Release the Endorphins

Even a Fake Supplement Can Boost Mind and Body in Older Adults

Thu, 26 Mar 2026 15:30:38 GMT

Placebo treatments taken knowingly—could be a simple and ethical way to improve quality of life in older adults.

A new study from the Università Cattolica in Milan suggests that belief alone can make a real difference to health. Researchers found that older adults who took a fake supplement for just three weeks showed improvements in both physical and mental performance—even when they knew the supplement had no active ingredients.

The study, published in the International Journal of Clinical and Health Psychology, involved 90 healthy older adults. They were divided into three groups: one group took no pills at all, one group took placebo pills they believed were real supplements, and a third group took placebo pills while being told clearly that the pills had no active ingredients.

Before and after the three‑week period, participants completed surveys about stress, well‑being, and fatigue, as well as tests measuring memory, attention, and physical ability.

The results were striking. Both groups taking placebo pills improved physically and mentally, but the biggest benefits were seen in people who knew they were taking a placebo. This group reported lower stress levels and showed better short‑term memory. Physical performance increased by up to 9%, and some cognitive tests improved by more than 20%.

According to the researchers, these gains are similar to those seen in studies on exercise and brain training. The findings highlight how powerful the mind can be in supporting healthy aging and suggest that open‑label placebos—fake treatments taken knowingly—could be a simple and ethical way to improve quality of life in older adults.

Reference

Diletta Barbiani et al, Placebo mechanisms in aging: A randomized controlled trial comparing deceptive and open-label placebos on psychological, cognitive, and physical functioning in older adults, International Journal of Clinical and Health Psychology (2026). DOI: 10.1016/j.ijchp.2026.100673

Why Open Water Swimming Is Beneficial to Your Health and the Influence of the Placebo Effect

Thu, 04 May 2023 16:21:07 GMT

Open water swimming is all about swimming in lakes, rivers and the sea, rather than at a swimming pool. It can be an invigorating and exhilarating experience, but it also has many health benefits that are unique to this type of activity. We explore here some of the reasons why open water swimming is good for your health and how the placebo effect may play a role in enhancing its positive effects.

Health Benefits of Open Water Swimming

Some of the health benefits of open water swimming are said to include:

Better sleep

Open water swim training can result in a natural increase in the levels of a certain hormone called prolactin in the body which may help to improve the quality of your sleep.

Increased happiness

Other hormones that stimulate the thyroid have been shown to be increased by more than 50 per cent after swimming. This has all kinds of benefits on regulating weight, body temperature, muscle strength but also can improve your mood, making you both healthier and happier. Additionally, open water swimming can boost dopamine and serotonin levels and stimulate the release of feel-good endorphins, which are neurotransmitters that are associated with pleasure and reward.

Boosted immune system

Open water swim training in colder water can reduce the potential over-production of certain hormones that can contribute to impaired immunity, in effect making your more body more robust and resistant to infection. Moreover, open water swimming can make other systems of your body more efficient and more effective, improving your body’s defensive response to damage and therefore potentially reducing your risk of cancer, neurological disorders and chronic respiratory disease.

Preventing and managing long-term health conditions

Cold water and open water swim training can help to improve the management of asthma and Type 2 Diabetes by increasing lung capacity and insulin sensitivity respectively. Furthermore, open water swimming can ease pain, fatigue or depression caused by conditions such as fibromyalgia or arthritis by providing a natural anti-inflammatory effect .

So how does the placebo effect play a role?

Research has found that the placebo effect can ease things like pain, fatigue or depression, which are some of the symptoms that open water swimming can also help with. The placebo effect may enhance the health benefits of open water swimming by creating a stronger connection between the brain and body and how they work together.

For example:

If you have prior expectations for improvement from open water swimming based on verbal cues (such as hearing about its benefits from others), actions (such as actively doing something to address your condition), or social cues (such as feeling reassured by your doctor or coach), you may perceive greater positive effects from it.

If you associate open water swimming with pain relief or mood enhancement based on previous experiences (classical conditioning), you may report decreased pain or increased happiness after doing it even if there is no physiological change. If you receive a placebo treatment (such as an inactive pill) along with open water swimming, you may experience a synergistic effect where both interventions reinforce each other's perceived efficacy.

In conclusion, open water swimming is not only a fun and adventurous activity but also a beneficial one for your health. It can improve various aspects of your physical and mental well-being by stimulating hormonal changes, immune responses, metabolic processes and neural pathways. The placebo effect may further amplify these benefits by influencing your perception of them through psychological mechanisms such as expectations or associations.

Microdosing Psychedelics: Hope or Hype?

Fri, 18 Nov 2022 16:43:04 GMT

Is this simply a placebo effect?

The term " microdosing " refers to taking tiny amounts of psychedelics, well below the dose required for a typical psychedelic experience. It has become fairly common; hundreds of thousands of individuals microdose each year. By far, the most common drugs used are LSD and "magic" mushrooms containing psilocybin.

The reported benefits of microdosing include improvements in one's overall sense of well-being, greater ability to focus, increased energy level, improved mood, less anxiety , and increased creativity . With potential benefits like those, it is not a surprise that many are using psychedelics. Despite this use, to date, only a few controlled studies have taken place. And the findings of these studies don't seem to line up with the positive user experiences reported. A negative view is also consistent with some of the small but carefully controlled placebo studies, which suggest that most if not all of the effects are due to the expectancy effect. So what's going on? Is this simply a placebo effect ?

The only way to separate the science from the hype is to take a closer look at the clinical studies that have been done, which I dive into in my book, The Promise of Psychedelics. Very recent peer-reviewed publications have also helped clarify this issue.

The positive data and its limitations

There have been several large studies based on users' self-reporting. However, when considering these results, a high level of caution is required. They are self-selected groups, often microdosing with a high level of expectation, and the results don't have a placebo-control group with which to compare. All of these things tend to make results more positive in general and also less useful for us to give advice.

Nonetheless, even recognizing these limitations, there are a lot of positive studies. For example, a 2018 study reported that nearly half of more than 1,100 microdose users self-reported improvements in symptoms of anxiety, depression , cognition , and creativity. Another study from 2019 included 410 individuals clinically diagnosed with a mental health disorder; participants reported better results from microdosing with psychedelics than from conventional treatments. A larger study from 2020, with over 6,570 participants, concluded that the benefits of microdosing outweigh the risks.

Recent microdosing studies

Three recent studies might help shed more light on this issue. Perhaps the most useful is a recent study from researchers in Canada and the Netherlands, published in June 2022 (Rootman et al.), in which the authors followed 953 psilocybin microdose users for 30 days and compared them to 180 non-microdosing controls. They found some mild-to-moderate improvements in both mood and mental health. While not a true placebo-controlled study, this was prospective and controlled, so we can give some weight to the findings.

This approach is also supported by a recent review published in May 2022 (Polito and Liknaitzky), which systematically reviewed over 65 years of research on low-dose psychedelics, including both laboratory and placebo-controlled studies. The researchers "argue that claims that microdosing effects are largely due to expectancy are premature and possibly wrong."

Another recent study, published in June 2022 (Sanz et al.), suggested that one issue is that microdosing studies use measures better suited for much higher doses. Subtle changes may not be picked up, which is what they found in their study. It was a small study (only 34 individuals) but well controlled, using a placebo and measuring natural speech. They concluded that there were real changes in speech and that it was not all placebo.

Reasons for hope

There is an increasing knowledge base of scientific evidence to support possible benefits mostly based on detecting the impact of psilocybin and other similar psychedelics on activity in the default mode network of the brain, brain changes in key areas ("neuronal plasticity"), impacts on nerve growth ("neurogenesis"), increases in connections between nerves ("synaptogenesis"), and a better understanding of the receptors involved (5HT2A, glutamate, etc.).

Reasons for caution

While there are reasons for hope, but many issues remain. There is still not much convincing evidence about when microdosing ought to be used, the best drug to use (although it is likely to be psilocybin-based), the best dose, how frequently it should be used, and if this is a short-term and/or longer-term benefit.

