Boots carries on promoting quackery despite the ASA

It’s now been almost seven months since Boots was the target of 240 Advertising Standards Authority complaints by myself and others.

I didn’t blog on the outcome at the time; so, here’s a quick catch-up. Once approached by the ASA and asked for evidence, Boots decided to avoid an embarrassing ASA adjudication against them by agreeing to remove the claims.

I checked the Boots web site shortly after this and found the situation hadn’t seemed to improve. In many cases, Boots had not removed the claims, but simply taken away the 3 for the price of 2 offer.

If you remember, the ASA will not adjudicate against claims made upon websites (not until March 1st). But, they will adjudicate against claims made as a part of a promotion wherever they appear. By removing quack products from the 3 for 2 offer, Boots simply side-stepped the claims outside the ASA’s remit.

So what’s the situation now? Well in many cases, Boots has removed the claims completely. In other cases though, they’ve reduced the misleading text but carried on making essentially the same point, or at least carried on implying it. Surprisingly, some of the claims are still sitting there in full with the 3 for the price of 2 offer displayed prominently on the page.

My favourite quack product was what can only be referred to as a “fanny magnet”, what sadly what Boots refers to as a “Ladycare menopause relief magnet”. By simply clipping it to your panties, Boots originally claimed it can help to “reduce or completely eliminate symptoms of menopause”. They’ve now removed this precise claim but are still making essentially the same point. They still call it a “menopause relief magnet”, there’s still a photo of it claiming it’s “the most exciting discovery for menopause”, and there’s a list on the photo of symptoms claiming it’s all you may need for everything from hot flushes to vaginal dryness. They’ve side-stepped the ASA by simply taking it out of the 3 for 2 offer.

Shockingly, Boots is still making implying effectiveness for two forms of homeopathic teething relief. Boots’ own brand “Teething Pain Relief - 24 sachets” makes its claims in the title. And their “Nelsons Teetha” product is apparently “a homeopathic remedy specially designed for the soothing and calming relief of the symptoms of teething”. The product photo contains the phrases "Teething Granules", "Teething and pain relief" and "Soothes and calms".

Overall, Boots has improved since the last complaint. A lot of claims have been removed.

Today, I reported Boots to ASA a second time for 5 separate products. I’m hoping this time the ASA will adjudicate and Boots will finally clean up their act.

1023

I wasn’t able to make Frank Swain’s talk at Westminster Skeptics in the Pub on Monday night, but I did catch up with the uncensored parts on The Pod Delusion Podcast later.

Frank is right when he says that there are a whole host of reasons why people believe, and to convince them we need to meet them on their own turf. If anecdotes convince people to believe, anecdotes will be more effective in convincing them not to believe. (I should clarify that I’m summarising what Frank says, these are my words.)

As an example of a campaign that was not effective, Frank cited 1023.

On the point of 1023 being ineffective, I disagree.

What Frank was saying is that the main message of the 1023 campaign is that “there’s nothing in it”. Homeopaths know there's nothing in it. People who have been shunning real medicine in favour of homeopathy for years know there's nothing in it.

And people who already know there’s nothing in it are not going to be convinced by being told that there’s nothing in it. Frank’s right here - but he’s very wrong when he says that this makes it an ineffective campaign.

A tiny percentage of the population shares our skeptical viewpoint. A larger, yet still small percentage; practice homeopathy.

In the middle sits the vast majority, ready to be plucked by either camp. They go to dinner parties and people tell them they’ve visited a homeopath. They walk past homeopathic practices on their way to work. They’re mostly rational, but don’t know what homeopathy is. They may know there isn’t much evidence to show that it works, but they don’t realise that it’s been tested time after time and shown to be ineffective. They don’t realise that it lacks an active ingredient altogether. They don’t realise that it’s a thoroughly discredited absurdity. They don't realise that there's nothing in it.

It is these people who will be convinced by 1023.

If you’re trying to convince as many people as possible, and are within an environment where the vast majority of people are ignorant yet open minded, only a complete fool would target those who already know about the subject, but are so close minded that they ignore the knowledge they already possess.

I have had a couple of opportunities to speak to open-minded, intelligent audiences on this subject. Most people don’t know what it is. Simply explaining it is all that is required to convince them, completely, that it’s nonsense. It takes minutes.

