Today’s headlines:
 
UK’s largest alternative medicine hospital to stop offering NHS-funded homeopathy
 
http://www.nationalhealthexecutive.com/Health-Care-News/uks-largest-alternative-medicine-hospital-to-stop-offering-nhs-funded-homeopathy?dorewrite=false
 
What surprises me is the singling out of natural medicines for culling when organisations focused on such culling haven’t had the same intent for mainstream medicines such as anti-depressants, some of which have been found to be no better than placebo in achieving their desired outcomes.

One conclusion of such paper was this:

“A key issue disregarded by critics is the patient’s point of view, as if the patient is benefiting from antidepressant treatment does it matter whether this is being achieved via drug or placebo effects?”
 
From:

The drugs don’t work? Antidepressants and the current and future pharmacological management of depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736946/
 
Why not apply that same conclusion to homeopathy?

This was a question I was asked earlier this week during a homeopathic consultation.

As serendipity would have it, an article printed on the same day as the consultation pretty much concluded what answer I gave to the parents. More oddly still, the chief investigator of the programme is Alastair Hay! It’s not me though, he’s the Professor of Primary care at The University of Bristol as well as a GP.

The answer I gave, was that we tend to go to the GP because we want reassurance that everything is OK, or that something is going on that’s beyond what we’re able to deal with ourselves. The GP then feels a duty to reassure, and often prescribe.

We live in an ever increasingly litigious society so the GP may also feel pressurised to prescribe something ‘just in case’. Imagine a situation where a GP hadn’t prescribed a medicine, yet could have done, and something more serious precipitated that was deemed preventable with early intervention with antibiotics.

We can also feel that we’ve wasted our GPs time if they don’t prescribe.

There’s also an increasing trend toward parents being considered negligent if they don’t seek medical advice, our GP often being the most reliable, first port of call.

Conclusions in this article which I wholeheartedly agree with are:

Dr Cabral and her colleagues believe that interventions to reduce unnecessary prescribing for children with respiratory tract infections (RTIs) should increase GPs’, and to a lesser extent parents’, confidence in the safety of not prescribing. This will allow them to modify their behaviour while still conforming to the social norm of ensuring child safety.

Dr Cabral added: “We also need to increase parents’ confidence in their ability to distinguish and care for self-limiting illness at home.  An increasing number of children are attending primary care or A&E and health services are struggling to cope. Our research shows that simple messages such as telling parents to manage these illness at home are unlikely to work when there is such a social pressure on parents to consult. We need to engage more widely with the social beliefs that create that pressure on parents.”

I understand hay fever to be an allergic response to pollen, centred especially in the eyes and nose, but can also affect the throat, chest, ears and skin. In general, we are likely to feel tired, as if fighting a cold, or even ‘flu.

Our immune system, or ‘defence’, is behaving as if attacked, by pollen. The response, our defence, is an inflammatory one, utilised to inactivate the ‘invader’, in this instance, pollen.

There are in essence, 3 ways in which this inappropriate allergic response can be managed.

1. Reduce exposure to pollen
2. Reduce immune response
3. Balance the person's reaction to pollen

Reducing the exposure to pollen

Physical barriers such as sunglasses or indeed regular glasses will impede the physical exposure of your eyes to pollen. Larger glasses are obviously better for this, but functionality and fashion may clash here, use your discretion!

To reduce pollen exposure in your nose, you can coat the inside of your nostrils with Vaseline (white petroleum jelly) or an unscented vegetable-oil / beeswax based lip balm. This has the effect of catching pollen in the external part of your nostrils.

Pollen is most prevalent where there are flowering plants. As well as flowers, this can be tree blossom, grasses and reeds. You may have a reaction to all of the above, or more likely, some of them. Please see this chart from The Met Office that shows when the pollen is at its peak. - More information about The Pollen Count from The Met Office (where you find the chart below a lot bigger!)

