Homeopathic Medicine Can’t Calm Your Baby.

[Image Credit: Cropped from Memekode, CC BY 2.0]

I dragged myself to the drugstore, hoping I could find something (anything) for my fussy 8 week old daughter who had spent most of her short life screaming. I had no idea what was wrong with her. Teething? Allergies? A general disdain for her new parents?

Her pediatrician suspected run-of-the-mill colic, a frustrating answer because colic describes effect rather than cause. Unfortunately, no one actually knows what causes colic, but the pediatrician assured me time would muffle my baby’s cries.

She was right. But, when I was knee deep in sobs, both my own and my daughter’s, I was willing to try anything for some peace. This is why I stood in that drugstore aisle, scanning the shelves for the zillionth time, grasping at any hint of relief.

And then I saw it—the magic elixir promising to calm my baby. How did I know this homeopathic medicine bottle would solve my problems? Because it said so. Indeed, it was called “Colic Calm.” According to its website, “Colic Calm” is a parental fantasy:

Join inconsolable, screaming babies and their inconsolable parents. If this were the first line of a party invitation, there would be zero attendees. But we’re all in this together, so let’s re-imagine the situation. Babies suffering from colic respond incredibly well to [insert brand name] Baby Colic Tablets. They relax and fall asleep. Their parents relax, too.

I wanted the description to be true, but I was skeptical. How does “Colic Calm” do all that? I turned to the drug facts for answers:

Uses: Temporarily relieves the symptoms of restlessness, irritability, gas pain and colic caused by food, feeding too quickly, swallowing air and similar conditions during teething, colds and other minor upset periods in children.
Active Ingredients | Purposes:
Dioscorea 6X HPUS: colic pains better from motion
Chamomilla 6X HPUS: restlessness & irritability
Colocynthis 6X HPUS: abdominal pain caused by gas

I’d never heard of those ingredients and wondered how they could remedy so many vague ailments. I also couldn’t wrap my head around the awkward grammar. What does “colic pains better from motion” mean? Nonetheless, I was desperate and vanquished, so I scooped up 3 bottles of homeopathic medicine, once again proving that seemingly rational parents will buy anything.

But we shouldn’t. Because homeopathy is nonsense.

The Allure of “Science-y” Homeopathic Medicine

Like most parents, I assumed any medicine sold in my drugstore had some evidence of efficacy. I didn’t realize the FDA has no administration over homeopathy. I also didn’t know about its prescientific roots, which means, as Dr. Steven Novella avows, it “cannot work.”

Despite my ignorance of its most basic failings, I had a vague familiarly with homeopathy. For some reason, my pregnancy had prompted a mini-collection of “natural healing” books, in which homeopathy is explained by the principle of “like curing like.” However, these books never examine whether this principle is rational. Instead, they detail preparation and selection methods.

This is like explaining the myriad ways unicorns benefit the world, the environment in which they live, their breeding practices, and their diet without acknowledging that unicorns don’t actually exist. How homeopathy “works” is irrelevant if the principles of homeopathy are completely made up.

Homeopathy Primer

Nonetheless, if you are unfamiliar with these principles, as are most parents scouring the drugstore aisle, let me provide a very brief primer. Homeopathy was invented in the late 18th century by a German physician named Samuel Hahnemann. Many homeopaths will insist he “discovered” homeopathy, but it is more honest to say he invented it, an invention based on anecdote, induction, and a fanciful imagination. In this respect, homeopathy was more akin to a new religion than to a scientific discovery.

Hahnemann published his Law of Similars in 1796. He claimed that substances causing particular symptoms in healthy people will then somehow treat the same symptoms in sick people. He also thought shaking the homeopathic medicine would make them more potent, as would diluting them because…why not.

Let’s examine “Colic Calm.” It contains three active ingredients: Dioscorea, Chamomilla, and Colocynthis. Translated into plain English, the ingredients are a tuber, a flower, and a fruit. I have no idea if these ingredients can actually calm a baby. However, that doesn’t matter since a 6X homeopathic dosage means the ratio of “active ingredient” to dilutant is 1:1,000,000. This means the already dubious ingredients don’t even exist in the final homeopathic preparation. Paradoxically, according to homeopathic logic, the MORE diluted a substance, the MORE powerful its effects. This means a 6C preparation would be even more “potent” than a 6X preparation because the ratio of active ingredient to dilutant would be 1: 1,000,000,000,000.

Frankly, I still can’t wrap my head around the dilution logic, but homeopaths have branded the nonexistence of any active ingredient as one of homeopathy’s most appealing benefits: no side effects. I can buy as many bottles as I please, give as much to my child as I want, and somehow it will not interact with other medicines or cause any side effects. In retrospect, I should have wondered about this homeopathic quirk. What other real medicine gains potency via dilution, yet also produces no side effects, even in its most “potent” form? Clearly I was too tired to ponder this paradox.

