Vlog 18: Teething Tablet Arguments
The FDA recently had some of Hyland's homeopathic teething tablets tested after, you know, babies died and 400 adverse events were reported. They found they contained undesirable levels of belladonna.
Was everyone relieved to find out these tablets should be removed from store shelves? No!
Jonathan looks at some of the comments left on this article:
Hey, this is Jonathan from The Body of Evidence.
I ended episode 25 of our podcast by talking about Hyland's homeopathic teething tablets and the FDA warning against them. In case you don't know, in late January, the FDA said that, following reports of adverse events, a laboratory tested these homeopathic teething tablets and found inconsistent levels of belladonna. This plant is supposed to be in there, but it should be extremely diluted. What the lab found was that it wasn't rigorously diluted, since the levels were not the same from tablet to tablet, and the FDA thought babies shouldn't be put at risk.
You would think that consumers everywhere would be happy that a regulatory agency, after receiving reports of 10 dead babies and a number of bad side effects, tested the tablets, found them to be potentially dangerous, and asked for a recall.
You would think... but no, that warning did not make everyone happy. The New England Journal of Medicine published the FDA warning and I want to address some of the comments that were left on that page. You can find the link in the description below.
So, potentially dangerous baby medication asked to be removed from store shelves. How can people be against that? Let's see:
"This is ludicrous! There is one part per trillion of belladonna alkaloid in homeopathic teething products. Belladonna is included in the formula to reduce inflammation. There are thousands of times more belladonna in conventional anti-spasmodics, but the FDA certainly would not put out a warning about them. A child would have to ingest 12 - twelve - bottles of tablets in order to develop even the most mild symptom of toxicity which is a dry mouth."
This assumes that there is one part per trillion of belladonna in there. What the FDA is saying is that there is more. And remember that babies are not adults. A glass of beer may go down well an adult stomach, but try the same thing with a baby. Actually, don't. I don't want to get sued.
And belladonna toxicity is not just dry mouth. It includes fast heart rate, increased body temperature, skin flushing, constipation, decreased urination, agitation, disorientation, hallucinations, dilated pupils and, in infants, drowsiness.
Belladonna has anticholinergic activity, which means that it blocks a neurotransmitter in your nervous system, and doctors are often taught to remember the main signs of anticholinergic intoxication with the following mnemonic: red as a beet, dry as a bone, hot as a hare, blind as a bat, mad as a hatter, and full as a flask.
So, no. Not just dry mouth.
"Hyland's is a highly respected company which has been in business for over 100 years. Millions of parents have used their teething medicines with safety and satisfaction for 90 years. I have always been extremely pleased with their medicines myself."
The fact that the company is highly respected and has been around for a long time does not mean it is incapable of making a manufacturing error. Bayer AG is a multinational corporation that's been around since 1863; yet, just last year, they did a voluntary recall of two lots of a hemophilia drug, Kogenate, because it was found that its potency was declining faster than it should in those lots only.
So, just because a company has been around for a while and that many people, including yourself, have been satisfied with their products doesn't mean they can never make a mistake.
"From a paediatrician,
I don´t understand how a product a lot of people thinks that is "placebo" can be harmful. People says homeopathy is like water... I don´t understand anything. I use homeopathy in my practice (sometimes) and it´s useful and non toxic. How can a substance so impossibly diluted that everybody says it has no chemical effect, be harmful or toxic?"
So, very good point here. A lot of skeptics dismiss homeopathy as pure water that never contains even a single molecule of the original ingredient.
That is not true.
There are homeopathic products that clearly cannot contain a single molecule of their original ingredient. Oscillococcinum is a great example. Every winter, you see it in drugstores. It's supposed to reduce the duration of the symptoms of the flu. It's duck heart and liver diluted to a factor of 200C. That means one part offals in 100 parts water, then one part of that into another 100 parts water, over and over again, 200 times. I made a video about this for my old blog, Cracked Science, and you can see the number of cups of water needed to do this dilution.
