Nocebo

Most people are familiar with the concept of a placebo. The word comes from Latin and means “I shall please.” We most frequently hear it used in medical terms. It can be a substance or a treatment that has no known therapeutic value. Common placebos include inert tablets (like sugar pills), and inert injections (like saline).

Sigmund Freud conjectured that since some placebos had a positive effect on what was considered a physical problem, the problem must really be in the mind. In his version of talk therapy providing positive information can improve the perception of well-being.

I have been fascinated with this concept ever since I heard about it in a high school course. But it was only recently that I heard the word nocebo. This is when negative data makes someone feel worse about their own health. Nocebo is Latin for “I shall harm.”

I heard nocebo used in the context of the negative effect that my wearing a fitness tracker on my wrist might have on me. I wear it to track my activities (steps, miles, exercise times). It also monitors my heart rate and my sleep. The device has a positive effect on me when it vibrates to tell me I have hit my steps goal for the day. But what is the effect on me when I spend all day working on the code for a website and discover at dinnertime that I have only taken 1200 steps all day and I have only been active for one of my waking hours? Nocebo effect.

“Placebo” was used in a medicinal context in the late 18th century to describe a “commonplace method or medicine.” In 1811, it was defined as “any medicine adapted more to please than to benefit the patient”.

In the 20th century, studies on the “placebo effect” showed that there could be a positive effect and that it could also have no effect. Inconclusive. However, placebo-controlled studies were used and are still used to evaluate new treatments. Clinical trials control for this effect by including a group of subjects that receives a “sham” treatment. Subjects in such trials don’t know if they received the treatment or a placebo.

I think it is interesting that if a person is given a placebo under one name, and they respond well, they will respond in the same way on a later occasion to that placebo under that name – but not if it is given with another name. Clinical trials are often double-blinded so the researchers also do not know which test subjects are receiving the active or placebo treatment.

I’m no medical authority so I must be careful what I suggest here, but I would think that when someone finds relief from a scientifically questionable treatment (copper bracelets for arthritis, some herbal products, etc.) that relief might be a placebo effect.

What was new to me (and perhaps to you) is the nocebo effect. It seems to apply to more than my fitness watch. What about social media “likes” and reposts and hit counters on your blog or website? They can all have a positive effect on you when you get them, but what about when you don’t get them? I think we might all need to be more conscious of any nocebo effects in out daily lives.

Detox

Image by marijana1 from Pixabay

I have been sick this past week. It is probably a spring cold not helped by some allergies. I did my COVID test and it was negative.

In that eerie way that your Internet browser seems to know what you’re thinking, I started seeing ads for detoxification products. I have seen them on the shelves of my local pharmacy too. There are 3-day juice cleanses, pills and drinks. I clicked on one for detox teas and, of course, that led to more suggestions.

The idea of doing something over the weekend that will cleanse your body of things that are hurting you is certainly tempting – but unlikely. Some of these detox programs remind me of doing the prep for a colonoscopy. But purging your body by urinating, bowel movement or vomiting can be more harmful than beneficial.

Detox diets are said to eliminate toxins from your body, improve health, and promote weight loss. There have been only a small number of studies on DIY detoxification programs in people. From what I found, the benefits seem to be minimal. There have been no studies on long-term effects of “detoxification” programs.

Juicing and detox diets can cause initial weight loss because of low intake of calories but that they tend to lead to weight gain once a person resumes a normal diet. There are also plenty of warnings on these products and online. Any harmful effects are more likely in people with a history of gastrointestinal disease, colon surgery, severe hemorrhoids, kidney disease, or heart disease. Some “detoxification” programs may include laxatives, which can cause diarrhea severe enough to lead to dehydration and electrolyte imbalances.

The idea of eliminating dangerous chemicals, such as those from forms of pollution, is appealing, but most of those cannot be eliminated by the methods available over the counter.

Hospitals and medical facilities do legitimate detoxifications and you likely first heard the term related to people who were dangerously intoxicated (drunk) or had an overdose of drugs or ingest some type of poisonous substance.