My personal feeling is that the ‘pollen count’ can be misleading since it is thetotal pollen. You may still be experiencing significant symptoms in a low pollen count if the majority of that count contains the one you’re most allergic to. Nevertheless, the chart is useful.


The University of Worcester that is home to the National Pollen and Aerobiology Research Unit gives a more accurate breakdown of the airborne pollen.

Current Pollen Forecast - from University of Worcester

Some people report keeping doors and windows shut whilst indoors improves their symptoms. Most modern cars with air-conditioning also have a pollen filter. It’s important that this is clean and isn’t harbouring mould-spores since this may add to your symptoms! Paradoxically, I also know clients that will insist that going outdoors improves their symptoms, finding indoors ‘stuffy’.

As night draws in, pollen tends to drop and settle, so dusk can be a particularly prevalent hay fever time.

Pollen will adhere to your clothes, skin and hair. So, drying your clothes on a washing line at dusk, may not be ideal…

Pollen will actually irritate more when the pollen spores are broken. Blowing your nose hard, and rubbing your eyes will encourage the pollen spores to rupture, and will exacerbate your reaction to it. It is prudent to be gentle when dealing with your symptoms, despite how irritating hay fever can be.

Also bear in mind that air-borne pollutants, such as exhaust fumes, that may not normally irritate you, may now exacerbate your hay fever symptoms due to already sensitised mucus membranes from prior inflammation.

Reducing the immune response.

Anti-histamines, as the name suggests, reduce the release of histamine in your body. Histamine is released by our bodies as part of our defence mechanism and is associated with inflammation. Although it may be hard to comprehend, this is a protective response, but in the instance of hay fever, it is somewhat misaligned!

NHS overview of antihistamines

Antihistamines are nearly always the first line of conventional therapy for dealing with hay fever. They can be very effective when used in conjunction with some of the ‘pollen avoiding’ protocols, above.

Some people have such severe symptoms as to be prescribed steroid-based medications in addition to antihistamines. These aren’t the same sort of ‘steroids’ that a body-builder may abuse, but are a particular type of steroid called ‘corticosteroids’. These reduce the immune response in a more generalised manner than antihistamines, but will take a few days to reach their peak effect.

NHS - Hay Fever, your options

Sadly, homeopathy isn't listed as an NHS option in the link despite it being available on the NHS (at the point of writing this!) and their being evidence to support its efficacy, but that rant's for another blog...

Antihistamines and steroid-based medications don’t suit everyone. Anti-histamines, especially, the first generation ones such as Piriton (chlorphenamine maleate) are associated with drowsiness, more modern ones are less associated with this. Some people may report that they are drowsy whilst taking modern antihistamines too. This may indeed be their anithistamines, or perhaps even the hay fever itself is persisting in producing drowsiness.

You may find that as the years go by, your symptoms improve, may be having good and bad years. If your symptoms are increasing with every year, you may wish to either supplement your medications with other approaches (complementary) or seek a different (alternative) approach to managing your hay fever.

This may be your first year of hay fever and you would like to try an alternative to conventional medications as your first resort.

Some conventional medications for hay fever are not recommended if you are pregnant, or trying to conceive, and some may interact with other medications you may already be taking. Do consult with the person who’s prescribed your medications before taking additional ones, whether conventional, or otherwise. Furthermore, some medications, whether conventional or herbally derived are banned by The International Olympic Committee (IOC), so alternatives may need to be sought.

Comprehensive list of banned substances in sport from WADA

UK Anti-Doping website

Balance the person

Fundamentally, there’s two ways you can overcome symptoms, work against them with medications such as anti-histamines (and indeed anti-biotics, anti-hypertensives, anti-emetics, anti-convulsants and so on…) or strengthen the person.

On a basic level, if you suffer with hay fever, your immune system believes that pollen is attacking you! Pollen is a protein-based structure that in hay fever sufferers, actives an immune, or defence response. For some people, it’s dog hair or horse hair or dust or peanuts or mushrooms or latex… For most people, they’re likely to be allergic to more than one thing. So, do you suppress it, or balance it, or perhaps a bit of both?