While Oscillococcinum is particularly outrageous, there are many homeopathic preparations that are not diluted out of existence. For instance, those Hyland's homeopathic teething tablets are supposed to contain, among other things, coffee at a 6X dilution factor and belladonna at 12X. "X" means a one part in ten parts water dilution; "6" and "12" are the numbers of dilutions done in a row. It's only at 24X that you reach essentially 0.6 molecule of the active ingredient if you started with one mole of the ingredient.
The reason homeopathy doesn't work is not simply that it's just water. Some of it is, and it's dropped on a tablet of lactose and that's what you ingest. Some of it has some molecules of an active ingredient in it, but the reason why this ingredient was chosen is unscientific. It's the principle of "like cures like", which is derived from sympathetic magic, the same prescientific belief system that gave us phallic sculptures to enhance fertility.
Ingesting undiluted coffee can lead to sleeplessness, right? So homeopaths think that by diluting it a lot, it can cure sleeplessness. By that logic, one could dilute alcohol to cure a hangover.
So, to answer that paediatrician who's wondering how come a product can be both ineffective and dangerous, it's ineffective because the active ingredient was chosen for the wrong reasons and it's diluted to a significant degree; it's dangerous because the manufacturing process was apparently compromised, meaning that doses that could cause toxicity in the babies were present in these tablets.
Remember: just because these ingredients, like belladonna, and coffee, and arsenic, are natural, does not mean they are harmless. Scorpion venom is also natural.
"As a retired certified medical transcriptionist & teacher of medical terminology in both private & medical school university settings for over 20 years, I hope the FDA has a closer look at the complaints to rule out other etiologies in the differential diagnosis; e.g., many teething babies are undergoing vaccinations during this same time period."
Ahhh, yes! The antivaxx people!
Naturally, embracing natural remedies is often associated with rejecting anything manufactured by "Big Pharma", including vaccines. Never mind that many natural health product companies are owned by pharmaceutical giants.
This is a great example of motivated reasoning. This person learned of a fact that contradicts their world view and threatens their identity, so they have to find alternative explanations.
Childhood vaccinations have been studied to death for many reasons. A) They are given to children, so safety measures are already very high. B) Some former doctor, in cahoots with a lawyer, decided to "prove" that the MMR vaccine was associated with a syndrome eventually tied to autism. Those findings were retracted and the guy lost his license. C) Scared parents and a whole industry that caters to their anxiety, applying pressure to the government and pharmaceutical companies over the years, which has led to major investigations that came up empty-handed.
Meanwhile, the FDA was faced with 10 deaths of children and 400 adverse events associated with these homeopathic teething tablets. Laboratory testing confirmed that the levels of belladonna, known to be toxic in large enough amounts, were inconsistent.
But, no, it must be a grand conspiracy to hide the fact that vaccines are killing our children.
"You can do the math. A whole bottle of this product would contain 0.0000000000405% belladonna. That's 4 x 10 to -11th power. Sounds to me like a very safe and potent placebo."
The underlying assumption here is that the manufacturing process was error-free. If I reformulate his argument, I can look at the BMW X1 SUV specifications and see that it has airbags which will deploy on impact. However, the same day that the FDA was issuing its warning against the teething tablets, Transport Canada was announcing a recall affecting 2 units of this BMW X1, stating that "the trim of the instrument panel which covers the passenger frontal air bag may not have been manufactured to specification. This could affect proper deployment of the passenger frontal air bag in a crash."
It fascinates me that some people who are pro-homeopathy seem unwilling to admit that their favourite company might have made a manufacturing mistake. Regardless of whether or not you think homeopathy is magic, you have to live in a world in which manufacturing can produce mistakes. Wouldn't you want to protect your own baby from these mistakes?
Anyway, that's where I'm leaving things. Let me know in the comments below what you think of these teething tablets and the arguments made by some people in their defence. Also, subscribe to our channel if you want to see more videos like this.