Don't ask the homeopath if you need a haircut

The November 14, 2008 edition of the Now EMC Ottawa-Orléans was kicking around my bag, and a couple weeks ago I got a chance to skim through it. This article on homeopathic flu remedies really got my goat and I wanted to write a letter to the paper's editor about it, but it was a bit late. Now it's really past due to respond in the paper, but I read the article again today and had to respond somewhere. So I'm doing it here, and I've spent all night to write out a full response (pardon any sleep-related errors). Click the article image for a closer view.

As my scribblings suggest, I have a great deal of problems with this article, and it's hard to figure out where to start. I could just embed a video of James Randi's critique of homeopathy, but that doesn't do this article justice. So I've put his video at the end of this post.

First, let me get out of the way the most obvious objections to the article:

• The byline refers to her as "Dr. Irma Boyle," which in the context of medical advice, suggests an M.D., which Boyle does not possess. However, this unfortunate attribution was likely made by the newspaper editor.
• Right off the bat in the third paragraph, Boyle suggests that "an oral homeopathic flu remedy" has the same effect as a flu vaccine. (If you're not already familiar with homeopathy and why it's a sham, see the YouTube video below, or read through the Wikipedia article)
  
• In fact, the article and headline both suggest that a "remedy" can be used for "immunization." This is impossible, as remedies cure problems, whereas immunization prevents them from happening in the first place.
• Boyle says "asking your doctor and getting information from the internet will give you more details on [the flu vaccine's] material chemical content." Repeat after me: DO NOT USE THE INTERNET TO SEEK MEDICAL ADVICE. If you have concerns about the flu vaccine, talk to a doctor. Preferably your doctor. Definitely a medical doctor. (Incidentally, this is not medical advice. This is criticism of something that closely resembles medical advice.)
  
• It has obviously been a long time since Boyle has associated with real medicine, because she claims that "the flu shot is injected directly into your bloodstream." It isn't. It's injected into your muscle tissue.
• She goes on to say frightful things about the flu shot, culminating in "it by-passes your natural defenses and weakens your overall immune system." Which is also patently false.
• The four final paragraphs (only the last three are italicized) advertise Boyle's services. While it references her "free homeopathic flu remedy clinic dates and locations" (two locations and two dates are listed on her website), Boyle's appointments normally cost $200 for the initial visit.
  

Before I delve into the details of the above points, I'd like to share some gems about the claims made on Boyle's website, healthdynamics.ca:

On the "flu vaccination vs homeopathic flu immunization" page, Boyle cites "the Dolisos(Boiron) Research Letter," which contains a text block of medical-sounding gobbledigook about Influenzinum and Thymuline, which apparently "are homeopathic remedies that are used in the oral homeopathic flu remedy."

• However, I am unable to find such a letter online. Archive.org doesn't have any entries for www.dolisos.ca after February 2007, and for www.boiron.ca after December 2007.
  
• The only results for this letter that I can find in a Google search are other homeopathic websites with similar (if identical) references to this alleged letter.
• Google Scholar returns no results for "influenzinum." Thymulin (evidently our esteemed colleagues at Dolisos zealously added an "e" to the name), being a hormone produced by the thyroid, has many hits in PubMed; the only reference to "Thymulin AND flu" appeared beacuse of references to "immunofluorescence."
• Therefore, not only is there no evidence of this letter claiming clinical success in demonstrating the effectiveness of these two chemicals "in infinitesimal dilutions," but there appears to be no published research about these two chemicals at all!

This, while egregious to my sensitive sense, pales in comparison to what we find on another page. Under "List of conditions that can be treated," Boyle lists a litany of "conditions and disease that are treated with Heilkunst and Advanced Homeopathy at Health Dynamics. These include physical, emotional, mental, relational, financial, life, career and soul/spiritual issues, ailments, conditions and dis-eases." This is directly reminiscent of the snake-oil carnival vendors who would claim their potion would cure whatever ails you. But this isn't the egregious thing.

On the same page are listed thirty-seven benefits of Homeopathy and Heilkunst, including this tremendously unredundant sample:

• Have more confidence – self, body, mental, emotional, physical, relationally.
• Get yourself out there even more than you are and have the confidence and clarity to do so.
• Speak and act with more confidence. Have a strong and clearer voice.
• Be and feel more present in the moment.
• Step into the world more.
• Be and feel more present in your day to day life.