Detoxification is the physiological or medicinal removal of toxic substances from a living organism, and in the human body, that process is mainly carried out by the liver.

Marketers have capitalized on the scientific fact and you can find “liver cleanses” available too. On one site, it had a list of symptoms that supposedly indicate that your liver needs help: You crave sugar, feel like you need more energy or your bowel movements aren’t as regular as you’d like them to be. I think everyone I know could check “”yes” next to one or all three of those.

This week I was good candidate for a fast way to eliminate whatever is making me feel lousy but I don’t think a cleanse is the way to go. Read the ingredients on even the mildest of detox products, such as the teas, and you’ll find “natural” ingredients that you have never heard of and don’t know their effects. Herbs like borage, comfrey, groomwell, and coltsfoot have “pyrrolizidine alkaloids” that can gum up the tiny blood vessels inside the liver over time or all at once (if you take a lot). Other herbs like Atractylis gummifera, celandine, chaparral, germander, and pennyroyal oil (used in tea) can also cause liver problems.

An article on webmd.com on how to keep your liver healthy has safe advice on what you should do.

MORE
nccih.nih.gov/health/detoxes-and-cleanses-what-you-need-to-know

Saving Some Extra Daylight

from pillow studies by Albrecht Dürer

Last night I set some clocks forward by two hours. I know you are supposed to spring forward one hour for spring but that way when I woke up today I was able to turn the clock back one hour. It is just a psychological effect but then again the whole daylight savings thing is psychological in many ways.

I see articles twice a year about “Reasons Why Daylight Saving Time Is Bad for You.” (That particular one actually says five deadly reasons, but I think that’s going a bit sensationalist.) You know that other things, like “jet lag,” can mess with your natural circadian rhythm. “Circadian” is from the Latin circa dies, meaning “approximately one day” because our natural rest–wake period rhythm is 25.5 hours. Exposure to sunlight resets the brain’s circadian clock every day.

Daylight Saving Time (DST) throws that off while Standard time is close to the sun’s natural time. When we switch into or out of DST the effects on sleep, wakefulness, mood, and general health last about 5 to 7 days. If you were not getting optimal sleep in the days before the switch, the effect are greater. One thing you can do help is get outside this morning and for the next few days and get some sunlight to help your internal clock. It will eventually reset itself, but not as quickly or easily as your smartphone.

Back in 1895, New Zealand entomologist and astronomer George Hudson proposed the idea of changing clocks by two hours every spring so that he would have more daylight hours to devote to collecting and examining insects. In 1907, British resident William Willett presented the idea as a way to save energy. But neither proposal was implemented.

setting the clock ahead 1918
Ohio Clock in the U.S. Capitol being turned forward for the country’s first daylight saving time on March 31, 1918 by the Senate sergeant at arms Charles Higgins. via Wikimedia

Germany was the first to adopt daylight saving time on May 1, 1916, during World War I as a way to conserve fuel. The rest of Europe followed soon after. The United States didn’t adopt daylight saving time until March 19, 1918. Though we have a Uniform Time Act, there are different local DST policies across the country. For example, Hawaii has never observed daylight saving time under the Uniform Time Act, having opted out of the act’s provisions in 1967

The Nap After Thanksgiving Dinner

dinner
Image by Julie Rothe from Pixabay

Are you already prepping for Thanksgiving dinner? That might mean food prep or it might mean sleep prep.

This has always been my wife’s favorite holiday – no gifts, no cards, no religious affiliations, just food and family and friends and a time to count your blessings. In years past, we had quite a crowd with our parents, some bachelor(ette) aunts and friends who didn’t have family and our own two boys. This year the parents and aunts have passed on. Our boys are off with their in-laws, so it will be a quiet holiday.

Thanksgiving is also a day when Americans – who already eat too much – will make and eat too much to an even larger degree. And that often leads to the after-dinner nap on the couch. Sleep after a big meal is never a good idea for digestion, but you cant’ help it after that turkey and fixings. Right?

