. Examples of
problems they noted include weaknesses in
design and/or reporting, choice of measuring
techniques, small numbers of participants,
and difficulties in replicating results. A
common theme in the reviews of homeopathy
trials is that because of these problems and
others, it is difficult or impossible to
draw firm conclusions about whether
homeopathy is effective for any single
clinical condition.
f.
A placebo is designed to resemble as much as
possible the treatment being studied in a
clinical trial, except that the placebo is
inactive. An example of a placebo is a pill
containing sugar instead of the drug or
other substance being studied. By giving one
group of participants a placebo and the
other group the active treatment, the
researchers can compare how the two groups
respond and get a truer picture of the
active treatment's effects. In recent years,
the definition of placebo has been expanded
to include other things that could have an
effect on the results of health care, such
as how a patient and a health care provider
interact, how a patient feels about
receiving the care, and what he or she
expects to happen from the care.
g.
In a systematic review, data from a set of
studies on a particular question or topic
are collected, analyzed, and critically
reviewed. A meta-analysis uses statistical
techniques to analyze results from
individual studies.
Top
9. Are
there scientific controversies associated
with homeopathy?
Yes.
Homeopathy is an area of complementary and
alternative medicine (CAM) that has seen
high levels of controversy and debate,
largely because a number of its key concepts
do not follow the laws of science
(particularly chemistry and physics).
- It is
debated how something that causes
illness might also cure it.
- It has
been questioned whether a remedy with a
very tiny amount (perhaps not even one
molecule) of active ingredient could
have a biological effect, beneficial or
otherwise.
There have been some research studies
published on the use of ultra-high
dilutions (UHDs) of substances, diluted
to levels compatible with those in
homeopathy and shaken hard at each step
of dilution.h
The results are claimed to involve
phenomena at the molecular level and
beyond, such as the structure of water,
and waves and fields. Both laboratory
research and clinical trials have been
published. There have been mixed results
in attempts to replicate them. Reviews
have not found UHD results to be
definitive or compelling.i
There have been some studies that found
effects of UHDs on isolated organs,
plants, and animals.15
There have been controversy and debate
about these findings as well.
- Effects
in homeopathy might be due to the
placebo or other non-specific effect.
- There
are key questions about homeopathy that
are yet to be subjected to studies that
are well-designed--such as whether it
actually works for some of the diseases
or medical conditions for which it is
used, and if so, how it might work.
- There is
a point of view that homeopathy does
work, but that modern scientific methods
have not yet explained why. The failure
of science to provide full explanations
for all treatments is not unique to
homeopathy.
- Some
people feel that if homeopathy appears
to be helpful and safe, then
scientifically valid explanations or
proofs of this alternative system of
medicine are not necessary.
h.
For some examples, see references 26-29.
i.
For examples of debates on UHDs and
reviewers' papers, see especially references
13, 15,
and 30-33.
Top
10. Is
NCCAM funding research on homeopathy?
Yes, NCCAM
supports a number of studies in this area.
For example:
- Homeopathy
for physical, mental, and emotional
symptoms of fibromyalgia (a chronic
disorder involving widespread
musculoskeletal pain, multiple tender
points on the body, and fatigue).
- Homeopathy
for brain deterioration and damage in
animal models for stroke and dementia.
- The
homeopathic remedy cadmium, to find out
whether it can prevent damage to the
cells of the prostate when those cells
are exposed to toxins.
Top
For More
Information
- NCCAM
Clearinghouse
Toll-free
in the U.S.: 1-888-644-6226
International: 301-519-3153
TTY (for deaf and hard-of-hearing
callers): 1-866-464-3615
E-mail:
info@nccam.nih.gov
NCCAM Web site: nccam.nih.gov
Address: NCCAM Clearinghouse, P.O. Box
7923, Gaithersburg, MD 20898-7923
Fax:
1-866-464-3616
Fax-on-Demand service: 1-888-644-6226
The
NCCAM Clearinghouse provides information
on CAM and on NCCAM. Services include
fact sheets, other publications, and
searches of Federal databases of
scientific and medical literature. The
Clearinghouse does not provide medical
advice, treatment recommendations, or
referrals to practitioners.
- CAM
on PubMed
Web
site: www.nlm.nih.gov/nccam/camonpubmed.html
CAM on
PubMed, a database on the Internet
developed jointly by NCCAM and the
National Library of Medicine, offers
citations to (and in most cases, brief
summaries of) articles on CAM in
scientifically based, peer-reviewed
journals . CAM on PubMed also links to
many publisher Web sites, which may
offer the full text of articles.
- U.S.
Food and Drug Administration (FDA)
Web
site: www.fda.gov
Toll-free: 1-888-INFO-FDA
(1-888-463-6332)
Address: 5600 Fishers Lane, Rockville,
MD 20857
FDA's
mission is to promote and protect the
public health by helping safe and
effective products to reach the market
in a timely way, and monitoring them for
safety after they are in use. On
homeopathy, see especially a 1996
article from FDA Consumer
magazine at www.fda.gov/fdac/features/096_home.html.
Top
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Comparing the Efficacy and Safety of
Luffa comp.-Heel Nasal Spray with
Cromolyn Sodium Spray in the Treatment
of Seasonal Allergic Rhinitis." Forschende
Komplementärmedizin. 1999.
6(3):142-8.
