Today’s post is a guest contribution from a Canadian pharmacist who is writing under the pseudonym Sara Russell:
Every morning I open up Facebook and expect to see the usual sharing of my friends’ latest adventures in pseudoscience, but it wasn’t until this morning that I felt compelled to write about something. A friend had posted this video asking for feedback.
When I saw the title “The Story of Mozi-Q”, I remembered that Scott had discussed it in his post “Homeopathic Insect Repellent: Is there anything the Natural Health Products Directorate won’t approve?” Fast forward one year, and it appears the marketing machine behind Mozi-Q is getting their message out there.
My initial thoughts after viewing the video were that it was very cleverly done. They were obviously trying to capitalize on the popularity of Dr. Mike Evans viral “23 and 1/2 hours: What is the single best thing we can do for our health?” Others have successfully used this format, with my favourite being “One Minute Medical School” – I admit the artwork isn’t as cute, but the result is still a concise, effective teaching moment.
My next few thoughts were that it was catchy enough that I was inevitably going to be getting bombarded with requests for this product at the pharmacy where I work. After all, it sure sounds compelling, and my entire town would be considered easy pickings. While I knew right away that as a homeopathic remedy it couldn’t actually do anything, I searched the web for a quick summary of the evidence for Mozi-Q hoping that I could post a rebuttal. I only found advertisements disguised as news reports. So I am resigned to writing this post.
Who is Mozi-Q?
Erin Bosch, the narrator of the video, is the creator of this product. I assumed Erin was a homeopath but I haven’t been able to find any educational qualifications for her. She is listed as the owner and founder of Xerion Dispensary, Xerion Homeopathie – a homeopathic clinic, as well as the CEO and President of the Western College of Homeopathic Medicine, where her mother, a homeopath, is listed as “College Director”. It seems that Erin’s entrepreneurial spirit is what inspired her mother to become a homeopath. Is it possible that the creator of this product has no formal training in homeopathy or science herself? I can’t say for certain, but I suspect she has some business training.
What is Mozi-Q?
According to Health Canada’s product information listing, Mozi-Q contains homeopathic dilutions of:
Cedron 4.0 C, Grindelia 6.0 C, Ledum palustre 3.0 X, Staphysagria 4.0 X, Urtica urens (stinging nettle) 6.0 X
Non-medicinal ingredients are aqua, croscarmellose sodium, ethanol, lactose, magnesium stearate and sucrose.
Homeopathy has been covered expertly by Scott, so I won’t go into what those dilutions mean in this post. Suffice to say, Wikipedia compares a 4C dilution as the allowable concentration of arsenic in U.S. drinking water. By homeopathic logic, this is actually a relatively low-potency remedy, so one wonders why they didn’t formulate it with much higher dilutions.
The video claims that Mozi-Q prevents mosquitos, ticks, sand flies, no-see-ums, black flies, head lice and bedbugs from biting, and further claims that if you do get bit, it’ll reduce the symptoms. The focus then turns to the ingredient staphysagria, commonly known as Delphinium. She tells a story about how mosquitoes have always been known to avoid delphiniums, so therefore if you make yourself a Delphinium by taking Mozi-Q, the mosquitoes will be repelled by you. Nice, neat explanation. But where’s the evidence?
Evidence for Mozi-Q
This is the evidence they’ve provided. That’s right, a YouTube video of 13 people – friends and family – who spent 40 minutes standing in tall grass beside a pond. Because they didn’t think it would be ethical to catch mosquitoes for a proper trial. No placebo group. Well, if this counts as evidence, then count me as a placebo. I have spent many hours outdoors the past few months, and have swatted at many mosquitoes in the air. I’m pretty sure my rain barrels have actually hatched most of them. I have not yet used mosquito repellent of any kind yet this year and have not had a single bite. My anecdote counts too, right?
A search for actual scientific evidence for the use of staphysagria as a mosquito repellent comes up with nothing. Popular homeopathy websites list many potential and interesting uses for it, and itchy skin is indeed listed as a symptom for which one might consider using it – topically. But again, no evidence is provided. Toxicity prevents it from being used in higher concentrations as an herbal remedy.
