This past week our Federal Trade Commission (FTC) commented on the FDA’s regulation of homeopathic medicines. While this might seem like all a bureaucratic fuss over not much, it points up the unique position homeopathy holds in the health care universe.
The 411 on Homeopathy
Homeopathy is based on the principle that “like cures like.” For example, a dose of something that makes your skin itch will help health skin that’s itchy from another cause. Mainstream medicine, though, claims that homeopathy is the height of quackery. Their claim is based on both the way homeopathic remedies are made and how they’re used.
Individual remedies are made by successive dilution of an original substance, such as sulfur or poison ivy. The label of a remedy will tell you how far it’s been diluted: 6X means it’s been diluted 10-to-1 6 times (“X” = 10 in Roman numerals), and 30C means it’s been diluted 100-to-1 30 times (“C” = 100). As you can imagine, it doesn’t take very many dilutions before the original substance is barely detectable in the final product. In fact, once you get to 30X or 15C dilution, there might not be any of the original substance available. (Google Avogadro’s number for an explanation of why.) And homeopathic theory holds that a greater dilution is often more effective.
Enter the Regulators…
The FDA is charged with ensuring that all medical items, whether drugs or devices, are both safe and effective. The FTC monitors advertising claims for truthfulness. Somehow, homeopathic remedies got grandfathered in under the FDA’s current structure in 1938, so for FDA approval they only have to show that they’re safe. And given the argument that they might not contain anything other than sugar, it’s hard to claim that the remedies might be dangerous. So as far as the FDA is concerned, homeopathic remedies are just fine for self-limiting conditions that aren’t chronic. You’ll see Oscillococcinum for flu, Zicam for colds, and SinuFix decongestant nasal spray in CVS and Walgreens, and many other more specialized remedies in your local health food store.
The FTC wants more, however—they want proof of effectiveness to back up any health claims on the label. There have been very few clinical trials run on homeopathy, though, for several reasons:
- “Respected” researchers don’t believe it’s plausible, so why waste money on the research?
- Treatments are very individualized, which makes it difficult to standardize results. Two people with high blood pressure will receive different treatments if one has headaches and the other doesn’t.
- Very few homeopathic physicians are also MDs. Being outside the system reduces the incentive to publish.
My take is that anything that works in animals—and homeopathy most certainly does work there—should work in humans as well.
…and Exit the Regulators
For now it appears to be a standoff between the two agencies. Back in 1972, the FDA said it was cracking down on advertising claims. In the more than 40 years since, though, nothing has been done regarding homeopathy. The FTC would like to change that, but there seems to be no movement at the FDA on the issue.
In the meantime, homeopathy continues on its merry way. If you decide that you want to try this therapy, work with a homeopathic practitioner to identify the best remedies and strengths for you.