In line with these hesitations, a placebo-controlled study of low-dose LSD from March 2022 (de Wit et al.) did not find any meaningful benefits on mood or task performance in healthy volunteers. Similar negative findings in volunteers were reported in a placebo-controlled study with psilocybin in January 2022 (Marschall et al.).

Additionally, caution is also required in terms of the potential underlying changes found in the neuroscience research since the effects of either short-term or longer-term psychedelic use remain uncertain, and researchers don't know how this may change with different doses.

A final note of caution: Psychedelics are more effective when combined with appropriate therapy, using the so-called psychedelic-assisted psychotherapy approach, but the role of therapy in microdosing is uncertain.

Microdosing and the treatment of mental health

So what is the takeaway? Overall, the balance of evidence suggests that microdosing may have mild-to-moderate benefits for patients with some disorders. However, the level of uncertainty at this time is such that psychedelics cannot be clinically recommended, although with more research in the next few years, this may change, and it may become an accepted treatment for certain conditions.

About the author

Peter Silverstone M.D. is a physician, neuroscientist, entrepreneur, and author focused on designing and implementing new solutions to prevent and treat mental health disorders. He is a professor in the Department of Psychiatry at the University of Alberta where he recently served as interim chair, as well as chief executive officer and founder of Zylorion Health.

Study finds surgery patients wearing VR headsets needed less anesthetic

Sun, 25 Sep 2022 16:30:00 GMT

Virtual worlds could distract you from the pain.

More evidence is mounting that virtual reality might relieve pain during surgery . MIT News reports that Beth Israel Deaconess Medical Center researchers in Boston have published a study indicating that patients wearing VR headsets required less anesthetic during hand surgery. While the average conventional patient needed 750.6 milligrams per hour of the sedative propofol, people looking at relaxing VR content (such as meditation, nature scenes and videos) only required 125.3 milligrams. They also recovered earlier, leaving the post-anesthesia unit after 63 minutes on average versus 75 minutes.

The scientists claim VR distracted the patients from pain that would otherwise command their full attention. However, the researchers also admitted that the headset wearers may have gone into the operating room expecting VR to help, potentially skewing the results.

Beth Israel Deaconess' team is planning trials that could rule out this placebo effect, though. One follow-up trial will also gauge the effect of VR on patients receiving hip and knee surgery. Past experiments, such as at St. Jospeph's Hospital in France, have indicated that the technology can help assuage patients.

The allure for healthcare providers is clear. Patients might suffer less and return home sooner. Hospitals, meanwhile, could make the most of their anesthetic supplies, free recovery beds and reduce wait times. What a provider spends on VR headsets could pay for itself if it allows for more patients and higher-quality treatment.

Antidepressants No Better Than Placebo for About 85% of People

Fri, 19 Aug 2022 12:15:00 GMT

Researchers can’t predict the 15% who benefit from antidepressants, and the other 85% are unnecessarily exposed to the harms of the drugs.

Clinical trials typically find that antidepressants are slightly better than placebo , at least in the short term. However, many researchers argue that this difference— about two points on a 52-point depression scale—is clinically imperceptible .

The question is what this minimal average difference means. There are two possibilities:

Most people experience just a tiny bit more improvement on the drug (a 12-point improvement) than they would on a placebo (a 10-point improvement); or
A small group of people experiences a larger effect from the drug, which is canceled out on average by the larger group of people who experience no effect.

In a new study , researchers have now concluded that it is the latter—in clinical trials, about 15% of people experienced a large effect from the antidepressant drug that they would not have received from the placebo. The authors write:

“The observed advantage of antidepressants over placebo is best understood as affecting a minority of patients as either an increase in the likelihood of a Large response or a decrease in the likelihood of a Minimal response.”

The paper appeared in BMJ. It was led by Marc Stone at the FDA’s Center for Drug Evaluation and Research. Also, it included famed Harvard placebo effect researcher Irving Kirsch, as well as researchers from Johns Hopkins and the Cleveland Clinic.

The study was a participant-level analysis of the double-blind, placebo-controlled trials of antidepressants to treat depression submitted to the FDA. The data included 242 studies that were conducted between 1979 to 2016—a total of 73,388 participants.

The researchers accounted for age, sex, and baseline severity of depression in their analysis.

Consistent with the previous research, they found the usual, minimal, less-than-two-point difference between the drug and the placebo effect, on average, across all 73,388 participants.

“The difference between drug and placebo was 1.75 points,” they write.

(This is the average for adults. For children and adolescents, the average difference between drug and placebo was less than 1 point, at 0.71.)

For both the drug and the placebo group, adults were more likely to get better if they were younger and had worse symptoms at the start of the trial.

However, because this was an individual patient-level analysis, the researchers were also able to break down the statistics further. They found that those who took the drug were a little more likely to experience a large improvement than those in the placebo group.

They write, “About 15% of participants have a substantial antidepressant effect beyond a placebo effect in clinical trials.”

Essentially, the researchers suggest that there is a small group of people for whom the placebo response doesn’t really happen and for whom the antidepressant drugs reduce symptoms.

More Information

The drug and placebo groups both had extremely high rates of symptom improvement: 84.4% of the placebo group found their depression symptoms improved, while 88.5% of the drug group improved. However, in many cases, this “improvement” was small.

More important is the number of people who experienced a large improvement. This improvement is more likely to be clinically relevant. The researchers found that those taking the drug were more likely to experience this level of improvement—24.5% of the antidepressant group experienced large improvement, versus 9.6% of the placebo group.

Based on these numbers, there seems to be a small group—about 15% of people—who experience a large response to the drug who would not otherwise improve to this level.

Unfortunately, the researchers found no way to predict who, exactly, is in this 15%. They write that if everyone with a depression diagnosis is given an antidepressant, about seven people need to be given the drug (and thus be exposed to the harmful effects with no benefit) before one person benefits.

“Further research is needed to identify the subset of patients who are likely to require antidepressants for substantial improvement,” they write.

“The potential for substantial benefit must be weighed against the risks associated with the use of antidepressants, as well as consideration of the risks associated with other treatments that have shown similar benefits.”

Common risks of antidepressants include weight gain, sexual dysfunction, and emotional numbing, and the drugs are challenging to discontinue once started.

Explanations for the Findings

Despite some newer arguments that the placebo effect has been increasing over time—thus making new drugs look worse—the researchers found that the placebo effect has remained stable since the 1980s.

“Depression symptoms” measured on common depression questionnaires include bodily responses like sleep and eating, and the drugs’ sedative and appetite effects could account for some of this improvement.

Another explanation is that some people receive an enhanced placebo effect because they can tell, from the side effects, that they are in the active drug group (breaking the “blind” of the study).

Clinical trials also usually hand-pick their participants, searching for those with no other conditions and who are not suicidal. This makes them very different from the individuals most often treated with the drugs in real life.

Indeed, in a study this year, other researchers found that response to treatment is much lower in real life. For example, in a study where over a thousand people with depression were treated with antidepressant drugs—more than half on multiple drugs—as well as therapy and hospitalisation, less than a quarter responded to treatment.

In another paper, those same researchers also found that those with more severe depression, those with co-morbid anxiety, and those who were suicidal were least likely to benefit from the drugs.

_______________________________________________

Bartova, L., Fugger, G., Dold, M., Swoboda, M. M. M., Zohar, J., Mendlewicz, J.,& Kasper, S. (2021). Combining psychopharmacotherapy and psychotherapy is not associated with better treatment outcome in major depressive disorder – evidence from the European Group for the Study of Resistant Depression. Journal of Psychiatric Research, 141, 167-175. https://doi.org/10.1016/j.jpsychires.2021.06.028

Peter Simons

Peter Simons was an academic researcher in psychology. Now, as a science writer, he tries to provide the layperson with a view into the sometimes inscrutable world of psychiatric research. As an editor for blogs and personal stories at Mad in America, he prizes the accounts of those with lived experience of the psychiatric system and shares alternatives to the biomedical model.

