Evidence Check 2: Homeopathy - Science and Technology Committee Contents

Memorandum submitted by the Complementary Medicine Research Group, University of York (HO24)


  The Complementary Medicine Research Group is based within Department of Health Sciences, which in the 2008 Research Assessment Exercise, was rated joint first nationally for health services research. We have a strong track record of conducting clinical evaluations of osteopathy, chiropractic, acupuncture and homeopathy.

  We have five primary aims:

    1. To establish the clinical, economic and individual impact of complementary therapies for specific conditions.

    2. To evaluate the safety of complementary therapies.

    3. To develop evaluative methodologies appropriate to complementary medicine.

    4. To build capacity for rigorous research into complementary and alternative medicine.

    5. To disseminate the results of research in order to inform the public and influence policy and practice.

  We have been successful in attracting a range of funding from the National Institute for Health Research (NIHR), including a Career Scientist Award (for Hugh MacPherson at £365,000 from 2007 to 2012), a Research for Patient Benefit Grant (£250,000 from October 2008 to September 2011) and a Programme Grant for Applied Research (£1,300,000 from 2009 to 2014). More information about our projects and publications can be obtained from: https://hsciweb.york.ac.uk/research/public/Group.aspx?ID=4.


  Homeopathy is regarded with scepticism by the establishment yet it is widely used by the general public who often experience it as a useful adjunct to conventional medicinal care. While the plausibility of homeopathy is of concern to many scientists, its widespread use leads those of us who conduct health services research to call for more and better research into the evidence in the interests of the public good. In parallel with the increased public interest in homeopathy is the demand to show evidence of clinical efficacy. While the evidence base is currently patchy for homeopathy, as it is for quite a number of conventional medical interventions, the imperative from the research point of view is to conduct research that reflects the way homeopathy is used, whether as over-the-counter remedies or with a consultation by a homeopath. Such research should build on the current evidence base, which is summarised below.


  Since the early 1970s, there have been a total of 99 randomised controlled trials investigating homeopathy with over half of those conducted since 2000. The reports of those trials have been published in good quality peer reviewed journals, and the results show a mixed picture.

  In 44% (n=60) the studies report positive findings, where the homeopathy treatment showed statically significant superior effect compared to placebo, and those effects have been replicated by two or more studies in conditions of Childhood diarrhoea (individualized treatment), [1-3] Fibromyalgia, [4,5] Influenza, [6,7] Osteoarthritis, [8,9,10] Seasonal allergic rhinitis, [11,12-21] Sinusitis [22-25] and Vertigo. [26,27]

  There have also been positive findings in RCTs investigating: Chronic fatigue syndrome, [28] Premenstrual syndrome, [29] Post-partum bleeding, [30] Sepsis [31] and Stomatitis [32], however, for these conditions conducted between 2001 and 2005, there has been no replication to verify the findings.

  In contrast 7% of the RCTs reported negative findings, where the homeopathy was considered to have a worse effect than the placebo, whilst nearly half (49% n=68) find inconclusive results.

  Negative or inconclusive results have been observed for: Anxiety, [33-35] Childhood asthma, [36,37 ] Insect bites, [38,39] Menopausal symptoms in breast cancer, [41,41] Migraine, [42-44] Muscle soreness, [45-49] Post-operative bruising/haematoma/pain/swelling, [50,51-57] Rheumatoid arthritis, [58-60] Stroke, [61,62] Upper respiratory tract infection (prevention) [63,64] and Warts [65,66].

  The most robust evidence presented is from several major systematic reviews of randomised controlled trials. The aim of the systematic review is to assess the quality and rigour of the individual trials that are included, and then compare and contrast the findings of each and comment on the consistency or inconsistency of the findings as a body of work. To date there are eight systematic reviews that provide evidence that the effects of homeopathy are beyond placebo when used as a treatment for childhood diarrhoea, influenza, post-operative ileus, respiratory tract infection and vertigo, and three providing consistent evidence of effectiveness for hay fever and associated pollenitis.


  Although there is an increasing body of trials available, the lack of independent confirmation of reported trials and the presence of conflicting results is a major limitation to homeopathy research. Furthermore the general field is bedevilled by the lack of well-designed replicable studies conducted by independent research teams. Two key factors inhibiting current and future homeopathy research are the lack of adequate funding and lack of well-trained homeopaths who are sufficiently qualified and interested in engaging in objective research.

