The science behind the body's surprising ability to heal itself.
By Kim Tranell
For decades doctors have documented the placebo effect -- in which patients feel better after getting fake treatments (sugar pills, saline injections, sham surgeries) they believe to be the real thing. But do placebos merely trick the mind or can they genuinely heal the body? That's the question Lissa Rankin, MD, set out to answer in her new book, "Mind Over Medicine." Diving into 60-plus years of research, Rankin has built a convincing case for the way optimistic thoughts and caring doctors can trigger the body's self-repair mechanisms to help prevent -- and maybe even treat -- illness. Prepare to be fascinated.
Q: Early in Mind Over Medicine, you admit that you used to be skeptical of the placebo effect. What changed your mind?
A: As an ob-gyn with conventional medical training, I was reluctant to buy into the idea that the mind can play such an important role in healing. But it's hard to dispute the fact that up to 70 percent of patients in clinical trials see their symptoms improve simply from a placebo. And doctors are observing these changes on a physiological level. For instance, in a report in the British Journal of Clinical Pharmacology, researchers found that when people with ulcers took a placebo four times a day, their ulcers healed at a greater rate than those given placebos only twice a day. The science proves that placebos don't just change how you feel; they can change your biochemistry.
Q: How does this happen?
A: When you're given a medicine -- placebo or not -- that you believe will help treat whatever is ailing you, your body's relaxation response can naturally turn on. You may think, "I'm doing something to help. My needs are being tended." These positive thoughts can set off the release of healing hormones and neurotransmitters -- such as dopamine, nitric oxide, and endorphins -- into your bloodstream. The effects of these chemicals can be powerful: Nitric oxide can increase blood flow to your organs, for instance, and endorphins can act like nature's morphine, dulling pain.
Q: Can negative thoughts have the opposite effect?
A: Yes. In some cases, negative thinking is the cause of the "nocebo effect" -- in which patients feel worse after learning that a treatment may have negative side effects. In fact, in one study, asthmatics who inhaled a harmless solution that they had been told contained irritating allergens started wheezing. What's more, the researchers found that the subjects' bronchi actually constricted as a result. Our body's natural self-repair systems can't work properly if we're chronically stressed or pessimistic. They're more effective when the relaxation response is dominant.
Q: Besides positive thinking, what else helps the healing process?
A: You need a healthcare provider who can give you the time you deserve -- not someone who's trying to see 40 patients in seven-minute visits. I used to be that kind of doctor, but hurrying through appointments doesn't put people at ease. Research suggests that nurturing care, specifically from those in the white coats, can have its own kind of placebo effect. The more face time a person gets with attentive, concerned doctors, the more likely that a placebo will work.
Q: Is it possible to harness the power of the placebo without a pill?
A: One of the most important questions I ask patients with chronic conditions is, what does your body need in order to heal? I hear all sorts of things, from "I need to fix my toxic marriage or leave" to "I need to quit my job." One woman said, "I need to move to my vacation home in Santa Fe. Whenever I go there, my symptoms disappear." I'm not saying medical care isn't necessary, but when you have a chronic condition, you owe it to yourself to do everything you can to activate your body's natural self-healing systems. Finding whatever it is that puts you in a state of neurologic relaxation can be just as important as going to the doctor.
Earlier on HuffPost OWN: What's Worse For Your Health?
An All-Nighter vs. 2 Hours Of Sleep
It's 3 a.m. and you need to get up at 5 a.m. for <a href="http://www.farecompare.com/travel-advice/morning-flight-or-red-eye-the-best-times-to-fly/" target="_hplink">your flight</a> or your <a href="http://healthland.time.com/2012/04/12/why-shift-work-and-sleeplessness-lead-to-weight-gain-and-diabetes/" target="_hplink">work shift</a> or your conference. The clock is forcing you to make a decision: curl up in bed for two hours of shut-eye, or power through the next day? While your instinct and your <a href="http://www.realsimple.com/beauty-fashion/skincare/face/treating-dark-circles-under-eyes-00000000029970/" target="_hplink">drooping eyelids</a> may urge you to take the nap, this might make you feel even worse than if you hadn't slept at all, says <a href="http://michaelgrandner.com/pages/" target="_blank">Michael A. Grandner, Ph.D.</a>, research associate at the <a href="http://www.med.upenn.edu/sleepctr/" target="_blank">Center for Sleep and Circadian Neurobiology at the University of Pennsylvania</a>. "If you get less than 4 hours, there's a good chance that you'll wake up in <a href="http://www.nydailynews.com/life-style/health/poor-sleep-contributes-memory-loss-age-article-1.1249814" target="_hplink">slow-wave sleep</a>, which can leave you disoriented, irrational and extremely irritable," Grandner says. (In other words, you'll feel like a hot mess.) He explains that our bodies are pretty resilient and can function reasonably well without sleep once in a while, so you'll be able to chug through the day even if your mind will be a little fuzzy (this means catching a plane wouldn't be a problem, but <a href="http://www.nbcnews.com/id/39214056/ns/us_news/t/driving-while-tired-safety-officials-are-slow-react-operator-fatigue/#.UQhwhkpQA-U" target="_hplink">driving a car would</a>). <strong>Best advice: </strong> Fire up the <a href="http://www.popularmechanics.com/technology/gadgets/reviews/single-serve-coffeemaker-showd" target="_hplink">coffeepot</a>, stay busy until your natural circadian rhythm kicks in, and then hang in there until your normal bedtime.
