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Author Topic: It's Not A Placebo If you Don't Think It Is.  (Read 366 times)
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ATB
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« on: June 24, 2013, 04:50:10 PM »

I'm about 10 weeks into my latest fitness comeback and whenever I get serious about exercising I start taking Glucosamine and Chondroitin.

I first started taking it several years ago due to nagging knee pain from running- sometimes being sidelined for days or weeks while I waited for it to heal.  I usually quit taking it immediately once I give up and return to a life of gluttony.

That said, in all of the times I've trained since beginning (and resuming the pills each time) I have never had any significant pain in my knees.  I naturally contribute this to the supplements I take.

My doctor, however, says it's malarkey as there's no scientific evidence supporting it and the bottle clearly says the FDA has not evaluated these claims.  So is this similar to the Bear Patrol Rock on the Simpsons?  Are my knees doing better just because I believe they are?


In addition:

I get sinus infections 2x per year. Usually 1x per year it goes into my chest and lays me out for several days.  This past winter a friend recommended Oil of Oregano.  As I was progressing into destruction, I started taking it and for the first time, literally, in my adult life, the infection was halted in its tracks and I recovered (it took several several days) but no bronchitis.  Oregano does have antibiotic properties, but, again, a quick search on the web dismisses it's capabilities as junk science/voodoo.
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SkyLander
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« Reply #1 on: June 24, 2013, 05:21:54 PM »

My wife and I go back and forth on a lot of "Home Remedies" basically herbal supplements or different vinegar/oils and things that are supposed to help with all sorts of things. So I would say some things works a bit better than a placebo and other things don't do anything at all. When it comes to health type things I've approached things from the perspective of "it might do something, but it was never designed for the specific purpose" Basically the herb might have the effect that you are looking for and it should be fine if you want to do it day to day but if you have a serious condition an herb won't have the punch that you might need. Although according to the internets Apple Cider Vinegar cures the world of everything.
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Harkonis
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« Reply #2 on: June 24, 2013, 05:45:24 PM »

It's entirely possible it's a little of each.

I do believe that the mind is a very powerful thing though.  Pain is something that the mind has an amazing amount of control over.
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PeteRock
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« Reply #3 on: June 24, 2013, 08:37:00 PM »

First, the term "placebo" does not refer to an element's level of effectiveness, but its application.  A placebo does not have to work in order to be considered a placebo.  The placebo effect is probably what you are referring to, in that some placebos can result in a subjective effect whereas others result in no change in condition.  Placebo has taken on a similar meaning to placebo effect in terms of general societal use of the term, but in actuality is a known ineffectual form of treatment utilized in order to maintain a control group in treatment studies without said group being aware it is acting as a form of control.  Primarily due to what Harkonis mentioned, in that the human mind can have quite the influence on perceived impact.  A patient can often subjectively feel better despite taking an ineffective remedy due to the power of the mind to subjectively perceive improvement when objective improvement may be completely nonexistent. 

In the case of over-the-counter forms of osteoarthritis treatment, current research indicates that it is entirely ineffective.  The only effective remedy for osteoarthritis (inflammation due to joint strain resulting from over-use) is to address the inflammation through the use of an anti-inflammatory such as ibuprofen, naproxen, etc. 

In ATB's specific case, when overweight and unaccustomed to regular exercise and strain on one's joints, osteoarthritis and general joint pain are an inevitability due to lack of use.  Joints much first acclimate to added strain before discomfort can subside.  This, as ATB has experienced first-hand, can result in an ongoing cycle.  Exercise, discomfort, ceasing of exercise, hiatus, return to exercise, return of discomfort, ceasing of exercise, repeat ad nauseum.

The ideal treatment of joint discomfort, which is due to inflammation, is to treat with OTC anti-inflammatories (like those already mentioned).  In more severe cases, higher doses, such as 800mg ibuprofen, may be necessary, but in most cases general OTC anti-inflammatories will treat the actual source of inflammation and pain whereas OTC remedies such as glucosamine, chondroitin, etc, have no therapeutic effect despite subjective experiences by those more susceptible to psychological influence.

I'd be more than happy to field more questions if my response hasn't addressed all inquiries, and if you doubt my claims on ineffective osteoarthritis treatment, there are numerous peer-reviewed journal entries readily accessible online or through academic research search engines (to which I have access).
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wonderpug
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« Reply #4 on: June 24, 2013, 09:46:28 PM »

I think it's bad medicine for your doctor to tell you he thinks the treatment you're using is bunk. Unless you're actively doing harm to yourself or using the alternative medicine in lieu of the treatment the doc thinks you need, the doctor should at least give you a "I see no issues with you continuing this treatment if it's working for you."

