CVMA/AVMA - The Case Against Homeopathy MUST READ
Posted: Wed Jan 08, 2014 4:17 pm
Please read the details of what Irene is up against, especially Addendum #1 below.
Many of the statements, assumptions and conclusions are so ridiculous, they are laughable
if they weren't so serious in their consequences
This isn't just an issue of veterinary homeopathy vs. allopathy but for ALL homeopathy and complementary, alternative medicines.
And not just USA, as British, Australian, Swiss, Czech info is included in their attack.
I was always amazed at how much research is put into pet food nutrition vs. human and the various quality formulations of pet foods far exceed those for humans.
Pets generally have far more healthier food options than humans.
Are there pet foods with aspartame, sucralose, ....?
Equally amazing at how much effort is put into discrediting homeopathy for animals, more than I've seen against human homeopathy.
A tactic I haven't seen before from the CVMA, the Connecticut Veterinary Medical Association:
The concept of "like cures like" has an appealing logic and symmetry to it. It is essentially a
variation of "sympathetic magic," the idea that things which resemble one another in some
superficial way must be meaningfully related and that one can influence the other.
While animals can't speak up, humans can.
The CVMA's main contention is that homeopathy lacks enough scientific evidence to be allowed for use with animals
and wants the parent organization, AVMA, to adopt this stance and discredit use of homeopathy.
Are there any organizations that can step up and help refute many of the claims the CVMA is making that can affect ALL homeopaths and CAM practitioners?
Susan
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The AVMA, American Veterinary Medical Association is having a meeting this weekend
The House of Delegates, the AVMA’s largest policy-making body, will gather Jan. 9-11 in Chicago to deliberate on foreign accreditation and the merits of homeopathy.
Also on the table is a bid to alter the group’s mission statement to shift its focus toward members and a rare petition-generated resolution that asks the AVMA to discourage owners from feeding jerky treats to their pets in the absence of adequate safety data.
http://news.vin.com/VINNews.aspx?articleId=30314
The AVMA is being beseeched by the CVMA, Connecticut Veterinary Medical Association to formerly discredit homeopathy
This is the resolution the CVMA is asking the AVMA to approve this weekend:
HOMEOPATHY HAS BEEN IDENTIFIED AS AN INEFFECTIVE PRACTICE AND ITS USE IS DISCOURAGED
http://www.vin.com/apputil/image/handle ... id=5642935
This weekend, the AVMA House of Delegates will gather in Chicago for the group’s Winter Session. On the table is a prospective bylaws change and seven resolutions, one of which calls for the AVMA to publicly discourage and identify homeopathy as an “ineffective practice.”
Submitted by the Connecticut Veterinary Medical Association (CVMA), the resolution asks the AVMA to affirm that the safety and efficacy of veterinary therapies should be determined by scientific investigation, and when scientific studies deem therapies to be ineffective or unsafe, those therapies should be discarded.
“Although veterinarians may legally employ any therapy that complies with the applicable laws and regulations governing the practice of veterinary medicine, the AVMA believes that veterinarians have an ethical duty to society, and to patients and their owners, to base medical judgments and recommendations on the best available scientific evidence,” the resolution states.
What prompted the CVMA to tackle the topic of homeopathy is unclear.
However, an accompanying white paper submitted by the group suggests that the CVMA’s decision to debunk homeopathy wasn’t made lightly. In some 30 pages, the group pokes holes in the methodology of studies that suggest homeopathic remedies are efficacious and challenges claims of positive clinical outcomes.
Supporters of homeopathy have fired back that many studies, including recent clinical trials , demonstrate the efficacy of homeopathic remedies.
Dr. Gary Block, board-certified in internal medicine and a House delegate representing Rhode Island, said that from an evidence-based standpoint, homeopathy is “hocus pocus.”
As an example, he points to water therapy — a traditional homeopathic remedy that’s prepared by diluting chosen substances in distilled water until none of the original substance remains. Water has memory, practitioners of homeopathy believe, allowing substances dissolved in water to leave an enduring impact even if the water is diluted beyond the point where no molecule of the original substance remains.
“To me, the resolution states the obvious,” Block said. “Homeopathy is not a scientific discipline. We do our clients a disservice when we promote it as one.”
Cooney believes that such criticisms might stem from a lack of knowledge about homeopathy. "I think there are a few people in AVMA who've just decided that they don't like it," he said.
A majority vote is required for resolutions to pass the AVMA House of Delegates, which has representatives from nearly every state and a dozen or more allied groups. While AVMA policies carry no legal or regulatory teeth, how the nation’s largest membership group for veterinarians stands on issues can influence state licensing bodies governing the practice of veterinary medicine.
The idea that the AVMA might publicly discredit homeopathy has officials with the Academy of Veterinary Homeopathy — a group of 133 veterinarians not represented in the AVMA House of Delegates — on the defense.
In a white paper that counters the CVMA’s findings, Dr. Shelley Epstein, a veterinary homeopath in Wilmington, Del., and former Academy of Veterinary Homeopathy (AVH) president, wrote that “… all medicine involves balancing risks against benefits.”
“In the case of homeopathy, the risks are negligible in the hands of trained veterinary homeopaths, and the benefits in some of even the most severe cases can be strong,” she stated.
Dr. Jeff Feinman, a veterinary homeopath in Connecticut, agrees. He’s dismayed that he and other veterinary homeopaths in the state weren't consulted by the CVMA before the group drafted its resolution.
“My personal feeling is that anything that can be done to limit therapeutic options is not a good thing,” he said.
Feinman worries that if the AVMA rejects homeopathy, other complementary and alternative modalities might be next. “This could just be the first target,” he said.
AVH officials echoed that concern in a Dec. 19 letter to House delegates: "On the surface, homeopathy would appear to represent an easy target for extinction, or at least for expulsion from the ranks of veterinary medicine. We have concerns that this would represent a slippery slope for the AVMA."
Bernard Rollin, a professor of philosophy and animal sciences at Colorado State University, chuckles about homeopathic remedies such as water therapy. His tone turns serious, however, when talking about the ethics of treating patients with remedies discredited by basic science.
Veterinarians take an oath to do no harm, Rollin said, and prescribing remedies that have no basis can do the opposite. That said, “There are lots of therapies that work in ways we never expected, even in mainstream medicine,” he acknowledged.
“If a veterinarian were to give full disclosure, and I mean full disclosure — admitting that there’s no scientific evidence for a homeopathic remedy — but the owner is still hell-bent on doing (the treatment), a veterinarian could offer it, and monitor the animal to make sure it doesn’t cause anything negative.”
That doesn’t mean Rollin endorses homeopathy. In fact, he notes “a very strong objection to alternative medicine in general.”
“There’s no such thing as alternative medicine. There’s medicine that’s scientifically proven and unproven,” Rollin said, playing off an editorial published in 1998 in the New England Journal of Medicine. “If homeopathy is true, modern chemistry is false. I’m not ready to give up modern chemistry. Are you?”
http://news.vin.com/VINNews.aspx?articleId=25587
The AVMA says in Who We Are
The American Veterinary Medical Association (AVMA), established in 1863, is a not-for-profit association
representing more than 84,000 veterinarians working in private and corporate practice, government, industry, academia, and uniformed services.
Structured to work for its members, the AVMA acts as a collective voice for its membership and for the profession.
https://www.avma.org/Pages/home.aspx
The CVMA is anti-homeopathy
Addendum #1 to CVMA Proposed AVMA Resolution:
“Homeopathy has been identified as an ineffective practice
and its use is discouraged.”
White Paper: The Case Against Homeopathy
Homeopaths frequently claim that homeopathy goes beyond the capabilities of conventional
medicine, aiming to cure the underlying cause of disease while scientific medicine merely
suppresses symptoms. And they frequently claim to be able to accomplish this with no
significant side effects, no need for withdrawal times in food animals, and none of the other
limitations of conventional therapies. Any therapy that was able to live up to these claims ought
to be able to easily and convincingly demonstrate them in clinical trials and other scientific
investigations.
However, while homeopathy has been studied and used for 200 years, and continues to be
supported by small minorities within the scientific and healthcare communities, in controlled
scientific investigations it has failed to demonstrate effectiveness beyond placebo for any
indication. This practice has failed to be validated scientifically at all levels of evidence:
1. The theoretical foundations proposed for homeopathy have not been substantiated and are
inconsistent with established scientific knowledge. A dramatically new understanding of
physics, chemistry, and biology which overturns the very foundations of modern
biomedical science would be necessary for these proposed mechanisms to be valid.
2. There is no consistent body of in vitro or animal model research evidence showing
presence of any biologically active factor in homeopathic remedies or a meaningful
biological effect of homeopathic treatment beyond placebo. While some apparently
positive studies exist, published almost exclusively in journals dedicated to the promotion
of homeopathy and other alternative therapies, independent investigation of these studies
have found a high risk of bias and have failed to confirm positive findings.
3. There is an enormous clinical trial literature in humans concerning homeopathic
treatment. Again, some apparently positive trials exist, but these are of low-quality and
highly subject to bias. Systematic reviews of the clinical trial literature consistently find
no evidence of an effect beyond placebo, and that lower quality trials are more likely to
be positive and higher quality trials more likely to be negative, consistent with placebo
effects and inadequately controlled bias, and confounding. The failure to find a consistent
effect in properly designed and conducted trials despite many hundreds of attempts over
two centuries is strong evidence of the lack of a meaningful therapeutic benefit.
4. There are very few veterinary clinical trials examining homeopathic treatment, most
published in homeopathic or alternative medicine journals and all with significant
methodological weaknesses. As in the human clinical trial literature, no consistent
evidence of a real effect is found when adequate controls for placebo, bias, and
confounding are in place.
