Fibromyalgia Homeopathy

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Homeopathy, or homeopathic medicine, is a medical therapy that is designed to stimulate the body’s natural healing ability. Homeopathy was invented in Germany more than two centuries ago; it has been practiced in the United States since the 1800s.

The premise of homeopathy is “like cures like,” meaning that a disease or symptom can be ‘cured’ by a substance that produces similar symptoms in healthy individuals. Homeopathy is performed by administering extremely small, diluted doses of substances that would normally produce illness or symptoms if administered in larger amounts. This “law of minimum dose” posits that the lower the dose, the more effective it is at treating the disease. For the purposes of homeopathy, substances are diluted incrementally and then shaken in between each dilution – a process known as potentization. The process of potentization is thought to transmit information in the form of energy from the original substance to the final diluted product. In reality, many homeopathic remedies are diluted so thoroughly that none of the healing substance remains following the final dilution. Homeopathy controls for this, however, by purporting that the substance has left its “essence” in the solution, which then stimulates the healing processes within the body. This particular theory is known as the “memory of water.”  Homeopathic remedies are extracted from natural substances found in plants, minerals, or animals.

Homeopathic practitioners typically take into account patients’ personal health history and genetic history, as well as their body type, and current symptoms. Treatments are often lengthy in duration, as they are individualized to each particular patient and their needs. As such, two individuals with the same condition may received completely different homeopathic treatments. Homeopathy has been used for a variety of health conditions, including allergies and asthma, chronic fatigue syndrome, depression, digestive problems, ear infections, headaches, and skin problems. In addition, some individuals use homeopathy to promote overall well-being and prevent disease.

Homeopathic remedies are required to be prepared in accordance with the Homeopathic Pharmacopeia of the United States (HPUS) guidelines, which were included in the Federal Food, Drug, and Cosmetic Act passed into law in 1938. As such, homeopathic remedies are regulated in the same way that over-the-counter drugs are, however they are not required to undergo the same rigorous safety and efficacy testing. In addition, the US Food and Drug Administration requires that homeopathic remedies meet various legal standards with regard to their potency, purity, and packaging materials, and some remedies require a prescription in order to be obtained for use. In general, there are no widely known side effects of homeopathy, and it is generally considered safe; however, individuals considering homeopathic treatments should always consult with their doctor before starting any homeopathic therapy.

Homeopathy and Fibromyalgia

Very few studies have shown positive results for the use of homeopathy, and most scientific research has failed to demonstrate that homeopathy is useful in the treatment of any specific condition or illness. Homeopathy also falls under scrutiny at times due in part to the fact that several of its key principles are not in line with the most current and predominantly accepted understanding of chemistry and physics. Furthermore, there is extremely limited evidence regarding the safety of many homeopathic treatments. Overall, the effectiveness of homeopathic therapies is difficult to study, as most treatments are highly individualized on the patient-level, and the extremely diluted nature of most remedies makes them difficult to measure and then compare between studies.

Randomized controlled trials are considered the “gold standard” of research study design, and several such studies have found various homeopathic remedies to be superior to control interventions at treating fibromyalgia symptoms. Nevertheless, major flaws in study execution and a lack of reproducibility preclude the ability to declare homeopathy as an effective treatment for fibromyalgia (Perry et al., 2010). In addition, some studies have suggested that individual personality and historical factors may predispose some individuals with fibromyalgia to respond better to homeopathic therapy than others (Bell et al., 2004a).

One such study by Relton et al. (2009) found that fibromyalgia patients who were treated with homeopathy in addition to standard therapy had greater improvements in pain, fatigue, and tiredness upon wakening when compared to patients who only received standard therapy for their fibromyalgia. However, this study was limited by flaws in study design, lack of control for a placebo effect of homeopathy, and a high dropout rate among the standard therapy group, which reduced the power of the study to detect a difference between treatments. 

Bell et al., (2004b) also demonstrated that individualized homeopathic therapy was superior to placebo when administered daily to fibromyalgia patients over a four month period. Improvements were found for tender point count and pain, as well as quality of life, global health, and depression. This study was a more robustly designed randomized controlled trial that was methodologically quite sound. It involved the use of a crossover design, in which patients in both groups had the option to switch over and receive the other treatment at the end of the study. The only main flaw with this study pertains to this crossover period, as the inadequate length of time between treatments may have resulted in confounding of the results (i.e., the effects of the first treatment may have carried over into the second treatment phase).

