Should we all be taking placebo pills?
My brief stint rowing for Canada in the 1990s was great. When things went well, I ended up standing on the podium for national or international championship medals. Then sometimes a less fun thing would happen: some of us were escorted off the podium to test for drugs.
I liked the idea of drug testing because I did not want to race against cheats. But being taken away from the podium put a damper on things, and the test was embarrassing, because it involved someone watching you pee in a bottle.
The testing also made you paranoid when you got ill and had to take medicine, because some athletes said that taking a routine medication made them test positive for banned drugs. So, when I developed an allergy to cats, I was worried at the prospect of having to take medication. Yet I had to do something, because my nose was running, I was sneezing, and I couldn’t sleep well. This made it impossible to train properly, so my performance began to suffer.
I visited the allergy doctor, who prescribed a nasal spray. I looked carefully at its ingredients, and stopped at the word "corticosteroid". Were corticosteroids the same thing as steroids that are banned substances, I wondered? I decided not to use the spray until I found out.
I wrote to Sports Canada to ask whether the nasal spray was banned. However, weeks went by and I still had not received a reply. As a last resort, I accepted my mother’s suggestion to meet her friend who was an herbal doctor. I was sceptical, but I had nothing to lose, so I visited her.
She took an interest in my allergies as well as other things going on in my life. We talked about my symptoms, the stress of being ill, and the competitiveness of top-level rowing. After an hour, I felt very calm and she gave me her prescription. She told me to keep my head and neck warm, and to drink ginger tea twice per day.
I didn’t believe her treatment would work, but figured wearing a scarf and hat was a good thing during winter in Canada, and ginger tea wouldn’t kill me. I gave it a try. After three days, I was almost completely better and could sleep and train properly again.
"When I developed an allergy to cats, I was worried at the prospect of having to take medication"
This got my inherently inquisitive mind racing. (I was that annoying kid who asks their teachers and parents "Why?" all the time.) Did ginger tea work because I believed it might—in other words, had it acted as a placebo? If it was "just" a placebo, did that matter if it helped? Had the calming effect of the herbal doctor taking time to listen to me made the difference?
Searching for answers to these questions ignited a fascination that has shaped my life ever since.
I have now done ten years of research in this area, and I have stuck firmly to conventional scientific studies (mostly "systematic reviews of randomised trials", which I describe in a fun way in the book). I’ve found answers to many of my questions:
- Placebos can be (almost) as good as drugs for moderate pain, anxiety, and depression.
- Doctors who give positive messages to patients can reduce pain by as much as most over-the-counter drugs.
- Empathic doctors can reduce the effects of many common symptoms.
- Placebos can work even if doctors tell patients they are placebos.
- Most UK doctors have prescribed a placebo at least once in their career.
- Spending quality time with friends, family, and social groups can add up to five years to your life.
Unfortunately, the science backing up these claims has generally been restricted to academic journals that are written in a way that few read and fewer understand. I’ve always been inspired by teaching and coaching, so naturally I wanted to share what I learned.
What I want readers to take away from reading Doctor You
Beyond being entertained and informed, I hope readers become the protagonists of Doctor You and experience the health benefits for themselves. Although it contains exercises, Doctor You is not a standard self-help book. Realising how amazing their bodies are, and that they can do things to improve their health and happiness can encourage a new way of thinking.
The results of reading the book will be different for everyone, but here are a few examples. If you knew that your body produced its own morphine, would you take as much aspirin—which can make your stomach bleed—for mild headaches? If you knew getting together with a friend had the same biological effect on depression as a pill, would you be less likely to try Prozac—which can have side effects ranging from sexual dysfunction to suicidal tendencies? If you knew that placebo knee surgery was as good as the real thing, would you choose the surgeon’s knife before trying physiotherapy?
5 ways to make the power of placebo work for you
- Give yourself positive suggestions and avoid negative thoughts. Negative thoughts are often false and rarely helpful.
- Choose an empathic doctor. I’m not recommending a friendly idiot who doesn’t know about evidence (or that you should choose a doctor who only tells you what you want to hear. For example if they say you don’t need antibiotics for your cold, maybe you don’t. Fortunately most doctors know about evidence and are empathic.
- Make an effort to connect with friends, family, and social groups. If you are already doing this frequently, do something nice for someone who doesn’t (volunteering is good for your health).
- Take time to relax. Traditional Yoga and mindfulness is a great way to do this, and there are many other options. It can lower your risk of heart disease.
- Reward yourself for achievements (even small ones). For example if you’re trying to lose weight and you have a healthy eating day, take that long bath you’ve been putting off, go to your favourite restaurant, …
Doctor You by Dr Jeremy Howick is out now (£20, Hodder & Stoughton). Find out more here.
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