Head To Head
Should doctors recommend homeopathy?
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3735 (Published 14 July 2015)
Cite this as: BMJ 2015;351:h3735

Sys review of AEs of homeopathy
The systematic review I and M A Aleem cited reviews a number of papers on the adverse effects of homeopathy and all are fully referenced. JK Anand requested:
"to let us have references to any reports of adverse reactions of any kind, to homoeopathic medicines, in the medical journals published in Germany and the UK"
It seems clear to me that this review fulfils that request, so I am puzzled by the response: the review is only eleven pages long so I'm unsure why Dr Anand equates the task to looking for 'a needle in that haystack of a review'. However, the whole point of a review is to summarise the current state of evidence and I'm certainly grateful to Prof Ernst et al. for doing so.
Competing interests: Director of the Nightingale Collaboration, which challenges misleading healthcare claims.
30 July 2015
Alan Henness
Director
The Nightingale Collaboration
BM The Nightingale Collaboration, London WC1N 3XX

Re: Should doctors recommend homeopathy?
Dear Dr Aleem
I am obliged to you - as I am to Mr Henness - for the RRs.
Both you and Mr Henness have offered me a lot of material thst I never asked for.
Both of you have referred to the review paper, by three authors (the seniormost being Prof Ernst), in the International Journal of Clinical Practice. Kindly see my comments to Mr Henness on the subject, so that I do not repeat myself.
Clearly Prof Ernst is the last port of call for me - and I hope to have his response in due course.
Sincerely
Dr JK Anand
Retired.
( not a homoeopathic practitioner)
Competing interests: A desire for facts requested by me.
30 July 2015
JK Anand
Retired doctor
Free spirit
Peterborough

Re: Should doctors recommend homeopathy?
Mr Henness has kindly replied (please see his RR today, 30 July).
Alas, his reference to the article in the International Journal of Clinical Practice is a review - it does not give me the information I specifically requested. Difficult to look for a needle in that haystack of a review.
I assume Mr Henness is unable to help any more.
As Prof Ernst is one of the three authors of the review mentioned above, perhaps he will, in due course, oblige me?
Now I await the replies from Dr Aleem and Prof Ernst.
Thank you
Competing interests: Impatiently waiting for precise answer to my original question.
30 July 2015
JK Anand
Retired doctor
Free spirit
Peterborough


Re: Should doctors recommend homeopathy?
This has reference to JK Anand
With homeopathy remedies there are so many direct and indirect adverse effects. The direct adverse effects included abdominal pain, flatulence, acute erythroderma, acute pancreatitis, severe allergic reactions, atopic dermatitis, burning lips, nausea, emesis, apnoea, cyanosis, regurgitation, anaphylaxis, arsenical keratosis and cancer, bladder cancer, bullous pemphigoid, severe asthenia, cardiac arrest, cognitive-behavioural disorders, coma, death, dermatitis, severe pulmonary involvement, emesis, euphoria, extreme agitation, hyponatraemia and hypoalbuminaemia, erythaema, limb oedema, irritability and albuminuria, melanosis and keratosis, skin lesions, acute gastrointestinal illness, leukopaenia, thrombocytopaenia, diffuse dermal melanosis, metabolic acidosis, weight loss, chronic diarrhoea, morbiliform and pruritic rash with hospital admission, multiple alopecia and hair loss, pain, pancreatitis, problem with balance, somnolence, pruritus, swelling and erythroderma, renal failure with metabolic acidosis, interstitial nephritis and hyperkalaemia, severe acute tubulointerstinal nephritis, severe bradycardia, reversible panconduction defect, hypotension and syncope, severe swelling, bleeding, rashes, sneezing, rhinitis, slight lethargy, symptoms of thall poisoning, tachypnea, high fever, lower limb areflexia, hypotension, pupillary abnormalities, gait ataxia, widespread leukocytosis and widespread maculopapular vesicular rash. The direct side effects of homeopathy occasionally resulted in serious outcomes including cancer, death, dialysis, toxic polyneuropathy and quadriparesis. In several instances, patients presenting adverse effects required hospital admission and pharmacotherapy .
The indirect side effects with homeopathy drugs included deterioration of pulmonary allergy, deterioration of sarcoidosis glomerulonephritis, hypertensive heart failure and encephalopathy, haemophilus influenzae meningitis, septicaemia high fever and seizures, malignant melanoma, multiple organ system failure, oedema, pneumococcal pneumonia with purulent pericarditis and coma, sepsis and death and severe aggravation of atopic dermatitis. Indirect side effects of homeopathy resulted in the following clinical outcomes: death, permanent hypertension, hydrocephalus and the need for neuro-surgical drainage.
Mechanism of Adverse Effects
With homeopathy agents in the majority of cases, the possible mechanism of action involved allergic reactions or ingestion of toxic substances. Preparations of heavy metals, such as arsenic, cadmium, mercury or iron, which are frequently used in homeopathy can be toxic, if not highly diluted. Other poisons regularly employed in homeopathy include aconitum, kerosene or thallium, which also can lead to serious health problems in sufficiently low dilutions.
There are several reports of adverse effects of homeopathy have been published and some of them had serious consequences. Clinicians should be aware of the risks associated with homeopathy.
References
1. Adverse Effects of Homeopathy
http://www.medscape.com/viewarticle/777749_2
2.Posadzki P et al In J Clin Pract.2012;66(12):1178-1188
Competing interests: No competing interests
30 July 2015
M A Aleem
Neurologist
ABC Hospital
Trichy 620018 Tamilnadu India


Re: Should doctors recommend homeopathy?
JK Anand said:
"May I request:
Dr Aleem
Mr Henness
Prof Edzard
to let us have references to any reports of adverse reactions of any kind, to homoeopathic medicines, in the medical journals published in Germany and the UK.
I hope this request is reasonable."
Not really. I was pointing out the disconnect between what M A Aleem said about the specific harms of homeopathic products and what various homeopathy organisations state about their inherent safety - it's up to them to provide good evidence one way or the other. There is evidence of harms, of course, [1] but the onus is on those who proclaim homeopathy to be safe to provide the evidence that is so, and, of course, that the purported benefits outweigh those possible harms.
However, obfuscation between specific and non-specific harms should not be allowed to hinder discussion. It seems unlikely that properly diluted and manufactured homeopathic products - containing as they do, no active ingredients but simply sugar or water - could have any serious harms in themselves. Those would be specific harms, but perhaps the greater issue is that of non-specific harms such as the delay in seeking proper medical attention for potentially serious and life-threatening medical conditions and, frequently, the distrust of science and medicines such as vaccines engendered by some homeopaths. [2, 3]
References
1. Posadzki, P., Alotaibi, A. and Ernst, E. (2012), Adverse effects of homeopathy: a systematic review of published case reports and case series. International Journal of Clinical Practice, 66: 1178–1188. doi: 10.1111/ijcp.12026
2. http://discoverhomeopathy.co.uk/victims-2/
3. http://whatstheharm.net/homeopathy.html
Competing interests: Director of the Nightingale Collaboration, which challenges misleading healthcare claims.
30 July 2015
Alan Henness
Director
The Nightingale Collaboration
BM The Nightingale Collaboration, London WC1N 3XX
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