Episode 5.: Homeopathy & Immunology; frenemies of a young immunologist
Aug 13, 2023Season 1Episode 5
Nora Balzer
Listen to our episode with the fabulous Dr. Natalie Grams, who talks about all aspects of homeopathy. We discuss the basic idea behind traditional German medicine, it's role in our model society, and it's potential harms as well.
Listen to our episode with the fabulous Dr. Natalie Grams, who talks about all aspects of homeopathy. We discuss the basic idea behind traditional German medicine, it's role in our model society, and it's potential harms as well.
Welcome everyone to the Young Immunologist podcast. Our topic is today homeopathy. It is an especially delicate topic in the field of immunology, and scientists tend to avoid talking about it or explain
[Natalie Grams]:
you
[Nóra Balzer]:
it. It is a traditional medical system developed in Germany more than 200 years ago based on the theories cure likes and the law of minimum dose. Natalie Grams is a German physician and science communicator her opinion and knowledge on homopathy. I am especially thrilled to talk Natalie today, who used to be a homopath, but became one of the greatest critical voices of homopathy and published her book, Homopathy Reconsidered, What Really Helps Patients. Natalie, thank you very much for taking your time and sharing your thoughts with
[Natalie Grams]:
Thanks for watching!
[Nóra Balzer]:
us. How did you get in contact with homopathy for the first time?
[Natalie Grams]:
Yeah, before I answer your questions, thank you for having me. I'm very happy to be here today. And well, like so many other people, I made an apparently good experience with homeopathy once. I was studying medicine at that time and after a nearly deadly car accident, I had several complaints, a trauma as I know today, but then I had all kinds of complaints for which no physical cause could be found. And after a long time, recommendation of a friend, I went to see a non-medical therapist, we call them Heilpraktiker in Germany, who took care of the matter with a lot of time and empathy. And homoeopathy was just one part of her efforts, but she gave me the so-called Globuli, which are the little sugar pills which homoeopathy uses as remedies. And I could take them as soon to cope with my symptoms whenever they occurred. It was a post-traumatic experience. And today I understand that no medical effect of the globally really played a role. They were only there to help me somehow regulate myself. And I also started a trauma therapy then, but it was somehow fatal. That I only draw the conclusion at that time that homo-epathy had cured me like a miracle soon after. that had helped me. And from that moment on I was somehow caught in the misjudgment that homoeopathy can help, perhaps even very impressively as in my case. And this led me to becoming a real fan of homoeopathy. I attended courses and trainings alongside my studies and I was sure that I had found something really good in it. And this later led me even to start
[Nóra Balzer]:
Well, such an interesting experience that you had. How would you explain homoapathy to someone who has never heard about it?
[Natalie Grams]:
Yes, it's not easy because if you hear about it for the first time, you might not believe it. Homeopathy
[Nóra Balzer]:
Yes.
[Natalie Grams]:
is not to be able to heal with nothing, but I try to explain how this comes. Homeopathy is assumed to be a healing method invented at the end of the 18th century by the German doctor and pharmacist Samuel Hahnemann. And I really mean it when I say invented, construct of homeopathy, the lies beyond homeopathy is full of unscientific theories and miracles. And the basic ideas have been completely overcome and refuted by the development of modern medicine. But I try, homeopathy is based on two completely untenable fundamental principles. Firstly, on the principle of similarity. triggered symptoms in healthy people could cause these symptoms to disappear in sick people. You said it like, cures like, this was one of his
[Nóra Balzer]:
Exactly.