Fisher and colleagues investigated homeopathy compared with placebo in a 1989 study in which study subjects received both homeopathy and placebo treatments. There was no break between treatments, which like the Bell et al. (2004b) study described above, may have confounded the findings. In addition, this study was flawed by a small sample size (24 total patients), a lack of detailed information regarding the manner in which patients were randomized to receive the treatments, and it also failed to provide any demographic data for the patients, which precludes generalization of the findings to various patient populations. Overall, this study found reduced pain and improved sleep in those who received the homeopathic intervention when compared to those in the control group (Fisher et al., 1989). However, a subsequent analysis of the same data, which was performed by other researchers who were not involved in the original study, found little if any evidence to support that homeopathy was effective at improving sleep or pain (Colquhoun, 1990).

More recent research by Bell and colleagues has documented brain wave changes, as measured by electroencephalograms (EEGs), may be useful at identifying fibromyalgia patients who have the greatest potential for successful outcomes following homeopathic therapy. These researchers have observed changes that correspond with reduced pain and overall health status improvement in patients who eventually show exceptional therapeutic response to homeopathy (Bell et al., 2004c)

Beyond the realm of fibromyalgia, homeopathy has also been studied for its ability to treat a variety of symptoms that fibromyalgia patients frequently experience. Homeopathy has been used in a number of studies to treat depression. It has generally proven to be less effective than conventional antidepressant therapy (Adler et al., 2009). This is due in large part to poorly designed clinical trials and insufficient sample sizes (Pilkington et al., 2005), as well as difficulties with regard to participant recruitment to studies (Katz et al., 2005). Despite these findings, more well-designed studies are underway to continue investigating the potential usefulness of homeopathy for depression (Adler et al., 2011). Homeopathy has also not proven useful in treating generalized anxiety disorder (Bonne et al., 2003) or chronic fatigue (Leyton & Pross, 1992).

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References

1.        Homeopathy: An introduction. National Center for Complimentary and Alternative Medicine. Last updated August 2010; Accessed April 26, 2012.

2.        Perry R, Terry R, Ernst E. A systematic review of homoeopathy for the treatment of fibromyalgia. Clin Rheumatol. 2010;29(5):457-464.

3.        Relton C, Smith C, Raw J, Walters C, Adebajo AO, Thomas KJ, Young TA. Healthcare provided by a homeopath as an adjunct to usual care for Fibromyalgia (FMS): results of a pilot Randomised Controlled Trial. Homeopathy. 2009;98(2):77-82.

4.        Bell IR, Lewis DA 2nd, Brooks AJ, Schwartz GE, Lewis SE, Caspi O, Cunningham V, Baldwin CM. Individual differences in response to randomly assigned active individualized homeopathic and placebo treatment in fibromyalgia: implications of a double-blinded optional crossover design. J Altern Complement Med. 2004a;10(2):269-283.

5.        Bell IR, Lewis DA 2nd, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin CM. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology (Oxford). 2004b;43(5):577-582.

6.        Fisher P. An experimental double-blind clinical trial method in homeopathy. Use of a limited range of remedies to treat fibrositis. Br Homeopath J. 1989;75(3):142.

7.        Colquhoun D. Re-analysis of clinical trial of homeopathic treatment in fibrositis. Lancet. 1990;336:441-442.

8.        Bell IR, Lewis DA 2nd, Schwartz GE, Lewis SE, Caspi O, Scott A, Brooks AJ, Baldwin CM. Electroencephalographic cordance patterns distinguish exceptional clinical responders with fibromyalgia to individualized homeopathic medicines. J Altern Complement Med. 2004c;10(2):285-299.

9.        Adler UC, Paiva NM, Cesar AT, Adler MS, Molina A, Padula AE, Calil HM. Homeopathic Individualized Q-potencies versus Fluoxetine for Moderate to Severe Depression: Double-blind, Randomized Non-inferiority Trial. Evid Based Complement Alternat Med. 2009; Aug 17. [Epub ahead of print]

10.     Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for depression: a systematic review of the research evidence. Homeopathy. 2005;94(3):153-163.

11.     Katz T, Fisher P, Katz A, Davidson J, Feder G. The feasibility of a randomised, placebo-controlled clinical trial of homeopathic treatment of depression in general practice. Homeopathy. 2005;94(3):145-152.

12.     Bonne O, Shemer Y, Gorali Y, Katz M, Shalev AY. A randomized, double-blind, placebo-controlled study of classical homeopathy in generalized anxiety disorder. J Clin Psychiatry. 2003;64(3):282-287.

13.     Adler UC, Krüger S, Teut M, Lüdtke R, Bartsch I, Schützler L, Melcher F, Willich SN, Linde K, Witt CM. Homeopathy for depression–DEP-HOM: study protocol for a randomized, partially double-blind, placebo controlled, four armed study. Trials. 2011;12(1):43.

Leyton E, Pross H. Chronic Fatigue Syndrome: Do herbs or homeopathy help? Can Fam Physician. 1992;38:2021-2026.

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