Cure or con? Do you think homeopathy can heal?

Every year, more Canadians embrace alternative medicines such as homeopathy, a fascinating and controversial 200-year-old system of medicine. In fact, its proponents swear by its unconventional focus on treating symptoms rather than diseases and reliance on a cornucopia of all-natural remedies, taking its claims to heal everything from colds to arthritis as a matter of faith.
For others, its hard-to-explain “science” is chalked up to hocus-pocus -- at best a placebo effect that could be dangerous should Canadians choose it over modern medicine.

Naysayers (many GPs among them) contend that the pending regulation of homeopathy in the province of Ontario, in spite of setting consistent standards of training and treatment, would give it a stamp of credibility it doesn't deserve. To complicate matters further, some homeopaths don't want regulation because it insinuates the medicine is unsafe. So where does this leave you? Here's what you need to know before trying homeopathy.
What is homeopathy
Homeopathy is a system of medicine based on a theory of healing called The Law of Similars. In a nutshell, the law alleges that a disease with a given set of symptoms can be cured by a medicine that is known to produce a similar set of symptoms; for example, a homeopath might prescribe coffea cruda (unroasted coffee) for insomnia and allium cepa (red onion) for watery eyes caused by allergies. Homeopathy was founded by a German physician, Dr. Samuel Hahnemann, in the early 1800s and flourished for 100 years before waning with the advent of modern medical science and pharmaceuticals in the first quarter of the 20th century. But by the 1980s, the manufacture and sale of homeopathic remedies was on the rise in Canada.

Today you can walk into a natural health products store and purchase a homeopathic remedy, often in liquid or pill form, for certain symptoms. Homeopathic medicines are regulated by Health Canada's Natural Health Products Directorate and labelled “HM.”

Rather than self-treat, however, homeopaths recommend that you consult with a trained practitioner. “Each treatment is highly individual,” explains Maya de Szegheo-Lang, a homeopath and president of the Ontario Homeopathic Association, which represents about 200 homeopaths. Homeopaths do not try to diagnose you by identifying the cause of symptoms like a GP would; instead they collect a medical, physical and emotional history of your life to help identify your symptoms. They believe that nothing can be known about disease except what is seen in the symptoms, and that symptoms are signs of the process of healing in a specific ailment. This is why symptoms guide homeopaths' remedies.

How much does it cost?
An initial consultation costs about $150 and often includes the remedy. Subsequent visits are anywhere from $40 to $60, says de Szegheo-Lang. Some health plans cover the cost of homeopathy, so check your plan. You can also get a homeopathic remedy from a naturopath who is trained in homeopathy. The difference between the two is that naturopaths treat with integrated medicines, including herbs, acupuncture and massage, whereas homeopaths use a specific treatment system that consists mainly of homeopathic remedies.

How does it work?
Homeopathic remedies are infinitesimal amounts of plant, animal and mineral substances, that, in a healthy person, are purported to cause the symptoms of the disease being treated. (Don't confuse the technique with vaccinations or immunizations, which contain some of the specific disease-causing agent to help your body build immunity.) Remedies are diluted and shaken down to the point that there is virtually nothing of the original substance – except its purported “energy signature,” says Rudi Verspoor, past-president of the National United Professional Association of Trained Homeopaths (NUPATH) in Belleville, Ont. Homeopaths believe the higher the dilution, the more powerful the remedy. More than 2,000 tinctures have been discovered through cumulative “provings,” a single trial with a single individual who purports to establish the medicinal effect. (Homeopaths very rarely use clinical trials to test remedies.) Most practitioners refer to the Homeopathic Pharmacopoeia of the United States, a guide that is compiled and maintained by the practice in the U.S.

Supporters of homeopathy explain it in metaphorical terms: disease is energy, and the energy signature of the substance in effect “cancels out” the disease. “It's a law of physics,” says Verspoor. “If you have two similar waves of energy coming at each other, the two cancel each other out.” Dr. Heather Boon, an associate professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto, doesn't recommend homeopathy but says that from a scientific point of view, physicists won't dismiss its theories as entirely impossible. They are familiar with other cases of matter and energy interacting in ways that are sometimes counterintuitive. “More research is needed,” stresses Boon. Verspoor admits that the theory that disease is energy, and that there are energy signatures in homeopathic remedies, is “complete nonsense” when judged by current medical and scientific knowledge.