The health-promoting programmes I feel may help include

1.                  Homeopathy
2.                  Herbalism
3.                  Acupuncture
4.                  NLP (Neuro-linguistic programming)
5.                  Nutrition including dietary programmes

Homeopathy is very much a person, rather than complaint-driven treatment – So, if you choose a homeopathic approach, the ‘individuality’ of your symptoms will play a major role. For instance, if you feel your hay fever symptoms are better outdoors, as discussed earlier, you are more likely to benefit from Pulsatilla than Allium cepa. There are some great books and websites that help you differentiate between homeopathic medicines to help you with your hay fever symptoms, however, to get the best from homeopathy you’d be wise to seek a homeopath. Homeopathy can work wonders if self-prescribed but some find that self-prescribed medications don’t work as well as those prescribed after a professional consultation. If you’re already taking medications, I’d pretty much insist on it!  Personally, I’d find it pretty difficult to self-prescribe with a streaming nose, red eyes and sneezing my head of…

Homeopathy is safe during pregnancy, fine with the IOC (International Olympic Committee), The Commonwealth Games Federation (CGF) and WADA (World Anti-Doping Agency), safe for children (tastes nice too!) and non-drowsy.

I buy in my homeopathic medicines from either Helios Homeopathic Pharmacy or Ainsworths Homeopathic Pharmacy

Did you know that only a pharmacist is legally allowed to manufacture homeopathic medicines?

Herbalism – somewhat more ‘material’ and tangible compared to homeopathy and just as effective. Being more ‘material’ is has a greater ability to interact with other medications. Some herbs may be contraindicated in pregnancy, some herbs taste pretty grim and can be a palaver to prepare. That aside, there’s some great individual, and mixed blends of herbs, again, best focussed on your symptoms rather than just ‘hay fever’ in general. For instance, you may be ‘bunged up’ or ‘itchy’, or have a ‘runny nose’ or be ‘perpetually sneezing’. Your symptoms will, to a large extent, dictate what’s most appropriate for you to try. I’m a fan of ‘tinctures’. These are herbs that have been prepared in alcohol solutions. They are relatively easy to carry around and prepare, with a pretty good ‘shelf-life’ – not far off being an ‘instant’ herb tea. I nearly always get my herbal tinctures from Neal’s Yard Remedies. They have great reference books my particular favourites are:

Bartram's Encyclopedia of Herbal Medicine

David Hoffman's Holistic Herbal

Neal's Yard Remedies - Store Finder UK

I would also consider looking at Aromatherapy, in the sense that there are essential oils, plant-based distillates, that when diluted can be inhaled to relieve the symptoms of hay fever.

I know some great herbalists if you’d like to consult with one.

Acupuncture - Now, I don’t profess to know much about acupuncture, although I know a few acupuncturists! I do know hay fever sufferers that have been relieved with the help of acupuncture. They may also offer you Chinese herbs depending on their training. When considering an acupuncturist, and all other complementary therapists, for that matter, do check their qualifications and credentials.

NLP - yes, NLP! Neuro-linguistic programming. My first experience with NLP was when I was suffering rather badly with hay fever myself – rather embarrassing for a homeopath, I know, but I’m human too, luckily I’ve pretty much overcome it now (the hay fever, not the being human!) In my session, in a café in Covent Garden, my practitioner asked me to imagine someone walking out of the lift, covered in pollen and wafting it everywhere as they walked by… I sneezed. Amazing what the mind can do isn’t it? So, we then explored a pollen-free arena within the depths of my mind and I felt somewhat better. It helped for quite a while too.

Nutrition - Foods (and other potential allergens) that we may not normally have a reaction to, become apparent when we have hay fever. It’s like a threshold of tolerance has been broken. Foods that may not normally aggravate, but may during the hay fever season include wheat (including beer – boo!) dairy products (including milk chocolate – double boo!)

