Homeopathic medicines: Legally sold but is there any evidence of effectiveness?

by Michael R. Cohen, R.Ph.

Published Apr. 3, 2014, 5:00 a.m. ET

Homeopathic remedies can be found on the shelf in just about every pharmacy, including the large chains like CVS, Walgreen and Rite Aid. Those who advocate their use believe that symptoms of illness are a normal response in the body to regain health. If a particular substance is causing these symptoms, homeopathic practitioners believe that giving a person a very small amount of that same substance will help boost the body's normal healing process and cure the illness.

According to the National Center for Homeopathy, more than 500 million people worldwide use homeopathic remedies. However, in my opinion these products offer nothing more than a placebo effect (sugar pills) at best and at worst they waste people's money. Some of the claims made about them could impede effective therapy. I'm not even sure that patients realize they are using a homeopathic medicine because they may not be prominently marked as such.

The highly diluted active ingredients in homeopathic remedies are usually made from plant material, although some are made from specific minerals, salts, and insects. Very few are made from animal products or disease material itself. Most homeopathic remedies start with these active ingredients but have very little left after the dilution process. They are available in various forms, including capsules and tablets, creams and ointments, gels, granules, liquids, and sprays.

Figure1. A homeopathic medicine for acne

While the active ingredients in homeopathic remedies are considered drugs by law, the US Food and Drug Administration (FDA) does not specifically evaluate homeopathic remedies for safety or effectiveness. Most are manufactured and sold according to ancient FDA guidelines but without FDA approval, as long as the remedy contains only an active ingredient listed in the Homeopathic Pharmacopeia of the United States (HPUS) and the product, outer container, or accompanying leaflet includes at least one major indication (i.e., symptom to be treated), a list of ingredients, the number of times the active ingredient has been diluted, and directions for use.

Most homeopathic remedies are available over-the-counter (OTC) because they treat minor health problems, like a cold or headache, which typically go away on their own without treatment. If there is any positive effect it's the placebo effect—meaning that thinking it will be helpful makes it so. Supporters of homeopathic remedies believe that the diluted active ingredients contain enough medicine for the body to recognize and react to it. However, actual evidence of effectiveness is conflicting. While several earlier studies suggested that the clinical effects of homeopathy were only due in part to a placebo effect, later studies, including a 2005 study published in The Lancet, concluded that the positive effects of homeopathic remedies were due only to the placebo effect.

Most homeopathic remedies are considered safe, but like all remedies, care should be taken to avoid misuse and errors. Although most are prepared in highly diluted form, some products labelled as homeopathic may not be very dilute and can contain significant amounts of active ingredients. Like any drug or dietary supplement that contains chemical ingredients, these homeopathic remedies may cause side effects or drug interactions. Homeopathic remedies fall under the category of "buyer beware." Like any drug or dietary supplement, these products could pose risks if they are improperly manufactured (for example, if they are contaminated with microorganisms or incorrectly diluted).

Inexplicably, liquid homeopathic drugs can contain alcohol but the FDA allows higher levels of alcohol in these remedies than it allows in traditional medicines. Obviously, homeopathic products containing alcohol should be used with extreme caution in children.

Never use homeopathy as a replacement for proven conventional care or to postpone seeing a healthcare provider about a medical problem. Certain homeopathic remedies have been promoted by some as an alternative to conventional immunizations, but data to support such claims is lacking and the idea is potentially dangerous. The National Center for Complementary and Alternative Medicine (NCCAM) supports the Center for Disease Control and Prevention's recommendations for immunizations/vaccinations. If you are considering using a homeopathic remedy, bring the product with you when you visit your doctor or pharmacist. They may be able to help you determine whether the product might pose a risk of side effects or interact with other drugs you are taking.