A search of ledum and urtica urens turned up a few references. This study looked at a commercial homeopathic gel which contained both of these ingredients, along with Echinacea augustifolia and Hamamelis extract. Note the study was the effect of a topical remedy, not an internal one. It was also used after a bite had already taken place and not to prevent bites. No difference was found between the homeopathic gel and the placebo in terms of itching, but there was a small reduction in size of the erythema. It is not mentioned in this abstract what the composition of the placebo gel was. This case report was published in BMJ as evidence to support the importance of not relying on homeopathic remedies, in this case ledum, to prevent malaria.
In summary, there appears to be no scientific evidence to support Mozi-Q . The focus of the video on Delphinium appears to be a marketing strategy to try to present a plausible explanation for its inclusion in the remedy. But since there is no plausible way that sugar pills homeopathy can work, there is no possible way that Mozi-Q will prevent mosquitos, ticks, sand flies, no-see-ums, black flies, head lice and bedbugs from being attracted to you. For that, you need to stick with what the evidence shows to be effective.
Carrying on with the video, after trying to convince us that staphysagria turns us into human Delphiniums (at 1 part staphysagria per 10,000 parts water dropped onto a sugar pill), Bosch discusses mosquito sprays as “toxic chemicals”, complete with sounds of evil laboratory bubbles. Then the video crosses over from a clever advertisement to, in my opinion, a dangerous one. While careful not to claim that Mozi-Q will prevent diseases, she discusses malaria as the #1 killer of children in the world and lists other insect-borne diseases, with the implication that Mozi-Q could eliminate them. The take-away message is “People who are crazy enough to think that they can change the world are the ones who do.” Someone has a mighty high opinion of herself.
As for my friend’s request, I didn’t end up posting a rebuttal, and if you’ve read my most recent post here on this blog you know why. Hopefully someone will find this one and send it to her.
Photo from flickr user dr_relling used under a CC licence.
Remember to like Science-Based Pharmacy on Facebook.
Science-Based Pharmacy 
“I assumed Erin was a homeopath but I haven’t been able to find any educational qualifications for her.”
So, she’s a self-taught fraud?
Would it make a difference if she was a board-certified charlatan?
Haha, definitely not! But maybe it’ll give some readers pause when they consider that this was a business invention, and not a medical one. I just noticed the irony in linking to the Health Canada website for evidence-based recommendations to prevent malaria. Yet Health Canada approved this remedy for sale. Why does Health Canada not include Mozi-Q in it’s malaria-prevention page?!
I agree that it will resonate with some readers.
However, I fear this ends up validating the credentialing process. I’ve had many a discussion of the form
Me:
They: But these are people who studied this. They have exams and certifications. This is not some fly-by-night, but a serious endeavor, just like Western Medicine.
Thanks for the feedback luispedro, and I agree with you. I am conditioned to soften my strong opinion about such things where I live. I am hoping that as I age I will approach these scenarios like some of my senior patients – with no filter!
By the homeopaths ridiculous laws of similarities then a substance that attracts mosquitoes would need to be diluted in order to repel them. This product is nonsense even in homeopathic terms, if that is possible.
I missed that – great point!
I have to wonder, who attempts to write a review of a product without even trying it? It’s apparent the author did not try the product, but is unhappy with the promotional materials and perhaps the product designer.
Wonder how she tests drives a car?!
Do you test a car’s crash protection before you buy it? Or do you rely on the ratings of published, objective tests done by independent third parties?
I wonder how many people consider “crash protection” their first consideration when purchasing a car? No, Scott, it’s the “test drive” and reading reviews of test drives by experienced test drivers and product comparisons.
But I have a solution. If the reviewer is sincere she can set up her own product test and honestly report on the results rather than opining on whether it fits into her preconceived ideas.
Laurie, I am a pharmacist. I am trained to sort through scientific data to determine what products / medication I should recommend to my patients. I don’t need to “test drive” all products. I have received training in homeopathy, so I am qualified to discuss it. There is no evidence for this product so why would I spend $25 of my hard-earned cash? If a company wants to me to recommend their products, or try it myself, there needs to be some sound research behind it. For Mozi-Q and any homeopathic remedy, that will never be the case. Besides, I’m trying to cut down on my sugar intake.