Did you see the Seinfeld episode where Jerry and George force a lot of turkey on a woman so that she will fall asleep and they can play with her classic toy collection? It has long been thought that because turkey has the amino acid L-tryptophan, that it causes that after-dinner hangover. But is the turkey really what makes you so tired?  Maybe not.

Fact: L-tryptophan is an amino acid responsible for producing serotonin in our brains and serotonin is a hormone that affects mood. It makes us feel happy and relaxed and plays a role in helping us sleep and also aids with digestion. And turkey has L-tryptophan. But some research shows that the amino acids and protein in turkey have the opposite effect. They can inhibit L-tryptophan’s ability to produce serotonin which means it would keep you awake.

And yet the after-dinner turkey day snooze is real. What is causing it? It’s carbohydrates. The bread, rolls, stuffing, potatoes, cake and pie, when eaten with high protein foods like turkey will lead to feeling sleepy and sluggish.

How can we beat that sleepy effect? Don’t starve before the main meal because you’ll eat too fast and too much. (I know that you said that you didn’t eat all morning in order to “save room” for dinner.) Eat smaller portions of those carbs. Fight off the habit or urge to nap by getting outside for a little walk or some touch football.

So, now that I have taken some of the pleasure out of the holiday meal, is there any good coming out of traditional Thanksgiving foods? I searched and yes, there is some good news.

I have never met a potato I didn’t like and mashed potatoes are high on my list. Potatoes are full of potassium which lowers blood pressure and nourishes muscles and they have a lot of vitamin B6 which helps metabolism. Note that adding a lot of salt, gravy or butter can cancel out any benefits.

Fresh vegetables have fiber, Vitamins A, B1, B2 and B6 and calcium. The green bean casserole with cream of mushroom soup and the crunchy onions is not so great for your health.

I love stuffing. I will have a stuffing sandwich the day after Thanksgiving. I know, it’s bread on bread. But stuffing can be made healthier with the addition of whole wheat bread with the crusts and nuts, seeds, meat or vegan protein and carrots, celery and other veggies so that you get more fiber, antioxidants and nutrients. My wife’s recipe has all that and it is delicious.

How about pumpkin pie? I just read that many pumpkin products are actually made from other squashes and they can legally be labeled as pumpkin. Bummer. Pumpkin pie with real pumpkin contains potassium, vitamin C and beta-carotene, which can help lower the risk of cancer. Again, what else you add to the pie (sugars, whipped cream etc.) might tip the scale from beneficial to harmful.

I wish you moderation and gratitude on your Thanksgiving day. Eat well. And after the meal, maybe toss a football around before you watch other people toss one around on a screen from your comfy couch.

Going Nowhere

brick street

Can going nowhere be a journey?

The pandemic certainly had many of us going nowhere. I canceled vacations that had been planned in 2020 and this year. The term “staycation” predates the pandemic but it is that idea of staying where you are or only traveling nearby. Travel can be wonderful. It can also be stressful.

It would seem counterintuitive to say that in this time of having more ways to connect than ever before that we often feel the need to disconnect or “unplug.”

Pico Iyer is a British-born writer known for his travel writing. At one point in his life, he decided to go to Kyoto and live in a monastery in order to learn about Zen Buddhism, the city and Japanese culture. The culture he wanted to explore was an older Japan of changing seasons and silent temples. And there, he formed a relationship with a Japanese woman. This experience led to him writing  The Lady and the Monk.

He has written other books about his travels into other cultures. Video Night in Kathmandu and The Global Soul are two of them. From the subtitle of The Global Soul – “Jet Lag, Shopping Malls, and the Search for Home” – you get a sense of the feeling that some people have these days of not really having one “home” in any traditional sense.

So, it might not be surprising that someone who so often travels might decide at some point to go nowhere.

All this background is to introduce the book I listened to recently by Iyer about stillness. In it, he writes about others who have found stillness and remaining someplace as being a journey. From Marcel Proust to Blaise Pascal to Phillipe Starck and more recently Leonard Cohen, he writes about people who make the choice to spend years sitting still and going nowhere. “Nowhere” becomes a kind of destination.

