What if I told you that with one pill, you could boost your energy levels, supercharge your strength, and even melt away mental and physical pain and discomfort?
And what if this pill could do those things naturally and safely?
And what if I even told you that it’s just a sugar pill, but so long as you truly believe in its ability to work, it will?
If that sounds like science fiction, I understand, but the underlying mechanism is actually science fact, and it’s called the placebo effect.
Many people have heard of the placebo effect, but it’s much deeper than many people realize, filled with quite a few surprising and interesting aspects.
That’s why I invited Kurtis Frank back onto the podcast to give us a little lesson on the placebo effect, including …
- The most surprising effects of placebo and how it works
- How the placebo effect can improve your workouts
- How resilient is the placebo effect and does it wear off?
- Why it’s important to have researchers blinded from the placebo in experiments
- Why you shouldn’t seek out the placebo effect
- How placebo relates to homeopathy, chiropractic, and acupuncture
Oh and in case you’re not familiar with Kurtis, he’s the co-founder and former lead researcher and writer of Examine.com, as well as the Director of Research for my sports nutrition company, Legion, which means he’s responsible for improving existing formulations and creating new ones.
So if you want a basic overview on what the placebo effect is and why it’s important, listen to this episode!
6:11 – What is the placebo effect?
6:46 – What are some examples of the placebo effect?
10:43 – What are examples of nocebo that are documented in literature?
18:58 – How does the placebo effect work if you are already aware of it?
21:40 – What are some other examples of the placebo effect that could help you with workouts?
26:08 – How durable is the placebo effect?
27:07 – Do you have any anecdotes for the placebo effect?
28:12 – What are your thoughts on medication and the placebo effect?
31:31 – Does not notifying the doctor of the placebo medication eliminate the chances of the placebo effect not working?
39:37 – Is homeopathy a placebo effect?
54:58 – How does placebo affect acupuncture?
Mentioned on The Show:
What did you think of this episode? Have anything else to share? Let me know in the comments below!
Mike: Hello, and welcome to another episode of Muscle for Life. I’m your host, Mike Matthews, and thank you for taking some time out of your day to join me for a discussion about the placebo effect. Now check this out. What if I told you that with one little pill every day, you could boost your energy levels, you could supercharge your strength, and you could even melt away mental and physical pain and discomfort.
And what if this pill could do those things natural? And safely no drugs involved. And what if I even told you that actually it’s just a sugar pill. But so long as you truly believe in its ability to work, which you actually can because of the placebo effect, it will work well if that sounds like science fiction to you.
I understand. But the underlying mechanism is very much. Fact, and it is called the placebo effect. Now, chances are you have heard of the placebo effect, but it probably also is a much deeper topic than you realize. It certainly is a lot deeper than many people realize. Even me, before I really started looking into it, the placebo effect is filled with quite a few surprising.
Interesting and even practical aspects, and that’s why I invited Curtis Frank back onto the podcast to give us a little crash course on the placebo effect. And if you’re not familiar with Curtis, he is the co-founder and the former lead researcher and writer of examine.com. So if you’ve ever been to that website and poked around in the highly technical writing on the website, on the blog, you have stuff that is more layman friendly, but really the core of examine is very technical.
Pretty much all of that was researched and written. By Curtis over the course of six or seven years, and now Curtis is the director of research and development for my sports nutrition company Legion, and that means that he is responsible for improving all of our existing formulations as well as creating new ones.
He’s the guy I go to for new product ideas, or I go to with new product ideas and ask him, Curtis, is this possible? Curtis, is it possible? A natural testosterone booster. No, Mike, it’s still not possible. Wow. Okay. Curtis, is there any reason for people to take BCAAs because they keep on asking for BCAAs? No, Mike, there’s still no reason to take BCAAs.
Okay, fine. . So anyway, in this episode, Curtis and I talk about many. Elements of many aspects of the placebo effect, including some of the more surprising ones about how it actually works, how it can improve your workouts. There are a couple cool little immediately useful tips that can help you gain strength faster in the gym in particular.
And of course if you do that enough over time, then you gain muscle faster. We talk about how resilient. Placebo effect is, and we talk about how the placebo effect relates to chiropractic, homeopathy, and acupuncture and more. Also, if you like what I’m doing here on the podcast and elsewhere, definitely check out my health and fitness books, including the number one best selling weightlifting books for men and women in the world, Bigger, leaner, stronger.
Thinner, leaner, stronger, as well as the leading flexible dieting cookbook, the Shredded Chef. Now, these books have sold well over 1 million copies and have helped thousands of people build their best body ever, and you can find them on all major online retailers like Audible, Amazon, iTunes, Cobo, and Google Play as well.
In Select Barnes and Noble stores. And I should also mention that you can get any of the audio books 100% free when you sign up for an Audible account. And this is a great way to make those pockets of downtime, like commuting, meal prepping, and cleaning more interesting, entertaining, and productive. And so if you want to take Audible up on this offer, and if you want to get one of my audio books for free, just go to www.by Legion, that’s b u y legion.com/audible.
Sign up for your account. So again, if you appreciate my work and if you wanna see more of it, and if you wanna learn time proven and evidence-based strategies for losing fat, building muscle, and getting healthy, and strategies that work for anyone and everyone, regardless of age or circumstances, please do consider picking up one of my best selling books, Bigger, Leaner, Stronger for Men, Thinner, Leaner, Stronger for Women, and the Shredded Chef for my favorite fitness friendly recipe.
Curtis Frank is back. We made it, We’ve rescheduled this several times, but here we. Finally we can get
Mike: done with . Get at it as the tough people say. Yeah. So we’re here to talk about the placebo effect, which is we were just talking offline and you were concerned that it’s such a complex and multifaceted and nuanced topic that you weren’t sure if you were ready to go that deep and.
