Episode transcript:
Music
Natalie Grams: I had a very bad car accident in my early 20s and I was suffering from a post-traumatic thing, but I did not know that then. I had some palpitations, feelings that my heart was beating too fast, and I was really stressed about it because I became unconscious because of the panic that I felt. So, I went from doctor to doctor...
Rachel Stewart: That's Dr Natalie Grams, she's from Germany. At the point in her life she’s describing, she was actually studying to become a doctor. But after she had this traumatic accident, none of the medical professionals she saw were able to help her with what she was experiencing. Then a friend recommended talking to a homeopath.
Natalie: She gave me a lot of time; she gave me homeopathic remedies. I could take them whenever I felt worse. And I got better in a very short time.
Rachel: Natalie was so convinced by her experience that she decided to train to become a homeopath herself. She wanted to help other people who'd been let down by conventional medicine and needed an alternative.
Natalie: I really believed in homeopathy to be the somehow better medicine. So, I used it for all kinds of diseases and illnesses, and I really was convinced that it might help against everything...
Phone ringing
Jingle: "развален телефон", "Chinese whispers", "telefono senza fili", "telephone", "kulaktan kulağa", "Stille Post", "испорченный телефон", "téléphone arabe", "głuchy telefon", "Russian scandal", "Don't drink the milk".
Dial tone
Sound of a lab – test tubes clinking, fridge opening, chopping onions
Rachel: Welcome to the Don't Drink the Milk laboratory. My name is Dr Rachel Stewart.
Voice from afar: "No, she's not a medical doctor!"
Rachel: Shhh! I’m starting off with 1 drop of this onion extract, I'll put that into this test tube here. And next, I'll use this pipette, or dropper, to add 100 drops of water.
Sound of dropper
Rachel: Now I’m going to shake it vigorously and bang it against this big leather-bound book.
Sound of shaking, banging, and beaker clinking
Rachel: Stage one complete. Now I take one drop of this solution and add it to another test tube.
Sound of opening cap on a test tube
Rachel: Again, I add 100 drops of water. And shake and bang.
Time for round three, one drop in another tube… Round 21... then 100 drops of water... round 48... put one drop in another test tube... round 67... and we shake it... round 82... 100 drops of water and bang it...
Once I’ve done this 100 times, I take some tiny white balls (sound of pouring out) made of sugar and spray the final solution onto them. (sound of spray bottle) Then I let them dry. And voilà! My homeopathic remedy is ready.
Sound of shaking pill bottle
Music
Rachel: So you've probably heard of homeopathy, you might have tried it before, maybe you've even got some homeopathic remedies in your medicine cabinet right now. But do you really know exactly what it is?
Homeopathy is often bundled in with things like acupuncture, Chinese medicine or naturopathy. But it’s actually one very specific branch of alternative medicine, usually administered in the form of a liquid solution made with water or alcohol or tiny white pills called "Globuli."
You just heard me making up a mock version of one of those remedies, and I was seriously watering down my onion extract. That's because a key part of homeopathic theory is a process known as "potentization." According to homeopaths, the more a substance is diluted, the more potent it will be. All remedies go through a process of extreme dilution, shaking and bashing. The theory is that water has a kind of memory, and the pattern of the original healing ingredient is imprinted on the water.
Music builds
Rachel: That first test tube mixture I made had a concentration of 1:100. Then I diluted it further, with one drop from my original solution and 100 more drops of water, making a ratio of 1:10,000. The next dilution was then 1:1,000,000. It’s common to continue diluting up to 200 times, which means that most homeopathic solutions are basically like a drop in the ocean. There’s unlikely to be a single molecule left of my onion.
Music ends
Rachel: Homeopathy is a really controversial topic. It’s also kind of fascinating and I have so many questions. Not only: does it work? But where did it come from? Where in the world did it find a foothold? And what can this tell us about these different cultures and about what happens when medicine lets us down?
Let's get back to Natalie's story. A few years into her work as a homeopath, a couple of journalists asked to interview her for a book they were writing, which ended up being called The Homeopathy Lie.
