How & Why the Placebo Effect Works

Hey there, welcome to the Dr. Josh Axe Show. I am your host, Dr. Axe. And each and every week on this show, we dive deep into the science and principles behind how to grow in body, mind, spirit, and take your health and your life to the next level. Did you know that you can heal your body just by belief?

You know, today on the show, I'm going to explore the fascinating world of placebo effects and prayer and discuss how our minds can influence our bodies. In surprising ways. And so maybe you're someone out there that has chronic pain every single day, and you've tried vitamins, you've tried dietary changes, exercise, and you still have chronic pain. Well, this could be a solution for you.

Or maybe you're someone out there that has hypothyroidism, or you're dealing with infertility, or low testosterone, or autoimmune disease, or cancer, some sort of chronic health problem. And if you're not harnessing the power of the placebo effect, and of course prayer, Uh, you may not be experiencing your highest level of healing.

So the reality is food is medicine, but your mindset is medicine as well. So we'll dive into how to harness the power of belief, placebo, and prayer on today's episode. But before I dive in, make sure to subscribe to this channel and hit the notification bell so you don't miss a single episode. Okay, here is the definition of the placebo effect.

The placebo effect occurs when people experience real improvements in their symptoms after receiving a treatment with no active therapeutic ingredients, like a sugar pill or saline injection. An example of this is someone is taking a sugar pill and they believe it's a painkiller, and so they actually feel pain relief. And this is something that has been documented and noted.

And by the way, here's something, oh, there is almost now, Zero doctors that would say the placebo effect isn't real. In fact, most doctors believe that placebo effect does make a big difference on someone's health. Now, I want to also talk about something else. It's not the placebo effect. It's, it's sort of evil twin, and it's called the nocebo effect. And this is the opposite of the placebo.

This is where if somebody believes something negative is going to happen, it actually leads to worsening their symptoms and greater side effects. This is, for instance, if a person believes a, this, a harmless pill will cause them to be not, uh, have nausea, um, they might actually start feeling nauseous. So this can happen, and it's the power of what we call the mind-body connection.

Both effects rely on the brain's ability to influence the body's response. You know, our beliefs about our expectations can trigger real chemical reactions. By the way, medical studies— I'm going to get into the numerous medical studies on everything from cancer to Alzheimer's, chronic pain, and many other conditions are connected to this.

I also do want to mention that this is referenced by some of the greatest sages and prophets of all time. You know, Jesus, for instance, says it's your faith, or in other times in the Bible talks about your belief has healed you. And so we know that faith and belief have a powerful effect on the body.

Now, I'll talk about later how our faith in prayer is different than placebo and what is actually happening within the body, but they can lead to some similar effects and outcomes. So we'll talk about both on this episode.

I do want to mention here that when you believe something, uh, we've seen through scientific research that these effects involve the release of something we call neurotransmitters.

These neurotransmitters are chemicals in the brain that help regulate mood, pain, and other functions, but it really impacts your body's cellular communication, your body's cells communicating with one another, and then hormones being released in the body. And we know that this could happen instantaneously, is you can release neurotransmitters.

For instance, if you start thinking about a really bad experience you've had, or you start thinking about the worst possible outcome of something happening in your life, Your body will start releasing cortisol, norepinephrine, epinephrine, these adrenaline hormones, putting your body in a fight-or-flight state.

Or, if you would sit here and start thinking about a moment in time where you were relaxed, you start thinking about yourself at the beach and waves crashing or walking in a serene forest and you start thinking about it, your body starts releasing more oxytocin. Yeah. Calming neurotransmitters and even dopamine.

And so, we do know that your beliefs and even what you're thinking about has a tremendous impact on physiological responses. So, your mind impacts the body. They're very connected. Now, as we're talking about this sort of brain chemistry, as I mentioned, a lot of this has to do with expectations. What do you expect to happen in the future? And this is a big deal. Yeah.

So, if you're sitting here right now or you're driving and you're listening to this and you're struggling with a condition, so think about what is your health problem that you're currently experiencing? Okay? Or maybe it's one that you could have in the future. Maybe your parents, like my mom had cancer and, you know, my grandmother had heart issues and I start thinking about those issues.

Well, if I expect myself to come down or have the same condition that my mom had, okay? And there's a lot of people that believe this, by the way, and you know this, that there are a lot of— I experience this even more with women than men.

But a lot of women, because let's say their mom had cancer or their mom had a hormone condition, they believe that they're genetically— they're likely to have it. Um, or dementia. I see this with men sometimes with heart issues, that they believe, oh, my dad had a heart attack at 60, I probably will as well.

Okay, sometimes they don't voice it, but there's something internally, this, this story that's playing within them that they believe that will happen. Just know that's very dangerous because your body will start doing things neurochemically to make that a reality. And so, you really want to expect the best. You want to have a positive mindset believing you're destined to live to be 100+ years old.

You're destined to still be running around feeling great in your 70s, 80s, and 90s. You should believe those things because— Yeah. Your beliefs will lead to the most likely outcome. That's the reality based on all the medical evidence. Now, I want to dive into where this all started, the placebo effect in particular.

