Sunday, March 23, 2014

"Alternative" Medicine, Part 1: Homeopathy

So, I you all know I feed my dogs and my cat a balanced raw diet. And for some reason, a species appropriate diet has to come with a seemingly hodge-podge semblance of holistic, homeopathic, natural, and other alternative ways of medicating and dealing with various issues. In particular, I'm a part of a raw feeding group on facebook. Will name no names, will not point out which, but it's really not all bad. Most of it is actually full of people who really care about their pets and just want the absolute best for them... which for the majority of active members, this means they are aiming for the most natural method as possible, vehemently cursing the failures in modern medical practices. This is not everyone, but for some reason, the more "natural" you are trying to become, the more you share this knowledge with everyone around you. Which can be a good thing... but can also come with some misconceptions.

So... over how long it takes, I'll be going practice/method by practice/method, doing a breakdown of the alternative medicine from a organization that heads up a lot if not all practitioners, giving an overview of beliefs and practices. I'll be looking for mention of studies, if not particular studies but at least a few things involving numbers, efficacy rates, etc. And then see what the National Center for Complementary and Alternative Medicine (government sanctioned source for simple up to date overview of the various topics with risks and side effects). First up... which might be the longest... I'm not sure... since it's one that is very very misconstrued and confused by most people, whether they are using it on themselves or their animals.





Homeopathy
This seems to be a term often used without real knowledge of what it means. Often people see "homeopathic" and just think natural and healthier. Which may or may not be the case. I will first show what homeopathy is from actual homeopathics, and show their side and point. From there, I will then give information from the "other" side, government medical sources.

According to The Society of Homeopaths (http://www.homeopathy-soh.org/about-homeopathy/what-is-homeopathy/), Homeopathy is "a system of medicine which involves treating the individual with highly diluted substances, given mainly in tablet form, with the aim of triggering the body’s natural system of healing." The key words here being "highly diluted". The entire principle behind Homeopathy is to treat using extreme dilutions, and the more diluted the substance, the better it's supposed to work.

They also believe in the principle of treating like with like. The example that the SOH gave was coffee. If too much coffee is consumed, a person becomes sleepless and agitated. So, in order to treat symptoms of sleeplessness and agitation, you give a highly diluted form of coffee, and the diluted coffee is supposed to trigger a muscle memory response to fix the problem of sleeplessness and agitation.

History as found on the SOH webpage: "It was discovered by a German doctor, Samuel Hahnemann, who, shocked with the harsh medical practises of the day (which included blood-letting, purging and the use of poisons such as arsenic), looked for a way to reduce the damaging side-effects associated with medical treatment." He found that with smaller doses of certain medications, people seemed to be getting better faster. An example the SOH gave was mercury on syphilis. Like treating like, and those who were medicating with dilutions of mercury instead of high amounts of it were being cured sooner. So, higher and higher dilutions became developed over the years since.

The SOH also has lists of evidence for homeopathic use: http://www.homeopathy-soh.org/research/evidence-base-for-homeopathy-2/ . Note, both their "Clinical Trials" and "Basic Science" links are broken. I hope they fix that soon.

Within these lists of evidence base, they try to show that they have clinical trials, show the viability of it through practice, show its cost effectiveness, the safety of it, and the basic science of using ultra-high dilutions. I will go through and share the basic gist of each (broken links will either be added in later or left as is).

The Clinical Trials link is broken.

The Homeopathy in Practice page shares case reports. The numbered bibliography says case reports can be found in various homeopathic textbooks and journals, and a news article is given that talks about a homeopathic hospital that treats 30,000 patients a year. So lots of cases. Next, it goes into detail about clinical outcome studies. 6,500 consecutive individuals were treated over 6 years at Bristol Homeopathic Hospital. 70% reported an improvement, 50% reported a major improvement.  A long-term outcome study was conducted with 3,981 patients in 103 German and Swiss locations. The conclusion was that those who were treated with homeopathic methods sustained a marked and significant improvement in quality of life and a decrease in disease severity. And the final study mentioned was of 500 patients. Many of those treated with homeopathic medications were able to stop conventional medication following a homeopathic treatment plan, however, for cancer patients, no reduction in conventional medicine was found. The rest of the page explains the validity of outcome studies in this situation.

The Economic Evaluations page explains the cost effectiveness of using homeopathic medications over conventional medicine. This one seems pretty obvious though, a very heavy dilution of various herbs, oils, and minerals is going to be cheaper to produce and then sell than traditional chemical medication which requires extensive studies for safety, rarer or more difficult to produce chemicals, minerals, and concoctions, not to mention synthetic or "lab created" stuff as well.

