The Placebo Project: An observational study and comprehensive analysis of 134 commonly prescribed homeopathic remedies in India uncovers potential for hepatotoxicity

Abstract

Homeopathy is a popular alternative medical practice globally. However, homeopathic formulations can cause allergies, anaphylaxis, fatal cardiovascular events, kidney injury, liver failure, and death due to their direct and indirect toxicities. This study examined commonly prescribed homeopathic formulations from 3 categories: classical dilutions, mother tinctures, and proprietary products. This cross-sectional study assessed the quality and safety of popular over-the-counter homeopathic formulations. Each remedy underwent complete organic and inorganic content profiling, including heavy metal detection, alcohol quantification, and steroid detection. We analyzed 134 homeopathic remedies and found high alcohol levels, insect and animal parts, carnivorous plants in alcohol, and toxic heavy metals. Classical dilutions had the highest alcohol content (median: 91.02% v/v). Highly diluted formulations of arsenic and mercury had detectable lead levels. Proprietary medicines also showed various potentially toxic bioactive plant compounds, heavy metal contaminants, industrial-grade solvents, and pharmaceutical intermediates, raising concerns about organ toxicity. Homeopathic formulations revealed high ethanol levels and toxic heavy metals like arsenic, lead, mercury, and cadmium. Tinctures and proprietary formulations contained multiple potentially toxic chemicals. Stricter regulatory oversight is needed, and consumers should be aware that the testimonials and anecdotal claims of homeopathic benefits lack scientific validation and can mask potentially harmful effects.

Keywords: AYUSH; herb-induced liver injury; homeopathy; phytochemicals; toxicology.

Figure 1.

Summary of analysis of heavy metals and alcohol in (A) classical Homeopathic dilutions, (B) Homeopathic mother tinctures, and (C) proprietary Homeopathic formulations. The haphazard levels of both between various categories of formulations, and the presence of alcohol in every type of Homeopathic remedies analyzed becomes a cause for concern in the context of public health, due to exposure to alcohol and potentially harmful heavy metals in products that are marketed to have “medicinal value.”

Figure 2.

Summary of Homeopathic dilutions and pertinent points on analysis results.

Figure 3.

Summary of Homeopathic mother tinctures and pertinent points on analysis results.

Figure 4.

Summary of proprietary Homeopathic medicines and pertinent points on analysis results.

Figure 5.

Comparison of median alcohol content (in v/v) in tested categories of various Homeopathic remedies shows highest content in commonly prescribed dilutional forms (A), followed by mother tinctures; the difference between detected alcohol versus disclosed alcohol content (delta-alcohol) between various types of Homeopathic formulations demonstrates that many formulations had higher than disclosed alcohol content, which some did not disclose alcohol, while others had lesser than disclosed amount showcasing an extreme lack of standardization and mislabeling and potential for increased exposure to alcohol at the consumer level (B–E).