Original article at Mad In America

Can’t afford coffee? Thinking about it is just as good: Study

Wed, 17 Aug 2022 23:00:00 GMT

According to a new study, merely thinking about coffee is as good as drinking it. Good one, brain.

Do you know what would go down well right now? Your morning coffee. Just think about it. That smell, that texture, the dance that goes with acquiring that ambrosia of the gods. According to the University of Toronto, you don’t need it. A new study from that institution believes that merely thinking about coffee is as good as drinking it.

Dr Sam Maglio, the co-author of the study, said: “People often encounter coffee-related cues, or think about coffee, without actually ingesting it…we wanted to see if there was an association between coffee and arousal such that if we simply exposed people to coffee-related cues, their physiological arousal would increase, as it would if they had actually drank coffee.”

Dr Maglio explained: “People who experience physiological arousal – again, in this case as the result of priming and not drinking coffee itself – see the world in more specific, detailed terms…this has a number of implications for how people process information and make judgements and decisions.”

The eggheads from Toronto have since moved beyond breakfast, and are expecting to see if this placebo effect also holds true to the universe of energy drinks.

World Homeopathy Day 2019: Here's What You Need to Know About Samuel Hahnemann & His Discovery

Thu, 02 Jan 2020 01:00:00 GMT

On World Homeopathy Day, scroll down to find out more about the discovery of the alternative system of medicine, Homeopathy

The scientific jury may still be out on its efficacy but few would dispute the popularity of homeopathy in India and many other countries. As the world celebrates World Homeopathy Day on April 10, did you know that German physician Samuel Hahnemann created the alternative system of medicine nearly 200 years ago out of disillusionment with medical practices of his era?

Born on 10 April 1755 near the German city of Dresden, Hahnemann started practising as a doctor in Saxony in 1781 after finishing his medical studies with honours. His thesis was titled ‘A Dissertation on the Causes and Treatment of Spasmodic Diseases.’

Disillusioned with bloodletting and other medical practices of his era, Hahnemann quit his job just three years later to work as a translator—he is said to have been proficient in proficient in several languages, including English, French, Italian, Greek and Latin— of scientific and medical textbooks. Hahnemann began to research cinchona's effect on the human body by self-application after he came across the claim in William Cullen's A Treatise on the Materia Medical that the Peruvian tree bark was effective in treating malaria because of its astringency.

He concluded that the drug could induce malaria-like symptoms in any healthy individual and eventually came up an alternative system of medicine which he named Homeopathy in an 1807 essay based on his “like cures like” doctrine.

“In other words, something that brings on symptoms in a healthy person can — in a very small dose — treat an illness with similar symptoms. This is meant to trigger the body’s natural defenses,” according to an article on Webmd.com.

At best a placebo effect?

Homoeopathy’s efficacy remains disputed in the West. A 2015 assessment by the Australian government’s National Health and Medical Research Council concluded that there is no “reliable evidence that homoeopathy is effective for any health condition.”

In 2017, England’s National Health Service (NHS) asked doctors not to hand out prescriptions for homoeopathic treatments, described by NHS chief executive Simon Stevens as “at best a placebo” and “a misuse of scarce NHS funds”. In fact, the NHS just last week announced that Homeopathic treatments will be blacklisted after it emerged that doctors were still issuing thousands of prescriptions a year.

Popular treatment in India

Not in India through which is hosting a two-day convention to mark the day. “Homeopathy is one of the most popular medical systems in India, in fact, a close second among the AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) services. There are growing numbers of users, practitioners, educational institutes, as well as public health clinics, compared to the AYUSH systems in India.

Academic homoeopathy institutes comprise 35.8% of AYUSH colleges, while homeopathy practitioners are 37% of the AYUSH in total. Our country has the biggest drug manufacture and traders’ sector in Homoeopathy, according to the Ministry of Ayush’s Central Council for Research in Homeopathy.

India's annual market size for Homeopathy is 516.9 million US dollars, according to media reports quoting industry experts.

PW's comment

It seems extraordinary that a cash strapped NHS would retract from homeopathic treatments that they describe as "at best a placebo" knowing that 1) The cost of homeopathic treatments are vastly cheaper than many MHRA approved drug treatments and 2) (Maybe they don't know this) that placebos work for a good proportion of the population.

Long-term treatment with antidepressants may not be justified by available studies

Mon, 15 Apr 2019 16:43:38 GMT

The higher occurrence of relapse in the groups assigned to placebo instead of drug continuation may be due to the studies not considering the potential occurrence of withdrawal syndromes

A new study published in the current issue of Psychotherapy and Psychosomatics sheds new light on long-term studies with antidepressant drugs. The higher occurrence of relapse in the groups assigned to placebo instead of drug continuation may be due to the studies not considering the potential occurrence of withdrawal syndromes.

In this first systematic review of psychotropic drug discontinuation in randomized-controlled trials (RCTs), about 30 percent of RCTs each investigated the discontinuation of antipsychotics, antidepressants, benzodiazepines, and about 10 percent investigated that of stimulants. RCTs of stimulants, antidepressants, and antipsychotics mostly aimed to reach conclusions about relapse prevention by testing abrupt or rapid discontinuations. RCTs of benzodiazepines mostly aimed to reduce drug use by testing longer-lasting, supportive discontinuations. Although the 30 percent rate of full industry funding of RCTs is half that of an earlier finding, 70 percent of RCTs in this review reported significant industry participation.

A first result showed that industry participation was paired with "discontinuation" in antidepressants and antipsychotics trials, but with " withdrawal " in stimulant trials. Benzodiazepines trials, with little industry funding, largely used "withdrawal." The preferential use of "withdrawal" in benzodiazepines and stimulant RCTs may indicate a persistent recognition of withdrawal symptoms that has resisted industry influence on terminology. Overall, in 67 percent of RCTs, no justification was given for the specific discontinuation strategy, which lasted under 2 weeks in 60 percent of RCTs. Possible withdrawal confounding of trial outcomes was addressed in 14 percent of eligible RCTs. Relapse prevention RCTs employed discontinuation to reach conclusions about "maintenance of treatment effect," yet, except in stimulant RCTs funded by industry, rarely explained the logic.

The study is commented by a leading Harvard psychopharmacologist, Ross J. Baldessarini, who calls for new, appropriately designed studies. Dr. Baldessarini points out that the effects of discontinuing treatment with psychotropic drugs , encountered in both clinical and therapeutic trials, raise important clinical and possible ethical concerns. Available research designed to test for the impact of various rates of discontinuing psychotropic treatments is rare, inconsistent, and inconclusive with respect to early withdrawal reactions commonly encountered with short half-life SSRIs and venlafaxine. Not investigating these issues, could compromise the scientific soundness of research, especially in trials that involve discontinuing a previous or current active treatment to a placebo. Indeed, trials involving discontinuation of an effective treatment are especially likely to produce exaggerated differences in morbidity between continuing treatment versus discontinuing it to an inactive placebo.

According to Dr. Baldessarini, these findings highlight the need to recommend discontinuing psychotropic medicines as slowly as possible as we await adequate investigations aimed at testing for ways of conducting drug discontinuations.

CBD Uncertainty: Sales Soar But Science Lags On Hemp Health Effects

Mon, 15 Apr 2019 16:36:53 GMT

Inside the Bluegrass Hemp Oil store in Lexington, Kentucky, the CBD oils and lotions lining the walls have an origin story — a story of a family’s struggle.

“We took a huge risk, to be perfectly honest, because we didn’t know. We weren’t trying other people’s CBD products that were out there,” Bluegrass Hemp Oil Co-owner Adriane Polyniak, said.

Polyniak’s son, Colten, began inexplicably having violent seizures in 2009 when he was three. He was diagnosed with idiopathic generalized epilepsy.

