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Distrust me, I'm a pharmacist?

A parliamentary committee is currently evaluating whether homeopathy should be available on the NHS.

A parliamentary committee is currently evaluating whether homeopathy should be available on the NHS.

On 25 November, the MPs questioned several expert, of whom I was one. Also among them was Paul Bennett, professional standards director for Boots.

Talking about homeopathic remedies, he told the committee: 'I have no evidence to suggest they are efficacious'.

When you walk into Boots, you are confronted with shelves full of 'alternative' medicines and you may well assume, 'if it is sold by this trusted pharmacy, it must work' – but does it? The 'alternative' products for sale at Boots – or any other high street chemist – fall into four categories.

Homeopathic Remedies

Boots offers its own brand of homeopathic remedies, anything from Arnica to arsenic. Yes, arsenic! But don't worry, they won't kill you. These homeopathic remedies are usually so highly diluted they contain no active ingredients at all. This is precisely why scientists argue they are implausible nonsense. About 200 clinical trials of homeopathy collectively fail to provide good evidence that homeopathic remedies are different from placebos. (1)

Aromatherapy Oils

Therapists like to call them 'essentia' oils, which implies that humans cannot do without them. The evidence, however, tells a different story. Aromatherapy consists of a soothing massage which clearly is pleasant; but pleasant does not necessarily mean healthy. In fact, there is no good evidence that the oils applied by the therapist are effective for any medical condition. (2)

Herbal Medicines

Herbal extracts usually contain a multitude of pharmacologically active ingredients. This means they can both kill and cure. Several herbal medicines are demonstrably effective. For instance St John's Wort alleviates depression, Devil's Claw reduces pain and Horse Chestnut Seed Extract improves the symptoms of varicose veins. (2) Other popular herbal medicines, by contrast, have been shown to be fairly useless: Evening Primrose oil, Bilberry and Goldenseal might be good examples for this category. Others again may actually be harmful: Borage, Black Seed oil or Comfrey, for instance, contain hepatotoxic ingredients. (2)

So why are so many nonsensical products available from Boots, our trusted family chemist? Has Boots become UK's largest purveyor of placebos? Are pharmacists shopkeepers, only out to make a profit, or healthcare professionals keen to improve public health?

To be fair, several pharmacists have tried to instil some scientific rigour into their colleagues thinking and behaviour – in fact, their code of ethics leave them no real choice. It states in no uncertain terms that pharmacists must provide their customers with the relevant information regarding 'alternative' medicines.

And who would argue that it is not relevant for the consumer to know that homeopathic remedies or Bach Flower Remedies are biologically implausible and scientifically unproven? Sadly, when pressed to take a position, the Royal Pharmaceutical Society of Great Britain has so far sided with the commercial interests rather than with the scientific truth.

Professor Edzard Ernst Professor Edzard Ernst

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