Homeopathic Preparations for Treatment of Seasonal Allergies
September 1998; Volume 1: 99-103
By Vance Dietz, MD, MPH, TM
Watery eyes, runny nose, and feeling miserable-the symptoms of allergies. Millions of Americans suffer every year, with an estimated 20% of the population suffering seasonally.1 An estimated $600 million is spent annually on allergy medications.
Whether motivated by concerns about drug side effects or simply a desire for something more "natural," many people are turning to alternative approaches to relieve their suffering. One of the most common of these involves the use of homeopathic remedies (HRs).
Introduction
The word "homeopathy" comes from the Greek homoios and pathos meaning "similar" and "disease," respectively.2 The practice of homeopathy is a self-healing method for treating the sick. It relies on the "principle of similars" developed in the late 18th century by the physician Samuel Hahnemann.3 This central principle states that the clinical signs and symptoms that a substance would cause in a healthy person can be cured by the same substance when they occur spontaneously in a sick person.3
Although homeopathic principles were developed in the early 1800s, this principle of healing was used by ancient Egyptians, Chinese, and in the Americas by the Incas and Aztecs.3 By 1900, homeopathy in the United States was popular, and its use was widespread. At the turn of the century, at least 22 homeopathic medical schools and more than 100 hospitals were operating. In addition, numerous conventional medical schools taught homeopathy (e.g., Boston University, New York Medical College, and Stanford University). Homeopathy was also popular among many well-known Americans such as Mark Twain, Louisa May Alcott, Henry Wadsworth Longfellow, and Henry David Thoreau.
Homeopaths came under attack from the American Medical Association in the 1840s and 1850s and, later, from drug companies. By the 1950s, the practice of homeopathy had almost died in the United States. It was the interest in "natural" and ecological issues in the late 1960s and 1970s that promoted a "comeback" for homeopathy.
The Use of Homeopathy
A widely cited 1990 national survey estimated that 33% of adults had used an unconventional form of medical therapy in the year preceding the survey.4 It was estimated that 1% of adults, or 1.8 million persons, had used homeopathy. Of these, 32%, or almost 600,000 adults, had seen a homeopathic provider, totaling an estimated 3.5 million visits. In 1992, sales of homeopathic medicines (HMs) in the United States were estimated to be between $200 million and $250 million.5 In 1994, sales in health food stores grew 52%, the largest for any product category in the health food industry.6 Between March 1994 and March 1995, sales of HMs in chain drug stores grew 258% over the previous year.7
Although currently not widely known in the United States, homeopathy is reportedly widely used in Europe.8 Up to 40% of French physicians and 20% of German physicians prescribe homeopathic medicines.8 Homeopathy is also used in India, which has more than 100,000 homeopathic doctors, Brazil, Mexico, and Argentina.
Folk History
Homeopaths have a long history in the field of allergy. In 1871, the British homeopath C.H. Blackely was the first to note a relationship between seasonal sneezing and exposure to pollen.9 Dr. Grant Selfridge, an American homeopath, was one of three physicians to start the association that is now the American Academy of Allergy. In England, the Royal Family reportedly received care from homeopathic physicians beginning during the time of Queen Victoria.9
Mechanism of Action
The mechanism of action for homeopathic preparations has not been clearly established. Basic scientific research has been published demonstrating the biologic activity of homeopathic medications and the absence of such activity.
Clinical Studies
Several studies of the effects of HRs on allergies have been published. In a meta-analysis of homeopathic studies published in 1991, at least four studies, three of which were considered to meet the minimal criteria to be considered a "good study" methodologically, evaluated homeopathic preparations for the treatment of allergies.10 All four were reported by the meta-analyzers to demonstrate a positive clinical result. A 1997 meta-analysis reported that, of 89 articles that could be critically reviewed, six (including 3 identified in the previous meta-analysis) examined the effect of homeopathic preparations in the treatment of allergies.11 Five suggested a positive clinical outcome.
For example, in a randomized, double-blind clinical trial, 34 of 41 (83%) of patients treated with the HR Galphimia glauca reported improvements in ocular symptoms compared to only 21 of 45 (47%) controls.12 A review of patients treated at selected medical centers in Germany in seven different randomized, double-blind, placebo-controlled studies and in four non-placebo-controlled studies suggested that HRs were superior to placebo in providing subjective relief of ocular symptoms.13 The rate of improvement in ocular symptoms was 1.25 (95% CI of 1.09-1.43) times greater within the HR-treated group than among the controls. However, one study failed to demonstrate any difference between HRs and placebo.14
A widely cited 1986 Lancet study compared the effect of a mixed grass pollen HR vs. placebo on patients with hay fever in a randomized, double-blind, placebo-controlled trial.15 The main outcomes included a daily visual analogue scale of symptom intensity; the number of medications needed (i.e., antihistamines) by patients; and an additional symptom score from their physicians. Only the homeopathic-treated group demonstrated a reduction in symptoms. (See Figure 1.) The mean change in the symptom score for the HR-treated group was -17.2 mm vs. -2.6 mm in the control group (P = 0.02). This finding persisted after controlling for daily pollen count. Significant differences between groups were also noted from the physician assessments.
While 47 patients treated with HRs also took an antihistamine at some point, by the fifth week, the mean number of antihistamine tablets taken by the HR-treated group was half that of the control group (3.1 vs 6.0; P = 0.03). (See Figure 2.) The mean total number of antihistamine tablets taken during the entire study period by the HR-treated group was 11.2 vs. 19.7 by the control group (P = 0.03).