It, it really was birthed— the way that we do a lot of our medical studies today was birthed during World War II. There was a physician and his name was Dr. Henry Beecher, and Dr. Beecher was treating soldiers who were severely wounded in battle. At one point, he ran out of morphine.

We know morphine is an incredibly strong pain-relieving drug, and these soldiers were— I mean, we're talking about major injuries, loss of limbs, incredible, incredible pain. And he was desperate to provide his patients some form of pain relief because they ran out of morphine. Well, Dr. Beecher instructed a nurse to inject saline solution. That's saltwater.

Inject saline solution into soldiers telling them it was a powerful painkiller. Well, remarkably, one of the soldiers reported significant pain relief after receiving the saline injection, which were— these were placebos.

And then they started doing it with many soldiers, and it's estimated that around 30 to 40% of those soldiers saw tremendous pain relief, some of them the same level of pain relief as if they were taking morphine.

I want you to think about that for a minute, that your brain can create chemicals within your own body that are as strong as morphine, one of the most powerful, if not the most powerful painkilling drug on the planet.

And then after this experience in World War II and treating these soldiers, Dr. Beecher— then he was an American anesthesiologist— In the mid-20th century, so around 1955, he wrote an article and it was titled The Power of Placebo.

This was then published in the Journal of American Medical Association, which is known as JAMA, and he argued in there that placebos could have a significant effect and should be factored into clinical trials. Well, this birthed then what we know today as sort of the gold standard of medical studies, which are known as double-blind placebo Studies.

And I also do want to mention, this is very interesting, Dr. Beecher had a whole health philosophy and it was called the terrain theory, which was opposed to the other most popular medical philosophy of the time, which was developed by Louis Pasteur, who developed pasteurization of milk. And he developed something called the germ theory.

And so most of the American Medical Association, the AMA, believed that the reason why we get sick today is due to germs. You're exposed to germs, you get sick because of germs. So anytime you're sick, for the most part, they believed it's due to germs. And this is why we started creating antibiotic hand soap and taking antibiotic medications.

And really antibiotics became by far the number one prescribed drug, of course, penicillin and others, uh, over time. Now, so I want you to think about these theories though. So Louis Pasteur was, you get sick Because of germs. Now, Beecher, who developed the placebo, he said, no, you get sick because of your environment, not because of germs. It's because your internal environment.

So he gave this sort of example that, listen, if you have garbage in your body, you're going to attract bugs and germs in that way. Not that you can't— not, not that. So, so he would say that if you are exposed to a cold virus, Okay. Everything from, you know, COVID to a rhinovirus, so different forms of a cold virus.

The germ theory states, and Louis Pasteur states, well, if you're exposed to it, you're going to get sick. Henry Beecher pointed out, though, that no, you get sick because your body, your environment is internally weak, or it's— or you have maybe too much sugar in your system or inflammation. And so, when the bug comes in, you created a good environment for it to thrive.

And so, that will make you sick. But if you create an environment internally within your body where your body is healthy, you likely won't get sick. And so, that was his philosophy, which I very much adopt and believe. The Beecher theory is most people that are into natural medicine and functional medicine really more adopt the Beecher theory.

Where a lot of standard medical physicians throughout history have adopted more of the germ theory of you get sick because of your exposure to germs. And so, we always just want to treat the germs, where Beecher said, no, we need to go and change your internal environment. For him, your environment wasn't just your physical state, it was your mental, emotional, and spiritual state.

So, if you truly want to heal, it's a mind-body-spirit treatment in terms of, again, it's eating healthier, it's sometimes taking medications, but It's a more holistic way of healing. Now, I want to dive into some studies that get into sort of the, the, uh, incredible effects of placebo. And one is called the Milkshake Study. Now, this study was performed by, uh, Doc— Professor Aaliyah Crumb.

She's a professor at Stanford University. And here's what they did. Uh, they took people and they put them into 2 groups. People were given A milkshake. Okay. One group was told that it was a 620-calorie indulgent shake. The other group, Group 2, was told they were given a 140-calorie sensible shake. Now, in reality, both groups of people were getting the exact same shake.

I want to say it was sort of in between, like around 350 calories. Here were the results. The participants Who believed they were doing a high-calorie shake, they stayed more full longer. And some of them even said, well, I don't even need lunch. I'm still full from breakfast. Okay.

The people who had the 140-calorie or what they thought was 140-calorie shake, they said even a few hours, even an hour after, they said, I'm still hungry. They felt like they had had something taken away from them and they had higher levels of food cravings. The reality is they were given the exact same shake. Another study was done on the placebo effect for treating clinical depression.

They found in this study around a 35 to 40% improvement in placebo effect. Also, here's a pretty amazing one on Parkinson's disease. Long-lasting placebo effects have been reported in Parkinson's. In trials, improvement in motor scores of about 20 to 30% in patients assigned to the placebo group. We also see this in cancer. Listen to this, there's 2 studies here.