1023 did this on a mass scale. It was a beautiful, engaging demonstration. Hundreds of people took 42 times the recommended dosage of so called "drugs". This impersonation of a crazed religious sect grasped the attention of newspaper reporters. How can a paper not report a mass drug overdose?

The message was clear: we’re able to do something that seems implausible because we’re using implausible medicine. Or - we’ll be fine: there’s nothing in it.

Of course you won’t convince a homeopath. But that homeopath needs customers. And because of 1023, homeopaths are now operating in an environment where many more people know they’re peddling pills that contain nothing. Their customers are socialising with more people who know the pills contain nothing.

Grow this simple understanding throughout the population and you create an environment where homeopathy will struggle to survive. 1023 did that beautifully.

Frank said people aren’t convinced by facts. Telling a story is in many cases more convincing. So I’ll end with a story. Here it is:

Before I was convinced by facts, I once suggested to someone that they might try visiting a homeopath.

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.

---

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

---

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

---

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

---

As yet - no response.

Trust Boots

This is a repost of my article in the Leicester Mercury. I wanted to repost it here so I could fix the messed up text. When they copied and pasted it they lost all the formatting and most importantly the scientific notation. I've fixed it below.

“Trust Boots” is the tagline that has been offered by the high street pharmacist since 2005. According to Boots’ 2006 Corporate Responsibility Strategy, “Everything we do that builds trust is good for our business; anything which could compromise it, a risk we can't afford to take.” So have Boots shown themselves to be worthy of our trust?

On the shelves of their pharmacy on Gallowtree Gate in Leicester you will find a small section devoted to homeopathy. Many people I meet are confused about exactly what homeopathy is – some thinking it is simply a type of herbal or natural medicine.

Allow me to explain.

The first principle of homeopathy is what they call the “law of similars”. Homeopaths look for a chemical that produces a similar symptom to the disease they aim to treat. For instance, caffeine causes you to stay awake, so homeopaths may decide to use this in a remedy to treat insomnia. Another example is hay fever. Hay fever causes runny eyes and so do onions – so some homeopaths will treat hay fever with a preparation of onions. I realise that all this may sound a little bit unconventional, but please bear with me – in a moment it’s going to sound even more so.

Turning a chemical such as onion juice into a homeopathic preparation involves a process of “dilution” and “succussion”. To create the centesimal or “C” remedies they sell at Boots, the homeopath takes one drop of the chemical and mixes it with 99 drops of water (dilution). In centuries past, this was then banged against a leather covered board or book, often a bible, although in modern times the shaking is often done by machine. This shaking is called "succussion". This is now a 1C homeopathic preparation. It contains 99% water and 1% “active ingredient”.

To turn this into a 2C remedy, the process is repeated. One drop of the solution is taken from the 1C remedy is mixed with 99 drops of water and then shaken. The 2C remedy now contains 99.99% water and 0.01% “active ingredient”. Repeat the process again to create a 3C remedy at 0.0001%, and so on. Homeopaths believe that the higher the level of dilution, the more powerful the remedy.

Many homeopaths will use the solution directly, but Boots and many others prefer to sell homeopathy as pills - or pillules as they call them. One pillule is meant to contain the equivalent of one drop of homeopathic solution.

We can calculate approximately how many molecules of “active ingredient” get into the one drop that makes it into the pillule. A drop of water contains about 1,700,000,000,000,000,000,000 molecules. Scientists write this as 1.7x10²¹. That’s a 17 with 20 zeros after it. Boots sell remedies at 6C and 30C. A 6C remedy will contain around 0.0000000001% “active” ingredient – which works out at about 1.7 billion molecules of active ingredient. But what about when we dilute this further? By the time you get to 10C, there are only 17 molecules of active ingredient left. And at 11C, you only have about a one chance in 6 of finding a single molecule.

The branch of Boots on Gallowtree Gate in Leicester display a guide, provided by the manufacturer, that states a Bryonia 30C remedy “Relieves the symptoms of a dry painful cough, pressure and dehydration headaches” and that a Kali Bich 30C remedy “Soothes the symptoms of sinusitis”.

30C. I already explained that at 11C, you only have about a one in 6 chance of finding a single molecule of active ingredient. At 12C, there is only about one chance in 600 that you will find a molecule and at 13C just one chance in 60,000. By the time you get to 30C, you have more chance of winning the National Lottery jackpot five weeks in a row than you do of finding a single molecule of active ingredient.

