#28: Is it the Remedy, a Placebo, or just Time? And, How Can You Tell the Difference?

Jan 28, 2025

Explore the intriguing world of placebos and nocebos, revealing how our perceptions can shape health outcomes. Discover personal stories, like how one trial with creatine confirmed real improvements. Unpack the historical context of placebo trials, sparking debates on the efficacy of treatments. Learn how expectations can lead to both relief and new symptoms. Delve into scientific findings that link placebos to actual brain responses in pain relief and depression, encouraging a critical look at health decisions.

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ANECDOTE

Creatine Experiment

Dr. Bobby wanted to build muscle strength and considered using creatine.
He conducted a rigorous N-of-1 trial, measuring muscle mass with DEXA scans, confirming creatine's effectiveness for him.

ANECDOTE

Tim's Placebo and Nocebo Experiences

Dr. Bobby's friend, Tim, experienced plantar fasciitis relief after chiropractic care, questioning if it was a placebo effect.
Tim also believed he caught colds after airplane travel, potentially a nocebo effect, but Dr. Bobby suggested his grandchildren might be the source.

ANECDOTE

Statin Holiday

Dr. Bobby experienced muscle soreness and fatigue, possibly due to statins.
He started a "statin holiday" and felt better, but acknowledged it could be a placebo effect.

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Fascinating interplay between placebos and nocebos: what they are, why they matter, and how they shape your health decisions. Understanding these effects can help you save money, avoid disappointment, and make better-informed choices.

Key Points:

Placebos and Nocebos Defined:
- A placebo is an inert treatment leading to perceived improvement.
- A nocebo occurs when negative expectations cause symptoms, even without an active trigger.
Personal Stories:
- My N-of-1 trial with creatine showed measurable improvements in muscle mass, confirming results beyond placebo effects.
- A friend’s experience with plantar fasciitis improvement through chiropractic care raised questions about the placebo effect.
- Taking a "statin holiday" revealed potential nocebo-related muscle soreness, which I’m further testing.
Historical Context:
- Early mentions of placebos include 16th-century sham exorcisms, where false holy relics exposed imagined reactions.
- The first placebo-controlled trial in 1863 tested rheumatism treatments, showing equal results between opium creams and inert plant-based ointments.
Scientific Insights:
- Pain Relief: A study using laser pain tests demonstrated reduced pain with a placebo cream compared to control groups (study link).
- Depression: Research on placebo antidepressants revealed that labeled placebos activated opioid receptors in the brain, mimicking real treatments (study link).
- Sham Surgeries: A study on knee arthroscopy found no difference between real and placebo procedures over two years, reshaping how such surgeries are viewed (study link).
- Sports Performance: Athletes showed enhanced cycling performance when they believed they received enriched oxygen, demonstrating the power of belief in physical exertion (study link).
Everyday Medicine:
- A UK survey found that 77% of doctors regularly use “impure placebos” such as unnecessary supplements or low-dose prescriptions to reassure patients (study link).

Takeaways:

Question Health Claims: Evaluate whether improvements from treatments or products might stem from placebo effects, not actual efficacy.
Test for Yourself: Apply N-of-1 experiments to discern the true impact of treatments, incorporating blind tests where possible.
Stay Skeptical: Avoid falling for placebo-driven marketing claims and expensive remedies that may lack scientific backing.

Let me know your thoughts or questions by visiting drbobbylivelongandwell.com. Let’s keep exploring how to live long and well!