Homeopathy & two athletes

Chronic suppurative otitis media, Helicobacter pylori and Antimicrobial resistance

'The nature of our remedies is that different kinds of stress produce different symptomatology, while each remedy can be said to be sensitive to a particular kind of stress.’

Professor George Vithoulkas on Baryta carbonicum¹

( This article is an abridged version of a webinar (May 2023) as requested by the Australian Homeopathic Association as promotional material after acceptance of my paper hormonal disorders and homeopathy in elite female athletes )

Homeopathy & Hormonal imbalance

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CASE 1

Commonwealth games silver medalist taking antibiotics since twelve months for chronic suppurative otitis media.

Chronic suppurative otitis media is a disease condition associated with chronic inflammation of the middle ear cleft characterized by persistent perforation of the tympanic membrane with recurrent or persistent mucopurulent otorrhoea. The duration of otorrhoea required for a diagnosis of chronic suppurative otitis media ranges from between 3 weeks to 3 months.

First appointment

October 2017.

Swimming at least 3kms daily for twenty-five years, development of chronic suppurative otitis media coincided with returning to full-time employment after which a ‘hurry, hurry, hurry’ attitude was adopted ‘to fit everything, and everyone, in.’

Although chronic suppurative otitis media pus swab cultures often show Methicillin resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA), the GP prescribed a repeat antibiotic course taken for over twelve months.²

REPERTORIZATION Vithoulkas Compass (2023)

Mercurius - ‘There is a tendency to chronic suppurations of all kinds, suppurations which can last for many years. There is simply not enough defensive force to eliminate the infection, so a stalemate results, until the allopath interferes and suppresses the infection to a deeper level.’ Professor George Vithoulkas on Mercurius³

In his special pathology and diagnostics with therapeutic hints, Raue states the following for otitis media requiring Mercurius; Deep-seated, tearing and shooting pain, extending to the malar or inferior maxillary bone; worse evening til midnight, by warmth in bed; enlarged, sensitive cervical glands; stomatitis or ulcerated sore throat; tongue large, flabby, indented; fauces inflamed; perspiration from least exertion; otitis, accompanied by facial paralysis.⁴

There was no further Chronic suppurative otitis media post prescription of Mercurius solubilis with a change in presenting symptoms to past symptomatology – in accordance with direction of cure theory - shortly thereafter. 

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According to Wang et al.,⁵ the most common ear problem in swimmers is acute diffuse otitis externa – aka swimmers ear - typically caused by the bacteria Pseudomonas aeruginosa which is becoming increasingly multi drug resistant⁶ and Staphylococcus aureus - can persist for weeks or even months despite intensive treatment, and once resolved there is significant risk of recurrence. Otomycosis, usually a unilateral FUNGAL infection, is also termed swimmers ear.  

Chronic suppurative otitis media poses significant challenges in medical management due increased incidence of multi drug resistance to commonly used antibiotics, with increased incidence of multi drug resistance.⁷

It is interesting to note here that since the 1990’s expert opinion has swung against doctors giving antibiotics for otitis media. However, in Australia where The Royal Australian College of General Practitioners recommend that for non-indigenous children between the ages of two and twelve years otitis media should not be treated with antibiotics unless there are signs of widespread infection, the highest rate of dispensing antibiotics in under 65’s is for children aged between two and four most commonly for – you guessed it… otitis media.⁸

Homeopathy & Otitis Media

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SYSTEMATIC REVIEWS

Systematic Reviews summarize the outcomes of various intervention trials and are considered an extremely efficient method for finding what works and what doesn’t. PubMed has 181 listed systematic reviews for homeopathy .

Systematic reviews of homeopathy & otitis media find:

• Marom et al.,2016 Mild treatment effect for homeopathy in otitis media, and some benefits in using homeopathy for the prevention, and treatment of Acute Otitis Media.⁹

• Reduction of antibiotic use in Otitis Media by Fixsen 2013 who argues a case for homeopathy to be integrated into the Otitis Media treatment strategy.¹⁰

• Clinical efficacy and effectiveness of homeopathy in acute paediatric infections are favourable in terms of faster responses, fewer and less serious side effects, and cost savings.¹¹ ¹² Bellevite et al., reviewed thirty years of homeopathy for the treatment of otorhinolaryngologic and other complaints, finding evidence that suggests classical, individualized homeopathy may have significant effects in otitis media.

