Homeopathy ("home-ee-AH-pah-thy"), also known as homeopathic medicine, is a form of health care that developed in Germany
and has been practiced in the United States since the early 19th century. Homeopathic practitioners are commonly called homeopaths.
This fact sheet answers some frequently asked questions on homeopathy and reviews scientific research on its use and effectiveness.
Key
Points
- In homeopathy, a key premise is that every person has energy called a vital force or self-healing response. When this
energy is disrupted or imbalanced, health problems develop. Homeopathy aims to stimulate the body's own healing responses.
Homeopathic treatment involves giving extremely small doses of substances that produce characteristic symptoms of illness
in healthy people when given in larger doses. This approach is called "like cures like."
Various explanations have been proposed as to how homeopathy might work. However, none of these explanations has been
scientifically verified.
Research studies on homeopathy have been contradictory in their findings. Some analyses have concluded that there is no
strong evidence supporting homeopathy as effective for any clinical condition. However, others have found positive effects
from homeopathy. The positive effects are not readily explained in scientific terms.
It is important to inform all of your health care providers about any therapy that you are currently using or considering,
including homeopathic treatment. This is to help ensure a safe and coordinated course of care.
What is homeopathy?
The term homeopathy comes from the Greek words homeo, meaning similar, and pathos, meaning
suffering or disease. Homeopathy is an alternative medical system. Alternative medical systems are built upon complete systems
of theory and practice, and often have evolved apart from and earlier than the conventional medical approach used in the United
States.a Homeopathy takes a different approach from conventional medicine in diagnosing, classifying, and treating medical
problems.
Key concepts of homeopathy include:
- Homeopathy seeks to stimulate the body's defense mechanisms and processes so as to prevent or treat illness.
- Treatment involves giving very small doses of substances called remedies that, according to homeopathy, would produce
the same or similar symptoms of illness in healthy people if they were given in larger doses.
- Treatment in homeopathy is individualized (tailored to each person). Homeopathic practitioners select remedies according
to a total picture of the patient, including not only symptoms but lifestyle, emotional and mental states, and other factors
- What is the history of the discovery and use of homeopathy?
In the late 1700s, Samuel Hahnemann,
a physician, chemist, and linguist in Germany, proposed a new approach to treating illness. This was at a time when the most
common medical treatments were harsh, such as bloodletting,c purging, blistering, and the use of sulfur and mercury. At the
time, there were few effective medications for treating patients, and knowledge about their effects was limited.
- Hahnemann was interested in developing a less-threatening approach to medicine. The first major step reportedly was when
he was translating an herbal text and read about a treatment (cinchona bark) used to cure malaria. He took some cinchona bark
and observed that, as a healthy person, he developed symptoms that were very similar to malaria symptoms. This led Hahnemann
to consider that a substance may create symptoms that it can also relieve. This concept is called the "similia principle"
or "like cures like." The similia principle had a prior history in medicine, from Hippocrates in Ancient Greece--who noted,
for example, that recurrent vomiting could be treated with an emetic (such as ipecacuanha) that would be expected to make
it worse--to folk medicine.14,15 Another way to view "like cures like" is that symptoms are part of the body's attempt to
heal itself--for example, a fever can develop as a result of an immune response to an infection, and a cough may help to eliminate
mucus--and medication may be given to support this self-healing response.
Hahnemann tested single, pure substances
on himself and, in more dilute forms, on healthy volunteers. He kept meticulous records of his experiments and participants'
responses, and he combined these observations with information from clinical practice, the known uses of herbs and other medicinal
substances, and toxicology,d eventually treating the sick and developing homeopathic clinical practice.
Hahnemann added
two additional elements to homeopathy
- A concept that became "potentization," which holds that systematically diluting a substance, with vigorous shaking at
each step of dilution, makes the remedy more, not less, effective by extracting the vital essence of the substance. If dilution
continues to a point where the substance's molecules are gone, homeopathy holds that the "memory" of them--that is, the effects
they exerted on the surrounding water molecules--may still be therapeutic.
- A concept that treatment should be selected based upon a total picture of an individual and his symptoms, not solely upon
symptoms of a disease. Homeopaths evaluate not only a person's physical symptoms but her emotions, mental states, lifestyle,
nutrition, and other aspects. In homeopathy, different people with the same symptoms may receive different homeopathic remedies.