A sw a waged What? How I’m checking the pronunciation. A you run into those words. You can spell what is it? Yeah. A It’s sue. A sue. Yeah. So I assuaged your misgivings by letting you know that okay. Let’s do like a placebo effect 1 0 1. Talk here, because I’m sure that most people listening have heard of the placebo effect, but don’t know much more than maybe Oh, that’s where something that shouldn’t work works.
And it works because you think it’s gonna work, but there’s a lot more to it. And that’s where we’re here. And I think where we should start is, let’s just start at the top. What is the placebo effect? Obviously, I just summarized it, but there’s a bit more to even just defining it, right?
Kurtis: At this moment time, there’s a few accepted definitions of it. They’re all the same, but we don’t know which is the best definition yet. The one that I like the most is that they’re measurable changes to the. That are based on your expectations and beliefs in the treatment, regardless of what the treatment is.
So it’s pretty much a psychological response based on what you think will
Mike: happen and what are some of the more interesting examples of that? Cause there are some very striking ones that really drive home how powerful it can be.
Kurtis: The most interesting one that I’ve found, like I haven’t delved too much into it, but basically when it comes to the placebo effect, it’s based on your perception of the treatment.
So it’s gonna have more power in anything that is both psychogenic
Mike: and acute. And can you just define psychogenic?
Kurtis: Born of just the psyche. So something like anxiety attacks, panic attacks, hot flashes, acute pain, just like getting hit. Those are psychogenic and they’re acute cuz they happen really fast.
Those things are the most subject to the placebo effect and I believe especially when it comes to hot flash. Up to 50% of all benefits seemed hot flashes is attributable to the placebo effect. Wow. Literally on par with the drug treatments, like best of the drug treatments,
Mike: which I guess if they are primarily stemming from the mind, then that would make sense that they could.
Heavily manipulated by somehow changing whatever is going on upstairs that is producing it, right? Correct.
Kurtis: And then in comparison to that, things that are not psychogenic and they’re chronic are either very resistant to placebo effect or placebo just has pretty much no effect on them. Like regardless of your expectations in a therapy, you can’t placebo your way into a cancer.
Because you don’t like just accidentally think yourself into cancer. Cancer doesn’t happen immediately. It happens over the course of many years. So placebo effect doesn’t really influence cancer that
Mike: much. It’s very specific and they can show you, here’s the problem. See that tumor right there?
That’s no good. Whereas I’m sure that you have come across the sham surgery examples in your research for this episode, which I thought were pretty fascinating, that you had people with actual physical problems. Now why they had these problems was not clear, but their knee hurt. There’s no question.
Every day their knee hurt. They get a shammed surgery, meaning that they thought they got a surgery. There was a little incision that was made. They were put under, but nothing else was done. And all of a sudden their knee’s better. There’s also, I think the example that sticks with me the most is the heart surgery, where normally it would be a very invasive.
Surgery where they have to go through your breast bone and there was a sham surgery, which you’d think the person would know that they didn’t get the surgery because they didn’t get destroyed by it. But where getting a sham surgery improved a heart condition in a patient. You’ve come across those, I’m sure the first
Kurtis: example, the knee surgery, that’s a pretty.
Obvious I’m about to explain why it’s obvious, because the placebo effect works mostly through the HPA access and H P T A for men. So the fight or flight response, the stress responses, but also the opioid system, which is why pain is very subject to placebo effects. So if you do experience a placebo effect, pain can be very much reduced.
And if you’re subject to it, the opposite, then nocebo effect, which is just like the bad side of the coin, you can actually greatly increase pain even when you shouldn’t. It
Mike: normally happens. And just to be clear on nocebo, so that’d be something that shouldn’t cause a negative effect, but it does pretty much.
Kurtis: Placebo is, there is no actual drug treatment, but there’s a positive effect. No placebo is, there is no actual drug treatment, but there’s a
Mike: negative effect. And what are some examples of that have just been documented in the literature?
Kurtis: Usually worsening of anxiety attacks. Cuz some people when they have like anxiety or whatever, they can just breathe and it gets better.
Some people, even though this stimuli, the stressor is gone, they pretty much psych themselves into more fear and then they legitimately get worse Symptom. , even when there’s no stressor anymore. That sort of repeated effect, that downward spiral is so much related to nocebo. And then of course there is a whole pain thing where if you tell someone that.
Doing this will cause you pain. Even when doing that thing will not normally cause them pain. They do tend to report a bit more pain associated
Mike: with that. Interesting. What, for example, like what kind of I’m sure these are benign activities. There’s one
Kurtis: that I saw a while ago. It was like old people doing like really small plyometric box jumps and it was like half a foot.
And they’re basically, Yeah.
Mike: So something that’s believable if you didn’t quite know how the body works, like Oh yeah. That maybe
Kurtis: it could hurt. Yeah, like apparently there was like one, I think it was actually three groups. One group was just saying do these box jumps. Another was saying, Do these box jumps.
Don’t worry, they’re not gonna hurt your knees at all. Then another one saying, Do these box jumps? They do tend to hurt the knees, but if that happens, we have some treatment on standby. Ready? And just those prompts influenced
Mike: the pain. It reminds me of a lot of the research that I’ve read regarding the practical application would be marketing, but just persuasion and psychology as applied to marketing, and there’s a lot of similarity there in that there’s so much that is happening subconsciously.
And how this is all of us, how impressionable we really are. Even those of us who think we’re pretty savvy consumers and yeah, maybe we’re immune to some of the crudes tricks used, but we’re not immune to all of them. And anyways, there’s just interesting research that shows just even the choice of words, how much of a difference that can make in terms of how people receive the what’s essentially the same communication.
Kurtis: Yeah. And also I just want to head on back a little bit. Cause back to the question you said, what’s the most surprising thing about the placebo response that I’ve seen? Cause we got a little bit sidetracked when I was warming up to the answer. The answer is that the placebo effect works in schizophrenia to a degree.