  Of those studies that have been conducted, a common finding by systematic reviewers is the poor quality research and weak methodology. Also problematic is the lack of reporting the key components such as allocation concealment after randomisation, pre-specified outcome measures, and the reporting of attrition rates and numbers of participants withdrawing from trials. The influence of indicators of methodological quality on study outcome cannot be underestimated. Linde and colleagues [67] find that studies with higher-quality scores had a tendency to be less positive than those with lower-quality scores. After discarding the lower-quality trials, however, they still found homeopathic treatment to be more effective than placebo.

  A common refrain among reviewers is to call for more trials and larger trials. However, it would be more meaningful to consider not only the need for more and larger trials, but for trials of more rigorous quality. Furthermore, we suggest that there should be a greater emphasis on comparisons to conventional treatments. There is a need for to develop pragmatic randomised controlled trials that compare homeopathy to the usual care available for the condition. For placebo controlled trials of homeopathic remedies prescribed by a homeopath, there needs to be a placebo control that adequately emulates the therapeutic relationship.

  Reporting of homeopathy trials will be enhanced by the implementation of the recent "RedHot" [68] supplement to the widely adopted CONSORT guidelines. The RedHot recommendations support the inclusion of information on consultations, practitioners, theoretical models, and case analysis strategies. These recommendations were developed as part of our research endeavour at the University of York to facilitate the replication of homeopathy trials and support the development of a more robust evidence base for homeopathy.


1.  Jacobs J, Jiminez L M, Gloyds S S, et al. Homoeopathic treatment of acute childhood diarrhoea. A randomized clinical trial in Nicaragua. British Homeopathic Journal, 1993; 82: 83-86.

2.  Jacobs J, Jimenez L M, Gloyds S S, et al. Treatment of acute childhood diarrhea with homeopathic medicine; a randomized clinical trial in Nicaragua. Pediatrics, 1994; 93: 719-725.

3.  Jacobs J, Jimenez L M, Malthouse S, et al. Homeopathic treatment of acute childhood diarrhoea: results from a clinical trial in Nepal. Journal of Alternative and Complementary Medicine, 2000; 6: 131-139.

4.  Bell I, Lewis D, Brooks A, et al. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology, 2004; 43: 577-582.

5.  Fisher P. An experimental double-blind clinical trial method in homoeopathy. Use of a limited range of remedies to treat fibrositis. British Homeopathic Journal, 1986; 75: 142-147.

6.  Ferley J P, Zmirou D, D'Adhemar D, Balducci F. A controlled evaluation of a homoeopathic preparation in the treatment of influenza like syndromes. British Journal of Clinical Pharmacology, 1989; 27: 329-335.

7.  Papp R, Schuback G, Beck E, et al. Oscillococcinum in patients with influenza-like syndromes: a placebo-controlled double-blind evaluation. British Homeopathic Journal, 1998; 87: 69-76.

8.  Shealy C N, Thomlinson R P, Cox R H, Borgmeyer R N. Osteoarthritic pain: a comparison of homeopathy and acetaminophen. American Journal of Pain Management, 1998; 8: 89-91.

9.  Shipley M, Berry H, Broster G, et al. Controlled trial of homoeopathic treatment of osteoarthritis. Lancet, 1983; i: 97-98.

10.  van Haselen R A, Fisher P A G. A randomized controlled trial comparing topical piroxicam gel with a homeopathic gel in osteoarthritis of the knee. Rheumatology, 2000; 39: 714-719.

11.  Taylor M A, Reilly D, Llewellyn-Jones R H, et al. Randomised controlled trials of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. British Medical Journal, 2000; 321: 471-476.

12.  Aabel S, Laerum E, Dølvik S, Djupesland P. Is homeopathic "immunotherapy" effective? A double-blind, placebo-controlled trial with the isopathic remedy Betula 30c for patients with birch pollen allergy. British Homeopathic Journal, 2000; 89: 161-168.

13.  Aabel S. No beneficial effect of isopathic prophylactic treatment for birch pollen allergy during a low-pollen season: a double-blind, placebo-controlled clinical trial of homeopathic Betula 30c. British Homeopathic Journal, 2000; 89: 169-173.

