I watched a show in the BBC the other night about whether or not some medications like homeopathy actually work. The findings weren’t surprising in that most of the time the only effect some medications have is the placebo effect, as in the case of homeopathy.
They tested pain medications and the difference between branded medication and unbranded medication. There is a big placebo effect with branded medications, making them almost a third more effective (if I remember that stat correctly). This placebo effect on top of the “actual” effect made the branded pain medications work much more effectively.
So I’m wondering…now that I know that branded medications work exactly as the unbranded ones, will I still get the placebo effect? If I take Exedrin instead of acetaminophen, will they work the same?
Sorry, IAMNAD, so I can’t answer your question, but this is a personal peeve of mine that has always bugged me. The placebo effect is 30% to 40% effective, yet many people deride things that “only” have the placebo effect and say they shouldn’t be used. Yet, considering both the nocebo effect, and the fact that side-effects from “effective” medication is known, shouldn’t placebo medication (That is really harmless, because it’s only sugar/flour pills, saline solution etc.) used much more in specific cases? NOTE: I’m not saying to chuck all evil pharma out the window.
But if you have a headache, and aspirin is widely known to cause stomach problems in many people (And thins the blood - operations had to be delayed because laypeople took an OTC aspirin against the pain), wouldn’t it be better to take a homeopathic pill first? If the placebo effect doesn’t work on you, you can still switch to the “real” medicine, and haven’t lost anything but a little time. But if it works, you save yourself all the complications from aspirin.
Similar, taking something controversial like cancer: I was absolutly opposed to a scammer like Dr. Rath basically letting a kid die because he wanted to upkeep his sale of “natural vitamins” instead of going the normal chemotherapy/surgery route. But normal treatment varies wildly in regards to chances depending on the type of cancer, progress, patient, etc. So if some type of leukemia the established treatment only has a chance of 10% success, shouldn’t you try additionally the placebo treatments? (They had good effects with visualisation, e.g., when patients play video games where the white blood cells blast the bad cancer cells apart, and similar). Of course that’s not a blanket prescription - a lot of so-called alternative medicine, esp. in the cancer area, can be harmful.
Some doctors over here even did placebo surgery on things like arthritic knees: there’s no real cure if the soft tissue is abraded, the surgery only consists of scraping out the inflamed tissue, which relieves pain short-term but makes things worse long-term. (Long-term, you either have to implant an artifical knee, which still don’t last long enough, or, with the new procedure, cultivate tissue cells outside the body and put them back. I hope that will be developed further!)
In half of the cases the doctors (without the patients knowledge or consent, they just told them about a “new and experimental technique”, they didn’t say placebo) simply cut the skin where the instruments for keyhole surgery would normally go, and then sewed it shut again. The other half of the patients got the normal procedure.
Aftterwards, about 40% of the patients with the placebo surgery reported that they felt better, the pain was noticeably less and that the new experimental technique was good.
To answer your question itself, considering that IAMNAD (but surely one of the real ones will be along, too), from what I understand of research into the healing powers of the body in general, a placebo can still work even if you know if you remember that a placebo (like a visualisation or other mental feats) is an aid to make your body work its own miracles.
There are other miracles, like (depending on what we’re talking about) 1/3 of all cases going into remission = healing itself without treatment, on their own (some cancers, some psychatric illnesses…), so there’s a lot of potential.
Also some people (buddhist monks with decades of training of meditation) have shown astonishing control over the body like heart rate and breathing slowed down (yes, I know some on TV were exposed as frauds or tricks like Randi. But others were tested by scientists in the lab with equipment and declared genuine).
So while not every claim is possible, and not every human is the same as every body else, but instead there’s a wide variation, there’S a good chance your body can surprise. I mean , think about what you are used to: skin grows after burns and abrasions, bones - an extremely hard substance - can mend after a break (the pins are just helping things to stay in place), the brain can relearn control after strokes - isn’t it amazing?
I’m not denying that the placebo effect is real and useful. In fact, the program I was watching also accepted this, and said that using the branded pain medications with their attendant placebo effect was useful.
You said:
Isn’t that a way to “believe” in the healing power of placebos? What if you reject this idea and instead say “This homeopathic medication has no real effect and is actually just a capsule of water.” Does it still help you at all?
The Placebo Effect is often confused with the concept of being Ineffective.
If a therapy is effective, it doesn’t matter whether it’s effective because of some external cause-and-effect related to the chemistry of a pill, for example, or an internal cause-and-effect related to the chemistry of your brain or your body triggered by a belief process. Faith healers run a pretty big business based on placebo effect, as do their buddies, the homeopaths. They are both wrong about why their approach works, but that does not mean their methods are ineffective.