The Logic is Silly, but Maybe It Works Anyway

Despite its silly origins, homeopathy’s popularity has led to numerous clinical trials examining its effectiveness: In summary, it doesn’t work. I highly recommend Simon Singh and Edzard Ernst’s book Trick or Treatment if you would like a more detailed discussion of homeopathy’s clinical trials.

Because homeopathy is not uniform, it has been tested from many different directions. For example, physicists and biologists have probed homeopathic water to see if it differs on the molecular or cellular level from regular water. No slam dunk differences have been discovered. Homeopathy has also been subjected to varying types of clinical trials, many of which have been poorly designed and executed. Nonetheless, according to Singh and Ernst,

Hundreds of trials have failed to deliver significant or convincing evidence to support the use of homeopathy for the treatment of any particular ailment. On the contrary, it would be fair to say that there is a mountain of evidence to suggest that homeopathic remedies simply do not work.

And according to the U.S. National Center for Complementary and Integrative Health,

A 2015 comprehensive assessment of evidence by the Australian government’s National Health and Medical Research Council concluded that there is no health conditions for which there is reliable evidence that homeopathy is effective.

People much smarter than I have noted that lukewarm positive results in some homeopathic trials point to the “placebo hypothesis.” Since homeopathy fails at both prior plausibility and clear clinical effectiveness, this conclusion makes sense.

I’ve been censured for criticizing homeopathy, often by people who tell me I am close-minded for trying to box homeopathy into my narrow conception of medicine or who insist our modern understanding of science can’t explain everything. I’ve also been criticized by parents convinced homeopathy helped their child. Usually the refrain sounds something like “I don’t know how it worked, but it did.”

I’m sympathetic to these critiques. In the context of human history, modern science is still young. And I too thought the homeopathic tablets calmed my daughter (for like 5 minutes, but still). Nonetheless, these critiques don’t prove homeopathy works, and the burden of proof is on those peddling the cure, not on those questioning it. Just because our modern understanding of the world is limited, doesn’t mean homeopathy makes sense. If anything, we should be skeptical of something that so blatantly contradicts what we actually know about the universe.

Similarly, just because we thought homeopathy worked, doesn’t mean it actually did anything. Placebos are powerful. Furthermore, regression to the mean can give the illusion of effectiveness. Why? Because our babies will appear calmer at the exact moment we buy the homeopathic preparation, if for no other reason than we succumbed to the colic tablets at our moment of most duress. Therefore, when our babies inevitably calm, we are likely to attribute this change to the latest thing we tried. This is like the pregnant woman who insists the spicy hummus caused her to go into labor simply because it was the last thing she ate before going into labor (I really wish I hadn’t believed that myth and downed a red pepper smoothie past my due date…).

As a consumer, I’m frustrated by homeopathy’s attempt to sound “science-y” without participating in the laws of science. It wants to exist outside the scientific models, but also hold court with real medicine. If companies want to sell sugar pills based on a mystical version of healing, then label it as such. Otherwise, homeopathic companies are profiting off consumers’ assumptions anything marketed next to real medicine is part of the same category.

Mass Produced Homeopathy Isn’t Real Homeopathy

Even within the homeopathic community, products like “Colic Calm” are controversial and crass. This is because mass marketed products are impersonal. Conversely, many professional homeopaths spend a great deal of time fitting “the remedy to the nature of the individual rather than a disease process.”. Homeopathic nuance is why many in the community reject clinical studies proving its ineffectiveness. For example, one homeopathic website explains why homeopathy cannot be tested by the scientific method:

The scientific method requires that for example, all individuals with headaches receive systematic treatment in order to validate the effectiveness of the single headache medicine they are testing. This is impossible in homeopathic treatment because medicines must be individualized with respect to the remedy given, the dosage and frequency of repetition, as each individual will have a unique manifestation in the way they experience their headaches.

This explanation is disheartening. Are consumers supposed to accept homeopathy on faith? If homeopathy can’t be tested by the scientific method, how will homeopaths prove (beyond anecdote) that it works? Are we simply supposed to ignore the overwhelming evidence from clinical trials that homeopathy is no more effective than a placebo?

I dislike the claim that homeopathy is somehow outside the bounds of science. But even so, if homeopaths truly believe homeopathic medicine can’t be tested by traditional clinical trials, then they must stop using the language of science to suggest their products work. They can’t have it both ways. If they can’t fulfill their burden of proof to demonstrate homeopathy’s effectiveness, then they should acknowledge their limitations.

Why Homeopathy isn’t Harmless, or The Clothes Without an Emperor

Homeopathy is a booming business. Large homeopathic manufacturers can’t provide this individualized attention. Therefore, they try to recreate an empathetic environment with their advertising copy. They remind us parents that “we’re all in this together.” At the time, I thought this kind of marketing was helpful. In retrospect, it feels sleazy. I unknowingly bought a message, rather than a medicine.

Still, what’s the big deal? After all, I only gave my daughter sugar pills and no harm was done.