Exercising On An Empty Stomach vs. A Full One
What's the problem with running (or spinning, or stair-climbing, or Zumba-ing) on empty? We asked <a href="http://www.nutritionconditioning.net/" target="_blank">Heidi Skolnik, MS, CDN, FACSM</a>, a nutritionist with a private practice who's worked with dancers at <a href="http://www.juilliard.edu/" target="_hplink">the Juilliard School</a> as well as players with <a href="http://www.nba.com/knicks/" target="_hplink">the New York Knicks</a>. First, Skolnik wants to know why you didn't have anything to eat. Saving calories? "You'll probably be so hungry later that you'll eat even more," she says, adding that she sees this over and over with her female clients. Think of pre-exercise snacks as fuel: Skolnik says research supports the idea that having something in your tank will help you work out harder, which will then help you burn even <i>more</i> calories. Worried that pre-exercise eating is bad for your body? Skolnik explains that working out immediately after a big meal will cause blood to be diverted to your muscles instead of your digestive system. But while she agrees that this can be uncomfortable, she says it's not physically harmful. Just plain too busy to eat before you exercise? Skolnik gets that, but she strongly advises against making it a regular habit: You'll be too weak and hungry to get the maximum benefit from your workout, and you'll be setting yourself up for a binge session later that night. And if your workout involves strength training, you could go into catabolic mode and start breaking down muscle. Now isn't that enough motivation to stock your gym bag with energy bars? <strong>Best advice:</strong> Eating too much will probably result in an unpleasant workout, but not eating anything can be bad for your workout, your diet <em>and</em> your long-term health.
Alcohol vs. Coffee Before Bed
Both are infamous sleep disruptors, but they act in opposite ways, says <a href="http://med.stanford.edu/profiles/Allison_Siebern" target="_blank">Allison T. Siebern, Ph.D., CBSM</a>, clinical assistant professor and the associate director of the <a href="http://insomnia.stanford.edu/" target="_blank">Insomnia and Behavioral Sleep Medicine Program at Stanford University School of Medicine</a>. Caffeine tricks your body into thinking that you aren't sleepy, Siebern explains. As soon as the effect wears off, you'll crash -- which in this case isn't such a bad thing. However, if one glass of wine leads to two or three, you may initially find yourself drowsy, but once the alcohol starts to leave your system, Siebern says, you could start snoring, slip into nightmares, drench the blankets in sweat, feel your head pounding or experience dry mouth. So the post-meal espresso is likely to decrease the quantity of your sleep, while the wine will insidiously tamper with the quality of it. Caffeine may also take 4 to 7 hours -- that's basically all night -- to leave your system if you drink a potent cup or are particularly sensitive to it. Alcohol has a shorter half-life, Siebern says, which means it will leave the body in about 3 to 4 hours. If you can wait that long before going to bed, then cheers to you. <strong>Best advice:</strong> Choose the coffee if you could use a few hours of alert time to get things done at home; the wine if you could use some more time to catch up with your friends. Skip both if you need to be up early tomorrow.
Energy Drinks vs. Soda
You may not realize this, but most energy drinks have just as much sugar as soda: <a href="http://www.foodfacts.com/NutritionFacts/Beverages-non-milk/Red-Bull-Energy-Drink--fl-oz/49678" target="_blank">A 12-ounce can of Red Bull</a> and <a href="http://www.hsph.harvard.edu/nutritionsource/files/2012/10/how-sweet-is-it-color.pdf" target="_blank">a 12-ounce can of cola</a> both have about 9 teaspoons. So they're even on that score, but <a href="http://www.mayoclinic.com/health/caffeine/AN01211" target="_blank">the smallest can of Red Bull also has 80 mg of caffeine</a>, which is double what's in a can of Coke. And it may do a lot more than perk you up: A 2006 New Zealand study revealed that <a href="http://www.menshealth.com/mhlists/effectiveness_of_energy_drinks/Glucose.php#ixzz2I0hocCFO" target="_blank">caffeine combined with the sugar in that Red Bull may temporarily inhibit the body's ability to burn fat</a>. More alarmingly, since 2009, 5-Hour Energy (<a href="http://www.5hourenergy.com/index.asp" target="_blank">which is sugar-free but has about 215 mg of caffeine</a>) <a href="http://www.nytimes.com/2012/11/15/business/5-hour-energy-is-cited-in-13-death-reports.html?_r=2&" target="_blank">has been mentioned in 90 filings with the F.D.A.</a>, including more than 30 that involved serious or life-threatening injuries, reports The New York Times. While it's true that most people can handle one regular-size can or bottle without ill effects, the high levels of caffeine involved in multiple servings could result in <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/">dangerous, even life-threatening, effects on blood pressure, heart rate and brain function</a>, according to a 2010 review in the The Mayo Clinic Proceedings. Most energy drinks also contain special ingredients that are said to boost physical or cognitive performance, like taurine (Red Bull), ginseng (Monster), and glucuronolactone (5-Hour Energy). But two researchers who conducted a review of these ingredients' effects concluded that <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.2012.00525.x/abstract" target="_blank">there isn't much evidence that any of these will make you faster, smarter, or better in any way</a>. <strong>Best advice:</strong> Energy drinks will rev your engine more than soda, but there are safer ways to wake up.