Despite the continued popularity of homeopathy among a small, but passionate community of
advocates, who respond aggressively to any criticism of the practice, a growing number of
veterinary, human healthcare, and governmental organizations are acknowledging that existing
scientific evidence strongly supports the conclusion that homeopathy has no effect beyond
placebo. Because it is unethical to offer ineffective therapies to clients, and dangerous to
substitute a placebo therapy for truly effective medicine, there is a movement towards publically
acknowledging that there is no reason to believe homeopathic treatment has any real value in
preventing or treating disease.
The veterinary profession has an obligation to society and to our clients to acknowledge the
conclusions of science even when there is not absolute unanimity within the profession. If we
wish to retain the trust of the public, upon which our work depends, we must demonstrate that
our recommendations are based on sound science and that we are willing to put the welfare of
our patients and clients first even when some of our colleagues object.
As the House of Commons Science and Technology Committee concluded after an extensive
review of the evidence concerning homeopathy:
“For patient choice to be real choice, patients must be adequately informed to
understand the implications of treatments. For homeopathy this would certainly
require an explanation that homeopathy is a placebo. When this is not done,
patient choice is meaningless.”
In veterinary medicine, our clients can only have real choice, and justified faith in their
veterinarians, if we are willing to be clear and honest in informing them when practices, such as
homeopathy, are shown to be ineffective.
Medical Therapies Should be Science-Based and Ineffective Therapies Should Be Discarded
I. Statements from the AVMA
The AVMA has repeated affirmed in numerous position statements that all veterinary therapies
should be evaluated by the scientific method, and that ineffective and unsafe therapies should be
avoided. The following is a selection of examples of AVMA positions and guidelines which
affirm this principle.
A. The AVMA Guidelines for Complementary and Alternative Medicine (Approved by AVMA
House of Delegates 2001; revised by the AVMA Executive Board April 2006, November
2007) state:
“The AVMA believes that all veterinary medicine, including CAVM, should be
held to the same standards. Claims for safety and effectiveness ultimately should
be proven by the scientific method… Practices and philosophies that are
ineffective or unsafe should be discarded...Recommendations for effective and
safe care should be based on available scientific knowledge and the medical
judgment of the veterinarian.”
These guidelines also point out that official recognition of veterinary specialty certification is
contingent on the existence of a substantive body of scientific knowledge supporting this status:
“The AVMA does not officially recognize diplomate-status or certificates other
than those awarded by veterinary specialty organizations that are members of the
AVMA American Board of Veterinary Specialties (ABVS)…Recognition of a
veterinary specialty organization by the AVMA requires demonstration of a
substantial body of scientific knowledge.”
As a consequence of the absence of a “substantial body of scientific knowledge,” the
ABVS does not recognize any certification or specialization in veterinary homeopathy,
including that of the Academy of Veterinary Homeopathy which identifies itself as “the
only certifying veterinary body in North America” for homeopathy.
B. The AVMA Guidelines for Assessment of New Therapies for Alleviation of Acute Pain in
Animals (Oversight: COR; EB approved 11/06; EB approved revisions11/11) also emphasize
the importance of scientific research in establishing safety and efficacy of therapeutic
compounds:
“The assessment of the analgesic efficacy and potency of a variety of
pharmaceutical agents for use in veterinary clinical practice is an important goal
of applied and clinical veterinary research. Well-designed and appropriately
controlled experimental clinical trials are vital to the development of safe and
effective compounds.”
C. The AVMA Guidelines on the Use of Biotechnology in Veterinary Medicine and Animal
Agriculture (Oversight: AALC; EB approved 4/07) state:
“The AVMA supports a science-based regulatory policy for the approval of
products developed through biotechnology…Future evaluations should be solidly
based on sound science and meaningful risk assessments.”
D. The AVMA position statement on Compounding (Oversight: COBTA; EB approved 11/00;
revised 03/05; 04/09) states:
“The decision to use a compounded drug should be veterinarian (not pharmacist)
driven, based on a veterinarian-client-patient relationship. Whenever possible the
veterinarian should make that decision utilizing evidence-based medicine.”
E. The AVMA position on Pet Food Health Claims (Approved by the AVMA Executive Board
April 2008) states:
“The AVMA encourages the pet food industry to act responsibly by only making
health or therapeutic claims that are supported by quality scientific evidence.
Veterinarians should assess relevant product information through principles of
evidence-based medicine prior to using or recommending wellness or therapeutic
pet foods.”
F. The AVMA Policy to Promote Veterinary Medical Research and Discovery (COR Oversight;
EB approved 11/09) states:
“The AVMA recognizes that the veterinary medical profession is uniquely
qualified to provide the highest quality science-based clinical services…the
AVMA also recognizes that without vigorous veterinary medical research
programs and a sustained infusion of new knowledge, the profession will be
unable to continue to provide science-based education and clinical service to meet
future societal needs…the Association will support programs that emphasize
research and science.”
G. The AVMA Policy of Raw or Undercooked Animal-Source Protein in Cat and Dog Diets
(Approved by the AVMA Executive Board April 2012; approved by the AVMA House of
Delegates July 2012) discourages the use of such diets based on scientific evidence of risk:
“The AVMA discourages the feeding to cats and dogs of any animal-source
protein that has not first been subjected to a process to eliminate pathogens
because of the risk of illness to cats and dogs as well as humans…Several studies
reported in peer-reviewed scientific journals have demonstrated that raw or
undercooked animal-source protein may be contaminated with a variety of
pathogenic organisms
There's much more to read including statements from British, Australian vet organizations
Homeopathy is Ineffective
I. Plausibility and Pre-clinical Research Evidence
A. Law of Similars
The foundational principle of homeopathy is that a substance which causes a symptom in a
healthy individual can, when properly processed (c.f. Potentization by Dilution and Succussion
below), cure the underlying cause of that symptom in a diseases individual.
The Academy of Veterinary Homeopathy gives the following description of this principle:
“Homeopathic practitioners have found that substances that produce symptoms
similar to the symptoms of disease can be used to cure that disease…. In
homeopathy a medicine (remedy) is selected which would produce in a healthy
body the same symptoms found in the sick animal (“like cures like”).
The way a particular substance is associated with a given symptom or set of symptoms is by
referring to collections of what are called “pathogenetic trials” or “provings.” This is a method in
which healthy individuals ingest or are otherwise exposed to a substance and keep a diary for
days or weeks afterwards listing every physical and emotional experience they have. These
diaries are then evaluated and patterns of similar symptoms are identified and then codified as
symptoms that substance can cause.
Many of the provings used to guide homeopathic treatment today were conducted by Samual
Hahneman himself, who invented homeopathy in the late 18th century. Subsequent efforts to
demonstrate consistency or reproducibility of homeopathic provings have been unsuccessful. (1-6)
The concept of "like cures like" has an appealing logic and symmetry to it. It is essentially a
variation of "sympathetic magic," the idea that things which resemble one another in some
superficial way must be meaningfully related and that one can influence the other. Many cultures
have magical practices in which one makes an effigy or figure resembling an individual, a
"voodoo doll" for example, and then uses it to indirectly affect the health of that individual.
Yellow plants are used to treat jaundice. Walnuts are eaten to treat problems in the brain because
walnuts look a little like the human brain. Preparations of mandrake root are used to aid fertility
because the root looks a little like a human penis. Examples of such sympathetic magic, which
can be found in folk medicine traditions throughout the world. Scientific investigation has not,
however, found the idea of sympathetic magic to be a reliable principle for deciding which
substances in the natural world will be useful as medicines.
And despite the primacy of the Law of Similars in homeopathic theory, it is often difficult to
relate this to the remedies actually used. It is possible, for example, to buy homeopathic products
made from body parts such as hip joints and colons, animals such as iguana and dragonfly, and
different kinds of sunlight. It is also possible to buy products derived from precious
archaeological features such as the Great Wall of China and Stonehenge. It is difficult to
understand what symptoms could be induced (and therefore be treated) by these products under
the like-cures-like principle.
B. Potentization by Dilution and Succussion
The problem with giving a remedy that causes certain symptoms in order to treat those
symptoms is that, obviously, doing so will almost certainly make the patient worse. In
developing the theories of homeopathy, Hahneman solved this problem by progressively diluting
the remedies until, in most cases, they no longer contain any active ingredients at all.
Homeopaths believe that the more dilute a remedy is, the more potent it is, though only if it is
vigorously shaken during the dilution process.
In testimony before the House of Commons Science and Technology Committee, Dr Peter
Fisher, Director of the Royal London Homeopathic Hospital, described how homeopathic
dilutions are made:
“[They] are prepared by a process of sequential dilution with vigorous shaking at
each stage of dilution, known as succussion. Dilution is usually in steps of 1:10 or
1:100, referred to as x or d (decimal) or c (centesimal) respectively.
For example, a 30C dilution indicates that the solution has been diluted in the
ratio of 1:100, thirty times successively; one drop of the original solution would
be diluted with 100 drops of water and the resulting solution would be diluted
again, and so on until 30 dilutions had taken place. According to the Prince's
Foundation for Integrated Health, in some homeopathic products "not even a
single molecule of the original substance remains in the diluted medicine
prescribed to the patient."
Dr Fisher stated that the process of "shaking is important" but was unable to say how much
shaking was required. He said "that has not been fully investigated” but did indicate that "You
have to shake it vigorously…if you just stir it gently, it does not work."
The principle that a therapeutic substance becomes more potent the lower the dose, and that it
can still be active even when it contains only the diluent (water), is inconsistent with the
fundamental principles of chemistry and physiology underlying all of scientific medicine. A
revolution in basic science would need to take place for this idea to have any possibility of being
correct, and the inconsistent and low-quality studies that have attempted to validate homeopathic
theory do not justify such a revolution.(7-9)
The Royal Pharmaceutical Society of Great Britain (RPSGB) offers the following comments on
this issue:
“The philosophy of homeopathy that a substance becomes more potent as it is
diluted goes against the conventional theory of the pharmacological action of
compounds in the body…There is no robust scientific evidence to suggest that
differences can be detected between ultradilute homeopathic remedies and the
diluent used to prepare the remedy in terms of their physical properties and
behaviour.”