But that's still not the nasty bit. Following the glowing list of benefits are "more examples of everyday occurrences for which Homeopathy and Heilkunst can be used successfully." She goes on to explain a vaccination-related application that isn't mentioned in her New EMC article. In the article, the homeopathy remedy was touted purely as an alternative form of vaccination, but on her website, she suggests the remedies "before and after each shot to avoid the potential traumatic effect of the event and the toxins involved." Not to be outdone, she subsequently suggests "the use of the same homeopathic remedies to create natural immunity to disease for those patients who prefer to not take the risk of a chemical vaccination."

We're almost at the nasty bit. She talks about travel immunizations. The fact that people will use homeopathy to immunize themselves for travel is a serious public health threat. She cites the "successful treatment of Cholera during an epidemic popularized homeopathy on the European mainland 200 years ago" as evidence for the effectiveness of travel immunizations. I will note that this predates the development of the modern scientific method.

But this is the part that knocks my socks off: the part where she lies!

Here is what she says: "In one large-scale study in Brazil in 1974 more than 18,000 children were successfully protected with the homeopathic remedy Meningococcinum against Meningitis, with no notable side effects (Ref. British Medical Journal, 1987:294-6)."

Here (PDF) is the article referenced. British Medical Journal, Novemer 28, 1987, pages 294-296. The title of the article is "Vitamin A supplements and mortality related to measles: a randomised clinical trial." It refers to a study conducted in Africa, not Brazil. In fact, the terms "Meningitis," "homeopathy," and "Brazil" don't appear anywhere in the article. Nor, even, does "1974"!

A closer look.

All this fishiness warrants a closer look at this article.

Let us start from the top.

How qualified is Irma Boyle?

On the "Flu vaccination vs homeopathic flu immunization" page on her website, she draws out the alphabet soup: "Irma Ally Boyle DMH, DHHP, DynBC, B.A. Psych."

• Let's start from the end. She has a bachelor's degree in psychology. On her "about" page, she also says she has a degree in computer science. I have no reason to doubt either of those (though she doesn't say where she got those degrees or when).
  
• DynBC apparently refers to "Certificate in Dynamic Blood Analysis," according to Heilkunst.com. A Google search for Dynamic Blood Analysis returns only references back to heilkunst.com and homeopathy.com (which are effectively the same website), and some scientific papers. Unfortunately, the scientific papers are all in engineering journals, and are not of a medical nature.
• DHHP refers to "Practitioner Diploma in Homeopathy and Heilkunst," a diploma received after the completion of a 4-5 year course of studies. This includes a module on Dynamic Blood, which seems to make the above diploma redundant.
  
• Upon payment of annual fees to the Canadian/International Heilkunst Association at www.heilkunst.com, DHHPs can use the tile "Doctor of Medical Heilkunst" (DMH), making the DHHP also redundant. Kinda like saying "I have a Ph.D. in Economics, as well as a Master's Degree in Economics and a Bachelor's Degree in Economics! Three degrees!"
• However, the website of the Canadian - International Heilkunst Association (whose website is actually at http://heilkunstinternational.com) recommends "To make clear that one is not a “Dr.” or “Doctor” as such. For example, using the title before the name generally denotes an MD. Avoid using the title of “Dr.” or “Doctor” (before your name) and specify exactly what type of doctor is designated."
  

And what, exactly, is Heilkunst? Best I can tell, it's an euphemism for "homeopathy," presumably that particular branch that jives with Canadian regulations on homeopathy. If you're not already familiar with Homeopathy, I again beseech you to take in the YouTube video at the bottom of the post.

• The German word for "Homeopathy" is "Homöopathie," so it doesn't mean that. It doesn't remotely resemble that.
• "Heilkunde" is the German word for "medicine". It definitely resembles that word.
  
• "Heil" means "well-being"; "Kunst" means "art", so "Heilkunst" presumably means "the art of well-being"
• "Heilpraktiker(in)" means "non-medical practitioner"
• Therefore, in English, "Medical Heilkunst" seems to suggest "Medical non-medical practise."
  
• But whatever the word might mean in German, the term is being used in English. What you need to know is that "Medical Heilkunst" is not English for "Medical doctor." Therefore, you should seek a medical doctor for medical advice. Not a Doctor of Medical Pixiedust. Not the Internet.
  

What does she say about flu shots?

Well first, let's look at what is known about flu shots from empirical data:

• According to Health Canada, "an estimated 10-25% of Canadians may get the flu each year," and "an estimated 4,000 to 8,000 Canadians, mostly seniors, die every year from pneumonia related to flu and many others may die from other serious complications of flu."
• Because of this, Canada's National Advisory Committee on Immunization encourages all Canadians over 6 months of age to get a flu shot.
  
