A chance to question NHS Wirral Primary Care Trust on homeopathy

Well, this could be an interesting event. At rather short notice, the NHS Wirral Primary Care Trust are to hold a public meeting this Wednesday March 6th at 6:30pm in the Old Market House on Hamilton Street, Birkenhead. There they will discuss a recommendation made by their Professional Executive Committee (PEC) to discontinue Homeopathic Services for Wirral Residents with effect from 1st April 2011. The full address is:

NHS Wirral
Old Market House
Hamilton Street
Wirral CH41 5AL

If you live on the Wirral (sadly I’m on the wrong side of the Mersey, but I’m going anyway) it’s your chance to tell the PCT what you think about homeopathy. The PCT could well discontinue funding for homeopathy in a month’s time!

How did I hear about this? Michael Marshall (of Merseyside Skeptics Society and 10:23 campaign fame) was making his latest appearance in the media, this time on the “Tony Snell in the Morning” show on BBC Radio Merseyside, to discuss homeopathy, and the apparent troubles of the Liverpool Homeopathic Hospital. Representing the homeopaths was one John Cook of North West Friends of Homeopathy, who must have mentioned the above meeting at least three times.

For the record, the ‘debate’ was what I have sadly come to expect from BBC local radio, with the usual endless parade of people with anecdotes about how they use homeopathy. I never even heard anyone discuss what homeopathy actually is, and the host kept making the ‘homeopathy is natural’ fallacy. If you can stand it, the debate can be found on the BBC iPlayer (Marsh appears about 2 hours in).

So, thanks to John Cook for publicizing the meeting! I’ll be there to support the skeptics, and I hope to see as many MSS members as possible make the trip!

Mike Adams the Health Ranger on the 10:23 campaign against homeopathy

As a skeptic, I’ve been waiting for this day for quite a long time. These days, no debate on health or science is complete without a contribution from the sparkling brain of Mike “Health Ranger” Adams. Today, Mike Adams has shared his thoughts on the 10:23 campaign against homeopathy, and my, is it a barnstorming rant of epic lunacy!

Like the homeopath (or ‘homeopathist’ according to 5live) interviewed with Michael Marshall on the BBC, Mike Adams doesn’t get the point of the 10:23 overdose. Convential medicines do something, and work at a recommended dose. If you take to much, you go over that dose and it can be harmful, hence ‘overdose’. However, with homeopathy there is nothing to ‘dose’ on in the first place, making an ‘overdose’ impossible. This is simply because there is nothing in it!

Anyway, Adams argues that we skeptics aren’t ‘sophisticated’ enough to understand the underlying mechanisms of homeopathy. Sadly, us skeptics require evidence to believe things and don’t follow the Mike Adam’s philosophy of ‘making shit up as we go along’. With this in mind, reading his attempts to grasp physics and chemistry are usually as funny as watching James Delingpole wrestle with the concept of peer review:

But homeopathy isn’t a chemical. It’s a resonance. A vibration, or a harmony. It’s the restructuring of water to resonate with the particular energy of a plant or substance. We can get into the physics of it in a subsequent article, but for now it’s easy to recognize that even from a conventional physics point of view, liquid water has tremendous energy, and it’s constantly in motion, not just at the molecular level but also at the level of its subatomic particles and so-called “orbiting electrons” which aren’t even orbiting in the first place. Electrons are vibrations and not physical objects.

Of course, there is no evidence that homeopathic preparations are ‘resonating’ or ‘vibrating’ any more than sugar pills or water, and even if they did, what effect would that have? His understanding of what an electron is gets worse:

For now, they’ve all convinced themselves that electrons are — get this — tiny “particles” flying around atomic nuclei and tremendous speeds which just happen to stay in their little orbits like little perpetual motion machines (which they say are impossible), until all of a sudden, these electron “particles” inexplicably leap to a higher or lower orbit without occupying the space in-between those orbits at any moment. Yep, magic teleporting particles! That’s the “scientific” explanation of these folks. No wonder so many of them are magicians: Believing their explanations requires that you believe in particle magic!

Amazing! Note how Mike Adams tries to justify homeopathy by invoking ‘resonances’, but massively misunderstands and rejects understood notions of electron behavior. Do we have an ‘electron denier’ on our hands?

Following on from this, Mike reveals that he has his own version of the 10:23 challenge: we should all overdose on real medicine. Although he’s oblivious to the fact that this would prove the point of the overdose, he comes up with my favourite line in the article:

What really drives the skeptics crazy is that no matter how hard they try, they just can’t seem to kill themselves. To be so out of touch with the beautiful, loving and holographic nature of the universe around us is to retreat to a self-loathing worldview that can only be resolved through self destruction.