14.  Aabel S. Prophylactic and acute treatment with the homeopathic medicine Betula 30c for birch pollen allergy: a double-blind, randomized, placebo-controlled study of consistency of VAS responses. British Homeopathic Journal, 2001; 90: 73-78.

15.  Kim L S, Riedlinger J E, Baldwin C M, et al. Treatment of seasonal allergic rhinitis using homeopathic preparation of common allergens in the southwest region of the US: a randomized, controlled clinical trial. Annals of Pharmacotherapy, 2005; 39: 617-624.

16.  Reilly D T, Taylor M A. Potent placebo or potency? A proposed study model with initial findings using homoeopathically prepared pollens in hayfever. British Homeopathic Journal, 1985; 74: 65-75.

17.  Reilly D T, Taylor M A, McSharry C, Aitchison T. Is homeopathy a placebo response? Controlled trial of homeopathic potency, with pollen in hayfever as model. Lancet, 1986; ii: 881-885.

18.  Wiesenauer M, Häussler S, Gaus W. [Treatment of pollinosis with Galphimia glauca]. Fortschritte der Medizin, 1983; 101: 811-814.

19.  Wiesenauer M, Gaus W. Double-blind trial comparing the effectiveness of the homoeopathic preparation Galphimia potentization D6, Galphimia dilution 10-6 and placebo on pollinosis. Arzneimittelforschung, 1985; 35: 1745-1747.

20.  Wiesenauer M, Gaus W, Häussler S. [Treatment of pollinosis with the homeopathic preparation Galphimia glauca. A double-blind trial in clinical practice]. Allergologie, 1990; 13: 359-363.

21.  Weiser M, Gegenheimer L H, Klein P. A randomized equivalence trial comparing the efficacy and safety of Luffa comp.-Heel nasal spray with cromolyn sodium spray in the treatment of seasonal allergic rhinitis. Forschende Komplementärmedizin und Klassische Naturheilkunde, 1999; 6: 142-148.

22.  Friese K-H, Zabalotnyi D I. [Homeopathy in acute rhinosinusitis. A double-blind, placebo controlled study shows the effectiveness and tolerability of a homeopathic combination remedy]. HNO, 2007; 55: 271-277.

23.  Weiser M, Clasen B. [Randomized, placebo-controlled, double-blind study of the clinical efficacy of the homeopathic Euphorbium compositum-S nasal spray in cases of chronic sinusitis]. Forschende Komplementärmedizin, 1994; 1: 251-259.

24.  Wiesenauer M, Gaus W, Bohnacker U, Häussler S. [Effectiveness trial of homeopathic drug combinations for the treatment of sinusitis. Results of a randomized double-blind study in primary care]. Arzneimittelforschung, 1989; 39: 620-625.

25.  Zabolotnyi D I, Kneis K C, Richardson A, et al. Efficacy of a complex homeopathic medication (Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial. Explore (NY), 2007; 3: 98-109.

26.  Issing W, Klein P, Weiser M. The homeopathic preparation Vertigoheel versus Ginkgo biloba in the treatment of vertigo in an elderly population: a double-blinded, randomized, controlled clinical trial. Journal of Alternative and Complementary Medicine, 2005; 11: 155-160.

27.  Weiser M, Strüsser W, Klein P. Homeopathic vs. conventional treatment of vertigo: a randomized double-blind controlled clinical study. Archives of Otolaryngology—Head and Neck Surgery, 1998; 124: 879-885.

28.  Weatherley-Jones E, Nicholl J P, Thomas K J, et al. A randomized, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatigue syndrome. Journal of Psychosomatic Research, 2004; 56: 189-197.

29.  Yakir M, Kreitler S, Brzezinski A, et al. Effects of homeopathic treatment in women with premenstrual syndrome: a pilot study. British Homeopathic Journal, 2001; 90: 148-153.

30.  Oberbaum M, Galoyan N, Lerner-Geva L, et al. The effect of the homeopathic remedies Arnica and Bellis perennis on mild postpartum bleeding—a randomized, double-blind, placebo-controlled study -preliminary results. Complementary Therapies in Medicine, 2005; 13: 87-90.

31.  Frass M, Linkesch M, Banyai S, et al. Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit. Homeopathy, 2005; 94: 75-80.

