Part of Number 7 of The Highlight, our home for ambitious stories that explain our world.
Natalie Grams once believed in homeopathy. She believed that sugar pills, distilled and diluted as prescribed by the practice of homeopathy, could treat ailments from colds and flu to depression and anxiety, allergies, asthma, chronic pain, immune dysfunction and digestive disorders, whatever.
As a medical student in his native Germany, he was increasingly frustrated with the limitations of conventional medicine. There was no time, says the 41-year-old doctor, to really care about patients; Symptom treatment was the end result. Then, in the middle of his studies, he survived a horrible car accident. She escaped almost unharmed, but soon suffered repeated fainting. The doctors couldn't find anything wrong. A friend suggested that she try a naturopath, an alternative medicine practitioner, who diagnosed Grams with PTSD and prescribed a homeopathic remedy, specifically Belladonna C200, small white pills with a diluted form of the poisonous plant of the same name.
"And then I felt better," says Grams. "So I thought,‘ Oh, it was homeopathy that cured me, that cured my symptoms. "
Homeopathy is a school of alternative medicine based on the principles that "I like cure", that less is more, that a detailed intake of the patient is necessary to get to the root of a medical problem. After recovering, Grams dedicated himself to it, not only as a patient, but also as a practitioner. First he completed his medical training, and then, after seven years of homeopathic training, including 300 hours of courses that cost him a non-insignificant sum (weekend training was up to 300 euros, or more than $ 300), Grams it became a homeopathic medical license and she opened her own practice.
Much of his homeopathic training was contrary to what he had studied in medical school. The instructors taught that vaccines contained chemical ingredients such as aluminum, and that antibiotics cannot cure the disease, Grams recalls. A supervisor eliminated all conventional remedies for most of the patients he saw, including those with chronic diseases that require medications, such as high blood pressure, diabetes and asthma. Grams, however, was all inside.
And, as is a traditional tradition in homeopathy, it contained skeptics and critics. To prove they were wrong, she began writing a book in defense of homeopathy.
Instead, he discovered that the facts and research did not support the field in which he had developed his career. He read about one clinical trial after another that he could not find conclusive evidence that homeopathic remedies worked; He consulted chemists and physicists, who explained why quantum physics cannot support the claim of homeopathy that water retains "the memory" of any substance with which it comes into contact; He turned to psychologists, who spoke in depth about the placebo effect. The result was a very different book that she titled. Homeopathy reconsidered.
"I was convinced (I was) doing something good, really good," she says about her homeopathic practice during FaceTime while on vacation with her family in an undisclosed location. (She has lived "hidden," as she puts it, since she became a public critic of homeopathy and death threats began.) "Even perhaps the best form of medicine."
Homeopathic remedies do not contain discernible molecules of their "active" ingredients. And yet, defenders claim that they retain the properties of what does not exist. "It's like smoke," says Grams, "as something that if you want to grab it, if you want to catch it, it just disappears. It's just a great illusion."
Homeopathy is a $ 1.2 billion industry in the US alone. UU., Used by approximately 5 million adults and 1 million children. It has become a staple of the US wellness industry, so leading brands such as Boiron and Hyland are readily available in high-end health-focused chains such as Whole Foods and Sprouts, supermarkets such as Ralphs and large stores such as Walmart Analysts project that the global homeopathic market will grow 12.5 percent by 2023.
Once regarded as marginal, conventional medicine now groups homeopathy under the motto of "alternative and complementary medicine", along with the other usual suspects of the modern Western welfare movement, a wave of health that grew in the 1970s and culminated twenty years later: acupuncture, massage, meditation, yoga, reiki, ayurveda, etc. "In the 1990s," writes Jennie Rothenberg Gritz in the Atlantic, "the word & # 39; alternative & # 39; was synonymous with hip and progressive thinking." Today, approximately half of adults in the United States say they have tried alternative medicine.
"It's like smoke, like something that if you want to grab it, if you want to catch it, it just disappears."
For those who buy it, homeopathy is synonymous with holistic health. Surely there are more answers, more remedies, argue homeopaths, than ibuprofen, antacids, statins, SSRIs and surgery. Its increase has been in tune with a growing sense of perceived failures in medicine, particularly that doctors do not take into account "integral health." For his followers, homeopathy does.
