Placebo Power

By definition, placebos have no direct biologic action. A newer understanding reveals a more nuanced picture—one of the power of placebos to change our body chemistry.

In reality, placebos can transform our brains into highly customized drug factories.

For example, people with Parkinson’s disease who took a placebo under the belief it was an active medicine tripled their level of dopamine—exactly the drug that they needed!

Placebos can also trigger the body’s internal production of endorphins, which are natural pain killers. In one study, patients with dental pain given a placebo had significant pain relief associated with a rise in endorphin level. When an endorphin-blocking drug was given without their knowledge, the relief subsided, underscoring the true biochemical nature of the placebo.

What Does Research Show About Placebos?

According to placebo researcher Daniel Moerman, the potency of a placebo is related to the meaning they have for the person taking them. These are some interesting findings culled from the placebo literature:

• Pain medicine given by a health professional was 1/3 more potent than when self-administered
• Brand-named aspirin provided more relief than taking the same medicine without a brand name
• Large placebo pills were more effective than small ones
• Blue placebo pills were more effective for sleep than red pills
• 4 placebo pills every day were more effective than 2
• Patients who took all of their prescribed placebos had a greater benefit than those who took only 80% of their placebos

Do People Need to be Deceived for Placebos to Work?

Surprisingly, no! In studies of “non-deceptive” placebos, where people were asked to take pills described as having no active drug, they still worked! In one study, people with irritable bowl syndrome who were asked to take a pill that they knew was a placebo experienced significant improvement in their GI symptoms.

What Are the Limits of Placebo Actions?

Not every biologic function appears to be within the reach of placebos. For serious infections, a placebo is definitely not the way to go. Placebos also do not appear to be helpful to lower cholesterol levels.

How Can Knowledge of Placebos Improve Your Health?

The effectiveness of a treatment is related to both the direct effect of the drug (or procedure), as well as one guided by expectation. The more that you can relate to your healthcare provider and feel that they have your best interests at heart, the better the outcome related to expectation. This was shown in a study of people with diabetes, where those who felt their doctors were more empathetic tended to have fewer diabetic complications.

Make sure that your health care provider is a good fit for you in matters of expertise, temperament, and philosophy. The right fit in health care provider will help you to cultivate the power of expectation for your better health—no placebo needed!

References:

Meaning and the Placebo Effect

Non-Deceptive Placebos

Blocking the Effect of Placebos With Real Drugs

Physician Empathy and Diabetes Complications