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I suffer from occasional sinus pain and headaches. Upon hearing this, a pharmacist friend of mine immediately recommended I take a "drug" that has proven to work wonders for her sinus problems. It turns out that it is a homeopathic remedy. While I am generally very skeptical of the claims of homeopathy, my pharmacist friend assured me that the ingredients can't possibly be bad for me. Here are the ingredients along with their homeopathic purpose:

  1. Allium Cepa (a.k.a. plain old onion) 6X HPUS: hay fever, watery eyes.
  2. Natrum Muraticum (a.k.a. table salt) 6X HPUS: sneezing itchy eyes.
  3. Histaminum Hydrochloricum (a low-dose form of ceplene, which is used in modern medicine for leukemia patients) 12X HPUS: sinus pain.
  4. Luffa Operculata 12X HPUS: sinus pain, headache.
  5. Galphimia Glauca 12X HPUS: sneezing, runny nose.
  6. Nux Vomica 6X HPUS: itchy nose & throat.

First of all, I don't suffer from all of those symptoms (my sinus problems aren't caused by allergies). If this is at best a placebo, though, I guess that shouldn't matter, should it?

My questions:

  1. Could there be any harm in taking this remedy, even if I don't suffer from all of the symptoms?
  2. Lets assume that the ingredients have not been diluted away; do any of those ingredients have known pharmaceutical properties that might help my sinus problems?

Bonus points for any peer-reviewed studies on the effectiveness of such remedies.

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    If this is at best a placebo, though, I guess that shouldn't matter, should it?: if you are convinced that it is a placebo then it probably won't have a placebo effect on you... you'll be better drinking some hot tea with ginger and honey, it's tastier and probably more efficacious. For the rest, sola dosis facit venenum, if they're homeopatically diluted it would be the same as drinking water. – nico Aug 14 '11 at 15:41
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    Oh, I know. If it turns out that this is at best a placebo then I wouldn't take it. Basically, the purpose of this question is to get some scientific/medical ammunition to forward to the pharmacist. – ESultanik Aug 14 '11 at 16:01
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    Well it will help when combined with a visit to physician and combined with undiluted medicine that relies on such boring things as laws of chemistry and physics. Although far away from the bleeding edge of water memory research. One question for your pharmacist - there had been a lot of toxic products dumped into the oceans and water basins throughout history. How did the water forgot them, so we are alive today? – Daniel Iankov Aug 14 '11 at 16:57
  • +close: too localized. – user unknown Aug 14 '11 at 21:34
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    What is HPUS? The link doesn’t help and I can’t find useful definitions elsewhere. Your usage suggests that it’s a dosage unit but it’s not a common one – Homeopathic dosages are usually in factors of orders of ten – so if that’s true, please convert to the common units. Either way, 6x sounds like a very non-homeopathic dosage; in other words, there can very well be an active ingredient in this “homeopathic” remedy. – Konrad Rudolph Aug 15 '11 at 11:08
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DISCLAIMER: I am not a doctor, anything written here should not be taken as medical advice

To complete Randolf's answer, I will answer part 2 of your question

Do any of those ingredients have known pharmaceutical properties that might help my sinus problems?

Allium Cepa is onion: onions are traditionally used against sore throat, although I could not find any peer-reviewed study on their efficacy. They also contain antioxidants such as quercitin and there are several studies (not sure how conclusive, I have not read them) that show that eating onion and garlic could reduce the risk of cancer.
For your specific case: onion has also antibacteric properties.

Two papers on that:
Anti-bacterial action of onion (Allium cepa L.) extracts against oral pathogenic bacteria.
Antibacterial and antioxidant activities of quercetin oxidation products from yellow onion (Allium cepa) skin.

