On the docket today: a meaty, slippery, jam-packed can of worms. Makes you just lick your lips in anticipation, doesn’t it? Last week’s direct to consumer health testing post got this one going. I mentioned this do-it-yourself health trend comes with both the good and the bad – as yet unproven and unsound alternative therapies like homeopathy being such a potential snare. From that point, a healthy and robust debate ensued in the comment board. Yes, that’s exactly the way it should be. I always appreciate and, indeed, relish the active discourse of our comment board. Folks offer up their experiences, questions, and perspectives in ways that thoughtfully challenge and extend the discussion of the post itself. It’s the beauty of a blog – and the “Internets” as a whole, wouldn’t you say? At times, I find these conversations stand by themselves. Other times, I’ll pick up on a certain thread that I think could use more Primal-based clarification and a further targeted discussion. Today I’m taking up the homeopathy debate and giving the full of my two cents. I’m up for it if you are. Let’s roll up our sleeves and dig in, eh?
First, what homeopathy isn’t. It’s not herbal medicine, Traditional Chinese medicine, or even flower essences. It’s not naturopathy or isopathy (pus anyone?). It’s doesn’t include nutritional supplements, energy work, or body manipulation. It’s not a catch-all term for all of CAM (complementary and alternative medicine). I say this because the term is sometimes mistakenly used in these ways, and I want to be clear about what I have on the dissection table today.
Here’s, in a nutshell, what it is. First, key caveat… In the space of a reasonable blog post, I cannot tell the entire history of homeopathy or touch on every study ever performed. I’ll go out on a limb and say that my decision to do so does not, by its own merit, discredit my critique. I’ve read many more books and many more individual studies and reviews – from both conventional and CAM journals –than I’ll mention here. Anyone else is free to similarly delve in while forming their own opinion about homeopathy or any other subject. (PubMed is a fantastic, thoroughly addictive site that I spend entirely too much time perusing.)
O.K. now what it is. First, the historical basics. Homeopathy is a medical practice first envisioned and designed by Samuel Hahnemann in the late 18th Century. As a philosophy, it fit within the vitalist framework and held that illnesses were the manifestations of disturbances to an individual’s life force. Effective intervention, according to Hahnemann, necessitated the rousing or provocation of the life force with a small (understatement) amount of a single, relevant substance. In the spirit of that approach, homeopaths today assess both a patient’s symptoms and overall mental and physical condition – usually through an extensive interview and a varying physical examination. Based on the findings, they determine a particular “remedy” that has been prepared according to homeopathic principles.
We could chat for long, languorous hours about all of Hahnemann’s principles. (PrimalCon, anyone?) Today, let me give particular attention to a few central tenets.
“Law of Similars”(a.k.a. like treats like)
Hahnemann believed that the ideal treatment for a patient’s symptoms was a substance that elicited the same physical signs in healthy individuals. The assigned homeopathic remedy is an artificial means intended to stimulate the disturbed life force into a self corrective mode – based on the similarity of symptoms, yes. In this process, the body will supposedly defuse the observed illness and rid itself of it. (Yeah, I don’t get it either really.)
“Law of Proving”
Because he believed like treats like, Hahnemann focused his proving (i.e. testing) on healthy subjects. He used large groups of volunteers, instructed them on lifestyle restrictions and recommendations during the testing period, and asked them to keep exhaustive journals of any and all symptoms or sensations they experienced. From this standpoint, he initiated early characteristics of the modern controlled clinical trial. (Hat tip.) He then matched these tested substances with diseases that displayed similar symptoms. (See above.)
“Law of Potentization”
Long story short, along the line Hahnemann decided that diluting the original substance would make it more potent. (Yes, do the double take.) He even developed his own scale for diluting his remedies – the centesimal or C measure. Each C indicates dilution by a factor of 100. Given Hahnemann’s penchant for a 30 C dilution, you can imagine – well, actually you probably can’t imagine – how dilute that would be. We’re talking exponentially diminishing here – as in there may or may not be a single molecule of the original substance or not. Ummmm…?
The power of a homeopathic remedy solution allegedly resides not simply in the remedy itself but in the full relationship and dynamic interaction among the homeopath, patient, and remedy. (This is one of the reasons those in the homeopathic field reject the applicability of conventional “blind” clinical trials.)
O.K., let me start by saying this. Compared to the rather brutal approaches of the medical community in his time, Hahnemann’s new take on treatment must have felt downright civilized, enlightened, and sophisticated. I’d rather take a small diluted remedy than have my blood let any day. And as irrational as his belief in super ultra mega diluting was, it must have seemed remarkably, even comfortingly precise when held up against the generally sloppy, arbitrary, and clueless practices of apothecaries.