“Essentially what that means is that he went from zero seizures to hundreds of seizures in a week, and the doctors didn’t know what was causing it,” Polyniak said. “We started a game called ‘pharmaceutical roulette’ — a lot of epilepsy parents are familiar with it — where we try a lot of different types of epilepsy medication to bring seizure relief to our kids.”

The various prescription drugs controlled Colten’s seizures but caused harmful side effects including hair loss, weight gain, and cognitive delay.

Adriane’s family saw on online forums that CBD might be of help for seizures. CBD, also known as cannabidiol, is a compound commonly sourced from the flowers of hemp, a type of cannabis related to marijuana. CBD doesn’t get a user intoxicated, unlike the better known cannabis compound, THC.

CBD is commonly put into oils and lotions, but some novelty products like CBD in water and vaping CBD have recently been put on the online market. When Kentucky began growing hemp under a pilot program in 2014, Polyniak’s family tried it. And she said it worked: Colten’s seizures disappeared.

The Polyniaks now want their business to help others with what they say are benefits from CBD.

“I think a lot of people are seeing relief with CBD products, and I think it goes a long way to prove the efficacy of what’s going on and what people are saying,” Polyniak said.

People across the country say CBD is helping them with a wide variety of issues including sleep problems, mental illness, arthritis, skin conditions, Crohn’s disease, and more.

But there is little to no scientific evidence to support these claims. Clinical researchers in the Ohio Valley say there’s still not a lot known about the substance, and some express concern that the CBD business boom is moving faster that the scientific research.

Lacking Research

“I think there’s a lot of concern amongst physicians, medical providers and research scientists like myself, that we’re moving too fast without proper evidence or information,” said Dr. Anup Patel, Section Chief of Pediatric Neurology at Nationwide Children’s Hospital in Columbus, Ohio.

Dr. Patel has been involved in several studies in the past five years to look at CBD’s effect on various forms of epilepsy. The promising results of those preliminary studies led to a more intensive, groundbreaking study in 2018, where he worked with patients who have a severe form of epilepsy called Lennox–Gastaut Syndrome.

The study results showed patients saw a median reduction in seizures of more than 40 percent. Months later, the Food and Drug Administration approved the first CBD-sourced drug, Epidiolex, because of that study. It remains the only FDA-approved CBD drug.

“There is potential benefit for certain types of patients with seizures or epilepsy. Beyond that, we have no idea. There aren’t any good studies using CBD in other areas,” Dr. Patel said.

Dr. Patel is referring to the current lack of “double-blind” studies , which are considered the most legitimate among researchers. Double-blind studies are where both the researcher and patients don’t know who is and who is not receiving the drug being studied.

This helps control for the placebo effect , a phenomenon where an individual may experience benefits because of their belief in a treatment, not because the treatment is actually working.

Dr. Alex Straiker, an Indiana University professor whose primary focus is studying cannabinoids’ effects on the brain and eye, is one of many researchers who think the hype and media coverage surrounding CBD could contribute significantly to the placebo effect.

“There’s a lot of enthusiasm on one hand, from the public and manufacturers, to market this. It’s kind of a bonanza mentality,” Dr. Straiker said. “The whole process of science is that you have to have multiple studies, and they have to be well done. A lot of [the claims] you have to take with a grain of salt.”

Studies Underway

In the meantime, researchers worldwide are getting busy. Human trials, some of them double-blind, are being conducted to determine CBD’s effects for a variety of issues , from cancer therapies to Parkinson’s disease.

Some preliminary CBD research has shown promising results toward CBD’s potential anti-inflammatory properties and how it affects brain chemistry, helping people with issues including anxiety disorders , rheumatoid arthritis and quitting tobacco .

Yet research on CBD’s potential side effects is also surfacing: a recent Indiana University study that Dr. Straiker led indicated that CBD could increase the risk of glaucoma.

West Virginia University dermatologist Zachary Zinn helped conduct one of these new studies. His study looked at CBD’s effect on three patients suffering from a rare skin condition called epidermolysis bullosa that causes severe blistering and extreme pain.

“The improvements the patients noted was marked,” Zinn said. “It wasn’t, ‘Oh, I’m having a little less pain.’ It was, ‘I no longer require morphine for my dressing changes.’”

Zinn thinks CBD is relatively safe to ingest in small doses, and he’ll tell patients that if they inquire about it. But he isn’t actively recommending it to patients because there’s still little clinical research.

“To think that it’s going to be a wonder drug for all the things patients are reporting, that benefit in, is probably not going to happen,” Zinn said. “That doesn’t necessarily mean it’s not effective, but it equally does not mean that it is effective.”

Pushing Forward

The expanding Ohio Valley hemp industry is pushing forward despite a lack of scientific backing. Roger Hayes of Louisville-based Green Remedy , a CBD product wholesaler, said clinical studies matter to verify their products’ value.

Like other CBD companies, Green Remedy doesn’t make any claims about CBD’s effects because they’re not approved by the FDA. But he said the company doesn’t necessarily need clinical studies or the FDA’s approval to be confident the products work.

“The [studies] on what the therapeutic effects are going to be, that takes years,” Hayes said. “America doesn’t need to wait that long to determine that something that has been around for thousands of years that people take for various reasons — we shouldn’t have to wait that long.”

Many in this expanding industry, including Hayes, want the federal government to hurry up with regulation, regardless of studies.

The FDA said in December that CBD in food products is still illegal without FDA approval. Ohio stores selling CBD food have been raided .

Kentucky Agriculture Commissioner Ryan Quarles is one state government official in favor for approval of CBD-infused food because of the boost it could give to regional hemp farmers.

“We don’t want to regulate hemp to death in America now that it’s finally legal,” Quarles said. “Because a lot of folks are making investments right now, we’re hoping CBD can be marketed as a healthcare supplement.”

Yet some in the industry are more hesitant. Matthew Smith is a licensed massage therapist in Parkersburg, West Virginia, who uses CBD oil to ease muscle pain and arthritis in his clients.

“Anecdotally, there’s a lot of people that it’s helped,” Smith said. “It is possible that we’ll find that it’s overblown, or that there are a lot of cofactors that go into making it more useful, or making it more safe. There’s still a lot of science to be done.”

The first FDA public hearing on CBD-infused food is scheduled for late May.

Ladies on feminine Viagra can now drink alcohol, FDA declares

Mon, 15 Apr 2019 14:17:44 GMT

Women who use the female libido pill, Addyi, no longer need to avoid alcohol, regulators have declared.

Previously, Addyi came with a warning to stop drinking two hours before taking the pill, or to skip the pill if they’d had a few drinks. But on Thursday, the US Food and Drug Administration found studies conducted by the drugmaker, Sprout, showed no need for such a warning.

Sexual health professionals hailed the shift as a win for women.

The little pink pill was first approved in 2015, and remains the only FDA-approved treatment for hypoactive sexual desire disorder (HSDD) in pre-menopausal women. Unlike Viagra, which increases blood flow to a man’s penis, Addyi (the brand name for flibanserin) targets the brain with similar effects to an antidepressant. It boosts dopamine to gear up motivation and excitement, and dulls serotonin, the neurotransmitter which makes us self-conscious.

The drug has plenty of critics: a significant portion of doctors say we do not know enough about female sexual desire to ‘fix it’ with one pill. The American Sexual Health Association, a 100-year-old nonprofit source of sexual health information, says HSDD affects a staggering one in 10 women – and ASHA CEO Lynn Barclay told DailyMail.com visits to the HSDD page on their website have been rocketing in recent years and months.

However, many health professionals question whether HSDD is real.

And there is growing concern about antidepressants in general, and how difficult they can be to wean off. This skepticism has created fertile ground for cannabis entrepreneurs, who thrive in grey areas of medicine, to market marijuana as a ‘natural’, less risky solution for women lacking libido. But plenty of sexual health practitioners and advocates say they are just happy to be able to provide women some tangible relief without caveats.