[Natalie Grams]:
maxims. Only neither biology nor medicine nor pharmacy are aware of such a principle. It simply does not exist, but it sounds good. Secondly, he postulated his law of the infinitesimals, which means that the more power, the energy he supposed they should contain would become. But this contradicts everything that we consider to be secured scientific knowledge and also every day's understanding, as you might know, because no one believes once coffee to get stronger, the more you dilute it. But at that time, I believed in this spiritual medical power. But today I know that there is no that would count as the, how Hahnemann called it, the imbalance of the spiritual life force in sick persons, which he believed to be the reason of all diseases. And thus, as a basic rule, homeopathic remedies no longer contain any quantities of substances that can trigger a physiological effect. Many remedies, especially the ones who are supposed to be the most effective ones, nothing of the original substance. These are the so-called high potencies. Because of these basic assumptions that are so untenable, no healing power in the sense of a medical effect can be expected from homopathy. And this is perhaps even more interesting for scientists. Empirical research overall, like in systematic reviews or meta-analyses, has not shown a reliable, strong condition. But as in my case, you can experience the placebo effect very strongly, and this is what made me forfeit it for myself.
[Nóra Balzer]:
Yes, it's very interesting because homeopathy has so many supporters. However,
[Natalie Grams]:
Yes.
[Nóra Balzer]:
it's against all the laws that we know from natural sciences. And
[Natalie Grams]:
Yes.
[Nóra Balzer]:
you also made your medical studies at the top German universities as a physicist. So did you ever learn there about homeopathy? Is traditional German medicine, I would call homeopathy like that,
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
is it part of the medical curriculum?
[Natalie Grams]:
not really or even in only very small parts. And this is changing too. But when I was a student in the nineties, homeopathy was not really part of the medical education plan. At that time, it was rather fatal coincidence that in my studies, scientific thinking, a scientific approach, basic medical statistics and the analysis of clinical trials were only very small parts of the education. not learn this. So when I look back, I see my studies mainly as a memorizing vast amounts of learning material. And unfortunately, this left a lot of room for some kind of openness in the sense that there might be something better than just university medicine. There was somehow, there must Germany are committed to evidence-based science
[Nóra Balzer]:
Yes.
[Natalie Grams]:
and medicine, but in the 19th, evidence-based medicine just started to be the new thing. And I remember many professors being skeptical about it at first. And just at the same time, the homoeopathic lobby had succeeded in pushing through elective courses in homoeopathy here and there at university, and also supported student I attended them. And you ask about traditional German medicine, there is no real teaching in that. But to a greater or lesser extent,
[Nóra Balzer]:
Thanks.
[Natalie Grams]:
all direction of pseudomedicine are trying to achieve a reputation for themselves. Homeopathy and anthroposophical medicine in Germany are well known and widespread even in the academic sector. And the tendency of politicians to set up or even alternative medicine, well holds the danger that pseudo medicine finds its way back into university again and again. And I think it's mostly a problem of political decision-making or wrong decision-making.
[Nóra Balzer]:
Oh yes, and it's so interesting how our our suspicions to science is changing by the time that
[Natalie Grams]:
Yes.
[Nóra Balzer]:
in the nineties education was mainly completely different or yeah, different than today and
[Natalie Grams]:
It was
[Nóra Balzer]:
then
[Natalie Grams]:
more learning
[Nóra Balzer]:
yeah
[Natalie Grams]:
than understanding at that time, in my opinion, or when I look
[Nóra Balzer]:
Okay,
[Natalie Grams]:
back.
[Nóra Balzer]:
very interesting. And then you also, so you also shared your personal experience with homeopathy and then you also choose to specialize into homeopathy and
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
not went to the Western type of medication. So how did it come that you didn't become like a surgeon or a gynecologist or some
[Natalie Grams]:
N-
[Nóra Balzer]:
Western type of medical doctor?
[Natalie Grams]:
Well, my original plan was to become a surgeon,
[Nóra Balzer]:
Okay.
[Natalie Grams]:
but I was so drawn to homeopathy. I had really found a method that corresponded somehow to a great extent to my ideals of medicine, which, well, in the first place had led me to decide to study medicine. And I wanted to learn it. And I started to turn away from my original plan to become a real doctor. one.
[Nóra Balzer]:
Very interesting. And you also specialised into geriatrics and piety of medicine. So would you explain what those fields are and how you exactly practised homopathy there?
[Natalie Grams]:
Yes, I practiced geriatrics and palliative medicine in a special time in hospitals after my studies. But there, there was no strong connection with the use of homeopathy then
[Nóra Balzer]:
Okay.