The Safety Studies page first explains that because they are strong dilutions, usually in tablet form with some sort of benign carrier such as solid lactose or alcohol. It then goes on to explain that in clinical trials, adverse effects with homeopathic drugs were mild or nonexistent vs the more conventional medication. It also makes sure to add that the effects that did occur were found more often in the groups given the actual homeopathic drugs rather than the placebo effect, so this is evidence that homeopathic drugs are different from simply placebo. But really, when you are dealing with actual medications that are not just in parts per million, but parts per BILLION even for the smaller dilutions, the adverse effects from the medication just won't be there... unless you have a reaction to the benign carrier.

The Basic Science link is broken.

So... in short, according to The Society of Homeopaths, Homeopathy is a safe and more effective treatment method for every single ailment....... except cancer. You should stick with conventional medicine if you have cancer.


Now, let's see what the National Center for Complementary and Alternative Medicine has to say about Homeopathy. http://nccam.nih.gov/health/homeopathy

Let me just share the key points that NCCAM gives:

"1. There is little evidence to support homeopathy as an effective treatment for any specific condition.
2. Although people sometimes assume that all homeopathic remedies are highly diluted and therefore unlikely to cause harm, some products labeled as homeopathic can contain substantial amounts of active ingredients and therefore could cause side effects and drug interactions.
3. Homeopathic remedies are regulated by the U.S. Food and Drug Administration (FDA). However, FDA does not evaluate the remedies for safety or effectiveness.
4. Several key concepts of homeopathy are inconsistent with fundamental concepts of chemistry and physics. There are significant challenges in carrying out rigorous clinical research on homeopathic remedies.
5. Tell all your health care providers about any complementary health practices you use. Give them a full picture of all you do to manage your health. This will help ensure coordinated and safe care."

So, right off the bat, little evidence to support it as a worthwhile treatment for ANY condition. Hmm... I'd have to take a closer look at the studies the SOH provides, but I do have to agree. For every single FDA approved conventional medication, studies upon studies are done, with efficacy rates, blind studies, double blind studies, safety, etc. And above the government web page states that, while homeopathic remedies are regulated by the FDA, they are not evaluated.

There have been many rigorous trials to test homeopathy though. Granted, some will be flawed and biased. That is unfortunately the nature of the beast. But the vast majority show very little evidence in favor of homeopathy. In addition to this, not all homeopathic medicines are alike. Some do NOT have the high dilutions that other medications do, and can and do cause drug reactions or strong side effects.

In short, according to the NCCAM, there is very little quality control for the majority of homeopathic medicines. They do not recommend using homeopathic alternatives for conventional vaccinations or as a replacement for the more regulated, tested, and quality controlled conventional medications available.


In addition, something not mentioned in the above, homeopathic treatments are almost ALWAYS given alongside an extremely healthy diet. In the case of dogs and cats a balanced raw or limited ingredient cooked diet are often part of the treatment plan, and for humans, it also involves a much healthier way of eating. Far more whole foods, organic is often recommended, a more balanced and healthier diet, whether you eat meat or not. And a strong encouragement for exercise is also included for both animals and humans. So a lot of the outcome studies include full homeopathic treatment, not just the medication. So that includes a diet change as well as the medicines. And for many people and dogs, there IS a strong link between diet and health. So it could be that with healthier eating practices, skin issues and migraines went away on their own due to their body getting more of some nutrient or another... and they didn't go away due to the homeopathic medications.





What I have found in regards to homeopathy being discussed, there is a lot of "this saved my son's life" or "my dog was dying under conventional medicine, I switched to a homeopathic vet and medication and he's now 16 years old and the picture of health". A ton of very emotionally charged testimonies, with no desire to offer or even see the value in studies and clinical trials. For them, homeopathy is what saved their baby's life, and will save everyone else's if they would just give up all conventional medicine and dive into homeopathy in every possible aspect of their life.

In particular, my pup has had some itchiness problems in the past couple of weeks. I have her on an elimination diet since a couple days after it started, and have been considering all options for why this is occuring. From environmental factors to diet.... which she's on a raw diet. But yeah.

