Home-remedies are usually used to ameliorate symptoms rather than treat diseases or target the cause of the disease, says Dr Cyriac Abby Philips, senior consultant, clinical and translational hepatology, at Rajagiri Hospital, Kerala, in conversation with Anna Jose. He points out that a large body of published evidence on home-remedies exists, but they lack quality studies and evidence.
Why is that a large percentage of the population in India seek out home remedies for illnesses ranging from mild to severe?
Home remedies have been an integral part of treatments throughout millennia. Not only in India, globally, home remedies were popular before pharmaceutical treatment became accessible. The remedies differ from place to place - for example steam-inhalation, hot lemon drink, honey, chamomile tea and chicken soup in a German study compared to use of herbal drinks, herbal extracts and over-the-counter natural products among communities in India. The selection of home remedies is based on multiple factors - such as inherent and popular knowledge from tradition or antiquity (eg: phyllanthus niruri for jaundice), role of traditional medical practices specific for the region (eg: ayurveda across India, siddha in Tamil Nadu) and various types of folk-medicines specific to cultural (honey for cough) and religious (hijama among Muslims) tenets. Home-remedies as an initial choice also depends on the lack of easy accessibility and deeply disproportionate infrastructure in scientific healthcare among regions and communities, and paucity in scientific temperament and education on informed rational and effective healthcare choices. In the current era, access to a tsunami of information and the dissemination of misinformation in healthcare through social media has also increased the use of home remedies for diseases initially, followed by realistic health-seeking behaviour.
Is there any scientific study that proves the inefficiency of home remedies?
Home-remedies are usually used to ameliorate symptoms rather than treat diseases or target the cause of the disease. For example, honey is used as a common remedy for cough. But coughing is only a symptom of an underlying disease—which can be a viral flu, a bacterial bronchitis, a fungal pneumonia or even lung cancer. Viral flu is self limiting and goes away when given the time, but the other causes require specific treatments to cure the illness. In this regard, most scientific studies done on home remedies have only looked at symptom reduction rather than disease treatment per say. And most of the positive studies are misleading - such as the infamous meta analysis study [https://ebm.bmj.com/content/26/2/57.responses] on honey in cough where the authors concluded that honey could be better than antibiotics when the results did not realistically support such a conclusion and the study and its methods were met with multitude of criticisms from the medical science community. Another study [https://pubmed.ncbi.nlm.nih.gov/34312974/] on ginger for reducing nausea and vomiting during post-surgery period showed that ginger may reduce nausea, but not vomiting, pending further randomized trials versus standard of care medicines - however, such quality trials never came. Or the study on ginger and prevention of nausea and vomiting in patients undergoing chemotherapy which showed that most studies were of poor quality, without haphazard methodologies and hence strong conclusions could not be made. Although a large body of published evidence on home-remedies exist, they lack quality studies and evidence.
Most alternative treatments do not guarantee safety. What are the disadvantages associated with home remedies?
In most Indian households, home remedies are considered the first line of defence. Giloy herb, for example, is a popular home medicine for cough, fever and general weakness. Giloy (Tinospora cordifolia) is a well-known liver toxic plant due to the presence of natural compounds known as furano-diterpenoids in it. It alters the human immune system and increases self-attack on liver cells, resulting in a condition known as herb-induced autoimmune hepatitis, which can be devastating in people who already have liver disease. Another well known remedy used in Indian households is Aloe Vera, which is associated with diarrhea, leads to dangerously low potassium in body (hypokalemia), kidney failure, severe hepatitis, as well as phototoxicity and hypersensitive reactions - when in fact, aloe vera has no proven clinical benefits for the prevention or treatment of any disease conditions. Similarly, taking high amounts of haldi (turmeric) with pepper to promote absorption might result in turmeric-related hepatitis, which is a prevalent cause of hepatitis in the west.
Numerous websites and professionals advocate using home remedies despite the fact that there are risk factors.
Websites or so-called “health influencers” who push, promote or advertise home remedies or sell home-remedies (through partnerships or their own handles/accounts/pages) are only looking at the business aspect of it and not realistic patient care or health promotion. People (especially the patient community) must be well-informed and educated to identify such deliberate misinformation in the healthcare space and avoid them so as to prevent avoidable disease burden.
How can we educate the general public about using modern medicine to treat health issues?
People have the right to effective healthcare. In many instances, the time taken to avail healthcare services matter. For example, a recent viral post on Meta (Facebook) which spilled over to WhatsApp and Twitter showed a supposed health influencer asking people to have chillies kept in jars to prevent heart attack or effectively improve active attacks without the need for hospitalization or medical evaluation. Imagine, if this was followed by even a handful of people when such a situation arose - it would definitely lead to loss of life, unnecessary loss of life. Raising awareness of scientific and effective healthcare-seeking behaviour by disrupting misinformation and disinformation at every given opportunity is of utmost importance, especially from the doctors’ community. The best way to educate people on how science-based medicine improves their life and controls their disease or helps in prevention of various illnesses is to teach them by demystifying healthcare misinformation online and offline. In this regard, the news media - print, visual and social - play a great role in imparting rightful information on healthcare by debunking health misinformation to the masses consistently with the help of domain medical experts.