[Natalie Grams]:
that would have not been very easy in the hospital where I was working at that time. And I have never really aspired to do it there, but I only learned homeopathy in my private life and treated my friends and my families then. up hospital work after three years because I got the opportunity to join homeopathic surgery and this was my first step into practicing only homeopathy and traditional Chinese medicine at that time and later I opened my own office in Heidelberg just for homeopathy.
[Nóra Balzer]:
Very interesting. But then at one
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
point also the change come into your life. So when you realize that homeopathy is not the medical help that you want to offer anymore, could you talk about it?
[Natalie Grams]:
Yes, but it was a hard journey, I can tell you, from really
[Nóra Balzer]:
Yeah
[Natalie Grams]:
believing in that method to becoming skeptical
[Nóra Balzer]:
Yeah.
[Natalie Grams]:
about it. And it all started with an interview for a book project in my time as a practice in homoapathy, where I had somehow advocated the cause of homoapathy with full conviction, as I thought at that time. And the book was later published under the title, critique on the subject. And I was outraged, to be honest, by this. And I decided to counter it with a book project of my own, so the real truth about homopathy, if you want. But this
[Nóra Balzer]:
Yeah.
[Natalie Grams]:
somehow happened to be the start of the end of my time in alternative medicine. Because during my research, I was constantly confronted with counter questions and counter arguments exactly based on? How do you know that the effects you see are not just psychological ones, just placebo? Have you never ever read the trials about homoeopathy? Where's the evidence?
[Nóra Balzer]:
Yeah.
[Natalie Grams]:
And so my first fundamental doubts about homoeopathy occurred, which I then saw more and more confirmed during the research And last but not least, the trials on homoerpathy. I just had never read them before, not completely. I just perhaps did some cherry picking like all homoerpathy do, but I did never really take a deep dive. And this led me to the process of rethinking or reconsidering. You named the title of my first book, Homoerpathy Reconsidered. book becoming more and more critical about homopathy, but also the abandonment of my daily work. I closed my surgery in 2015, just weeks before the book was published. And I simply could no longer offer my patients a treatment that I myself could no longer stand behind. But this sounds so easy now. You must not imagine this as a sudden decision or short process. It was really a long painful period. with a lot of doubts that turned the supposed life plan completely upside down. And perhaps you know Professor Etzard Ernst, a famous criticiser of homopathy, who in fact now is a real friend and somehow a mentor to me. He called this time once the status of agony. And it's really true. It did hurt to lose a belief. And if I'm honest, it still hurts now.
[Nóra Balzer]:
I can imagine when you feel that you have a call that you want to create patients with that method and then you just start to not believe anymore in this
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
method, in this way of creating people, that can be really hard and you are really brave that you made this pass through and also speak
[Natalie Grams]:
Thank
[Nóra Balzer]:
about
[Natalie Grams]:
you.
[Nóra Balzer]:
it. And indeed I also made some literature research on how homoapathy affects the immune system I was surprised that I found a few publications on PubMed and Google Scholar, which is the general publication
[Natalie Grams]:
Thanks for watching!
[Nóra Balzer]:
source of science. So can
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
you share any knowledge of how homopathy affects the immune system? What is the current state of knowledge? Is it really only sugar or is there something more inside?
[Natalie Grams]:
Well, to start with this, the fact that these studies or studies on this topic can be found in medical databases shows two things, in my opinion. First, that an entry into PubMed is not a quality criterion. And secondly, that homeopathy has managed to establish itself in scientific community, even in immunology. And as for the relevance of such findings on PubMed, there is overwhelming overall evidence against homopathy based on
[Nóra Balzer]:
Yes.
[Natalie Grams]:
numerous systematic reviews. But whenever we talk about trials, I think it's important not to forget that its basic assumptions are incompatible with established knowledge. So if you find some positive trials, just keep that in mind. overall evidence because of single, possibly positive sounding trials. And to know today, I know that all positive studies on homeopathy are more or less of a bad scientific quality. And even with regard to the immune system, the basic statement remains valid that homeopathy has no medical relevance. No medical intervention has even been able to prove that it reinforces immune system, as I have read again and again. And it's interesting that such an advertising claim for homoapetreate remedies has been prohibited by a court in Germany, because the manufacturer could not prove this claim to be true, that it somehow pimps up the immune system. But as you ask, is it only sugar? I try to turn the question around, how should sugar, on which a solution from which the original substance was previously diluted with great effort have
[Nóra Balzer]:
Yes.