Hans
Burch Gram, a Boston-born doctor, studied homeopathy in Europe and introduced it into the United States in 1825. European
immigrants trained in homeopathy also made the treatment increasingly available in America. In 1835, the first homeopathic
medical college was established in Allentown, Pennsylvania. By the turn of the 20th century, 8 percent of all American medical
practitioners were homeopaths, and there were 20 homeopathic medical colleges and more than 100 homeopathic hospitals in the
United States.
In the late 19th and early 20th centuries, numerous medical advances were made, such as the recognition
of the mechanisms of disease; Pasteur's germ theory; the development of antiseptic techniques; and the discovery of ether
anesthesia. In addition, a report (the so-called "Flexner Report") was released that triggered major changes in American medical
education. Homeopathy was among the disciplines negatively affected by these developments. Most homeopathic medical schools
closed down, and by the 1930s others had converted to conventional medical schools.
In the 1960s, homeopathy's popularity
began to revive in the United States. According to a 1999 survey of Americans and their health, over 6 million Americans had
used homeopathy in the preceding 12 months. The World Health Organization noted in 1994 that homeopathy had been integrated
into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka,
and Mexico. Several schools of practice exist within homeopathy.
Persons using homeopathy do so to address a range
of health concerns, from wellness and prevention to treatment of injuries, diseases, and conditions. Studies have found that
many people who seek homeopathic care seek it for help with a chronic medical condition. Many users of homeopathy treat themselves
with homeopathic products and do not consult a professional.
What kind of training do homeopathic practitioners
receive?
In European countries, training in homeopathy is usually pursued either as a primary professional
degree completed over 3 to 6 years or as postgraduate training for doctors.
In the United States, training in homeopathy
is offered through diploma programs, certificate programs, short courses, and correspondence courses. Also, homeopathic training
is part of medical education in naturopathy.e Most homeopathy in the United States is practiced along with another health
care practice for which the practitioner is licensed, such as conventional medicine, naturopathy, chiropractic, dentistry,
acupuncture, or veterinary medicine (homeopathy is used to treat animals).
- Laws about what is required to practice homeopathy vary among states. Three states (Connecticut, Arizona, and Nevada)
license medical doctors specifically for homeopathy.
- What do homeopathic practitioners do in treating patients?
Typically, in homeopathy, patients
have a lengthy first visit, during which the provider takes an in-depth assessment of the patient. This is used to guide the
selection of one or more homeopathic remedies. During followup visits, patients report how they are responding to the remedy
or remedies, which helps the practitioner make decisions about further treatment.
What are homeopathic remedies?
Most
homeopathic remedies are derived from natural substances that come from plants, minerals, or animals. A remedy is prepared
by diluting the substance in a series of steps. Homeopathy asserts that this process can maintain a substance's healing properties
regardless of how many times it has been diluted. Many homeopathic remedies are so highly diluted that not one molecule of
the original natural substance remains. Remedies are sold in liquid, pellet, and tablet forms.
- How does the U.S. Food and Drug Administration (FDA) regulate homeopathic remedies?
Because of
their long use in the United States, the U.S. Congress passed a law in 1938 declaring that homeopathic remedies are to be
regulated by the FDA in the same manner as nonprescription, over-the-counter (OTC) drugs, which means that they can be purchased
without a physician's prescription. Today, although conventional prescription drugs and new OTC drugs must undergo thorough
testing and review by the FDA for safety and effectiveness before they can be sold, this requirement does not apply to homeopathic
remedies.
Remedies are required to meet certain legal standards for strength, quality, purity, and packaging. In 1988,
the FDA required that all homeopathic remedies list the indications for their use (i.e., the medical problems to be treated)
on the label. The FDA also requires the label to list ingredients, dilutions, and instructions for safe use.
The guidelines
for homeopathic remedies are found in an official guide, the Homeopathic Pharmacopoeia of the United States, which is authored
by a nongovernmental, nonprofit organization of industry representatives and homeopathic experts.24 The Pharmacopoeia also
includes provisions for testing new remedies and verifying their clinical effectiveness. Remedies on the market before 1962
have been accepted into the Homeopathic Pharmacopoeia of the United States based on historical use, rather than scientific
evidence from clinical trials.