Natalie: And I got really angry when I read it because I thought they did not understand anything of the real practice of homeopathy in my daily life. I saw so many patients who got better.
Rachel: She was so mad, in fact, she decided to write her own book. She would once and for all silence the critics and lay out the facts about homeopathy and why it really works. But once she got deep into the research, reading studies and literature and debates…
Natalie: I became more and more aware that the arguments of homeopathy are based on like sand. And the sand was pouring through my fingers.
Rachel: Today, Natalie is one of the most outspoken critics of homeopathy in Germany. She did write that book, and several others, just from the opposite perspective than she'd planned. But even now, she can still totally relate to the people who seek this kind of treatment.
Natalie: Medicine is not treating us well. There's no time, there's no money. You're just a number of another thousand numbers today and you're not feeling treated good enough. And homeopathy offers a lot of time, a lot of empathy, natural remedies that are perfectly shaped to you as a person. And there you are, worshipped in a way. You need to be worshipped to become better, to feel better, to get healthy.
Sound of a phone notification
Vox pop 1: "I grew up with homeopathy. So, I used to take those little white pills all my childhood when I was sick. But now I don't use them anymore. But my mum, she's still a huge believer."
Vox pop 2: "When I was a young man and a young father of two children, we used homeopathy very often. When we have a cold, sickness by ears, nose or head or higher temperature. Very often it was a good alternative way to heal."
Vox pop 3: "I don't trust that. I always used to throw three spider legs above my right shoulder on midnight. It helps much better."
Vox pop 4: "I use arnica globulis when my daughter is injured. And this helps in many cases just to calm down."
Rachel: When I moved to Germany 8 years ago, I was really surprised to find out how big homeopathy is here. Surveys suggest around half of Germans use it. I have friends and family who do.
For the past 5 years, I presented a YouTube show called "Meet the Germans." It was basically my job to dig into the German culture and all the quirks that make this country well, quirky. And while some stereotypes turned out to be pretty accurate – like Germans being unapologetic straight-talkers – there were also many things that really surprised me about my new home. And one of those things is how in touch many Germans are with their spiritual side.
Music
Rachel: Although religion is in decline in Germany, it's still a more religious country than I'd realized before. Ok, maybe it's a bit of a leap... but I'm thinking about the faith aspect. There’s also a huge interest in things like meditation and mindfulness. And then there's the German love of nature. They’re into hiking, and gardening and sweating it out in a sauna with a bunch of naked strangers. And I’ve been wondering if some of these cultural habits might help explain the popularity of something like homeopathy. I asked Natalie what she thinks about this.
Music ends
Natalie: I think in Germany we are known for our rational thinking and all of that, but we are somehow irrational as well. And homeopathy is the best example for it because it's not rational. It's an emotional, perhaps psychological thing, and we just want to believe in it because the features that are delivered with it, like being natural or without harm or without any side effects, just are so popular that we tend to close our eyes towards the rational arguments against it. Germany is the cradle of homeopathy because the inventor, Samuel Hahnemann, was born here. So, it belongs somehow to Germany.
Music – Ode to Joy
Rachel: I need to take you back to the late-18th century in Leipzig, a city in eastern Germany. Samuel Hahnemann, a doctor and chemist, has become increasingly disillusioned with his profession, perhaps unsurprisingly. The medicine of the day is crude and brutal, using methods like bloodletting and leeching.
Sounds of heart beats and leeching
Rachel: Then comes the experiment that will change everything for him. He reads about a Peruvian bark containing quinine, which has been used to treat malaria. Hahnemann starts ingesting it himself and realizes that he's developing symptoms that are similar to malaria symptoms. And this is how he comes up with the theory of "like cures like".
He thinks something that causes particular symptoms in a healthy person could cure similar symptoms in a sick person. Remember the onion extract in my makeshift lab? Well, when you cut up an onion, it makes your eyes water.
Sound of chopping onion
Rachel: Your nose might get a bit tickly, maybe your eyes itch. Those symptoms will sound very familiar to anyone who has suffered from hay fever.
Sneeze
Rachel: So, onions are often used as the homeopathic cure for hay fever.