[Natalie Grams]:
any influence on such complex things, I say it again, have any influence on such complex things as the immune system.
[Nóra Balzer]:
Yes,
[Natalie Grams]:
If you hear it like
[Nóra Balzer]:
it can.
[Natalie Grams]:
that you cannot believe it that there is anything about it.
[Nóra Balzer]:
Indeed, however, so many people in Germany are using homeopathy
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
and you can just get it from the pharmacy. It's really almost unbelievable that if
[Natalie Grams]:
Yeah
[Nóra Balzer]:
science knows and the rational way of thinking knows that it cannot help except the placebo effect, but you can
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
still go to the pharmacy and buy it. And
[Natalie Grams]:
Mm.
[Nóra Balzer]:
I also made some Google research to see what the general public sees, not
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
really into PubMed and I found
[Natalie Grams]:
Mm.
[Nóra Balzer]:
terms or sentences like homeopathy is particularly effective in helping patients to strengthen their natural immunity
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
or homeopathy is the best treatment for autoimmune disease and people who have immunologic conditions they read it and they believe it, why would not believe it, the internet says. So do you think it should be somehow controlled what is stated in general on homeopathy?
[Natalie Grams]:
that would be hard to be done, but I think such statements are insubstantial. And in my opinion, I agree, really a little dangerous. And that is precisely the problem with the use of homopathy and its good reputation in the public. And it's somehow the motivation I have to speak about it in public. And the quoted sentences are collections of buzzwords of empty generalities serve to impress the public as I think today. The claim to strengthen natural immunity is simply false and without evidence again and in fact it's not referred to a concrete remedy. I think it's not correct to propose homopathy as effective, I say it again, I think it's not And I here see one of the greatest dangers of home apathy at all, that if you believe in it or are made to believe in it, you might skip or postpone a really helpful therapy. And this is what I criticize.
[Nóra Balzer]:
Yes, indeed. And I have the feeling that taking some homeopathic pills is way easier than taking really an immune therapy or
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
making such immunologic conditions get a treatment. But it's really necessary if people are sick, then they should see a doctor.
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
But still, so do you have any knowledge how many people use homeopathy in general? Is there any statistics on that?
[Natalie Grams]:
Not really. There are some surveys, but many of them have been conducted by order of homeopathy itself. And that's why I consider them to be somehow meaningless or their results are usually
[Nóra Balzer]:
I see.
[Natalie Grams]:
highly dependent on the questions posed. And I have one survey in mind. And if you see the answers, they are asking about the awareness of the method 90 percent of people or the questions are whether one has already used it by approximately 60 percent. So it's again popularity and not effectiveness or efficacy.
[Nóra Balzer]:
Yes.
[Natalie Grams]:
And I think what the core question is, is homeopathy, I say it again, is homeopathy a specifically effective method? And with these surveys, you can just hear the marketing success of homeropathy. And only few people really know what homeropathy is about and how effective it really is, not beyond the placebo effect. And that's perhaps why homeropaths themselves just tend to ask about the how much do you like homeropathy? to draw the attention elsewhere. I
[Nóra Balzer]:
I
[Natalie Grams]:
think
[Nóra Balzer]:
see.
[Natalie Grams]:
with, yeah, and I think that the with such surveys, the homoopathic lobby only tries to support its narrative of the gentle and side effect free method. But if you view it correctly, these surveys are nothing more than an admission of the fact that not to be shown.
[Nóra Balzer]:
Yes.
[Natalie Grams]:
I think then otherwise the focus would not be on the popularity but on the scientific proven validity of homopathy.
[Nóra Balzer]:
Yes, I believe they cannot show any evidence, so they just
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
show the popularity. I see and I agree.