Explain. If you’re schizophrenic, there is actually an appreciable placebo response. It’s not as strong on something like pain or hot flash. , but it’s present. And this is important because the just schizophrenia is associated with the inability to at times, the inability to differentiate between reality and delusions, and just not knowing what is real and what is not.
And because of that, you would think that, just you wouldn’t have expectations associated with the treatment. That could be reliable in any sense. Because if your delusions just switch all the time, your expectations should be all over the chart. , like you should just get, getting random placebo effects.
Random, No placebo effects every like other of the day. Yeah. But there is actually a reliable placebo effect in schizophrenia, and I think researchers know. How is it tricking that? I do not know. I was trying to look into it. Okay. But right now it seems like there’s a bunch of theories, but a lot of the theories are, this is what.
Think is happening right now, but we need to confirm it later.
Mike: What intervention is the reliable one? If I’m understanding you correctly, but I may not be
Kurtis: understanding. Oh, it’s not like any specific intervention. It’s just whenever there is a study, you would expect a placebo effect to occur just for everything.
Hence why there’s like double blind placebo effects. Sorry, the double blind placebo controlled study is the gold standard because you can literally never avoid the placebo effect. You have to make science built around it. But when it comes to schizophrenia, everything we know about the placebo effect, we should be saying, schizophrenia should not have a reliable placebo effect.
It doesn’t make sense for them to have it, but they do. And so we’re still trying to figure out I’m still trying to figure out like maybe some researchers know exactly why. But yeah, like it normally should not happen, but it does. So that’s kinda cool. And I guess the other interesting thing is how I still adore the fact that placebo effect works, even if you know there’s a placebo effect.
Mike: That’s what I was gonna ask you about next, because that makes it even more interesting and in some ways practical,
Right? Yeah. Because in a way, if it’s all based on expectations and beliefs, then you could argue that at least a certain aspect of the placebo effect could be pavlonian in nature.
Mike: And what do you
Kurtis: mean by that? Your expectations towards something like when you. Say, take a drug like,
Mike: Oh no. So I just meant the pavlonian, just to be clear. In turn, are you talking about stimulus response?
Kurtis: Yes. Pavlos dogs and all that? Sure. Cause I know like a lot of weightlifters who, they go to the gym, they’re tired or whatever, they take a pre-workout and all of a sudden they’re like super amped, but they’re amped in like literally two seconds.
And you’re like, you can’t absorb the nutrients that fast in two seconds.
Mike: Take caffeine alone. It’s about 30 minutes when it peaks after taking it. Yeah, pretty
Kurtis: much. Unless you sublingual. But even then, like I remember seeing a few of the guys I used to work out with, whenever they got a new pre-work, that Spark was gone.
It’s like they had to train themselves to get used to the new pre-workout. because they had their old pre-workout, they had their baby, and now they switched it and it’s yeah, I still gotta get used to this one. So they’re basically trading themselves to get expected to that new pre-workout. That does seem bit pavlonian.
Yeah, and at least in my position, like first of all what I’m about to say, I haven’t really looked in the science on it yet. Cause I really only thought about this yesterday when I was doing prep work. I still need to double check it. Alogenic response to music. How much does placebo play a role in?
because when I was like just working on my prime, I always had a little secret playlist, so to speak.
Mike: Yep. Yeah, same. I had a few songs. I had my, three songs were my deadlift songs, slash squat songs. Like when I was going heavy, there were a few songs I would go to. .
Kurtis: Yeah. I had my leg press song, My Crock Row song and my widow maker song, and I never listened to them aside from those exercises, and I gotta.
I would just be like chilling in my room or whatever that song would act. I come on my playlist and all of a sudden I would just get jazzed outta my head and I’m just like, Oh no, I need to do leg day right now. Then I have to switch the song . And so I’m just wondering like how much crossover that have low in conditioning has with the placebo effect, if they’re both.
Mike: Generals have known the power of music for a long time. There’s a reason why armies, going back to antiquity, had drummers and they used music just to amp their troops up.
Kurtis: I don’t know, like that’s just a huge can of worms. That’s the main reason why I was a little bit cautious about getting ’em to the podcast today.
Cause. The placebo effect is definitely a topic where every time you answer one question, two more rise up. Yeah. And plus, like it just delves into psychology and that’s not necessarily my field. So Takes a while for me
Mike: to learn all this stuff. Yeah. That’s why again I think we can just cover the main questions that people have when they hear about it and some of the main points that are made.
If you were just to Google around for a little bit and what you’re gonna find and we can discuss, I think just at a high. What it is. How it works. So then in terms of making it work, even when you know it’s a placebo effect. So how does that work? So does that, what you’re saying is that I could have a sugar pill, but if I were able to convince myself that it’s going to do something for my pain because of listening to this podcast where I learned that’s how it can work, that could generate enough buy-in to then actually reduce pain, even though I know it’s a sugar.
Yes. That’s very inception, but the
Kurtis: issue, you know what I mean? Yeah. The only problem is that you actually have to legitimately convince yourself and simply saying, I want to reduce my pain, is not necessarily enough. No,
Mike: you have to believe it.
Kurtis: This is why do you know where the placebo effect first was discovered?
Mike: actually I don’t. World War
Kurtis: I trenches. Basically supply lines were running out and soldiers were coming back really wounded, really sick, and they needed medical treatment, and the medical staff had nothing like literally nothing. So they would pretend to give medical treatment to the soldiers.
Although what they were doing was essentially like point out a bandaid. It’s I kiss your boo better. Hey go back on the fields and die. Now you still have one good arm. You’re okay. Yeah. Like they were doing that kind of stuff, but they were saying that they were actually giving treatment and it actually worked, like pain was being reduced and all the soldiers are like, thank the medical staff for their effort.
And the medical staff is thinking, What the hell? We literally didn’t give them. And so that’s why initially when people were first looking at the placebo effect, they thought it was all based on trickery, because trickery is the easiest way to get someone to truly believe something. The second one would be faith itself.