In 2022, Nathan et al., stated that use of properly prescribed homeopathic medicine (by a registered homeopath) can lead to: Faster relief. Decreased pain. Quicker resolution of infection, in combination with conventional therapy.¹³

Bell & Boyer (2013) found the following evidence based advantages for homeopathy in otitis media: Lower antibiotic fill rates. Less serious side effects. No drug interactions, and reduced parental leave from work!(2) Stating that numerous clinical studies demonstrate that homeopathy accelerates early symptom relief in acute illnesses at much lower risk than conventional drug approaches.¹⁴

The (still) well regarded 2001 Jacobs et al., randomized controlled trial published in Pediatric Infectious Diseases Journal found significant decrease in symptoms of otitis media at 24 and 64 hours after homeopathic treatment.¹⁵

A 2007 non-randomised study by Haidvogl M, et al., compared homeopathy compared to conventional treatment in acute respiratory and ear complaints in over 1,500 adult and paediatric patients in a primary care setting - Otitis media was the most frequently diagnosed paediatric condition. Onset of improvement within 7 days of treatment was significantly faster in the homeopathic groups leading the researchers to conclude contribution the growing evidence that homeopathy is a beneficial treatment strategy for acute diseases in primary care settings.¹⁶ 

A 2001 observational study conducted by Frei & Thurneysen found pain control in 40% of children after 6hours, with resolution of all otitis media symptoms being twice as fast with homeopathic medicine.¹⁷

As otitis media is an especially common paediatric complaint and we have a small but growing robust data set for homeopathy in its treatment, in my opinion homeopaths would do well to publish more otitis media cases.

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CASE 2

A twenty eight year old male bounced around by doctors and naturopaths for over six years who, at the insistence of his wife, returned a positive (urea breath) test for Helicobacter pylori in 2017 was prescribed a course of antibiotics which relieved his symptoms for just three weeks.

First appointment

September 2018

REPERTORIZATION & RESULTS (Vithoulkas Compass, 2023)

Nux vomica ‘Among other affections, many chronic maladies, also the evil consequences arising from drinking much coffee and wine, especially when the usual mode of life is a sedentary one in close rooms, and those affections caused by prolonged mental labour, find their remedy in this seed; as also several epidemic diseases and other acute fevers, especially such as have heat before the chill or mixed up with it.’ Dr. Samuel Hahnemann on Nux Vomica¹⁸

October 2018 – Except for one attack (quickly relieved by a dose of Nux-v) after heavy drinking, the presenting symptom of trapped eructations has gone. No change in the unfinished feeling after stool. Nose still obstructed at night. New symptom – occasional esophageal burning.

February 2019 – Trapped eructations brought on by heavy drinking (quickly relieved by a dose of Nux-v). Now drinks coffee without issue every day. No longer feeling unfinished after stool. Has not experienced the nightly nasal obstruction for months. No further esophageal burning.

Removal of symptoms in this case revealed further layers of disturbance (suppressed symptoms) requiring subsequent prescriptions of Rhus tox (2019) and Carcinosinum (2019).

SUZUKI ET AL., 2022. THE IDEAL HELICOBACTER PYLORI TREATMENT FOR THE PRESENT AND THE FUTURE. DIGESTION. 103(1):62-68. Available from: https://pubmed.ncbi.nlm.nih.gov/34662879/

Helicobacter pylori

(H. pylori), a group-1 definite carcinogen,¹⁹ is a spiral-shaped, flagellated, microaerophilic, extra-cellular bacterium infecting the human gastric sub-mucosa of approximately 4.4 billion people, and is implicated in diverse and serious gastric and extra-gastric conditions.²⁰ H. Pylori testing is done via stool sample, urea breath test or an upper endoscopy exam.

The 2005 Nobel Prize for Physiology or Medicine was awarded to West Australian doctors Robin Warren and Barry Marshall for the first introduction, culture, and isolation of H. pylori in 1983²¹ and the investigation of its relevance to peptic ulcer disease – Dr. Marshall intentionally swallowed H. pylori bacterium and developed a stomach ulcer within ten days, resulting in subsequent major breakthroughs in the study and treatment of stomach cancers. 

H. pylori was present in our early east African ancestors of 58,000 years ago and infection is a major risk factor for gastric cancer, non-alcoholic fatty liver disease, hypertension - H. pylori-infected people have a 13% higher risk for hypertension, atherosclerosis, and increased carotid intima-media thickness which may indirectly contribute to major vascular events.

