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The Science of Homeopathy

Coffee cures insomnia. Duck liver fights flu, and honeybees heal stings and swelling. No, you're not in Bizarro World. But you could be inside the office of a practitioner of homeopathy, a 200-year-old approach to medicine that operates according to "the law of similars": Conditions can be alleviated by substances that trigger the same types of symptoms in healthy people.

An estimated four million people in the U.S. use homeopathy. According to the 2007 National Health Interview Survey, the most recent statistics available, the number of users has doubled since 1990. And another study says the average user is 48 years old, female, and educated. The practice has a longer tradition in Europe, where consumers spend about one billion euros on homeopathic remedies every year, according to a recent report. Are the devotees onto something?

It's not surprising that the treatments appeal: They're natural, safe, affordable, and accessible. And some compelling data is surfacing to back them up. A review by the Cochrane Collaboration, an evidence-based medical group, found that while the popular flu remedy Oscillococcinum probably doesn't prevent infections, it may shorten the course of the illness. In one study, nearly 63 percent of patients showed clear improvement or no symptoms at all after taking it, compared to 49 percent in the placebo group; the remedy also reduced symptoms like fever and chills. And recent data from Brazil suggests that the law of similars may apply to inflammation.

Despite this research, mention homeopathy to your primary care doctor and you're likely to get that skeptical look. Compared with acupuncture, meditation, and other alternative practices, which are supported by reams of scientific evidence, homeopathy hasn't yet been subjected to intensive clinical research. Isolated studies have shown certain remedies to be effective, however, and recent research in Germany, where about 5,000 MD's are trained in the approach, found that patients who use homeopathic treatments tend to see improvement in their symptoms and their quality of life.

The Theory
Just exactly how homeopathy works, though, is something of a mystery. The remedies are based on the theory that "like treats like." If, for instance, you were suffering from hives, the doctor might prescribe a remedy made from honeybees. 

Oscillococcinum, for influenza, is derived from duck heart or liver because these organs often serve as reservoirs for the virus, as seen with the spread of avian flu. But unlike herbalists, who use tinctures of botanical substances, homeopaths take the active ingredient -- which can come from a plant, mineral, or animal -- and dilute it repeatedly with distilled water, shaking it vigorously between each dilution. 

The approach was created by a German doctor, Samuel Hahnemann, after he realized that cinchona bark, which was used to treat malaria at the time, caused symptoms similar to the illness. He began testing other substances to see what symptoms they caused, then theorized that rather than using doses that produced overt symptoms, it would be more effective to engage the body's healing mechanism with minuscule amounts. 

"The process of diluting and shaking seems to actually change the structure and nature of the water," says Dana Ullman, MPH, a coauthor of "Everybody's Guide to Homeopathic Medicines."

According to homeopathic theory, paradoxically, the lower the dose, the greater the effectiveness of the medication. A remedy labeled "6X" has been diluted six times -- a mild solution compared with one labeled "200C." (The letter refers to the proportions in the solution: X is 10, C is 100.) Most remedies are so highly diluted they contain mere molecules, if that, of the healing substances -- another reason many doctors are dubious about their effectiveness.

"The mechanism of action isn't understood, and that's galling to a rational scientist," admits Woodson Merrell, MD, chairman of the department of integrative medicine at Beth Israel Medical Center in New York City. "But it's important to remember that there's a lot about conventional medicine we don't understand, like how anesthesia works. What I tell patients is this: Homeopathy is very safe, so it won't hurt to give it a try. I've been using it since I was a kid, and I've seen it work wonders," says Merrell, who sometimes recommends Oscillococcinum for flu or arnica for bruises, or refers patients to a homeopathic practitioner for a thorough diagnosis and individualized treatment.

See for Yourself
The National Center for Complementary and Alternative Medicine agrees that homeopathic remedies have a very low risk of adverse reactions -- and, unlike some herbs, they're not known to interact with other medications. Moreover, they're regulated just like other over-the-counter drugs, and the FDA requires that they meet certain standards for strength, purity, and packaging.

Perhaps the best way to test them out is on acute, routine problems -- colds, flu, muscle soreness, headaches. "For those types of things, it's fine to try to treat yourself with a remedy from the health-food store," says Todd Rowe, MD, a homeopath and president of the newly opened American Medical College of Homeopathy in Phoenix, the first full-time homeopathic medical school to launch in the U.S. since the 1920s. "Homeopathic treatments work fairly quickly, so if you don't see a response within a day or so, you should consult a practitioner or try something else."

If you want to make homeopathy part of your treatment plan for an ongoing or more serious illness, proponents recommend seeing a homeopathic specialist to find the remedy that's right for you. 

"Like Chinese medicine, homeopathy is very whole-person oriented," says Iris Bell, MD, PhD, a professor of family and community medicine at the University of Arizona and head of the research department at the American Medical College of Homeopathy. "The treatment is highly individualized and depends on specific characteristics of the person being treated -- which is very different than conventional medications." 

There might be many remedies that work for people with a specific condition, but the one the doctor prescribes depends on your symptoms, your temperament, and other things going on in your life -- stress, anxiety, grief. 

Look for someone who is board certified by the Council on Homeopathic Certification, Rowe suggests. Homeopathic.org, the site of the National Center for Homeopathy, has a searchable database of homeopaths around the world. Some integrative medicine doctors suggest specific homeopathic treatments, or they may be able to help you determine whether you'd benefit from consulting a homeopath. 

Don't forget to ask the homeopathic provider if he or she accepts your insurance. "Some insurers cover homeopathy," Rowe says. "About half of my patients get reimbursed. "That said, most remedies cost less than $20, so even without insurance the approach is relatively affordable. And since you typically don't take most remedies for more than a day or two, one vial often lasts a good long while. Which can make a little of what ails you easier to swallow.

Homeopathic Remedies That Really Work
Research indicates a variety of conditions may be alleviated by homeopathic remedies. Check with your doctor to see whether they're good options for you or your family.

1. For easing the pain of arthritis or a sprained or strained muscle, try Rhus toxicodendron, or poison ivy. "It's one of my favorite remedies because it works well for a number of things, including cold sores and chicken pox. But the most well-proven use is for pain," says Jennifer Jacobs, MD, MPH, clinical assistant professor in the department of epidemiology at the University of Washington School of Public Health in Seattle.

2. Rashes and other skin flare-ups can be treated with calendula cream, or marigold extract. A study of women receiving radiation treatment for breast cancer found that when the cream was applied to the skin a couple of times a day, it reduced redness, pain, and irritation.

3. Hot flashes or night sweats are calmed by Lachesis mutus, derived from the venom of the bushmaster snake, sepia (ink from the cuttlefish), or belladonna (deadly nightshade). In 2008 French researchers affiliated with the homeopathic company Boiron reported on an international survey of homeopathic doctors, which found that homeopathic remedies reduced or eliminated menopausal symptoms in 90 percent of women, usually within 15 days of starting treatment.

4. When you have the fever, aches, and chills of the flu, try Oscillococcinum, or duck heart and liver. "It works best if you take it in the first 48 hours," Jacobs says.

5. If your child has an ear infection, ask the pediatrician whether Pulsatilla, or windflower, might help. "If they have a postcold earache with a little discharge, it should respond well to Pulsatilla," Rowe says.

6. When your child has diarrhea, ask about Podophyllum (mayflower). "Some very well-done studies have shown that homeopathic remedies can be highly effective in treating the condition," Ullman says.

 

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