Millions of people worldwide seek homeopathy when mainstream medicine is daunting, costly, or unsuccessful. It offers a very attractive notion of soft, natural healing. But does homeopathy work, and is there really any benefit at all?
This has been a question debated by researchers, health authorities and people who use homeopathy for many years. In this article we cover what is homeopathy, what can be proven, the science behind the theories used, the potential side effects and why it is still so popular with patients.
What Is Homeopathy and Why Do People Use It?
Homeopathy is a form of alternative medicine created in the late 1700s by German doctor Samuel Hahnemann. It is based on 2 main hypotheses, first that a substance that induces symptoms in healthy volunteers can cure those same symptoms in the sick and second, that the more a remedy is diluted, the more potent it becomes. This involves diluting a chemical in water or ethanol many times over and shaking it vigorously during each process- termed succussion.
Used for an astonishing array of ailments—from allergies to depression, from migraines to diabetes, from the common cold to cancer—homeopathy has undeniable appeal. Homeopathic consultations are generally protracted, intimate and caring—that’s not always the case with traditional medicine. Money, suspicion of drugs and a drive to use “more natural” remedies all play a part.
Culture, tradition and desperation are other factors.
Does Homeopathy Work? What Scientific Evidence Shows
The simple answer, given the weight of current evidence, is no—certainly not beyond placebo. This is not mere down-market conjecture. This is the result of a number of major, carefully controlled studies by reputable scientific organizations and government agencies that have been ongoing for decades.
Evidence From Systematic Reviews and Large-Scale Assessments
In 2015 the Australian National Health and Medical Research Council collated and reviewed over 1,800 studies about homeopathy. The final report was a resounding no: there is no good quality evidence that homeopathy is any more effective than placebo for any health condition. The UK’s House of Commons Science and Technology Committee echoed this sentiment in 2010; calling for the NHS to withdraw funding for homeopathy.
The European Academies Science Advisory Council has reached a similar conclusion; that homeopathic remedies had no more effect than an inert control for conditions across the spectrum. These are not outliers, this is a consistent pattern emerging from forty years of rigorous research.
Homeopathy vs Placebo: What Clinical Trials Reveal
In rigorous, randomized, controlled trials (which are the gold standard of testing medical therapies), homeopathic remedies never outperform the placebo. “No better than placebo” is a bit of a misnomer – people often equate it with “does nothing,” but placebos can give real, measurable symptom alleviation. The trouble is that when a treatment can’t outperform a dummy pill in the setting of a controlled trial, the evidence cannot be used to support a given treatment for general use. There are trials where homeopathy has shown benefit, but the evidence emerges from systematic reviews that find those positive studies are either flawed, or too few, or that all the negative studies go unpublished.
How Homeopathy Is Supposed to Work vs Established Science
To understand the reasons for such extreme cynicism, we need to examine the theoretical principles which underlie homeopathy and to compare them with the information provided by chemistry and biology.
Core Principles: “Like Cures Like” and Extreme Dilution
The first principle is that of “like cures like” or the law of similars. This means that what may cause a healthy person to have, for example, watery eyes, could cure hay fever. The second principle is dilution.
Remedies are diluted to 30C, which is a 1-in-100 dilution, carried out 30 times. By this stage there is statistically no chance of a single molecule remaining in the homeopathic remedy. It is claimed that water has a memory of the original substance and this is why homeopathic remedies work:
Scientific Plausibility and Mechanism of Action
The water memory hypothesis has not received any credible scientific support. Molecules in water form and reform hydrogen bonds around 3× per trillionth of a second, meaning they cannot maintain structural “imprints” of whatever soluble matter was used at a level sufficient to have any biological impact. Pioneering Chemist Linus Pauling and others have investigated and disproven this concept.
Furthermore, the dose/response effect (more dilution translates to increased potency) directly contradicts the dose/response effect observed in pharmacology. For scientists in the main stream, homeopathy not only has no evidence to support it, but also has no conceivable way to work.
Safety, Side Effects, and When Homeopathy Can Be Harmful
Another common misconception is that because homeopathics are so dilute they must be perfectly safe. This is essentially correct for standard homeopathics, but not always, and the dangers are not entirely negligible.
Direct Risks From Homeopathic Products
Some so-called homeopathic products are not actually diluted enough to have any active ingredient. The Food and Drug Administration in the United States has warned of homeopathic teething products, which contain detectable belladona plant material. Tests have shown contamination, poor quality controls during manufacturing, and mislabelling.
It has also been found that some products may have interactions with prescribed medicines, especially if the product does contain measurable amounts of herbal or chemical substances. Homeopathic products are not subject to the same level of scrutiny as conventional drugs, resulting in gaps in quality control that most consumers are unaware of.
Indirect Risks: Delayed or Missed Conventional Treatment
This is perhaps the greater risk. A person with a life-threatening bacterial infection, or cancer or a heart problem who chooses to treat themselves with homeopathy instead of conventional medicine is certainly losing time—and in the field of health, time is critically important. There have been reports of children dying of preventable conditions, because they were being treated with homeopathy instead of antibiotics or other urgently-needed intervention in various countries.
Even relatively minor ailments, left untreated, can develop into more serious problems, and at the very least it may be a while before they’re noticed. The problem may not always be the remedy itself; it may be its opportunity cost.
Why Do Some People Say Homeopathy Works?
Despite the consensus in science, so many users say they experience noticeable advantages. Those stories are genuine – however the reasoning behind those aren’t for homeopathy to have any pharmacological activity.
Placebo Effect, Expectation, and Therapeutic Ritual
The placebo effect is strong and proven. If you “think” there will be an effect you are “putting in” effects via your brain which will set off real effects including less pain, less anxiety, changes in immune system parameters. The consultation, the very fact that you are in a long, caring, individualised session, is in itself therapeutic, no matter what is prescribed or taken.
Misattribution, Natural Recovery, and Other Explanations
The vast majority of health problems can get better by themselves. Cold, mild infections and many long-term flare ups will tend to improve with or without treatment. If an individual takes a homeopathic medicine during this seemingly spontaneous remission, then it is fairly reasonable – but ultimately wrong – for that individual to attribute it to the homeopathic drug itself.
This phenomenon, known as regression to the mean, describes how the presenting complaints tend to be at their worst when people present for treatment – and, therefore, they will tend to improve merely because they have already hit rock bottom. It is also an interesting coincidence that people tend to make large lifestyle modifications – such as improved sleep, altered diet, less stress etc – that would actually be more reasonable reasons for improvement.