I’ve written more times that I want to about homeopathy, the elaborate placebo system of “remedies”. It looks like medicine, and pharmacies stock it on shelves alongside products that contain medicine. But with homeopathy the common “strengths” or “potencies” of products are usually so dilute there’s no possibility of a single molecule of the original substance remaining in the remedy. What’s further, the original substance isn’t medicine, either. They can be derived from from substances like Stonehenge (yes, that Stonehenge), shipwrecks, ascending colons, light bulbs, and even vacuum cleaner dirt. While homeopathic products are deemed “safe and effective” by Health Canada’s Natural Health Products Directorate, the awareness that homeopathic products contain no active ingredients and have no medicinal effects has become increasingly well known. In 2011, I noted that manufacturer Boiron had been served by two class action lawsuit, and that this might be the beginning of a trend.
The legal action route seems to be having an effect – which is good, given pharmacies and even regulators have refused to act. Homeopathy manufacturer Heel has decided to exit the North American market completely: Continue reading
Once again, it’s influenza season. The vaccine clinics are open, and the hysterical posts about the vaccine’s danger are appearing in social media. There’s familiarity to all of this, but also a big new change – at least in Canada, where I am. Pharmacists can now administer the vaccine. And it’s completely free to anyone in Ontario (where I am), so the barriers to obtaining the vaccine are pretty much eliminated. There’s no longer a need to drag your kids to their family doctor or line up at a public health clinic. Anyone can walk into a pharmacy, show their health card, and walk out minutes later, vaccinated. It’s another enabling change that may help improve immunization rates, as uptake rates in the population remain modest.
This year’s flu season is (as of week 47) fairly quiet. Google Flu trends suggests a fairly typical picture, nothing like what we saw in 2009/10, the year of H1N1. My city’s influenza tracker reports only a dozen cases so far this season. Many of us will get our flu shot, continue with our lives, and not think about the flu until next season’s announcements. That’s the hope, anyway. Influenza can kill, and in its more virulent forms, is devastatingly deadly. The worst case scenario (so far) is almost unimaginable today. In 1918/19 an influenza pandemic killed 50 million people worldwide (5% of the population). So among public health professionals, that worry about the next wave is always present. Much has been written at this blog and at Science-Based Medicine on the efficacy and safety of the flu vaccine. In short, the vaccine is effective for both individual and population-level protection, but only modestly so, and its effectiveness varies based on its match with circulating strains. And despite widespread use for decades, there are frustrating limitations with the current vaccine beyond efficacy, including the need to repeat the shot annually. Donald Rumsfeld once said, “You go to war with the army you have—not the army you might want or wish to have at a later time.” The quote is relevant to influenza. The flu vaccine is not a perfect vaccine, but it does offer protection – if not directly to you, then indirectly to those at greater risk of infection. Hospitals and health facilities have been criticized for demanding health professionals either get the vaccine or wear a mask – and the arguments against vaccination are losing. But even the strongest advocates of influenza vaccine will acknowledge its limitations, which perhaps contributes to the understandable perception that there is more that could be done- beyond reasonable and effective precautions like handwashing and hygiene. Continue reading
I can across a strange full-page ad in yesterday’s Globe and Mail. The headline was huge:
Reclaim your inner peace. Homeopathic Preparations. Scientifically proven effective.
Proven effective? Large comprehensive reviews have concluded that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible. Consequently, it seems quite a stretch to say any homeopathic remedy is “Scientifically proven effective”. This particular ad was for two homeopathic products from Heel. Both Nervoheel N (“calms stressful moments, eases nervousness”) and Neurexan (“restores your natural sleep patterns, improves sleep quality”) are approved by Health Canada as safe and effective. Kim Hebert over at Skeptic North went looking for the published clinical evidence to support these efficacy claims:
- For Nervoheel N there was one open-label, non-randomized cohort study that stated “The differences between the treatment groups [Nervoheel and lorazepam] were not significant.” The paper concluded that Nervoheel N is non-inferior to lorazepam. No placebo group was included.
- For Neurexan there were two studies. Both non-random studies compared Neurexan with another unproven treatment, valerian, in the absence of a placebo group. There is no objective way to separate these results from unintentional researcher/patient bias or the placebo effect. Therefore, the results of both are clinically meaningless.
This data was presumably adequate for Health Canada (search their database for products 80007796 and 80004914 here) unless there’s unpublished data that was supplied. The ad continues:
Both products are suitable for the whole family, for short or long-term use, as they are clinically proven effective, non-addictive, and non-sedative. They have no known side effects, medicinal interactions, or contraindications.
In order to have side effects, first a product has to have effects. So no surprise there. The strangest statement, however, is at the bottom of the ad:
AVAILABLE IN PHARMACIES AND HEALTH FOOD STORES.
Ask your chiropractor or naturopath for more infomation.
Presumably they don’t want you to ask your pharmacist for more information. What kind of response might a pharmacist give about the scientific evidence supporting this, or any other homeopathic remedy? Hopefully, a science-based one.
It’s World Homeopathy Awareness Week. Today’s post is a deeper dive into the world of homeopathic “evidence”. Looking at the science, we’ll highlight the implications of regulators applying two sets of standard to health products: One for medicine, and one for homeopathy. Today’s post is a collaboration with Kim Hebert, who blogs at Science-Based Therapy.
The kindest that can be said about most homeopathic products is that they won’t cause adverse effects. After all, most common “strengths” or “potencies” used in homeopathy are so dilute there’s no possibility of a single molecule of the original substance remaining in the remedy. But what if, instead of diluting a product the typical 30 times, it’s only diluted once or twice? Is it still homeopathy? There’s a very good chance of some molecules of the original substance remaining. That’s the case with today’s case study, Traumeel. Continue reading