My new patient appointments generally go like this: a full intake, with lots of probing questions either sparked by stories the patient tells me or by comments on the very long new patient paperwork. We cover diet if it’s relevant; we cover lifestyle, if it’s relevant; we cover lab work if they’ve brought it or I send the patient for whatever else is necessary. Sometimes I’ll prescribe supplements or botanical medicine, and very occasionally I’ll prescribe pharmaceuticals… but one of my favorite modalities (methods of treatment) to add in to the rest of the protocol is homeopathy.

Certain conditions lend themselves to homeopathy better than others, but when the case fits, I love to prescribe it. This is because 1) if I choose the right remedy, almost nothing else has such a powerful and rapid curative effect; and 2) if I choose the wrong remedy, nothing happens. (“First do no harm,” of course.)

What Homeopathy Is

For every action, there’s an equal and opposite reaction, right? So if you give someone a drug to suppress a symptom, the first effect will be that the symptom improves or disappears. But the body is a living system, seeking to achieve homeostasis (or balance). That means there’s going to be a secondary effect: the body will attempt to create a new set point, and it’s going to be farther in the direction of ill health. So for instance: if you’re constipated and take a laxative, at first you poop more. But if you become addicted to laxatives, you have to take higher and higher doses of them in order to achieve the same effect–they actually make you more constipated over time. That’s your body acclimating, creating a new set point in the direction of ill health.

Homeopathy does the opposite: it attempts to give your body a tiny, energetic push in the direction it’s already going, so that the secondary effect will be towards health, rather than towards further disease. This is the principle of “like cures like”: identify what symptoms a crude (undiluted) substance would cause in a healthy person; give an extremely diluted amount of that same substance to a patient who already has those symptoms, and watch them improve.

Of course, if you’re giving the body a tiny push in the direction of the present symptoms, it is possible to aggravate with that first effect before the secondary corrective effect takes over. This means the symptoms you’re trying to treat might briefly worsen before they improve. It’s a good sign, really: it means you’re taking the right remedy, it was just too hard a push for you. You’ll go back to baseline and proceed to improve after that, if you stop the remedy and just wait it out.

Why Does Dilution Work?

The big controversy over homeopathy is primarily about the idea of dilution. The numbers after the remedy are the remedy’s potency, and they’re usually listed in X, C, M, and LM. These are Roman numerals, and they refer to the number of times the original crude substance has been diluted. So for instance, a 200 c means the substance has been diluted 200 x 100 or 20,000 times. From a chemistry standpoint, there’s not even a single molecule of the original substance left in the medicine. So why does this still work? Is it just placebo?

What you’ll find if you scour PubMed are two sets of homeopathic clinical trials. One set are those that follow the standard double-blind, placebo-controlled setup, and according to those, yeah, homeopathy is total placebo (which, if you’re curious, I go into further in this article. It basically means you get better because you believe you’re going to get better—and the fact that by conservative estimates, about 30% of the population are susceptible to the placebo effect has some pretty staggering implications of the power of our minds that nobody ever seems to talk about. But I digress.)

The problem is, homeopathy was never designed to be given as a blanket treatment for a given symptom. It doesn’t work that way. You can’t say migraines are migraines, and the same remedy will therefore get rid of them across the board. One person’s migraines may be on the right side of her head and another’s on the left. One person may feel much better lying flat in a cold room, and another may want her head elevated on pillows. One person may feel better with hot drinks while another loathes them. One’s migraines may be related to her period and another person’s may have nothing to do with hormones at all. Western medicine has lumped sets of symptoms together under a diagnosis, but the manifestations of these symptoms are different for each person; therefore the treatment has to be individualized. Each of these cases requires a different remedy. If I just give one remedy that happens to cover migraines pretty often to all of those patients, maybe 30% of them will get better… which is no better than placebo. 

When you look at PubMed for non-randomized trials in which homeopathy was prescribed in an individualized fashion the way it’s supposed to be, though, it far outstrips that 30% placebo number. Occasionally the effect may still be placebo for some of those, but the same could be said for any medication whatsoever.

So if it works, why does it work?

Different Structures of Water?

There do exist a few research papers which demonstrate the increased efficacy of diluted and shaken solutions, such as “Thermodynamics of Extremely Diluted Aqueous Solutions” (Elia and Niccoli, 1999) and “The Structure of Liquid Water; Novel Insights from Materials Research; Potential Relevance to Homeopathy” (Roy et al, 2004). These papers imply that water itself can take on different organizational structures, and perhaps this is the mechanism of energetic imprinting in homeopathy.

These ideas were not new. In 1988, French immunologist Jacques Benveniste published a paper in Nature claiming that a water sample once containing antibodies could still elicit an immune response from white blood cells, despite the fact that the antibodies were no longer present. The backlash from the scientific community at the time was extreme, and despite the fact that according to Benveniste, multiple independent scientists successfully replicated Benveniste’s results, an inquisitorial team deemed that the results were not in fact replicable, and they investigated him for fraud. They could not find any traces of fraud, but Benveniste still subsequently lost his funding, his lab, and his career.

More recently, Dr. Gerald Pollack, University of Washington professor of bioengineering and author of “The Fourth Phase of Water”, has spent the past decade arguing that water has a fourth phase (other than solid, liquid, and gas). It’s what he calls Exclusion Zone water, or structured water. How it works: when water molecules interact with charged surfaces (like what’s found inside the cell), they become structured in arrays—like ice, except not solid. This structured water has some distinct properties from liquid water as we know it: like ice, it retains an internal order and excludes other particles. More importantly, Pollack notes that the properties of the water’s crystalline structure differ, depending on the substances with which the water comes into contact. He stops short of claiming that water has a “memory” as Benveniste did, but proponents of homeopathy see that as the clear implication of his work. 

The Upshot:

Homeopathy tends to inspire concern—either because there’s nothing in it and it therefore can’t do anything physiological; because it’s “energetic medicine” and it therefore must be spiritual in some way (it isn’t); or because it’s made from substances which are toxic or even poisonous in their crude forms (nux vomica = strychnine; arsenicum album = arsenic, etc)!

All reasonable concerns. But the salient points to remember here:

  • Curative properties of homeopathy are based on the principle of living organisms seeking homeostasis: “like cures like” — as opposed to the suppressive model of pharmaceuticals, which produces rebound effects.
  • Not all homeopathic remedies are made from toxic substances, but of those that are, no molecules remain of the original toxic substance. From a chemical standpoint, there’s nothing in it. 
  • We’re not sure why the dilution still works, but it’s looking like it has something to do with a fourth structure of water, which can retain information of the substances it comes into contact with even after those substances are no longer present.
  • And the beauty of homeopathy, I think: if you pick the wrong remedy, nothing happens! But if you pick the right one, it can really open up some difficult cases.