I’m surprised nobody ever advised you that absence of evidence is not evidence of absence. It appears the evidence for this product is clinical experience, which is where all products succeed or fail.
The concept of “sound research” is also subject to a myriad of opinion.
If I want an opinion about a homeopathic treatment my best resource is a trained professional homeopath with clinical experience. But seeing as this is a product geared towards a non-medical condition, methinks the lady doth protest too much.
It’s a foregone conclusion that you have a bias against anything homeopathic and you are judging, not reviewing.
@Laurie,
Consumers don’t have to consider “crash protection” because governments set safety standards for car manufacturers to follow if they want to sell cars. They extensively study and evaluate crash tests before they sell cars on the market. Surely you must agree this is a good thing.
In medicine, there are literally small armies of experts who investigate drugs to satisfy government standards of not only safety but also efficacy. Thats because if a drug has been shown inneffective for a disease, it wont get approved for sale. I assume you agree that this is a good thing because alot of diseases are incurable and/or deadly.
This includes a disease called malaria. As the case report cited in Sara’s great post shows, mosquitoes can – in certain areas of the world – spread malaria infections and cause death in a significant portion of those infected. Homeopathic remedies have been extensively studied and all the most rigorous trials have shown they are inneffective. I hope you can see how “testing out” a mosquito repellent in those parts of the world is extremely dangerous.
@nic
At present there is no independent oversight of drug development whatsoever, it’s entirely in the hands of pharma employees. The major concern is drug toxicity. So perhaps you can explain how Vioxx made it past that “small army of experts”.
The fact that homeopathics are now used in Cuba to prevent annual Leptospirosis outbreaks, malaria outbreaks in India, and dengue outbreaks in Brazil refutes your opinion that they are “ineffective”.
Anti-malarial drugs are ineffective in many parts of the world according to the WHO.
Since this blog is obviously prejudiced towards pharmaceuticals (the pharmacists prime source of revenue) it comes as no surprise that an erstwhile “review” becomes a condemnation.
Fortunately consumers have the last word.
You go get them Laurie. Give them the smack down by showing opinion, anecdote, and sugar water is superior to science!
Laurie says: “Since this blog is obviously prejudiced towards pharmaceuticals (the pharmacists prime source of revenue)…” You really don’t know much about pharmacy, do you? Why do you see so many of them selling shelves and shelves of homeopathy and other so-called “natural” products? Because gullible people are willing to spend big $$ on them. If money were our motivation we would be happy to sell them – usually they go for between 100-200% markup. Way better than the lousy 10% we might make on a prescription. Most pharmacists, like me, are paid by the hour. So what we recommend is not motivated by sales commissions. Can the same be said of the supplements purchased through MLM and health food stores?
So you’re willing to go behind your employer’s back and run down products in the store you work at and call paying customers “gullible” if they don’t agree with your opinion?
I noticed in your previous post that you referred to some of these customers as “my patients”. I think their MDs would have an issue with your attitude and likely put you in your proper place in the medical hierarchy — you are not a health care practitioner.
As far as product markups go, consumers are aware that the drugs they’re paying for are marked up thousands of percent over the base cost of materials:
http://www.wanttoknow.info/a-Huge-Prescription-Drug-Price-Markups
“According to the independent medical journal Prescrire, of the 104 new drugs introduced in 2009, only three offered a minor therapeutic advance, while 95 offered nothing new to improve health outcomes.
The reviewers conclude 19 of these new drugs should not have been marketed because they posed a potential danger to health. The decision to prescribe a new drug is often the result of drug companies’ promotional campaigns and not because of evidence-based medicine. Drug companies spend up to $61,000 per physician in order to influence their prescribing habits.”
http://behindthenumbers.ca/2011/04/19/why-canadas-system-for-buying-prescriptions-drugs-is-broken/
Ahh, the irony of a homeopathy proponent pointing to the cost of drugs. You do realize that Mozi-Q is $24.95USD for 60 sugar pills? There are no medicinal ingredients in Mozi-Q. None. When it comes to gouging the consumer, prescription drugs have nothing on homeopathy. Prescription drugs actually have medicine in them. Homeopathic remedies are sugar pills. Homeopaths hurt consumers three ways:
The rest of your response is just ad hominem and handwaving away the fact that Mozi-Q has no credible evidence to show it works. The burden of proof is on the person making the extraordinary claims. If sugar pills prevent mosquito bites, where’s the published evidence? Where’s the published evidence that sugar pills are effective for Leptospirosis, malaria, and dengue? Citations please.