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Why is it popular? Does it work?
There is anecdotal evidence that homeopathy works, and there are 500 practitioners in Ontario alone. “Many people are drawn to homeopathy because they feel it is all-natural and has no side-effects,” says Dr. Lloyd Oppel, a physician and professor at the University of British Columbia in Vancouver who specializes in analyzing the research on complementary medicines. According to Ontario's Health Professions Regulatory Advisory Council (HPRAC), up to 20 per cent of Canadians seeking alternative remedies use homeopathic options. In the past 20 years, de Szegheo-Lang has seen cases of everything from colds to flu viruses to mental and emotional issues. Verspoor says he sees patients for everything from arthritis to depression.

However, research has yet to provide a conclusive answer supporting the effectiveness of homeopathy. While there are hundreds of studies that show homeopathy may successfully treat an array of ailments, there are as many studies that indicate the opposite is true, says Boon.
If it's safe, why regulate it?
Regardless of whether homeopathy works, HPRAC found there was enough public interest to warrant regulation. Debate on the dangers of homeopathy is mired in politics between associations pushing for and against regulation in Ontario (a landmark decision since other provinces will likely follow Ontario's lead). In order for a health practice to meet the criteria for regulation, there must be proof of risk of harm. And the Ontario Homeopathic Association (OHA), in its case for regulation, noted that there is a significant risk from homeopathy, chiefly the result of improperly prescribed remedies. Many individual practitioners, as well as NUPATH, the other large provincial association, vehemently disagree with the OHA's claims and do not want regulation. “Homeopathy is not harmful in any way. We believe this is a political issue,” says Verspoor.

Nevertheless, after conducting a lot of research and hearings with industry stakeholders HPRAC recommended homeopathy be regulated by the Ontario Ministry of Health, in part because it poses direct and indirect risks of harm. Specifically, it found there is chance of adverse reactions, allergic reactions to low-potency preparations, and compounding (making someone more ill), as well as risk of misdiagnosis, preventing or delaying effective treatments or interference of remedies with conventional treatments. No one interviewed for this article could cite a case of death as a result of homeopathy in Canada, although the OHA gathered many anecdotal incidences of adverse reactions from published literature. All stakeholders, including GPs, agree that reactions are likely underreported in Canada.

HPRAC stated in its proposal to the ministry that it is generally agreed that if a remedy is properly prescribed by a well-trained homeopath, there is a low likelihood of side-effects. But without a recognized accrediting body, there is no assurance that all homeopaths are trained equally. And since there are no regulations for homeopaths in Canada, anyone could call her or himself a “doctor of homeopathy.”

Another potential safety concern identified by HPRAC involves a group of homeopathic practitioners called Heilkunst. They contend that conventional vaccinations are risky because they can cause death and recommend homeopathic “vaccinations” instead, which are oral doses of homeopathic remedies. “The issue is not that we are against immunizations,” says Verspoor, a Heilkunst-based practitioner. “There's no doubt they are a good idea. The big issue is what form of immunization you get.”

Oppel says that if regulations are passed, homeopaths, like other medical practitioners, will establish their own governing body, effectively resulting in less protection for the public, who will perceive regulation as “a stamp of approval.” Putting faith in ineffective therapies, such as homeopathy, he says, can cause people to: “waste money, turn down effective treatments or delay getting real help when such assistance truly is needed. It's the same thing we all do as parents when we comfort a child with a kiss. But there's a huge difference between temporary psychological comfort and actually fixing the problem.”

While there was obviously some proof homeopathy works or HPRAC wouldn't have considered it for regulation, it didn't examine efficacy as part of the proposal. Homeopathy is one profession among several up for regulation in Bill 171, which is in its second reading and could be passed within the year. If passed, it would take several years for standards to be developed.

Can a homeopath replace my GP?
The short answer is no. A homeopath cannot refer you to a specialist, provide injections, conduct a Pap smear, take blood or prescribe pharmaceuticals. Regulation will not enable one to do these things either. Someday the OHA would like practitioners to be able to diagnose illnesses; however, they would need permission (it's a controlled act). If you choose to get treatment from a homeopath, let your GP know of the health problem and your plan to get advice from outside the medical field so he or she is aware of all the factors that may affect your health.

Should I try it?
“It can't work and it doesn't work,” says Oppel. Boon agrees, but says if you try it, remedies labelled between 12C and 30C should not trigger allergies.

Start with an association to find a homeopath. Until regulations are in place, ask where the practitioner was trained (there are 17 facilities in Canada) and if she is a member of an organization. Investigate organizations' codes of ethics and standards of practice. At the end of the day, use your judgment -- you're ultimately in charge of your health.

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