From The March 2001 Issue of Nutrition Science News
by Bill Sardi
Any beneficial effect derived from natural remedies such as vitamins, minerals and herbs is often discounted as being nothing more than the consumer's belief that they will work. With an air of authority, skeptics claim that natural medicine is quackery, effective only because of the placebo effect.
In 1955, Henry K. Beecher, M.D., was the first to report on the so-called placebo effect. Beecher claimed that about 35 percent of the time, patients who took a pill containing no active ingredients experienced an improvement in their condition.
In 1997, researchers at the Institute for Applied Theory and Methodologies in Health Care, in Frieburg, Germany, decided to look into Beecher's theory. Reporting in the Journal of Clinical Epidemiology, they scrutinized the 15 different clinical studies cited by Beecher. Here is what they found.
In 10 of the 15 studies cited by Beechera full 66.7 percentthe patients' condition improved as a normal course of their illness and was not attributable to placebo. And in another study, about a third of the patients who had colds and were given a placebo experienced symptomatic improvement within six days. However, in general, most patients begin to experience symptomatic improvement six days after the onset of a cold even if they take nothing at all.
Beecher also reported that patients taken off a drug experienced improvement only after the drug was switched with placebo. What he neglected to disclose was these patients were being taken off the drug because of side effects, which dissipated upon cessation of use, leading patients to feel an improvement in symptomswhich had nothing at all to do with the placebo.
In addition, the examination of Beecher's work determined that he reported only on the percentage of conditions that showed improvement from placebo, not the percentage that deteriorated. Yes, one-third of the time conditions improved while on, but not necessarily because of, placebo; however, about 40 percent of the time conditions worsened. Beecher did not report all the data.
After examining another 800 studies on the placebo effect, published worldwide since Beecher's initial report, the research team found no evidence for the alleged placebo effect. The clincher was when the researchers examined studies that used three groups of patients: a group given medicine, a second group given a placebo, and a third group that received no treatment. The results of the placebo and "no treatment" groups matched 100 percent of the time.
The term "placebo effect" is often mistakenly attributed to what is called statistical regression. In simple language, the body tends to heal itself over time.
A denunciation of the placebo effect doesn't deny a variety of mind-body responses. These include psychosomatic (e.g., hives when under stress), stress-induced (e.g., adrenal hormones raising blood sugar and cholesterol), and conditioned responses (e.g., an allergic individual beginning to sneeze upon sight of a pot of flowers, until it is discovered the flowers are plastic). But none of these biological responses should be mistakenly confused with Beecher's infamous, and now dethroned, placebo effect.
Before the discovery of modern medicines, there were only placebosthose food factors called vitamins that cured beri beri, rickets, pellagra and scurvy, and that are now halting cardiovascular disease and a host of other maladies. Vitamins and herbs are for real. The placebo effect is imaginary.
Bill Sardi is a health journalist writing from Diamond Bar, Calif. He is the author of The Iron Time Bomb (Bill Sardi, 1999)
1. Kienle GS, et al. The powerful placebo effect: fact or fiction? J Clin Epid 1997;50:1311-8.