Have any side effects or complications been reported from the use of homeopathy?
The
FDA has learned of a few reports of illness associated with the use of homeopathic remedies. However, the FDA reviewed these
reports and decided that the remedies were not likely to be the cause, because of the high dilutions.
Here is some
general information that has been reported about risks and side effects in homeopathy:
- Homeopathic medicines in high dilutions, taken under the supervision of trained professionals, are considered safe and
unlikely to cause severe adverse reactions.
- Some patients report feeling worse for a brief period of time after starting homeopathic remedies. Homeopaths interpret
this as the body temporarily stimulating symptoms while it makes an effort to restore health.
- Liquid homeopathic remedies can contain alcohol and are permitted to have higher levels of alcohol than conventional drugs
for adults. This may be of concern to some consumers. However, no adverse effects from the alcohol levels have been reported
either to the FDA or in the scientific literature.
- Homeopathic remedies are not known to interfere with conventional drugs; however, if you are considering using homeopathic
remedies, you should discuss this with your health care provider. If you have more than one provider, discuss it with each
one.
As with all medicinal products, a person taking a homeopathic remedy is best advised to:
- Contact his health care provider if his symptoms continue unimproved for more than 5 days.
- Keep the remedy out of the reach of children.
- Consult a health care provider before using the product if the user is a woman who is pregnant or nursing a baby.
- What has scientific research found out about whether homeopathy works?
This section summarizes
results from (1) individual clinical trials (research studies in people) and (2) broad analyses of groups of clinical trials.
The
results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared
to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater
than one would expect from a placebo.
Systematic reviews and meta-analyses take a broader look at collections of a
set of results from clinical trials. In sum, systematic reviews have not found homeopathy to be a definitively proven treatment
for any medical condition. Two groups of authors listed in Appendix II found some positive evidence in the groups of studies
they examined, and they did not find this evidence to be explainable completely as placebo effects (a third group found 1
out of 16 trials to have some added effect relative to placebo). Each author or group of authors criticized the quality of
evidence in the studies. Examples of problems they noted include weaknesses in design and/or reporting, choice of measuring
techniques, small numbers of participants, and difficulties in replicating results. A common theme in the reviews of homeopathy
trials is that because of these problems and others, it is difficult or impossible to draw firm conclusions about whether
homeopathy is effective for any single clinical condition.
Are there scientific controversies associated with homeopathy?
Yes.
Homeopathy is an area of complementary and alternative medicine (CAM) that has seen high levels of controversy and debate,
largely because a number of its key concepts do not follow the laws of science (particularly chemistry and physics).
- It is debated how something that causes illness might also cure it.
- It has been questioned whether a remedy with a very tiny amount (perhaps not even one molecule) of active ingredient could
have a biological effect, beneficial or otherwise.
There have been some research studies published on the use of
ultra-high dilutions (UHDs) of substances, diluted to levels compatible with those in homeopathy and shaken hard at each step
of dilution.h The results are claimed to involve phenomena at the molecular level and beyond, such as the structure of water,
and waves and fields. Both laboratory research and clinical trials have been published. There have been mixed results in attempts
to replicate them. Reviews have not found UHD results to be definitive or compelling.
There have been some studies
that found effects of UHDs on isolated organs, plants, and animals.15 There have been controversy and debate about these findings
as well.
- Effects in homeopathy might be due to the placebo or other non-specific effect.
- There are key questions about homeopathy that are yet to be subjected to studies that are well-designed--such as whether
it actually works for some of the diseases or medical conditions for which it is used, and if so, how it might work.
- There is a point of view that homeopathy does work, but that modern scientific methods have not yet explained why. The
failure of science to provide full explanations for all treatments is not unique to homeopathy.
- Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of
this alternative system of medicine are not necessary.
Is NCCAM funding research on homeopathy?
Yes,
NCCAM supports a number of studies in this area. For example:
- Homeopathy for physical, mental, and emotional symptoms of fibromyalgia (a chronic disorder involving widespread musculoskeletal
pain, multiple tender points on the body, and fatigue).
- Homeopathy for brain deterioration and damage in animal models for stroke and dementia.
- The homeopathic remedy cadmium, to find out whether it can prevent damage to the cells of the prostate when those cells
are exposed to toxins
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