Thank you to Dr Sujata Naik for this update on respiratory allergies and homeopathic treatment.

Respiratory allergies are reported to be among the most frequent types of allergies in the world. Epidemiological studies indicate a rapid increase globally in this condition over the last couple of decades, with a prevalence of almost 10-30% in urban areas and 13-15% in rural areas.

The impact of climate change and human activities on the environment has resulted in global warming. There is an increase in carbon dioxide concentration and increased frequency of extreme events such as heat waves, droughts, thunderstorms, floods and hurricanes. Respiratory health can be particularly affected by climate change with an increase in allergic rhinitis, hay fever and allergic asthma. Sensitivity to dust, pollen and mould allergens trigger the release of pro-inflammatory and immuno-modulatory mediators that accelerate the onset of IgE mediated sensitisation and allergy.

Bronchial hyper-reactivity and airway inflammation are together responsible for the characteristic variable airflow limitation in asthma.

The inflammatory response in asthma involves an interaction between genetic susceptibility and environmental factors including allergens.

The surge in global popularity of Homeopathy for allergic conditions

Homeopathy is among the most sought after alternative treatments for respiratory allergies as it is natural, safe and effective both for prevention and for treatment of this condition. Increasing antimicrobial resistance and the potential side effects of certain conventional drugs is drawing people towards alternative treatment options, chiefly homeopathy. According to statistics, more than two fifths of the population in India take homeopathy for all their health issues. Almost 10-12%, about a hundred million people take homeopathy for their respiratory health problems including asthma.

In Britain the market for homeopathy is growing by 20% every year and an estimated 6 million people take homeopathy some time or the other.

Homeopathic medicines are ultra dilutions of substances derived from nature, whether plant, mineral or animal sources. While conventional medicines suppress the response to the allergy, homeopathic remedies are prescribed to strengthen the patient’s immune response and natural defence.

On the other hand conventional treatment generally involves antihistamines; corticosteroids (local and systemic); decongestants; bronchodilators; anticholinergic drugs in symptomatic cases of allergic rhinitis/bronchitis and desensitisation shots to prevent the allergy.

A paper written by Dana Ullman (MPH) and Michael Frass (MD) reviews the research in homeopathy in patients with respiratory tract allergies. It reports significant amelioration (almost 87%) in the majority of cases and remarkable relief in symptoms of allergic bronchitis too! Several clinical trials published in high impact conventional journals including The Lancet have described notable effects of homeopathic dilutions in respiratory allergies.

Dr David Reilly MD, and his team at Glasgow University conducted 4 double blind placebo controlled trials over a period of 18 years, demonstrating the efficacy of homeopathy greater than that of placebo in allergic conditions related to respiratory tract, and that these results are reproducible. David took drastic measures to protect the study from frauds, hired a neutral statistician and plugged every loophole to make the homeopathy study as transparent and plausible to the scientific World. Every trial on hay fever and asthma proved positive in favour of homeopathy.

A research article in Immunology and Homeopathy (2005) by Paolo Bellavita and Anita Conforti states:

“The profound analogies between homeopathic thought and immunology are due to the fact that the whole of homeopathic theory is substantially based on the principle of regulating endogenous systems of healing, the best known of which is certainly the immune system and it’s neuroendocrine integrations.”

Reports on all randomised trials reported in this article indicate the effectiveness of homeopathy in allergies, the premise being its action of working with the body defences, allowing the constitution to heal itself.