You may wish to experiment with avoiding these foods, or at least reducing them to see if your hay fever is affected. I feel this is best carried out under the supervision and direction of a nutritionist.

Depending on where you live, I can put you in touch with some good ones.

Supplements… There’s a myriad of supplements out there, some people find one thing beneficial, and someone else, another. I have personally found local honey and quercetin beneficial. This is not the case for everyone.

I use Cytoplan products since they manufacture their products in a manner that makes them ‘bio-available’ in a ‘food-state’ form and therefore nearer to nature, so your body absorbs most, if not all of the product. They are also very reasonably priced!

Conclusion

1. Safe
2. Effective
3. Permanent

 

1. Safe - It’s vital that what you choose to do regarding your hay fever management is safe. – The safest way of doing this is to seek the advice of a professional. If you’re already taking prescribed medication, and that includes the contraceptive pill, I would seek the advice of the professional that prescribed it. There is a mistaken belief that ‘natural’ = ‘safe’… but natural can certainly be effective…
2. Effective – There’s no point spending a significant amount of money aiming to allay your symptoms only to find it doesn’t work. The hay fever solutions, especially when being used for its acute phase, whether conventional or otherwise need to lead to significant improvement quickly. What may work for your friend, or the lady in the newspaper, may not suit you. I would also encourage you to try and stick to one or two therapies at a time. More than that can create confusion both for your body, and your practitioners!
3. Permanent – My feeling is that it’s important that what we do to deal with our symptoms makes a lasting difference. My belief is that using products such as antihistamines, although they have their place, and can precipitate rapid relief, do not address the deeper issue of why our immune system is over-reactive, with the potential that if we suppress our immune system long-term, its likely result are deeper symptoms and disorders.

I’d like to leave you with this…

I was having a chat with a friend of mine about his hay fever, it wasn’t a formal consultation as such, but it was very apparent that he was suffering. I explained to him my viewpoint of the over-active immune system and he pondered… and he pondered… and he pondered. He then said, or words to this effect… “That’s it, you’re right! …I over-react to everything. I come from a family of ‘over-reactors’, I don’t just sneeze, I ‘very’ sneeze. I don’t just get cross, I get ‘very’ cross. My immune system is just reflecting this isn’t it?!”

Now this guy is a salesman, not a fluffy hippee. He decided there and then, to stop over-reacting (ironic in some respects since that, in itself, seemed like an over-reaction!) and his hay fever stopped. Yes, stopped! It has never returned.

Amazing what the mind can do isn’t it?

This blog has been inspired by a recent Facebook post I read from a well-educated member of NHS staff citing 'herd immunity' and those now shunning the MMR vaccine as the reason she may now be susceptible if exposed to rubella virus that could affect her unborn child’s development.

‘Herd immunity’ is the protective effect that occurs when a population contracts and recovers naturally from an infection.



The phrase ‘herd immunity’ was originally coined in 1933 by epidemiological research from A W Hedrich (1). He studied measles patterns in the US between 1900 and 1931, before the introduction of a measles vaccine. His observation was that measles epidemics only occurred when >68% of children had developed natural immunity to it. This is based on the principle that people build their own immunity after suffering with, or being exposed to the disease. Therefore, if at least 68% of the population were allowed to build their own natural defence, there would be no epidemic, there would literally be ‘herd immunity’.

However, ‘herd immunity’ is a term that has been applied to vaccine-induced immunity without scientific basis.

Have you read that vaccination uptake needs to be 95% for it to be effective and protect the rest of the ‘herd’? Where does this information come from? I can’t find any scientific data that justifies or explains the extrapolation of 68% of a population being naturally immune to 95% of a population being vaccinated to produce ‘herd immunity’ within that population. It appears that Henrich’s data has been manipulated to suit a vaccination agenda.