32.  Oberbaum M, Yaniv I, Ben-Gal Y, et al. A randomized, controlled clinical trial of the homeopathic medication Traumeel S in the treatment of chemotherapy-induced stomatitis in children undergoing stem cell transplantation. Cancer, 2001; 92: 684-690.

33.  Baker D G, Myers S P, Howden I, Brooks L. The effects of homeopathic Argentum nitricum on test anxiety. Complementary Therapies in Medicine, 2003; 11: 65-71.

34.  Bonne O, Shemer Y, Gorali Y, et al. A randomized, double-blind, placebo-controlled study of classical homeopathy in generalized anxiety disorder. Journal of Clinical Psychiatry, 2003; 64: 282-287.

35.  McCutcheon L E. Treatment of anxiety with a homeopathic remedy. Journal of Applied Nutrition, 1996; 48: 2-6.

36.  Freitas L, Goldenstein E, Sanna O M. [The indirect patient-doctor relationship and the homeopathic treatment of childhood asthma]. Revista de Homeopatia, 1995; 60: 26-31.

37.  White A, Slade P, Hunt C, et al. Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomized placebo controlled trial. Thorax, 2003; 58: 317-321.

38.  Hill N, Stam C, Tuinder S, van Haselen R A. A placebo controlled clinical trial investigating the efficacy of a homeopathic after-bite gel in reducing mosquito bite induced erythema. European Journal of Clinical Pharmacology, 1995; 49: 103-108.

39.  Hill N, Stam C, van Haselen R A. The efficacy of Prrrikweg gel in the treatment of insect bites: a double-blind, placebo-controlled clinical trial. Pharmacy World and Science, 1996; 18: 35-41.

40.  Jacobs J, Herman P, Heron K, et al. Homeopathy for menopausal symptoms in breast cancer survivors: a preliminary randomized controlled trial. Journal of Alternative and Complementary Medicine, 2005; 11: 21-27.

41.  Thompson E A, Montgomery A, Douglas D, Reilly D. A pilot, randomized, double-blinded, placebo-controlled trial of individualized homeopathy for symptoms of estrogen withdrawal in breast-cancer survivors. Journal of Alternative and Complementary Medicine, 2005; 11: 13-20.

42.  Brigo B, Serpelloni G. Homoeopathic treatment of migraines: a randomized double-blind study of sixty cases (homoeopathic remedy versus placebo). Berlin Journal on Research in Homeopathy, 1991; 1: 98-106.

43.  Straumsheim P, Borchgrevink C, Mowinckel P, et al. Homeopathic treatment of migraine: a double blind, placebo controlled trial of 68 patients. British Homeopathic Journal, 2000; 89: 4-7.

44.  Whitmarsh T E, Coleston-Shields D M, Steiner T J. Double-blind randomized placebo-controlled study of homoeopathic prophylaxis of migraine. Cephalalgia, 1997; 17: 600-604.

45.  Jawara N, Lewith G, Mullee M, Smith C. Homoeopathic Arnica and Rhus Toxicodendron for delayed onset muscle soreness: a randomized, double-blind, placebo-controlled trial. British Homeopathic Journal, 1997; 86: 10-15.

46.  Tveiten D, Bruseth S, Borchgrevink C F, L¾hne K. [Effect of Arnica D30 on hard physical exertion. A double-blind randomized trial during the 1990 Oslo Marathon]. Tidsskrift for den Norske Lœgeforening, 1991; 111: 3630-3631.

47.  Tveiten D, Bruseth S, Borchgrevink C F, Norseth J. Effects of the homoeopathic remedy Arnica D30 on marathon runners: a randomized, double-blind study during the 1995 Oslo Marathon. Complementary Therapies in Medicine, 1998; 6: 71-74.

48.  Vickers A J, Fisher P, Smith C, et al. Homoeopathy for delayed onset muscle soreness: a randomized double blind placebo controlled trial. British Journal of Sports Medicine, 1997; 31: 304-307.

49.  Vickers A J, Fisher P, Smith C, et al. Homeopathic Arnica 30X is ineffective for muscle soreness after long-distance running: a randomized, double-blind, placebo-controlled trial. Clinical Journal of Pain, 1998; 14: 227-231.

