Boots avoid admitting there's nothing in it. 10:23

If you thought I'm too old for this sort of childish moron-baiting, I'm afraid you're sorely mistaken. This month I've been emailing Boots to ask how much Arnica is in one of their Arnica 30C remedies. Obviously I know the answer - there is none. Boots also know the answer.

It's quite amusing however, to see them trying to avoid giving me this answer. The email trail follows.

10:23.

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8 January 2010 21:03

Hi,

I'm used to seeing the quantity of ingredients listed in mg rather that as "6C" or "30C" as your homeopathic remedies are labelled.

Can you clarify for me how many mg of Arnica is in one of your "Arnica 30C" tablets? I tried to work it out, but I think I got confused at some point.

Thanks,

Simon

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11 January 2010 17:39

Dear Simon

Thank you for taking the time to email me regarding Boots Arnica 30c (item code 37-71-814) with regard to converting the content of Arnica into milligrams.

I am afraid, however, that it is not possible to convert "centesimal" (c) dilutions of Homoeopathic remedies into milligrams (mg) or micrograms (mcg).

During the manufacturing of Homoeopathic remedies the amount of Arnica is not quantified in milligrams or micrograms. Instead one drop of Arnica (or other Homoeopathic ingredient) is added to ninety-nine drops of diluent (carrier) to produce a 1 centesimal (1c) potency, which is then further diluted to produce a 6c or 30c product.

I hope that this information is of use to you.

Regards

Paul Williams MRPharmS
Medical Information (Pharmacist) Officer

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11 January 2010 18:17

Hi,

Sorry, I'm confused by this. Surely there is a specific amount of Arnica in the pills which can be measured in mg?

If, as you suggest, that a 1C remedy is 1% Arnica then surely if it was a 100mg pill, then this would be 1mg Arnica. Why isn't this correct?

Simon

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14 January 2010 13:27

Dear Simon

Thank you for your second e-mail regarding Boots Arnica 30c (item code 37-71-814).

Unfortunately, the amount of Arnica (or other Homoeopathic ingredient) in the drop that is then subsequently diluted with 99 drops of diluent (carrier) is not quantified in milligrams (mg) or micrograms (mcg).

Thus, although it is true to say that a 1 centesimal (1c) Homoeopathic remedy contains 1 part of Arnica, as the amount of Arnica is not initially quantified then it is not possible to convert this into milligrams (mg) or micrograms (mcg).

Therefore, with regard to Homoeopathic remedies we are not able to state the quantity of Arnica in milligrams (mg) or micrograms (mcg) for the reason outlined above.

The labelling of our products is in accordance with guidelines on the labelling of Homoeopathic remedies, which are derived from The Medicines and Healthcare Products Regulatory Agency (known as the MHRA), which is the UK medicines regulator. These guidelines state that the scientific name of the "stock" (i.e. Arnica) and centesimal dilution should be declared on the labelling.

I hope that this further information is of use to you.

Kind Regards

Paul Williams MRPharmS
Medical Information (Pharmacist) Officer
Medical Services

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14 January 2010 15:39

Dear Paul,

Thank you for your reply, and I understand that without knowing the mass of the original drop of Arnica it would be impossible to determine the subsequent mass of Arnica in the final product. However, it should easily be possible to determine the percentage of Arnica in the final 30C remedy.

Am I correct that a 1C remedy is 1% active ingredient? That it is 99% water and 1% Arnica?

What is the percentage of Arnica in the final 30C product?

I've been trying to work this out myself, but I think I've gone wrong somewhere. This will allow me to make an approximate estimate of the number of mg of Arnica.

Many thanks for your help,

Simon

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18 January 2010 16:29

Dear Simon

Thank you for you further e-mail regarding Boots Arnica 30c (item code 37-71-814).

I can confirm that a 1c Homoeopathic remedy comprises of 1% of the Homoeopathic ingredient i.e. Arnica and 99% of the diluent (carrier).

I can also confirm that to produce a 2c Homoeopathic remedy 1 drop of the 1c Homoeopathic dilution is then further diluted with 99 drops of diluent (carrier). This would equate to 0.01% of the Homoeopathic ingredient i.e. Arnica.

To produce a 3c Homoeopathic remedy this method of dilution is repeated with one drop of the 2c dilution and so on in order to produce a 30c Homoeopathic remedy.

The labelling of our products is in accordance with guidelines on the labelling of Homoeopathic remedies, which are derived from The Medicines and Healthcare Products Regulatory Agency (known as the MHRA), which is the UK medicines regulator. These guidelines state that the scientific name of the "stock" (i.e. Arnica) and centesimal dilution should be declared on the labelling.