“As a consequence of their extreme dilution, most high dilution/potency
homeopathic remedies do not contain a single active molecule. The administration
of a preparation containing substance at such large dilutions leads to a RPSGB
view that such preparations will not produce clinical effects.”
There have been many attempts to demonstrate that ultradilute substances can have biological
effects, in vitro or in vivo. Some studies in dedicated homeopathy or alternative medicine
journals have reported positive findings, but a review of these studies found numerous
methodological problems and ultimately concluded:
“There is a lack of independent replication of any pre-clinical research in
homoeopathy. In the few instances where a research team has set out to replicate
the work of another, either the results were negative or the methodology was
questionable.”(9)
Other reviews have also found that replications of pre-clinical studies in homeopathy are often
not successful, leading to an absence of consistent, repeatable evidence for the basic theoretical
principles behind the practice.(10) Even the Prince's Foundation for Integrated Health, which is
generally supportive of homeopathy, notes, "any specific mechanism of action based on extreme
dilution is implausible and regarded as unsupportable by the majority of scientists working in
this field."
One of the few studies published in the mainstream medical literature concerning ultradilute
homeopathic remedies, published in Nature in 1988, purported to show that such a remedy could
influence the degranulation of human basophils. (11) Because the findings were so revolutionary,
the journal took the unprecedented step of arranging for an independent team of investigators to
observe replications of the experiment.
This team found that the results had been generated by an unblinded technician, and when this
individual was unaware of the treatment given to each sample, the positive findings
disappeared.(12) Subsequently, multiple attempts by independent researchers to replicate the
original experiment also failed to find an effect.(13-14) A review published in a homeopathy
journal in 2009 concluded that after twenty years of research, it was still impossible to determine
conclusively that purported effects of ultradilute solutions on human basophils were not due
solely to artifact.(15)
Many theories have been proposed to explain how water containing no other substances could
have potent and specific therapeutic effects. Homeopaths have claimed water has selective
memory for the substances used to make homeopathic remedies or that in some way not yet
understood quantum mechanics validates their claims. Attempts to validate claims that
homeopathic remedies are measurably distinct from ordinary water have been methodologically
weak and not reproducible.(16-18)
The proposed mechanisms of homeopathy are shown to be implausible when analyzed from a
physical and chemical perspective, and thus it is of no surprise that the biological effects of
homeopathy cannot be measured in large-scale clinical trials.
II. Clinical Trial Evidence
A. Human Studies
There have been an enormous number of clinical trials of homeopathy conducted in humans.
These have been summarized in many systematic reviews over the last twenty years, and several
clear patterns have emerged:
1. Most studies are of poor quality, at high risk of bias, and published in journals dedicated
to homeopathy and other alternative therapies. Despite this, a consistent clinical effect
has not been identified.
2. Higher quality studies are much more likely to have negative findings. Studies with poor
control for bias, confounding, and non-specific effects of participation in a clinical trial
(placebo effect, Hawthorne effect, regression to the mean, spontaneous resolution, etc.)
are more likely to have positive results.
3. Occasional positive findings cannot be replicated and disappear when methodological
flaws are corrected.
4. The positive effects sometimes reported are far weaker than those for matched
conventional therapies and unlikely to be clinically meaningful.
5. The balance of the evidence unquestionably indicates that the effects of homeopathic
treatment are due to placebo effects, chance, bias, confounding, and other sources of
error, not true therapeutic effects.
After an extensive review of the evidence and testimony from experts both supportive and
critical of homeopathy, the House of Commons Science and Technology Committee concluded:
“In our view, the systematic reviews and meta-analyses conclusively demonstrate
that homeopathic products perform no better than placebos. We could find no
support from independent experts for the idea that there is good evidence for the
efficacy of homeopathy.
The most recent review has specifically compared studies of homeopathic treatments with
matched studies of conventional therapies to identify whether a clear effect beyond placebo
could be seen for either. The conclusion was that while all clinical trials are imperfect, it is
possible to distinguish a true therapeutic effect from placebo effects for conventional therapies
but not for homeopathic treatment:
“Biases are present in placebo-controlled trials of both homoeopathy and
conventional medicine. When account was taken for these biases in the analysis,
there was weak evidence for a specific effect of homoeopathic remedies, but
strong evidence for specific effects of conventional interventions. This finding is
compatible with the notion that the clinical effects of homoeopathy are placebo
effects.”(19)
Because there have been so many systematic reviews of clinical trials on homeopathic treatment,
there is even a systematic review of those reviews. This review evaluated all prior systematic
reviews and meta-analyses of homeopathy. According to the summary of this review:
“Electronic databases were searched for systematic reviews/meta-analysis on
[homeopathy]. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of
them related to re-analyses of one landmark meta-analysis. Collectively they
implied that the overall positive result of this meta-analysis is not supported by a
critical analysis of the data.
Eleven independent systematic reviews were located. Collectively they failed to
provide strong evidence in favour of homeopathy. In particular, there was no
condition which responds convincingly better to homeopathic treatment than to
placebo or other control interventions. Similarly, there was no homeopathic
remedy that was demonstrated to yield clinical effects that are convincingly
different from placebo.
It is concluded that the best clinical evidence for homeopathy available to date
does not warrant positive recommendations for its use in clinical practice.”(20)
The assessment of the eleven independent systematic reviews analyzed is summarized in Table
1.(21-31)
The “landmark meta-analysis” referred to in this review, and often cited by supporters of
homeopathy, concluded homeopathy did have an effect greater than placebo:
“The results of our meta-analysis are not compatible with the hypothesis that the
clinical effects of homeopathy are completely due to placebo. However, we found
insufficient evidence from these studies that homeopathy is clearly efficacious for
any single clinical condition.”(32)
Due to numerous criticisms of the methodology used, this study has been re-analyzed six times,
including one re-analysis by the original authors. These subsequent analyses are summarized in
Table 2.(33-38) All of the independent re-analyses concluded that the appearance of effects
greater than placebo was related to the inclusion of poor-quality studies in the original analysis.
The authors’ re-analysis of their own study concluded:
“Studies that were explicitly randomized and were double-blind as well as studies
scoring above the cut-points yielded significantly less positive results than studies
not meeting the criteria. In the cumulative meta-analyses, there was a trend for
increasing effect sizes when more studies with lower-quality scores were added…
We conclude that in the study set investigated, there was clear evidence
that studies with better methodological quality tended to yield less positive results.”(35)
A comprehensive and critical look at the voluminous clinical trial evidence in humans
concerning homeopathy demonstrates that despite centuries of use and study, no reliable or
consistent evidence has been generated to show homeopathy is effective for a single indication,
and it is impossible to demonstrate that the effects which are sometimes reported for
homeopathic treatment are due to anything other than placebo effects and non-specific clinical
trial effects inadequately controlled for in poor-quality trials. This contrasts starkly with the
enormous advancement scientific medicine has made in the same time period, and illustrates
clearly that homeopathy is an ineffective therapy.
B. Veterinary Studies
Not surprisingly, the clinical trial literature concerning homeopathy in veterinary medicine is
considerably weaker in quantity and quality than the human clinical trial evidence. No systematic
reviews or meta-analyses exist. The clinical trials that have been reported are generally small, not
replicated, and have significant methodological limitations. Both positive and negative trials are
reported, but despite claims of efficacy and decades of use and investigation, no clear pattern of
evidence has emerged to support the efficacy of homeopathy for any indication.
An informal review in 1998, which was rather positive in tone about the potential value of
veterinary homeopathy, identified 3 trials with purportedly positive effects, 6 reporting no effect,
and 7 that were difficult to interpret.(39) All trials had significant methodological problems.
Since then, there have been a number of additional clinical trials, but clear evidence of any
meaningful clinical effect is still lacking. Table 3 lists some of the better clinical trials reporting
an effect for a homeopathic treatment, illustrating the limitations of even the best of such
studies.(40-53) None have been independently replicated, and negative studies of homeopathy
for similar indications are frequently available.
Given that publication bias, placebo effects, and the other sources of error that affect all clinical
trial research generally lead to falsely positive, rather than falsely negative findings, the
abundance of negative studies of veterinary homeopathy is compelling evidence for a true lack of
efficacy. Many of the studies with the tightest controls for bias and chance are among those
reporting negative results.( 56-70)
Most studies reporting an effect of homeopathy have been published in journals devoted to
homeopathy or alternative therapies, so the issue of publication bias must also be considered.
Negative studies are far less commonly published in such journals, so the relative numeber of
positive and negative trials should be considered with this in mind. In any case, despite decades
of research, only a few positive trials have been published, all small and with important
limitations.
Considering the clear pattern for small, poor quality human clinical trials to show positive results
which cannot be replicated and which are contradicted by negative results in larger, better quality
trials, the veterinary literature is not convincingly supportive of homeopathy. None of the few
positive trials are methodologically adequate to rule out chance, bias, confounding, and other
sources of falsely positive results.
The argument is sometimes made that the presence of some positive results in the published
literature, even given limitations in the control for potential sources of error, justifies deferring
judgment on the efficacy of homeopathy and pursuing additional research. While those interested
in this therapy are, of course, free to continue trying to produce convincing evidence of efficacy
for homeopathy, it is difficult to justify indefinitely withholding judgment on a medical therapy
that has failed to conclusively demonstrate its value in over 200 years.
The theoretical foundations of the practice are implausible and incompatible with established
science. The enormous pre-clinical and clinical trial literature in humans has failed to validate
the practice. And the limited research in veterinary species is more compatible with homeopathy
being a placebo than with having a clinically meaningful therapeutic effect. As the House of
Commons Science and Technology Committee concluded:
“There has been enough testing of homeopathy and plenty of evidence showing
that it is not efficacious. Competition for research funding is fierce and we cannot
see how further research on the efficacy of homeopathy is justified in the face of
competing priorities.”
