From childhood diseases to oncology – when does homeopathy have a place and when does it not? Dr. Enev speaks to FACTI

In modern medicine, a balance is increasingly sought between classical treatment approaches and complementary methods such as homeopathy. In this context, the role of the doctor is key – to assess when and how different therapies can be combined in the interest of the patient. The topic is particularly sensitive in severe and chronic diseases, including oncology, where expectations are high, and the limits of the possible – clearly outlined. How and when is homeopathy used… Dr. Ivan Enev, a general practitioner in Vratsa, spoke to FACTI, who recently gave a lecture at an event that is part of the international project Mon Homeo Mon Choix.

- Dr. Enev, how do you combine classical medicine with homeopathy in your daily practice? What are you guided by?
- I am guided primarily by the interests and medical indications for the patient's treatment. Let's not forget that homeopathic medicines are medicines like all others. They are registered with the Bulgarian Medicines Agency and are available for prescription in the doctors' medical software, just as all other medicines are available for prescription. The indications for prescribing one or another homeopathic medicine are determined by the patient's clinical picture. There are three conditions for prescribing homeopathic medicines. The first is that irreversible functional changes in the tissues and organs have not occurred. That is, a homeopathic medicine cannot replace a missing thyroid hormone or a missing insulin in diabetics, for example. The second is that there are no life-threatening conditions - respiratory or heart failure, severe conditions in which specific protocols are used. And the third is to choose a medicine that can cause a clinical picture similar to that of the patient. If these conditions are present, then it is possible to apply homeopathic therapy.
In order to resort to homeopathic treatment, doctors undergo training that lasts two years. At the same time, many patients have already heard about certain homeopathic medicines and sometimes use them independently - for example, for seasonal allergies such as hay fever, which we will soon encounter in the spring.

- You often emphasize that homeopathy is a complementary method. Where is the boundary between the two therapies?
- The boundary is where the doctor sets it and where the patient's ability to respond to the therapy is. The doctor must be qualified enough to know which disease is affected by which homeopathic medicines and to what extent. The patient must also be able to respond to this treatment. Homeopathy cannot replace a nutritional deficiency. If the patient needs vitamin B12 or vitamin D, the homeopathic medicine cannot compensate for this deficiency. It must be corrected with appropriate treatment or diet. In the same way that a doctor prescribes an antibiotic according to an antibiogram or a medication according to the patient's condition, homeopathic medicines have specific indications that are systematically studied.

- Can you give an example of the use of a homeopathic medicine?
- For example, the medicine Bryonia can be used for various conditions - for flu symptoms, for dry mucous membranes, as well as for some injuries to joints and tendons. That is, a medicine can have multiple indications, which the doctor must be well aware of in order to use it correctly.

- You have been working with patients with oncological diseases for many years. When is it appropriate to use homeopathy in these cases?
- It should be clearly stated that homeopathic medicines do not cure the cancer itself. They are used as a complementary therapy to help the patient go through the treatment more easily - surgery, chemotherapy, radiotherapy. All of these methods have side effects, and homeopathy can help alleviate them. In addition, even when the diagnosis is made, the patient often experiences a strong psychological shock. During this period, homeopathy can also be useful because it helps adapt to the treatment. In patients with cancer who end their lives as a result of this disease, even in this last stage, when we talk about palliative medicine, there are indications for prescribing homeopathic medicines. That is, homeopathic medicines can be prescribed at the entire stage - from the diagnosis, through the various phases of treatment, to the terminal state of the patient. At each of these stages, a homeopathic medicine can be prescribed and deserves to be prescribed. There are studies that prove that in oncological patients who use such drugs, they use less immunostimulants, less corticosteroids that suppress immune reactivity, as well as less antiallergic drugs. Homeopathy is useful at each of these stages because it has one very important advantage - there are no toxic side effects, since the drugs are prepared in significantly low doses and do not lead to a burden on the body.

- You have many years of experience as a lecturer in clinical homeopathy. How is the interest of young doctors changing now, are they interested in homeopathy?
- At the beginning, when we started the trainings - I am talking about the beginning of the 90s, when I myself studied - there was exceptional interest. The auditoriums were full of 400-500 colleagues. For these nearly 30 years, a large part of the doctors in Bulgaria received some form of knowledge and experience. Some of them got interested and started practicing homeopathy seriously, like me, others tried and were disappointed, and still others continue, but to a lesser extent have integrated the method into their practice. Young doctors now also have the opportunity to take such courses - we train medical students at Varna University, just as we used to at Sofia University. Whether a doctor will start practicing homeopathy largely depends on his practice. Most often this happens when working with children, because they are the main users of homeopathic medicines.

- In which medical specialties is homeopathy most widely used?
- My observations are that it is most widely used by general practitioners and pediatricians, because they work with children. The more specialized the practice, the more limited the possibilities of homeopathy. For example, in ophthalmology there is a limited number of medicines that can be used. In orthopedics too - trauma medications such as Arnica or Bryonia are used, sometimes without even realizing that these are homeopathic remedies.

- What are the most common misconceptions about homeopathy among doctors and patients?
- One of the most common misconceptions among colleagues is that homeopathy is a placebo and does not work. This is false and has been disputed by a number of international studies. Usually, this opinion is held by people who are superficially familiar with its principles and believe that since the medicines are highly diluted, they cannot work. On the part of patients, the misconception is the opposite - too high expectations. There are diseases that cannot be treated with homeopathy and require conventional medicine. For example, multiple sclerosis or severe advanced arthrosis diseases that require joint replacement. In such cases, homeopathy cannot replace the main treatment.