Hahnemann continues to experiment on himself and other volunteers, testing ingredients and recording the broad range of symptoms they apparently provoke.
Sound of scribbling things down
Rachel: He also develops the second part of his theory - the diluting and shaking bit I demonstrated earlier.
Sound of pour water and shaking test tube, banging it on a book
Rachel: In his book, the Organon of the Healing Art, he explains that he thinks all illness stems from a disturbance in the body's "vital force".
Hahnemann quote, read aloud: "The diseases of man are not caused by any substance, any acridity, that is to say, any disease-matter, but... they are solely spirit-like derangements of the spirit-like power that animates the human body."
Rachel: Some people are really into Hahnemann's new theory. His followers are often referred to as his "disciples.” His wife compares his book to the "Holy Scripture.” Hahnemann himself seems to see a kind of divine power to homeopathy:
Hahnemann quote, read aloud: "In time, our art shall become the God-blessed oak. It will extend its enormous branches, steadfast through the storms. Humanity, who has already suffered from so much evil, shall rest below its righteous shadow."
Rachel: But many in the medical community denounce him as a quack and accuse him of taking patients for a ride. A group of physicians, who called themselves the "society of truth-loving men", want to put Hahnemann's theory to the test. The resulting Nurenberg Salt Test ended up being one of the earliest examples of a randomized double-blind trial. Its conclusion? Homeopathic remedies have no effect beyond the power of a participant's imagination or preconceived opinion.
Musical embellishment
Rachel: You might know this as the placebo effect. It occurs when someone's condition seems to improve even though they were given something with no active ingredients in it – a placebo. It basically has a lot to do with conditioning and our expectations.
And it's no joke. It doesn't cure diseases, but when it comes to things like pain management or insomnia, it really can make some patients feel better.
Since that test back in 1835, many more studies have been run on homeopathy – some claiming to show that it works, other claiming to show that it doesn't. So how do we know what to trust?
Edzard Ernst: In general, it is a bad idea to look at single clinical trials. If you have a research question, you ought to look at the totality of the evidence and not only that, you also need to critically analyze and evaluate that evidence.
Rachel: That's Edzard Ernst, Professor Emeritus at Exeter University in the UK. He ran a research unit for alternative medicine, which conducted clinical trials and systematic reviews of published data. And the conclusion they came to? Homeopathy doesn't work.
Edzard: If you critically evaluate the totality of the evidence, it is impossible to arrive at a positive conclusion.
Rachel: But if some people feel better after visiting a homeopath or taking a sugar pill, even if it's the placebo effect, it's still helping them, right? So, what's the harm? I put this question to Natalie. We'd slipped into German by this point in the conversation, so I'll sum up what she said:
Natalie speaking in German
Rachel: You might start off using homeopathy because you or your child has a cold or a stomach ache. Maybe it would have gone away on its own, or maybe the placebo effect kicks in – but for whatever reason, you notice an improvement. So you try it out for something more complicated – maybe a lung or bladder infection. It gets really serious if we're talking about about things like depression or cancer.
Natalie speaking in German
Rachel: When I ask if it really ever goes that far. She tells me that, in her experience, there are doctors who will prescribe homeopathy for everything. They know what to say in public – that they would never use this treatment for things like cancer – but behind closed doors when noone else is listening, they might do just that and really expect it to work.
One of the main arguments against homeopathy is that it might cause someone to avoid or even just delay medical treatment for something serious. And that could have serious consequences.
But why else is Hahnemann's homeopathy so controversial in Germany today?
Ding sound
Rachel: Number one: Regulation
Edzard: The law for homeopathy provides that they do not need proof of efficacy. The only thing that is regulated is safety. Homeopathic products need to be safe, which is not difficult because they contain absolutely nothing.
Rachel: That's Edzard again. In the 1960s, drug regulation in Germany was ramped up after the thalidomide scandal, when thousands of birth defects were tied back to a drug given to pregnant women to treat morning sickness. The drug had been developed by a pharmaceutical company in West Germany. But when the rules were tightened, homeopaths resisted and secured a special status for their treatments. They need to prove their products are safe, but not that they actually work.
Ding sound
Rachel: Controversy Number two: Health insurance.