Mainstream Scientific Interpretation of Existing Evidence
II. Statements from Veterinary Organizations
A. Since 2009, the Registry for Approved Continuing Education (RACE) has denied approval
for continuing education offerings involving the teaching of homeopathy because
homeopathy does not meet the requirements set forth in the RACE standards as it is not
taught in accredited schools of veterinary medicine. In response, the community of
homeopathy providers (and other providers of alternative therapies) attempted to bypass the
standards set by the mainstream veterinary community and established a separate CE
approval organization, the Registry of Alternative and Integrative Veterinary Medical
Education (RAIVE). RAIVE is not recognized by any of the veterinary state medical boards.
This further illustrates that homeopathy as a discipline does not to meet the standards of
evidence for safety and efficacy established for veterinary medicine as a whole.
B. The AVMA requires specialty boards to demonstrate “a substantial body of scientific
knowledge,” and does not recognize the Academy of Veterinary homeopathy certification
process due to the failure to meet this requirement:
“The AVMA does not officially recognize diplomate-status or certificates other
than those awarded by veterinary specialty organizations that are members of the
AVMA American Board of Veterinary Specialties (ABVS), nor has it evaluated
the training or education programs of other entities that provide such certificates.
Recognition of a veterinary specialty organization by the AVMA requires
demonstration of a substantial body of scientific knowledge. The AVMA
encourages CAVM organizations to demonstrate such a body of knowledge.”
C. The British veterinary Association does not recognize the scientific legitimacy of claims of
efficacy for homeopathy.
“The BVA cannot endorse the use of homeopathic medicines, or indeed any
medicine making therapeutic claims, which have no proven efficacy.”
D. The Australian Veterinary Association has concluded:
“That the Board agreed that the veterinary therapies of homeopathy and
homotoxicology are considered ineffective therapies in accordance with the AVA
promotion of ineffective therapies Board resolution.”
II. Statements from Other Medical Organizations
A. The British Medical Association has issued numerous statements decrying the use and
teaching of homeopathy by the National Health Service, including these:
“No UK training post should include a placement in homeopathy”
“Pharmacists and chemists should remove homeopathic remedies from shelves indicating
they are 'medicines' of any description, and place them on shelves clearly labeled 'placebos'.”
“Homeopathy should not be funded by the NHS due to lack of convincing evidence that
it is effective. In fact there is recent evidence that it does not work any better than a
placebo and can divert patients away from more evidence based therapy that they may require.”
Dr. Tom Dolphin, an official of the BMA, has gone so far as to call homeopathy “witchcraft”
and to argue that British government involvement with the practice is “a disgrace.”
Several other national medical associations, including those of Sweden and the Czech Republic,
have officially declared homeopathy to be ineffective and have discouraged their members from
utilizing it.
III. Statements from Government Agencies
A. Even National Center for Complementary and Alternative Medicine (NCCAM) of the
National Institutes of Health, which is specifically charged with investigating alternative
therapies, acknowledges the lack of scientific evidence for efficacy:
“Most rigorous clinical trials and systematic analyses of the research on
homeopathy have concluded that there is little evidence to support homeopathy as
an effective treatment for any specific condition.”
“Homeopathy is a controversial topic in complementary medicine research. A
number of the key concepts of homeopathy are not consistent with fundamental
concepts of chemistry and physics. For example, it is not possible to explain in
scientific terms how a remedy containing little or no active ingredient can have
any effect. This, in turn, creates major challenges to rigorous clinical investigation
of homeopathic remedies. For example, one cannot confirm that an extremely
dilute remedy contains what is listed on the label, or develop objective measures
that show effects of extremely dilute remedies in the human body.”
“Certain homeopathic products (called “nosodes” or “homeopathic
immunizations”) have been promoted by some as substitutes for conventional
immunizations, but data to support such claims is lacking. The National Center
for Complementary and Alternative Medicine (NCCAM) supports the Centers for
Disease Control and Prevention’s recommendations for
immunizations/vaccinations.”
C. The Food and Drug Administration (FDA) regulates medical therapies and drugs.
Homeopathic remedies are categorized as a drug and exempt from FDA requirements for
pre-market clinical trial evaluation because they were grandfathered into the Food, Drug and
Cosmetic Act of 1938 by the author, a senator who also practiced homeopathy. However, the
FDA clearly states that while homeopathic remedies may be freely marketed for this
historical reason”
“FDA is not aware of scientific evidence to support homeopathy as effective.”
With regard to veterinary use, the FDA considers homeopathic unapproved animal drugs but
has made no attempts to regulate their use or require any evidence of safety and efficacy.
D. European Union Regulations, designed to accommodate a variety of countries some
of which have a historical tradition of homeopathic medicine and others which do not,
acknowledge that these remedies have no therapeutic indication and requires they be
labeled to indicate this. These remedies can be marketed so long as:
1. They contain no active ingredient:
“there is a sufficient degree of dilution to guarantee the safety of the medicinal
product; in particular, the medicinal product may not contain either more than one
part per 10000 of the mother tincture or more than 1/100th of the smallest dose
used in allopathy with regard to active substances whose presence in an allopathic
medicinal product results in the obligation to submit a doctor's prescription.”
2. They are acknowledge to have no recognized therapeutic use:
“The proof of therapeutic efficacy shall not be required for homeopathic
medicinal products.”
3. The label indicates the absence of any recognized therapeutic use with the words:
"homeopathic medicinal product without approved therapeutic indications."
E. The Australian National Health and Medical Research Council, in a draft statement in
2010, has said:
“NHMRC’s position is that it is unethical for health practitioners to treat patients
using homeopathy, for the reason that homeopathy (as a medicine or procedure)
has been shown not to be efficacious.”
F. As already noted, the House of Commons Science and Technology Committee
conducted an in-depth investigation into the scientific merits of homeopathy in 2010
and concluded that the fundamental principles behind the practice were implausible
and inconsistent with established science, that there was adequate evidence to
conclude the practice was ineffective, and that there was little justification for further
research on the subject. After the report was completed, the Chief Scientific Advisor
to the British government accepted it and stated that he could not “envisage
scientifically credible proposals for funding research into homeopathy in the future.”
IV. The Dangers of Homeopathy
A. Direct Harm
It is generally assumed that because homeopathic preparations frequently do not contain any
active ingredients or any trace of the substance from which they were originally made, that
they are intrinsically safe. For the most part, direct harm from ingestion of homeopathic
remedies is very uncommon. However, there is evidence that direct harm from such remedies
does occur.
The World Health Organization (WHO)
supports, as a matter of policy, traditional or folk
systems of medicine as an expression of cultural identity. Without taking a position on the
scientific evidence for efficacy, the WHO has provided guidelines for countries wishing to
permit the sale and use of homeopathic remedies. In these guidelines, the WHO
acknowledges:
“there are a few aspects of the production of homeopathic medicines that could
constitute potential safety hazards. Firstly, not all homeopathic medicines are
administered at a high dilution. Sometimes, a homeopathic medicine made from
source material, such as a mother tincture, is administered in the most
concentrated form.
Secondly, homeopathic medicines are made from a wide range of natural or
synthetic sources: minerals and chemicals, but also plant materials, including
roots, stems, leaves, flowers, bark, pollen, lichen, moss, ferns and algae;
microorganisms, including fungi, bacteria, viruses and plant parasites; animal
organs, tissues, secretions and cell lines. Human materials may include tissues,
secretions, hormones, and cell lines. Some of these source materials constitute
potential safety hazards, even at high dilutions.”
“However, safety assessment should also consider possible impurities of the
source material or contamination and failures of good manufacturing practice.”
There have been some reports of detectable heavy metal contamination of homeopathic
remedies.(71) Given the absence of evidence for efficacy, even such small risks seem
difficult to justify.
B. A much more significant risk is the substitution of an ineffective therapy for truly beneficial
care. Homeopaths frequently recommend their patients avoid conventional medicine. For
example, the Academy of Veterinary Homeopathy (AVH) Standards of Practice state:
“Only the remedy that is homeopathic to the patient is to be used.”
“Drugs and methods of treatment which are not homeopathic to the case are to be
avoided because of the possibility of interference with the progress of cure.” [the
footnote reads," Organon of Medicine, 6th edition, paragraphs 23, 25-45, 69, and
291. Here discussion of the curative effect of similar medicines and the harmful
effects of non-similar medicines is made clear. Drugs, herbs and other forms of
treatment prevent cure and cause ultimate harm to the patient. Hahnemann states
that only the medicine homeopathic to the patient's condition is to be used in
treatment."]
Exceptions are made for life-threatening illnesses and situations in which there is a clear reason a
patient cannot stop taking a conventional medicine, but this only emphasizes that homeopathy is
self-evidently not effective in such cases. The danger lies in selecting homeopathic treatment
over scientific medicine in cases where the threat to health and life is not immediately apparent.
The AVH also takes a position well beyond that justified by science concerning the use of
vaccines:
“During homeopathic treatment, vaccination is usually contraindicated. If health
problems have arisen or are exacerbated by vaccination, homeopathy is one of the
few medical specialties that recognizes these problems and has the potential to
address them curatively. Some veterinary homeopaths recommend no vaccines of
any kind. Some will tailor a limited vaccination protocol for you and your pet.
Whatever your options and your decision, your veterinary homeopath can provide
guidance and an important perspective.”
While not all homeopaths discourage conventional therapy, the practice is fundamentally based
on the premise that conventional, scientific medicine is in error in its basic approach and that
homeopathy is an entirely different, and superior, way to truly cure disease. There have been a
number of well-documented cases of people following this line of reasoning strictly and
suffering severe injury or death as a result.(72)
Given that all medicine involves balancing risks against benefits, the case against homeopathy
seems clear. There is a conspicuous absence of evidence of benefits despite centuries of use and
investigation. And there are real risks, not to mention ethical concerns, associated with
substituting an ineffective therapy for truly beneficial medical care. The balance seems
unquestionably weighted against treating homeopathy as a legitimate veterinary therapy.
https://www.avma.org/About/Governance/D ... Attch1.pdf
Many of the statements, assumptions and conclusions are so ridiculous, they are laughable
if they weren't so serious in their consequences
This isn't just an issue of veterinary homeopathy vs. allopathy but for ALL homeopathy and complementary, alternative medicines.