Homeopathy styles in the treatment of respiratory allergies

1. Use of specific remedies with an affinity to the lining of the respiratory tract: Homeopathic remedies like Allium cepa, Sabadilla, Antimony tartaricum, Euphrasia, Natrum mur, Galphimia Antimony tartaricum, Euphrasia, Galphimia gauca, to name a few, have been observed to be effective in significantly reducing symptoms related to the allergy. Dilutions of the offending substance that caused the allergy as well as specific anti-miasmatic remedies (Medorrhinum, Tuberculinum, Psorinum) have been found to be effective in hay fever and allergies. There is a similarity between homeopathic medicine and modern allergy desensitisation treatment which both use small doses of substances that cause symptoms in a hypersensitive state. However, there are substantial differences in conventional and homeopathic allergy treatment. Desensitisation shots are aimed to only prevent the allergy symptoms whereas homeopathic remedies are meant to prevent as well as treat allergies.
2. Use of complexes: Some studies have demonstrated the use of remedies in certain combinations have proven effective in treating symptoms of respiratory allergies. They could be useful for short term treatment in seasonal and acute conditions, but have their limitations.
3. The constitutional approach: The cornerstone of homeopathy lies in individualisation. Prescriptions are based on the totality of physical and psychological symptoms in addition to those related to the chief complaint. The homeopath does not assume that the allergen (pollen, dust or other) is the cause of the ailment, rather considers it to be the trigger. It is the patient’s innate, weak defence system that is the predisposing factor. Rather than suppressing the symptoms or only avoiding the allergen, the homeopath seeks to find the remedy that will augment the patient’s immunity, helping him fight the allergy while healing himself! Most clinical trials to date are based on the role of specific homeopathic medicines for treating acute allergy symptoms and are generally short term trials (3 to 6 months). Very few studies have evaluated the efficacy of long term homeopathic constitutional treatment. Therefore, many clinical trials in homeopathy are designed on a conventional protocol with the same remedy given to several patients at the same time for a given ailment. That type of trial contradicts the principle of individualisation where different remedies may be needed for different individuals with similar ailments. This may limit the proof of their efficacy. An example of a study of the constitutional approach was a retrospective study of cases of allergic bronchitis conducted at a community hospital in rural Maharashtra, India. The objective of the study was to validate the value of the individualised homeopathic prescription in an observational study on cases of allergic asthma. This was an important study because according to WHO, 15-20 million people suffer from allergic asthma in India, characterised generally by breathlessness, wheezing, cough and fatigue.

Common symptoms of allergic asthma

1. Sudden bouts of cough or wheezing
2. Shortness of breath
3. Frequent cough worse at night
4. Signs of a cold or allergy – sneezing, running nose, nasal congestion, cough
5. Trouble lying down
6. In chronic allergic asthma, episodes of wheezing and cough may start sometimes with the smallest trigger or even without obvious triggers indicating an aberrant immune response leading to non pathogenic stimuli in the asthmatic airway causing a chronic inflammatory response.

In recurrent allergic asthma, symptoms are often common with very few characteristic symptoms pertaining to the individual. This can be a challenge to the homeopath who treats with the objective of giving symptom relief as well as a long term care to the patient.

The above study was done on a sample size of 225 patients in the community hospital. The patients (over 18 years of age) suffering from recurrent episodes of breathlessness and wheezing, not responding with sustained relief with conventional measures and who were under homeopathic treatment were included in the study. The patients came from a low income strata with poor levels of nutrition, hygiene and education. Living in crowded, damp humid surroundings.

Most of them complained of almost identical and common symptoms related to asthma, with very few notable individual characteristics. In such cases, because of a paucity of characteristic symptoms, inadequate verbal communication and persistence of a maintaining cause (living conditions), it was decided to employ the KEYNOTE METHOD, as explained by Hahnemann in Organon of Medicine (aphorism 172-179). He explains the concept of one sided diseases where common symptoms predominate, making it justifiable to prescribe the similimum based on partial totality by using at least one or two symptoms which are characteristic to the patient. This is totally in conjunction with basic homeopathic principles. Dr Henry Guernsey further endorsed and practised the Keynote method successfully, where he quoted the Keynote as:

“The fundamental note or tone  of which the whole piece is accommodated”

The Keynote is simply the predominating symptom or feature which directs attention to the totality .

The advantages of using the Keynote method

1. Very useful in mass settings in community practise and in clinical conditions with large number of patients suffering from a similar ailment, exhibiting similar symptoms.
2. Standardised module making it easier to monitor follow ups
3. Characteristic symptoms though few, can be elicited and used as differentiating rubrics. For example: a gesture, concomitant, thermal, a craving or aversion
4. More sustainable and reproducible model

The remedy is arrived at with following steps:

• Concentrate on presenting predominant symptoms of disease
• Devise a common totality
• Repertorise
• Derive a group of remedies based on common totality
• Select one characteristic keynote rubric to differentiate the indicated remedy from the common group of remedies

The common repertorial totality of symptoms of allergic asthma related by patients indicates the following remedies in majority of cases:

Ipecac, Sulphur, Arsenic album, Carbo veg, Pulsatilla, Kali carb, Antim Tartaricum, Bryonia, Natrum Sulph, Hepar Sulph, Sambucus and Spongia.