Homeopathy is covered by many public health insurers here. Some people argue this is unethical, especially when other proven treatments are not covered.
Ding sound
Rachel: Number three: "Heilpraktiker"
There are some 50,000 so-called 'healing practitioners' in Germany. They can offer services in almost all areas of medicine without any medical training. They offer many types of alternative therapies, including homeopathy.
But anyway, plenty of medical doctors also offer it alongside conventional treatment. Which, honestly, I find pretty confusing as a patient!
Ding sound
Rachel: Number four: Point of sale
In Germany, you can't just get a pack of aspirin in the supermarket or the drug store. You have to go to a pharmacy. And it's the same for homeopathic remedies. Some argue this lends them more legitimacy.
Edzard tells me he thinks homeopathy has survived in modern day Germany in part thanks to a strong political lobby and a general public suspicion of the pharmaceutical industry.
Edzard: The homeopathic industry is pitched against the pharmaceutical industry. The pharmaceutical industry is said to be evil, out for profit. But you quickly see that they behave exactly the same. They're out for profit.
Street sounds
Rachel: I’m off to a pharmacy right now to see if I can get a homeopathic remedy and basically what to see what they tell me about it. I can’t record inside, so I’ll report back...
Door sounds, entering the shop
Rachel: Ok, so I asked for something homeopathic for headaches. First of all, the guy recommended peppermint oil onto rub on my temples, but then he got a little book out and looked up "Kopfschmerzen" for headaches and spent quite a while looking on his computer, before he finally gave me this...
Sound of shaking a pill bottle within a box
Rachel: It's a little bottle of those "Globuli" pills. They kind of look like something a pixie would use for a headache. I did also ask the guy what he thinks of homeopathy, and he sort of dodged the question. He said it's good to avoid taking too much ibuprofen. And when I asked if he thinks homeopathy was basically just placebo, he said something along the lines of: "Well, if it works, it doesn’t matter." So, I paid my €12 and off I went. I definitely would agree that putting this stuff behind the counter in the pharmacy kind of gives it an air of legitimacy. Then again, there is a bit of a running joke among immigrants here that German pharmacies are basically like half stocked with tea anyway, so, maybe that fits.
[Trailer for After Dark: Myths Misdeeds & the Paranormal]
Rachel: Of course, homeopathy hasn't stayed in Germany. Today some of the countries with the most widespread use of it are just over the border - like France, Switzerland and Austria. But it's also made its way much further afield. I’ve invited producer Sam and our colleague Shabnam to the studio. Sam is from the US and Shabnam’s from India – the next two stops on this little homeopathic journey. So, Shabnam, what's your experience of homeopathy?
Shabnam Surita: It was a very big trend in my circle. It still is a very big trend to go for homeopathic medicine when you feel like all other options have kind of dried out. And it's a lot like rituals. It's a lot like faith-based systems, you know, where you don't really have clear answers going into a process, but you have faith that we try this out and we see what comes out of this.
Rachel: Do you still use it?
Shabnam: No, I don't use it anymore because all the times that I have taken it, it has never worked on me. But people have told me it has worked on them.
Rachel: Sam, what about in the US? Did you come across homeopathy much?
Sam Baker: I didn't because I would say it's not something that's offered as part of standard medical practice. And when you first started talking about this episode, I actually thought it was just the same thing as alternative medicine. I thought it was all like one pot of possible things that were kind of outside the medical establishment.
Rachel: Yeah, it's a bit confusing. And so are the labels for these homeopathic remedies. Have a look at this one...
Sam: Ok. Uh, lots of... Latin it seems?
Rachel: Yes, the ingredients are usually in Latin. And do you know what these letters and numbers mean?
Shabnam: Oh my god no.
Rachel: That's the potency. So, this says 30C – the C means 100, so the active ingredient is diluted at a ratio of 1:100 – like my onions from earlier. But because it's 30C, the dilution and shaking process has been repeated 30 times.
Sam: So, the final product is insanely weak.
Rachel: Yes. Which in homeopathic terms means 'very potent'.
Sam: Uh huh.
