The placebo effect is a psychological effect that was first discovered in 1785 after European physicians cured patients with false medicine. It has been known for greatly affecting patients’ outcomes, especially if they know the administered placebos are expensive and valuable to doctors. Along with faith and symbol cognitive expectancy (expecting a blue pill to work better than a red pill, for example), these factors create a conditioning effect in patients, which is the base of placebo responses. (1)
This diagram maps how the placebo and conditioning effect work: The cycle starts in the reticular formation (responsible for consciousness) when patients are aware that they will ingest medicine. The thalamus sends signals to the sensory cortex, which decides how the body will react. The sensory cortex activates the limbic cortex (responsible for emotion and behavior) and the hippocampus, which regulates the limbic cortex’s reaction and elicits feelings of relief and trust. These emotions activate the amygdala (the reward center of the brain) and the release of dopamine in the hypothalamus to reduce inflammation and stress. The hypothalamus then activates the periaqueductal gray matter (regulates pain) and elicit analgesic effects. Patients are conscious that their pain is gone, and the reticular formation creates a confirmation bias that the medicine works and restarts the cycle. (2)
The placebo and conditioning effects are accepted in the scientific community. Since patients claim placebo provides about 15-75% of the relief drugs would, drugs have to undergo rigorous double-blind testing (testing a placebo, a non-placebo, and a control group) to prove their effectiveness and reach the market.
But this only applies to FDA approved drugs. Alternative medicine, on the other hand, companies do not have to undergo this rigorous testing, which allows them to sell placebo treatments in large quantities. Albeit they are, by law, required to inform patients that “this statement has not been evaluated by the Food and Drug Administration and this product is not intended to diagnose, treat, cure, or prevent any disease,” many people still trust these treatments blindly.
In fact, over 30% of adults in the United States use some form of alternative medicine. Additionally, 2.2% of adults and 1.8% of children in the United States use homeopathic remedies. Of these, 81% of users do not consult homeopathy’s usage with a certified doctor. (3)
The placebo effect can be very useful to cure headaches and joint pain, among other relatively minor ailments. Nonetheless, alternative medicine treatments can worsen the conditions of patients with serious illnesses.
A study done by JAMA Oncology compared the cancer survival rates of 258 alternative medicine users and 1,032 control patients. The 258 alternative medicine users of herbs, vitamins, acupuncture, homeopathy, naturopathy, and yoga had lower five-year survival rates than the control group. (4)
This is due to the placebo effect’s confirmation bias, which makes many alternative medicine users distrust real treatment, believing their alternative treatment is the only cure.
While alternative medicine can be relatively safe, many of these treatments can be dangerous for misleading people.
Homeopathy and its relationship with the placebo effect is an example:
Homeopathy is a therapy that was created in the 18th century by French doctor Samuel Hahnemann. Homeopathic treatments, based on the axiom of “like cures like,” consist of diluted plants, vitamins, minerals, animal tissue, and even poisons that should cure the illness they would cause if they are administered in a higher dosage. Dr. Ángel Marzetti, in his book “Homeopathy, Medicine of the Future,” claims: “ten to twenty grams of sodium sulfate would cause a mild gastrointestinal ailment so ten to twenty grams or a lesser quantity of sodium sulfate would cure a similar gastrointestinal ailment.”
Dilution of homeopathic remedies usually occurs in powers of ten. A solution of one part solute per one hundred parts solvent would be called “c.” C is then diluted in another similar solution as many times as needed. If done six times, it is a 6c solution. A hundred times, 100c solution, and so on and so forth. The more diluted a solution is, the stronger its claimed curative effect. Sometimes products are diluted beyond Avogrado’s number (6.02 x 10²³), leaving virtually no molecules of the remedy left.
The pharmacological actions of homeopathy are dubious. Proponents of this therapy claim it acts by “memory of water,” or “the transmission of electromagnetic action in water.” In simple terms, the water should hold the “essence” of the remedy after dilution. After many dilutions, barely (if any) atoms of the molecule are left, but the “scented water” is what should cure the patients. When ingested, the water should act by “immunological assistance,” which suggests that white cells should digest the molecules in the water and send a short chain of amino acids from those molecules to the MCH (a set of proteins that recognize foreign molecules). This should alter a patient’s lymphocytes and stimulate their body’s hemoglobin production to cure their diseases. However, this pharmacological action has not been scientifically proven. (5)
Like all alternative medicine remedies, though, its usage and promotion are widespread among some parts of the population—especially women with children—and mainstream medical shows.