No harm was physically done to my daughter, but false advertising dilutes our culture’s scientific literacy. It also wastes our money. By and large, we are not savvy consumers. We buy homeopathic products because we think they work. The FTC wants to change this. It has asked the FDA to reconsider the way homeopathic products are regulated because “most consumers do not understand homeopathy, how the FDA regulates homeopathic drugs, or the level of scientific evidence needed to support health claims for homeopathic products.”

Homeopathy can also be dangerous. The danger is most pernicious when homeopathy is recommended for deadly diseases, such as a natural alternative to vaccines (it’s not). But it can also be dangerous for conditions like colic or unknown baby fussiness. Most of the time, a fussy baby won’t need any type of medicine. Still, parents who wholeheartedly believe in homeopathic efficacy could overlook a serious medical condition as they patiently wait for the homeopathic medicine to work, instead of going to a real doctor. Or worse, they might shun the pediatrician if they believe the homeopathic supposition that mainstream medicine suppresses symptoms. If homeopathy prevents parents from seeking out other forms of needed medical care, then homeopathy is doing real harm.

Nonetheless, most parents aren’t using homeopathy in lieu of vaccination. Most parents buy homeopathy because we have no idea what it is, assume it is natural (whatever that means), and are seduced by the lack of side effects. We want our babies to stop crying, and if Target wants to sell us homeopathy, maybe, just maybe, it will work. However, closing our eyes and buying into homeopathy makes us complicit in pseudoscience, and it makes us a little less smart.

Sometimes homeopathy is compared to the fable “The Emperor’s New Clothes.” In this story, the townspeople are told that the emperor’s new clothes are invisible to anyone who is stupid or incompetent. No one wants to admit their incompetence, so they all pretend to see the clothes. At the end, a child proclaims the embarrassing truth no one else can admit: “He isn’t wearing anything at all!” In this homeopathic analogy, consumers can’t acknowledge the naked emperor because we assume anything sold in the drugstore has been approved by some ubiquitous quality control agent. I knew “like curing like” or “dilution makes it stronger” didn’t make sense, but I’m not a doctor, so I assumed my ignorance was my own problem. Therefore, I didn’t want to admit homeopathy was probably bunk, especially as my friends also bought it for their children.

I like this analogy. But I’d like to switch it around a bit. In the land of homeopathy, perhaps the emperor, rather than his clothes, has disappeared. Indeed, the homeopathic bottle looks nice, the descriptions look convincing with their Latin words and Roman numerals, yet at the core, nothing is inside.

And we are the unwitting dupes, enthusiastically bowing to the empty air.

What do fellow parents think? Should the FDA remove the homeopathic exemption from the Food, Drug, and Cosmetic Act (and therefore require homeopathic evidence of safety and efficacy), or should it leave well enough alone?

References:

“Colic-What to Expect.” WebMd. http://www.webmd.com/parenting/baby/tc/colic-what-to-expect

David Gorski. “Fun with Homeopaths and Meta-Analyses of Homeopathy Trials.” Science Based Medicine. 13 October 2008. https://www.sciencebasedmedicine.org/fun-with-homeopaths-and-meta-analyses-of-homeopathy-trials/

Edzard Ernst. “Homeopathy: What Does the “Best” Evidence Tell Us?” The Medical Journal of Australia. 2010; 192 (8): 458–460. https://www.mja.com.au/journal/2010/192/8/homeopathy-what-does-best-evidence-tell-us

“FAQS.” Hauser Homeopathy. http://www.hauserhomeopathy.com/frequently-asked-questions.html

“Homeopathy.” National Center for Complementary and Integrative Health. U.S. Department of Health and Human Services. https://nccih.nih.gov/health/homeopathy

“Hyland’s Baby Colic Tablets.” Hylands Homeopathic. http://hylands.com/products/hylands-baby-colic-tablets

Kausik Datta, “Homeopathy: Diluted out of existence?” 22 January 2011. SciLogs. http://www.scilogs.com/in_scientio_veritas/homeopathy-diluted-out-of-existence/

Michael Mezher. “FTC Asks FDA to Reevaluate Framework for Homeopathic Products.” Regulatory Affairs Professional Society. 24 August 2015. http://www.raps.org/Regulatory-Focus/News/2015/08/24/23049/FTC-Asks-FDA-to–Reevaluate-Framework-for-Homeopathic-Products/

Science Pony. “Nosodes. Fake medicine, real danger.” Sciencepony.com. 26 August 2015. http://www.sciencepony.com/index.php/2015/08/26/nosodes/

Simon Singh and Edzard Ernst. Trick or Treatment: The Undeniable Facts about Alternative Medicine. New York: W.W. Norton, 2008. Print.

Stephen Barrett. “Classical Homeopathy: ‘Fitting the Remedy to the Individual’ (1986).” HomeoWatch. 6 December 2001. http://www.homeowatch.org/articles/wember.html

Steven Novella. “Another Review Finds Homeopathy Worthless.” Science Based Medicine. 11 March 2015. https://www.sciencebasedmedicine.org/another-review-finds-homeopathy-worthless/