Rachel: Ok but the ingredients themselves can also be really interesting and some of them can be pretty wild…
Sam: Ok.
Rachel: Let's do a little quiz. Remember the remedies should cause symptoms in a healthy person that are similar to the symptoms of the thing it is supposed to cure. First up: Belladonna. Do you know what that is?
Sam: Mm mm…
Rachel: It's also known as Deadly Nightshade. It's basically a very poisonous plant. So, if you consumed this in pure form, you'd probably die. What might you feel if you're being poisoned by a poisonous plant?
Shabnam: Diarrhea?
*laughter*
Rachel: This one restricts breathing. So, what could that maybe cure?
Sam: Respiratory illness.
Shabnam: Lung cancer.
Rachel: Most common? Asthma.
Shabnam: Asthma! I went too far. I went to lung cancer.
Rachel: Next up, let's go to a toxic metal, mercury.
Sam: I just know I have to avoid eating tuna, so I don't get too much mercury.
Rachel: Oh, well maybe you could just dilute your tuna with a lot of water.
Sam: Have the tiniest piece of sushi!
Shabnam: One to a million parts.
Rachel: Okay I'll tell you some of the symptoms that it helps with. Discharge and pus, fever, profuse sweating and bad breath. Do you know what those symptoms might also be a sign of?
Shabnam: That's a very wide range of symptoms.
Rachel: It's a sexually transmitted infection.
Shabnam: Syphilis?
Rachel: Yes! 10 points to my right.
Shabnam: My width and breadth of knowledge on homeopathy!
Rachel: Okay, so something that's used for glandular issues, you might see the Latin word 'carbo animalis'. What do you think that actually is?
Sam: Dead animals or something?
Rachel: You're very close. It is charred animal bones or skin, usually cow or pig.
Shabnam: Wow.
Rachel: It’s also important to note that these remedies are not just used for physical symptoms or illnesses. Sometimes it’s more emotional. So, with that in mind, I’ve got one more for you. What do you think the ingredient Maurus Berlinensis could be?
Shabnam: Mauer, something to do with the Berlin Wall?
Rachel: Yes. What did the Berlin Wall create? What kind of feelings did it create in people?
Sam: Separation anxiety.
Rachel: Very good. Separation. What else is it a symbol of?
Shabnam: Being closed, stuck, anxiety?
Rachel: Yep! People experiencing feelings of loneliness, isolation, oppression, etc. might genuinely be offered a remedy made up of highly diluted pieces of the Berlin Wall.
Shabnam: Fascinating.
Music
Rachel: In the early 19th century, German missionaries brought homeopathy all the way to India. The ruler of Punjab, who was suffering from paralysis of the vocal cords at the time, was treated by one of Hahnemann's disciples. He was delighted with the results, and homeopathy received royal patronage.
Today, India has more than 200,000 registered homeopathic doctors. That's more than anywhere else in the world. Reporter Anupama Chandrasekaran went to meet one of them.
Sounds of opens the cupboard and taking out bottles
Anupama Chandrasekaran: I'm at this homeopathy clinic in Chennai, a coastal city in South India. It’s run by Dr. Kushali Gambhir. She's showing me around, unlocking a cupboard. Inside are these small glass bottles with red caps.
Kushali Gambhir: All homeopathic dilutions are stored in amber bottles.
Anupama: Dr. Kushali shows me how she prepares her remedies. She reaches out inside the cupboard to get an alcohol solution made with extract of the Arnica montana plant.
Kushali: So, we take Arnica from here. Then we go over to the globules...
Anupama: She takes a small cylindrical container filled with tiny white pills.
Kushali: These are made from cane sugar, and we medicate it – 10 drops of Arnica, so that it coats everything. This is shaken.
Sound of pills shaking
Anupama: These pills will be given to patients who have bruising or muscle soreness. Dr. Kushali has been practicing homeopathy for 27 years and she says she is seeing a growing number of younger patients seeking treatment. Many of them are often frustrated with conventional medicine – like 22-year-old Aditya Ponnudurai. After a surgery a few years ago, frequent urinary tract infections left him bedridden. So, his mother turned to this alternative.