Or think about it this way: how much water would you need to contain one molecule of active ingredient at 30C dilution? According to my calculations, the body of water would weigh 5 billion times more than the planet you are standing on. If you want that in pillule form, you'd need to buy 6x10³⁸ pillules (a 6 with 38 zeros after it). At Boots' retail prices, that would cost you 35 trillion trillion trillion pounds. That's a rather expensive molecule.

These pills do not contain any active ingredient.

To my way of thinking, homeopathy is entirely implausible, but science is incredibly open-minded to seemingly implausible ideas. Ideas such as Einstein’s theory of general relativity and quantum theory are utterly bizarre, but once they were demonstrated to be true with fair tests then scientists accepted them.

Testing for a pill is essentially simple. Take a large number of people with a particular disease and randomly divide them into two groups. Give one group the pills you want to test and the other group some placebo pills that don’t contain anything. Neither the patient nor the researchers working with them can know which patients were given which pill. After an agreed period of time count how many people in each group got better.

So what do the trials show? Actually, that’s a little complicated. Some of the poor quality trials where the patients were told which drug they were getting, or had very small sample sizes showed an effect. But those effects could easily be down to the placebo effect or random variation due to the small sample sizes.

But when the experiments are done properly with larger numbers of patients, the vast majority do not show homeopathy to be any better than a placebo. A quick search of Cochrane articles leads us to reviews of homeopathy for the treatment of dementia, chronic asthma and attention deficit/hyperactivity disorder. They all end in similar conclusions: “No evidence that homeopathy is effective in treating dementia”, “Until stronger evidence exists for the use of homeopathy in the treatment of asthma, we are unable to make recommendations about homeopathic treatment.” and “Overall the results of this review found no evidence of effectiveness for homeopathy for the global symptoms, core symptoms or related outcomes of attention deficit/hyperactivity disorder.”

But what do they tell you in Boots? When I popped into their Oadby branch and asked about homeopathic treatment, the pharmacist tried to politely steer me away from the homeopathic remedies citing the lack of evidence. Fair enough.

But a pharmacist at the Gallowtree Gate branch was not so off putting. Despite a couple of points in the conversation where I felt she certainly gave the impression that she did not believe in homeopathy, she was still happy to say things that I would never expect to come out of the mouth of professional pharmacist, by explaining that homeopaths “don't just treat the condition, they look at the whole person” and “If you want absolutely spot on accurate treatment you need to see someone who is a qualified homeopath."

Boots' professional standards director Paul Bennett was asked about homeopathy at a parliamentary science and technology sub-committee on the 25th October: "Do they work beyond the placebo effect?" He replied, "I have no evidence before me that they are efficacious and we look very much for the evidence to support that."

I think it's unlikely that Boots don't know where to look for medical evidence. So what we're being told by Boots' professional standards director is that they've looked around, found evidence - but he hasn't found any that show homeopathy to work.

He was asked to clarify with the line, "You sell them, but you don't believe they are efficacious?" He replied, "It's about consumer choice for us."

If it is about consumer choice, I personally believe that Boots should be ensuring that their consumers are properly informed to make a choice. Their labels should clearly state "the best evidence shows that these products work no better than placebos." But their labels don't say that. The information on their shelves makes claims such as "Relieves the symptoms of a dry painful cough." Selling this quackery may well be about consumer choice. Making these claims of efficacy is most certainly not.

Is this likely to lead you to “Trust Boots”?

Homeopathy Maths Quiz: My Answers

Here are the answers to my previous maths quiz. At the end, I've added some notes including an argument showing the "memory of water" idea spouted by homeopaths to be invalid.

1. What is the probability of there being a single molecule of active ingredient in a 30C homeopathic remedy? Assume no contamination and pure water.

Molar mass of water = 18.01528 grams.
1 drop of water approx = 0.05 grams.
=> 1 drop of water = 0.05/18 = 0.0027 moles
=> 1 drop of water = 6 * 10^23 (Avogadro constant) * 0.0027 = 1.66*10²¹ molecules

Number of molecules in a 30C preparation:
= 1.7x10²¹ (molecules in a drop) / 100³⁰ (level of dilution) = 1.7*10^-39

As this is less than one, it is the probability of finding a molecule.