But these products are not FDA approved. In 2016, the Federal Trade Commission began an offensive against the homeopathic remedies that were filling the supermarket shelves, demanding that they clearly state that, in fact, they are not medications. The Boiron website now has that legally required disclaimer: "Claims based on traditional homeopathic practice, no accepted medical evidence."
Consumers are beginning to feel "scammed and cheated," the nonprofit Research Center argued in a lawsuit filed last month against Walmart and CVS for the sale of what it called "homeopathic fake medicine." A consumer survey conducted by the nonprofit organization found that 41 percent of respondents felt negatively about homeopathic remedies "(or) they were told the essential facts about the pseudoscientific claims of homeopathy ".
In a statement provided to Vox, Boiron's chief executive and president, Janick Boudazin, wrote: "We do not comment on ongoing cases or cases of others. However, it should be clarified that homeopathic drug products are legally marketed in the States. United, which ensures that consumers have access to safe and clearly identified homeopathic products to choose according to their health care needs. "
Requests for comments from two leading homeopathy organizations, the American Homeopathy Institute and the National Homeopathy Center, were not answered at the time of publication.
A history of distilled homeopathy.
Many mistakenly identify homeopathy as "natural" and describe it as a herbal or herbal medicine. It is not. In his 2016 book, Homeopathy: the undiluted factsEdzard Ernst, a physician, homeopathy researcher and notable skeptic, classified the "natural" qualifier as one of the many myths about homeopathy spread by believers and skeptics. But "it's not natural," he wrote: Homeopathic remedies include alcohol exposed to X-rays to minimize the effects of radiation therapy and fragments of the original Berlin Wall to "cure a patient's communication problems," Ernst wrote.
Homeopathy is not oriental medicine either. He is a little over 200 years old and was born in Germany.
Samuel Hahnemann, an 18th-century physician described by Ernst as a "deeply religious and spiritual man, as well as an eccentric, innovative, nonconformist and polymic," first published a new school of medical thought he called homeopathy in 1790. He "He became disillusioned with the medical model of the time, but he was fascinated by cinchona bark powder, then it was used to treat malaria (and then it was discovered that it contained the quinine alkaloid, which is still used to treat malaria today ) Large amounts of cinchona bark were given, ingesting it repeatedly to document the fever, sweating, and nausea that appeared.Its objective: to test whether the malaria remedy produces the symptoms of malaria in a healthy person.
Hahnemann declared this as the first of what would be known as "homeopathic tests." (The etymology of the word "homeopathy" is "like a disease"). He performed more experiments and came to more tests. Soon, he defined several of the so-called laws; Two are guiding principles of homeopathy today:
- As priests as: Homeopathy states that a substance that produces the symptoms of a disease in a healthy person is a cure for that disease. (In the case of the aforementioned remedy of the twentieth century known simply as "Berlin Wall", it is said that the conditions caused by communication problems are cured with tablets made of finely ground and diluted fragments of the actual Berlin Wall, because once It was a concrete barrier to communication.)
- Minimum dose law: The lower the dose, homeopathic doctors say, the more potent the remedy. To that end, homeopathic remedies are extremely diluted. Many are so diluted, in fact, that they do not contain detectable "mother tincture" molecules. Hahnemann intended to avoid poisoning, since many of the substances he introduced as remedies were toxic. But soon his reasoning became less, well, rational: "vital energy" was transmitted during the dilution, Hahnemann believed, so that none of the original substances should remain.
Hahnemann's theories represented a radical change in medical philosophy, a rejection of what he coined as "allopathy," remedies that produce the opposite symptoms of a disease, and mockingly mocked "school medicine." Hahnemann thought that the doctors of his time hurt the patients, and he was not bad. The medicine of the late eighteenth century revolved around the balance of the four moods, most often through bleeding. The less invasive approach to homeopathy attracted followers, who in turn spread the Hahnemann Gospel in Europe, India and the United States. The American Homeopathy Institute, founded in 1844, arrived even three years before the American Medical Association.
Conventional medicine finally became increasingly science-oriented, ruling out bleeding and the like for more effective (and drastically less dangerous) treatments. Homeopathy, on the other hand, maintained its original dogma, one that depended on individualized treatment and made clinical trials that adhere to the scientific method almost impossible.