Aditya Ponnudurai: She thought 'ok fine, the antibiotics are not working, let’s try homeopathy,' and so I’ve been taking homeopathic medications from March of this year and in that time these UTIs, the frequency, it's almost gone right now.
Anupama: Aditya was aware of the questions surrounding homeopathy, but he felt he had little choice as the medicines he was taking weren’t helping.
Aditya: I mean I just wanted to get better.
Anupama: Another patient, Uma Praba Balakrishnan, tells me she prefers the interaction with homeopathic doctors.
Uma Praba Balakrishnan: He would not just say 'ok, what is your problem? This is the medication,' and test your heartbeat and all that.
Anupama: She says it's about both physical and emotional wellbeing. And homeopathy hasn’t just been restricted to humans.
Sound of dogs barking
Sharmila Krishnan: Coco is about 11 now and Loki is 9.
Anupama: That’s Sharmila Krishnan, a chartered accountant and the proud owner of two golden retrievers.
Sharmila: Because of age-related issues they have had hypothyroidism. For that, I have consulted with a homeopathic doctor.
Anupama: Sharmila herself turned to homeopathy when her migraines didn't improve with regular medication.
Sharmila: A lot of people say it is placebo, it's whatever. But it has worked. In my case, it's worked. I don't know for whatever reasons, but it has worked.
Anupama: So she tried out homeopathic treatments for her dogs, too. Which has one more benefit...
Sound of pills shaking
Sharmila: All the other medicines, they tend to spit it out. It's a struggle to give them any pill whatsoever. But these medicines, they are sweet, they enjoy having them. So they just think that I am giving them a treat.
Sound of more barking
Rachel: Ah the pet question. Interestingly there is apparently such as thing as 'placebo by proxy' where the behavior and signals given by a parent or pet owner can trigger the placebo effect in kids and pets.
As we just heard, many people in India have well and truly embraced homeopathy. This 200-year-old therapy from Germany, has even managed to get a seat at the table alongside traditional Indian therapies that have been practiced for thousands of years.
Abby Philips: Yeah, so AYUSH is basically, it's an acronym… A stands for Ayurveda, Y stands for Yoga and Naturopathy, U stands for Unani, S stands for Siddha, and H stands for Homeopathy.
Rachel: Dr. Abby Philips, better known online as TheLiverDr, is a senior consultant from Kerala, South India. He's telling me about AYUSH – the Indian government ministry dedicated to alternative medicine.
Abby: And homeopathy is basically nothing to do with the Indian systems per se, because it's a German invention. But it is still clubbed into AYUSH because homeopathy is very, very, very frequently and commonly used by the public here in India.
Rachel: When the COVID-19 pandemic hit, this government department recommended and distributed a homeopathic treatment.
Abby: Arsenicum album, which is basically diluted arsenic trioxide…
Rachel: A lot of the concerns Abby has about homeopathy are similar to ones we've heard already – like a lack of scientific evidence and the danger of patients turning to this for a serious condition. But he says there's something else going on here too...
Abby: So, a lot of the homeopathy formulations are adulterated with modern medicines, conventional medicines like antibiotics, pain killers and steroids. We even identified cancer chemotherapy agents in some of the homeopathic remedies that we analyzed. It was that bad. And then obviously a lot of heavy metal poisoning like arsenic, lead and mercury.
Rachel: Homeopathy is not supposed to have any side effects. Because by definition it's supposed to be super diluted. But what if there's not enough oversight of how the remedies are being made?
Abby: I call it a dangerous placebo. Because you will never know what you're going to get. And because of the very poor regulation here, a lot of people are playing with their lives, opting for homeopathy in India.
Rachel: So why do they do it? Abby says one reason is a lack of access to good medical care in rural areas.
Abby: So, they are dependent on these local doctors who are in and around the towns and villages... They are either folk healers, traditional healers, homeopaths, or Ayurveda practitioners and things like that.
Rachel: India is the world's biggest exporter of homeopathic products. But it's not all a one-way street...
Abby: I mean, believe it or not, there is a special place in the hearts of Indians for German homeopathic medicine. And the best part is that it will be like three to four times more expensive than the Indian version.