I think you are asking whether or not an understanding that a particular effect is internal (secondary to a process triggered by belief alone) or external (secondary to a process which would occur independent of whether or not that belief exists) diminishes or eliminates the placebo effect.
The answer is that knowing any putative effect is a placebo effect reduces or eliminates the placebo effect. If you truly believe Tylenol works better than Equate Acetaminophen, you might get a placebo effect. If you truly believe they are equivalent preparations, the placebo effect will not occur.
Of course, “truly believe” is hard to quanitfy, and some sort of nagging suspicion that (for instance) the Equate brand is manufactured to a lesser standard might create a persistence of the placebo effect even if you tell yourself they are really equal.
My understanding is the placebo effect works whether you take something or not.
The reasons you should have nothing to do with homeopathy are that it’s an expensive fraud and it encourages people not to get effective medical treatment. Don’t give your hard-earned money to these criminals!
If you want to test the placebo effect on a minor condition* (e.g. a benign spot), simply:
eat a balanced diet
take some exercise
get sympathy from a friend
get a good night’s sleep
be positive that you’ll get better
You’ll be amazed how many things promptly clear up. And it didin’t cost you anything!
*I cannot stress enough that you must seek medical advice for anything serious or suspicious
Um, I see you are from England; I thought the UK health system had approved homeopathy similar to Germany? Because here, Doctors (Med.) can take additional courses to qualify natural healing, homeopathy etc. There’s also a qualification for acupuncture (which has been shown to work for certain circumstances, just not do wonders and cure everything). One of the big pharma companies (forgot the name) is promoting both homeopathic medicine (though in a different concentration than the diehard homeopaths use, from what I understand) and herbal medicine. They have an extensive herb garden at their headquarters and are busily researching old healing herbs. Sometimes, if one special compound is identified in tests as useful, it’s isolated; othertimes, the general healing qualities of e.g. chamomile for stomach, it’s simply certified to be good so it can be sold in apothecaries (as opposed to being gathered god-knows-where and maybe have high concentrations of unwanted stuff).
The scientists also do the cross-research on e.g. Johannis herb making people photosensitive (while proven to help lighten the mood and relieve anxiety), or how the healign enzymes of Ananas for flesh wounds get in conflict with milk products or whatever, and then the doctors and apothecaries can warn about possible cross-effects.
Also, they avoid those herbs that can be dangerous. As they say: half of the herbs written down in old medieval books are effective for a reason (certain ingredients); the other half is uselss or harmful, and was used for superstitioun. The challenge to the modern scientists is finding out which is which.
And I don’t give my money to scammers. I go to my normal doctor, and tell him I want to try the mild approach first (and look beforehand that he has an additional qualfication in the natural field), and then he prescribes me homeopathic pills instead of the usual ones, and says “Try those, if they don’t work, tell me”. He says the same thing when he gave me standard headache /throatache pills from Brand X: try if this combination works, if not, we’ll try type B from Brand Y.
What’s a benign spot? You mean a small brown spot on your skin? I don’t know if it’s beningn, that’s what my dermotologist is the expert for.
But whenever I have a cold, I go to my doctor, (not only to get the certificate for work) but because as layperson I don’t know the difference between harmless bacterial cold (will go away by itself in one week), dangerous influenza from Virus (will go away in 10 days, but needs to be watched), or the first stages of pneumonia/ brain inflammation/ whatever else, because a dozen illnesses start out with “Headache, feeling feverish, dull feeling in the body, feeling tired, feeling sick”, and can suddenly become bad or stay inconcispous until long-term damage is done. That’s why the doctor studied, so he can tell the difference and do the necessary tests.
Sadly we do allow homeopathy here, despite the fact that its been repeatedly proven not to work. (There’s also a few private schools that teach Creationism. :smack: , a bunch of UFO abductees and a Loch Ness Monster Society.)
Chemists will sell you copper bracelets (supposedly to cure ‘iron deficiency’, rheumatism, arthritis etc.) These are not regulated because they are not ‘medicine’ but ‘health support’ or some such drivel.
P.S. What ‘qualification in the natural field’ can there possibly be?
If I tell you I’m qualified to teach Levitation by the British Institute of Levitation, does it count for anything? Would you pay me for a course in Levitating?
I don’t mean to call you out like this constanze, but you’re misinformed about a lot of things.