‘Women are really looking for information on this,’ Barclay said. ‘I think, unfortunately, women think that what’s happening to them only happens to them, and that there’s nothing to be done about it. But Addyi might be something.’

The reason an alcohol warning was slapped on Addyi in 2015 was because Sprout had not adequately studied the drug’s interaction with alcohol. As a result, the FDA allowed the drug onto the market but with a warning, and ordered the firm to conduct three post-approval studies, which is fairly common with drug and device approvals.

Sprout conducted three studies.

The first lasted a week, with 24 women taking either Addyi or a placebo, and on two of the days some had a couple of alcoholic drinks with dinner, then took their pill a couple of hours later. Sprout wanted to see if there was a risk of fainting; in this scenario, there wasn’t.

The second involved 96 women, who had three drinks, didn’t eat much, then took Addyi in the morning. Again, there was no risk of fainting and blood pressure was stable, but some felt faint.

The third saw 64 women take Addyi or a placebo for 10 days. On four of those days (days four, six, eight and 10) they had a couple of alcohol drinks varying hours before taking their pill. Again, there were no clear side effects.

Dr Diana Zuckerman, president of the National Centre for Health Research, said the studies leave many questions unanswered. ‘Some women drink every day or almost every day, but the studies only include women drinking one or two drinks on some days but not others,’ Dr Zuckerman told DailyMail.com. ‘As a result, we don’t know what happens if a woman drinks daily or almost daily, whether or not any of those days are what would be considered excessive drinking.’

But the bigger question that still remains, Dr Zuckerman says, is whether Addyi really works well at all. Sales have been disappointing, driving Sprout to half the price in summer 2018. Dr Zuckerman believes this may have something to do with the fact that, even in the clinical trials, the drug did not work much better than the placebo. ‘The original Sprout studies only found a greater benefit than placebo when they changed the way they asked women to report their frequency of “satisfying sexual experiences”, using a less accurate measure,’ Dr Zuckerman said. ‘We think the poor sales of Addyi reflect the fact that it isn’t effective (in addition to the outrageous cost and concerns about alcohol). ‘Women’s loss of libido is an important health issue, but it might or might not be something that can usually be fixed with medication. ‘Taking Addyi every day is inconvenient and expensive, after the placebo effect wears off, why would any woman keep paying for a product that she realises doesn’t actually work?’

Brain hacking with entrainment

Wed, 10 Apr 2019 13:02:04 GMT

Can you electronically enhance your brain? I’m not talking about surgically turning into a Borg. But are there electronic methods that can improve various functions of your brain? Fans of brainwave entrainment say yes.

There was an old recruiting ad for electrical engineers that started with the headline: The best electronic brains are still human. While it is true that even a toddler can do things our best computers struggle with, it is easy to feel a little inadequate compared to some of our modern electronic brains. Then again, your brain is an electronic device of sorts. While we don’t understand everything about how it works, there are definitely electric signals going between neurons. And where there are electric signals there are ways to measure them.

The tool for measuring electric signals in the brain is an EEG (electroencephalograph). While you can’t use an EEG to read your mind, exactly, it can tell you some pretty interesting information, such as when you are relaxed or concentrating. At its most basic we’ve seen toys and simple hobby projects that purport to be “mind controlled” but only at an incredibly rudimentary level.

Brainwave entrainment is a hypothesis that sending low frequency waves to your brain can give your mind a nudge and sync up brain activity with the equipment measuring it. The ability to synchronize with the brain could yield much better measurements for a meaningful interface between modern electronics and electric storm of thought happening in your head.

Keeping the measurement on the outside

When Hans Berger took the first human EEG in 1924, he built on 50 years of research about electrical brain activity in monkeys, dogs, and rabbits. It was known that placing electrodes directly on an animal’s brain produced signals that changed if, for example, you changed the light level in the room. Of course, you couldn’t pop the top on a human subject and wedge electrodes in their brain, so Berger had to be more subtle.

An EEG has several frequency bands where your brain produces repeating waves. The alpha band (8-15 Hz) occurs when relaxing or with eyes closed, for example. beta waves (16-31 Hz) occur when you are focused, alert, or anxious. You can find a nice table of the waves and what they seem to indicate on Wikipedia.

Here’s where things get tricky. If your brain produces, say, alpha waves when you are relaxed, can you impose alpha waves on your brain to make you relax? That idea is known as brainwave entrainment.

Entrainment is known to happen in regular systems. Christiaan Huygens reported in 1665 that several pendulum clocks in close proximity eventually synchronized. This is due to energy from each clock affecting the other clocks. When out of phase, the effect is negative. When in phase, the effect is positive, so over time, the pendulums are all in phase — you can see this effect (exacerbated by using a moving platform) in the video below.

Does it work?

The human body — and the brain in particular — is pretty strange. So this might work the way people think. Or it could be a placebo effect. I might be able to tell you that putting a copper coin under your armpit will improve concentration and because of the placebo effect, it just might. Or perhaps it is just baloney.

However, you have the tools to find out if it works for you, even if you can’t prove why it works. There are plenty of ways to wire up an EEG , by the way, if you want to be even more rigorous. We’ve even seen a doggy EEG recently.

The idea is that if you can impress sound waves at a particular frequency on your brain, it will cause your brain to sync up just like the pendulums in the video. This might sound silly, but EEG evidence seems to bear it out and it even has a name: FFR or frequency following response. This happens unintentionally sometimes. For example, music or chanting can produce changes in the EEG, presumably from this same effect.

Nudging brainwaves using audio

One issue with trying to entrain brainwaves is that the frequencies of interest are so low. There are a few methods commonly used. One idea is binaural beats. Suppose you want the brain to get an 8 Hz signal. That’s hard to do with a sound card. But it is easy to send one ear a, say 250 Hz signal and the other ear a 258 Hz signal. The brain will mix these frequencies and you will hear an 8 Hz signal (along with the other two and a 508 Hz tone, too).

Another method is isochronic tones, were you hear bursts of a higher frequency sound and the bursts are at the lower frequency. With the binaural system, you should really use headphones. While headphones are always good, the isochronic tones don’t require them.

While it is a little scary to mess with your brain, you have to figure that just listening to some tones shouldn’t have much potential to mess anything up permanently. It’s a world away from inserting some electrodes in your brain, but we have looked at instances where external stimuli will have a lasting effect. Examples include how you perceive color after exposure to the McCollough Effect , and how flashing lights have the ability to trigger seizures in some people.

Pseudoscience, at least for now

I know, this sounds like pseudoscience. There have been some studies, but I don’t know of any that are solid and widely accepted by the mainstream scientific community. Still, it’s not inconceivable that external influences could sync up something in the brain. For example, light flashes can trigger seizures in some people. Certain kinds of music, chants, or drum beats are known to affect people in different ways. So the link between sound and your brain state isn’t that hard to imagine.

There is some evidence that when we talk to others our brains synchronize , which is another thing that sounds crazy but is apparently true. While it isn’t quite entrainment, scientists recently used similar techniques to let people communicate brain-to-brain by looking at LEDs flashing at different frequencies. The result was a multiplayer Tetris game where the players were mind-melded.

Citizen science and entrainment

This is an area where a large coordinated citizen science effort could make some interesting and relevant contributions. Producing tones is easy. Here’s a generator for isochronic tones and another for binaural . It would be interesting to design a little experiment. For example, consider Web Sudoku . Sudoku is a fun game that is mentally challenging but pretty easy to learn. It would be interesting to try a few games with no entrainment, a few games with perhaps headphones in silence, and a few games with headphones and a concentration tone using one of the above generators. My first cut at a list of data to collect would be:

Time of day
Level of difficulty
Type of entrainment used (isochronic or binaural and at what settings)
Number of games played in this session
Headphone use (yes or no)
Result (time to succeed or time when you gave up)

I set up a project for this on Hackaday.io . If you are interested, join and we’ll design some experiments and collect some data. Would the time of day matter? It seems like you’d use the “normal” plays as a baseline to see how variable your times are game-to-game. Share your thoughts here or on the Hackaday.io project.

