Placebo effect can work as well as real medicine – but your body may need permission to use it

The first time the placebo effect really got under my skin was when I read that roughly one-third of people with irritable bowel syndrome improve on placebo treatments alone. Usually this statistic is presented as a fascinating quirk of medicine. My reaction was anger. Humanity possesses an extremely effective treatment, with essentially zero side effects – and patients need someone else’s permission to use it. The placebo effect refers to the improvements in symptoms that patients experience after they’re given an inert treatment like a sugar pill. Driven by expectation, context and social cues rather than pharmacology, the placebo effect is often dismissed as all in the mind. But decades of research have shown it is anything but imaginary. Placebo treatments can trigger measurable changes in the brain, immune system and hormone function. In studies on pain, placebos cause the brain to release endorphins, the body’s natural opioids. In Parkinson’s disease, placebo injections increase dopamine activity in the brain. The placebo effect isn’t magic. It’s biology. Having spent nearly a quarter-century teaching evolutionary medicine, I’ve come to see placebos not as curiosities of clinical trials but as windows into how human biology responds to social signals. And it’s that relationship…

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