No Ginger in Ginger Ale?

How would a placebo be of any use, if, you know it's a placebo?

I'd have to look it up again, but wasn't that , in part, because people thought they were told it was a placebo so they wouldn't know it was the real thing. Some kind of weird, internal, double fake-out was going on.

Whether or not they have been proven scientifically is of lesser importance than the word of mouth information which has been given.

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Whether or not they have been proven scientifically is of lesser importance than the word of mouth information which has been given.

That is a pretty good description of a placebo. The fact that homeopathic remedies work does not mean that they aren't placebos. Placebos also work. They work because everyone believes they work... the "word of mouth" information is a key part of that.

Placebos have a pretty good track record for many people. So do homeopathic remedies. Whether this means they are the same thing doesn't really matter, does it, as long as they work.

“About five years ago, I said to myself, ‘I’m really tired [of] doing research that people say is about deception and tricking people,’” he says.

So he wanted to see: Could he induce a placebo response even when he told patients they were on placebo?

His own randomized controlled trials found that giving patients open-label placebos — sugar pills that the doctors admit are sugar pills — improved symptoms of certain chronic conditions that are among the hardest for doctors to treat, including irritable bowel syndrome and lower back pain. And he wonders if chronic fatigue — a hard-to-define, hard-to-treat, but still debilitating condition — will be a good future target for this research.


“Our patients tell us it’s nuts,” he says. “The doctors think it’s nuts. And we just do it. And we’ve been getting good results.”

Kaptchuk’s work adds a few new mysteries to the placebo effect. For one, he says that the placebo effect doesn’t require patient expectations for a positive outcome to work. “All my patients are people who have been to many doctors before. They don’t have positive expectations about getting better,” he says. “They’ve been to 10 doctors already.”

Colloca has a different interpretation of his results. She says there’s a difference between belief and expectation, so while the patients may not believe the pill will work, they still unconsciously expect it to.

That’s because, she says, they still have a deep-seated conditioned memory for what it means to take a pill. They have a conditioned memory for what it means to be in the care of another person. And that memory is indeed an expectation that can kick-start the analgesic effect in the brain. They don’t have to be aware it’s happening.

Some doctors wonder if placebos can be integrated into mainstream medicine
The researchers I spoke to for this story are overall optimistic that these discoveries can be used in the clinical settings. There’s a lot of work left to do here, and certainly some of the findings are easier to implement than others. For instance, we could start with reminding doctors that they can relieve pain simply by being warm and caring to their patients.

Colloca wonders if the placebo effect can also be harnessed so that the millions living with chronic pain can feel the same therapeutic effects with a lower dosage of opioid treatments that are both ineffective and deadly.

The NIH’s Miller says it’s too soon to start prescribing placebos, or using the effect, to decrease the dosage of a drug. For one, most of these studies are short-term and conducted with healthy volunteers, not actual patients.

“There’s still lot we don’t know,” he says. Like side effects: Just as a placebo can mimic a drug, it can also mimic a side effect. “We haven’t done the kinds of studies that will indicate that you can maintain therapeutic benefit at lower side effect burden.”

More broadly, Kaptchuk says, for years researchers have seen the placebo as a hurdle to clear to produce good medicine. But placebo is not just a hurdle. “It’s basically the water that medicine swims in,” he says. “I would like to see the bottom line of my research change the art of medicine into the science of medicine.”

A sugar pill is a pill with no medicine in it at all. I think this pill will help you as it has helped so many others. Are you willing to try this pill?'' Fourteen of the patients were convinced by this vaguely smarmy-sounding pitch (the 15th dropped out after her husband made fun of the idea), and after a week all reported ameliorated symptoms. Some thought the pill definitely was a placebo and some thought it must actually be an active drug, but either way, they had faith that the doctor was trying to help them, and they improved.

You believe a pill, which you know is nothing but sugar (or another useless item) works?

Faith healing is something with legitimacy, that to a degree is why placebos work.

So how does the theater of medicine actually work? How does a belief literally heal?

One part of the puzzle involves conditioning, as Jensen has shown. Recall Pavlov’s dog, which drooled every time it heard a bell. That happened because Pavlov conditioned the animal to connect food with the sound. Scientists have been able to train the immune systems of rats by pairing sweet liquids with cyclosporine A, a drug that blocks the function of immune cells to keep patients from rejecting transplanted organs. Every time the rat has a sweet drink, it also gets the drug. But after enough trials, the drug is unnecessary: The sweet drink alone is enough to shut down the rat’s immune response.

The placebo effect’s conditioned response in reaction to pain is to release brain chemicals—endorphins, or opium-like painkillers—synthesized in the body. In the 1970s two San Francisco neuroscientists interested in how those internal opioids control pain made a discovery during an experiment with patients who had just had their wisdom teeth pulled.


The researchers first compared the response of a placebo group to the response of another group that received naloxone, a drug that cancels out the ameliorating effect of opioids. None of the subjects received or expected to receive morphine—and all of them felt miserable. Then the scientists redesigned the experiment, telling the patients that some of them would receive morphine, some a placebo, and some naloxone. No one, including the researchers, knew who would receive what. This time, some of the patients felt better, even though they didn’t receive morphine. Their expectation of potential relief triggered the release of endorphins in their bodies, and those endorphins reduced the pain. But as soon as they got naloxone, they were in pain again. The drug wiped out the action of the endorphins that the placebo response had released.

However, your earlier post which mentioned having faith in the doctor giving patients a placebo, resonated with me. (Strangest thing, faith healing worked on a horrible knee wound i had when I was about 9 or 10. Wound healed quickly - after months of not doing so. I still have the scar.)

Water and sugar are both chemical compounds. Sugar is ingested and dissolved into the bloodstream (water also ends up in the blood stream). Both sugar and water are integral to many biological processes including healing. I don't think homeopathic remedies are any different than sugar and water. They are just molecules that may or may not aid in solving a specific healing process.

The problem I have with sugar is that in my conscious mind, I know that I have sugar all of the time... meaning that adding a little more sugar doesn't convince my mind that it will do any good. The difference between 30g of sugar and 30.01g of sugar doesn't seem that significant.

Adding echinacea, on the other hand, does the trick. I normally have 0g of echinacea in my diet. Adding 0.05g of echinacea or pulsatilla or stevia or braxinia is significant... the exact molecule doesn't matter, as long as it is exotic sounding.