There is correlation between H. pylori and Coeliac Disease, but causality cannot be clarified. Virulent strains of H. pylori may underlie some autoimmune diseases particularly the cagA positive strain, which modulates and dysregulates immune responses, disrupts signaling pathways, and damages cells.²²

Interestingly, seroprevalence of H. pylori infection was higher in adolescent Korean athletes than in age- and sex-matched regular students.²³

Nux vomica 10C prepared in ethanol was found to inhibit H. pylori-induced gene expression in vitro.²⁴ A 2012 study concluded that the H. pylori nosode possesses potent prophylactic anti H. pylori activity in vivo after the nosode was shown to be able to stop the initiation of H. pylori infection in a pre-treatment group.²⁵

Allopathic treatment of H. pylori typically involves at least two different antibiotics at once – and of course the antibiotic resistance of H. pylori is currently increasing worldwide, with resistance to frontline treatments detected in up to approximately 14% of samples.²⁶

Leading researchers state that the ideal concept for the present and future H. pylori eradication treatment must involve "a simple, cost-effective strategy that fosters compliance without having a negative impact on the gut microbiota or contributing to future antimicrobial resistance."²⁷ 

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ANTIBIOTIC RESISTANCE

According to NPS Medicinewise antibiotic resistance began applying to our ‘reserve’ antibiotics in 2016²⁸ but scarily antibiotics are still being overprescribed (in direct contravention of Australian national evidence-based prescribing guidelines) with ever increasing rates of resistant bacteria in our communities.²⁹

It has been estimated that antibiotic-resistant Urinary Tract Infections alone could cost Australia A$1.6 billion per year…³⁰

In 2020, two doctors and two veterinarians, published their narrative review “Evidence-based homeopathy and veterinary homeopathy, and its potential to help overcome the antimicrobial resistance problem – an overview”.³¹

Factually clarifying the evidence of the effectiveness for human and veterinary homeopathy in general, and in particular the homeopathic treatment of infections the authors, critical of the anti-scientific second Australian NHMRC (National Health and Medical Research Council) homeopathy report and the EASAC (European Academies Science Advisory Council) Statement, reviewed level 1a studies on the general use of human and veterinary homeopathy, providing level 1a, 1b, and 2c evidence for the use of homeopathy in infections.

Real World Data, show the potential for a significant reduction in the use of antibiotics through homeopathic treatments. Not least because of the global threat posed by the problem of antibiotic resistance, further methodologically high-quality studies are urgently needed in human homeopathy just as in veterinary homeopathy.

Homeopathy shows potential for significant reduction in the use of antibiotics and further methodologically high-quality human and veterinary homeopathy studies are urgently needed due to the global threat of antibiotic resistance. Effectiveness of homeopathy in general, in particular treatment of infections, is adequately proven for further research in this field.³²

Homeopathy & Animals

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• Weiermayer et al., 2020. Evidence-based homeopathy and veterinary homeopathy, and its potential to help overcome the anti-microbial resistance problem - an overview. Schweiz Arch Tierheilkd. Oct;162(10):597-615.PMID: 33006555

• Fixsen A. Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections? Homeopathy. 2018 May;107(2):99-114. PMID: 29767829

• Van der Werf et al., 2018. Do NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016. BMJ Open. Mar 5;8(3):e020488. PMID: 29555793.

• Bell and Boyer. 2013. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children. Glob Adv Health Med. Jan;2(1):32-43. PMID: 24381823

• Sinha et al., 2012. Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Homeopathy. 2012 Jan;101(1):5-12. PMID: 22226309

Although bactericidal effect via homeopathic medicine has been shown, this is not in accordance with the general principles of homeopathy with its hypothesis that the individualized homeopathic medicine affects the host, by, for example, activation of the immune system to prevent hospitality to, and adhesion of, bacteria rather than by direct bactericidal or bacteriostatic effects.³³

Homeopathy & recurrent urinary tract infections

Retrospective case series have also shown Individualized homeopathy to be an effective approach in the management of antibiotic-resistant Recurring-Urinary Tract Infections (R-UTI),³⁴ and able to reduce the frequency of R-UTIs and antibiotic use in women.³⁵ A case report (of mine) outlines a lifetime dependence on antibiotics, steroids, and ventolin in a five-year-old Australian boy reversed after treatment with classical homeopathy.³⁶

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Individualized homeopathy outlines the process whereby a single homeopathic medicine is chosen based on the totality of signs and symptoms of an individual that is, concomitant conditions and diseases, psychological features and feelings, all inform the homeopathic prescription – it is crucial to note here that no generalized homeopathic medicine by condition exists - I have prescribed Mercurius in H.pylori and Nux vomica in otitis media.

In many dysbiotic conditions disease development involves the mutual relationship between the gut microbiota and the immune system - having multi layered causations, not just the overgrowth or absence of microorganisms.

Homeopathic medicine is not out to kill - it enables us to exist in improved harmony within ourselves, our surroundings, and the world of bacteria and micro-organisms.