The authors repeated this study evaluating the effect of HRs on allergic asthma.16 Using a daily analogue scale of overall symptoms, the HR-treated group had better relief of symptoms than the placebo group, although the groups were similar in respiratory function and bronchial reactivity.
In contrast, however, a recent study reported in the lay medical press stated that a comparison among seven persons with seasonal allergies given either an HR or placebo resulted in no difference in terms of improvement of their symptoms.17
Adverse Effects
Properly made HRs are considered extremely safe. However, a case of mercury poisoning that required chelation therapy was reported in an infant treated with a topical HR of mercury.18
Drug Interaction
No drug interactions with homeopathic preparations have been reported. Although no studies were found directly addressing co-administration with conventional medication, the homeopathic literature states that remedies can be taken with other medications.
Preparation
Central to homeopathy is the use of Ultra High Succussed Dilutions (UHSD), also known as potentization. The manufacture of homeopathic medicines involves consecutive dilutions of substances in a water and alcohol mixture in repeated doses of 1:10 or 1:100, coupled with vigorous shaking to produce highly diluted preparations. For example, a substance from a plant is diluted in distilled water at usually one part to nine parts of water and then vigorously shaken. This process is repeated, each time diluting the original mixture. When the process is completed three times, the solution is said to have a potency of 3X. When the substance is diluted 1 to 99 and then repeated three times, the potency is said to be 3C, and so on.
Formulation and Dosage
Many companies promote homeopathic preparations. The preparations may be self-prescribed or administered and prescribed by a homeopathic physician or practitioner. Many people get prescriptions from homeopathic physicians, and different doses and potencies are recommended for different conditions, depending on the individual. Homeopathic preparations can be obtained in different potencies and, ideally, are based upon the unique symptoms and signs of the individual.
In addition, since most HRs do not require a prescription from a physician, individuals may purchase HRs from a health food store or directly from a manufacturer. Individuals choose a particular remedy from their own study of homeopathy or from the indications listed on the remedy's package. Some companies produce combinations of remedies. In other words, the remedy contains a number of the most common remedies generally prescribed for a particular disorder or symptom (e.g., allergies).
Common HRs for allergies include: allium cepa for symptoms of profuse watering from the eyes and nose which are worse in warm rooms and better in cool air; sabadilla for symptoms of paroxysms of sneezing; kali bichromicum for copious, thick, stringy nasal discharge; and pulsatilla for thick nasal discharge, commonly used for children. Dosage for adults includes four tablets HRs are often produced as soft sugar tablets and as pillules (i.e, small, hard, tablet-like, or as hard pellets) prescribed every four hours in the 6, 12, or 30 potency. Generally, one expects to see an effect within 24 hours.
Conclusion
Homeopathic preparations for the treatment of allergies have been used for more than a century and a half. When questioned by their patients about the use of HRs for allergies, clinicians could advise that clinical improvement with the use of HRs has been documented. Specifically, data suggest that homeopathic preparations may be effective in alleviating ocular symptoms associated with allergies; therefore, clinicians could recommend use as an adjunctive therapy. For persons desiring an alternative therapy for the symptoms of allergies, physicians could recommend trying HRs prior to using conventional anti-allergy medication. In addition, clinicians can feel confident that the use of homeopathic preparations for this purpose is safe, and reports of side effects are rare.
References
1. Wolf D. Drug-free answers for allergies. Natural Foods Merchandiser; March 1997.
2. Ullman D. The Consumer's Guide to Homeopathy. New York: G.P. Putnam's Sons; 1995.
3. Hahnemann S. Organon of Medicine. New Delhi, India: B. Jain Publishers PVT, LTD; 1993.
4. Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States-Prevalence, costs and patterns of use. N Engl J Med 1993;328:246-252.
5. Update US. OTC Market Report. Essex, England: Nicholas Hall and Co.; July 1994.
6. Natural Foods Merchandiser; June 1995.
7. Drug Chain Report. Towne-Oller and Associates; 1995.
8. Ullman D. The Homeopathic Treatment of Asthma: A Breath of Fresh Air. Homeopathic Educational Services. Berkeley, CA; 1995.
9. Panos M, Heimlich J. Homeopathic Medicine at Home. New York: The Putman Publishing Group; 1980.
10. Kleijnen J, Knipschild P, ter Riet Gerben. Clinical trials of homeopathy. BMJ 1991;302:316-323.
11. Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997;350:834-843.
12. Wiesenauer M, Haussler S, Gaus W. [Pollinosis therapy with Galphimia glauca- in German]. Fortschr Med 1983;101:811-814.
13. Ludtke R, Wiesenauer M. [A meta-analysis of homeopathic treatment of pollinosis with Galphimia glauca- in German]. Wien Med Wochenschr 1997;147:323-327.
14. Wiesenauer M, Gaus W. [Double-blind trial comparing the effectiveness of the homeopathic preparation Galphimia potentiation D6, Galphimia dilution 10(-6) and placebo on pollinosis-in German]. Arzneimittelforschung 1985;35:1745-1747.
15. Reilly D, McSharry C, Taylor M, Aitchison T. Is homeopathy a placebo response? Controlled trial of homeopathic potency, with pollen in hay fever as model. Lancet 1986;2(8512):881-886.
16. Reilly D, Taylor M, Beatti M, et al. Is evidence for homeopathy reproducible? Lancet 1994;344:1601-1606.
17. Stenson J. Homeopathy doesn't help allergies, study says. Medical Tribune News Service. February 25, 1997.
18. Montoya-Cabrera M, Rubio-Rodriguez S, Velazquez-Gonzalez E, Avila Montoya S. Mercury poisoning caused by a homeopathic drug. Gac Med Mex 1991;127:267-270.
September 1998; Volume 1: 99-103You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content