Hence why the focus on belief systems and then the hardest, but perhaps most ethical way in my mind, would be the conditioning effect expectations. But ultimately it’s. You have to truly believe in something and unless you want to get tricked or unless you want to intertwine it with some sort of faith or belief system.
Sometimes you just gotta do the exact same thing all the time and eventually associate it with your successes.
Mike: Interesting. So if we’re talking about then let’s say improving workout performance, keep it on topic for the podcast. So you mentioned something like, you mentioned pre-workout, you mentioned music.
What are some. We’re talking about almost like rituals, right? There could be beliefs or there could just be things that you do. What are some other examples that might just help you have better workouts, even though they maybe technically, quote unquote, shouldn’t, I can
Kurtis: answer this question, but I can’t necessarily call them placebo effects at this moment in time, but ritual is a good example of what you just.
The other one would be like little habits or quirks that you have in the gym. Like for me, whenever I’m about to bench press, I have a little habit where I grip the bar on the rings, and then I immediately like rub the sweat between my pinky and ring finger on the bar. Then my ring finger and middle finger on the bar.
And I just do that on each hand just to get the sweat out. And that’s just a sort of like ritual and quirk that I have. It really helps. And why
Mike: does that why do you think that? Like how did you come up with that? Like for me, I don’t do that. I just try to squeeze the bar as hard as I can and try to bend it in half.
Those are my cues for bench that reliably make a difference.
Kurtis: They for me it was just, cuz the first time I did it, it’s cuz I was going for bench and there was a lot of sweat in between my fingers. And I’m like, Ew, sweat. I don’t want to do that. So I just rubb the sweat off and I had a really good bench session that day, and then the next time I felt sweat there, I rubbed it off, had a really good bench session, and then I essentially started to associate the rubbing of the sweat with a good bench
So it’s finding what works for you. It’s almost and this is something we were talking about offline, almost like personalizing your placebo. Yeah, like trial and error. It’s
Kurtis: just if it works for you, do it. If it doesn’t, don’t do. But ultimately you have to train your mind to associate itself with success in a way.
Mike: Yeah. Which means that you have to actually succeed. If you do something and then you have bad, you have a bad set, then maybe you should abandon that one and try something else. Cause if we’re talking about conditioning there needs to be that positive association and it needs to be reinforc.
Probably a number of times before it becomes reliably useful, I would think. Yeah, and
Kurtis: also everything that we’re talking about for maximizing the placebo effect also applies to the nocebo effect. So if you routinely do something and it only results in failure, stop doing that thing. It’s not gonna work out in your favor.
Mike: It’s one of those things that shouldn’t even need to be said, but it’s a good point. . If it’s not going make some changes. Just stop doing the same thing. Just make some changes. And especially if we’re talking about working out, It’s funny how these little changes could be the thing where you find something that just works for you for whatever reason.
And I guess this is an intuitive type of process, right? You almost just go, Hey what sounds like a good idea right now, , there’s that. There’s maybe weightlifting queues would be something a little bit more standardized, I guess you could say. And anybody listening if you wanna learn more about that.
I just recorded a podcast. We published it, I don’t know, maybe a week ago where I think it was nine different queues. I share some different queues that have helped me, and I think that there’s probably some overlap here in that. Some of the cues, they’re more just reminding you of your form and just how to keep your technique in.
But then some of them are probably just kind of placebo, that you’re imagining a certain thing and then that helps you do a little bit better on the exercise. And then you just do that a few times and now that is, it just works for you even though there’s no technical reason why it should be working, yeah. It just,
Kurtis: reminds your body of its success.
Mike: Yeah. Yeah. Which actually reminds me of, there was I read about this, I don’t remember what book, Hayleigh, I think is how you pronounce his name, The famous soccer player, and how before games he used to spend, I believe it was like 30 minutes just remembering.
His prior performance, like stellar performances, the Times when by his own standard, he did really well where he like impressed himself with how well he played. And I believe he also would envision, I believe it was like a bit of both. He would remember the times he played extremely well and then envision himself.
Playing extremely well in, In the upcoming game. Yeah.
Kurtis: Like I don’t really know if that’s placebo, but that is definitely based on the whole cues. And perhaps like even
Mike: Facebook. Yeah. I mean it’s just, it’s a psychological priming effect. Yeah. Nothing else,
Kurtis: they’re all the sort of same category in a sense.
Mike: And how durable are the effects of the placebo effect, because some people. Say that you can find something like this and it works for a little bit, and then it wears off that it’s not going to work. Whether it’s something like a pill that you’re taking for pain or some other placebo for pain, or the placebo effect as applied to working out.
Kurtis: do you mean resilient?
Mike: Yeah. Yeah, like again, what I’ve seen is I’ve seen people say that the placebo effect tends to wear off in a few weeks. In most cases, you won’t find something that just reliably works for you consistently for a long time. Oh, from what I’ve
Kurtis: seen, I would actually liken the placebo effect of porcelain really strong, yet fragile because the placebo effect can continue to give you great benefits over a very long period of.
But if you lose your expectations or beliefs in it, it’s just gone. It shatters.
Mike: Interesting. And do you have any just anecdotes that you’ve come across in the literature of how that has happened where a person, they just lose confidence completely in it, which is, seems strange because if it is working well for you, how do you lose confidence in it?
Now? Of course you can, but I’m just curious. Not
Kurtis: in the literature specifically, but when I was looking into belief systems, I did come across some I’m not sure if these would be related to placebo effects. I believe they are. But there’s people who are reformed Christians and basically they just had an irrationally strong belief in God that God would cure them of their pain disorders.
And they actually felt less pain because of that. But then when they became secular, they lost those benefits,
Mike: which I guess makes sense given what you’ve already covered. So they would have to find some new. Placebo effect .
