homeopathy, the placebo effect, and mainstream medicine.

[George]

A stand-up comic is doing a show called "Laughter Is The Best Placebo" locally.

At first I thought this showed great insight, but reading the rest of the advertisement suggests that the show is all about his angst and relationship difficulties.

Assuming he can generate laughter, are there laughter categories that have no placebo effects?

[profloater]

Semi-seriously, I expect being laughed at, humiliated, is a powerful nocebo while laughing with peers at a goggle box is a placebo. After all just living near a gym makes you fitter even if you never visit it!

[wd40]

Alchemy, quantum physics, relativity, AC, antibiotics, vaccines etc were initially viewed as being counterintuitive and wrong, but led to greater things. Maybe research in to homeopathy's principle of "Less Is More" will too

"Prince Charles and homeopathy: crank or revolutionary?"
http://www.telegraph.co.uk/news/ukne...lutionary.html

"India and Israel to boost research in homoeopathy"
https://www.homeobook.com/india-and-...n-homoeopathy/

[grant hutchison]

"Prince Charles and homeopathy: crank or revolutionary?"
http://www.telegraph.co.uk/news/ukne...lutionary.html

Crank.

"India and Israel to boost research in homoeopathy"
https://www.homeobook.com/india-and-...n-homoeopathy/

And who knows what that's about?

Grant Hutchison

[Gillianren]

Homeopathy has had a long time to prove its efficacy. It hasn't.

[profloater]

Homeopathy has had a long time to prove its efficacy. It hasn't.

that's not true. It can be very effective as discussed, what has never been demonstrated is any pharmacological effect or any active chemical in the extreme dilution. It's placebo! But it's an effective placebo.

[grant hutchison]

that's not true. It can be very effective as discussed, what has never been demonstrated is any pharmacological effect or any active chemical in the extreme dilution. It's placebo! But it's an effective placebo.

Technical usage of the word efficacy:

Efficacy refers to whether a drug demonstrates a health benefit over a placebo or other intervention when tested in an ideal situation, such as a tightly controlled clinical trial.

How FDA Approves Drugs and Regulates Their Safety and Effectiveness (400KB pdf)

Grant Hutchison

[profloater]

Technical usage of the word efficacy:
Grant Hutchison

here a study compared homeopathy with placebo
http://www.bmj.com/content/321/7259/471
the homeopathy group did better!
thank you for the clarification on efficacy.

[grant hutchison]

here a study compared homeopathy with placebo
http://www.bmj.com/content/321/7259/471
the homeopathy group did better!
thank you for the clarification on efficacy.

Ah, a famous poster child paper for homeopathy fans. You'll find several out there.
Trouble is, when you put all studies together into a systematic review of the evidence, focusing on well-designed studies with low risk of bias, the apparent superiority over placebo disappears. Efficacy is zero.

Grant Hutchison

[profloater]

Ah, a famous poster child paper for homeopathy fans. You'll find several out there.
Trouble is, when you put all studies together into a systematic review of the evidence, focusing on well-designed studies with low risk of bias, the apparent superiority over placebo disappears. Efficacy is zero.

Grant Hutchison

But we still agree it's a classic placebo? loads of ritual and caring time and the practitioners are believers, so it's easy to believe and presto patients get better.

[grant hutchison]

But we still agree it's a classic placebo? loads of ritual and caring time and the practitioners are believers, so it's easy to believe and presto patients get better.

It's a strong placebo. As such it will probably work better than a weak placebo, which is one of the problems with trial design for homeopathy vs. placebo which can result in an advantage to homeopathy.
If you put one limb of the trial through a homeopathy consultation, and give the other limb placebo without ceremony, then of course you may see homeopathy working better. But that would fail the FDAs stipulation that efficacy must be shown relative to placebo in a "tightly controlled clinical trial".

Grant Hutchison

[wd40]

Even though a homeopathic substance contains not one molecule of active ingredient, they are
now all illegal in the USA?

[grant hutchison]

Even though a homeopathic substance contains not one molecule of active ingredient, they are
now all illegal in the USA?

It's the absence of active ingredients that has prompted the FDA's "risk-based enforcement approach", to a large extent.

Grant Hutchison

[Swift]

Even though a homeopathic substance contains not one molecule of active ingredient, they are
now all illegal in the USA?

That article appears to be exaggerating what the FDA is actually doing (it seems a biased site from a group with a pro-homeopathic agenda).