Apart from being polychrests, they also show a strong affinity to the respiratory tract during provings. Based on the common symptom totality, each case was individualised by applying the differentiating rubrics. The indicated remedy was, in most cases selected from the above mentioned rubrics. However, certain cases did have more characteristic symptoms, throwing up uncommon, constitutional remedies. Remedies were administered in standard dosage and in 30 c potency to avoid aggravations.

Follow up after 4 weeks

The results were as follows:

• 211 patients out of 225 reported relief in dyspnoea in the first week itself
• 190 had presented with wheezing. 170 reported amelioration
• 209 presented with cough, 180 better
• 193 of total 225 reported reduction in frequency of episodes
• 219 of 225 reported improved sense of well being and less fatigue.
• 32 patients did not show clinical response
• Only 11 patients reported aggravation in their presenting complaints like cough, wheezing and breathlessness with varying severity. They were recalled for constitutional re-case taking later.

The above observational study shows the role of homeopathy as a viable and strong treatment modality for allergic asthma. An observational study has limitations, yet it is encouraging enough to further explore and validate the justification of homeopathy as a viable primary treatment modality for allergic conditions of the respiratory tract. Its growing popularity worldwide is a reflection of Homeopathy being a science of the present and future.

References:

A  review of homeopathic research in treatment of respiratory allergies. Ullman & Frass. Altern Med Rev.2010 Apr;15(1):48-58.

Advances in homeopathy and immunology: a review of clinical research. Bellavite et al. Front Biosci 2011 Jun 1;3(4):1363-89.

Homeopathy and respiratory allergies: A series of 147 cases.  Colin. Homeopathy 2006 Apr;95(2):68-72.

Randomised Controlled Trial of Homeopathy Versus Placebo in Perennial Allergic Rhinitis with Overview of Four Trial Series. Reilly & Taylor. BMJ. 2000 Aug 19; 321(7259): 471–476.

Passalacqua & Bousquet. Systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol. 2006 May;117(5):1054-62. 

Krishna MT.  An appraisal of allergic disorders in India and an urgent call for action. World Allergy Organ J. 2020 Aug 1;13(7):100446. 

Boericke, W.(2012). Pocket manual of homoeopathic materia medica and repertory. (Reprint edition). New Delhi:  Indian Books & Periodicals Publishers.

Organon of medicine 6th edition. (Reprint edition.). New Delhi: Indian Books & Periodicals Publishers.

Harrison’s principles of internal medicine.vol 1 and Vol 2. (16th edition). USA: The McGraw Hill Companies D. Behera. (2010)

Textbook of Pulmonary Medicine. Vol 1 and Vol 2. (2nd edition). India: Jaypee Brothers Medical Publishers (P) Ltd.

Allen, H. (2014). Keynotes rearranged and classified with leading remedies of the materia medica and bowel nosodes. (10th edition). New Delhi: Indian Books & Periodicals Publishers.

Clarke, J. (2012). A dictionary of practical materia medica. (Reprint edition). New Delhi: Indian Books & Periodicals Publishers.

Koul (2018) Economic burden of asthma in India, Lung India, Vol. 35 (4) Pages 281-283.

Boger C.M. (2011) A Synoptic Key of the Materia Medica (Reprint edition) New Delhi: B. Jain Publishers (P) Ltd.

Stuart Close (2014) The Genius of Homoeopathy (Reprint edition) New Delhi: Indian Books & Periodicals Publishers.

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Thank you to Dr Sujata Naik for contributing this article for World Homeopathy Awareness week 2024.

Dr Sujata Naik, MD (Hom) is a clinically trained Homeopathic Doctor who has been practising extensively in Mumbai for over three decades, during which time she has treated thousands of patients. Known for her keen diagnostic skills and deep knowledge of Homeopathy, she believes in integrating healthcare through a patient-centric approach. Dr Sujata Naik, is an affiliate member of the Faculty of Homeopathy UK.

Dr Sujata Naik’s research team is committed to homeopathic practice and research, and to expanding the reach of homeopathy to every strata of society. Their clinic is in Mumbai, Maharashtra, India.