Translate This Blog

Monday, September 1, 2014

Does Homeopathic Therapy Work?

A reader recently asked me my thoughts about "quack" treatments (their words) such as homeopathy, accupuncture, and so on.  This is another very polarizing subject, but as long-time readers know by now (and new readers find out quickly) that doesn't make me be quiet.  Polite discourse and debate is good for the mind!

As should be pretty clear, I am a trained in and practice traditional Western medicine.  I fully support traditional methods of diagnosis and treatment, using them myself on a daily basis.  For example, I would much rather use antibiotics than colloidal silver to treat an infection.  I also only have limited knowledge of many homeopathic/holistic treatments as that was never part of my education and I tend to think that there isn't a lot of evidence for many treatments.  That being said, I don't think that all homeopathy is "quack" medicine.

The hallmark of Western science is scentific study and peer reviews.  If we say that a prevention, test, or treatment is effective, we had better be able to support that with properly conducted scientific studies.  No, not all of them are 100% accurate and over time opinions can change.  But those opinions often change based on new evidence and data or new studies.  The duration of immunity ascribed to certain vaccines has increased over the years based on trials rather than merely thought and anecdote.  From what I've seen there is a lack of rigorous, independent, double-blind studies with many homeopathic treatments.  And really, that's the biggest complaint that most scientists and vets have about these therapies.  Show us the studies!  Show us the proof!  Don't say "well, it's worked well for me"!

Let me give a recent example that I came across.  I had a client tell me that she had started using black walnut extract to prevent heartworm disease based on things she had seen on the internet.  I had never heard of this so I started looking into it.  I found many websites, blogs, and articles from naturopaths on the benefits of black walnut, on how toxic traditional heartworm preventions are, and how safe and effective this extract was.  Do you know what I didn't find?  Proof.  Studies.  Sure, plenty of proponents of this method of prevention talked about what the mechanism of action should be, and I read a website from a vet about how he only recommended it and had never seen a case of heartworm disease in a dog using black walnut.  But all of these were opinions.  There wasn't a single scientific study, or even a report by parasitologists, immunologists, or toxicologists.  Some of the articles were by vets but most were by laypeople or people with an interest in homeopathy rather than a degree in a related field.  I even found articles and opinion pieces written by advocates of homeopathic therapy who had looked for direct proof or studies and found none.  Those same people were very honest in cautioning people about quickly jumping on black walnut extract because it really hadn't been appropriately studied for safety and efficacy.

"But it works!  And I know it does because I haven't seen a case of it!"  Really?  Okay, by the same logic when I see a dog who has never been on heartworm prevention and they test negative, it means that it's okay to not give preventative to that dog.  Right?  And in the same vein if I run back and forth across the interstate and never get hit by a car it must mean that doing so is safe.  Right? 

Not seeing a case does not constitute proof.  There is a difference between correlation and causation.  For example, I can see a graph that shows as temperature goes up the number of pirates also increases (yes, this is from the Wikipedia article I linked above).  Does this mean that an increase in temperature causes pirates to multiply?  That would be causation.  And that's the same kind of thinking that we often see with people advocating homeopathic treatment.  "I give A and I haven't seen a problem with B, so A must be working."  "My dog had X so I gave it Y and X went away.  Therefore Y works."  This is directly attributing causation when you may actually have correlation.  Using this method of determining efficacy contains a huge logical fallacy.  Scientific analysis and study through hypothesis testing and experimentation is supposed to differentiate between correlation and causation, allowing us to make a proper conclusion.  That has historically been missing in homeopathy.

I know that anyone reading this who is very much into holistic or homeopathic medicine is likely becoming very red-faced about now. But bear with me, as I'm not done. Because using the same logic we must keep in mind that just because there are no studies doesn't mean that a given treatment won't work.  If we say "Medicine P probably doesn't work because there haven't been rigid studies" we make the same mistakes of logic and once again place causation as a direct result when it may not be.  I do think that there are several homeopathic treatments that do work.

SAM-e has been studied quite a bit as a supplement to help liver function in animals, and has been attributed to improvement in osteoarthritis and even Alzheimer's in humans.  Glucosamine, chondroitin, and green-lipped mussel are all well known to help reduce joint pain and improve arthritis.  Omega fatty acids and fish oils have considerable benefit in certain kinds of skin and joint disorders.  All of these were at one point (and to many still are) considered "alternative" or "natural" therapies.  But because of scientific studies and considerable use we have been able to document true effects instead of simply anecdotes and personal reports.  Because of the scientific analysis they have become accepted by maintream medicine.

There is a form of "Western" accupuncture that seems to also have a legitimate basis in physiology.  I knew a vet in my area, a colleague whom I knew well and trusted, who had been trained in this form of accupuncture.  She said that it worked with known nerves and nerve clusters, stimulating them with the puncture of the needle.  It had also been studied and accepted at several veterinary colleges.  This particular method of accupuncture is different from the Eastern philosophies which tend to lean more towards energy clusters and similar mechanisms of action (as I understand them). 

There is much of homeopathic medicine and therapy that I do think is entering the realm of "quackery" and for which you won't find true scientific support.  However, I don't think that we should throw the baby out with the bath water and automatically eliminate all natural or holistic therapy.  More and more we are seeing proper studies done on these methods, many of which are showing real results and supporting the idea of a given treatment as being effective and safe.  As these studies build in number and are more widely known I would not be surprised to start seeing other formerly homeopathic-only treatments become commonly accepted in traditional Western medicine.  It's certainly happened before.

If you are interested in finding a vet who practices these methods of pet care, here are a few links.  And for now I'll continue to support my own methods and practice as I was taught in school.

American Holistic Veterinary Medical Association
Academy of Veterinary Homeopathy
British Association of Homeopathic Veterinary Surgeons