• The Ontario Ministry of Health and Long-Term Care says that "Ontario is the only jurisdiction in North America to make the influenza vaccine available free to all residents."
• It is free, and it is likely to reduce your chances to get the flu. The only reason an objective person would advise against getting a flu shot is if it is dangerous.

While she doesn't outright say it, Boyle certainly paints the flu shot in frightening terms. I've already pointed out and refuted her erroneous claims that "the flu shot is injected directly into the bloodstream" and that it weakens the immune system. She also point out that:

• "Getting the flu shot means that your body is injected with substantial amounts of several viruses along with other toxic materials used to preserve the vaccine." (Okay, "substantial" amounts if you're used to dealing with homeopathic dilutions)
  
• "Along with the virus material, the vaccine fluid may contain chemical carrying agents." (And your homeopathic pill contains lactose as a carrying agent. Lactose is also a chemical. As is water.)

She contrasts this with the wonderful and painless homeopathic "remedy" which has the following benefits:

• It's not an injection, but "processed orally through the mucous membranes, as it would be if the virus were contracted naturally."
  
• This dose provides "an extremely minute amount of the virus material alone," and "because the viral agent is so diluted, it's a lot less toxic and doesn't place strains on the body's filtering system (kidney, liver)." (This suggests that the flu virus is toxic (i.e. "Having a chemical nature that is harmful to health or lethal if consumed or otherwise entering into the body in sufficient quantities."), which is technically true (in the sense that water is toxic if consumed "in sufficient quantities"), but highly unlikely. The net result of a flu vaccination is to boost health, not harm it.)
  

Now, the article proceeds, that you've been presented with this frighteningly terrible flu shot, and this painless and riskless homeo-pill, "what would you like to introduce into your body"? Oh, by the way, the author has some free homeopathic flu remedy clinics and more information on her website.

Except the homeopathic stuff doesn't do as promised. Health Canada's "Evidence for Homeopathic Medicines" guidelines require homeopathic remedies to be diluted to at least 12CH. Which, according to this page, means one part per 10²⁴ parts--Avogadro's limit. Simply put, beyond this degree of dilution are not likely to have a single molecule of the active ingredient present in the solution. Yet homeopaths claim that this still has remedial properties--indeed, that the more diluted something is, the better!

After 200 years of practise (older than modern medicine!), certainly you'd expect there to be lots of research showing how Homeopathy works.

Frankly, skeptics like Randi and me would settle for evidence that it works, much less how. Scientific literature on the topic of homeopathy returns this type of conclusion:

• "Up to now, no research has categorically proven that homoeopathy has a specific pharmacological action, consequently it is not a proven scientific therapy. " (Mudry, A. "Is Homeopathy a Scientific Therapy?" Rev Med Suisse Romande. 2000 Feb;120(2):171-7 )
• "Contrary to many claims by homeopaths, there is no conclusive evidence that highly dilute homeopathic remedies are different from placebos. The benefits that many patients experience after homeopathic treatment are therefore most probably due to nonspecific treatment effects. Contrary to widespread belief, homeopathy is not entirely devoid of risk. Thus, the proven benefits of highly dilute homeopathic remedies, beyond the beneficial effects of placebos, do not outweigh the potential for harm that this approach can cause." (Ernst, E. "Is homeopathy a clinically valuable approach?" Trends Pharmacol Sci. 2005 Nov;26(11):547-8. Epub 2005 Sep 13. )
  

The burden of proof is not on me to prove that Homeopathy is ineffective; the onus is on homeopaths to prove that their dilutions actually do anything. Nevertheless, criticisms by skeptics are often met with accusations of bias, and claims that skeptics aren't being open-minded. Open-mindedness, however, can have serious consequences when extended beyond the rational...

It is unfortunate that the New EMC was tricked into printing this homeopathic drivel as "health" advice, though I don't think the publishers will care. Ms. Boyle's article is a collection of FUD to promote distrust in evidence-based medicine while simultaneously peddling their overpriced sugar pills. If she has tricked herself into believing this stuff as well (which is questionable, considering the outright lies exposed above), then that is a pity as well.

And what, exactly is homeopathy?

For those who aren't familiar with how insanely impossible it is for a homeopathic solution to have any effect, please view James Randi's concise description of homeopathy:

If you can't believe his characterization, check out the Wikipedia article on Homeopathy, or browse a homeopathy book at the local library, and you'll see it's exactly the same as he describes it, only with a bit more pixie dust.

- RG>