The placebo effect only works on pain. That’s it. No amount of “fake chemotherapy” is going to put cancer into remission anymore than doing nothing would. If I started taking a sugar pill for my acid reflux instead of Prilosec (and didn’t know it,) it would return within a week.
The reason it works for pain is because pain is a very subjective measurement. There is no standard test to determine how much pain patient A is in compared to patient B. All you can do is ask them on a ‘pain scale’ ranging from one to ten, and combine that with your own observations. A placebo works for pain (and even then, not that much…most studies find only about a 10% reduction in overall pain,) because it allows the patient to focus their mind elsewhere. You get a similar effect if you can just distract the patient with something like a movie, video game, etc…
To say there’s no harm in trying “alternative” treatments first because it might get better because of the placebo effect is wrong. There is harm because you’re delaying proper treatment and could make the disease/illness/whatever worse.
And just because a large pharmaceutical company is investigating homeopathy and herbal “remedies” doesn’t mean there are in any way legitimate, it just means that they see a market where they can make money. There are people buying this stuff, so why not jump on the bandwagon and make money off of them? Sell a sugar pill or bottle of homeopathic water for a 1000% profit because someone thinks an ingredient diluted so far down that not even a single molecule remains of the original substance still has an effect? Hell, I doubt they ever even put the original chemical in, they probably just fill the bottles from a tap and slap a label on it.
Like I said, IAMNAD, I only read the reports of scientists in lay papers about their findings, but they cite the placebo effect for a variety of things. After all, each new medications, during the process of being admitted by the Ministry/Office (FDA for you, I think) is also tested against a placebo and has to perform better than the 30-40% placebo rate. Not only Aspirin, but also medication that lowers blood pressure or similar. And even there, you have a placebo effect.
You’ll also notice that my first placebo example was aspirin, which is taken usually for pain.
My cancer example was broader about natural methods which might or might not help.
As for your reflux: I Don’t know what type of anti-reflux medication Prilosec is, but I recently watched a show where they said that the first generation of simple OTC acid blockers should no longer be used, because they only deal with the acid, the new generation provides a protection for the damaged part of the throat. And you should have a doctor watching that.
But also in that case, natural remedies can be used in addition. That’s why I talked about doctors with additonal qualitfication. There are several causes for reflux, from purely anatomical the way your throat and stomach opening is constructed, to lifestyle, like eating less spicy food or doing Yoga/other relaxation exercises.
That’s news to me. I haven’t heard that 10% anywhere. And yes, pain is subjective to some degree. However, it’s the same patients you’re asking before and after, esp. in double blind studies.
As for distracting patients with a movie - are we talking about the same thing here? People with a serious headache? With inflamed joints in pain for years??? You just show them a movie instead of giving them a pill?
You seem to have misread or misunderstood my example. I talked about a headache; the case cited last week or so on TV was a woman with a heart/stomach ache, taking an aspirin. Her sugery for appendix had to be delayed several days because the aspirin had thinned the blood too much. Taking a homeopathic pill wouldn’t.
I also said to get to a doctor who determines what’s wrong, and then decides what he needs to describe.
If you have a generic headache, fever and throat ache and it’s clear it’s a normal cold/flu that will take one week to heal anyway, therefore the pills are only to relive the symptoms, then it doesn’t matter if you get a sugar pill, a homeopathic pill or paracetamol in regards of making the disease worse.
It DOES work for about 30% to 40% of people using it. Give an aspirin instead, and some number of people will have stomach pain from it, and a small number will have other side effects, and 10 to 20% may show nocebo effects.
If a hundred people buy these copper bracelets, and for 30 it releaves the pain, then who cares? The rest go to a doctor and get a pain pill. There is no real cure for either athritis or rheumtism; it’s degenerative. You try to stop the pain, and keep the joints moving, that’s bascally all.
I AM NOT A DOCTOR. I don’t know where my doctor went to get his MD, I don’t know where he got his additional qualification for “Hausarzt” general practioner, I don’t know who teaches homeopathy. I know it’s regulated and controlled. Would it help you if I link you to the german site of the Bundesärztekammer (federal doctors chamber, the general body for doctors)?
No, it doesn’t work. Otherwise it would be medicine.
As has been shown many times (see here for example), give patients placebos and homeopathy and the effects are equal.
If a hundred people don’t buy these bracelets and for 30 the pain is relieved, then those patients have saved money.
There is no trial where copper bracelets have done better than placebos.
Sadly people are ‘regulated’ here too in homeopathy. But since there’s nothing to see, all that happens is that they are told what some crackpot came up with a century ago.
Real doctors study operations and see the clinical results of drug trials.