Answer: 1.7*10^-39

2. What is the probability of winning the National Lottery 5 weeks in a row. You get one ticket per week of course.

There are 6 balls drawn out of 49 and you can pick 6 numbers.

Probability that your 1st number will match any one of the 6 drawn = 6/49
Probability that your 2nd number will match any one of the remaining 5 drawn = 5/48
Probability that your 3rd number will match any one of the remaining 4 drawn = 4/47
Probability that your 4th number will match any one of the remaining 3 drawn = 3/46
Probability that your 5th number will match any one of the remaining 2 drawn = 2/45
Probability that your 6th number will match any one of the remaining 1 drawn = 1/44

Probability that all 6 match = 6/49 * 5/48 * 4/47 * 3/46 * 2/45 * 1/44 = 7.15 x 10-8

Or, about 1 in 14 million.

Probability of winning 5 weeks in a row = (7.15x10^-8)⁵ = 1.87 x 10^-36

3. Which is more likely?

Comparing 1.7*10^-39 and 1.87 x 10^-36, you can see that winning the national lottery 5 times in a row is about 1,000 times more likely.

Unless of course, there was some contamination during the process.

4. How much would it cost to buy enough pills that you'd expect to have one molecule of active ingredient? Note: At Boots, they're about £5 for 84 pillules.

To get one molecule, you'd need 100³⁰ water molecules (10⁶⁰).

Molar mass of water = 18 grams.

10⁶⁰ molecules would therefore weigh 18x10⁶⁰/6x10²³ = 3.0 × 10³⁷ grams

One drop of water weighs approx 0.05 grams

So you'd need 3.0 × 10³⁷ / 0.05 = 6 x 10³⁸ pills

At £5 for 84, that will cost 5/84 * 6 x 10³⁸ = £3.57 * 10³⁷

A Trillion is 10¹². Trillion Trillion Trillion = 10³⁶

So that's about 35 Trillion Trillion Trillion pounds.

Other Notes

David P made a good point when he pointed out that the mother tincture may not be pure. Obviously the mathematics above assumes it is.

Another point I realised while I was doing this is that there is another argument here against the "memory of water" bollocks" spouted by homeopaths.

At 12C, there are no molecules of the mother tincture remaining. So the only molecules in the final preperation that could have been in the same mix as any of the original ingredient must come out of this mix.

So by the time you get to 24C, there are not only no molecules of original ingredient left, but there are no molecules of water that have ever been in the same mix as the original ingredient left.

Even the water has memory argument therefore breaks down at dilutions beyond 24C. At best, homeopaths would need to argue that water not only has memory, but that water is capable of passing this memory on.

Are homeopaths going to come to the conclusion that a 30C remedy works because the water contains the memory of a rumour passed on by other water molecule that remembers the mother tincture?

A quick maths quiz

Here's a quick maths quiz. Post your answers, ideally with your working and I'll be able to see how well they compare to mine.

1. What is the probability of there being a single molecule of active ingredient in a 30C homeopathic remedy? Assume no contamination and pure water.
2. What is the probability of winning the National Lottery 5 weeks in a row. You get one ticket per week of course.
3. Which is more likely?
   
4. How much would it cost to buy enough pills that you'd expect to have one molecule of active ingredient? Note: At Boots, they're about £5 for 84 pillules.

I'll post my answers tomorrow.

Edzard Ernst shows Society of Homoeopaths break their own code of conduct

In this excellent article in the BMJ, Zosia Kmietowicz interviews Edzard Ernst on the Society of Homoeopaths breaking their own code of conduct. Similar observations were made on Gimpyblog back in 2007. Apparently they didn't learn too much from that then.

Homoeopath society breaks own ethics code by making speculative claims on website, says expert Zosia Kmietowicz

The Society of Homeopaths is in breach of its own code of ethics by posting "speculative," "misleading," and "deceptive" statements on its website, claims a leading UK expert in complementary medicine.

Edzard Ernst, professor of complementary medicine at the Peninsula Medical School in Exeter, identified numerous statements on the society’s website that he claimed could be seen as contravening the code. He was writing in the International Journal of Clinical Practice (doi:10.1111/j.1742-1241.2009.02249.x).

The code of ethics, which runs to 23 pages, sets out the rules that the society expects its members to abide by. These state that advertising should not make claims to "cure named diseases" or be "false, fraudulent, misleading, deceptive, extravagant or sensational." It adds that "all speculative theories will be stated as such and clearly distinguished."

