Question Two: Alternative Health Practices

This question deals with ‘alternative health’ resources. A video of the question can be found here.In recent years we have seen a great increase in the use of so-called alternative remedies or medicines. These alternatives are rarely, if ever, based on any empirical research (that we would recognise as such). Research conducted into homeopathy is (and very fairly) reviewed in Ben Goldacre’s book Bad Science (2008) Fourth Estate.

In this particular chapter he concludes that while there is little evidence that homeopathy does any physical harm (most the the remedies are water) there is no evidence to suggest that it does any good, beyond a ‘placebo effect’.  Given the evidence (or lack of it) should we be more vocal in our criticism of homeopathic/alternative medicine approaches? Many of these actually run contrary to our understanding of science. They talk of ‘energy flows’ through the body, but never specify a recognisable form of energy (Heat? Kinetic? Potential?) When I asked recently, I was told that it is ‘life energy’ – which was a new one on me.

So, isn’t letting people believe that something is going to do them good, when there is no evidence (such as prescribing a course of red M&M’s) contrary to our science training? Shouldn’t we be vocal in our rejection of these approaches and challenge them openly?

8 thoughts on “Question Two: Alternative Health Practices

  1. Here is our joint response:
    From UK
    If the remedies make people feel better then surely they are good? If people are feeling better then it would help reduce the amount of pressure on the health services as people wouldn’t be going to hospital and using resources and time that wasn’t necessary. However, although this isn’t backed up with evidence, if it is just a placebo effect it may cover up the real problem which may come to light later, which could be too late. I think its a personal choice, as not everyone want to put chemicals into their bodies but want to use natural sources to get better. Alot of illness can be overcome just by change of thought, by thinking more positive, if these remedies make someone think positively and this helps them get better then I think its quite good.

    From Canada
    In our nursing program, we were not really taught any forms of alternative medicine so I do not have enough evidence to base my decision on. However, I know that some forms of alternative medicine are being implemented in medical schools since they are realizing that “western” medicine is not effective for treating chronic illness. If treatment from western medicine do not work, people should have freedom to choose other forms of medicine whether it be from herbs, acupuncture, etc. And whether it’s from placebo, herbs, or not, if they seem to have a better outcome from patient’s point of view, we shouldn’t stop them from seeking it out since they have the right to their own care.

  2. While the biomedical evidence may be lacking or absent at this time, to completely disregard alternative medicines would not be appropriate. Especially in Western society, there is much information we do not understand in regards to traditional medicine. For example, ancestors passing on their special medications/remedies may have a better understanding of them than any physicians here in North America.

    Overall, to advertise alternative medicines as an effective drug may be wrong, since in some cases a placebo effect is the only thing that is actually occurring. But one must be entirely sure that there is no biomedical or pharmacological effect of these alternatives, before dismissing them as merely placebo. Hence, it remains essential to study certain medicines, as opposed to dismissing them all entirely.

  3. Thanks for your responses. You all seem quite accepting of ‘alternative’ and/or ‘traditional’ medicine. There seems to be two primary points being made, the first that if it makes people feel better, then whats the problem and the second there doesn’t seem to be much research in the area. Well let’s get a bit provocative…Isn’t homeopathy is a multi million pound, international industry that trades on desperation and ignorance? Smoking used to make me feel much better, but I doubt if my doctor would have agreed!
    As for the lack of research, well, there isn’t much, that’s true, but the primary reason is that the work that has been done finds no evidence in favour of homeopathy and remember, research costs money. There are perhaps, better things to spend it on.
    Having said that, please feel free to come back to me and thanks for the inputs. I’ll look forward to reading your responses to question 3.

  4. Hi folks,

    Great discussion thanks. Indeed, there are many alternative, traditional or complementary therapeutic health practices, but as discussed, the question is “do they work, and how do we know they work?”

    We still don’t understand exactly how some established medicines work (e.g. steroids), but we have some theoretical ideas and more importantly have excellent verifiable evidence of their effectiveness for a range of conditions.