In the 1900s, homeopathy was even recognized by the United States government. Royal Copeland, a surgeon, health commissioner for New York City, a famous American senator and homeopath, used his medical authority to grant credibility to homeopathy and his political influence to ensure his recognition by law. The Food, Drug and Cosmetics Act of 1938 oversees homeopathy to this day.
From "alternative medicine" to complementary medicine
In the world of homeopathy, there are believers and there are skeptics. There are also passive participants looking for over-the-counter remedies such as supplements, believing in these pills (and ointments, tinctures, tablets, creams) enough to buy them, if not necessarily to compromise their health on them completely. There are those who believe in invisible forces, in energies, in spirits; There are those who do not, who discard homeopathic remedies such as water with alcoholic sugar. And some perspectives, like Grams, fluctuate over time.
Boiron was the brand of homeopathic choice for my family in Southern California in the 1990s and early 2000s. I grew up in the suburbs, my father is a doctor and my parents vaccinated me completely, but there was something about "natural medicine" and homeopathy in particular, which spoke to them. Every time I had the flu, my mother gave me a bottle of pink-sized Oscillococcinum, sweet "flu crystals," as we call them, which I happily dissolved under my tongue. Every time I had a cold, she gave me something called ColdCalm, which I drank, but I regretted its chalk taste and its easily wrinkled blister packs.
Now I know that the active ingredient in Oscillococcinum is Anas barbariae, heart extract and duck liver. (The Research Center asked consumers about their knowledge base of Anas barbariae as part of their survey mentioned above; 46 percent of respondents "saw the product less favorably" once they learned about these things from Ducks). I don't know if it worked. My symptoms would eventually disappear, but I don't know if my conditions improved faster with the remedy than without it. However, I do know that my parents sought beyond the limits of conventional medicine ways to improve our health that were more "natural" than prescription drugs and standard over-the-counter medications, or that they seemed more natural anyway, And they are not alone.
As alternative treatments are immersed in the culture of conventional consumption (see again: Whole Foods, with a value of $ 13.7 billion as of 2017), there has been a semantic change, from "alternative" to "integrated" . Namely, the National Institutes of Health changed the name of its Alternative Health Department focused on the National Center for Complementary and Integrative Health in 2015.
"The name change really reflects our deep interest in the study of complementary and integrative health as part of conventional care, and not as an alternative to conventional care," says David Shurtleff, deputy director of NCCIH. He uses cancer as an example: there is no known alternative treatment for cancer that has proven effective, but research supports that alternative treatments can relieve common cancer symptoms, such as yoga for anxiety and depression or attention. full for insomnia.
For supplementary users, homeopathy is an alternative medicine, another option in the medicine cabinet. Critics see all homeopathic use as an alternative to medicine. It is a subtle distinction, but important. For the critics point, consider this Pew Research Center statistic: one in five adults in the US. UU. Use alternative medicine instead of conventional medicine.
For Grams, this is the biggest risk: that people give up conventional and proven treatments in favor of homeopathic remedies that, according to her, are nothing more than sugar pills. "You might think:" Oh, if that remedy doesn't help me, I'll use another one, I'll use another one. "And you waste time. If you have cancer, time is life."
In the shadows of the failures of conventional medicine
Doug Brown was happy in his practice as a family nurse practitioner for a while. Eventually, however, ambivalence about modern medicine emerged. "As I became more aware that many of my patients with chronic diseases were not really getting better," says Brown, 62, "I was managing their illnesses, often ordering many laboratory tests and adding more and more medications, I started to wonder what I was doing. "
His path to homeopathy followed a familiar script: disillusionment with conventional medicine, a sense of despair and longing for what Brown describes as "something" more. After his 2-year-old son's ear infection withstood two cycles of antibiotics, Brown – who had spent more than a decade prescribing pharmaceutical medications to his patients, turned to homeopathy.The belladonna remedy, says Brown, cured his son's infection.
"It seemed like a miracle," says Brown from his office in Portland, Oregon, where he has practiced homeopathic healing for almost 20 years. "And then, when I saw that it worked on other people, I began to realize that homeopathy was the key to this missing link that I was intuitively looking for in all my years of conventional medicine."