About half a week before any itchiness began, she was given her first puppy vaccination. Had mentioned this in my list of symptoms when I was first looking for ideas of what could be a cause, and how to treat. Got an overwhelming response of "it's the vaccine you gave her, don't ever vaccinate again." And then when I asked for more information or some solutions if it is the vaccine, and got people telling me I'm being stubborn and not wanting to listen to what they were saying, and just wanted to listen to what I wanted to hear. Whereas I was under the impression that I was open to it, and looking for a remedy. They then tell me to go to my homeopathic vet... which I don't have one, and then got upset and defensive when I said I don't believe in the premise of homeopathy, and gave me the sob stories.

And like with humans, homeopathic medications are often very very commonly confused with holistic or natural medications. They are not the same. Even had one person tell me to try a particular "homeopathic" drug... and when looking at it, it was not homeopathic in that it was not highly diluted, but a mixture of essential oils and herbs.

And then... some do claim to use homeopathic medications with their animals and find it works. One common homeopathic treatment a lot of people use without thinking of it as homeopathic is Rescue Remedy (do a google search, there are a TON of places that sell it). Here's a wikipedia (I know, not what you're supposed to be using in research, but oh well) page on the Bach Flower Remedies used in it: http://en.wikipedia.org/wiki/Bach_flower_remedies

In addition to these "remedies" (which, when looking at the claims for each remedy and the whole ingredients' normal use, just don't add up), it contains 36% alcohol. Now... unless you down several bottles of this you aren't going to be getting drunk... but when placed under the tongue by blood vessels... the alcohol could have a slight calming effect. Otherwise, placebo effect. There is nothing scientifically backed to indicate otherwise. Apparently the company who created rescue remedy has attempted blind and double blind studies, but none have passed peer review.

HOWEVER... the placebo effect is strong. People buy Rescue Remedy believing it works. So... to an extent... it will work, because you're expecting it to. Unlike something like cancer, placebo effect does cause a lot of changes in your body, both chemically and mentally. So... back to Rescue Remedy. When human beings use it on themselves, they take it when they are nervous. And in their head, they'll just take the rescue remedy and it'll all be better... and the vast majority of the time, it is. Not because the medication is forcing you into a more calm and submissive state, but because you told your brain that after you take this you'll be calmer and more relaxed. Kind of like having your "lucky underwear" on. If you define something as "lucky" or "special" in some way that it's not physically capable of being if it was just lying there, you have just made it so. So... next time you don't have your lucky underwear on when playing your game of baseball, your mind will be in a tense and worried state because you know it's not there, that it's not "right". So you play worse. Not because you were missing the lucky underwear, but because your brain associate it with playing well. Just like people associate rescue remedy with calming them down.

And... to make things simple... I'll use Rescue Remedy as the example with animals. The placebo effect can be transferred... to an extent. People use the product say... to calm their dog down on road trips. They put a drop or two into their water bowl, let them drink, and then, because THEY believe it has an effect, their demeanor is calmer (and they didn't have any of the rescue remedy themselves... ;) ), they aren't worried about a tense and nervous dog because that dog "took it's rescue remedy!". Dogs are extremely perceptive to moods and attitudes. Suddenly you are calmer about going into the car. The dog is no longer worried because you are worried, because you're not. The dog notices this difference, and as a consequence of you expecting it to work and calming yourself, the dog is calmer. Has nothing to do with the actual chemical or application of any of the Bach Remedies inside of the tiny drop in the water bowl... all in the transferred placebo effect (not the actual term, so don't quote me on this).

So the placebo effect is strong. Kinda like the Force... it's strong within you. And THAT is why most people will claim that homeopathic treatments work so well. It's not because it's scientifically or statistically proven to work... but because they believe.



So... in short... homeopathy has not been proven, through extensive clinical studies or other forms of data gathering, to actually work. It contradicts the way chemistry... well... works. However, the placebo effect is strong. REALLY strong. And if that placebo effect managed to cure you of your ailment, great!! However... for cancer, diabetes, heart disease, and so many others... talk to your doctor, and if you want, get a second or third opinion from multiple types of physicians. And for your pets... there's nothing wrong with having a main holistic vet. However, realize that with most homeopathic treatments (not herbal tinctures, essential oils, etc), the placebo effect doesn't quite work the same way. And for serious issues, like with humans, heart disease, diabetes, cancer, etc... get a second, get a third, get a fourth opinion... and be OPEN to listening. And don't be afraid to research. There's a lot out there... if you just look. And don't be complacent. If you're buying from a company that doesn't test their medication in any way but just makes dilutions and then puts them up for sale... think twice. Don't just assume that it does what it's claiming... be a skeptic.

And for benign things, have fun playing with the placebo effect... except I think I might have just spoiled it for you.

And overall... no matter whether you are using homeopathic medications or not... a good diet is important. ;)

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