Unsurprisingly researchers recently found ‘the reliability of homeopathic prescriptions may increase through resource to objective signs and guiding symptoms with significant positive likelihood ratio (LR)’ concluding ‘objective signs with significant positive LR might increase the reliability of homeopathic prescriptions.’³⁷

Robert Mathie reminds us that the heart of homeopathy is INDIVIDUALIZATION.³⁸

Isn’t it time for recognition of the importance in promoting a person’s own innate immune system responses, via homeopathy, as important in combating antimicrobial resistance?

‘In contrast to frequent claims, the available Meta Analyses of homoeopathy in placebo-controlled randomised trials for any indication show significant positive effects beyond placebo. Compared to other medical interventions, the quality of evidence for efficacy of homoeopathy was similar or higher than for 90% of interventions across medicine. Accordingly, the efficacy evidence from placebo-controlled randomised trials provides no justification for regulatory or political actions against homoeopathy in health-care systems.’³⁹

1. VITHOULKAS, G. 1997. MATERIA MEDICA VIVA - VOL. 4 BACILLINUM TO BENZOIC ACID. INTERNATIONAL ACADEMY OF CLASSICAL HOMEOPATHY, ALONISSOS, GREECE.

2. Abraham et al., 2019. Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania. BMC Res Notes. 2019 Jul 17;12(1):429. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637475/

3. VITHOULKAS, G. 2012. ESSENCE OF MATERIA MEDICA. (1ST ED. 1988). B.JAIN PUBLISHERS, NEW DELHI.

4. RAUE, CG. 1992. SPECIAL PATHOLOGY AND DIAGNOSTICS WITH THERAPEUTIC HINTS – FOURTH EDITION. B.JAIN PUBLISHERS. NEW DELHI.

5. Wang et al., 2005. Ear problems in swimmers. J Chin Med Assoc. Aug;68(8):347-52. Available from: https://pubmed.ncbi.nlm.nih.gov/16138712/

6. Foulkes et al., 2022. Impact of fluoroquinolones and aminoglycosides on P. aeruginosa virulence factor production and cytotoxicity. Biochem J. Dec 22;479(24):2511-2527. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788569/

7. Abraham et al., 2019. Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania. BMC Res Notes. 2019 Jul 17;12(1):429. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637475/

8.

9. MAROM ET AL., 2016. COMPLEMENTARY AND ALTERNATIVE MEDICINE TREATMENT OPTIONS FOR OTITIS MEDIA: A SYSTEMATIC REVIEW. MEDICINE (BALTIMORE). FEB;95(6):E2695. Available from: https://pubmed.ncbi.nlm.nih.gov/26871802/

10. FIXSEN A. 2013. SHOULD HOMEOPATHY BE CONSIDERED AS PART OF A TREATMENT STRATEGY FOR OTITIS MEDIA WITH EFFUSION IN CHILDREN? HOMEOPATHY. APR;102(2):145-50. Available from: https://pubmed.ncbi.nlm.nih.gov/23622265/

11. BELLAVITE ET AL., 2011. ADVANCES IN HOMEOPATHY AND IMMUNOLOGY: A REVIEW OF CLINICAL RESEARCH. FRONT BIOSCI (SCHOL ED). JUN 1;3(4):1363-89. Available from: https://pubmed.ncbi.nlm.nih.gov/21622275/

12. BUKUTU ET AL., 2008. COMPLEMENTARY, HOLISTIC, AND INTEGRATIVE MEDICINE: THERAPIES FOR ACUTE OTITIS MEDIA. PEDIATR REV. JUN;29(6):193-9. PMID: 18515336https://pubmed.ncbi.nlm.nih.gov/18515336/

13. Nathan et al., 2022. Complementary/Integrative Medicine for Pediatric Otitis Media. Otolaryngol Clin North Am. Oct;55(5):1055-1075. Available from https://pubmed.ncbi.nlm.nih.gov/36088163/

14. Bell and Boyer. 2013. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children. Glob Adv Health Med. Jan;2(1):32-43. Available from https://pubmed.ncbi.nlm.nih.gov/24381823/

15. Jacobs J, Springer DA, Crothers D. 2001. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatric Infectious Diseases Journal. Feb;20(2):177-83. Available from https://pubmed.ncbi.nlm.nih.gov/11224838/

16. Haidvogl et al., 2007. Homeopathic and conventional treatment for acute respiratory and ear complaints: a comparative study on outcome in the primary care setting. BMC Complement Altern Med. Mar 2;7:7. Available from: https://pubmed.ncbi.nlm.nih.gov/17335565/

17. Frei & Thurneysen. 2001. Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? Br Homeopath J. Oct;90(4):180-2. Available from https://pubmed.ncbi.nlm.nih.gov/11680801/