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
And indeed, your role as a science communicator is extremely important in this field to explain the knowledge on homeopathy to the general public, to parents who worried about their children, to relatives with diseased family member. So how do you see your role? How hard is to work about homeopathy nowadays in Germany with your critical voice?
[Natalie Grams]:
Well, the fact that in Germany, homeopathic remedies are unfortunately privileged as medicine under the law. This further
[Nóra Balzer]:
So.
[Natalie Grams]:
fuels the misconceptions. And I think it's hard to understand that politics have not corrected this in over 50, 40, 40 years by now. But maybe this just highlights the power and resources of the homeopathic lobby in Germany. practically the only thing of private activists like me and groups such as the Homopathy Information Network which I co-founded in 2016 and it's very difficult to get the things here.
[Nóra Balzer]:
Yes, and it's also so surprising that in Germany, so their medications and drugs are sold in the pharmacy and their
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
effects need to be proven through clinical trials and a lot of regulatory processes. And the homeopathic substances are also sold at the pharmacy.
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
So is there any clinical trials or monitoring of homeopathic substances?
[Natalie Grams]:
Well, there has been a lot of research and the result is clear. Homeopathy has not been proven to be more than a placebo, but it's still allowed
[Nóra Balzer]:
Yes.
[Natalie Grams]:
to be sold in pharmacies only is a contradiction. Well, the role of homeopathy in medicine and healthcare, especially in pharmacy is the result of extremely, I say homeopathy friendly laws starting in the EU medicines directive and extending to the homopathy regulations in the German medicine law. And this cannot be justified if one accepts the reliable and reproducible proof of efficacy according to scientific standards. As the basis of modern medicine and contemporary health systems, I think it's misleading because people think if something is sold in a pharmacy, it must be helpful. And that's why
[Nóra Balzer]:
Exactly.
[Natalie Grams]:
I think But the law makes it possible and at least
[Nóra Balzer]:
Yes.
[Natalie Grams]:
homoeopathy should be sold in front of the pharmacy desk where the cough drops are sold so it would not be this disturbing.
[Nóra Balzer]:
Yeah, so do you think that homeopathy still has a place on the market or how would you regulate it?
[Natalie Grams]:
Well, first of all, it's really important for me that it's nice, my personal aim or that of the science-based critique on homoeopathy to ban homoeopathy or to forbid it. I think none of us want to restrict freedom of choice or even patient autonomy, but I think both freedom of choice and the motto of the homoapathy information network, we explain you have the choice. But realistically people will always look for a remedy that fits them and their needs and whether it is homoapathy or something else. The only thing is that homoapathy should clearly no longer be called effective medicine. Thus I think further education and communication is needed there very that it does not continue to get its good reputation through the obligation to be sold
[Nóra Balzer]:
Yes.
[Natalie Grams]:
in pharmacies only, and also by the reimbursement by the health insurances. I think this really must change. Otherwise, patient education alone
[Nóra Balzer]:
you
[Natalie Grams]:
will simply reach its limits. And my personal wish would be that everybody is free to take homeopathy, but really knows what it is. And then you're really free to choose, but you should know that there is an end placebo effect and it does not replace a really helpful therapy or treatment. And furthermore, I think homeopathy should be sold in the supermarkets near the sweets and candies because it's really sugar and should not be funded any longer by the health insurances. And doctors should not be able to specialize in the pseudo medical method, but should be able perhaps as an alternative to talk as long to their patients as they are. they undertake a homeopathic assessment. I think time and empathy are the real benefits of homeopathy, not the magical energy. And this should be clear or become clear to us all.
[Nóra Balzer]:
Yes, and here again science communication is a main thing that we scientists can do. And of
[Natalie Grams]:
Mm.
[Nóra Balzer]:
course the regulation needs to be changed and we need to speak up for that. That it's not right that homeopathic substances are in the pharmacy and involved with the health insurance.
[Natalie Grams]:
Yeah.
[Nóra Balzer]:
And you are one of the main science communicators in the field of homeopathy and I've seen that you get hot and cold as well, so what would you wish from both the scientific and the general community to support you?
