Alexa Ray Joel, the daughter of Billy Joel and Christie Brinkley, was hospitalized Saturday with what I originally thought was an overdose of some type of sedative.
However, today’s Newsday and MTV are reporting that the family is calling this an overdose of a homeopathic medication called Traumeel. Traumeel is manufacturer by an Albuquerque-based company called Heel USA, a company founded by a German physician in the 1920s.
If Traumeel is truly homeopathic, there is absolutely no way this product could have caused Joel’s hospitalization.
If you are new to our blog, you may not know the different between herbal medicines and homeopathic remedies. Herbal folk remedies are actually the source of some commonly used pharmaceuticals. And like drugs, herbs have the potential to have a therapeutic effect in direct proportion to the dose given. The more herb, the more likely a benefit – or side effects – may be observed.
Homeopathic remedies, however, have nothing to do with herbal medicines. In fact, the basic principles underlying their use are diametrically opposed to everything we know about physics, chemistry, and biology. They are the remnants of a pseudoscientific practice developed in the 1800s whereby it was deemed that a substance which produces effects similar to an illness can be diluted out (or “potentized”) to create a remedy that might treat that illness. Hence, extremely dilute ipecac (which is used to induce vomiting) might be used homeopathically to treat disorders that involve vomiting.
The primary reason people get confused between herbal/botanical medicines and homeopathic remedies is that both are often derived from similar plant materials.
However, homeopathics differ in one critical respect: they are often so dilute that they contain not a single molecule of the original starting material. Homeopathic remedies are essentially water that is sold at even more exorbitant prices than bottled drinking water.
An excellent and approachable overview of homeopathy can be found in this 1996 article (free PDF) in the American Journal of Pharmaceutical Education by Dr W Steven Pray of Southwestern Oklahoma State University’s School of Pharmacy. I have used it for over 10 years in teaching students and educating the public.
So let’s look at the composition of Traumeel, purported for used as an anti-inflammatory agent for musculoskeletal injuries. Traumeel comes in several dosage forms, including one for injection, but let’s look at the tablets, especially since the New York Daily News reported reports a 911 call that Joel “had taken some pills”:
Each 300 mg tablet contains: Aconitum napellus 3X (Reduces pain after injury) 30 mg; Arnica montana, radix 3X (Reduces swelling and bruising) 40 mg; Belladonna 4X (Reduces swelling and pain) 75 mg; Bellis perennis 2X (Treats bruises) 6 mg; Calendula officinalis 2X (Stimulates healing process) 15 mg; Chamomilla 3X (Soothing pain relief) 24 mg; Echinacea 2X (Immune support) 6 mg; Echinacea purpurea 2X (Stimulates healing process) 6 mg; Hamamelis virginiana 2X (Relieves bruised soreness) 15 mg; Hepar sulphuris calcareum 8X (Stimulates injury healing) 15 mg; Hypericum perforatum 3X (Relieves pain) 8 mg; Mercurius solubilis 8X (Reduces swelling) 15 mg; Millefolium 3X (Treats minor bleeding) 15 mg; Symphytum officinale 8X (Relieves joint pain) 24 mg. Inactive ingredients: Lactose, Magnesium stearate.
I need to describe the nomenclature for those readers used to working with science-based medicine. Homeopathic remedies are defined by the magnitude of dilution from the original product or plant extract with terms like 12X or 20C. X refers to a 10-fold dilution and C refers to a 100-fold dilution and the number denotes how many times each dilution was made. Therefore, a 12X remedy would be a 1012 dilution; a 20C remedy would be a 10020 dilution.
However, some of the plant products used in this homeopathic remedy are only of modest dilution. These 2X and 3X remedies are, by definition, only 100-fold and 1000-fold dilutions of the starting material. These concentrations are probably too dilute to have any positive or negative biological effect but I can’t be certain.
There are a couple of very, very toxic components in the remedy but, again, are even more dilute so as to be unlikely to have any harmful effect. For example, the toxic belladonna alkaloids are 10,000-fold diluted and Symphytum officinale (also known as comfrey) is diluted 108-fold. Conventional concentrations of comfrey extract contain well-documented hepatotoxins called pyrrolizidine alkaloids, which are converted into highly-reactive metabolites by hepatic cytochrome P450 enzymes.
As you can see, this is going to be a confusing issue as the lay press sifts through the facts and fallacies associated with homeopathic remedies.
The makers of Traumeel, you might expect, are on the defensive.
They don’t exactly come out and declare it specifically but I can practically sense they want to say, “There’s really nothing in our product so how can you claim it is dangerous?”
As this story continues to develop, be sure to pay attention to discussion of Traumeel. I’ve seen one report via Twitter that declares it to be a herbal medicine.
Let me just add another very serious note about this case: I truly hope that Ms Joel gets the assistance she needs, given new reports that she called 911 and said that she wished to die. She is very fortunate that she took what appears to be a homeopathic remedy rather than some other kind of pill. Some types of mental disorders first rear their heads in a person’s early 20s, even those without the stress of a new musical career or coming from a high-profile family. My warmest wishes go to all involved.
If you are a journalist looking for comment or interpretation of this story, please feel free to e-mail me at the address under “Contact” and I will be happy to provide background under my real name and credentials.