So, how much quercitine is there in a 6X HPUS solution (that means the original solution is diluted 1000000 times)? I'll do some rough calculation, but bare in mind that this is very approximative and could be off by a few orders of magnitude! Also, I will not repeat this calculation for all the other components, I'll leave it to you :)

  • The quercitin content in yellow onions is ~30-300mg/kg (see Quercetin content in yellow onion (Allium cepa L.)), so let's set for an average of 100 mg/kg.
  • Now I don't have a clue how they extract the onion, but let's say 10% of it is lost during processing (may be more, may be less, I don't know), if we extract one 100g onion into 1l water we'll end up with ~9mg quercitine. (This is the critical passage. I am assuming 1 100g onion in 1l of water. Anything else and the numbers will vary a lot. Anybody knows what a "standard onion solution" is?)
  • The molecular weight of quercitine is 302.24 g/mol, so 9mg/l corresponds to 29.8μM (μM = micromolar, that is 10-6 moles in a liter), which is in the normal range of action of many drugs.
  • We dilute that 1 million times and get to a 0.0000298μM solution, that is a 29.8yM (yM is called yoctomolar and corresponds to 10-24 moles in a liter). A mole is defined as the amount of matter containing one number of Avogadro (NA = 6.0221418×1023) of molecules. So 29.8 yM contain approximately 18 molecules of quercitine per liter. Assuming you take a few drops of it, let's say 2ml, you will get approximately 0.04 molecules of it.

Natrum Muraticum is table salt. Already the fact of giving it a some sort of pig-latin name sounds very fishy. It's sodium chloride, NaCl, no need to call it salis magicus or whatever. The solubility of NaCl in water is 359g/l. Supposing they start from a saturated solution, and dilute it 1 million times they'll get 359μg/l. When you cook pasta you put ~10g/l of salt in the water. 1 hot dog contains 1.3 mg of salt. I do not feel the need to go into further details on this.

Histaminum Hydrochloricum (or histamine dihydrochloride, which is its proper chemical name) is marketed as an "unapproved homeopathic" product against cold.

From the Wikipedia page for Zicam, one formulation of Histaminum Hydrochloricum

The only possibly biologically active ingredients present in Zicam Cold Remedy are slightly diluted zinc acetate (2X = 1/100 dilution) and zinc gluconate (1X = 1/10 dilution); the product's other originally active ingredients have been serially diluted to the point that Zicam should no longer contain any molecules of those ingredients, and are listed as "inactive ingredients" on the label.

Histamine dihydrochloride is a salt of histamine, a physiologically occurring compound that is involved in the triggering of inflammation (ever heard of anti-histaminic treatment for allergy? They counteract the effects of histamin). I cannot think of why it would have any positive effect on sinusitis, being a bronchoconstrictor, nor could I find literature at that regard.
As you noted, at biologically active concentrations, histamine dihydrochloride is used as a leukemia treatment.

Luffa Operculata or sponge cucumber is another "unapproved homeopathic" product. In Brazil it is used as a folk remedy (known as Buchinha), although they don't use it at 12X (remember that in certain cases phytotherapy is not equal to homeopathy, although there is much confusion about it). At the doses used in traditional Brazilian medicine there is some evidence of toxic effects on the palate for it. At 12X I doubt you'd even had that.

Luffa operculata effects on the epithelium of frog palate: histological features

I found this paper on a rather obscure journal which claims that Luffa Operculata is efficacious against sinusitis.

Efficacy and safety of a fixed-combination homeopathic therapy for sinusitis

Even just by reading the abstract, however, you can conclude that the article is seriously flawed. I do not have access to the full text, unfortunately, but I found this blog post which analyses the article quite well (I love the part where they show that the authors cite papers that show that homeopathy is not efficacious!).

Blinded by pseudo-science?

Galphimia Glauca or thryallis is a plant with nice yellow flowers, yet another FDA-unapproved homeopatic.

One study caught my attention A homoeopathic proving of Galphimia glauca

If you're not familiar with homeopathy, you should know that the idea is that if substance X causes headache you can dilute it a lot, whilst you do some magic dance, and it will cure headache. This is called a proving.

From the abstract:

Our results confirm the toxicological and clinical effects of Galphimia glauca compared to placebo, but the ICCH criteria for proving symptoms were not suitable to distinguish between specific and unspecific symptoms.

So, essentially, even at doses that do have pharmacological effects, its effects cannot be distinguished from placebo... well, not very impressive, is it?

And, last but not least Nux Vomica, or the strychnine tree. The seeds and bark of this tree contain two potent alkaloids called strychnine and brucine, along with other poisonous substances. In the past strychnine was used for gastrointestinal problems, but has since been abandoned from medical practice.

