2010
Dana Ullman, MPH, Michael Frass, MD
Abstract
There are conceptual and historical links between homeopathic medicine and modern allergy desensitization treatment.
Conventional allergy desensitization and homeopathic treatment both utilize small doses of substances that might cause symptoms in order to prevent or treat a hypersensitive state. Homeopathy has historically been associated with allergy treatment.
This article reviews evidence from controlled trials for the use of homeopathy in respiratory allergies. Several clinical trials, many of which were published in “high impact” conventional medical journals, describe significant effects of homeopathic treatment in allergic patients.
Most of these clinical studies have been deemed to be high quality trials, according to the three most commonly referenced meta-analyses of homeopathic research. Basic in vitro experimental studies also provide evidence that the effects of homeopathy differ from placebo.
Introduction
A small footnote in medical history involves a Scottish homeopathic physician, C.H. Blackley, who in 1871 first identified pollen as the cause of hay fever. Another historical fact is that one of three physicians who founded the American Academy of Allergy was a San Francisco homeopathic physician, Grant L. Selfridge. Selfridge was also the first to conduct a botanical and pollen survey in western United States.
The primary precept of various modern allergy treatments derives from the homeopathic principle of treating “like with like,” suggesting the primary principle of homeopathy has unconsciously been part of mainstream medicine.
Homeopathic medicine is a type of nanopharmacology or “medical biomimicry” in which extremely small and specially prepared doses of various substances from the plant, mineral, animal, or chemical kingdom are prescribed to treat speci!c syndromes they are known to cause in overdose.
As opposed to pharmacological agents prescribed to inhibit or suppress a patient’s symptoms, homeopathic medicines are prescribed to mimic and augment the patient’s immune response and natural defenses.
Homeopathic Research
There is actually a larger body of clinical and basic science research that has tested homeopathic medicines than most people realize. Several clinical trials have demonstrated the efficacy of homeopathic medicines for treatment of serious illnesses, such as profuse tracheal secretions in critically ill patients suffering from chronic obstructive pulmonary disease and severe sepsis.
Furthermore, the homeopathic treatment of influenza and influenza-like syndrome has undergone four large clinical trials, the results of which the Cochrane Review refers to as “promising.”
Although The Lancet published a review of homeopathic research that suggested no significant differences between homeopathic treatment and placebo, there were significant problems with this analysis, including inadequate external validity of the small number of trials selected and significant bias in choosing the limited number of trials to evaluate. Shang et al recognized one trial on polyarthritis as “high quality.”
This trial, however, was discarded because the reviewers asserted there was no comparable trial in allopathic medicine – a surprising claim that there has never been a double-blind, placebo controlled trial on patients with polyarthritis. It was also surprising the researchers chose to include a large clinical trial using a single homeopathic medicine (Thyroidinum 30C) in the treatment of weight loss, even though there is no evidence this remedy in this potency is typically prescribed for weight loss.
More comprehensive reviews of this body of clinical research show that the results reported in The Lancet are less definitive than the review suggests. These recent reviews show that several high quality trials testing homeopathic medicines were not included in the analysis, that the definition of “large” clinical trial was different for allopathic (n=146) than homeopathic (n=98) trials, and that the designation of large trials seemed to be post hoc.
Homeopathy and Allergies
Although the homeopathic principle of similars may be utilized in conventional allergy desensitization shots, there are substantial differences between conventional and homeopathic allergy treatment. First, desensitization shots are only used in the prevention of allergy symptoms, whereas homeopathic medicines are used for prevention or treatment of allergies. Second, homeopathic medicines utilize much smaller doses.
Although sometimes the substance to which the person is allergic is prescribed in a homeopathic dilution, more frequently a medicine is given based on its ability to cause the similar complex of symptoms (beyond just the allergy symptoms) the sick person is experiencing.
Classically trained homeopaths often prescribe a “constitutional medicine,” a homeopathic remedy individually chosen based on the constellation of physical and psychological symptoms the person is experiencing, not just the allergy symptoms.
Finding a person’s constitutional medicine requires the individualized care of a professional homeopath. Homeopaths contend this approach to prescribing homeopathic medicines has the potential to provide significant relief of acute and chronic ailments, sometimes leading to significant improvement or a cure of the person’s allergy state.
From a homeopathic perspective, one of the great misunderstandings about allergies is the assumption that the allergen (e.g., the cat dander, pollen, or house dust mite) is “the problem.”
Instead, the allergen is the trigger and the allergic person’s body is the loaded gun. Rather than treating and suppressing the person’s symptoms or avoiding the allergen as a means of staying healthy, homeopaths seek to find the homeopathic medicine that will strengthen the individual’s defense system.
No studies, however, have evaluated the efficacy of long-term homeopathic “constitutional” treatment. Instead, clinical trials have evaluated the use of homeopathic medicines for treating various acute allergy symptoms, usually over a one- to three-month period.