    In the 2005, August 27 issue, The Lancet published an article titled “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy”. It was based on a metaanalysis done by Aijing Shang, Karin Huwiler-Müntener, Linda Nartey, Peter Jüni, Stephan Dörig, Jonathan A C Sterne, Daniel Pewsner, and Matthias Egger (of Switzerland’s University of Berne). It found that overall homeopathic remedies were no better than placebo, as have a number of other studies.

    As scientists I would argue we should explore what we don’t understand, and in the case of homeopathy there has been a huge body of investigative work undertaken, and it has been clearly established that there is no evidence to support it’s use or value. So, as Roger notes why do you think it still persist as a therapy valued by significant members of western society? I would be interested to hear if homeopathy is as popular in Africa. Let us know!

    Some Interesting (and fun) Links:

    http://www.badscience.net/index.php?s=homeopathy

    http://hpathy.com/homeopathy-scientific-research/homeopathy-research-the-lancet/

    Bernie

  5. We both had opinions on the use of homeopathy but for some reason we were cautious to make any conclusions. Although there is a lack of evidence to support the use of it, there is also a lack of evidence for any reason not to use it. For example, acupuncture is a commonly used alterative treatment and has been around for over a millennium, so why should we stop using it.
    It was mentioned in the question/blurb about ‘flow of energy’ through the body and’ life energy’. Although we know very little quantative data about the subject a great deal of science is founded on arguably unquantifiable things. And just because we have not been able to measure it does not
    mean that we should reject it.
    The question says, “…isn’t letting people believe that something is going to do them good, when there is no evidence … contrary to our science training?,” which it may well be. But isn’t stopping people using homeopathy when although it may not do them any good, there is no evidence to prove that it does them any harm, other than financial.
    Is it any wonder that some people want an alternative method of treatment to our traditional methods of drugs and medication. When you can look on the back of any medicine and see the never ending list of ‘possible side effects’ which can do you harm.
    So, for the time being, we think we might want to first examine our own western medicine back yard before we go messing in alternative medicine’s back yard…
    Tim & Emily

  6. Great comments,

    One of the main issues with homeopathy is the actual infinitesimal dilutions of the active substances used (which work out at about 1 molecule in a sphere of fluid that stretches from the earth to the sun)!

    Anyhow I thought you folks might enjoy this, and hope our colleagues in Africa can access this very funny video.

    https://www.youtube.com/watch?v=HMGIbOGu8q0

    Regards
    Bernie

  7. From Ethiopia

    Homeopathy (traditional medicine) in Ethiopia includes medicinal preparations from plant, animal, and mineral substances, as well as spiritual healing, traditional midwifery, hydrotherapy (holly water), massage, surgery, and bonesetting.
    Homeopathy, here in Ethiopia, is largely practised by traditional medicine practitioners, although, particularly for certain common health problems, it is also practised at home by the elderly and by mothers.
    Majority of our rural population and sectors of the urban population rely on homeopathy where there is little or no access to modern health care.
    people here rely more on homeopathy for economic reasons than for any other reasons, the deeply entrenched attitude and the lack of modern health care being contributing.
    As per to the question my idea is we don’t have to run to reject homeopathy ( traditional medicine) merely because they don’t depend on scientific background. I personally have seen the traditional healers curing a range of diseases from a simple nodule to a full blown jaundice. I saw a fully diagnosed jaundice man to be cured with a simple leave extraction with no recurrence. Especially to countries like mine, traditional healing systems are doing great though they have an avoidable side effects and they are not always found effective.
    My recommendation is much research and education is needed as neither officially recognized education is provided in traditional or complementary/alternative medicine nor does any research is done so far.

  8. Thanks Hale,
    Great points thank you. I am not sure if homeopathy here has a different meaning to the Eithiopian context, as here is refers to a very specific health treatment (see http://en.wikipedia.org/wiki/Homeopathy ), rather than traditional medicine generally.

    I think your point on exploring these practices with further investigations and getting evidence is an excellent one. However, homeopathy has had a lot of research done on it over the years and is a therapy that lacks any supporting evidence, as it appears to offer no difference in outcome compared to placebo. Are there other specific theraputic practices that people think should be further investigated, which don’t currently have an evidence base?

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