Kurtis: Like again, like these aren’t academic journals that I was looking at, so they could have been embellished.
Sure. Just per personal. Yeah. But I’ve seen a few of those, so I think that there’s something there. Interesting.
Mike: And what are your thoughts on the placebo effect in the context of medications and mechanisms of healing surgeries? I’m sure some people have thought about those things. Wondering then how many.
Surgeries are actually unnecessary. How many medications are unnecessary? How many people could just be treated with placebos instead of potentially harmful interventions?
Kurtis: I think that’s a sort of it’s a bad line of thought to go down. Because again, like all science is based around the double blind placebo control study because placebo effects are omni present.
Mike: Do you wanna just quickly actually describe what that is just for anybody if they haven’t, Maybe they’ve heard of the term, but they don’t know exactly how it was. Yeah, so double blind
Kurtis: placebo control means that there is the active drug and then the placebo drug. And placebo drug is just something that is medically inert and only has the placebo effect.
whereas the active drug has the actual drug acting, but also the placebo effect on top. So if you assume that the placebo effects between the two groups are the same, then they negate each other statistically and you’re left with inert versus drug, and then you can see if the drug’s better than just a sugar pill.
And then the double blind just refers to neither the patients, nor the medical doctors know which
Mike: is which. And why is that important? Like how did that become a thing where at one point, obviously it was not, the practitioner wasn’t also blinded. Why is that necessary to maximally minimize the placebo effects influence on the study?
Kurtis: subjects are blinded
Mike: because, that’s obvious, right?
Kurtis: Because if I did mention earlier that the placebo effects still works, even if you know it’s placebo, but it works better if you have better expectations. So you think it’s gonna work better. Yeah. So if you know you’re getting the drug, your placebo effect’s gonna be stronger.
But the researchers are blinded because they may accidentally give physical cues to the patient. It’s here is your drug. And if they’re looking optimistic, Nape, you’re getting the good drug. And if they say Here’s your drug, and then they just look to the side and have a little bit of shame on their face.
You’re like, That’s not the drug. That’s the foreseeable effect. Yeah. So patients can actually pick up on that and it can influence the results.
Mike: Okay. So that’s the key. It’s not on a deeper level where even if the patients have no idea, but the doctors do that somehow. Could influence the results. It potentially could.
Kurtis: It’s hard to determine, but. Why Don of you have a study where you can’t prove if X is a variable that screwed your results, but you think it might have. That just gets annoying and it’s let’s just make sure that variable X isn’t an issue in the future.
Mike: like what I’m doing here on the podcast and elsewhere, definitely check out my health and fitness books, including the number one best selling weightlifting books for men and women in the. Bigger, Leaner, stronger and thinner. Leaner, stronger, as well as the leading flexible dieting cookbook, the shredded.
Does it eliminate the, or let’s say not eliminate, does it neutralize the placebo effect enough to make it more or less a non-factor in the results of research? Or is there something else in play that just can’t be controlled for? Is it just the best we’ve got, It’s the
Kurtis: best we’ve got at keeping the placebo effect similar between both groups.
And as long as they’re similar between both groups, they can negate each. And all difference observed can be due to drug versus inert compound. But anyways when it comes to just using the placebo effect as medical treatment, I don’t like that line of thought because first and foremost, you’ll always have the placebo effect.
Just always, whether it’s small or whether it’s large. It doesn’t matter if you have inert or an active. You either have the placebo effect itself, or you have the active drug and the
Mike: placebo effect, so it can have an additive effect. It can make an effective drug more effective. Yes, you’re
Kurtis: either choosing one benefit or you’re choosing two benefits, and so you go for the two benefits
Yeah, no, I understand that. But some people, and I don’t disagree with you, but I know that some people would push back and say medications and surgeries come with risks. And if you want to live a long, healthy, enjoyable life, it’s probably a good idea to avoid medications and surgeries as much as possible.
If you gotta do it, you gotta do it. But if you can not, then it’s better to not. And Would a placebo treatment before you go there? Make sense? You know what I mean? In that sense, I
Kurtis: would probably disagree mostly because at the end of the day, you shouldn’t seek out the placebo treatment. You should just seek out the safest drug treatment because there are gonna be drugs that are highly effective with side effects.
Then there gonna be some drugs like Metformin, my baby, who pretty much has very few side effects. And could very well improve health greatly. They’re all gonna give you a placebo effect. So if you simply choose whatever drug is the safest. You’ll get the drug effect and the placebo effect, but if you intentionally seek out the placebo effect, you run the risk of actually trying to argue for things like homeopathy.
That’s what I was gonna
Mike: say. You could turn to just some quote unquote natural type of solution for something that if it’s, let’s say it’s not a serious health condition, it’s something that needs to be addressed. But could it be resolved through something that shouldn’t make a difference? But in your case, we’re going back to this personalization point that placebo just works well for
As much as, I hate to say, like if it works, but I would prefer trying to find the best treatment possible even when there is no good treatment. A good example of this would be fibromyalgia. Where there is no actual good pharmaceutical treatment for it yet, but on Q1 and PQQ
Kurtis: work. Like P QQ is super theoretical on Q 10 is somewhat theoretical.
No real good evidence, but they at least have a little bit of evidence and argumentation going for them. So if you get the placebo effect for those things, You get the placebo effect and you’re basically gambling on also getting a good drug effect. But if you go for just something completely random like lavender oil, whatever, You’re gambling on the placebo effect and feels like no chance for a drug
Makes sense. And if we’re talking about surgeries, take back surgery, for example, which I’m sure, I don’t know how much you’ve looked into it. I haven’t, I wouldn’t say I’m an expert on it at all. I’ve spoken to some experts, like I had Stuart McGill on my podcast and that it’s very interesting and he is, if anybody wants to go listen to that interview, if you want to hear his whole position.
