Homeopathy

Homeopathy (also spelt homoeopathy) is a system of alternative medicine, about 200 years old, built on the idea of treating "like with like". Its practitioners describe it as holistic, and it uses specially prepared, highly diluted preparations that are intended to stimulate the body's own healing response. It was first developed by Samuel Hahnemann.

Description

Like with like

Homeopathy rests on the principle of similars: the idea that a substance which produces certain symptoms in a healthy person can, in a highly diluted form, treat an illness with similar symptoms. Homeopaths choose treatments, and recognise patterns of signs and symptoms, in ways that differ from conventional medicine.

Preparations

Homeopathic preparations are made from many kinds of starting material, including plants, animals, minerals and chemicals, following the methods set out in homeopathic pharmacopoeias (official reference books of preparation standards). The starting substance is diluted step by step, with vigorous shaking (succussion) after each dilution. The whole process is called potentisation.

The strength of a preparation, its potency, is labelled by scale. Each step of an "X" (or "D") potency is a tenfold dilution, and each step of a "C" potency is a hundredfold dilution. Better Health notes that after the twelfth dilution no chemical trace of the original substance can be detected, although homeopaths believe the preparation keeps its qualities. Preparations may be given as liquids, powders, granules or tablets.

Approaches

The 2024 evidence evaluation describes two broad types of homeopathy, and the difference matters when reading research about it:

• In individualised homeopathy, a trained practitioner chooses a single preparation after a detailed consultation about the person's mental, emotional and physical symptoms. Its most common form is known as classical homeopathy.
• In non-individualised homeopathy, the same preparation, or a fixed combination, is given to everyone with a particular condition, with or without a consultation.

A consultation

Homeopaths say they aim to treat the whole person, taking into account personality, lifestyle and inherited factors as well as the history of the illness. Consultations are long, usually at least an hour. The practitioner may also suggest general changes to lifestyle and diet. Homeopaths say symptoms sometimes get worse for a while before they improve, and call this aggravation. Better Health still advises telling both your homeopath and your doctor about any reaction (see Safety below).

Scope

What it includes

• Consultations that consider the whole person
• Prescribing homeopathic preparations, sometimes with advice on nutrition and hygiene, or counselling

What it is not

• It is not vaccination. There is no such thing as a homeopathic vaccine, and homeopathic preparations are not an acceptable alternative to vaccines. Better Health explains why: vaccines work by prompting the body to make antibodies against particular germs, and homeopathic medicines are not based on that process.
• It is not a replacement for medical treatment of serious diseases or infections.
• Naturopathy is not homeopathy. Naturopathic training does not meet the government standards for homeopathy, although some naturopaths have done further study to meet them.

What the evidence reviews found

In 2015 the National Health and Medical Research Council (NHMRC), after assessing the evidence, concluded that there is no health condition for which there is reliable evidence that homeopathy works. The Commonwealth Ombudsman later investigated a complaint about how that review was carried out, and in August 2023 closed its investigation with no adverse findings about the review or the NHMRC.

A 2024 systematic review for the Australian Government's Natural Therapies Review reached a similar overall picture. For the conditions it assessed, homeopathy appeared to give little or no benefit over placebo (a dummy treatment) for most outcomes with available evidence, and the few studies comparing it with no treatment gave similar results. The certainty of the evidence ranged from moderate to very low. There was low-certainty evidence that homeopathy may do better than placebo on two outcomes: reducing medication use in allergic rhinitis and reducing severity in atopic dermatitis. One trial gave moderate-certainty evidence that homeopathy probably reduces how often infections come back in people with recurrent upper respiratory tract infections, compared with no treatment, although the comparison with placebo for that condition was very uncertain.

Traditions and lineage

Homeopathy was first developed about 200 years ago by Samuel Hahnemann. The first homeopathic practitioner arrived in Australia in the 1840s, and the first of several homeopathic hospitals opened in 1876. The hospitals had all closed by the late 1920s, mainly because of medical advances such as antibiotics. Over the past 50 years homeopathy has revived in Australia, largely because public attitudes to health have changed.

Context

Within Spiritualism

Homeopathy appears at the edges of Spiritualist history rather than at its centre. The Encyclopedia of Occultism and Parapsychology records that The Spirits' Book, the founding text of Allan Kardec's Spiritism, drew on the trance communications of the medium Celina Japhet, who under the control of spirits named as her grandfather, "M. Hahnemann", and Franz Mesmer gave out medical advice. In a 1981 study of Spiritualists, Paul Gillen wrote that the movement's wider setting had shifted over time, from Swedenborgianism and mesmerism through Theosophy and Christian Science to, most recently, homeopathy and meditative practices.

Present-day Spiritualist guidance keeps healing separate from other treatments. The US National Spiritualist Association of Churches tells spiritual healers not to recommend drugs or a specific treatment when giving healing.

In Australian Spiritualism

In his study of a Sydney Spiritualist church (given the pseudonym "Mortfield"), Gillen found that its healers, who worked mainly by touch, also gave "homeopathic and folkloric remedies", sometimes on the instruction of a spirit guide. He added that Spiritualists there did not see spiritual healing as being at odds with other treatments, including orthodox medicine. Spiritfold has found no Australian Spiritualist organisation that lists homeopathy among its present-day activities.

A Spiritualist perspective

Spiritualists have long sat comfortably beside other approaches to health, and the Sydney study above records healers who also gave homeopathic remedies, sometimes at a guide's suggestion. A thoughtful Spiritualist teacher would still ask healers to keep the two apart. Spiritual healing is offered by a medium who attunes to the spirit world and steps aside; it involves no diagnosis, no prescription and no remedies. Passing on a remedy, even one said to come from a guide, puts the healer in the role of a practitioner, which is not what healing asks of them. It also places a heavy weight on the person receiving healing, who may give a guide's suggestion more authority than it can bear.