People who turn to homeopathy are a subset of a larger demographic group focused on well-being that tend to be women, young, middle-aged, non-smokers, with lower body mass indexes, who make healthy lifestyle decisions (diet, exercise, supplements, you get it). "People who use homeopathy have the same profile, but even more," says Michelle Dossett, an assistant professor of medicine at Harvard Medical School who studied the use of homeopathy and published the results of her national survey in the American Journal of Public Health in 2015..
At the same time, there is a subset of this homeopathy seeker population that has a low perception of conventional medicine. They feel that conventional medicine is failing.
"I think there is a great disconnect between what aspires to do conventional medicine and what sometimes happens in the consultation room," says Dossett. "Because doctors face incredible pressures these days." A 2017 study found that doctors in the United States spend about 20 minutes with their patients, reports Reuters. (Even worse: primary care consultations last only 5 minutes for half of the world's population). It is not for lack of attempts. Physicians' schedules are usually stacked, and waiting times are usually long, since the 2017 Patient Foundation Patient Survey Report found that only 11 percent of patients and 14 percent of patients Primary care doctors feel "they have all the time they need together."
Most attitudes towards modern medicine are positive. Pew Research Center discovered in 2017 that more than two-thirds of Americans visited a health care provider in the previous year, with almost 90 percent of that cohort feeling they were heard and 84 percent feeling that their provider "really He worried "about his health. But the rest, even if it is a relatively small portion of the cake, should not be overlooked. Misdiagnosis and lost diagnoses may be one of the reasons for your dissatisfaction: according to the health care magazine BMJ Quality and Safety, 12 million American adults, about 5 percent of the adult population of the United States, are misdiagnosed every year.
"We have a kind of industrial medical system that really does not care for patients and does not care for health professionals who are trying to care for patients," says Dossett, who adds that many homeopathic professionals, on the other hand, tend to pass More time with your patients.
They also spend more time exploring aspects of a patient's health that may not be immediately linked to the reason they made an appointment, the "main complaint" or the "filing problem" in Medicare. Homeopathy is decidedly more complete, even exhaustive, on its tack, from the inside out and from top to bottom. "Homeopathy is holistic because it treats the person as a whole, instead of focusing on a sick part or a labeled disease," says AIH's description of homeopathic medicine, and adds that the practice "stimulates one's own healing power. the person ", also known as invisible energy. within each individual that Hahnemann called "life force."
In the doctrine of homeopathy, mental, emotional and social considerations are as important as what X-rays, images and laboratory tests can reveal, Brown explains: "What the mind expresses, the body expresses." This does not suggest that diseases are psychosomatic, he adds, but more a matter of trusting patients in their word.
The problem with homeopathic self-medication
Buy homeopathic remedies at Walmart and the like, homeopaths want you to know, it's not a real homeopathy. Dossett's research found that most people in the US UU. Over-the-counter medications are prescribed for homeopathy, as my family did with Oscillococcinum and ColdCalm; Only 19 percent of American homeopathic users consult a homeopathic provider.
"It is very unlikely that the remedies at a Whole Foods clinic are what the patient needs," says Brown. There are more than 4,000 remedies available today, he adds, while in any store, there can be about 10 on the shelves (none of them "Berlin Wall"). "I am certainly not in favor of restricting that, but I want people to understand that homeopathy is not just the remedies, or just taking remedies," Brown continues. "It is a process of becoming aware of one's experiences."
Hahnemann believed that homeopathy was the only true medicine. He called the homeopath who combined his teachings and practices with conventional medicine "an apostate and a traitor," according to Ernst. I would hate the supportive role that homeopathy has been placed under the complementary and integrated health umbrella.
Today's homeopathic practitioners often train in conventional medicine such as MD (such as Grams) or practicing nurses (such as Brown), and greatly recommend seeing general practitioners and primary care physicians at the same time, and getting X-rays. and imaging and laboratory tests. "Nothing can be a substitute for what modern medicine can offer in critical and life-threatening situations," says Brown. "That does not mean that homeopathy does not have a role."
"It is a process of becoming aware of one's experiences."