I'm also of the mindset that while some alternative medicines probably are completely useless medicinally, I think plenty others will end up being scientifically confirmed at some point in the future, despite being scientifically unconfirmed today.

That still doesn't mean I'm going to eat that ox eyeball a Vietnamese dormmate gave me for a headache way back when.
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Ironrod
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« Reply #5 on: June 24, 2013, 10:26:37 PM »

Quote from: PeteRock on June 24, 2013, 08:37:00 PM

Primarily due to what Harkonis mentioned, in that the human mind can have quite the influence on perceived impact.  A patient can often subjectively feel better despite taking an ineffective remedy due to the power of the mind to subjectively perceive improvement when objective improvement may be completely nonexistent. 

That pretty much sums it up. The placebo effect can give you real relief even if the substance you're using has nothing to do with it. As long as it's not harmful or ridiculously expensive it's all good.
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Misguided
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« Reply #6 on: June 24, 2013, 11:11:55 PM »

I tried taking a couple of different glucosamine/chondroitin supplements recently, because of chondromalacia in my right knee, even though it didn't really make sense to me medically. They ripped my intestines to shreds. Badly. It turned out that I had underlying IBD, but the supplement precipitated a nasty episode, which I hadn't had up until that point. I don't think I'll be trying it again.

That said, I think there are a lot of things that "modern" western medicine doesn't understand that herbalists and various practitioners in other societies have known for thousands of years.
« Last Edit: June 24, 2013, 11:13:36 PM by Misguided » Logged

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ATB
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« Reply #7 on: June 24, 2013, 11:16:27 PM »

I would like to add a disclaimer:

I've never been obese, but have been over weight. And most of the knee injuries have been WELL into training so weight was not a factor.  slywink

Also, I usually quit, not because of pain, but because I get sick of dealing with exercise.

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PeteRock
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« Reply #8 on: June 24, 2013, 11:22:45 PM »

Quote from: wonderpug on June 24, 2013, 09:46:28 PM

I think it's bad medicine for your doctor to tell you he thinks the treatment you're using is bunk. Unless you're actively doing harm to yourself or using the alternative medicine in lieu of the treatment the doc thinks you need, the doctor should at least give you a "I see no issues with you continuing this treatment if it's working for you."

The doctor's statement is true in that there is little to no scientific evidence supporting the effectiveness of OTC joint supplements.  It is also true that the FDA has not evaluated claims on joint supplement labeling.  Finally, it is good medicine to inform patients about what they are taking, whether it is actually effective, and if it poses any risks.  Joint supplements, for example, do in fact pose a risk to patients also on a blood anticoagulant such as warfarin.  But, I would agree that it is in fact bad medicine simply to dismiss OTC supplements as "malarky" without any support for the claim.  But, in ATB's family physician's case, there is support for his claim.  

My only real disagreement is to continue a treatment if it is subjectively working rather than providing any actual therapeutic benefit.  But that stems more from a professional philosophy that patients should only utilize chemical supplements and medications when necessary.  In part because with added chemical variables come additional potential adverse reactions, and also in part because medication application has become an alternative to healthier living practices.  As an example, patients suffering from metabolic syndrome (hyperlipidemia, hypertension, and type II diabetes) often rely on medication to manage their poor quality of life rather than adjusting lifestyle to eliminate any need for such medications.  

Finally, it is simply cheaper to eliminate a supplement with no therapeutic effect rather than continuing use for psychological peace.  Some laud ginko biloba as a fantastic memory supplement.  But in actuality it provides no intellectual therapeutic effect.  Is it better to remain ignorant and think that one feels smarter, or actually to be smarter and identify supplements providing zero physical benefit?

Quote
I'm also of the mindset that while some alternative medicines probably are completely useless medicinally, I think plenty others will end up being scientifically confirmed at some point in the future, despite being scientifically unconfirmed today.

This is entirely possible.  Drug testing is a ridiculously complex and lengthy endeavor.  If joint supplements are eventually found to provide a worthwhile therapeutic effect, medicine will obviously adapt accordingly.  Adverse effects are discovered in a similar manner, with time.  Just as some medications and supplements are eventually discovered t provide therapeutic effect, existing medications with a therapeutic effect are often discovered to pose more risk than reward.

Quote
That still doesn't mean I'm going to eat that ox eyeball a Vietnamese dormmate gave me for a headache way back when.

Would peer-reviewed journal support as well as FDA approval change your perspective?   icon_wink
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wonderpug
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« Reply #9 on: June 25, 2013, 12:37:40 AM »

Quote from: PeteRock on June 24, 2013, 11:22:45 PM

Finally, it is simply cheaper to eliminate a supplement with no therapeutic effect rather than continuing use for psychological peace.  Some laud ginko biloba as a fantastic memory supplement.  But in actuality it provides no intellectual therapeutic effect.  Is it better to remain ignorant and think that one feels smarter, or actually to be smarter and identify supplements providing zero physical benefit?