What I understood talking with him is he’s very against surgery unless it is very clearly indicated, and he talked about what that meant, and there are many ways non-surgical methods of resolving back problems and they are. Mechanical in, in what he was talking about. So he has a book called The Back Mechanic that has a self diagnosis protocol and then based on what you find okay, move this weight, does that hurt, move that weight, does that hurt?
Can you do this? Can you do that? And based on what you find, he then describes. This is what’s going on, and here are some exercises and things that, some remedial stuff you can do to resolve that. And he has some very interesting stories resolving like really bad problems without surgery. And he talks about how hit and miss back surgery can be and how debilitating it can be.
And so that to me, if I was somebody with a back problem, for example, and. I was being told that it’s surgery, dude, it’s surgery time. I would look for probably, again, unless it was very clearly an issue that, okay, you see this nerve right here, You see how it’s happening? We have to fix that. Or, and again, he talks about this, I would be very reluctant to just run into the operating room.
I would be willing to try a lot of placebo things before I would do that. But I
Kurtis: just do want to clarify, since we’re on this topic, the placebo effect when it comes to issues like, Would only affect the perception of pain. Whatever causes the pain would most likely not be fixed because that would most likely be either a nerve injury or muscular or bone injury, and that’s neither psychogenic nor acute.
So the placebo effect would be like literally a bandaid effect. It’ll simply make your life a bit better to live. But it wouldn’t actually fix the issue at hand. You would need something like what McGill talked about, the actual exercises to fix the root of the issue.
Mike: Yeah, I had Paul Ingram on, which will, I think we Good guy.
Good guy. Yeah. Yeah. I liked Paul and we talked about repetitive stress injuries, but got into, of course, in his wheelhouse is pain and he just talked about some really interesting. Just how mysterious pain is in many ways and how I really liked anybody who hasn’t listened to that episode. I’d recommend go listening to it because there’s some really practical stuff in there.
He talked about trigger points, certain parts in the body that you just rub every day, , and you find like he had, I think he called him one of his 12 or 13 magical miracle points, magical points, something like that. But just points in the body that many people find are painful. and that by rubbing them with their hands, or if you can’t get to, If you can’t get to it with your hand, then you could use a lacrosse ball or a squash ball, or in some cases a foam ruler.
But usually it’s a ball cuz you need to get a bit more specific and by just rubbing these points you can. Make pain in other areas, just go away. You can make back pain, go away. You can make hip pain go away. Knee pain, elbow pain. Shoulder pain. Pretty cool. Did he mention
Kurtis: the ancient Chinese chakra system at all?
Yeah. Okay. Cuz the chakra system, which founded the formation of acupuncture, even though I don’t like acupuncture, did focus on like centralized neuron paths. , and it did mention that there are multiple locus points on the body of which pain centralizes. So what he was talking about may actually be like the actual scientific interpretation of what the chakra system was trying to refer to.
Interesting. I’ll have to look into
Mike: that. Interesting. Just to come quickly back on topic. So homeopathy you would say, is that completely placebo, if it does anything for anybody? Cause what I’ve heard, not from a reliable source, so I just put it in the. Shrug bucket, Is that what you would buy at the grocery store?
Yeah. All of that stuff is, if it does anything for you, it’s just the placebo effect. But if you have an individual practitioner who knows what they’re doing, quote unquote, then that can actually. Produce an effect that could be replicated in scientific research, not just placebo effect. What are your thoughts?
Kurtis: So I’ll agree with what that source said, but before I get into that, I just wanna say that if homeopathy, if it’s anything more than the placebo effect, is an insult to all of dietary supplements. I hate homeopathy with a passion . Like why? Because when you have something like mathematics, If cuz mathematics is like the hardest of the hard sciences and mathematics can literally predict the future if you have the right formula and apply it to the right situation.
The issue is finding the right formula and applying to the right situation, which is a heck of a lot harder than you’d ever think it would be. But if you do that correctly, you can predict the future. That’s how accurate mathematics is. Sociology, the softest of all sciences. It has one of my favorite sayings, which I learned from an actual PhD in sociology.
If you think you know sociology, you’re not a sociologist , like there’s just way too many unknown factors, and biology is somewhere in the middle. If you can get a cellular system and you can predict even like 70, 75% of what happens after drug therapy. In that cell. That’s pretty good. There’s no way you can predict 100%.
There’s always gonna be some weird genetic monkey wrench born from stuff that we just don’t understand about the cell, but we can get a pretty good prediction. So that’s why biology has so many general rules of thumb and so few laws, but law, out of the laws, we do have one. The dose makes the. Basically, if you want a molecule to affect the body, the molecule needs to actually exist and the molecule can affect more things.
If there’s more of that molecule, homeopathy looks at this one rule we have and say and says, Hey, let’s reverse that. It literally takes the entire concept of pharmacy and says, Law. Let’s run in the opposite direct. And
Mike: why is that just for anybody not familiar with the fundamental premise of homeopathy?
Kurtis: pretty sure homeopathy was just like a running gig between a bunch of guys saying, what’s the stupidest thing we can make when they’re like drinking? It’s what if we just took pharmacy and reversed it? We can trick people like that’s the best explanation
Mike: I can get. This involves then is using very small amounts of something that otherwise would be a problem?
Yes. They believe
Kurtis: that diluting a molecule makes it stronger. And that is literally the opposite of the truth. I believe it’s because they like the concept of hormesis where a small dose of a toxin causes a positive effect. They took that, completely misinterpreted it, and then took it way too far.
Because even when it comes to say like resveratrol and curcumin are both hormetic compounds, they work via hormesis, but we use let’s say in fort. 500 milligrams per percumin because that is the hormetic dose. That is the dose of which the hormetic effects are strongest. If you dilute it even more, you don’t get more hormetic effects, you get less.