In a system where most of us are lucky if we get five uninterrupted minutes with our physicians, I appreciate the extensiveness of the repertory interview homeopaths undertake with patients. Finally in a very generalized way, I even loosely sympathize with the idea that treating a condition with conventional medications can simply mask it and drive it deeper into the body. (Granted, I see it more as metaphor in these modern times, but it’s a good one. We do a lot of ineffectual “band-aid” work in Western medicine.) Oh, and the life force thing sounds pretty groovy.
I’m afraid that’s pretty much where I part paths with Hahnemann and homeopathy. Call me too close-minded, but I stand with homeopathy’s critics when it comes to its shortfall in the scientific principle department. Let’s say you momentarily accept the life force concept as metaphor and just put aside the law of similar out of sheer frustration. (The alleged vaccine comparison, I’ll simply say, is another ball of wax entirely and fodder for another day.) Even then, there’s still the ginormous elephant in the living room (yes, the one that every critic focuses on because it’s kind of important) – the dilution issue otherwise known as active ingredient-free medicine. Yes, recall that it’s supposed to not simply be present but be more potent. Yes, homeopathy supporters claim that the original substance leaves a residual energy imprint of sorts in the remaining diluted solution (a.k.a. water memory). Theories have been put forward regarding movement and cohesion at the molecular level, “dynamic ‘ordering’” of the water’s intermolecular bonds and the like. (Random thought: if water that contained a homeopathic agent still can retain an active, potent energy imprint, does my waste water treatment plant do a good enough job of removing the imprint of sewage, industrial chemicals, and other refuse particles?)
In all seriousness, I realize that science is still evolving, particularly in the area of nanophysics and the like, but everything about this potentization concept flies in the face of scientific principle, defies all known laws of chemistry and physics, and appears to exist primarily in the hazy, moving shadows of ambiguity. I’m all ears if it’s ever pinned down, but it’s no dice right now.
A few readers last week said it was ironic that I was badmouthing another health related area subjected to the same rejection as many tenets of the Primal Blueprint (e.g. the dietary fat boogeyman.). It’s true that the PB gets its share of quackery accusations. I wholly support being skeptical when the establishment dismisses a health philosophy out of hand. Nonetheless, I don’t see homeopathy in that situation. I’ve read many studies over the years and paid attention to the reviews that have been conducted. When it comes to research, homeopathy just doesn’t bear out.
Yes, there’s the claim that true homeopathy can’t be accurately assessed within the current clinical trial system. There’s the issue of individualization of remedy – that an individual’s treatment also is influenced by their overall well-being, personality, etc. Then there’s the concept of entanglement – that dynamic, misty interaction among the perceived triad of homeopath, patient, and treatment. I don’t know how you’re going to overcome those hurdles. Right now it’s a deadlock, but I’m going to have to side with hard science for now.
I’ve given my critique. Here’s what I think works about homeopathy, and – mind you – I’m being wholly earnest. I know what you’re thinking: placebo. Well, yes, but let me explain. The placebo effect, ladies and gentlemen, is nothing to shake a stick at. As mentioned before, it can claim a 30% effectiveness rate, and that number can go higher based on the people receiving the treatment. Some of us are more likely to experience physical effects from a placebo not because we’re gullible saps but probably because we’re more in tune with our mental power, so to speak. Some of us, for example, can creatively visualize our way through the intense physical pain of a medical procedure or the pain of childbirth. Some can’t as much. The placebo effect is such a force that a recent study showed the pretense isn’t necessary. And if your doctor believes that the “placebo” is actually an effective treatment, the effect is even stronger.
Much has been made lately of the therapeutic impact of the doctor-patient relationship itself – the connection, the empathy, the listening, and the basic human touch of the physical exam. Imagine the result if your caretaker took two hours instead of ten minutes to listen to your concerns, asked about your general well-being, and inquired about your life overall. Is it much of a stretch to see that there would likely be a more intensive healing element to this relationship itself?
My final thought on homeopathy is this. I can’t accept it as a medical practice given what is currently known. I leave room for the effectiveness of a few substances when given in a non-traditional formula (actually present in the solution). Furthermore, I respect the humanistic elements of homeopathy practice and wish conventional medicine would learn a thing or two in this department. I understand why people might be interested in its therapies and experience suggested relief from the idea of a gentle treatment that gets them thinking about the power and essential balance of their bodies. The truth of its impact, however, lies outside the bounds of medical science.
The floor is now open. Good Primal ladies and gentlemen, please avail yourself of the comment board.
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.