- Rastogi,
D.P., Singh, V.P., Singh, V., Dey, S.K.,
and Rao, K. "Homeopathy in HIV
Infection: A Trial Report of
Double-Blind Placebo Controlled
Study." British Homeopathic
Journal. 1999. 88(2):49-57.
- Vickers,
A.J., Fisher, P., Smith, C., Wyllie,
S.E., and Rees, R. "Homeopathic
Arnica 30x Is Ineffective for Muscle
Soreness After Long-Distance Running: A
Randomized, Double-Blind,
Placebo-Controlled Trial." The
Clinical Journal of Pain. 1998.
14(3):227-31.
- Weiser,
M., Strosser, W., and Klein, P.
"Homeopathic vs Conventional
Treatment of Vertigo: A Randomized
Double-Blind Controlled Clinical
Study." Archives of
Otolaryngology-Head & Neck Surgery.
1998. 124(8):879-85.
- Linde,
K., Jonas, W.B., Melchart, D., and
Willich, S. "The Methodological
Quality of Randomized Controlled Trials
of Homeopathy, Herbal Medicines and
Acupuncture." International
Journal of Epidemiology. 2001.
30(3):526-31.
- Ernst,
E. and Pittler, M.H. "Efficacy of
Homeopathic Arnica: A Systematic Review
of Placebo-Controlled Clinical
Trials." Archives of Surgery.
1998. 133(11):1187-90.
- Long, L.
and Ernst, E. "Homeopathic Remedies
for the Treatment of Osteoarthritis: A
Systematic Review." British
Homeopathic Journal. 2001.
90(1):37-43.
- Jonas,
W.B., Linde, K., and Ramirez, G.
"Homeopathy and Rheumatic
Disease." Rheumatic Disease
Clinics of North America. 2000.
26(1):117-23.
Top
Appendix
I.
Clinical
Trials on Homeopathy Published from 1998 to
2002j
Citation |
Description |
Findings |
Vickers
and Smith, 200234 |
Seven
trials were included in the review
(three prevention and four treatment
trials); only two studies had
sufficient information for complete
data extraction. |
The
homeopathic remedy oscillococcinum
appears safe and effective in
reducing the duration of influenza,
but has no effect on prevention. |
Lewith
et al., 200228 |
Randomized,
double-blinded, placebo-controlled
trial of 242 participants aged 18 to
55 years. |
Trial
compared an oral homeopathic
treatment to placebo in asthmatic
people allergic to house dust.
Authors found the homeopathic
treatment "no better than
placebo." They noted "some
differences between the homeopathic
immunotherapy and placebo for which
we have no explanation." |
Oberbaum
et al., 200135 |
Randomized,
double-blinded, placebo-controlled
trial in 32 children; 30 completed
the study. |
Traumeel
S, a homeopathic skin cream, may
significantly reduce the severity
and length of pain and
inflammation of the tissues lining
the inside of the mouth from
chemotherapy in children being
treated with bone marrow
transplantation. |
Taylor
et al., 200036 |
Randomized,
double-blinded, placebo-controlled
trial of 51 participants aged 17
years or older (50 completed the
study). |
Team
tested the hypothesis that
homeopathy is a placebo by examining
effects of an oral homeopathic
preparation in patients with perennial
allergic rhinitis. They found a
"significant objective
improvement in nasal airflow"
compared with the placebo group.
However, both groups reported
subjective improvement in
"nasal symptoms" (with no
statistically significant difference
between groups). Authors concluded
that the objective evidence supports
that "homeopathic dilutions
differ from placebo." |
Jacobs
et al., 200037 |
Randomized,
double-blinded, placebo-controlled
trial of 126 children; 116 completed
the study. |
Individualized
homeopathic treatments improved
digestive problems in children with acute
childhood diarrhea. Results are
consistent with findings of a
previous study. |
Weiser
et al., 199938 |
Randomized,
double-blinded trial of 146 people. |
For
the treatment of hay fever, a
homeopathic nasal spray is as
efficient and well tolerated as a
conventional therapy, cromolyn
sodium. |
Rastogi
et al., 199939 |
Randomized,
double-blinded, placebo-controlled
trial of 100 people between 18 and
50 (71 percent male/29 percent
female). |
A
subgroup of patients with HIV
in the symptomatic phase, receiving
treatment, had increased levels of
CD4 cells at the end of the trial;
the placebo subgroup did not. |
Vickers
et al., 199840 |
Randomized,
double-blinded, placebo-controlled
trial of 519 people; 400 completed
the study. |
Homeopathic
remedies, including arnica, are not
effective for muscle soreness
following long-distance running. |
Weiser
et al., 199841 |
Randomized,
double-blinded, controlled trial of
119 people; 105 completed the study. |
The
homeopathic treatment vertigoheel,
and the standard treatment of
betahistine, are equally effective
in reducing the frequency, duration,
and intensity of vertigo attacks. |
j.
Due to the large number of trials, these
studies have been selected to give a
representative overview of the findings
published in peer-reviewed scientific and
medical journals in English and indexed in
the National Library of Medicine's MEDLINE
database.
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NCCAM
has provided this material for your
information. It is not intended to
substitute for the medical expertise
and advice of your primary health
care provider. We encourage you to
discuss any decisions about
treatment or care with your health
care provider. The mention of any
product, service, or therapy in this
information is not an endorsement by
NCCAM.
|
Above
excerpt is taken from:
NCCAM
Publication No.
D183
[download PDF version]
April 2003
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