When vaccines were first introduced, their proponents asserted that they provided a ‘life-long’ immunity in the same way as natural immunity. This was shown not to be the case, hence the introduction of ‘booster shots’ at intervals between 2 and 10 years. Furthermore, outbreaks still occur in groups where vaccination uptake is 100% even having had booster shots. (2, 3)

Herd immunity is based on an active disease and not based on mimicking the disease with a vaccination. A vaccine isn't nature, it's manufactured to challenge the immune system to produce antibodies to a pathogen. We cannot apply the same model of herd immunity in a natural disease to vaccination policy, yet we do... falsely.

and finally...

Whether I’m immune or not, does not determine whether I carry a virus (or a bacteria for that matter), so it’s nonsensical to deduce that a child vaccinated with pertussis (whooping cough) vaccine for instance, somehow stops carrying pertussis bacteria in their lungs simply because they have been vaccinated. Furthermore, it won’t prevent the vaccinated children from spreading the bacteria either. The vaccine is, however, designed to modulate the vaccinated individual’s response to the exposure of the bacteria. Vaccination rates for whooping cough have no impact on whether pertussis bacteria is in the air, or whether they breathe them in. Should you choose to vaccinate, there is no need to worry about unvaccinated individuals - a non-vaccinated child is no better at transmitting pertussis than a vaccinated one.

We have been led to believe that vaccination will stop you carrying a virus or bacteria... it won’t.
However, it's likely to modify your reaction to the bacteria or virus.

My Summary:

• Unvaccinated individuals are no more disease vectors than vaccinated individuals.
• Do not choose, or be coerced into vaccinating solely on the basis of herd immunity. 

References:

1. Monthly estimates of the child population “susceptible” to measles, 1900–1931, Baltimore,Maryland. Am J Hyg 1933;17:613-636.
   
2. Measles outbreak in a fully immunized secondary-school population.
3. Failure to Reach the Goal of Measles Elimination - Apparent Paradox of Measles Infections in Immunized Persons.

Further reading:

           Evolution of Measles Elimination Strategies in the United States.

This is the difference between looking for an action of something or assessing a reaction to something.

Are homeopaths really salespeople?

A homeopath’s standing is largely built upon their reputation of helping people get well and stay well i.e. upon their results... and a homeopath will tend to stay in a town, settle down, become part of the community, integrate and obviously earn their reputation, rather than plying their wares then clearing off.

If you come from the sceptical-activism viewpoint of ‘ban homeopathy’ you’ll chastise homeopaths for both making lots of money, or making no money. If you make ‘lots’ of money from being a homeopath, a skeptic would interpret that as exploitation, since in their eyes it’s money for nothing :) ...and, if you don’t make any money as a homeopath, you’re deemed useless, or homeopathy is.

Therefore, being 'good' or 'bad' salespeople makes no difference as to whether skeptics want to ban homeopathy. 

As outlined earlier, our ability to make money, or as I call it 'earn a living', is based upon our reputation.

When I was at college, we didn’t have lessons in sales and marketing despite when practising as a homeopath, it is, in fact, a business. College taught us to be great prescribers and case managers but there were no lessons in how to be salespeople.

‘Homeopaths make money from gullible sick people’?

Not really...

We actually make a living from ill people getting well.

www.britishhomeopathic.org/evidence/the-evidence-for-homeopathy/Homeopathy is placebo - ban homeopathy

Homeopathy... there’s nothing in it, it’s a sham.

Homeopathy is a con as the medicines contain nothing.

You are a ‘deluded fool’ to believe it works.

It’s a great leap to go from concluding that something is placebo, to banning it.


A total of 164 random controlled trial, (RCT) papers in homeopathy (on 89 different medical conditions) have been published in good quality scientific journals.