From the Washington Post

The Food and Drug Administration on Monday proposed a tougher enforcement policy toward homeopathic drugs, saying it would target products posing the greatest safety risks, including those containing potentially harmful ingredients or being marketed for cancer, heart disease and opioid and alcohol addictions.

Homeopathy is based on an 18th-century idea that substances that cause disease symptoms can, in very small doses, cure the same symptoms. Modern medicine, backed up by numerous studies, has disproved the central tenets of homeopathy and shown that the products are worthless at best and harmful at worst.

Under U.S. law, homeopathic drugs are required to meet the same approval rules as other drugs. But under a policy adopted in 1988, the agency has used “enforcement discretion” to allow the items to be manufactured and distributed without FDA approval. Agency officials don't plan to begin requiring that homeopathic products get approval — officials say that would be impractical — but they are signaling stepped-up scrutiny for items deemed a possible health threat.

Examples of high-risk products include ones that are administered by injection, are intended for vulnerable populations like children or the elderly, or are marketed for serious diseases, the agency said.

The FDA's proposed approach, outlined in a draft guidance that will be open for public for 90 days, comes more than a year after homeopathic teething tablets and gels containing belladonna were linked to 400 injuries and the deaths of 10 children. An FDA lab analysis later confirmed that some of the products “contained elevated and inconsistent levels of belladonna,” a toxic substance, the agency said.

So it is a draft proposal, now open for public comment.

And even if they were going to make homeopathic substances without a single molecule of active ingredient illegal, I would support that. It should be illegal to sell water as something that can treat a disease or medical problem, unless that medical problem is dehydration. The FDA not only regulates drugs that will harm you, but those that are a sham.

[grant hutchison]

It is, after all, illegal to sell oxygen tanks that contain not one molecule of oxygen.

Grant Hutchison

[profloater]

the sad part is that while anyone can see the logic of having no active ingredients the debate demotes the power of the placebo response. It should be renamed or re-explained at least because it is a major body brain phenomenon using both the unconscious and conscious models inside the brain and stimulating powerful natural defences which mysteriously get wound down (nocebo). A homeopath may be a western witch doctor playing entirely on the belief system but that is a big thing. We should not call it bad but just redefine it, plenty of other belief systems remain legal. Most do not offer the placebo effect nearly so well as homeopathy.

[Swift]

the sad part is that while anyone can see the logic of having no active ingredients the debate demotes the power of the placebo response. It should be renamed or re-explained at least because it is a major body brain phenomenon using both the unconscious and conscious models inside the brain and stimulating powerful natural defences which mysteriously get wound down (nocebo). A homeopath may be a western witch doctor playing entirely on the belief system but that is a big thing. We should not call it bad but just redefine it, plenty of other belief systems remain legal. Most do not offer the placebo effect nearly so well as homeopathy.

I have a serious moral problem with selling a homeopathic treatment to treat a medical condition, when the only possible way that the treatment would have any possible positive effect would be the placebo effect. The seem indistinguishable from a scam. And I say this even if the placebo effect is shown to have a possible positive effect in the condition under consideration.

[grant hutchison]

I have a serious moral problem with selling a homeopathic treatment to treat a medical condition, when the only possible way that the treatment would have any possible positive effect would be the placebo effect. The seem indistinguishable from a scam. And I say this even if the placebo effect is shown to have a possible positive effect in the condition under consideration.

Ben Goldacre once made the point that we shouldn't leave the placebo effect in the hands of a group of people who denigrate mainstream medicine - they're not just using the placebo effect in their patients, but generating a nocebo effect for drugs with proven pharmacological action.

Grant Hutchison

[Ken G]

Most do not offer the placebo effect nearly so well as homeopathy.

I'm afraid I see the old-fashioned greed motive whenever I see bottled water expensively sold as a "homeopathic remedy." I don't see an effective placebo there, just somebody trying to make a buck by fooling a sucker. That's a lot different from a person who hangs a shingle and takes in clients and asks about their lives and their symptoms and speaks to them supportively and convincingly and recommends some placebo remedy. The bottled water folks are just taking advantage of the dedicated placebo practitioners, and the latter are perhaps a bit too naive to realize they are being cashed in on.