Homeopaths are as qualified as Loch Ness Monster researchers (they don’t have any evidence either).
The study, as you may have guessed, was not double blind.
As to the ethics of placebos, remember that effective treatments have as much placebo effect as ineffective ones and also include of the real effect.
For myself, I’d rather know whether I’m getting a real treatment or not, even at the expense of my health but that’s just me; I couldn’t impose my values on others. The problem is that dishonestly using a placebo inherently includes imposing a value on the patient that he or she may not share.
Here’s the thing- people respond well if a trusted profesional sez it will work, or they will get better. They also respond better if a person cares about them.
So if you have a caring professional, who sez these pills will work, and who then asks after you and seems to really care if you do get better, you will get better faster. Placebos work fairly well on pain, byt they can also help with other conditions where you are just going to get better anyway- like a cold. You’ll just feel better if they give you something.
In the example you cite, explaining that the placebo is a sugar pill is not the same thing as the patient “knowing the treatment is inert.” Patients are surprisingly unscientific. If a trusted professional were to tell a patient that 5 deep breaths every hour plus hopping up and down with your eyes closed has been shown to help their condition, then even if the trusted professional goes on to explain that there is no possible way there can be any physiologic correlation, many patients would get a placebo effect. Their belief, and the placebo effect that results, is not necessarily based on the science of demonstrating a direct physiologic cause and effect. In this case it would be based on a trust that doing A will produce B.
If, instead, the trusted health professional were to say, “I want you to take this sugar pill to see what happens. It is completely inert. It will not change your symptoms in any way. It will not help you.” then the placebo effect would go away (or at least be diminished by the amount the belief that it would help was diminished).
That’s a very unique definition of medicine you are using. As Chief Pedant said above
He who heals is rights, as the old saying goes. Yes, it’s better to understand the mechanism behind how things work to make medicine more effective; but there are still many cases where medicine can’t do anything besides help the body heal itself, whether it’s a virus cold or a degenerative disease.
And giving somebody that is not directly effective IN THESE CASES , but helps people activate their bodies healing power through the placebo effect, then it’s not wrong.
If you give somebody an Aspirin, just because you can explain that the chemical acetylsalicidacid (or whatever it’s called) blocks some nerve receptors in the brain and thus stops the pain - without affecting or healing the real cause ot the pain - doesn’t mean it’s more or better Medicine than giving them a sugar placebo pill or homoepathy, just because you know those don’t work in the direct mechanical way of chemical A acting on receptor B. Instead, they might work indirectly by making the brain produce dopormin (or whatever it’s called), the body’s own pain blocker, that also acts on receptor B. Somehow or other, something happens that makes the pain go away.
First, I never said that homeopathy was more effective than a placebo, I used homeopathy as an example for a placebo that many people believe.
Second, that article doesn’T give any solid numbers. The wikipedia Article gives the usual 30 to 40% numbers.
Third, I found this from your link quite interesting:
As much as I’m against scammers, and for the scientific protocol, this sounds very much like “We don’t want to hear results we can’t explain”. If there were methodological flaws in the study - then show them or repeat the study. But to wave the results away because they don’t know how it works is unscientific in the extreme. (And bad science history - a lot of stuff got observed first, and then a theory to explain those new finds had to be found. Then new tests followed etc.)
You don’t seem to understand the placebo effect. If people don’t buy the copper bracelets and get well, that’s not placebo effect, that’s spontanteous remission (which medical science also can’t really explain. The doctors basically shrug their shoulders and say “Well, we feel happy for the patient, but because we don’t know how, as scientists we are frustrated, so we don’t talk about it much”).
Yes, the copper bracelets are the placebo effect. That’s what I was talking about. The trial would be between copper bracelets and a proven medical treatment, like pain blockers, which also don’t cure arthrits/rheumatism, but do relieve the pain.
But if you, instead of 100 people buying copper bracelets first and seeing for how many it will work, and giving pills to the rest, you start off with giving a 100 people pain pills - with chemically active compounds - then you have a higher number of people who risk side effects like liver problems or others.
But hey, if iit’s more important to you that you can explain what hapens than you can help people, or more important that people don’t spend their money on “unproven” things, but instead risk side effects - go ahead.
Just to be not misunderstood - in no way do I want people buying copper bracelets over the internet for a hundres dollars or more. That’s a scam. But selling the copper bracelets in the apothecary for 15 $ if it helps, then I am for it.