Let’s ignore the fact that we skeptics aren’t trying to kill ourselves, and look at his description of the universe. How does Mike Adams accept the ‘holographic principle’ of the universe when he doesn’t believe in electrons?

For the rest of the article, Adams bashes out the same tired old canards about chemotherapy killing people, acquiring repeat business (of course, no one ever visits a homeopath more than once), and that vaccines lower IQ. His final words on homeopathy and the 10:23 campaign is this sober thought:

So if you’re looking for safe medicine, definitely take a look at homeopathic remedies. They so safe that even the critics can’t overdose on them… but you have to admit the attempt makes for great entertainment.

Ah, ‘safety’. Yes, homeopathy is safe, in the same way that sitting on a comfy sofa is safe. Unfortunately for homeopathy, the comfy sofa is just as effective in treating disease.

He ends the article by revealing that the nonsense on naturalnews.com is about to be raised by another power. None other than one of twitter’s rudest members, Dana Ullman is joining their ranks! Rejoice!

Homeopathy: Brought to you by Big Pharma, Merck and Seven Seas

Combination a tissue salts

Combination "A" tissue salts, one of the many New Era homeopathic products from Seven Seas

One of the more common complaints from homeopaths and antivaxxers is that we skeptics are in the pockets of “Big Pharma”, who pay us to co-ordinate the 10:23 campaign against homeopathy. As an example, check out this email sent to 10:23 HQ, ingeniously sent from a work email address (ActewAGL Water Division take note).

While I wait for my next Big Pharma cheque, please take this into consideration: Merck, a pharmaceutical company with a turnover of 7.7 billion euros, owns vitamin company Seven Seas. Amongst their cod liver oil and multivitamins, you can find their New Era range. This range consists entirely of homeopathic products!

They are all based on Dr. Schuessler’s Nutritional Biochemic System of Medicine, which I believe to be a nineteenth century homeopathic text. So there we are homeopaths, a multi-billion dollar pharmaceutical company makes and sells homeopathy. Where do the homeopaths stand on that? If it’s acceptable for big pharma to make money with homeopathy, will they drop the ‘skeptics are funded by Big Pharma’ line? Or will they campaign against Merck? Homeopaths, comments please!

ipadio: A Reading Of A Homeopathic Medical Article

Listen to my latest phonecast

OK, this phlog turned out to be a strange and overly long experiment! Having seen a particularly tantalizing tweet from @TredinnickMP talking about shamanistic homeopathy, I became dazzled by this article from the bad BHA, and for some reason I thought it would be a good exercise to read it out and commit it to iPadio. It ended up being quite an exhaustive exercise, taking over twenty minutes (all in one go) to record! However, if you stick through it you’ll be treated to some particularly batty homeopathic nonsense!

Respen-A: A homeopathic treatment for autism? I’m skeptical

Homeopathy, is there nothing it can’t cure? Now, Neuro-Med, a company in Washington, USA, are selling a homeopathic treatment for autism: Respen-A, only available on prescription. Of course, I’m skeptical that a homeopathic treatment for anything can exist, let alone for autism, so I’m keen to find out more about this product.

For starters, the introduction in the manufacturers literature is quite worrying, as it lists vaccines (and thimerosal) as being implicated in the onset of autism, and does not provide references. So immediately, I get the impression that they are pandering to the antivax market. They then go on to try and link epidurals to autism, explain the benefits of a gluten free casein free diet, before finally arriving at the theory behind their treatment.

The active ingredient in Respen-A is reserpine, an indole alkaloid. It has been used to treat high blood pressure and the relief of psychotic symptoms. The manufacturers of Respen-A claim that high doses of reserpine can cause hyperactivity, irritability, inattentiveness, and depression, all of which are symptoms of autism. Following the homeopathic principal of “like cures like”, the manufacturers hypothesize that a low dose will alleviate the symptoms of autism. The resperine in Respen-A is diluted to 4X, which I believe is the same as 2C (1:10,000). If that is the case, there should be something in it!

What tests have been carried out on Respen-A? According to the manufactures website, a grand total of zero. Instead, they appear to be prescribing Respen-A (for a mere $82 for a 28-day supply), then inviting doctors and patients to submit data to the website.

Needless to say, this is not generally how a medicine goes from testing to sale. A medicine (certainly one of this nature) should go through a series of randomized double blinded placebo controlled trials to determine if the treatment is efficacious. According to the Respen-A Twitter account, these studies have not been done and all evidence for the effectiveness of Respen-A is anecdotal.