• 43% had a balance of positive evidence
• 6% had a balance of negative evidence
• 49% were not conclusively positive or negative
• 2% of the RCTs do not contain data that are suitable for analysis

Reference: http://www.britishhomeopathic.org/evidence/the-evidence-for-homeopathy/

A sobering thought then, for homeopaths: Pretty much half of the data utilised is neither positive or negatively conclusive.
​
However, by comparison, out of 1016 systematic reviews of RCTs in conventional medicine:

• 44% of the reviews concluded that the interventions studied were likely to be beneficial (positive)
• 7% concluded that the interventions were likely to be harmful (negative)
• 49% reported that the evidence did not support either benefit or harm (non-conclusive)

Reference:  http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2753.2007.00886.x/abstract

These statistics reflect the fact that research in homeopathy is a relatively new field (hence a smaller
numbers of trials leading to fewer systematic reviews), but the trends seen in the evidence base to
date are similar to conventional medicine.

So, what do we know about the placebo effect?

Placebo is more than just ‘nothing’, hence the term ‘placebo effect’.

To maximise its effect you can apparently employ some interesting tactics:

Give big tablets, even better, give big, coloured capsules, hell no, suggest two at a time, often, from branded boxes from someone in a white coat... Oh and charge a fortune for it.

You may be surprised then, to hear that homeopathic medicines are nearly always small and white, taken one at a time and quite often, infrequently, from an unbranded packet from someone in ‘civilian’ clothes who will either have included the tablets into their consultation fee or asked you to order them from a homeopathic pharmacy for a pricely sum of about £5 per item.

Maybe we’re missing a trick here? Well, the pharmacologists aren’t...

Here’s a quote from Trends in Pharmacological Science Volume 33, Issue 3, March 2012, Pages 165–172

Utilizing placebo mechanisms for dose reduction in pharmacotherapy

“The pairing of a placebo and a pharmacological agent may achieve satisfactory treatment outcomes in combination with a lower dose of medication.”

The reality is 66% of the treatment procedures and drugs that are commonly used in conventional medicine have no or little evidence of benefit, yet they are still prescribed. (British Medical Journal, 2007)

Now, I’m not actually an advocate of banning conventional medicines, not even the ones for which there is 'unknown effectiveness'... This isn’t a blog about conventional medicine bashing, but more about demonstrating the illogical and somewhat paradoxically, unscientific skeptic’s agenda.

You may be surprised to learn that I’ve actively encouraged some clients to take conventionally prescribed medications, some of which have worked very well, when homeopathy hasn’t done all we wanted it to do. Their relief is all the more interesting since some of these conventional medications have been openly regarded as not significantly different to placebos!

But IS homeopathy placebo?

To accept that a response to a homeopathic medicine is purely placebo is, for me, a hard pill to swallow... pun intended.

Put yourself in my position... I’ve seen just over 1000 different clients, the majority of whom have initially followed a conventional healthcare path.

Quite frankly, they believed in the conventional route, or their parents did, more so than they believed in homeopathy, hence they tried the conventional route first. They took medicines in the form of big coloured tablets or capsules daily, they may even have had surgery, yet these medicines didn’t do all that was expected of them. Surely, the placebo response should have kicked in sooner than when they chose me as a last resort? But it didn’t.

Of those 1000 or so clients whom I’ve seen, most, but not all, have derived benefit, often long-lasting or even permanent benefit from treatment. The benefits are both observable and palpable. I find it more amazing still, astonishing even, if their favourable responses are really just from having a chat and dishing out sugar pills. I just find that claim more implausible.

To summarise...

• RCTs of evidence for the effectiveness of homeopathic and conventional intervention are pretty similar.
• Homeopaths and manufacturers of homeopathic medicines could do more to maximise the placebo effect but they don’t.

• To conclude something is 'placebo', is not the same as concluding it is 'ineffective'.
• The placebo effect whether derived via conventional or homeopathic medicines is still an effect.
• If I can help people get better by just having a chat and dishing out sugar tablets that’s astonishing!

Further reading:

Harvard says placebos are going mainstream
10 Crazy Facts About the Placebo Effect
Are antidepressants just placebos with side-effects?
Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why
Pavlov and placebos could reduce the side-effects of drug treatments