No, there’s far more to learning homeopathy. It’s not only learning which element/plant/mineral works for which symptom, it’s also learning how to observe exactly what symptons the patient is exhibiting, to prescribe the right “medicine”. Whereas a normal doctor simply orders a test by machine and then says “cold= paracetamol”, the homeopathy /natural doctor will spend fifteen minutes at least talking to the patient.
As numerous medical, scientist studies have shown (and as said above), the time and bedside manner of a doctor can help the patient’s recovery a lot.
And yes, normal doctors should have a decent bedside manner, too. Only it’s not taught well enough in current normal courses with the emphasis on what can be measured by machines.
You seem to have trouble understanding the concept that people study the whole nine yards of a normal doctor FIRST and then ADD the homeopathy course on top. They already know how drug trials work. Probably they think that in many instances it’s not necessary to shoot with (chemical) cannons at sparrows (pain or similar) if they can’t attack the cause anyway.
But since homeopathic medicines are basically placebos, which you recognize, then surely they could only work for those 30 to 40% of people who believe they work, no? Since I don’t believe in the effectiveness of homeopathic medicine, there is no point in prescribing it to me.
On the other hand, I do believe that herbal remedies may contain active ingredients and have an effect above the placebo effect, and there is some scientific evidence of this. (They can also have side effects and cause bad interactions with other products, like refined pharmaceuticals can.)
You also seem to believe doctors should prescribe placebos (including homeopathic pills) as a way to avoid negative side effects from pharmaceuticals. While it is true that these effects happen, I think it’s up to the doctor and patient together to decide whether it’s worth taking the risk. Maybe in some cases a placebo is indicated, but I’d rather see a doctor educate their patient than save medicine “for later” in case a placebo doesn’t work.
And why would Aspirin cause a nocebo effect? Because people expect it to upset their stomach and cause them to bleed?
Interestingly enough, if I remember a research on homeopathy I did in high school well (it’s been a long time), homeopathy was actually invented by a physician who wanted to bring medicine into the realm of science. He noticed that some pharmaceuticals (quinine is an example, I believe) can, in large doses, cause the effect that they would counter if administered in small doses. He speculated that other chemicals could do the same.
Of course, as far as I know there is no evidence that this effect is a common one, nor is there evidence that the current homeopathic products offered for sale have any effect.
‘Very unique’ huh? I do not think that word means what you think it means!
My dictionary defines ‘medicine’ as:
science or practice of diagnosis, treatment and prevention of disease …
any drug or preparation used for the treatment or prevention of disease …
a charm, spell or fetish, which is thought to clear afflictions …
So I’ll accept that homeopathy is ‘medicine’, just like going to a witch doctor or a wizard is ‘medicine’.
It has no place in a modern society.
It is wrong if it costs money, or prevents someone getting a proven medical treatment.
Please look at what you’re saying!
Is homeopathy a genuine treatment or a placebo?
Its practitioners claim it really works, even though there is no evidence it’s genuine.
If it’s merely a placebo, why bother to go to all the trouble of diluting different substances?
Why charge any money at all?
You said “there’s far more to learning homeopathy. It’s not only learning which element/plant/mineral works for which symptom, it’s also learning how to observe exactly what symptons the patient is exhibiting, to prescribe the right “medicine”. Whereas a normal doctor simply orders a test by machine and then says “cold= paracetamol”, the homeopathy /natural doctor will spend fifteen minutes at least talking to the patient.” If homeopathy is just a placebo, all this ‘training’ is a complete waste of time and money. Give everyone a sugar pill!
Actually you don’t understand the placebo effect. It can be triggered by:
a sugar pill
a sympathetic bedside manner
an assurance that the patient just needs rest
a psychic telling you the spirits will help
meditation
Tibetan chanting
copper bracelets
Hopi ear waxing
etc
The big difference between homeopathy and spontaneous remission is that one is a fraud that costs money.
And we already know from double-blind scientific trials that proper medical treatment is way more effective than placebos.
So any trial of copper bracelets would be against the list above. Placebo v placebo (except one costs money).
Wow. $15 is good value, but $100 is a scam?
How do you know the placebo effect isn’t more powerful if you spend more money?!
And just to repeat again - buying copper bracelets (for any price) doesn’t help any more than any other placebo. And it stops people getting proven medical treatment.
The very first thing you need to do is to learn to read the Active Ingredients list on the medication’s container. This will tell you whether the branded and unbranded versions even have a chance of giving you similar results.
For example, Excedrin and acetaminophen are very different. You can switch off between Tylenol and acetaminophen all you want. But Excedrin is acetaminophen plus aspirin plus caffeine. Expecting the same results from both can be dangerous. Especially if your doctor said to avoid aspirin.