An example of homeopathic dietary supplements is the following:
Dr. Oz is a promoter of ‘’raspberry ketones,’’ a dietary supplement that contains a compound similar to capsaicin and synephrine, which increase fat metabolism by inhibiting trioleoylglycerol hydrolysis (the body’s fat storage mechanism) and sugar metabolism.
Raspberry Ketone’s effectiveness was unknown because it had never been tested in humans, so scientist tested it in rats. Raspberry ketones are commonly sold in 180 capsule packets of 1g each, and the rats were given the recommended dose: a pill per day. The study was divided as a control group, rats with a high-fat diet, and rats with a high-fat diet plus the supplement. It was found the rats in the fat diet plus the ketones gained less weight than the rats in the fat diet. Nonetheless, these rats gained more weight than the control group. Therefore, this supplement does not help you lose weight, but it helps you not to gain as much weight. In fact, for the rats in the ketone diet to lose weight, they would have to ingest a daily dose about x100 greater than 1g. Hence, this is an ineffective homeopathic remedy. (6)(7)
Numerous studies fail to prove the efficacy of homeopathy is better than placeboes. A 1997 meta-analysis of 150 studies stated that 89 studies proved homeopathy’s efficacy. While homeopaths call this a victory, six re-analyses of this data, including two by the original author, prove those studies are not enough to claim homeopathy is more effective than placebo.
Although homeopathic remedies are mostly composed of water, alcohol, or sugar, they are not harmless. Homeopathic practitioners tell their patients that they will experience “homeopathic aggravations,” and in fact, one-quarter of patients feel worse after the treatment. (8)
Other forms of alternative medicine also have numerous side effects. Acupuncture is highly invasive and can cause infection if performed with unsterilized needles. Herbal medicine has plenty of side effects and risk of allergic reactions.
Most forms of alternative medicine are placebo, but many can also be harmful and misleading. However, this article does not discourage their usage. Rather, it discourages their misusage. Placebos have outstanding alleviating effects, but they do not substitute real medicine. The consumption or practice alternative medicine should be consulted with a certified doctor. (9)
(1) “Placebo Effect – A Basic History.” Nursing School Hub, http://www.nursingschoolhub.com/placebo-effect/.
(2) Bergado, Jorge A. “SciELO – Scientific Electronic Library Online.” Revista Cubana De Medicina General Integral, 1999, Editorial Ciencias Médicas, 2012, scielo.sld.cu/scielo.php?pid=S0864-34662012000500002. (In Spanish)
(3) Clarke, Tainya C., et al. “Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002–2012.” National Health Statistics Report, 2015, http://www.cdc.gov/nchs/data/nhsr/nhsr079.pdf.
(4) Bakalar, Nicholas. “Alternative Cancer Treatments May Be Bad for Your Health.” The New York Times, The New York Times, 23 July 2018, http://www.nytimes.com/2018/07/23/well/alternative-cancer-treatments-therapies-harm-health-death.html?rref=collection%2Ftimestopic%2FAcupuncture.
(5) Morin, Bernarda. “SciELO – Scientific Electronic Library Online.” Cuadernos De Historia (Santiago), Universidad De Chile. Departamento De Ciencias Históricas, 2009, scielo.conicyt.cl/scielo.php?pid=s0034-98872009000100018. (In Spanish)
(6) McCoy, Terrence. “Half of Dr. Oz’s Medical Advice Is Baseless or Wrong, Study Says.” The Washington Post, WP Company, 19 Dec. 2014, http://www.washingtonpost.com/news/morning-mix/wp/2014/12/19/half-of-dr-ozs-medical-advice-is-baseless-or-wrong-study-says/?noredirect=on.
(7) Morimoto, Chie, et al. “Anti-Obese Action of Raspberry Ketone.” ScienceDirect, 2005, http://www.sciencedirect.com/science/article/pii/S0024320505001281.
(8) Ernst, Edzard. “Is Homeopathy a Clinically Valuable Approach?” ScienceDirect, 2005, http://www.sciencedirect.com/science/article/pii/S016561470500218X.
(9) “Topic Index – Complementary and Alternative Medicine.” Johns Hopkins Medicine Health Library, http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/complementary_and_alternative_medicine/topic_index_-_complementary_and_alternative_medicine_85,P00191.