Guide to evaluating health claims, quacks and cures

Tue, 09 Apr 2019 17:42:40 GMT

The lifestyle sections and health pages of many major newspapers and magazines routinely tout questionable health claims that are unsupported by scientific research or evidence.

Some, like the popular claim that eating eggs and bananas at the same time may kill are really relatively harmless, with the main risk being passing indigestion.

But others can have severe repercussions. Take for instance the many treatments that have been falsely peddled as cures for HIV . If patients forsake their proven-to-work antiretroviral treatment in favour of these “cures”, the outcome will most certainly be devastating.

Or this “advice” by a doctor to consume a concoction of sweet pepper, raw eggs and sea salt as a miracle five-minute cure for diabetes. Getting off your treatment regimen in favour of this approach is unlikely to end well. Given that false health claims are often perpetuated by people who, at first glance, appear to be credible professionals, it is not always clear that the treatments they are touting are unproven.

Whatsapp is among the key channels

False health-related claims also make up a significant part of fake news that is being spread via social media and other messenger channels like WhatsApp.

In England, false claims regarding the link between the MMR vaccine and Autism continue to be fanned in this way, even though they have long been disproven . This particular myth has been perpetuated so effectively that MMR vaccine uptake in England is troublingly low and declining further , with 87.5% of children under five vaccinated, compared with the World Health Organization target of 95%. This has led to calls for censorship by social media.

Even if the media were to clamp down on health hoaxes and quack products, they are unlikely to weed out all of the quackery. For the sake of our health and that of our communities, it is more crucial now than ever that we learn how to fact check information whether we’ve read it on a website, a newspaper, our newsfeed or on a group message.

We have put together this guide to assist journalists, editors and Joe Public in telling fib from fact.

Don’t take anything at face value

When testing the legitimacy of health claims it pays to embrace your inner sceptic. Do not take anything at face value. Instead, ask: “Who has made this claim, what are their credentials and can those credentials be independently verified?”

Be aware, for instance, that titles can be deceiving. “Doctor” can refer to any number of things: a medical doctor (MD), a doctor of philosophy (PhD), a doctor of science (ScD), an honorary doctorate or even a sham “doctorate” purchased online from one of the many websites that peddle bogus qualifications.

To get to the bottom of this, do a quick search for the credentials and associations of the person or organisation making the claim. Are their qualifications relevant to their claims?

Check and check again

Be wary if you cannot independently verify someone’s academic qualifications. Similarly, be cautious of companies and organisations that claim to be legitimate but have a limited footprint on the web.

Usually companies and organisations have a clearly marked and detailed “about” section on their website and often also list their board of directors there. That is a good place to start. Who are the directors? Are they really on the board of the organisation or company? What are their qualifications and backgrounds and can those qualifications be verified independently?

If you struggle to find this information, tread carefully. It stands to reason that anyone looking to market a proven treatment would be embracing publicity, not shying away from it.

Often just having a look to see who else is talking about a claim can help you discern between fact and fiction. Important breakthroughs in medicine will be covered by major news agencies, websites, radio stations and television channels and published on reputable medical websites. If the treatment has not received recognition in these channels, it is unlikely that there is sound evidence that it works.

The devil is in the detail

Sometimes it is the smaller stuff that gives away a false health claim. Inconsistencies, half-truths and disclaimers are all hints that the product or its promoter might not be sincere. Is it clear what the ingredients of the treatment are, what its mechanisms of action are and how effective it is? Why for example would a product that does not claim to be medicine be packaged to look like a pharmaceutical product?

If it looks too good to be true, it usually is. The FDA warns that products sold as a panacea, capable of treating a range of ailments, are usually hoaxes. So too are quick fixes and products that offer a satisfaction guarantee.

Also be weary of unnecessary medical jargon, confusing flourishes and name-dropping. Take for example this CBD oil , the manufacturers of which claim to have “normalized extensive testing to confidently assert the potential of [their] products”.

They also want you to know that their oils are made in Swiss laboratories. These statements are designed to create the illusion of science in the absence of conclusive proof. In reality, the jury is still very much out on CBD, which has been called “ the new snake oil ” thanks to the frenzied enthusiasm with which hit has been embraced.

False claims are also often supported by anecdotal evidence and personal testimonies intended to make the ailment seem relatable and the treatment highly effective. But without scientific proof that a treatment works, these endorsements are about as reliable as office gossip.

Clinical trials and patient safety

To determine whether a treatment is safe and effective, it must undergo an extensive protocol of clinical testing where it is first deemed safe for human consumption and is then given to a large sample of people to determine whether it is effective. In order to obtain conclusive proof that the treatment works, it is compared to a placebo. This is known as a “controlled trial”.

Not all of this research is published, although there is growing support for this information to be made universally accessible. The abstracts of most published studies are available online and they should give you a good overview of the findings. Google Scholar will bring up results from most reputable academic journals. The Medline database also features a comprehensive collection of published research.

Whilst there are arguments that the clinical trial process is prohibitively expensive for less profitable treatments, trials are considered integral to ensuring patient safety.

If you were unable to find any published research to support a claim, approach the person or organisation marketing the product or service and ask what evidence they can provide for the effectiveness of their product.

Remember: If a treatment has not been tested on humans, it cannot be considered safe or effective. If the study was not controlled and the sample was not large enough, the findings cannot be considered conclusive. (Later phases of clinical testing involve thousands of participants).

Always try to speak to an expert

You might be told the product has been tested or is currently being tested, but without the results of these tests, the claim remains unproven. Wherever possible, also speak to a reputable expert in the relevant field to get their views on the issue and to help you make sense of complicated research.

Keep in mind that just because there is no conclusive proof that a treatment works, it does not necessarily mean it isn’t effective . It simply means it has not (yet) been subjected to rigorous testing. In that case, saying with certainty that a treatment does not work would be incorrect.

However, selling or otherwise promoting a treatment or cure without proof that it does work is deeply unethical and should be called into question. It usually also means not enough is known about the safety of a particular treatment. It is important that these concerns are raised and readers are made aware of the lack of evidence and the repercussions this may have for them.

First, do no harm…

Sometimes patients will still choose to take a treatment even if they know there is not yet conclusive proof that it works. Their decision may be influenced by cultural norms or a need for spiritual engagement. Traditional herbal practitioners are often consulted as counsellors and spiritual healers, not just for the treatment of physical ailments.

Others may be inherently sceptical of modern, allopathic medicine and choose to look for what they consider more natural treatment options. Often this is spurred on by the common misconception that because something is labelled “herbal” it cannot be harmful.

This belief is easily challenged by the fact that technically, nightshade, oleander and hemlock are all herbal, though definitely not safe for human consumption .

The public has a right to know

Interestingly, the placebo effect suggests that even if treatments are proven to have no effect at all, they may still have some positive impact on the people taking them simply because they believe it will make them feel better.

All these considerations make it extremely important that even if treatment is known to be ineffective, it is at least safe for human consumption. And if it is not, the public has a right to be told this in no uncertain terms.

In some cases those promoting a treatment will offer guidelines for safety. The Placenta Network, for instance, is clear about the precautions that need to be taken when new mothers decide to consume their placenta, a practice they say will assist in recovery after birth.

In other cases the safety of supposed treatment can be less clear and you may have to consult a medical doctor to get a better sense of the risks involved. Some herbal treatments can induce vomiting and thus interfere with the effectiveness of existing medication.

Follow the money

There is more scientific research to navigate now than ever. As a society, we have a growing faith in science and rising expectations that through it, we will lead long, pain-free, vital lives. Yet a large amount of scientific research is not undertaken in the pursuit of truth or even health, but rather in the hope for profit or success .

Here it helps to follow the money. Most credible academic journals require the authors to submit a declaration of interest in which they are expected to disclose any competing interests .