Is Respen-A a viable treatment for autism, or is it just another quacks attempt to con vulnerable parents out of their money for a “treatment” that offers nothing but false hope? I couldn’t possibly say. I don’t want to get sued.

10:23 announces global homeopathic ‘overdose’ challenge

In the latest move in their campaign against the quackery of homeopathy, 10:23 have announced their plans for next year: a global “overdose” of homeopathic products, scheduled for February. This will follow up the original overdose event from last year, which saw around 400 people take part in a somewhat spontaneous worldwide ‘overdose’, intended to show that homeopathy has ‘nothing in it’.

I was lucky enough to take part in the Liverpool event, and I made a little video with the help of Rachel Stephanie Waller, Helen Wynn and the Merseyside Skeptics Society. Hope to see you all with your deadly 30C sugar pills in February!

Nadia Sawalha: case study of a celebrity dimwit supporting homeopathy

At the moment, all eyes are on “celebrity nutritionist” Gillian McKeith as she struggles in the Australian jungle, but I’d like to talk about a celebrity who is a keen advocate of homeopathy: Nadia Sawalha.

I might as well say from the off that I find Nadia Sawalha on TV to be very annoying. Her only talents seems to be for shouting and staring maniacally at the camera. Now that I’ve got my prejudices out of the way, lets look at a few of her interviews: two from the Daily Mail, and one from Candis, a Northern-based lifestyle magazine that just happens to sound like a venereal disease.

They all center around her life experience of homeopathy, and all read like a lesson in “Bullshit detection 101”. Here’s a little anecdote that she heard from a friend:

Then my sister bumped into a friend who had suffered from bad acne since she was a teenager, but whose skin was now clear. She’d repeatedly been to the doctors, spent a fortune on creams, yet nothing worked. Eventually, she went to see a homeopath and the remedy he’d prescribed made her skin clear up.
It doesn’t take a genius to see that you have someone who suffered from acne as a teenager, and the acne went away as they got older. Regression to the mean methinks, no evidence whatsoever that the homeopathy played a role.
She goes on to talk about her experience with headaches:
I booked to see a homeopath, Rachel. For an hour, she asked me every question under the sun about my physical and emotional well-being, stress, my likes and dislikes, the food I craved, then she gave me some pills to take every day, for two weeks. After a week, not only had my headaches subsided – I felt fantastic.
What we are seeing here is the benefit of the homeopathic consultation and the placebo effect, both of which are well studied phenomena, especially with regards to headaches.
So far, so easy to dismiss Nadia’s claims of efficacy. However, what really convinces Nadia of the effectiveness of homeopathy is her experience of eczema, despite admitting that she first suffered it age 17:
Not everyone has a pet name for their eczema, but actress and TV presenter Nadia Sawalha called hers ‘my John rash’ after a mild attack was triggered as a 17-year-old after she broke up with her boyfriend.
So straight away, she admits that she has had eczema following stress, and stress is known to exacerbate some skin conditions. She tells us of a major attack of eczema later in her life:
Just over six years ago, it got so bad I couldn’t even pick up my baby, Maddie, who’s now seven. Her birth had been very traumatic, but I hadn’t talked to anybody about it. When she was about six months old, my hands started to blister very badly. I tried hydrocortisone cream, which had no effect. Back in the UK, the hospital said there was nothing they could do, apart from regularly dress my hands. Feeling helpless, I went back to my homeopath, Rachel. Through talking, we finally established the real issue behind the eczema – it was 
a physical symptom of the emotional trauma of Maddie’s birth.
In fact, she also reveals in the Mail articles that she was working 13 hour days at the time and gave up on breast feeding her baby. Now, I’m not likely to experience any of this, but I imagine that giving birth for the first time, unwillingly giving up breast feeding and working 13 hours a day on a TV program is pretty stressful. There is evidence to show that the homeopathic consultation has clinical effects, which in this case would most probably have relaxed and reassured Nadia, helping her to get over her eczema.
In conclusion, what we see with Nadia are several straightforward examples of regression to the mean, the placebo effect and the effects of long consultations. I’m all for people having their own opinions, but it does anger me that some people take her stupidity seriously. Oh, one final thing: she is anti-vaccine.
Nadia says her daughters Maddie, now seven, and Kiki, two, have never seen a GP and not had any childhood vaccinations. Rather, they consult the homeopath every few weeks.
Oh dear.

My Take on Homeopathy

Boots homeopathy

Sugar pills, available at your local Boots!

One of the disadvantages of starting a new blog is that all the articles that make your position clear on certain subjects disappear into the ether. Therefore I thought I’d write a few words about one of my favourite topics, homeopathy.

What is Homeopathy?