18. HAHNEMANN, S. 1986. MATERIA MEDICA PURA - VOL. II LEDUM TO VERBASCUM. (1ST ED.1817). B.JAIN PUBLISHERS. NEW DELHI.

19. AlEraky et al., 2022. Potential Antigenic Candidates for the Development of Peptide-Based Vaccines to Induce Immunization against Helicobacter pylori Infection in BALB/c Mice. Int J Mol Sci. Oct 24;23(21):12824. Available from https://pubmed.ncbi.nlm.nih.gov/36361614/

20. Simon et al., 2022. Helicobacter pylori Infection Is Associated With Carotid Intima and Media Thickening: A Systematic Review and Meta-Analysis. J Am Heart Assoc. Feb;11(3):e022919. Available from https://pubmed.ncbi.nlm.nih.gov/35060390/

21. Warren & Marshall, 1983. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet. Jun 4;1(8336):1273-5. Available from https://pubmed.ncbi.nlm.nih.gov/6134060/

22.

23. Choe YH, Hwang tS, Hong YC. 2002. Higher seroprevalence of Helicobacter pylori infection in Korean adolescent athletes compared to age- and sex-matched non-athletes. J Gastroenterol Hepatol. Feb;17(2):131-4. Available from: https://pubmed.ncbi.nlm.nih.gov/11966941/

24. Hofbauer R, Pasching E, Moser D, Frass M. 2010. Heparin-binding epidermal growth factor expression in KATO-III cells after Helicobacter pylori stimulation under the influence of strychnos Nux vomica and Calendula officinalis. Homeopathy. Jul;99(3):177-82. Available from https://pubmed.ncbi.nlm.nih.gov/20674841/

25. Gosavi et al., 2012. Therapeutic Effect of H. pylori nosode, a homeopathic preparation in healing of chronic H. pylori infected ulcers in laboratory animals. Asian Pacific Journal of Tropical Disease. 2;2, S603-S611. Available from https://www.sciencedirect.com/science/article/pii/S2222180812602308

26. Kouhsari et al., 2022. Heteroresistance to clarithromycin and metronidazole in patients with a Helicobacter pylori infection: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob. May 20;21(1):19. Available from https://pubmed.ncbi.nlm.nih.gov/35596211/

27. Suzuki et al., 2022. The Ideal Helicobacter pylori Treatment for the Present and the Future. Digestion. 2022;103(1):62-68. Available from https://pubmed.ncbi.nlm.nih.gov/34662879/

28. https://www.nps.org.au/news/antibiotic-resistance-in-australia-here-and-now

29. https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021

30. https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543

31. Weiermayer et al., 2020. Evidenzbasierte Veterinär-/Homöopathie und ihre mögliche Bedeutung für die ­Bekämpfung der Antibiotikaresistenzproblematik – ein Überblick [Evidence-based homeopathy and veterinary homeopathy, and its potential to help overcome the anti-microbial resistance problem - an overview]. Schweiz Arch Tierheilkd. Oct;162(10):597-615. German, French. Available from https://pubmed.ncbi.nlm.nih.gov/33006555/ Synopsis at https://cam-europe.eu/evidence-based-homeopathy-and-veterinary-homeopathy/

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34. Chand KS, Kapoor P. 2020. Two Case Reports of Integrated Management of Antibiotic-Resistant Urinary Tract Infection. Homeopathy [online]. May;109(2):97-106. Available from: https://pubmed.ncbi.nlm.nih.gov/31958866/

35. Gaertner et al., 2020. Individualized Homeopathic Treatment in Women with Recurrent Cystitis: A Retrospective Case Series. Complementary Medicine Research [online]. 27(3):193-199. https://pubmed.ncbi.nlm.nih.gov/31945769/

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37. Eizayaga et al., 2021. Prevalence and Likelihood Ratio of Six Objective Signs among Good Responders to Natrum muriaticum: Multi-centre Observational Assessment. Homeopathy. Feb;110(1):36-41. Available from https://pubmed.ncbi.nlm.nih.gov/33482668/

38. Mathie RT. 2022. Individualisation: The Heart of Homeopathy. Homeopathy. Feb;111(1):1. Available from: https://pubmed.ncbi.nlm.nih.gov/35100648/

39. Hamre HJ, Glockmann A, von Ammon K, Riley DS, Kiene H. Efficacy of homoeopathic treatment: Systematic review of meta-analyses of randomised placebo-controlled homoeopathy trials for any indication. Systematic Rev. 2023 Oct 7;12(1):191. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02313-2#Abs1