But sometimes false claims can be the result of misinterpreted or insufficient research that has been exaggerated or sensationalised to inform or entertain. We see examples of this where a certain food is singled out for its beneficial properties without sound evidence to back up the claim.

When it comes to health advice, always turn to trusted sites. You can quickly get a sense of how seriously a publication takes the health content it creates by reading about their contributors and reviewers, sources of funding and partners. Take the extensive panel of medical professionals who contribute and check the content on Healthline , for example.

Do not assume regulators keep up with quack cures

As consumers, we easily fall into the trap of thinking all treatments being sold in reputable pharmacies or on legitimate-looking websites have been tested and proven effective. But it would be a mistake to assume that the government or any regulating body can weed out all false claims or that the public is protected from quack cures because their sales are not legal.

In South Africa, the newly-launched South African Health Products Regulatory Authority is expected to strengthen protections for users. Its predecessor, the Medicines Control Council , was not always seen as being on the ball on this.

Whilst proven treatments are usually marketed directly to the medical community, quacks often go straight to the media or social media platforms and rely on the press and the public to advertise their products to the public. This makes it critically important that reporters take the time to interrogate health claims before publishing them.

We all have a role to play

But it cannot only be left up to the press to snuff out misinformation, especially those myths that are spread through personal messenger services.

In an age where everyone participates in creating and spreading the news, we all have to learn to embrace our inner skeptic. Regularly reading myth busting content on websites like Africa Check, or this: “ Behind the headlines ” series by the UK’s National Health Service, or the FDA’s Health Fraud Scams content can help you hone your ability to sift through the fake and the fraudulent.

It is not always possible, practical or fair to label a treatment as ineffective or to make out a salesman as a fraud. But unless there is conclusive evidence that they are effective and safe, health claims should always be presented as what they are: merely claims.

This report was written by Africa Check, a non-partisan fact-checking organisation. View the original piece on their website

Are men more susceptible to the 'placebo effect'?

Tue, 09 Apr 2019 00:00:00 GMT

It was not until the 1990s that researchers fully began to include both genders in health research. Sara Magelssen Vambheim has contributed with valuable new insights in her study of gender differences in pain experiences.

Sara Magelssen Vambheim recently submitted her PhD thesis on gender differences in experiences of pain, fear of pain and placebo at UiT the Arctic University of Norway.

The project was planned on the basis of findings related to placebo effects at the laboratory at the university.

Vambheim wanted to examine this closer. Were the mechanisms biological or psychological? Were there systematic differences? She began to experiment.

Test with heat pain

Young, healthy respondents between the age of 18 and 40 had their forearm connected to an instrument that inflicted heat pain on the participants.

“All test persons participated on the same conditions, where we examined underlying effects of placebo. The pain was measured through verbal reports and through response from the brain via thirty-two electrodes attached to the head. The data file registered a marker for when the pain was inflicted,” Vambheim explains.

The participants met in the laboratory on two different days; one day for the placebo condition and one day for the control condition.

A maximum of five days between the two experimental conditions was set as a criteria. Each time, pain was inflicted upon the participants in three tests.

On the day of the placebo condition, the participants were given capsules without active ingredients, which they swallowed with a glass of water.

They were told that the capsules would effectively reduce the pain.

“We then asked the participants to report the level of pain and stress according to a scale from zero to ten. The result showed that the placebo treatment reduced verbally reported pain and stress, and this also manifested itself in the brain response – but only among the men. There were no such responses among the women,” says Vambheim.

Fooled in different ways

This finding is in line with previous research. When Vambheim and her team reviewed the scientific literature on the topic, they also found gender differences in the nocebo effect: Women responded better to nocebo treatment than men did.

“The nocebo effect means that we see an increase in symptoms after we inform the test person that a substance will increase the pain. Thus it is easier to trigger nocebo effects in women than in men.”

“Many will probably ask: are men more easily fooled than women?”

“We don’t know about that, but our findings suggest that it is easier to trigger placebo effects in men, whereas it is easier to trigger nocebo effects in women. This means that it is easier to activate positive expectations in men than in women, with subsequent reduction of negative symptoms. With women, it was easier to activate negative expectations, with subsequent increase of negative symptoms.”

The researcher now wishes to find out how the placebo effect may be used in clinical contexts.

“In the future, we may be able to provide tailor-made treatments for women and men based on our knowledge of how men and women respond differently.”

“Few explore gender differences”

“If these studies confirm previous findings, what is new here?”

“What is new with these studies is that we measure pain both subjectively and objectively, we measure emotions and explore gender differences. We are the first to produce a summary of the knowledge that we have on gender differences in the placebo and nocebo effects based on the existent literature on the topic,” says Vambheim, and continues:

“Part of the problem with studies up until now is that many do not report on gender differences. Today there is a requirement in the USA to include both genders in research funded by the national health institute, but this requirement did not appear until the 1990s. Ten years later, we saw that many included both genders in their studies, but they wrote little about gender differences.”

According to Vambheim, exploring gender differences in health research should become routine, since we now know that there are major differences.

“It will improve the quality of health research and increase its utility value, but it will also have value for the integrity of the research.”

Anxiety and fear of pain

Sara Magelssen Vambheim conducts research on pain at UiT the Arctic University of Norway. She has found several gender differences in the placebo and nocebo effects. (Photo: UiT)

“We know that fear of pain is central when it comes to placebo and nocebo effects in pain. When the fear of pain is high, the placebo effect is low,” says Vambheim.

In another part of the study, she therefore examined gender differences in fear of pain. She distinguished between fear of low pain such as paper cuts, medical pain such as surgery and needles, and strong pain such as car accidents and broken necks. There were no gender differences in the fear of low pain, but women were more afraid of strong pains than men were.

“One possible explanation to this is that there is a difference between how men and women reflect upon various types of pain, and that this triggers different psychological reactions in women and men. We distinguish between fear and anxiety. Anxiety is strongly related to a lower pain threshold and limit of pain tolerance. Fear may either reduce or increase pain. We know that anxiety releases a substance in the brain that affects the limit of pain tolerance,” says Vambheim. She continues:

“It is important to ensure that the instruments used in the research measure what it is supposed to measure. If you want to measure the fear of pain, you need to ensure that you actually measure fear in both genders and that you do not measure anxiety in women and fear in men.”

Masculine ideal to hide pain

Gender roles affect how pain is reported. For instance, research shows that women report the same level of pain to both male and female test leaders, whereas men reported lower pain to female test leaders than to the male test leaders.

“The fact that men report differently to male and female experimentalists may complicate research on pain.”

An interesting finding from pain research is that gender differences occur around puberty and then increases with age. Before we reach puberty, there is no significant difference between girls’ and boys’ experience of pain.

“This raises some interesting research questions. One of these is to what extent expectations related to gender roles affect our experience of pain and how pain is expressed by girls and boys and women and men. Another interesting topic is the significance of biological differences such as hormonal divergences.”

“There are also gender differences when it comes to coping strategies. Women use social support, emotionally focused techniques, attention and reinterpretation when they experience pain, whereas men to a higher extent distract themselves away from the pain.”

Many patients with chronic pains regularly seek medical attention, lose income and receive ineffective treatments. Chronic pain illnesses may reduce the quality of life and lead to higher risk of psychiatric disorders such as depression and anxiety. We know for instance that twice as many women as men with chronic pain illnesses also suffer from depression.

Socio-cultural variations

“You write that the pain experience may vary significantly from person to person, but also from country to country. Is pain also a cultural phenomenon?”

“Globally, we have seen that women have a higher frequency of a number of chronic pain illnesses, and that they are more sensitive towards most types of induced pain compared to men. In one study, researchers have looked at the cultural variation between eastern and western test persons.”

The findings showed that the pain tolerance was higher and the acceptance for pain lower in eastern cultures.

As a group, men both in the east and in the west have a lower acceptance for other men expressing pain than for women doing the same thing.

Since it is more socially accepted that women express pain, researchers fear a bias in the pain reports – that men possibly underreport pain.