I could not find any proper medical trials for this.

So, in conclusion, don't waste money on it.

  • This is excellent information. I barely started on some research in an attempt to improve my answer, but had to stop due to time constraints, so thank you for making all that effort! Well done (+1). I added an update to my answer that refers to yours. – Randolf Richardson Aug 15 '11 at 10:59
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    @Randolf: no problem, it was actually quite a bit of fun to research this stuff, looked pretty much like I was reading an Harry Potter book with all that fake Latin :) – nico Aug 15 '11 at 11:18
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    As to why a histamine would be used to treat sinusitis, despite being the opposite of what you expect, that's probably because homeopathy assumes that "like cures like". – Mr. Shiny and New 安宇 Aug 15 '11 at 12:22
  • @Mr. Shiny: surely, that must be the reason. I just added that comment as my personal reflection but of course from the perspective of an homeopath that would make sense. – nico Aug 15 '11 at 12:34
  • @nico: Yeah, and "like cures like" isn't even the weirdest part of homeopathy. See youtu.be/dyhcEl0b-Kc, for example. – Mr. Shiny and New 安宇 Aug 15 '11 at 12:38
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I am not an authority on this matter but have explored the validity, or lack thereof, of homeopathy for about 10 years; the answers already provided are excellent, and here is my answer (from the USA):

Paraphrasing question #1: Can this product be harmful? In short, potentially yes. In the US, and similarly in other countries, homeopathy is exempt from the FDA's standard safety (and efficacy) requirements for medications, even as many of the active ingredients used in homeopathic remedies are purposely derived from dangerous if not deadly substances. In the remedy under discussion, for example, Nux Vomica contains high levels of strychnine (AKA "poison nut"), a dangerous neurotoxin. True, the active ingredients in this and most homeopathic products are so diluted that they are very unlikely to (and often cannot plausibly) cause either harm (or benefits), but that is only if the listed dilutions are accurate and if the product is not contaminated or adulterated. To illustrate my point, note that Hyland's teething tablets were recalled after a number of consumers' reported babies suffering symptoms consistent with Belladonna poisoning; the FDA issued a consumer alert and recall after finding inconsistent amounts of the poison in samples of the product and no child proof safety caps.

Not pertaining to the product under question, but the public should be aware that some OTC products labeled as "homeopathic" use relatively high concentrations of active ingredients, thus they can conceivably have a physiological effect -- including side-effects. E.g. Zicam's cold remedies used just a 1x dilution of zinc (one part zinc to 10 parts water) in their cold remedies, resulting in hundreds of reports of permanent loss of smell. Products are exempt from many FDA safety regulations if they are claimed as "homeopathic."

Paraphrasing question #2: Assuming there are sufficient quantities to have a clinical effect after dilution, can any of these particular ingredients help with sinus problems? In short, very highly doubtful, given the dubious premises of homeopathy. Aside from believing that the heavy dilutions make remedies MORE potent as they are "succussed" (shaken) more times, homeopathy makes another irrational assumption that "like cures like" (or law of similars). First, they use a highly subjective and unscientific process ironically called "provings" (more like testimonials) to fill a pharmacopeia of physical and mental symptoms that are assumed to be universal reactions to particular substances. Then, they use these substances, many of which are toxic-- after diluting them to render them harmless (let's hope!) -- as "active ingredients" to treat the listed symptoms. Underlying causes for the person's symptoms are regarded as irrelevant.

Homeopathic "law of similars" can't be farther from what scientists regard as "laws" of nature, as it is implausible to believe that all substances that cause certain symptoms will reduce those symptoms if heavily diluted and shaken between dilutions. Ironically, many homeopaths reject vaccines, an actual example of a substance that causes illness being used to treat it (actually to prevent it), while favoring instead, for example, ground duck liver and heart - giving it a sciency name, Oscillococcinum - diluted to non-existence to purportedly treat influenza symptoms.

Based on homeopathic premises, I will guess that the manufacturer of the product in question added diluted onion because eating onions caused a prover's eyes to tear and nose to run, and perhaps histamines were added because histamines in the body can lead to upper respiratory allergy symptoms. Even if not diluted, I couldn't find any scientific evidence online that any of the listed ingredients can effectively treat sinus problems.