I hope that this information is of use to you and is sufficient to allow you to calculate the percentage of Arnica.

If you require further support in understanding Homoeopathic remedies then you may wish to contact the supplier for this product, Nelsons, via enquiries@nelsons.net.

Regards


Paul Williams MRPharmS
Medical Information (Pharmacist) Officer

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18 January 2010 18:02

Hi Paul,

Thanks for your reply, however I'm still having problems with my calculation. While the figures seem to make sense from a mathematical point of view, the percentage of Arnica seems to reduce fairly rapidly to seemingly absurd quantities.

As you said in your email, these products are licensed by the MHRA and of course they are sold by Boots, so I've no doubt as to their effectiveness.

So the only logical conclusion I can draw is that I've made a mess of the mathematics.

Can you confirm the answer you get for a 30C remedy?

Many thanks,

Simon

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22 January 2010 15:37

Dear Simon

Thank you for your further e-mail regarding Boots Arnica 30 c (item code 37-71-814) with regard to calculating the percentage of Arnica.

Whilst the information about the dilutions of Homoeopathic remedies is freely available from validated reference sources, the actual percentage in a 30 c Homoeopathic remedy is not stated and, therefore, I am afraid I am unable to provide this information.

At Boots we take our responsibilities as the leading Pharmacy-led Health & Beauty retailer in the UK very seriously and as part of this we pride ourselves on being able to offer all of our customers a choice of products that support them in their day-to-day lives. We know that many people believe in the benefits of complementary medicines and we aim to offer the products we know our customers want.

I can confirm that Boots Arnica 30 c are a licensed Homoeopathic product without approved therapeutic indications. The pack is labelled in accordance with the requirements placed upon the Marketing Authorisation holder, Nelsons, by the Medicines and Healthcare Products Regulatory Agency. If you would like to contact the Marketing Authorisation holder to discuss the formulation of this product and the manufacturing process in more detail they are contactable at enquiries@nelsons.net.

Our Pharmacists are trained Healthcare Professionals and are on hand to offer advice on the safe use of complementary medicines. The Royal Pharmaceutical Society of Great Britain issues guidance to Pharmacists on the correct selling of Homoeopathy, which our Pharmacists adhere to.

I would like to conclude by confirming that Boots support the call for scientific research and evidence gathering on the efficacy of Homoeopathic medicines as this would help our patients and customers make better informed choices about using Homoeopathic medicines.

I hope that this information is of use to you.

Regards
Paul Williams MRPharmS
Medical Information (Pharmacist) Officer
Medical Services

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23 January 2010 08:52

Hi Paul,

I get the impression that you are trying hard to avoid answering my question.

In an earlier email you say that it is possible to calculate the percentage of Arnica in a 1C and 2C remedy but then without reason you say you cannot do it for a 30C remedy. Yet in a previous email you state that the information you gave me should be sufficient for the calculation.

The problems I was having when calculating the amount of Arnica is that every time I did the maths, the result came out that there was no Arnica remaining in the 30C remedy.

This is a perfectly simple and clear question: is there any Arnica remaining in an Arnica 30C remedy?

Many thanks,

Simon

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As yet - no response.

David Tredinnick MP Promotes Dangerous Ideas

The ability to use reason, weigh evidence and make rational decisions is an essential skill. Strongly held beliefs unsupported by evidence can cause significant damage to the deluded individual and those who surround them.

An individual approaching a homeopath for a cold remedy will probably do no more self harm than to waste their money and feed their own delusion, but the homeopath who convinces their client that they're safe to go to West Africa with nothing more than a sugar pill for malaria protection may well kill them.

But mumbo-jumbo becomes most dangerous when it is believed by those with power.

In the late 1980s, the Government launched an Aids awareness campaign warning people not to "die of ignorance". But 13 years later in South Africa, the Mbeki government was infected with the very ignorance we Brits were warned against.

Mbeki started to doubt HIV was the cause of Aids and the regime started promoting the eating of potatoes and garlic as Aids treatment while warning of the dangers of anti-retro viral drugs.

The South African government's stance is estimated by scientists to have caused the premature deaths of between 300,000 and 350,000 people, the equivalent of a 9/11-sized catastrophe once a week for two years.

Under Chairman Mao, the People's Republic of China embarked on its Great Leap Forward, combining a set of absurd pseudo-scientific farming practices with a socialist economic doctrine so daft that its flaws could have been spotted by a teenager half way through their economics GCSE.

The farming practices were devised by Trofim Lysenko, who denied many basic tenets of biology, even genetic theory.

