Lactose Intolerant

By Jim McVeagh 11/02/2010 7


The recent stunt by the New Zealand Skeptics Society might be very amusing, but it fails to add much to the debate on homeopathy. The skeptics swallow large amounts of homeopathic remedy to attempt to show its overall uselessness. Unfortunately, this demonstration is no more significant than an atheist demanding that God strikes him dead with a thunderbolt to prove his existence and then claiming that proves God does not exist, because he survived. I suspect it does little more than ignite acrimonious debates and certainly proves nothing at all. One hopes that none of the skeptics involved were diabetic – ingesting that much lactose (the principle ingredient) might push them into a coma.

There is no real scientific theory to explain the “effects” of homeopathy above and beyond the obvious one of placebo effect. I recall reading an article in New Scientist (that I can no longer locate) which described an elegant experiment that demonstrated that protein molecules being created by DNA, folded themselves into their normal shapes much faster than simple molecular attraction would allow, suggesting that, perhaps, water maintains a memory of the shape of the protein molecule; helping the long strand fold into its working shape. This is a far cry, of course, from suggesting that water maintains the memory of the shape of arnica after a 30C dilution. It also ignores the fact that the single glass of water you use to swallow the arnica would contain billions of other different “memories”. It also gives no insight into how that “shape” (should it exist) can alleviate symptoms caused by entirely different molecules.

The lack of a coherent scientific theoretical basis does not necessarily invalidate homeopathy. The claim “we have no idea how this works, but it does work” is not an unreasonable one (we can call it awaiting a scientific theory), if one can prove a reproducible effect. This is the essential problem with homeopathy. Occasional RCTs may show an effect above and beyond the placebo effect, but this effect is not reproducible in subsequent trials, particularly trials with larger numbers of subjects and more rigorous designs. The net result is that, when analysed together, homeopathic trials demonstrate only placebo effect and a little observer bias. Shiang et al’s meta-analysis Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy (Lancet 2005; 366: 726—32) showed that, once they were controlled for observer bias, homeopathic trials demonstrated only an effect similar to placebo, whereas comparative conventional medicine trials produced an effect far above the placebo effect. I have not seen a convincing homeopathic rebuttal to this study, though several have been attempted.

I have several colleagues who use homeopathic remedies on a regular basis in their practice. I have no particular objection to this. I occasionally deliberately use a placebo to help a patient overcome a problem that is clearly volitional rather than pathological. Some would charge that this is unethical and an abuse of the patient’s right to choose. I say that is politically correct nonsense.

I do, however, have a problem with the pharmacies selling these remedies over the counter. As far as I am concerned, they may as well be charging for magic water. Homeopathy proper requires a great deal of input from the practitioner to determine the symptoms and settle upon an individualised regime. Buying an over-the-counter homeopathic medicine for “allergies” is simply purest quackery, regardless of what you may think of homeopathy itself.

I also have grave doubts about practicing homeopathists with little or no medical training. These people are not skilled enough to recognise an illness that requires conventional medication urgently. In fact, their very suspicions about the nature of “allopathic medicines” may make them resistant to referring a patient on to their general practitioner. This disadvantaging of patient occurs far more often than you would like to think. Fortunately serious harm or death is rare.

Complementary medicine needs to follow the rules of proper scientific enquiry – develop a theory, test it, reject it for another. Instead, most CAM studies consist of anecdotal series or poorly design small trails that serve little purpose than to fool a lay person. I am not a skeptic about homeopathy – I am prepared to view it with an open mind, But that does not mean I will uncritically accept anything thrown at me.

Show me some real science. I will be listening.

Additional

Peter Cresswell provides some amusing and interesting links on this issue.

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7 Responses to “Lactose Intolerant”

  • “I am not a skeptic about homeopathy – I am prepared to view it with an open mind, But that does not mean I will uncritically accept anything thrown at me.

    Show me some real science. I will be listening.”

    Which is what any reasonable sceptic should say. Sceptic =/= close minded.

  • Indeed, that was poorly expressed. Unfortunately, once you’ve pressed “publish” it’s pretty hard to change it unless you stop it straight away. *Sigh*

  • While the general thrust that homeopathy needs to demonstrate it’s claim itself with evidence, etc., is fine, but excuse me nitpicking this…. (maybe you were just having an off day…)

    protein molecules being created by DNA, folded themselves into their normal shapes much faster than simple molecular attraction would allow, suggesting that, perhaps, water maintains a memory of the shape of the protein molecule; helping the long strand fold into its working shape

    needs more explaining. With no disrespect I’m not even sure what point you’re trying to make with this never mind precisely what molecular activity you are referring to. Reference please?! (Food for thought: when I can’t chase something back to it’s source, I resist including it in a blog post…) In particular, this bit doesn’t make sense to me: “suggesting that, perhaps, water maintains a memory of the shape of the protein molecule”. I doubt that this will be whatever the science is demonstrating.

    I would guess/take it that this is referring to some sort of chaperone activity, and hence that the molecule being folded is protein, but then what’s the reference to “being created by DNA” for then? It wouldn’t be relevant unless it’s a clumsy attempt to capture the central dogma. (Unless it’s referring to the likes of teleomerase.) My wild guess is that what might have been illustrated was local effects on water structure induced by the protein or the chaperone which, in turn, aid folding; these would have nothing to do with a “water memory” per se. But then again I really need to know what it is that your are referring to first.

  • Picky, picky…

    If I was writing a scientific paper rather than a blog, I would certainly agree with you. And if I was actually trying to develop a comprehensive theory for homeopathy, I most certainly would need more evidence. But I am writing a blog designed to be interesting and spark debate. As such I can usually get away with murder (figuratively speaking of course), knowing I will be corrected by commentators if I am wrong. In this case my point still stands, regardless of the nebulous nature of the article I am trying to recall – homeopathy is without a decent scientific theory.

    However, because it’s you, Grant, I endeavored to find the original article. No such luck – but I did find an article in an similar vein HERE.

  • I generally try to read through posts a couple of times before publishing and I still find I miss things so fair enough.

    On topic though, I would say that the reasonable arguments against homeopathy have been made ad nauseam (though they should continue and this is a good piece) but the public yawns through them. Sometimes a stunt is what is needed to get them to sit up and take notice. But I agree that a stunt is a poor basis for for a reasoned position.

  • Far from being picky, I was being generous, giving you the benefit of the doubt. Your excuse re writing a blog vs. a paper doesn’t wash with me. You’re writing for the public who unfortunately tend to consider doctors as having credibility. I think that what comes with that is a responsibility to check what you’re saying. Perhaps that’s just me (and other scientists): we like to make sure what we’re saying is right first.

    I ran into the particular “example” that you cite myself (I did take the trouble of searching before asking), but disregarded it as (a) it isn’t based on what you describe and (b) my memory was that it had been debunked. You’re welcome to locate a replication of this “finding” by a credible source to back your support for it. I haven’t time to do this homework for you, but I’d point out that people have widely pointed out the the lack of controls. (It’s well outside my field, but I’d venture a guess that all this work is illustrating is that if you shake water, gas that gets mixed into it alters it’s atomic properties when viewed in toto, which wouldn’t be particularly surprising to me. That wouldn’t say anything in favour of “succussion” or “water memory”.)

    Of course your main point stands, I said as much myself in my comment. However, both of your “examples” don’t.

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