Homeopathy is a form of quackery. It was cooked up by Samuel Hahnemann in 1796, who came up with three “laws” for homeopathy:

  1. The law of similars. This is the idea that “like cures like”, that something that will cause symptoms in a healthy person will cure those symptoms in an unwell person.
  2. The law of infinitesimals. This states that the more you dilute something the stronger it gets. No joke.
  3. The law of succussion. This is a believe that dilutions should be firmly struck against a hard yet elastic surface following preparation.

Homeopathic preparations are usually made by taking a substance, diluting it multiple times, and succussing each dilution (a process homeopaths like to call potentization). The final dilution is then placed on a sugar pill and left to dry. So usually there is no active ingredient, and there isn’t even any solvent.

And that is pretty much it! The basics of homeopathy.

What do you have against homeopathy?

I have many issues with homeopathy. Firstly, the premise of it is ridiculous. Homeopaths teach that if you dilute something, you make it stronger. Anyone who has ever made a glass of orange squash knows that diluting a solution makes it weaker! Added to that, homeopaths dilute their preparations to an absurd degree:

Homeopathic preparation are diluted using the C (centesimal) scale. In this scale, each ‘C’ preparation is a 1 in 100 dilution of the one before. So, 1C is 1 part of the the original solution to 99 parts solvent. 2C is 1 part 1C to 99 parts solvent, etc. So, every time you go up one C, you are decreasing the concentration of the solution by a factor of 100. Most homeopathic preparations are 30C, which means the original solution is diluted by a factor of 1060.

To appreciate just how dilute this is, we need to consider Avogadro’s constant. This tells us the amount of molecules in one mole of a substance, and is about 6 x 1023. A typical solution will contain 1 mole per liter of solvent (1M), or 6 x 1023 molecules per liter. Every time you dilute it by 1C, you decrease the concentration by a factor of 100, so a 1C dilution of our original solution will contain 6 x 1021 molecules per liter. If you keep going along the C scale, you have less than 1 molecule per liter at 12C. With this perspective, you can see how dilute 30C would be! So, homeopathic preparations above 12C have practically no active ingredients.

However, my major problem with homeopathy is that it can lead to death if used in place of conventional medicine. A list of these occurrences can be found at whatstheharm.net.

Is there any evidence that homeopathy works?

In short, no. There is certainly no reliable scientific evidence that it works. However, in order to define “works” we need to consider two terms, “efficacy” and “effectiveness”. In medicine, a treatment is considered effective if it “does what it says on the tin”, but to qualify as efficacious it must do this in a controlled clinical setting, where the placebo effect can be measured. The placebo effect is considered when judging effectiveness, it is not when judging efficacy.

So, the important question is “how efficacious is homeopathy?”. According to the UK House of Commons Science and Technology Committee’s Evidence Check on homeopathy, it is not efficacious. It merely acts as a placebo. The best evidence for this comes from Randomized Controlled Trials (RCTs). These trials are designed to eliminate the placebo effect and other biases from the trial, so that efficacy can be gaged. While some of these trials do show that homeopathy can work better than placebo, these results are not statistically significant. When these trials are examined with meta studies, homeopathy comes out as being no better than placebo (Shang et al 2005).

Why do people believe homeopathy works?

When someone claims that homeopathy has worked for them, they usually attribute the success of the placebo treatment to one of three things:

  1. Regression to the mean (a posh way of saying “You would have gotten better anyway”).
  2. The placebo effect, where you feel better because you expect to feel better.
  3. If they are taking homeopathy as a “complementary” medicine, the real medicine the patient is taking has done it’s job.

Again, the important thing to consider here is quality of evidence. As someone with a scientific background, I like to think that I would place evidence from RCTs in the forefront of my judgment. However, someone who has experienced regression to the mean after taking homeopathy may not understand this, and they will take their own anecdote as evidence for the efficacy of homeopathy. To believe that homeopathy works, you have to put anecdotal evidence ahead of scientific evidence, something that I simply can’t do.

What is being done about homeopathy?

10:23 campaignHomeopathy costs the NHS an estimated £4 million per year, and understandably many people are not happy about this. For this reason, and the others mentioned above, the 10:23 campaign was formed. The group promotes homeopathy awareness and campaigns for it’s  removal from the shelfs of Boots, a major UK pharmacy chain. In January 2010, they organized a worldwide demonstration against homeopathy, which saw several hundred people “overdose” on Boots brand homeopathy, to show that there is nothing in it. I wholeheartedly support this campaign, as you can see in the video below. The next demo is planned for the QED conference in February 2011, so see you there!

Of course, I could say so many more things about homeopathy, but this will have to do for now!