His farming advice included ploughing to a depth of two metres, storing wet seed in snow and planting rows of seeds extremely close together under the belief they would not compete with each other.

With the expected productivity gains, they reasoned there was little need to farm much of the land. But then these expectations were not based on any kind of rational thought or evidence.

This lethal combination of nonsense-biology, nonsense-agronomy and nonsense-economics caused the greatest famine in history, with estimates of the number of deaths ranging from 15-30 million.

But you think you're probably safe, right? Our MPs place their trust in independent scientific advisers who are at the top of their profession, right? Well, no.

Should you wish to find the MP who I believe promotes some of the most scientifically illiterate and dangerous ideas in Parliament, then look no further than the Leicestershire constituency of Bosworth.

On October 14 last year, David Tredinnick, MP for Bosworth, voiced controversial ideas during a Parliamentary question. His speech included: "There are now people who teach, such as Jane Ridder-Patrick, who published A Handbook of Medical Astrology. They look at aspects of the subject and how it affects people's health. Whatever one believes personally, the issue is one that we should look into and consider."

I find it unbelievable that a democratically-elected MP seems to be suggesting we should be looking into using astrology within our system of health care.

His question also included the lines: "A number of disciplines were mentioned and I could have referred to radionics, for example, for which a double-blind trial is almost impossible, yet it is very popular because people believe that it gives them the ability to get remote healing.

"We need to think out of the box here. As with healers who can do remote healing, it is no good people saying that just because we cannot prove something, it does not work. The anecdotal evidence that it does is enormous."

Radionics is a system of healing where you take a sample of hair or blood, or even a signature and use it in what I can only describe as a kind of remote psychic healing machine.

It's the friendly but equally wacky equivalent of sticking pins into a voodoo doll. Yet it seems Mr Tredinnick is suggesting we should consider it within the NHS.

But, in my view, the most dangerous of Mr Tredinnick's suggestions concerns his promotion of homeopathy: "Attacks have also been made on the efficacy of homeopathy. A letter was sent to the World Health Organisation warning against the use of homeopathy, but it ignored the very clear randomised, double-blind trials that proved it is effective in the particular area of childhood diarrhoea on which it was criticised.

"Will the Government therefore be robust in their support for homeopathy and consider what can be done so that it is used more effectively in the health service?"

Let's put this into context. Homeopathy is best described as a magical belief system that uses chemicals at such ludicrously huge dilution levels the majority of remedies contain little but water. The implausibility of homeopathy has been already covered in my column on December 10 and I will not bore you by repeating it.

Mr Tredinnick is technically right when he says there have been double-blind trials that have come out positive. However, that is not the whole story.

The trials he refers to were all conducted by the same person. In science, repeatability is key: if other people repeat your trial and get the same results then your results are likely to be trusted. If all the trials are performed by the same person they should be treated with more skepticism. The first name on all the papers Tredinnick refers to is Jacobs J. I'm not confident in the open-minded nature of this person's experiments.

For a start, writing an article entitled "Homeopathy, not evidence-based, but now?!" seems to me to be implying a motivation to create evidence in favour, rather than simply conducting research and be led by the outcome.

What's more interesting is in 2003, Jacobs did a meta-analysis of his previous three trials. In a meta-analysis, a researcher will combine the results of several trials into one to produce more statistical power.

Of course, if you combine the results of three positive trials all done by the same person the outcome will be positive. But in total, the three trials only involved 242 children.

In the conclusion, Jacobs noted the results "suggest larger sample sizes be used in future homeopathic research to ensure adequate statistical power".

In 2006, Jacobs did just that. This time, six other researchers were involved in the trial and the number of subjects in the test was larger even than the total of the previous trials – 292 children.

The latest trial, which had the largest number of subjects, concluded: "There was no significant difference in the likelihood of resolution of diarrhoeal symptoms between the treatment and placebo groups".

Or, in other words: homeopathy does not seem to work for childhood diarrhoea.

But all Mr Tredinnick is suggesting is that we use this form of quackery to treat a bit of Delhi Belly.

Diarrhoea, according to the World Health Organisation, kills about 2.2 million people each year – most of them children.

Internationally, it is responsible for 4% of all deaths.

And by specifically mentioning the advice given out by the Worldwide Health Organisation his agenda appears to take a global perspective.

Yes, one in every 25 people worldwide will die of diarrhoea. They need the best that medical science has to offer them – which is usually simple and pretty cheap really: just a basic mix of water, salt and sugar.

But if you live in the Bosworth constituency, it seems your MP may prefer to treat these poor children with something even simpler: quackery.