There are elements of the contemplative life found in the book, though that is not what it is really about. Iyer has known the 14th Dalai Lama since he was in his late teens when he accompanied his father to Dharamshala, India. But Iyer does not have a formal meditation practice. He does practice regular solitude. He will visit a remote place to practice solitude too.

In The Art of Stillness, Iyer looks at old and new “wanderer-monks” and his own travel experiences. One of his conclusions is that advances in technology are making us more likely to retreat.

He does not promote or reject attaching a  religious commitment to this practice of stillness. Many people have meditation, yoga, tai chi, and other practices without a religious or even formalized spiritual element. All of these things call back to ancient practices.

I have written here about a good number of things that seem to fall into this non-category, such as forest bathing, Internet sabbaths, and lots of meditation and spending time in nature.

I will go in the woods near my home this week. Maybe I’ll read there a bit. Maybe I’ll draw. Maybe I’ll just bathe and observe. All good.


More about Pico Iyer’s journeys at picoiyerjourneys.com

Caffeine and Consciousness

coffee tea

Like a number of things, coffee, or rather caffeine, seems to be good for you and then bad for you depending on what year we are in.

Currently, caffeine “contributes much more to your health than it takes away.” Says who? Says food, drink and psychedelics writer Michael Pollan.  Caffeine has been shown to improve focus and memory, and even your ability to learn. Did you pull some caffeine-fueled late-night study sessions in college? Did it work?

Caffeine doesn’t help most people sleep. I avoid it after 3 pm but my wife can have an espresso before bedtime and sleep the same.

I don’t know if I’m so much a caffeine fan as I am a coffee and tea fan. I even like herbal teas (no caffeine and technically not tea but tisanes) and decaf drinks. But considering that caffeine keeps me awake at night, I suppose that my morning coffee must do the opposite. I do know that when I tried going decaffeinated I experienced severe headaches for a week. Withdrawal from cold turkey.

I have read a half dozen books by Pollan and written about him before. He is a good, serious and interesting writer. Pollan wrote Caffeine: How coffee and tea created the modern world as an audiobook. It’s not that the Enlightenment occurred because of coffee but “Isaac Newton was a big coffee fan… and Voltaire apparently had 72 cups a day,” writes Pollan.

Ah, the Enlightenment, the Age of Reason, and the Industrial Revolution. Big things that owe something to the coffee house. These places appeared London around 1650.

Coffee houses quickly found their clientele which gathered around interests, like literature, and professions, like writers, poets, philosophers and scientists. There was even one dedicated to selling stocks. Eventually, that one became the London Stock Exchange.

Sober and civil drinking – pub – changed the way people thought and worked. Well, alcohol was safer than most drinking water. But boiling water had benefits then too.

Pollan has also written This Is Your Mind on Plants which is a broader look at how we rely on plants. They give us sustenance, beauty, medicine, fragrance, flavor, fiber. But the book’s focus is on how they change our consciousness. Plants can stimulate or calm. They can temporarily tweak our consciousness or completely alter it.

We don’t think of caffeine as a drug. We don’t consider daily users as addicts. Well, it is legal, socially acceptable and readily available. Pollan wants people to rethink that. Drug or medicine? You can make a drink from the leaves of a tea plant and that’s fine. Make a drink from the seed head of an opium poppy and you break a federal law. In This Is Your Mind on Plants, Michael Pollan goes deep into three plant drugs – opium, caffeine, and mescaline.

It probably seems odd to you to group caffeine in with opium and mescaline. It seemed odd to me considering those first London coffee houses were almost the opposite of the pubs and opium smokers. And those philosophers like Kant, Voltaire and Kierkegaard weren’t just having a cup with breakfast. They were mainlining their caffeine and it seemed to work.

I’m writing this at 6 pm. No caffeine since 1 pm. I wonder what I would have written after several 16 once dark roasts at 11 am.

Listen to Michael Pollan talk about how he gave up caffeine entirely for three months while working on his audiobook, Caffeine, and he says “I recommend it. I had some great sleeps.” But he also had an unexpected loss of confidence and lack of focus as he went through withdrawal.