[Natalie Grams]:
Well, yes, I got a lot of support and hate as well. My whole life has changed since I started talking about homeopathy and its unscientific claims in public. But if you ask me, I would like the scientific community to finally take a more offensive stance against the scam method and other obvious pseudo medicines and make it clear on a broad In my estimation, the overwhelming majority of the community knows very well what to take of homoepathy scientifically, but they see it as a too small thing that is not worth the time or the effort to oppose. And I think they fail to realize that homoepathy not only undermines the acceptance of the scientific method itself, but also has a concrete potential for harm. to see more critical thinking from the general public you referred to. I think it's not so very easy because the law makes it a rightful medicine and the lobby has promoted it as an effective medicine over the last 40 years. And especially when the myth about homopathy are perpetuated by interested circles again and again, it's
[Nóra Balzer]:
you
[Natalie Grams]:
hard to think differently I think we cannot blame the single patient or consumer, but I would wish that they would be open to some education and new information about homeopathy and about pseudo medicine in general, which is slowly gaining a momentum. And I think if we are not able to see things clearly here, how can we able to be clear about much more complicated things, especially in the times where fake news are so common
[Nóra Balzer]:
Yes.
[Natalie Grams]:
is willingly be harmed by populistic attempts. It's easy with home apathy, in contrary
[Nóra Balzer]:
Yes.
[Natalie Grams]:
to many other things that are not so easy.
[Nóra Balzer]:
Yes, on the platform they're not the smartest, but the loudest win.
[Natalie Grams]:
Mm.
[Nóra Balzer]:
That's really hard.
[Natalie Grams]:
Yeah, yeah, you're
[Nóra Balzer]:
So
[Natalie Grams]:
saved.
[Nóra Balzer]:
what are your projects you are currently working on?
[Natalie Grams]:
Well, yes, after I think seven years in the front line of science communication, especially to educate people about homeopathy and pseudo medicine and vaccines. Three books on the topics. A lot of hate. I returned to a somehow normal job in 2020, which has to do with science and science communication in a wider, more public health related field. But as you see, available for interviews to a certain extent. And I also publish articles on the subject from time to time. But I do not any longer give public lectures on the topic because I experience direct personal threats on such occasions. And likewise, as you mentioned, the platforms, the social media platforms, I no longer see Twitter as a platform on which factual clarification and fact-orientated discussion is still possible. my long-standing account there in the summer. But I'm still very close to the Home Apathy Information Network, also with some advice and support. And I have a podcast of my own, Grams Sprechstunde, Podcast für echte gute Medizin, which is perhaps translated into German, into English as Grams Consultation Hour for Really Good Medicine, for which I produce a new episode every fortnight. close project to my heart and not only pseudomedicine is a topic there but also good, better medicine in general especially everything that stands in the way of it.
[Nóra Balzer]:
That's amazing and I think you are so curious that also if you get many negative comments, I think I can speak in the voice of all young immunologists that we really
[Natalie Grams]:
Thanks for watching!
[Nóra Balzer]:
appreciate your work, what you all do for science communication and to explain the harm of homopathy to the general public
[Natalie Grams]:
Thank you.
[Nóra Balzer]:
and raise a voice for that. And we will also put all your publications and your podcast or the link
[Natalie Grams]:
Thank you.
[Nóra Balzer]:
you.
[Natalie Grams]:
Yes.
[Nóra Balzer]:
Do you have any closing words? So that would be that would have been all my questions. Thank you very
[Natalie Grams]:
Mm-hmm.
[Nóra Balzer]:
much for for giving your insight. Do you have any closing message?
[Natalie Grams]:
Well, yes, the really one important thing I learned in all this time is that homopathy and the placebo effect are no real medicine and are not fit to replace it. Not in children and not in any of us, because I think in Germany, homopathy is somehow kind of a we do that to our child, child's children thing. placebo effect, but they should be treated in the best way we have, not with deuteromedicine.
[Nóra Balzer]:
Exactly. Thank you very much. Thank you for your interview.