Tuesday’s post on Target’s decision to sell homeopathy for the treatment of asthma stirred a lot of questions towards Target, given their decision to market the a product that has no proven medical benefit. There were also supporters of homeopathy in the comments, from a pharmacy student who said homeopathy works because of radiation, and another that suggested that if I don’t believe in homeopathy, I can’t believe in the warmth of the sun. To be absolutely clear, homeopathy is not only unproven, it’s disproven. There is no serious scientific debate about this fact. The best evidence demonstrates that homeopathy is exactly what we expect – an inert placebo with no therapeutic effects. Homeopathy is not “alternative medicine”, it is an alternative TO medicine, and to consumers who may not understand what “homeopathic” means, it’s highly misleading to package and sell this on pharmacy shelves alongside products that actually contain medicine.
Some defended the placebo value of an asthma treatment, confusing objective with subjective effects. This could be dangerous for patients, as placebos have no meaningful therapeutic benefit in asthma. There were also defenders of Target’s right to sell homeopathy, noting that it does say “NOT A RESCUE INHALER” on the front of the box. I disagree. This product is labelled as a oral asthma spray. But it contains absolutely no medicinal ingredients to treat asthma. It is no more an “asthma” spray than it a remedy to treat diabetes or arthritis. Here’s a shot of the side of the box (thank you Pieter B):
It looks indecipherable – and that’s the point. Homeopathic labeling is confusing, deliberately so, and is designed to obscure the fact that these products have no medicinal ingredients in it.
The label says that it has “Equal volumes of each ingredient in 10X, 30X, and LM1 potencies. There are 15 “ingredients” listed and the bottle is 2 fluid ounces (60 mL). If there is no further dilution of each each “ingredient” during the manufacturing, then let’s assume there is 4 mL of each diluted substance, divided by the three potencies, or about 1.3mL of each dilution:
10X – This is dilution of a substance one part in ten, ten times in a row. Each time you perform a homeopathic dilution, you are supposed to bang the container on a hard surface (the inventor of homeopathy reportedly used a bible). After 10 serial dilutions, the final concentration (compared to the original) is now 10−10 or 1 part per billion. (By comparison, this is more dilute than the allowable concentration of arsenic in drinking water.) If there is 1.3 mL of this solution in the bottle, that means there is 1.3mL x 10−10 of the original mixture or 0.00000000013mL of each “remedy” at the 10X dilution.
30X – This portion has been diluted one part in ten, thirty times in a row. The final concentration (compared to the original) is now 10−30. As per Quackwatch,
A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic centimeter of water contains 15 drops, this number is greater than the number of drops of water that would fill a container more than 50 times the size of the Earth.
Basic mathematics tells us therefor that there isn’t a single molecule of the original remedy. So the 30X component is 1.3mL of pure water.
LM1 – This dilution is made by starting with a 3C dilution (1:1000) and then taking a single drop, and diluting it 1:50,000. Suffice to say it’s unlikely there is a single molecule of the original substance in the product. So this component would also be effectively 1.3mL of pure water.
When we add it up, for the 15 “ingredients” there’s actually only 0.00000000195mL of potential substance in the entire 2 oz (60mL) bottle. Given a single drop of water is 0.05mL, that’s only 0.0000039% of a single drop of possible ingredients in the bottle. So this means Target’s asthma remedy is, by my calculation, 99.999999% water.
Homeopathy’s defender’s will claim that, despite the lack of medicine in the product, homeopathy is working through some mysterious mechanism we don’t understand. So for the sake of argument, let’s look at the ingredient list. Where data are available, I’ve pulled efficacy (for asthma) and safety information from the Natural Medicines Comprehensive Database:
- Aconitum napellus: Common name: Aconite, from plant genus Aconitum. Efficacy: None established. Safety: Unsafe when consumed at non-homeopathic doses. Aconite is a toxic alkaloid and a strong, fast-acting poison.
- Adrenalinum: Common name: a secretion of the adrenal glands. Efficacy: None established. Conceivably the original substance could have contained some epinephrine, which has medicinal effects. However it would quickly degrade in water and be ineffective – even before any dilution. Safety: Not established.
- Ammonium carbonicum: Common name: Ammonium carbonate or “baker’s ammonia” Efficacy: None established. Safety: Probably safe.
- Antimonium tartaricum: Common name: Tartrate of antimony or Antimony potassium tartrate. Efficacy: None established Safety: A powerful emetic, antimony potassium tartrate is used to induce vomiting in animals. The The chemical is probably safe at homeopathic dilutions.
- Aralia racemosa: Common name American spikenard, an ornamental plant. Efficacy: None established Safety: Considered unsafe in pregnancy.
- Bromium: Common name: Bromine. Efficacy: None established. Safety: Unclear. Laughably, one homeopathic reference notes that “most homeopaths give [Bromium] up as a perfectly useless medicine.”
- Chlorinum: Common name: Chlorine Efficacy: None established. Safety: Probably safe. There’s more chlorine molecules in the diluent (from chlorination) than from the remedy.
- Eriodictyon californicum: Common name: Yerba Santa Efficacy: None established Safety: Safe when consumed.
- Eucalyptus globulus: Common name:Eucalyptus, Blue Gum. Efficacy: None established. There is a preliminary study in asthma, using 200mg, 3x/day. No efficacy data when diluted as per homeopathic principles. Safety: Likely safe.
- Grindelia: Common name: Gum Weed. Efficacy: None established. Safety: Possibly safe.
- Lobelia inflata: Common name: Indian tobacco Efficacy: None established. Safety: Considered unsafe when consumed in large amounts.
- Natrum Sulphuricum: Common name: Sodium Sulphate. Efficacy: None established. Safety: Appears non-toxic.
- Phosphorus: Common name: phosphorus: Efficacy: None established. Safety: Depending on the form, it’s considered a poison.
- Quebracho: Common name: quebracho. Efficacy: None established Safety: Likely safe in foods.
- Trifolium pratense: Common name: Red clover. Efficacy: None established. Safety: Safe when consumed.
What can we conclude? Target is selling an asthma “treatment” that is chemically indistinguishable from water, and taking advantage of consumers to sell an ineffective product, that if used in place of real medicine, could cause life-threatening harm. Target and its pharmacists have a professional and ethical responsibility to stop selling this product, immediately.
Update: A petition has been started asking Target to stop selling homeopathic asthma treatments. Go sign it.