When asked if his line of homeopathic remedies should be considered conventional medicine supplements or substitutes, Boiron's CEO, Boudazin, wrote to Vox: “Homeopathic medicines are one of the safest options for self-treatment of everyday conditions as symptoms of cold and flu, allergies, and muscle pain. They are often a first line of treatment that can offer relief with a low risk of side effects when used as directed. There are no known interactions with conventional medications or herbal supplements, which allows users to supplement other treatments as well. "
Can "harmless" homeopathy be harmful to society?
There will not be a meeting of minds on this subject. Devotees say homeopathy works. Critics say that any perceived benefit is the work of the placebo effect. Devotees respond with success stories between animals and children. (Ernst reported that Prince Charles wrote about his homeopathically treated animals: "(Homeopathy) is not the quackery they say it is. Or if it is, then I have some very smart cows in my shed!") Critics counter that accountant, asking, well, what about the placebo by proxy?
"Much of conventional medicine could actually be legitimately criticized as exercises in the nocebo effect," says Brown. The nocebo effect is the phenomenon in which a diagnosis, pill or treatment causes negative symptoms associated with that diagnosis, pill or treatment in the patient. Tell someone who is three months old and kill their hope, and the prophecy may very well come true. Brown adds: "Our conscious attitude and our conscious expectations have a profound effect on our patients."
However, the old debate of evidence versus feelings can be dangerous, particularly when taken to the extreme. (See: Trump supporters). And for that purpose, with more than 1,090 people in the United States contracting measles this year alone, at the risk of losing their measles-free status after the measles vaccine eliminated measles only 19 years ago, and with the number of unvaccinated children in the United States that quadrupled since 2001, we have to talk about anti-vaxxers.
It may seem that vaccines follow the same logic of "similar remedies" as homeopathic remedies, and they do, to some extent; However, vaccines contain measurable amounts of their active ingredients. And to be clear, the anti-vaxxer ideology is not intrinsically part of homeopathic philosophy, nor is it prescribed by the dogma of homeopathy. "You will find some homeopathic providers that will recommend modifications to the vaccination (calendar), but it is not something that becomes an integral part of homeopathy," says Dossett.
Even so, there is some overlap between people who avoid conventional treatments in favor of homeopathic remedies and people who give up vaccines in favor of homeopathic substitutes.
"Vaccines are a controversial issue," reads a 2004 blog post from the National Homeopathy Center, which appears at the top of the site's search results for & # 39; vaccines & # 39; e & # 39; immunizations & # 39 ;. "Before making decisions about them, it is better to arm yourself with information from many different sources." Four of the five homeopaths interviewed in the publication seem to approve the "option" of not vaccinating, although not necessarily the decision itself.
Concern about this possible overlap is so great that NCCIH includes a warning box on its homeopathy information page titled, "There is no evidence to support homeopathic vaccines."
What can homeopathy teach conventional medicine?
There is a strip of intermediate ground in the debate of the great believers / skeptics that revolves around homeopathy, and this is empathy.
"There is so much contempt and so ridiculous that it creates a tremendous blockage," Brown reflects of the negative attitudes towards homeopathy. "And for me that is very, very sad." He is tired of seeing homeopathy labeled "pseudoscience," "quackery" or "scam." His lived experience and homeopathic practice tell him otherwise.
"What do patients value from homeopathy?" Asks a German study published in 2013 in Quality in primary care. “And what can family medicine learn from this?” The study highlights empathy as a key to establishing positive relationships between the patient and the doctor, and to achieve positive results for the patient. Homeopaths listen to their patients. They believe their patients. Individualization is the most basic driver of your medical philosophy.
Conventional medicine, according to this argument, could take a page from the homeopathy book and rely more on what their patients consider true. Doing so could be the key to closing the gap between the conventional and the alternative, for a truly holistic and integrated medicine.
Grams left homeopathy behind her, but she still believes in one of her principles: the power of self-healing. "Our powers of self-healing are enormous," she says. “The patients I treated in my (homeopathy practice), many of them improved. It was not due to homeopathy, but to self-healing. And I think we can be more aware of that power, which is really in us. "
Stephie Grob Plante He is a writer and essayist based in Austin. His work has appeared in The Goods by Vox, The Atlantic, Smithsonian Magazine, The Verge, Curbed, Southwest: The Magazine, Playboy and elsewhere.Additional Tags for this post:
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