50.  Hart O, Mullee M A, Lewith G, Miller J. Double-blind, placebo-controlled, randomized clinical trial of homoeopathic arnica C30 for pain and infection after total abdominal hysterectomy. Journal of the Royal Society of Medicine, 1997; 90: 73-78.

51.  Kaziro GS. Metronidazole (Flagyl) and Arnica montana in the prevention of post-surgical complications, a comparative placebo controlled clinical trial. British Journal of Oral & Maxillofacial Surgery, 1984; 22: 42-49.

52.  Lükken P, Straumsheim P A, Tveiten D, et al. Effect of homoeopathy on pain and other events after acute trauma; placebo controlled trial with bilateral oral surgery. British Medical Journal, 1995; 310: 1439-1442.

53.  Seeley B M, Denton A B, Ahn M S, Maas C S. Effect of homeopathic Arnica montana on bruising in face-lifts: results of a randomized, double-blind, placebo-controlled clinical trial. Archives of Facial Plastic Surgery, 2006; 8: 54-59.

54.  Stevinson C, Devaraj V S, Fountain-Barber A, et al. Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery. Journal of the Royal Society of Medicine, 2003; 96: 60-65.

55.  Robertson A, Suryanarayanan R, Banerjee A. Homeopathic Arnica montana for post-tonsillectomy analgesia: a randomised placebo control trial. Homeopathy, 2007; 96: 17-21.

56.  Wolf M, Tamaschke C, Mayer W, Heger M. [Efficacy of Arnica in varicose vein surgery: results of a randomized, double-blind, placebo-controlled pilot study]. Forschende Komplementär-medizin und Klassische Naturheilkunde, 2003; 10: 242-247.

57.  Andrade L, Ferraz M B, Atra E, et al. A randomized controlled trial to evaluate the effectiveness of homoeopathy in rheumatoid arthritis. Scandinavian Journal of Rheumatology, 1991; 20: 204-208.

58.  Fisher P, Scott D L. A randomized controlled trial of homeopathy in rheumatoid arthritis. Rheumatology, 2001; 40: 1052-1055.

59.  Wiesenauer M, Gaus W. [A randomized double-blind trial on the efficacy of a homeopathic drug for rheumatoid arthritis]. Aktuelle Rheumatologie, 1991; 16: 1-9.

60.  Savage R H, Roe P F. A double blind trial to assess the benefit of Arnica mo ntana in acute stroke illness. British Homeopathic Journal, 1977; 66: 207-220.

61.  Savage R H, Roe P F. A further double blind trial to assess the benefit of Arnica montana in acute stroke illness. British Homeopathic Journal, 1978; 67: 210-222.

62.  Davies A E. Clinical investigations into the actions of potencies. British Homeopathic Journal, 1971; 60: 36-41.

63.  Steinsbekk A, Bentzen N, F¾nneb¾ V, Lewith G. Self treatment with one of three self selected, ultramolecular homeopathic medicines for the prevention of upper respiratory tract infections in children. A double-blind randomized placebo controlled trial. British Journal of Clinical Pharmacology, 2005; 59: 447-455.

64.  Steinsbekk A, F¾nneb¾ V, Lewith G, Bentzen N. Homeopathic care for the prevention of upper respiratory tract infections in children: a pragmatic, randomized, controlled trial comparing randomized homeopathic care and waiting-list controls. Complementary Therapies in Medicine, 2005; 13: 231-238.

65.  Kainz J T, Kozel G, Haidvogl M, Smolle J. Homoeopathic versus placebo therapy of children with warts on the hands: a randomized, double-blind clinical trial. Dermatology, 1996; 193: 318-320.

66.  Labrecque M, Audet D, Latulippe L G, Drouin J. Homoeopathic treatment of plantar warts. Canadian Medical Association Journal, 1992; 146: 1749-1753.

67.  Linde K, Scholz M, Ramirez G, et al. Impact of study quality on outcome in placebo controlled trials of homeopathy. Journal of Clinical Epidemiology, 1999; 52: 631-636.)

68.  Dean M E, Coulter M K, Fisher P, Jobst K, Walach H. Reporting data on homeopathic treatments (RedHot): a supplement to CONSORT. HOMP 2007; 96(1): 42-45.

Dr Hugh MacPherson

Complementary Medicine Research Group

University of York

November 2009

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