[profloater]

I can agree with all those comments. The placebo effect has been demonstrated both in studies and anecdote enough to be taken seriously as an important healing procedure. Yet we still say it's just a placebo and shrug when sugar pills stimulate the immune response. Or breathing exercises, or laying on hands or whatever. I used to think it was out of control how those beliefs formed and out of control to change them but now I begin to believe that a person might take control of her own beliefs sufficient to stimulate the placebo effect without a white coat, pill or procedure. I take heart from just one trivial example. If you force yourself to smile, adopt an upright posture and deliberately think positively, you can change blood chemistry. Of course there's an irony there because some body said that and reported the trials but nevertheless the way is open to train people to obtain a placebo effect without taking a physical placebo, but by a kind of self discipline. The charlatans can still cash in and the book writers sell books, but the individual can take some control.

[Ken G]

Yes, the essential definition of a charlatan is someone who sells at significant cost things that can be obtained for free.

[CJSF]

So, I basically have to decide/figure out if the placebo effect will be strong enough (or effective or whatever) to work on my headaches if I get daith piercings, even knowing it's placebo. Great.

CJSF

[wd40]

If Parliament outlawed homeopathy, would the Queen be exempt?
http://www.telegraph.co.uk/news/heal...hy-on-NHS.html

My favourite homeopathic remedy? Hydrophobinum (rabid dog's saliva) in 5M potency, for treating those with omnicidal tendencies.

[Ken G]

My favorite is oscillococcinum, https://en.wikipedia.org/wiki/Oscillococcinum. You can't make that one up.

[grant hutchison]

If Parliament outlawed homeopathy, would the Queen be exempt?

The Queen (but no other member of the Royal Family) is immune from prosecution, simply because there's no mechanism by which a case of the form Regina vs. Regina could be brought to court. She does, however, "self police" by leading her life in accordance with the laws that are made in her name.
The Plantagenets found out what happens when the British monarch starts ignoring British laws.

Grant Hutchison

[Gillianren]

The Stewarts, possibly?

[grant hutchison]

The Stewarts, possibly?

The Stuarts, too.
But it was the Plantagenets who first learned that English kings had to operate within the law and with the consent of the governed, or risk the consequences.

Grant Hutchison

[Solfe]

I love this place. We did science, history, medicine, and preparations of duck poop all in one place.


What I have learned is that homeopathy is one big thing. Prior to this, I didn't know what it was and was not. I had no idea that it had a key figure and an actual (loopy) process besides deception.

So, I basically have to decide/figure out if the placebo effect will be strong enough (or effective or whatever) to work on my headaches if I get daith piercings, even knowing it's placebo. Great.

CJSF

My wife does flotation for her back and headaches at a spa. To my knowledge, the salt water may make your skin soft and is different experience than a bathtub, but that is all. I selected this option because she dislikes massage and other forms of spa treatments and I know getting her nails done is somewhat old hat. However, she does not have back problems like she did. It is probably a little placebo, a little less stress and cleaner living that fixed her back and headaches. She also goes to the gym now, which is definitely better for your health than lying around waiting for pain to come or go.

I had to google daith piercings, so I don't want to say to "do this or that", but many people find personal care to be relaxing. Relaxing, self indulgent, personal care can't hurt much. Most spas and some gyms like to create that feeling in people. Maybe by research you will find something to help.

[profloater]

I love this place. We did science, history, medicine, and preparations of duck poop all in one place.


What I have learned is that homeopathy is one big thing. Prior to this, I didn't know what it was and was not. I had no idea that it had a key figure and an actual (loopy) process besides deception.



My wife does flotation for her back and headaches at a spa. To my knowledge, the salt water may make your skin soft and is different experience than a bathtub, but that is all. I selected this option because she dislikes massage and other forms of spa treatments and I know getting her nails done is somewhat old hat. However, she does not have back problems like she did. It is probably a little placebo, a little less stress and cleaner living that fixed her back and headaches. She also goes to the gym now, which is definitely better for your health than lying around waiting for pain to come or go.

I had to google daith piercings, so I don't want to say to "do this or that", but many people find personal care to be relaxing. Relaxing, self indulgent, personal care can't hurt much. Most spas and some gyms like to create that feeling in people. Maybe by research you will find something to help.

I happen to know research will be published soon showing Floatation is more than placebo and greatly helps with anxiety. There is loads published on Floatation and pain, among other things, fMRI confirmation.

[Copernicus]

My favorite is oscillococcinum, https://en.wikipedia.org/wiki/Oscillococcinum. You can't make that one up.

Funny thing is how does one dilute to 1 part per 10^400.