This may have significance for our understanding of the research findings, but also for the treatment of pain.

Placebo in practice

Whether or not the gender differences may be explained with different expectations and reliance in the medical practitioner will therefore be interesting to explore further.

“The most recent research investigates whether genetic differences may explain individual variations in the placebo effect. We wish to take the genetics research a step further by including gender differences. Our knowledge about the biological foundation for the placebo effect has come far. Now it is important to find out how the mechanisms behind this may be used in clinical practice in order to improve various forms of treatment.”

The research team at UiT has already begun this work, and has recently published an article about how doctors and nurses use placebo mechanisms in clinical practice.

“We have seen that they actively use mechanisms such as stress reduction, hope and positive expectations in order to improve the results of treatment, and that they find this useful. In the future, it will be important to find out how this may be used systematically and effectively,” Vambheim concludes.

Treating pain with Neuromodulation

Wed, 03 Apr 2019 00:00:00 GMT

In 1992, Richard Hanbury was in a Jeep accident that left him wheelchair-bound with such intense pain that he rarely slept. He was just 19-years-old. The doctors gave him five years to live.

He was put on strong prescription pain medications and morphine, but their effectiveness wore off and Hanbury’s pain, due to severe nerve damage, intensified.

It was a film, “Hudson Hawks,” that set Hanbury on a course to develop an alternative manner to treat his pain. The movie had a series of twists and turns and, as Hudbury watched, he realized the ups and downs were more effective at altering his pain levels than morphine. That’s when the idea of using visual stimuli to create a different state of consciousness dawned on him. Shortly afterwards, he founded Sana, a company whose goal is to utilize neuromodulation to relieve pain.

According to the Institute of Medicine of The National Academies, approximately 100 million Americans experience chronic pain. One of the most effective treatments is opioids. However, side effects and the risk of addiction make opioids a less-than-attractive option for many. Another viable treatment plan is prescription medication. Unfortunately, medicines often become less effective as the body gets used to them – and have negative side effects.

Hadbury’s Sana uses an entirely different approach to relieve pain. Users wear a mask – which covers the upper half (eye area) of the face – for 15 minutes before bed and for 15 minute intervals throughout the day, depending on their specific pain level. The mask measures minute changes between each heartbeat and administers precisely-timed pulses of light and sound to stimulate the audio and visual cortex of the user’s brain. The result? Users enter a more relaxed state with significantly less pain.

Sana is not the first neuromodulation device developed to help those suffering from pain. Cefaly developed a nerve stimulation device (approved by the FDA in 2017) to reduce migraine pain and Bioness created SlimRouter (approved by the FDA in 2015) to reduce pain of peripheral nerve origin by delivering gentle electrical stimulation.

But Sana treats chronic pain across the board. Close to 130 Americans are dying every single day from opioids, according to data from the Centers of Disease Control and Prevention, in what has become a full-blown epidemic. So if Sana can provide a viable alternative to opioids for chronic pain sufferers, perhaps a dent – albeit a small one – can be made in the opioid crisis.

Will Sana’s pain relieving mask become a mainstay in the healthcare industry or a passing phenomenon? Only time will tell. When people purchase expensive healthcare products, they have a tendency to believe they work, even if they have no healing properties, simply to justify the cost of the products or the energy spent on acquiring them.

Scientists have no way of knowing how this placebo effect will influence the viability of Sana’s pain relieving mask just yet. In addition, the length of time Sana’s mask is able to keep away pain and side effects is unclear. Thus, the jury is still out on this device. Regardless, though, chronic pain sufferers have reason to feel hopeful.

The Sana mask is currently in clinical trial. The company is seeking to classify the mask as a medical device and Hadbury hopes to get FDA approval by October of this year.

What Exactly Is A Jade Egg And Do They Have Any Legit Benefits?

Tue, 02 Apr 2019 00:00:00 GMT

Placebo World's comment on following article

Let's settle this once and for all

Perhaps no sexual-wellness "aid" has created as much of a stir as the jade egg. Last year, Gwyneth Paltrow's wellness brand, Goop, had to pay $145,000 in fines for selling the eggs on their website with unsubstantiated health claims, per CNN , and yet, they're still being talked about—and sold. Just, ya know, with very vague (or zero) descriptions.

So what exactly is a jade egg, anyway?

A jade egg, a.k.a. yoni egg, is an egg-shaped weight (typically made out of a stone like jade or rose quartz) that you insert and hold inside your vagina. Similar to a Kegel or Ben Wa ball (does anyone remember Fifty Shades Darker ?), the egg has been said to strengthen the pelvic floor, by requiring the muscles there to clench to keep it in place. The problem is—and this is a major problem—they can do more harm than good.

"There are no proven benefits of using a jade egg, but there are several risks," says Women's Health advisor Kate White, MD , an ob-gyn and director of the Fellowship in Family Planning at Boston University.

Number one: Because they're made of stone, "the eggs are porous and can absorb bacteria, which means it's not possible to fully clean them in between each use," says Dr. White. "So when you insert the egg into your vagina after the first use, you're literally putting bacteria back into your body." That's like asking for an infection.

What's more, because the egg has a glass-like, slippery texture, it can be rather hard to remove, says Dr. White. While some eggs have a string attached to them, extraction could require a visit to your gyno's office or even the emergency room. Um, no thank you.

Are there any possible benefits to using a jade egg?

When Goop first advertised the jade egg, which really kicked off the hype, it purported that the egg supports hormonal balance, menstrual regulation, and bladder control, none of which had any scientific research behind it, according to Forbes .

And while it's possible that a jade egg could help strengthen your pelvic floor muscles, there's no reason, given its risks, to choose one over the tried-and-true, all-natural (not to mention, free) method: Kegel exercises. Kegels involve simply squeezing your down-there muscles as if you're holding in your pee, and experts say they work.

There's one other potential perk of a jade egg: increased sexual desire. Once again, there's no proof of this, but "it's possible that you would feel a bump in your libido from the placebo effect, which is powerful," says Dr. White. (As in, just thinking you're doing something to boost your drive could boost your drive.) That said, it still isn't worth the risk.

In terms of lubrication—another supposed benefit of a jade egg—"the body produces more discharge in the presence of a foreign body inside your vagina, so it's theoretically possible that it would increase," Dr. White explains. "But there are other ways to increase your lubrication without risk...like, you know, with lube."

The bottom line: Save your money (a jade egg will put you out $66), and focus on doing Kegels instead.

First, do no harm

Thu, 28 Mar 2019 00:00:00 GMT

Researchers are discovering more about the power of placebos, but it’s alternative health providers who have fully incorporated them in their business model. Does evidence-based medicine need to pay more attention to contextual effects?

A leading science journal reported in 2007 the case of a young man with plummeting blood pressure who was admitted to hospital shaking and sweating. He said that after an argument with his girlfriend he had taken 29 antidepressant pills, which he had been given as a participant in clinical trial of a new drug. Even after six litres of saline drip, his condition was worrying. Then it was discovered the pills contained no active ingredients: he had taken an overdose of placebos. In less than 15 minutes he had recovered and his blood pressure was back to normal.

Not all contextual effects in medicine are this spectacular, but they are part of many recoveries: 25% of men with erectile dysfunction reported significant improvement after taking an inactive substance they believed to be Viagra. In some cases of arthrosis of the knee, traditional surgery and ‘placebo surgery’ both reduce pain to a comparable degree. The quality of life of some patients with Parkinson’s disease has been improved by faking stem cell implantation. Even babies are receptive to placebos, as are most domestic and farm animals.

But the context in which a treatment is administered can have negative consequences: the young man who took the antidepressants had suffered a ‘nocebo effect’. In 1983 the British Stomach Cancer Group told 411 prospective recipients of a new chemotherapy treatment that nausea and hair loss were possible side effects. Over 30% suffered hair loss and 56% reported vomiting before the treatment began. All they had had was a placebo.