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Hormesis is not homeopathy
Toxicology and Applied Pharmacology 206 (2005) 365 – 366 www.elsevier.com/locate/ytaap
Letters to the Editor
Hormesis is not homeopathy In his article, Calabrese (2005) gives hormesis a strong association with homeopathy as a leading reason for its marginalization by the medical establishment. Without getting into a discussion on the validity of homeopathy, we contend that this linkage is misconceived. Homeopathy and hormesis indeed share in common the use of small doses, but differ conceptually on at least four important issues:
Menachem Oberbaum4 Noah Samuels Shepherd Roee Singer The Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel 4Corresponding author. Fax: +972 6666975. E-mail address: [email protected]. 24 May 2005 doi:10.1016/j.taap.2005.05.011
(1) Unlike the non-specific effect of hormesis, induced by a variety of chemically unrelated substances, homeopathy is highly specific. A homeopathic remedy that does not bfit like a gloveQ will not elicit biological activity. (2) Whereas hormetic (chemical) responses are induced by small but measurable concentrations (above Avogardo’s number), homeopathic concentrations are often far below this. The use of a remedy with a bconcentrationQ of 10 400 of the stem solution is common practice in classic homeopathy. (3) The hormetic effect is reversible, reverting with cessation of the hormetic substance. The homeopathic effect is enduring. A single exposure initiates a healing process which continues long after administration of the remedy. (4) Hormetic substances do not require any special preparation. Homeopathic remedies, in contrast, require a lengthy and exacting process before they are ready for administration. It appears to us that the medical establishment’s neglect of hormesis stems more from hormesis’s lack of clear clinical indications than from its purported relationship with homeopathy. Rigorous evidence of hormesis’s effectiveness in even a single clinical indication would do much to extract this field from its current state of disrepute.
Reference Calabrese, E.J., 2005. Toxicological awakenings: the rebirth of hormesis as a central pillar of toxicology. Toxicol. Appl. Pharmacol. 204, 1–8.
Factors affecting the historical rejection of hormesis as a fundamental dose response model in toxicology and the broader biomedical sciences Response to Oberbaum et al., 2005: My article explored factors that may have affected the recognition and acceptance of hormesis within the toxicological sciences. As such, there were a variety of factors that impacted its acceptance including the fact that hormesis is difficult to prove because of the modest nature of its response. This requires considerably stronger study designs including more doses, careful spacing of doses below the NOAEL, stronger emphasis on statistical power considerations, temporal features as part of the study design and greater emphasis on study replication. In addition, toxicology has long been a high dose and few doses discipline making hormesis little studied and, when possibly observed, easily dismissed as random variation. Hormesis has been further handcuffed by the fact that as early as the 1930s, biostatistical modeling of dose response relationships started to constrain responses to be above background. As if these factors were not enough of a challenge, the early and close association of the concept of hormesis with homeopathy adversely affected its acceptance with the pharmacology community as a result of the longstanding and bitter feud between homeopathy and traditional medicine from which pharmacology and subsequently toxicology emerged. This latter point was particularly important because leading pharmacologists, especially Alfred J Clark, incorporated
Letters to the Editor
Hormesis is not homeopathy In his article, Calabrese (2005) gives hormesis a strong association with homeopathy as a leading reason for its marginalization by the medical establishment. Without getting into a discussion on the validity of homeopathy, we contend that this linkage is misconceived. Homeopathy and hormesis indeed share in common the use of small doses, but differ conceptually on at least four important issues:
Menachem Oberbaum4 Noah Samuels Shepherd Roee Singer The Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel 4Corresponding author. Fax: +972 6666975. E-mail address: [email protected]. 24 May 2005 doi:10.1016/j.taap.2005.05.011
(1) Unlike the non-specific effect of hormesis, induced by a variety of chemically unrelated substances, homeopathy is highly specific. A homeopathic remedy that does not bfit like a gloveQ will not elicit biological activity. (2) Whereas hormetic (chemical) responses are induced by small but measurable concentrations (above Avogardo’s number), homeopathic concentrations are often far below this. The use of a remedy with a bconcentrationQ of 10 400 of the stem solution is common practice in classic homeopathy. (3) The hormetic effect is reversible, reverting with cessation of the hormetic substance. The homeopathic effect is enduring. A single exposure initiates a healing process which continues long after administration of the remedy. (4) Hormetic substances do not require any special preparation. Homeopathic remedies, in contrast, require a lengthy and exacting process before they are ready for administration. It appears to us that the medical establishment’s neglect of hormesis stems more from hormesis’s lack of clear clinical indications than from its purported relationship with homeopathy. Rigorous evidence of hormesis’s effectiveness in even a single clinical indication would do much to extract this field from its current state of disrepute.
Reference Calabrese, E.J., 2005. Toxicological awakenings: the rebirth of hormesis as a central pillar of toxicology. Toxicol. Appl. Pharmacol. 204, 1–8.
Factors affecting the historical rejection of hormesis as a fundamental dose response model in toxicology and the broader biomedical sciences Response to Oberbaum et al., 2005: My article explored factors that may have affected the recognition and acceptance of hormesis within the toxicological sciences. As such, there were a variety of factors that impacted its acceptance including the fact that hormesis is difficult to prove because of the modest nature of its response. This requires considerably stronger study designs including more doses, careful spacing of doses below the NOAEL, stronger emphasis on statistical power considerations, temporal features as part of the study design and greater emphasis on study replication. In addition, toxicology has long been a high dose and few doses discipline making hormesis little studied and, when possibly observed, easily dismissed as random variation. Hormesis has been further handcuffed by the fact that as early as the 1930s, biostatistical modeling of dose response relationships started to constrain responses to be above background. As if these factors were not enough of a challenge, the early and close association of the concept of hormesis with homeopathy adversely affected its acceptance with the pharmacology community as a result of the longstanding and bitter feud between homeopathy and traditional medicine from which pharmacology and subsequently toxicology emerged. This latter point was particularly important because leading pharmacologists, especially Alfred J Clark, incorporated