These are entirely your opinions, Scott. I’ve just tried the product and it works. So obviously your and the author’s advice about it is not only wrong, it’s misleading.
I’ve also had great success using other homeopathic preparations, so I wasn’t surprised at all by the result.
People learn through experience, not argument.
The only issue with homeopathy is that there is no agreement on how it works, but anybody who actually spends more than 5 minutes “studying” it realizes that the picture you paint is far from reality.
@Laurie,
There are many off-topic statements you made which readers of this post will obviously know are false, so I won’t bother correcting them. As a pharmacist, I can assure you that Sara is absolutely right in her post and comments.
You do raise a legitimate point about post-marketing surveillance of approved drugs. There are many flaws with the currect regulatory system, many of which came to light after the Vioxx debacle. However, this issue is extremely complicated and way beyond the scope of this post.
But this has nothing to do wether Mozi-Q really works. Without evidence based on rigorous trials, it is irresponsible and dangerous to recommend this product since mosquitoes are sources of deadly Malaria in many under-developed countries. Your anecdotal experience means next to nothing since many biases and confounding factors are not accounted for, while statistical analysis of clinical outcomes are not assessed to see wether your results are due to a real effect, placebo effects or simply due to chance. Besides, the best evidence we have shows that homeopathy is inneffective for malaria (see references).
Your claims about WHO recommending homeopathy are demonstrably false. The reality is that WHO recommend anti-malarials but, due to increased resistance in certain areas, some medications are becoming less effective and the WHO specifically calls for using combination therapy (of drugs, not homeopathy) and a greater focus on prevention of infections.
References (happy reading!)
Re-analysis of old trials shows over-estimation of homeopathy
K. Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas WB. Impact of study quality on outcome in placebo-controlled trials of homeopathy, J Clin Epidemiol 1999; 52: 631–36
Comparative study show homeopathy comparable to placebo
Shang A, Huwiler-Müntener K, Nartey L et al. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo- controlled trials of homeopathy and allopathy, Lancet 2005; 366: 726–732
WHO Warns against homeopathy for malaria, HIV and tuberculosis” http://www.bmj.com/content/339/bmj.b3447
WHO recommends antimalarial therapy
http://www.who.int/topics/malaria/en/
@Laurie, your standard for efficacy is “it worked for me”? That’s not great evidence at all. I see you’ve also raised the red flag of Big Pharma and Vioxx. Those are pretty scary, but again, they don’t mean that infinitely diluted tinctures in water work. The problem here is that the manufacturer of Mozi-Q is advertising their product as preventing insect and arthropod borne diseases, and that’s dangerous. When requested for evidence, they provide a reference to an “old book” that listed their ingredient as being effective. That’s about it.
I have challenged the manufacturer to conduct the same test that Consumer Reports does for insect and tick repellents. Still no reaction on that. Would you be willing to put your arm to the test?
Being a Pharmacist (some also known as Dangerous Drugs Pushers for financial reward does NOT make you an expert. Go, try the product and then give us an educated tested opinion. Anything short of that is just a preconceived mambo-jumbo. Just remember, Louis Pasteur and many others were ridiculed just because they did not waste their time in school repeating lies.
If there are any errors in the post, please cite them, with supporting evidence, and I’ll happily post the corrections. I won’t hold my breath.
What a rubbish post! This product works for me and my 2 year old! We live in an area where there are a lot of mosquitoes and ticks. West nile virus is very prominent in our neck of the woods. I don’t care that there is a lack of scientific studies with this product, who cares? A lot of studies are bias anyway or done very poorly. And these days, anyone can get a study published!!!!! Sometimes individual testimonies are enough! This product works and is brilliant and I would rather take something natural with a bit of sugar then spray myself with harmful chemicals! Our family uses homeopathy and naturopathy over seeing our medical doctor. We are a family that is very healthy and rarely ill. You can’t put a price on your health. This product is worth every penny in my opinion!