And not just USA, as British, Australian, Swiss, Czech info is included in their attack.
I was always amazed at how much research is put into pet food nutrition vs. human and the various quality formulations of pet foods far exceed those for humans.
Pets generally have far more healthier food options than humans.
Are there pet foods with aspartame, sucralose, ....?
Equally amazing at how much effort is put into discrediting homeopathy for animals, more than I've seen against human homeopathy.
A tactic I haven't seen before from the CVMA, the Connecticut Veterinary Medical Association:
The concept of "like cures like" has an appealing logic and symmetry to it. It is essentially a
variation of "sympathetic magic," the idea that things which resemble one another in some
superficial way must be meaningfully related and that one can influence the other.
While animals can't speak up, humans can.
The CVMA's main contention is that homeopathy lacks enough scientific evidence to be allowed for use with animals
and wants the parent organization, AVMA, to adopt this stance and discredit use of homeopathy.
Are there any organizations that can step up and help refute many of the claims the CVMA is making that can affect ALL homeopaths and CAM practitioners?
Susan
---------------------------------------------------------------------------------------------------------------------------
The AVMA, American Veterinary Medical Association is having a meeting this weekend
The House of Delegates, the AVMA’s largest policy-making body, will gather Jan. 9-11 in Chicago to deliberate on foreign accreditation and the merits of homeopathy.
Also on the table is a bid to alter the group’s mission statement to shift its focus toward members and a rare petition-generated resolution that asks the AVMA to discourage owners from feeding jerky treats to their pets in the absence of adequate safety data.
http://news.vin.com/VINNews.aspx?articleId=30314
The AVMA is being beseeched by the CVMA, Connecticut Veterinary Medical Association to formerly discredit homeopathy
This is the resolution the CVMA is asking the AVMA to approve this weekend:
HOMEOPATHY HAS BEEN IDENTIFIED AS AN INEFFECTIVE PRACTICE AND ITS USE IS DISCOURAGED
http://www.vin.com/apputil/image/handle ... id=5642935
This weekend, the AVMA House of Delegates will gather in Chicago for the group’s Winter Session. On the table is a prospective bylaws change and seven resolutions, one of which calls for the AVMA to publicly discourage and identify homeopathy as an “ineffective practice.”
Submitted by the Connecticut Veterinary Medical Association (CVMA), the resolution asks the AVMA to affirm that the safety and efficacy of veterinary therapies should be determined by scientific investigation, and when scientific studies deem therapies to be ineffective or unsafe, those therapies should be discarded.
“Although veterinarians may legally employ any therapy that complies with the applicable laws and regulations governing the practice of veterinary medicine, the AVMA believes that veterinarians have an ethical duty to society, and to patients and their owners, to base medical judgments and recommendations on the best available scientific evidence,” the resolution states.
What prompted the CVMA to tackle the topic of homeopathy is unclear.
However, an accompanying white paper submitted by the group suggests that the CVMA’s decision to debunk homeopathy wasn’t made lightly. In some 30 pages, the group pokes holes in the methodology of studies that suggest homeopathic remedies are efficacious and challenges claims of positive clinical outcomes.
Supporters of homeopathy have fired back that many studies, including recent clinical trials , demonstrate the efficacy of homeopathic remedies.
Dr. Gary Block, board-certified in internal medicine and a House delegate representing Rhode Island, said that from an evidence-based standpoint, homeopathy is “hocus pocus.”
As an example, he points to water therapy — a traditional homeopathic remedy that’s prepared by diluting chosen substances in distilled water until none of the original substance remains. Water has memory, practitioners of homeopathy believe, allowing substances dissolved in water to leave an enduring impact even if the water is diluted beyond the point where no molecule of the original substance remains.
“To me, the resolution states the obvious,” Block said. “Homeopathy is not a scientific discipline. We do our clients a disservice when we promote it as one.”
Cooney believes that such criticisms might stem from a lack of knowledge about homeopathy. "I think there are a few people in AVMA who've just decided that they don't like it," he said.
A majority vote is required for resolutions to pass the AVMA House of Delegates, which has representatives from nearly every state and a dozen or more allied groups. While AVMA policies carry no legal or regulatory teeth, how the nation’s largest membership group for veterinarians stands on issues can influence state licensing bodies governing the practice of veterinary medicine.
The idea that the AVMA might publicly discredit homeopathy has officials with the Academy of Veterinary Homeopathy — a group of 133 veterinarians not represented in the AVMA House of Delegates — on the defense.
In a white paper that counters the CVMA’s findings, Dr. Shelley Epstein, a veterinary homeopath in Wilmington, Del., and former Academy of Veterinary Homeopathy (AVH) president, wrote that “… all medicine involves balancing risks against benefits.”
“In the case of homeopathy, the risks are negligible in the hands of trained veterinary homeopaths, and the benefits in some of even the most severe cases can be strong,” she stated.
Dr. Jeff Feinman, a veterinary homeopath in Connecticut, agrees. He’s dismayed that he and other veterinary homeopaths in the state weren't consulted by the CVMA before the group drafted its resolution.
“My personal feeling is that anything that can be done to limit therapeutic options is not a good thing,” he said.
Feinman worries that if the AVMA rejects homeopathy, other complementary and alternative modalities might be next. “This could just be the first target,” he said.
AVH officials echoed that concern in a Dec. 19 letter to House delegates: "On the surface, homeopathy would appear to represent an easy target for extinction, or at least for expulsion from the ranks of veterinary medicine. We have concerns that this would represent a slippery slope for the AVMA."
Bernard Rollin, a professor of philosophy and animal sciences at Colorado State University, chuckles about homeopathic remedies such as water therapy. His tone turns serious, however, when talking about the ethics of treating patients with remedies discredited by basic science.
Veterinarians take an oath to do no harm, Rollin said, and prescribing remedies that have no basis can do the opposite. That said, “There are lots of therapies that work in ways we never expected, even in mainstream medicine,” he acknowledged.
“If a veterinarian were to give full disclosure, and I mean full disclosure — admitting that there’s no scientific evidence for a homeopathic remedy — but the owner is still hell-bent on doing (the treatment), a veterinarian could offer it, and monitor the animal to make sure it doesn’t cause anything negative.”
That doesn’t mean Rollin endorses homeopathy. In fact, he notes “a very strong objection to alternative medicine in general.”
“There’s no such thing as alternative medicine. There’s medicine that’s scientifically proven and unproven,” Rollin said, playing off an editorial published in 1998 in the New England Journal of Medicine. “If homeopathy is true, modern chemistry is false. I’m not ready to give up modern chemistry. Are you?”
http://news.vin.com/VINNews.aspx?articleId=25587
The AVMA says in Who We Are
The American Veterinary Medical Association (AVMA), established in 1863, is a not-for-profit association
representing more than 84,000 veterinarians working in private and corporate practice, government, industry, academia, and uniformed services.
Structured to work for its members, the AVMA acts as a collective voice for its membership and for the profession.
https://www.avma.org/Pages/home.aspx
The CVMA is anti-homeopathy
Addendum #1 to CVMA Proposed AVMA Resolution:
“Homeopathy has been identified as an ineffective practice
and its use is discouraged.”
White Paper: The Case Against Homeopathy
Homeopaths frequently claim that homeopathy goes beyond the capabilities of conventional
medicine, aiming to cure the underlying cause of disease while scientific medicine merely
suppresses symptoms. And they frequently claim to be able to accomplish this with no
significant side effects, no need for withdrawal times in food animals, and none of the other
limitations of conventional therapies. Any therapy that was able to live up to these claims ought
to be able to easily and convincingly demonstrate them in clinical trials and other scientific
investigations.
However, while homeopathy has been studied and used for 200 years, and continues to be
supported by small minorities within the scientific and healthcare communities, in controlled
scientific investigations it has failed to demonstrate effectiveness beyond placebo for any
indication. This practice has failed to be validated scientifically at all levels of evidence:
1. The theoretical foundations proposed for homeopathy have not been substantiated and are
inconsistent with established scientific knowledge. A dramatically new understanding of
physics, chemistry, and biology which overturns the very foundations of modern
biomedical science would be necessary for these proposed mechanisms to be valid.
2. There is no consistent body of in vitro or animal model research evidence showing
presence of any biologically active factor in homeopathic remedies or a meaningful
biological effect of homeopathic treatment beyond placebo. While some apparently
positive studies exist, published almost exclusively in journals dedicated to the promotion
of homeopathy and other alternative therapies, independent investigation of these studies
have found a high risk of bias and have failed to confirm positive findings.
3. There is an enormous clinical trial literature in humans concerning homeopathic
treatment. Again, some apparently positive trials exist, but these are of low-quality and
highly subject to bias. Systematic reviews of the clinical trial literature consistently find
no evidence of an effect beyond placebo, and that lower quality trials are more likely to
be positive and higher quality trials more likely to be negative, consistent with placebo
effects and inadequately controlled bias, and confounding. The failure to find a consistent
effect in properly designed and conducted trials despite many hundreds of attempts over
two centuries is strong evidence of the lack of a meaningful therapeutic benefit.
4. There are very few veterinary clinical trials examining homeopathic treatment, most
published in homeopathic or alternative medicine journals and all with significant
methodological weaknesses. As in the human clinical trial literature, no consistent
evidence of a real effect is found when adequate controls for placebo, bias, and
confounding are in place.
Despite the continued popularity of homeopathy among a small, but passionate community of
advocates, who respond aggressively to any criticism of the practice, a growing number of
veterinary, human healthcare, and governmental organizations are acknowledging that existing
scientific evidence strongly supports the conclusion that homeopathy has no effect beyond
placebo. Because it is unethical to offer ineffective therapies to clients, and dangerous to
substitute a placebo therapy for truly effective medicine, there is a movement towards publically
acknowledging that there is no reason to believe homeopathic treatment has any real value in
preventing or treating disease.