If someone has been a believer in ginkgo biloba and you manage to convince them that it's useless, do you truly think their behavior after quitting the juice will be unaffected?  I dunno.  I think more often than not, instead of the person getting a "the power was in me all along!" lesson, they'll think "oh, now I have no longer have a way to get that extra edge" and be less confident or happy or something.

I don't believe all the magical things magnets can do to your body, but I sat next to a nervous flyer on a flight earlier this year and she had some sort of magnet bracelet that she said helped her stay calm on the flight.  If I convinced her that no, the magnet was not helping her in any way, would she have a more comfortable flight than if I just kept my mouth shut?  And hey, maybe I'm wrong and it'll turn out in a study in 10-20 years that the magnets were providing some benefit we didn't yet realize.

Epilogue:
Spoiler for Hiden:
My plane crashed into the Pacific Ocean after my neighbor's magnet health bracelet irrevocably ruined the pilot's navigation systems.  But the gal next to me stayed calm the entire way down!
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morlac
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« Reply #10 on: June 25, 2013, 01:04:53 AM »

I call Bunk.  I've tried smoking oregano like six times and still haven't gotten high.
« Last Edit: June 25, 2013, 01:08:10 AM by morlac » Logged

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PeteRock
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« Reply #11 on: June 25, 2013, 01:31:47 AM »

Quote from: wonderpug on June 25, 2013, 12:37:40 AM

Quote from: PeteRock on June 24, 2013, 11:22:45 PM

Finally, it is simply cheaper to eliminate a supplement with no therapeutic effect rather than continuing use for psychological peace.  Some laud ginko biloba as a fantastic memory supplement.  But in actuality it provides no intellectual therapeutic effect.  Is it better to remain ignorant and think that one feels smarter, or actually to be smarter and identify supplements providing zero physical benefit?

If someone has been a believer in ginkgo biloba and you manage to convince them that it's useless, do you truly think their behavior after quitting the juice will be unaffected?  I dunno.  I think more often than not, instead of the person getting a "the power was in me all along!" lesson, they'll think "oh, now I have no longer have a way to get that extra edge" and be less confident or happy or something.

The key is, there was no "edge."  But we've now gone beyond medicinal treatment with a therapeutic effect and started to delve into psychological well-being.  Would you rather your health care provider be honest or instead allow for psychological dishonesty because, hey, it works?  Would you be just as supportive of non-therapeutic "supplements" if the same concept applied to prescription treatments?  For sake of argument, let's say a patient cannot be treated for a specific ailment, but is lead to believe that a placebo would improve the problem.  And so that patient is treated with a form of placebo, such as a sugar pill, and their condition improves, or at least their perceived status of condition improves.  Is this any more or less dishonest than allowing patients to believe supplements with no therapeutic effect are making them "healthier"? 

Quote
I don't believe all the magical things magnets can do to your body, but I sat next to a nervous flyer on a flight earlier this year and she had some sort of magnet bracelet that she said helped her stay calm on the flight.  If I convinced her that no, the magnet was not helping her in any way, would she have a more comfortable flight than if I just kept my mouth shut?  And hey, maybe I'm wrong and it'll turn out in a study in 10-20 years that the magnets were providing some benefit we didn't yet realize.

It is not necessarily your place to correct said passenger.  However, these magnets are typically fairly costly.  If current research demonstrates that they provide absolutely zero health benefit, is it not a patient's health care provider's responsibility to honestly explain the situation? 

Quote
Epilogue:
Spoiler for Hiden:
My plane crashed into the Pacific Ocean after my neighbor's magnet health bracelet irrevocably ruined the pilot's navigation systems.  But the gal next to me stayed calm the entire way down!

 icon_lol
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Turtle
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« Reply #12 on: June 27, 2013, 02:53:01 AM »

I think it's bad medicine to take, or have someone tell you to take something that is either unproven, or has been shown to do nothing in properly blinded trials.

I'd rather someone pay the same money for proper treatment for her phobia so she can fly forever without paying for "magic charms," which is what those magnet bracelets are. I'd rather she learn to focus manually and willfully, even if she has to use say, a cheap rubber band with no magnets as her focus item to concentrate on. It's a better option than relying on fake magic charms.

Think about it this way, we have MRI machines that produce magnetic fields so strong that it will pull large metal objects from across the room to slam into these machines and embed themselves in the framework. Just google MRI accidents. They put people in those machines, turn them on, and the people inside feel nothing as their insides are imaged. If an MRI machine does nothing, do you think that a tiny magnet honestly will do something?
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