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White pill wonderings

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Alternative therapies are making a splash across the pond this week. Several docs have banded together in the UK to ask that the National Health Service (NHS) stop spending money on this stuff and start concentrating on therapies that work.

Why should we be funding treatments that haven’t been conclusively proven, critics argue, when women are battling the courts to receive ground-breaking breast cancer drugs?

One of the therapies under heaviest fire is homeopathy.

Many, of course, say it does too work. Members of the royal family, especially Prince Charles, are among its staunchest supporters.

Scientists and the medical community want to see the evidence backing the little pills, while alt-practitioners say double-blind, randomized, controlled trials are impractical for therapies based on the individual patient.

But how else can they prove themselves, beyond just saying, “I know it works!”?

What the experts say

“Lots of studies in journals of varying quality have said homeopathy is beneficial. If you refine your search, you will find the best studies are overwhelmingly negative. From a scientific standpoint, that should speak loudly to the public. Homeopathy relies on diluting substances well beyond the point where you would have a single atom of the allegedly active substance. Proponents bring up all kinds of ad hoc arguments about things like ‘quantum effects,’ but none of those are seen as credible by the scientific community. It’s very hard to make a pitch for a remedy that has no active ingredient. The statement that you can’t do randomized, controlled trials because the care is individualized is not a true one. There are ways of setting up randomized controlled trials.’ Lloyd Oppel , MD, chair, Allied Health and Alternative Therapies Committee, BC Medical Association

“Over-the-counter homeopathic remedies are the same ones that practitioners use. Yes, they do work, but only if applied properly. If you take a remedy that does in fact match your symptoms, it will work. The problem is that people buying over-the-counter medications might not be getting something that will address the particular symptoms they are experiencing. An unfortunate aspect of homeopathy is that people try to find shortcuts. [Manufacturers] will put five to 20 different remedies in a [product] known to be effective for a condition and hope that one will [be able to treat] your cold or headache. But homeopathy would have died a long time ago if it didn’t work.”

Raymond Edge , dean of the Toronto School of Homeopathic Medicine

“A number of [randomized controlled trials] have been done, and despite what is being said, most of them are positive. Not all homeopathic treatment has to be individualized. Perhaps the best example is Oscillococcinum , a remedy for the flu. I think there have been seven double-blind trials, and the Cochrane review of the results says it works, but not for prevention. [The Cochrane Collaboration is an international body dedicated to providing accurate health care info.] Few people get into homeopathy by reading the evidence. They get into it because they’ve heard it works. We have a little acronym, TEETH (Tried everything else? Try homeopathy). We do get a fair number of last-ditch attempts. I wouldn’t advise you to use homeopathy for a broken leg, pulmonary tuberculosis or acute appendicitis. There’s a whole range of things I wouldn’t treat with homeopathy. At our hospital we don’t claim to cure cancer, but we do have well-documented success treating many complications of cancer or cancer treatments.’ PETER FISHER , MD, clinical director, Royal London Homeopathic Hospital, UK “I don’t use homeopathy in my practice any more since I could never see consistent results with any of the remedies I prescribed over the years. My overall impression was that the good results are due to the placebo effect. I suppose if you believe in it strongly enough, it works.”

ZOLTAN RONA , MD, holistic practitioner, Toronto

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