Rachel: So, it's like the "made in Germany" label that you might see on electronics, you also get it on homeopathy?
Abby: Exactly, yeah, something like that, yeah.
Music
Britt Hermes: I told both my OB and my midwife to please not offer me any homeopathic therapies and that I didn't believe in them, and I didn't need them.
Rachel: This is Britt Hermes, a scientist and medical writer from the United States. But she's recounting what it was like talking to her gynecologist when she was living in Germany while pregnant with her first child.
Britt: My OB had a very interesting response to me. She said, when I declined homeopathy for my morning sickness, she said, 'Oh, it's interesting that you would decline it.' And I said, 'Yes, well, it doesn't work.' And she said, 'I know. You're right. But women like to be offered something.'
Rachel: This reminds me of something Natalie told me, about how the marketing for homeopathy seems to target women in Germany. Ads in women's magazines promise soft, natural remedies that seem somehow more palatable than antibiotics and pharmaceutical drugs. And this is actually kind of how this story makes its way to the US...
Music
Rachel: Although homeopathy did crop up on the other side of the Atlantic in the early 19th century, its popularity didn't last. But it made a comeback in the 1970s.
The New Age movement was in full swing. Spiritualism and holistic healing were all the rage and sales of homeopathic products shot up. Part of the appeal was the focus on natural remedies.
Music ends with a record scratch effect
Britt: The whole idea of "natural" in medicine, to me is such a massive misunderstanding. These homeopathic products are formulated and refined and go through a process to produce them in a way that I think definitely doesn't fit someone's strict definition of natural.
Rachel: The 'natural' label has stuck with homeopathy, and these days it's finding an even wider audience online.
Britt: I think the health influencer, the natural health influencer, that is posting on Facebook, or TikTok now and Instagram, plays a huge role in the perpetuation of these alternative therapies and the belief that they're real and safe and that you are a better person, better mom, better woman, better anything if you are looking for a natural alternative rather than pursuing standard medical care.
Montage of Tiktok clips with claims about homeopathy:
"Homeopathic remedies that are non-toxic, they're safe, they're non-addictive. // I want to talk to you about autism and how homeopathy works to help minimize symptoms and, in some children, completely eliminate symptoms. // This remedy is arnica, and it is incredible for all kinds of trauma – physical trauma, emotional trauma, psychological trauma and sexual trauma. // Put that under your tongue 2-3 times daily, until your symptoms, disease or cancer have dissipated or gone away. // Trust your instincts as a parent and take control of your child's health with homeopathy."
Some four million people in the US use homeopathy. And surveys suggest the vast majority of them are self-prescribing.
Britt: Homeopathy is super accessible in the US. You can find it in the over-the-counter drug section of grocery stores like Whole Foods or Walmart or other standard grocery stores. You can find them in pharmacies like CVS and Walgreens. And I wouldn't be surprised if you can even find them next to medications in gas stations.
Rachel: Homeopathic products can be sold in the US without approval from the FDA – the Food and Drug Administration. But the agency has announced plans to increase its scrutiny of certain homeopathic products, such as ones that claim to treat or prevent serious conditions, or those marketed to vulnerable people like children, pregnant women and the elderly.
Britt: Oh, I do not think health consumers have a clear idea of what they're buying when they pick up a homeopathic product. I was checking out homeopathic products last night for example, and there's a really popular one here marketed as reducing flu symptoms and the duration of the flu. Ocillococcinum, I believe is how it's pronounced. It's a difficult one to say.
Rachel: By the way the active ingredient in this one is "Anas barbariae, hepatis et cordis"... that's duck liver and heart. Mmm.
Britt: On the box for this medication and on the website marketing for this homeopathic product, it says that this is a 'effective medicine'. Now homeopathy is not a medicine. It is a sugar preparation of a hyper diluted substance. But when you're a healthcare consumer and you're picking up a box and you read the word medicine on that box, then of course you're going to think that what you're taking is a medicine.