The veterinary profession has an obligation to society and to our clients to acknowledge the
conclusions of science even when there is not absolute unanimity within the profession. If we
wish to retain the trust of the public, upon which our work depends, we must demonstrate that
our recommendations are based on sound science and that we are willing to put the welfare of
our patients and clients first even when some of our colleagues object.
As the House of Commons Science and Technology Committee concluded after an extensive
review of the evidence concerning homeopathy:
“For patient choice to be real choice, patients must be adequately informed to
understand the implications of treatments. For homeopathy this would certainly
require an explanation that homeopathy is a placebo. When this is not done,
patient choice is meaningless.”
In veterinary medicine, our clients can only have real choice, and justified faith in their
veterinarians, if we are willing to be clear and honest in informing them when practices, such as
homeopathy, are shown to be ineffective.
Medical Therapies Should be Science-Based and Ineffective Therapies Should Be Discarded
I. Statements from the AVMA
The AVMA has repeated affirmed in numerous position statements that all veterinary therapies
should be evaluated by the scientific method, and that ineffective and unsafe therapies should be
avoided. The following is a selection of examples of AVMA positions and guidelines which
affirm this principle.
A. The AVMA Guidelines for Complementary and Alternative Medicine (Approved by AVMA
House of Delegates 2001; revised by the AVMA Executive Board April 2006, November
2007) state:
“The AVMA believes that all veterinary medicine, including CAVM, should be
held to the same standards. Claims for safety and effectiveness ultimately should
be proven by the scientific method… Practices and philosophies that are
ineffective or unsafe should be discarded...Recommendations for effective and
safe care should be based on available scientific knowledge and the medical
judgment of the veterinarian.”
These guidelines also point out that official recognition of veterinary specialty certification is
contingent on the existence of a substantive body of scientific knowledge supporting this status:
“The AVMA does not officially recognize diplomate-status or certificates other
than those awarded by veterinary specialty organizations that are members of the
AVMA American Board of Veterinary Specialties (ABVS)…Recognition of a
veterinary specialty organization by the AVMA requires demonstration of a
substantial body of scientific knowledge.”
As a consequence of the absence of a “substantial body of scientific knowledge,” the
ABVS does not recognize any certification or specialization in veterinary homeopathy,
including that of the Academy of Veterinary Homeopathy which identifies itself as “the
only certifying veterinary body in North America” for homeopathy.
B. The AVMA Guidelines for Assessment of New Therapies for Alleviation of Acute Pain in
Animals (Oversight: COR; EB approved 11/06; EB approved revisions11/11) also emphasize
the importance of scientific research in establishing safety and efficacy of therapeutic
compounds:
“The assessment of the analgesic efficacy and potency of a variety of
pharmaceutical agents for use in veterinary clinical practice is an important goal
of applied and clinical veterinary research. Well-designed and appropriately
controlled experimental clinical trials are vital to the development of safe and
effective compounds.”
C. The AVMA Guidelines on the Use of Biotechnology in Veterinary Medicine and Animal
Agriculture (Oversight: AALC; EB approved 4/07) state:
“The AVMA supports a science-based regulatory policy for the approval of
products developed through biotechnology…Future evaluations should be solidly
based on sound science and meaningful risk assessments.”
D. The AVMA position statement on Compounding (Oversight: COBTA; EB approved 11/00;
revised 03/05; 04/09) states:
“The decision to use a compounded drug should be veterinarian (not pharmacist)
driven, based on a veterinarian-client-patient relationship. Whenever possible the
veterinarian should make that decision utilizing evidence-based medicine.”
E. The AVMA position on Pet Food Health Claims (Approved by the AVMA Executive Board
April 2008) states:
“The AVMA encourages the pet food industry to act responsibly by only making
health or therapeutic claims that are supported by quality scientific evidence.
Veterinarians should assess relevant product information through principles of
evidence-based medicine prior to using or recommending wellness or therapeutic
pet foods.”
F. The AVMA Policy to Promote Veterinary Medical Research and Discovery (COR Oversight;
EB approved 11/09) states:
“The AVMA recognizes that the veterinary medical profession is uniquely
qualified to provide the highest quality science-based clinical services…the
AVMA also recognizes that without vigorous veterinary medical research
programs and a sustained infusion of new knowledge, the profession will be
unable to continue to provide science-based education and clinical service to meet
future societal needs…the Association will support programs that emphasize
research and science.”
G. The AVMA Policy of Raw or Undercooked Animal-Source Protein in Cat and Dog Diets
(Approved by the AVMA Executive Board April 2012; approved by the AVMA House of
Delegates July 2012) discourages the use of such diets based on scientific evidence of risk:
“The AVMA discourages the feeding to cats and dogs of any animal-source
protein that has not first been subjected to a process to eliminate pathogens
because of the risk of illness to cats and dogs as well as humans…Several studies
reported in peer-reviewed scientific journals have demonstrated that raw or
undercooked animal-source protein may be contaminated with a variety of
pathogenic organisms
There's much more to read including statements from British, Australian vet organizations
Homeopathy is Ineffective
I. Plausibility and Pre-clinical Research Evidence
A. Law of Similars
The foundational principle of homeopathy is that a substance which causes a symptom in a
healthy individual can, when properly processed (c.f. Potentization by Dilution and Succussion
below), cure the underlying cause of that symptom in a diseases individual.
The Academy of Veterinary Homeopathy gives the following description of this principle:
“Homeopathic practitioners have found that substances that produce symptoms
similar to the symptoms of disease can be used to cure that disease…. In
homeopathy a medicine (remedy) is selected which would produce in a healthy
body the same symptoms found in the sick animal (“like cures like”).
The way a particular substance is associated with a given symptom or set of symptoms is by
referring to collections of what are called “pathogenetic trials” or “provings.” This is a method in
which healthy individuals ingest or are otherwise exposed to a substance and keep a diary for
days or weeks afterwards listing every physical and emotional experience they have. These
diaries are then evaluated and patterns of similar symptoms are identified and then codified as
symptoms that substance can cause.
Many of the provings used to guide homeopathic treatment today were conducted by Samual
Hahneman himself, who invented homeopathy in the late 18th century. Subsequent efforts to
demonstrate consistency or reproducibility of homeopathic provings have been unsuccessful. (1-6)
The concept of "like cures like" has an appealing logic and symmetry to it. It is essentially a
variation of "sympathetic magic," the idea that things which resemble one another in some
superficial way must be meaningfully related and that one can influence the other. Many cultures
have magical practices in which one makes an effigy or figure resembling an individual, a
"voodoo doll" for example, and then uses it to indirectly affect the health of that individual.
Yellow plants are used to treat jaundice. Walnuts are eaten to treat problems in the brain because
walnuts look a little like the human brain. Preparations of mandrake root are used to aid fertility
because the root looks a little like a human penis. Examples of such sympathetic magic, which
can be found in folk medicine traditions throughout the world. Scientific investigation has not,
however, found the idea of sympathetic magic to be a reliable principle for deciding which
substances in the natural world will be useful as medicines.
And despite the primacy of the Law of Similars in homeopathic theory, it is often difficult to
relate this to the remedies actually used. It is possible, for example, to buy homeopathic products
made from body parts such as hip joints and colons, animals such as iguana and dragonfly, and
different kinds of sunlight. It is also possible to buy products derived from precious
archaeological features such as the Great Wall of China and Stonehenge. It is difficult to
understand what symptoms could be induced (and therefore be treated) by these products under
the like-cures-like principle.
B. Potentization by Dilution and Succussion
The problem with giving a remedy that causes certain symptoms in order to treat those
symptoms is that, obviously, doing so will almost certainly make the patient worse. In
developing the theories of homeopathy, Hahneman solved this problem by progressively diluting
the remedies until, in most cases, they no longer contain any active ingredients at all.
Homeopaths believe that the more dilute a remedy is, the more potent it is, though only if it is
vigorously shaken during the dilution process.
In testimony before the House of Commons Science and Technology Committee, Dr Peter
Fisher, Director of the Royal London Homeopathic Hospital, described how homeopathic
dilutions are made:
“[They] are prepared by a process of sequential dilution with vigorous shaking at
each stage of dilution, known as succussion. Dilution is usually in steps of 1:10 or
1:100, referred to as x or d (decimal) or c (centesimal) respectively.
For example, a 30C dilution indicates that the solution has been diluted in the
ratio of 1:100, thirty times successively; one drop of the original solution would
be diluted with 100 drops of water and the resulting solution would be diluted
again, and so on until 30 dilutions had taken place. According to the Prince's
Foundation for Integrated Health, in some homeopathic products "not even a
single molecule of the original substance remains in the diluted medicine
prescribed to the patient."
Dr Fisher stated that the process of "shaking is important" but was unable to say how much
shaking was required. He said "that has not been fully investigated” but did indicate that "You
have to shake it vigorously…if you just stir it gently, it does not work."
The principle that a therapeutic substance becomes more potent the lower the dose, and that it
can still be active even when it contains only the diluent (water), is inconsistent with the
fundamental principles of chemistry and physiology underlying all of scientific medicine. A
revolution in basic science would need to take place for this idea to have any possibility of being
correct, and the inconsistent and low-quality studies that have attempted to validate homeopathic
theory do not justify such a revolution.(7-9)
The Royal Pharmaceutical Society of Great Britain (RPSGB) offers the following comments on
this issue:
“The philosophy of homeopathy that a substance becomes more potent as it is
diluted goes against the conventional theory of the pharmacological action of
compounds in the body…There is no robust scientific evidence to suggest that
differences can be detected between ultradilute homeopathic remedies and the
diluent used to prepare the remedy in terms of their physical properties and
behaviour.”