Even when it works via hormesis, there is an optimal dose. You can’t just keep on diluting something over and over. But that’s what homeopathy does. You
Mike: can reduce your cost of
Kurtis: goods a lot that Oh yeah. It just increases the profit margin incredibly. So we’ve
Mike: established that homeopathy is very
Kurtis: profitable, very sketchy.
And the only homeopathy that works is the stuff that sets this homeopathy when it actually isn’t,
Mike: which is when it really is just supplementation at that point. Yeah,
Kurtis: exactly. But I remember seeing a homeopathic zinc lozenge with 15 milligrams of zinc, and I’m like, that’s. That’s just a supplement at that point.
Yeah. But anyways what your source was saying that it’s like better if you have a practitioner that is technically true, because if homeopathy is only the placebo effect, a good practitioner with good social skills and a good. Charisma, I guess is the best way to say it. I
Mike: think bedside manner, Is that the term perhaps?
Although that would, I guess that’s with doctors and sick people. I don’t know. I have to actually look at the definition. Yeah. I like
Kurtis: charisma because I can apply that to sh
Mike: No. It says bedside manner is just a doctor’s approach or attitude. Yeah, but anyone
Kurtis: who uses homeopathy or refuse to call the doctor, so charisma,
Mike: but they might have a, They might have a PhD and then they say they’re a doctor or they might be a chiropractor and they say they’re a doctor.
Yeah. The only
Kurtis: chiropractors I respect are those who are actually physiotherapists. Different discussion, but basically, yeah, the whole chiropractor stuff is like, as long as they say cracking your back helps your back, that’s fine. As soon as they say it helps with the common cold.
Yeah, I, I actually haven’t looked too much into chiropractors. Something I get asked about. I just haven’t taken the time to really get into the literature. I go to a chiropractor every once in a while. If I’m in Florida, there’s a guy I like to see. He’s a nice guy and it feels good and that’s it.
I don’t really. Much more stock into it than that. And I have no problem with, I have friends who are chiropractors and as far as I know, they do a good job and they help people. So I have no problem with the work and with the field. What I don’t like though, and I, it does seem to be chiropractors who.
Who do this the most is chiropractors who actually just try to mislead people into thinking they are medical doctors. They’re MDs because they know it’s good marketing. They know that although the prestige of an MD has declined, and this has been shown in research, the last survey I saw in terms of who on an individual level, who do you trust the most? My doctor is still number one and so people still on the whole put a lot of, give doctors a lot of credence and so there are shady chiropractor marker guys and gals out there who know that and say, Oh, I’m Doctor Soandso. And they might, even in their marketing pictures, I’ve seen them even wear like the white coat and have the stethoscope and they’re really trying to make you think that they’re an MD That is not cool.
And that often is chiropractors. Yeah, from what I’ve seen.
Kurtis: But like as long as chiropractors stick to hold back cracking and just making your body feel good, I’m totally okay with that. It’s just when they get into the unable claims and the pretending to be someone that they’re not, as you just suggest.
But yeah, like anyways Have you
Mike: ever looked into, I don’t wanna get off on a tangent cause I, it might make for a good podcast if I’m asking, have you ever looked into the whole muscle testing thing that chiropractors will use to see? Sometimes it’s for, to find the subluxations or go, Okay, where do we need to adjust?
And then other times it, it’ll go as far as supplementation. What supplements do you need? How many do you need to take? You know what I’m talking about?
Kurtis: I vaguely do, but
Mike: I don’t know much about that. Okay.
Kurtis: Okay. Yeah. Cause like I’ve, all the chiropractors I know were like kind of physiotherapists in a. And all the supplements that they sold were quite literally just for osteo product women, because that’s who they were helping most.
I see. So yeah, I have a pretty good experience with
Mike: chiropractors. I go to a chiropractor now and then, and I been to a few in particular who I really liked and it, I did feel good to get adjusted and I didn’t put much more thought into it than that. That’s about it, .
Kurtis: But anyways like back to the whole thing that I was saying earlier, I like saying charisma.
A lot of homeopaths. I do view as charlatans, but if you have high charisma and you can convince people of something,
Mike: You can maximize a placebo effect from any source and that then opens the door to the justification that it’s okay. Oh, I actually am helping people.
Kurtis: Yeah. But I don’t know.
Mike: That’s like a whole ethical rabbit hole that I know. , the end justifies the means.
Kurtis: I hate that saying so much. That’s actually my. Do you mind if I go on a tangent there? Yeah. Cuz I was thinking like,
Mike: I agree it’s a, it’s, that is a very slippery slope and that line of thinking has been used to do a lot of very bad things throughout history and a very different discussion.
But I would say there are people in power today who. That’s a just a, that’s a rationalization. It’s just so easy. It’s so cheap and it can justify very evil actions that the person, they will say until the end that it was for the best.
Kurtis: Yeah. Cause like the way I view it is just when you think of any situation of where you say the end justifies the means, it’s only topics of grant.
Such as politics, science, theocracy, that sort theology, I should say medicine, basically, things that don’t actually have an end. Something that does have an end would be, I go to the grocery store to get some cheese. Cause if I go to the grocery store or get some cheese, I just reach the end. But if I were to take an end justifies the means approach, I can’t just say, Oh, there’s a traffic jam.
But then cut through a park, run over three children. If the cops arrest me when I’m eating my cheese and I say, But bro, it’s shutter. They’re not gonna accept that they’re gonna arrest me. Cause in that case, the end clearly doesn’t justify the means.
Mike: But should they, I know.
Kurtis: Or is that just the cheese, is the justify?
It’s just a social construct. Yeah, the cheese is justification. But anyways so the only time you really say the end justifies the means are not for the minor issues of which there are an. But the major issues of grant design, of which there is no end.
Mike: But couldn’t you postulate an end?
Couldn’t you say we’re working toward, Let’s talk about this would be in the realm of politics or just power and the development of civilization. Say, Hey, the end is this utopian state and unfortunately the only way to get there, the only viable way we can see to get. Is to do things that some people would say are evil, but they just don’t understand.