Rachel: Britt's story is not unlike Natalie's. She had a bad experience with a medical doctor when she was 16 and turned to alternative therapies. She then trained as a naturopath, including homeopathic training. She was fully on board until the day she found out that a colleague was treating cancer patients with an imported non-FDA approved naturopathic medicine. But, again just like Natalie, even after stepping over to the other side of the debate, she can still see why these therapies appeal to people.
Britt: One piece of this puzzle I think has to do with the healthcare system in general. The healthcare system in the US is expensive. It's complicated to navigate. And I think many times people feel let down by their healthcare here in the United States. Even if a person is receiving quality healthcare from their physician in the US, it's oftentimes fraught with financial or logistical frustration, meaning finding access to care, getting the insurance to cover care that they're supposed to cover, finding a physician that's in your network - it's time consuming, you have to advocate for yourself, and it's sort of a constant battle. And when you don't feel heard or taken care of by the system that is sort of charged with taking care of you, it's easy to want to step outside of that system.
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Rachel: In some countries, the debate does seem to be shifting. In the UK, these treatments are no longer covered under the National Health Service. Some Spanish universities are dropping homeopathy courses. Even in Germany, some states have stopped allowing medical doctors to complete further training in homeopathy and the current health minister wants to remove it from public health insurance.
Of course, Samuel Hahnemann was operating in a very different context. He was reacting to a version of medicine he saw as unjust and ineffective. But medicine has come a long way in the past 200 or so years.
Nevertheless, the fact that homeopathy has found such a wide audience in all the countries we've visited – countries with really different cultures and health care systems – it reveals a lot about the cracks that still exist modern medicine and what we really need from it. It's not always accessible or affordable, it rarely treats us like individuals, it doesn't tend to treat our physical and mental health at the same time and most doctors just don't have the time to really listen. But perhaps it's not too late to learn from this.
Britt: The medical students going through school now are definitely more attentive to this and definitely pay more attention to how they're talking to the patient and how much time they can spend and trying to get away from this sort of like rushed, you know, revolving door healthcare system.
Rachel: And what about the placebo effect? Researchers are becoming more interested in studying it for its own merits and seeing how and when it could fit into healthcare.
And there's even research being done into "open-label placebos" – to see if there might still be a positive effect even if you're aware that what you're taking is a placebo! The mind is a powerful thing.
What about Natalie who we heard from right at the beginning? Does she regret taking her friend's advice and turning to homeopathy, even though it did help her back then?
Natalie: Yes, I wish somebody had used the time not only to check my body, but to talk to me and detect the problem. The problem was the car accident. And it was some kind of anxiety. Somebody taking some minutes to talk to me would have been able to see that. I wouldn't have needed any homeopathic remedies if somebody had told me, 'Oh, it's a post-traumatic thing that you have. Perhaps you talk to a specialist in this field, but it's no need for magical pills.'
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Rachel: This episode was hosted and produced by me, Rachel Stewart, with help and editing from Sam Baker. Extra reporting by Anupama Chandrasekaran and fact checking by Katharina Abel. Thanks to Shabnam Surita and Andreas Becker, and to Dr Michelle Dossett for filling me in on placebo research. Our team also includes Charli Shield and Chris Caurla.
You might have noticed a little Beethoven sprinkled in this episode – that's a nod to homeopathy's homeland and, fun fact, the great composer was apparently partial to a bit of homeopathy himself.
Have you got an idea for an episode? Drop us a line at dontdrinkthemilk@dw.com - that's without an apostrophe. And no, it doesn't have to be a topic that's as heavy as this one was. I think I need to go and lie down for a bit...
On a lighter note, we've got a Christmas special coming up for you next week – and you can even catch the video version over on the DW Podcasts YouTube channel. As ever, if you're enjoying Don't Drink the Milk – tell a friend about us!
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Rachel: Before you go, I've got a final recommendation especially for our Indian listeners, but also for anyone else who likes hearing other's relationship problems and advice for them. Top Indian sex educator, Leeza Mangaldas, hosts Love Matters – taking listener questions and covering taboo topics along with other experts. It makes for a fun exploration of love, sex and relationships - from marriage in a caste society to being kinky in India. "Love Matters" can be found wherever you get your podcasts, or you can watch it on YouTube!
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