Blog: Placebos Can Fool Your Mind, but Not Your Body by James Coyne

Andy

Senior Member (Voting rights)
It is not meant to be a story about people with asthma, but about all of us — how we are susceptible to certain kinds of illusions when we use our subjective feelings to determine if a treatment is effective for something that ails us.

Placebos are greatly misunderstood by professionals, not just laypersons. Placebos are not magic. They do not produce measurable body change. If a substance produces measurable body changes, it is not a placebo.

What is a placebo? Something that being performed or provided with positive expectations and social support for someone believing that it is effective, plus the passage of time.

A lot of adults take a single aspirin for a headache. The headache goes away.

But one aspirin is too low a dosage for reducing pain. The headache was going to go away without the aspirin. A randomized clinical trial (RCT) could easily show that.

The problem is that people do not typically conduct their own RCTs. They judge what works by before/after comparisons of their subjective experiences.

People can be tricked into believing that something has affected a change in their bodies if there is a ritual and they experience something as being different about them. The ritual can be as simple as taking a pill or can involve more hocus pocus.
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I can see a massive flaw in the above argument.

I see another one....

A lot of adults take a single aspirin for a headache. The headache goes away.

But one aspirin is too low a dosage for reducing pain. The headache was going to go away without the aspirin. A randomized clinical trial (RCT) could easily show that.

Pain relief of choice aside, we all know that the headache is going to go away eventually. We take pain relief to make it go away quicker.

So the question is not whether the medication made the pain go away, it is whether is reduced pain to a more tolerable level more quickly than would otherwise have been the case.
 
I remember reading many years ago that the commonest cause of ordinary headaches is dehydration. So I started drinking some water if I got a headache just to see what would happen. I would say that it works to get rid of headache often enough that it is worth continuing this habit. If I am no better within 10 - 15 minutes I'll take a couple of paracetamol.
 
the invention of forms based on the subjectivity of individuals is responsible for so much stupidity in the academic /medical circles with their ridiculous belief in an abstract ie the mind having power over the physical a belief created by philosophers in ancient greece that should have have lost all credence in a so called scientific age . just infuriating how this has been disseminated as some kind of fact over two and a half millennia .
 
Another reason why taking a headache pill is a poor example occurred to me.

Unless you're suffering from something fairly serious it is simply not permissible to be ill, take time out and allow nature to take it's course.

It is no longer the done thing to take a couple of days or a week off if a person catches the flu, for example. No, you take something that makes you feel better but leaves you infectious so you can feel well enough to go out and about and infect others, who in turn will buy something that allows them to do the same and so on. Slogans that talk about separating the men from the boys have been used in ad campaigns for these cold and flu products, implying only the weak "give in" and allow themselves to feel ill.

Culturally, it is not acceptable to allow a mere headache to knock you out of action for a few hours. There are also a great number of people who can't afford to miss out on an afternoon's work.

So, given that many feel that taking a few hours out when suffering from a headache is a luxury they can't afford either in terms of self image or financially, an asprin (paracetamol or ibuprofen) at least gives a feeling of being able to take control or do something about it. In the ever turning hamster wheel that is modern life that feeling of having some control is likely to have some psychological benefit in and of itself that has nothing to do with a placebo effect.

Edit - spelling & omitted word
 
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No, one, takes, one, aspirin.
my mother did. Hated taking tablets thought they were all poison and only EVER took 1 of anything.... asprin, paracetamol, ibuprofen. Acted as though taking 2 was basically overdosing & 'if you take too many you'll become immune and they will stop working'.

She said it always worked 'oh no one will be more than enough for me' & it always was. Nothing you said or showed her would persuade her otherwise.
 
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I do wish he would proof read his blogs there are several missing/added words
Is this supposed to have the word 'effective' in it? it doesnt make sense.
So far, placebos are powerful and patients thought the sham acupuncture as the real or fake drug in the inhaler.
 
Perhaps a better example placebo than the single aspirin is how I use the ‘energy drink’ Lucozade.

When I was a child Lucozade was still marketed as a health drink to be used as part of treating common ailments like cold and flue. For me Lucozade is inseparably linked to being taken care of, to having a fire lit in the bedroom grate, to chicken soup, etc. So I will now have the drink at times when my ME is particularly bad or I am in a lot of pain not because it has any impact on my condition but because by association it makes me ‘feel good’.

(Though having said that I am aware of over looking the confounding factors of a glucose rush and the fact that longer term it may be unhelpful.)
 
When I was a child Lucozade was still marketed as a health drink to be used as part of treating common ailments like cold and flue. For me Lucozade is inseparably linked to being taken care of, to having a fire lit in the bedroom grate, to chicken soup, etc. So I will now have the drink at times when my ME is particularly bad or I am in a lot of pain not because it has any impact on my condition but because by association it makes me ‘feel good’.

Oh my word! Lucozade! I remember that. D'you remember when it came with that weird coloured plastic wrapping on the bottle?

I loathed the stuff. I struggled to eat when I was very unwell as a child & my mother would make me drink this. Yuck!
 
I remember reading many years ago that the commonest cause of ordinary headaches is dehydration. So I started drinking some water if I got a headache just to see what would happen. I would say that it works to get rid of headache often enough that it is worth continuing this habit. If I am no better within 10 - 15 minutes I'll take a couple of paracetamol.
Do you take the paracetamol with a glass of water? How do you know whether it's the paracetamol or the additional dose of water which does the job?

When I get a ME headache I can take ibuprofen, paracetamol, and everything else available over the counter, or even the very strong stuff my wife brought home with her last time she had surgery which we shouldn't have lying about the house. None of it works. I obviously need to work on my placebo response.
 
If an athlete arrives at a training session or competition in a HYPO state (USG > 1.020), they can consume 600 ml of water or a CES solution over 15 minutes, and they will retain about 75% of the ingested fluid over the following hour. The importance of the ingested fluid is that it will move the athlete into an HYD state as assessed by USG measures (USG < 1.020) within 30–45 minutes from their arrival. This will minimize the possibility that preexercise hypohydration will exacerbate any exercise-induced sweat losses and decrease the likelihood that fluid loss-related performance decrements will occur.

https://journals.lww.com/nsca-jscr/...cute_Effects_of_Fluid_Intake_on_Urine.18.aspx

A study from the Journal of Strength and Conditioning Research says that your body can alleviate mild dehydration in 45 minutes with 600ml of water.
 
Do you take the paracetamol with a glass of water?

Usually.

How do you know whether it's the paracetamol or the additional dose of water which does the job?

I can't know under those circumstances.

But I'm lucky - I get far fewer headaches these days since I had surgery for my hydrocephalus. And the ones I do get are rarely as bad as they used to be.
 
So a study on whether or not water can be used to help deal with dehydration?

Did they consider it a serious risk that it wouldn't?

Will there be a follow up study to determine if hunger can be treated with food?

The wonders of scientific research when getting a positive result is more important than what that result means.
 
I didn't know that it took 45 minutes to get rehydrated. I thought it was a lot sooner.

Yep me too.

I found I would start to feel a bit grim, lightheaded and headachy. I'd sit with my feet up and have a piece of fruit and a large glass of water.

I had always assumed starting to feel better fairly quickly was to do with the fruit and water. Since learning more about OI & POTs type issues I now realize feeling better in the short term was probably more to do with putting my feet
up.
 
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