  • Hello and welcome to Skeptics. All answers must be supported by appropriate references here. Please correct yours (you can put links as text if your reputation is not enough). More info – Sklivvz Sep 20 '11 at 8:26
  • @Sklivvz: I created two links within the text (is this what you mean by putting links as text?), and the edit screen lists these as 1 and 2 references on the bottom, but I don't see these on the post itself. Am I supposed to manually add references? – LSA Sep 22 '11 at 3:34
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    I can't see any other URL to edit in. However you should now be allowed to add as many refs as needed. In particular, could you cover the question #2 paragraph? – Sklivvz Sep 25 '11 at 14:58
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To answer your first question, probably not -- aside from a possible placebo effect, those solutions will very likely be ineffective due to extreme dilution in water or alcohol.

To answer your second question, a diagnosis is needed to know exactly what your problem is (since pain can have a wide variety of different causes, including a physical injury, an abnormal growth putting pressure on something, a nervous system issue, a birth defect, a disease, etc.) before the results of any treatment can be estimated (and a qualified Doctor should probably be involved in the diagnosis as well as the prescription of any medicines).

In essence, it appears that Homeopathy is quackery:

  QuackWatch - Homeopathy: The Ultimate Fake
  http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html

The following text is a short quote from the above document (which contains 17 good references, all listed together near the end) in which I've highlighted a few items of particular interest:

At Best, the "Remedies" Are Placebos

Homeopathic products are made from minerals, botanical substances, and several other sources. If the original substance is soluble, one part is diluted with either nine or ninety-nine parts of distilled water and/or alcohol and shaken vigorously (succussed); if insoluble, it is finely ground and pulverized in similar proportions with powdered lactose (milk sugar). One part of the diluted medicine is then further diluted, and the process is repeated until the desired concentration is reached. Dilutions of 1 to 10 are designated by the Roman numeral X (1X = 1/10, 3X = 1/1,000, 6X = 1/1,000,000). Similarly, dilutions of 1 to 100 are designated by the Roman numeral C (1C = 1/100, 3C = 1/1,000,000, and so on). Most remedies today range from 6X to 30X, but products of 30C or more are marketed.

A 30X dilution means that the original substance has been diluted 1,000,000,000,000,000,000,000,000,000,000 times. Assuming that a cubic centimeter of water contains 15 drops, this number is greater than the number of drops of water that would fill a container more than 50 times the size of the Earth. Imagine placing a drop of red dye into such a container so that it disperses evenly. Homeopathy's "law of infinitesimals" is the equivalent of saying that any drop of water subsequently removed from that container will possess an essence of redness. Robert L. Park, Ph.D., a prominent physicist who is executive director of The American Physical Society, has noted that since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000 molecules of water. This would require a container more than 30,000,000,000 times the size of the Earth.

...

Dr. Park has noted that to expect to get even one molecule of the "medicinal" substance allegedly present in 30X pills, it would be necessary to take some two billion of them, which would total about a thousand tons of lactose plus whatever impurities the lactose contained.

Update: See @nico's Answer for the additional information that @Sklivvz ♦ suggested was needed.

  • I think that @esu wanted a more specific answer... – Sklivvz Aug 14 '11 at 17:18
  • @Sklivvs: I tried to show that the solution is ineffective, and why (extreme dilution of ingredients). For his second question, I feel that more information is needed because the cause of his ailment is unclear. This is a very difficult question to answer. How could I have improved it, especially when the credibility of the medicinal system being suggested is very questionable? – Randolf Richardson Aug 14 '11 at 17:29
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    The concentrations he's referring to would contain some active ingredients. What he's asking is if he can have any non placebo effects from them. – Sklivvz Aug 14 '11 at 18:35
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    @Sklivvz - But is medical advice on topic for this site? Where is the notable claim? If the question actually is "Does Allium Cepa work for hay fever" I don't think that is on topic for our site. The first question "is there any harm in taking this remedy" is also not notable if it is not asking about homeopathy in general. – going Aug 15 '11 at 4:52

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