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domingo, 19 de junio de 2011

Homeopathic treatments are a hard pill for science to swallow

(Extraído de Los Angeles Times)

Though it has been used for centuries and some studies have reported positive findings, the practice has no known scientific basis. (Ricardo DeAratanha / Los Angeles Times)

By Julie Deardorff, Chicago Tribune

June 15, 2011, 10:29 a.m.

A popular homeopathic flu remedy boasts that it has no side effects, causes no dangerous drug interactions and won't make you drowsy. But the product also lacks something most people expect to find in their medicine: active ingredients.
Oscillococcinum (O-sill-o-cox-see-num), a tongue-twisting concoction used to treat flu-like symptoms, is a staple in many European homes. Sales are steadily growing in the U.S., where it can be found at storefront pharmacies and major retailers.

Homeopathy critics, however, derisively call the product "oh-silly-no-see-um," a nicknamed inspired by its absence of biologically active compounds. It's products such as Oscillococcinum that have placed homeopathy in an awkward position: popular among holistic-minded consumers but scorned by scientists and most Western-trained doctors.
The British Medical Assn. vehemently objects to government funding for homeopathic treatments, considering any effect to be placebo. Around the world, activists have staged mass public "overdose" events outside pharmacies to demonstrate there's literally nothing inside the small white pills. One U.S. group, meanwhile, has offered $1 million to anyone who can prove homeopathy works and has challenged major drug retailers such as CVS, Rite-Aid and Walgreens to stop selling the products.
"Nobody, not even homeopaths, have an idea how the remedies work," says Dr. Edzard Ernst, a longtime critic of homeopathy and professor of complementary medicine at the University of Exeter's Peninsula Medical School in Britain.
Few things rile scientific skeptics more than homeopathy, a baffling form of alternative medicine in which patients are given highly diluted and vigorously shaken preparations to trigger the body's natural healing ability. Though it has been used for centuries and some studies have reported positive findings, the practice has no known scientific basis. Most analyses have concluded there's no evidence it works any better than taking a sugar pill.
Yet homeopathy hasn't just survived the years of scathing criticism, it's prospering. In the U.S., consumer sales of homeopathic treatments reached $870 million in 2009, growing 10% over the previous year, according to estimates from the Nutrition Business Journal.
For Oscillococcinum, sold in 60 countries, estimated annual retail sales in the U.S. are more than $20 million, according to the manufacturer, Boiron of Lyons, France. It ranks 49th out of 318 products marketed as cold and flu remedies that generate more than $1 million in sales, the company says. Other popular homeopathic products include arnica gel for bruises and strains. and diluted zinc remedies for colds.
"Some people feel these products shouldn't work due to the dilution level," says pharmacist Christophe Merville, director of education and pharmacy development for Boiron, the world's leading maker of homeopathic medicines. But he says basic science studies have shown "that highly diluted solutions have biological properties that are different than water."
Ernst, who calls homeopathy the "worst example of faith-based medicine," said that even if the solution is structurally different, it doesn't matter. "After doing my washing up, the water in my sink is very different from pure water," he says. "Yet it would be silly to claim it had therapeutic effects."
Homeopathy is one of the most polarizing forms of complementary and alternative medicine in part because it's based on principles that defy the laws of chemistry and physics. One pillar is the assumption that "like cures like." Chopping a red onion, for example, can make your eyes tear and nose run. Seasonal rhinitis can trigger the same symptoms, so a homeopathic treatment derived from a red onion, Allium cepa, may be a possible remedy.
The second assumption proposes that diluting and violently shaking (or "succussing") the remedies makes them more effective, even if — and this is the part most scientists find hard to swallow — the final preparation no longer contains a single molecule of the original ingredient. The final product usually is a tiny ball of sugar the patient swallows, though homeopathic products also are sold as gels.
The mechanism behind the diluting and shaking remains a mystery. Some say homeopathic medicine may stimulate the body's natural defenses; others suggest homeopathic medicine retains a "memory" of the original substance in the water and the effect is due to nanoparticles.
Regardless, proponents say it shouldn't be discounted simply because it can't be explained. For years, no one knew how aspirin worked. And scientists still don't fully understand the mechanism behind some conventional drugs, such as Ritalin, argues Dr. Tim Fior, director of the Center for Integral Health in Lombard, Ill.
"Homeopathy challenges the belief in the molecular paradigm of medicines," says Fior, who recently gave an introductory lecture on homeopathy to medical students at the University of Illinois at Chicago. "Conventional pharmacology is based on — and profits immensely from — the idea that you can synthesize a molecule, patent it and produce it in bulk and then have a monopoly selling it. Homeopathic medicines are so dilute that they work more according to a biophysical or energetic paradigm."
People often use homeopathy to treat chronic pain, digestive issues, colds, influenza and allergies when they're not getting relief from conventional medicine or are looking for a cheaper alternative. Homeopathic practitioners tend to spend more time with patients than regular doctors, though an appointment isn't necessary to obtain medication. The products also appeal to those looking for a "natural" or holistic product or who can't tolerate the side effects of conventional drugs.
Mona Grayson, a raw food chef and happiness coach in the Chicago suburb of Warrenville, turned to homeopathy for chronic digestive issues after her insurance expired and she could no longer cover the $500-a-week cost of her conventional treatment. Though she was tolerating her pricey medication, she had concerns about the long-term effects.
After an initial two-hour consultation with Fior, Grayson was given a remedy of phosphorus and says she hasn't had problems since. "What matters to me is that I feel good," she says.
There's scant evidence that homeopathy provides anything beyond a placebo effect (even critics agree the treatments are safe and don't cause allergic reactions). Many homeopathy studies are small, of poor quality and funded by homeopathic manufacturers.

Copyright © 2011, Chicago Tribune

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