However, a review of some members’ websites showed a series of violations of the code that led Professor Ernst to scrutinise the society’s own website.

Despite there being no good clinical evidence to substantiate such claims, says Professor Ernst, the society’s website carried statements claiming that homoeopathy can help with various symptoms and illnesses, including fever, sore throat, toothache, arthritis, eczema, asthma, anxiety, insomnia, chicken pox, erectile dysfunction, and prostate problems.

"In my view, they [the statements] do ‘expressly or implicitly’ claim ‘to cure named diseases,’" writes Professor Ernst. "If this is so, they violate the SoH’s [Society of Homeopath’s] own Code of Ethics."

He concludes, "If the SoH wants its members to behave ethically it should evaluate its own website carefully and deliberate whether it is responsible for a professional organisation to make health claims which are not supported by the current best evidence."

Professor Ernst told the BMJ that advertising by members of the Society of Homeopaths "should be more than lip service to evidence based medicine, otherwise it is confusing and potentially harmful."

Paula Ross, the society’s chief executive, said she was grateful to Professor Ernst for highlighting his concerns and that the society would be investigating the concerns and making amendments "where appropriate."

BMJ 2009;339:b4605

Sara Stevens and the Ultra-Woo Allergy Test

I visited Sara Stevens of "The Complementary Health Team" in Blaby back in May. I've been incredibly slow to blog this, but just realised that blogging my letter of complaint in full would be much better than writing anything new.

Enjoy!

Dear Ms Stevens,

I visited your premises in Blaby on the 7th May 2009 around 5pm for what was sold to me as an “allergy test”.

Having thought about the tests I received, I have got quite suspicious of the methods used and am not convinced that they could work.

To summarise your methods:

• You took a homeopathic preparation of an allergen and put it into my left hand.
• I held it close to my stomach and outstretched my arm.
• You pushed my arm down.
• If my arm moved easily you deduced that I was allergic or sensitive to the preparation from which the homeopathic remedy was made. If not, you deduced that I was not allergic or sensitive.

The problems I am having difficulty overcoming are as follows:

• Homeopathic solutions are typically dissolved to the point where there is none of the original substance remaining. With no substance remaining, I see no difference whatsoever between the 35 preparations you presented me with. How could this work without a chemical difference between the solutions?
• With the preparations contained within glass phials, my body did not even come into contact with the pills. How could my body produce a reaction against a chemical it did not come into contact with?
• I can find no reliable evidence to suggest that coming into contact with an allergen near your stomach reduces your strength in a different part of your body.
• You merely pushed my arm down to subjectively measure the force. This is obviously a completely inaccurate way of measuring resistive force.

To summarise, you attempted to test me for an allergy by pushing my arm down while I didn’t touch a preparation that probably contained no trace whatsoever of an allergen. What evidence do you have to demonstrate that this test actually works?

Following the allergy test, you then gave me two further “tests”. The first, you claimed, was to assess the proportion of “bad bacteria” to “good bacteria” in my body. You did this by counting in tens (0, 10, 20 etc) up to 100 while repeatedly pushing down my arm. After assessing it was weakest between the times when you said “10” and “20”; you then pushed down my arm while counting between 10 and 20. From this, you deduced that my “Candia Level” as you called it, was 14%.

What evidence do you have to demonstrate that this second test actually works?

You then carried out a further “test” to find out what “good bacteria” I needed to buy to restore the balance. You did this by repeatedly pushing down my arm whilst pointing at descriptions of bacteria in a book. You then recommended I take “acidobifidus”.

What evidence do you have to demonstrate that this third test actually works?

I’ve read a fair bit about these tests online and opinion seems to be split. Practitioners of Applied Kinesiology appear to endorse the test, while the common consensus, including all reputable scientific studies, dismiss the practice as pseudo-science with no evidence that it produces accurate repeatable results.

If you do have good evidence that this test works, could you send it to me please? If you do not, I believe that you are operating an unfair commercial practice under the 2008 consumer protection regulations and would like a full refund.

If you do not have reliable evidence for this test, I assume you will from now on comply with the 2008 consumer protection legislation and discontinue your applied kinesiology service. Can you clarify if this is the case?

Regards,

Simon Perry