Someone who has studied homeopathy may practise it in their own right, separately and honestly named. In every case, a Spiritualist would gently remind people that healing works alongside medical care, never in place of it, and that anyone with a health concern should see their doctor and keep to any treatment they have been prescribed.

Homeopathy in Australia

Practitioners and registration

Homeopaths in Australia mostly work for themselves in private practice in towns and cities. Some other practitioners, such as naturopaths, also use homeopathic preparations. National Competency Standards in Homeopathy were set in 1999 to help make sure practitioners are properly qualified and keep to ethical and professional standards that protect their clients. The Australian Register of Homoeopaths (AROH), also set up in 1999, is the profession's national, non-government registration and self-regulation body. To stay registered, practitioners must renew each year, meet continuing professional development requirements and hold indemnity insurance. Better Health advises anyone choosing homeopathy to see a registered homeopath, and also names the Australian Homoeopathic Association as a source of help.

Regulation of practitioners

Homeopaths are not registered under national health practitioner law; the 2024 evaluation describes them as unregistered health practitioners who are not required to register under legislation. Instead, some states use a lighter form of oversight. In 2014 the Australian Health Ministers' Advisory Council published a National Code of Conduct for health care workers, and New South Wales, Queensland, South Australia and Victoria have passed laws putting it into effect, covering homeopaths among others. These laws are sometimes called negative licensing: they do not set minimum qualifications or restrict who can practise, but they allow action against practitioners who fall below minimum standards, such as fines or orders banning or limiting their practice. Some other states and territories, such as Tasmania, have other ways to make complaints about unregistered practitioners.

Regulation of homeopathic medicines

In Australia, medicines containing homeopathic preparations are treated as low-risk medicines and are regulated by the Therapeutic Goods Administration (TGA) under the Therapeutic Goods Act 1989. The level of oversight depends on how dilute the preparation is:

• Most preparations more dilute than a thousandfold dilution of the starting tincture (4X and above) do not have to be entered on the Australian Register of Therapeutic Goods (ARTG), because the TGA considers them low enough in risk.
• Less dilute preparations, meaning the starting (mother) tincture and 1X, 2X and 3X potencies, must be on the ARTG before they can be supplied, and listed preparations may contain only ingredients on the TGA's list of permitted ingredients.
• A preparation made up by a practitioner for one patient after a consultation is also exempt from the ARTG.
• All homeopathic medicines supplied commercially, whether or not they are on the ARTG, must meet advertising requirements and labelling rules, and their labels must say they are homoeopathic medicines.

The TGA notes that some source materials used in homeopathy are poisonous, and that the high dilution of homeopathic preparations is considered to make them non-toxic. This helps explain why the rules are stricter for the less dilute preparations.

Private health insurance

Before 2019, health fund rebates for homeopathy were paid only when people saw practitioners registered with AROH or belonging to certain associations. Since 1 April 2019, homeopathy has been one of 16 natural therapies that private health insurers cannot cover. The exclusion followed the 2015 review of the government rebate on natural therapies, which found too little evidence to reach firm conclusions about how well the therapies work.

The Natural Therapies Review 2024 looked at the evidence again. Its Chair, Professor Michael Kidd, set the bar for re-inclusion at moderate-certainty evidence of effectiveness for at least one health outcome in one condition, explaining that higher certainty is hard to reach when studies of these therapies often cannot use double blinding or placebos. On that basis he recommended that seven therapies become eligible again, but did not recommend homeopathy.

Safety and good practice

The main risk: delaying effective treatment

Better Health says homeopathic medicines are not considered harmful in themselves. The danger lies in relying on homeopathy instead of conventional treatment for a serious disease or infection. The NHMRC advises against using homeopathy for conditions that are long-lasting, serious, or could become serious. Its reasoning is that people who refuse or delay treatments with good evidence of safety and effectiveness, and choose homeopathy instead, may be putting their health at risk. It recommends that anyone thinking about homeopathy first seek advice from a registered health practitioner, and that anyone using it tell their health practitioner and continue any prescribed treatment.

Good practice for anyone using homeopathy

Better Health advises people to:

• tell their doctor before starting homeopathic treatment
• never stop taking conventional medicines without their doctor's knowledge and approval
• tell their homeopath which medicines they are taking
• tell their homeopath and doctor about any reactions.

Children and immunisation

The Victorian Department of Health continues to advise parents to have their children immunised according to Australian Government recommendations. As explained above, homeopathic preparations are not vaccines and cannot take their place.

What the review did not cover

The 2024 evidence evaluation did not assess safety. As in 2015, the Natural Therapies Review left safety, quality and cost-effectiveness out of its scope, because studies of effectiveness generally lacked that information.

Related modalities

• Naturopathy
• Western herbal medicine
• Flower essences
• Iridology
• Spiritual healing

Further reading

• Better Health Channel. "Homeopathy". Department of Health, State Government of Victoria, 2024.
• Department of Health, Disability and Ageing. "Natural Therapies Review 2024". Australian Government.
• HTANALYSTS. Homeopathy for preventing and treating health conditions: evidence evaluation report. National Health and Medical Research Council, 2024.
• National Health and Medical Research Council. NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions. NHMRC, 2015.
• Therapeutic Goods Administration. "Understanding the different types of complementary medicines". Australian Government, 2018.