“As a consequence of their extreme dilution, most high dilution/potency
homeopathic remedies do not contain a single active molecule. The administration
of a preparation containing substance at such large dilutions leads to a RPSGB
view that such preparations will not produce clinical effects.”
There have been many attempts to demonstrate that ultradilute substances can have biological
effects, in vitro or in vivo. Some studies in dedicated homeopathy or alternative medicine
journals have reported positive findings, but a review of these studies found numerous
methodological problems and ultimately concluded:
“There is a lack of independent replication of any pre-clinical research in
homoeopathy. In the few instances where a research team has set out to replicate
the work of another, either the results were negative or the methodology was
questionable.”(9)
Other reviews have also found that replications of pre-clinical studies in homeopathy are often
not successful, leading to an absence of consistent, repeatable evidence for the basic theoretical
principles behind the practice.(10) Even the Prince's Foundation for Integrated Health, which is
generally supportive of homeopathy, notes, "any specific mechanism of action based on extreme
dilution is implausible and regarded as unsupportable by the majority of scientists working in
this field."
One of the few studies published in the mainstream medical literature concerning ultradilute
homeopathic remedies, published in Nature in 1988, purported to show that such a remedy could
influence the degranulation of human basophils. (11) Because the findings were so revolutionary,
the journal took the unprecedented step of arranging for an independent team of investigators to
observe replications of the experiment.
This team found that the results had been generated by an unblinded technician, and when this
individual was unaware of the treatment given to each sample, the positive findings
disappeared.(12) Subsequently, multiple attempts by independent researchers to replicate the
original experiment also failed to find an effect.(13-14) A review published in a homeopathy
journal in 2009 concluded that after twenty years of research, it was still impossible to determine
conclusively that purported effects of ultradilute solutions on human basophils were not due
solely to artifact.(15)
Many theories have been proposed to explain how water containing no other substances could
have potent and specific therapeutic effects. Homeopaths have claimed water has selective
memory for the substances used to make homeopathic remedies or that in some way not yet
understood quantum mechanics validates their claims. Attempts to validate claims that
homeopathic remedies are measurably distinct from ordinary water have been methodologically
weak and not reproducible.(16-18)
The proposed mechanisms of homeopathy are shown to be implausible when analyzed from a
physical and chemical perspective, and thus it is of no surprise that the biological effects of
homeopathy cannot be measured in large-scale clinical trials.
II. Clinical Trial Evidence
A. Human Studies
There have been an enormous number of clinical trials of homeopathy conducted in humans.
These have been summarized in many systematic reviews over the last twenty years, and several
clear patterns have emerged:
1. Most studies are of poor quality, at high risk of bias, and published in journals dedicated
to homeopathy and other alternative therapies. Despite this, a consistent clinical effect
has not been identified.
2. Higher quality studies are much more likely to have negative findings. Studies with poor
control for bias, confounding, and non-specific effects of participation in a clinical trial
(placebo effect, Hawthorne effect, regression to the mean, spontaneous resolution, etc.)
are more likely to have positive results.
3. Occasional positive findings cannot be replicated and disappear when methodological
flaws are corrected.
4. The positive effects sometimes reported are far weaker than those for matched
conventional therapies and unlikely to be clinically meaningful.
5. The balance of the evidence unquestionably indicates that the effects of homeopathic
treatment are due to placebo effects, chance, bias, confounding, and other sources of
error, not true therapeutic effects.
After an extensive review of the evidence and testimony from experts both supportive and
critical of homeopathy, the House of Commons Science and Technology Committee concluded:
“In our view, the systematic reviews and meta-analyses conclusively demonstrate
that homeopathic products perform no better than placebos. We could find no
support from independent experts for the idea that there is good evidence for the
efficacy of homeopathy.
The most recent review has specifically compared studies of homeopathic treatments with
matched studies of conventional therapies to identify whether a clear effect beyond placebo
could be seen for either. The conclusion was that while all clinical trials are imperfect, it is
possible to distinguish a true therapeutic effect from placebo effects for conventional therapies
but not for homeopathic treatment:
“Biases are present in placebo-controlled trials of both homoeopathy and
conventional medicine. When account was taken for these biases in the analysis,
there was weak evidence for a specific effect of homoeopathic remedies, but
strong evidence for specific effects of conventional interventions. This finding is
compatible with the notion that the clinical effects of homoeopathy are placebo
effects.”(19)
Because there have been so many systematic reviews of clinical trials on homeopathic treatment,
there is even a systematic review of those reviews. This review evaluated all prior systematic
reviews and meta-analyses of homeopathy. According to the summary of this review:
“Electronic databases were searched for systematic reviews/meta-analysis on
[homeopathy]. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of
them related to re-analyses of one landmark meta-analysis. Collectively they
implied that the overall positive result of this meta-analysis is not supported by a
critical analysis of the data.
Eleven independent systematic reviews were located. Collectively they failed to
provide strong evidence in favour of homeopathy. In particular, there was no
condition which responds convincingly better to homeopathic treatment than to
placebo or other control interventions. Similarly, there was no homeopathic
remedy that was demonstrated to yield clinical effects that are convincingly
different from placebo.
It is concluded that the best clinical evidence for homeopathy available to date
does not warrant positive recommendations for its use in clinical practice.”(20)
The assessment of the eleven independent systematic reviews analyzed is summarized in Table
1.(21-31)
The “landmark meta-analysis” referred to in this review, and often cited by supporters of
homeopathy, concluded homeopathy did have an effect greater than placebo:
“The results of our meta-analysis are not compatible with the hypothesis that the
clinical effects of homeopathy are completely due to placebo. However, we found
insufficient evidence from these studies that homeopathy is clearly efficacious for
any single clinical condition.”(32)
Due to numerous criticisms of the methodology used, this study has been re-analyzed six times,
including one re-analysis by the original authors. These subsequent analyses are summarized in
Table 2.(33-38) All of the independent re-analyses concluded that the appearance of effects
greater than placebo was related to the inclusion of poor-quality studies in the original analysis.
The authors’ re-analysis of their own study concluded:
“Studies that were explicitly randomized and were double-blind as well as studies
scoring above the cut-points yielded significantly less positive results than studies
not meeting the criteria. In the cumulative meta-analyses, there was a trend for
increasing effect sizes when more studies with lower-quality scores were added…
We conclude that in the study set investigated, there was clear evidence
that studies with better methodological quality tended to yield less positive results.”(35)
A comprehensive and critical look at the voluminous clinical trial evidence in humans
concerning homeopathy demonstrates that despite centuries of use and study, no reliable or
consistent evidence has been generated to show homeopathy is effective for a single indication,
and it is impossible to demonstrate that the effects which are sometimes reported for
homeopathic treatment are due to anything other than placebo effects and non-specific clinical
trial effects inadequately controlled for in poor-quality trials. This contrasts starkly with the
enormous advancement scientific medicine has made in the same time period, and illustrates
clearly that homeopathy is an ineffective therapy.
B. Veterinary Studies
Not surprisingly, the clinical trial literature concerning homeopathy in veterinary medicine is
considerably weaker in quantity and quality than the human clinical trial evidence. No systematic
reviews or meta-analyses exist. The clinical trials that have been reported are generally small, not
replicated, and have significant methodological limitations. Both positive and negative trials are
reported, but despite claims of efficacy and decades of use and investigation, no clear pattern of
evidence has emerged to support the efficacy of homeopathy for any indication.
An informal review in 1998, which was rather positive in tone about the potential value of
veterinary homeopathy, identified 3 trials with purportedly positive effects, 6 reporting no effect,
and 7 that were difficult to interpret.(39) All trials had significant methodological problems.
Since then, there have been a number of additional clinical trials, but clear evidence of any
meaningful clinical effect is still lacking. Table 3 lists some of the better clinical trials reporting
an effect for a homeopathic treatment, illustrating the limitations of even the best of such
studies.(40-53) None have been independently replicated, and negative studies of homeopathy
for similar indications are frequently available.
Given that publication bias, placebo effects, and the other sources of error that affect all clinical
trial research generally lead to falsely positive, rather than falsely negative findings, the
abundance of negative studies of veterinary homeopathy is compelling evidence for a true lack of
efficacy. Many of the studies with the tightest controls for bias and chance are among those
reporting negative results.( 56-70)
Most studies reporting an effect of homeopathy have been published in journals devoted to
homeopathy or alternative therapies, so the issue of publication bias must also be considered.
Negative studies are far less commonly published in such journals, so the relative numeber of
positive and negative trials should be considered with this in mind. In any case, despite decades
of research, only a few positive trials have been published, all small and with important
limitations.
Considering the clear pattern for small, poor quality human clinical trials to show positive results
which cannot be replicated and which are contradicted by negative results in larger, better quality
trials, the veterinary literature is not convincingly supportive of homeopathy. None of the few
positive trials are methodologically adequate to rule out chance, bias, confounding, and other
sources of falsely positive results.
The argument is sometimes made that the presence of some positive results in the published
literature, even given limitations in the control for potential sources of error, justifies deferring
judgment on the efficacy of homeopathy and pursuing additional research. While those interested
in this therapy are, of course, free to continue trying to produce convincing evidence of efficacy
for homeopathy, it is difficult to justify indefinitely withholding judgment on a medical therapy
that has failed to conclusively demonstrate its value in over 200 years.
The theoretical foundations of the practice are implausible and incompatible with established
science. The enormous pre-clinical and clinical trial literature in humans has failed to validate
the practice. And the limited research in veterinary species is more compatible with homeopathy
being a placebo than with having a clinically meaningful therapeutic effect. As the House of
Commons Science and Technology Committee concluded:
“There has been enough testing of homeopathy and plenty of evidence showing
that it is not efficacious. Competition for research funding is fierce and we cannot
see how further research on the efficacy of homeopathy is justified in the face of
competing priorities.”