They don’t even have the intellectual or maybe the ethical capacity to understand that creation requires destruction and we are trying to minimize the destruction, but you have to destroy what’s there to create something better.
Kurtis: Yeah. But the thing is, whenever it comes to like stuff like this, at least when it comes to science, at least, The closer you get to the end, to the closer, you realize it wasn’t actually the end, but rather than just a checkpoint on the way to the end.
So the closer you get to your end goal, you realize that wasn’t the end. That was just step one, and then you head to the next end and you realize that was just step two. And so you live your entire life. I aiming for this end of which doesn’t actually exist. And so if you have the end justifies the means mentality and you never reach the.
Where is the justification? There was none.
Mike: But sometimes ends are reached though, again, I don’t wanna get off on too long of a tangent. This might make for an interesting, a separate episode. This is really just a philosophical discussion, but you could find with what I’m talking about, you could find in history credit quite a few examples of people who did achieve.
Ends that were good and they got there by doing things that many people would say were bad. But the outcome, if we were to measure it in terms of how it affected the population, how many people it affected, you would say yes. That was definitely a lot more good than bad, even though it did require doing some things that were.
Questionable. If you were to just be an absolute in terms of morals, it is always good to do this. It is never good to do that and so forth,
Kurtis: yeah, I do agree. But what the situations that you bring up, like I would’ve probably referred to those as the checkpoints. Because at the very least, they were once thought to be ends, so something was accomplished.
Mike: So the checkpoint justifies the means .
Kurtis: I could agree with that. Okay. All right. All right. To a degree, it depends on nuances and all that stuff. All the nitty gritty that I really don’t care for.
Mike: Just in case we have to join the new old order one day, we have to have these things worked out for ourselves.
Yeah. Oh yeah, definitely. That’s gonna be on the entry exam. Does the checkpoint justify the means?
Kurtis: The checkpoint justify the means.
Mike: I like that. Anyway I like the tangent actually. I like the topic. It might be worth just doing an episode on that, but to bring this back and to wrap up. With the placebo effect.
How do we even get to that point? I know we were talking about homeopathy and then chiropractor.
Kurtis: Yeah. It was just the ethical component of ah of with homeopathy.
Mike: Okay. Yeah. I understand that. It really, if we’re talking about, if we wanted to get into real science, it would be supplementation because that has good evidence behind.
But I am helping people. Therefore, lying to them is okay. I’m with you. In that, I would disagree because I would say why don’t you just do something that’s honest? Like, why don’t you help people without lying to them? Have you thought about that?
Kurtis: Because you can either help people by lying or help people by not lying.
So you can either have two goods or one good and one bad that neutralize each other. It’s like the choice is obvious.
Mike: Yep. And that would be a counter-argument. Again, this isn’t something I’ve thought too much about, so somebody who’s more well versed in philosophy might laugh at this, but that would be my instinctive response to the checkpoint justifies.
The means thinking is okay, yes, in theory, but are you telling me that was the only way to get there? That you had to do all of these destructive things that you couldn’t come up with any other? Means that was maybe less unpleasant for so many people, yeah. That’s why I like the
Kurtis: whole of the means justify the ends, because whether or not you reach the checkpoint, every step you take has justification within it.
Mike: Yeah. Which then just comes down to, again, the individual and each individual action being Yeah. The most, that you can try that kind of Jordan Peterson type of approach to living.
Kurtis: And even if you fail at reaching the checkpoint, the life is still worth lived.
Mike: Totally. And before we head off into our weekend, let’s quickly, cuz you mentioned acupuncture and.
How much does the placebo effect factor into that?
Kurtis: I’m not a huge fan of it. If it works. From what I can tell, most of it is placebo. But at the same time, there does seem to be some benefit, maybe cause a lot of the acupuncture studies reliable is not the best way to describe them.
They’re really over the map. I’d say the majority of them do say that. Not different from placebo, which is what you would expect if the majority of the benefit is from placebo. Yeah. But even then the degree of from placebo and the degree of potentially actual benefits like that aren’t placebo.
It seems to change. And you mentioned earlier what Paul Ingram said about those locus points on the body where like pain centralizes, I think that might be related. , but I don’t really know too much about that because I only know about the chakra system from traditional Chinese medicine. I didn’t actually know that there was a modern day equivalent or potentially equivalent to that.
So gonna have to look into that and see if there is a connection between the two.
Mike: But, and in Paul’s case, he was just saying, you can just rub these things. You don’t have to get someone to stick needles in ’em.
Kurtis: Yeah. If you can rub them like by yourself, then that saves a lot of money. If you wanna have needles stuck in you to like some relaxing hoo music and like incense floating the air as someone just just poke.
And you’re wondering if any of the needles happen to be poisoned with opioids, who knows? You could do that if you want, but I don’t know. I don’t want to completely discount it out of hand, but at the same time, I’m not gonna go around praising it in any way. So I’m keeping it on the back burner for now.
And I also do have to mention that a lot pain scientists and physiotherapists that I follow, acupuncture is like their trigger word, where if you just say acupuncture, they just come out of the woodworks like, Oh, you said the bad word. I’m pretty sure I’m just gonna defer to the experts on this one.
Apparently it’s not good
I like it. It’s like saying homeopathy three times while staring into the mirror. I’ll just peer with a knife. That’s, it’s like the bloody Mary of supplements. .
Mike: Maybe that’s what your afterlife is gonna hold for you. Maybe you’ll have a chance to actually Bloody frank . Yeah. To haunt your enemies until you get bored of that.
And then maybe you’ll have to, Reroll, restart. Yeah. . All right, man. This was a great discussion. Very informative. Thanks for taking the time and I look forward to our next whatever it’s gonna be. We’ll figure out something.
Kurtis: Yeah. Looking forward to it.
Mike: All right. That’s it for today’s episode.
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