Mainstream Scientific Interpretation of Existing Evidence
II. Statements from Veterinary Organizations
A. Since 2009, the Registry for Approved Continuing Education (RACE) has denied approval
for continuing education offerings involving the teaching of homeopathy because
homeopathy does not meet the requirements set forth in the RACE standards as it is not
taught in accredited schools of veterinary medicine. In response, the community of
homeopathy providers (and other providers of alternative therapies) attempted to bypass the
standards set by the mainstream veterinary community and established a separate CE
approval organization, the Registry of Alternative and Integrative Veterinary Medical
Education (RAIVE). RAIVE is not recognized by any of the veterinary state medical boards.
This further illustrates that homeopathy as a discipline does not to meet the standards of
evidence for safety and efficacy established for veterinary medicine as a whole.
B. The AVMA requires specialty boards to demonstrate “a substantial body of scientific
knowledge,” and does not recognize the Academy of Veterinary homeopathy certification
process due to the failure to meet this requirement:
“The AVMA does not officially recognize diplomate-status or certificates other
than those awarded by veterinary specialty organizations that are members of the
AVMA American Board of Veterinary Specialties (ABVS), nor has it evaluated
the training or education programs of other entities that provide such certificates.
Recognition of a veterinary specialty organization by the AVMA requires
demonstration of a substantial body of scientific knowledge. The AVMA
encourages CAVM organizations to demonstrate such a body of knowledge.”
C. The British veterinary Association does not recognize the scientific legitimacy of claims of
efficacy for homeopathy.
“The BVA cannot endorse the use of homeopathic medicines, or indeed any
medicine making therapeutic claims, which have no proven efficacy.”
D. The Australian Veterinary Association has concluded:
“That the Board agreed that the veterinary therapies of homeopathy and
homotoxicology are considered ineffective therapies in accordance with the AVA
promotion of ineffective therapies Board resolution.”
II. Statements from Other Medical Organizations
A. The British Medical Association has issued numerous statements decrying the use and
teaching of homeopathy by the National Health Service, including these:
“No UK training post should include a placement in homeopathy”
“Pharmacists and chemists should remove homeopathic remedies from shelves indicating
they are 'medicines' of any description, and place them on shelves clearly labeled 'placebos'.”
“Homeopathy should not be funded by the NHS due to lack of convincing evidence that
it is effective. In fact there is recent evidence that it does not work any better than a
placebo and can divert patients away from more evidence based therapy that they may require.”
Dr. Tom Dolphin, an official of the BMA, has gone so far as to call homeopathy “witchcraft”
and to argue that British government involvement with the practice is “a disgrace.”
Several other national medical associations, including those of Sweden and the Czech Republic,
have officially declared homeopathy to be ineffective and have discouraged their members from
utilizing it.
III. Statements from Government Agencies
A. Even National Center for Complementary and Alternative Medicine (NCCAM) of the
National Institutes of Health, which is specifically charged with investigating alternative
therapies, acknowledges the lack of scientific evidence for efficacy:
“Most rigorous clinical trials and systematic analyses of the research on
homeopathy have concluded that there is little evidence to support homeopathy as
an effective treatment for any specific condition.”
“Homeopathy is a controversial topic in complementary medicine research. A
number of the key concepts of homeopathy are not consistent with fundamental
concepts of chemistry and physics. For example, it is not possible to explain in
scientific terms how a remedy containing little or no active ingredient can have
any effect. This, in turn, creates major challenges to rigorous clinical investigation
of homeopathic remedies. For example, one cannot confirm that an extremely
dilute remedy contains what is listed on the label, or develop objective measures
that show effects of extremely dilute remedies in the human body.”
“Certain homeopathic products (called “nosodes” or “homeopathic
immunizations”) have been promoted by some as substitutes for conventional
immunizations, but data to support such claims is lacking. The National Center
for Complementary and Alternative Medicine (NCCAM) supports the Centers for
Disease Control and Prevention’s recommendations for
immunizations/vaccinations.”
C. The Food and Drug Administration (FDA) regulates medical therapies and drugs.
Homeopathic remedies are categorized as a drug and exempt from FDA requirements for
pre-market clinical trial evaluation because they were grandfathered into the Food, Drug and
Cosmetic Act of 1938 by the author, a senator who also practiced homeopathy. However, the
FDA clearly states that while homeopathic remedies may be freely marketed for this
historical reason”
“FDA is not aware of scientific evidence to support homeopathy as effective.”
With regard to veterinary use, the FDA considers homeopathic unapproved animal drugs but
has made no attempts to regulate their use or require any evidence of safety and efficacy.
D. European Union Regulations, designed to accommodate a variety of countries some
of which have a historical tradition of homeopathic medicine and others which do not,
acknowledge that these remedies have no therapeutic indication and requires they be
labeled to indicate this. These remedies can be marketed so long as:
1. They contain no active ingredient:
“there is a sufficient degree of dilution to guarantee the safety of the medicinal
product; in particular, the medicinal product may not contain either more than one
part per 10000 of the mother tincture or more than 1/100th of the smallest dose
used in allopathy with regard to active substances whose presence in an allopathic
medicinal product results in the obligation to submit a doctor's prescription.”
2. They are acknowledge to have no recognized therapeutic use:
“The proof of therapeutic efficacy shall not be required for homeopathic
medicinal products.”
3. The label indicates the absence of any recognized therapeutic use with the words:
"homeopathic medicinal product without approved therapeutic indications."
E. The Australian National Health and Medical Research Council, in a draft statement in
2010, has said:
“NHMRC’s position is that it is unethical for health practitioners to treat patients
using homeopathy, for the reason that homeopathy (as a medicine or procedure)
has been shown not to be efficacious.”
F. As already noted, the House of Commons Science and Technology Committee
conducted an in-depth investigation into the scientific merits of homeopathy in 2010
and concluded that the fundamental principles behind the practice were implausible
and inconsistent with established science, that there was adequate evidence to
conclude the practice was ineffective, and that there was little justification for further
research on the subject. After the report was completed, the Chief Scientific Advisor
to the British government accepted it and stated that he could not “envisage
scientifically credible proposals for funding research into homeopathy in the future.”
IV. The Dangers of Homeopathy
A. Direct Harm
It is generally assumed that because homeopathic preparations frequently do not contain any
active ingredients or any trace of the substance from which they were originally made, that
they are intrinsically safe. For the most part, direct harm from ingestion of homeopathic
remedies is very uncommon. However, there is evidence that direct harm from such remedies
does occur.
The World Health Organization (WHO)
supports, as a matter of policy, traditional or folk
systems of medicine as an expression of cultural identity. Without taking a position on the
scientific evidence for efficacy, the WHO has provided guidelines for countries wishing to
permit the sale and use of homeopathic remedies. In these guidelines, the WHO
acknowledges:
“there are a few aspects of the production of homeopathic medicines that could
constitute potential safety hazards. Firstly, not all homeopathic medicines are
administered at a high dilution. Sometimes, a homeopathic medicine made from
source material, such as a mother tincture, is administered in the most
concentrated form.
Secondly, homeopathic medicines are made from a wide range of natural or
synthetic sources: minerals and chemicals, but also plant materials, including
roots, stems, leaves, flowers, bark, pollen, lichen, moss, ferns and algae;
microorganisms, including fungi, bacteria, viruses and plant parasites; animal
organs, tissues, secretions and cell lines. Human materials may include tissues,
secretions, hormones, and cell lines. Some of these source materials constitute
potential safety hazards, even at high dilutions.”
“However, safety assessment should also consider possible impurities of the
source material or contamination and failures of good manufacturing practice.”
There have been some reports of detectable heavy metal contamination of homeopathic
remedies.(71) Given the absence of evidence for efficacy, even such small risks seem
difficult to justify.
B. A much more significant risk is the substitution of an ineffective therapy for truly beneficial
care. Homeopaths frequently recommend their patients avoid conventional medicine. For
example, the Academy of Veterinary Homeopathy (AVH) Standards of Practice state:
“Only the remedy that is homeopathic to the patient is to be used.”
“Drugs and methods of treatment which are not homeopathic to the case are to be
avoided because of the possibility of interference with the progress of cure.” [the
footnote reads," Organon of Medicine, 6th edition, paragraphs 23, 25-45, 69, and
291. Here discussion of the curative effect of similar medicines and the harmful
effects of non-similar medicines is made clear. Drugs, herbs and other forms of
treatment prevent cure and cause ultimate harm to the patient. Hahnemann states
that only the medicine homeopathic to the patient's condition is to be used in
treatment."]
Exceptions are made for life-threatening illnesses and situations in which there is a clear reason a
patient cannot stop taking a conventional medicine, but this only emphasizes that homeopathy is
self-evidently not effective in such cases. The danger lies in selecting homeopathic treatment
over scientific medicine in cases where the threat to health and life is not immediately apparent.
The AVH also takes a position well beyond that justified by science concerning the use of
vaccines:
“During homeopathic treatment, vaccination is usually contraindicated. If health
problems have arisen or are exacerbated by vaccination, homeopathy is one of the
few medical specialties that recognizes these problems and has the potential to
address them curatively. Some veterinary homeopaths recommend no vaccines of
any kind. Some will tailor a limited vaccination protocol for you and your pet.
Whatever your options and your decision, your veterinary homeopath can provide
guidance and an important perspective.”
While not all homeopaths discourage conventional therapy, the practice is fundamentally based
on the premise that conventional, scientific medicine is in error in its basic approach and that
homeopathy is an entirely different, and superior, way to truly cure disease. There have been a
number of well-documented cases of people following this line of reasoning strictly and
suffering severe injury or death as a result.(72)
Given that all medicine involves balancing risks against benefits, the case against homeopathy
seems clear. There is a conspicuous absence of evidence of benefits despite centuries of use and
investigation. And there are real risks, not to mention ethical concerns, associated with
substituting an ineffective therapy for truly beneficial medical care. The balance seems
unquestionably weighted against treating homeopathy as a legitimate veterinary therapy.
https://www.avma.org/About/Governance/D ... Attch1.pdf