One, in trials that assessed response to a placebo in individual cancer patients, up to 27% of patients showed appetite improvement, and up to 14% of patients showed improvement in performance status. Another study found, concluded that around 40% of patients who received placebo experienced a 50% or greater pain relief.

So we know that even within cancer, in terms of these symptoms, that someone has when they're going through cancer, those are greatly improved through the power of the placebo.

Now remember that not only is there a placebo effect, there is a nocebo effect, and this is driven by negative expectations and anxiety, which activate stress pathways in the brain connected to what we call your, uh, hypothalamic-pituitary-adrenal axis, or your HPA axis. And this can lead to symptoms such as pain, nausea, fatigue, uh, and a number of issues.

And I've told this story, I, I wrote this in, in my book, Think This, Not That. But I get into a story about the nocebo effect where there was a man who, and this is a real story, a real, a, a, a, a, a real person who had this happen. He was told he had liver cancer and he had 3 months to live, and he died 3 and a half months later.

Well, this man, upon autopsy, they realized they misdiagnosed him and he did not have liver cancer at all. He had a small benign tumor, and and he could have lived another thirty plus years. All that being said, there are people today who are given diagnoses, and they're diagnosed incorrectly. By the way, this happens very commonly with cancer.

Okay, people are diagnosed with cancer, and they don't have it, and they can go on and die early. This happens a lot. I'll tell you the condition I've seen it the most with is MS. I've seen a lot of patients in my career with MS, multiple sclerosis, and they were told they have MS, and later we found out they didn't. Maybe they had something like mold toxicity. Okay.

Or, or, or there were just a few general symptoms that, that then they believed they had MS, and so they started to decline. I had one patient come in to see me, and she was told she had MS. She was in a wheelchair. After a couple weeks of doing dietary changes and me, I, I, I basically told her, I said, listen, I don't think you have MS. I think we have mold issues.

We put her on a treatment plan. 2 Weeks later, she was out of the wheelchair, and she'd been in it for years. And so this is something I have personally experienced in working with patients of the power of both the nocebo effect and the placebo effect on the other side of things.

So just so you know, one of the most dangerous things you can do is believe you have a medical condition and that you are going to, or that you are predestined to have what your parents had or some sort of negative medical outcome. Because if you believe it, it is much, much more likely to happen.

And listen to this reality about medication side effects: up to 97% of reported pharmaceutical side effects are not caused by the drug itself, but rather by the nocebo effect and symptom misattribution. Now, believe me, I do believe that almost every medication out there causes symptoms, including nutritional deficiency.

But the reality is, if somebody knows that there is a side effect of a medication that there can be a nocebo effect that then causes symptoms serious enough to require hospitalization and medical intervention. If you believe a side effect is going to happen from something, it is much, much more likely to occur.

Now, a few other real-life examples and studies that I want to point out when it comes to the placebo effect. One has to do with erectile dysfunction. A study involving the use of finasteride— this is with patients with benign prostatic hypertrophy— revealed a threefold increase in the incidences of erectile dysfunction when this potential side effect was disclosed to the patient.

So you can see, if, if the patient believes that there's going to be a side effect of something that they're doing, it is much, much more likely to happen. And a very similar thing happened with beta blocker medications.

Uh, around 3.1% of men reported ED if they did not know that to be as a side effect, whereas closer to 15.6% or even 31% percent closer potential risk of erectile dysfunction for those who believed that it would have that side effect. So your belief about the side effects and symptoms, um, is going to have a real impact on your body. Now here's some surprising facts.

The placebo effect can work from varying degrees based on your strength of belief about something. So here's an example. Did you know that the brand name and packaging of a placebo pill can have a big effect on the outcome.

So, for instance, if somebody believes that something is a quality brand name, okay, let's say you look at a company like Bayer or Pfizer and you see a drug that's more popular out there, like a thyroid drug like Synthroid or a cholesterol drug like Lipitor, okay, that has stronger outcomes. Okay. On the patient taking the drug.

Here's some other facts that are both surprising, yet not so surprising. The color, the shape, and the size of the placebo pills can influence their effectiveness. For example, red pills are often perceived as stimulants, while blue pills are often seen as calming. And larger pills, or those that look more medical, are often more effective as placebos.

So, for instance, if you get a tiny little pill like an aspirin versus a big red pill, The outcomes are stronger if you're taking a big red pill versus a tiny white pill. Okay, the belief that this is going to have a more profound effect on your body. The also, the other reality is the more invasive the procedures, such as injections, are stronger than, uh, than a pill.

And so the more invasive, the stronger the belief about what's going to happen. Now I wanted to Dive into, I think, an interesting topic here, and that is prayer versus placebo effects and their differences, but how they can have some similar effects on the body. You know, I am a big, big believer in prayer. I have seen incredible results in my life and the life of others via the power of prayer.

And in the Judeo-Christian tradition, prayer is a direct communication with God. It's a conversation with God, and it's intended to express everything from worship, to seek guidance, to request assistance, to intercede, asking God to intercede on your own behalf or the behalf of someone else.

And it's an act of faith rooted in a belief that God is omnipotent and benevolent and capable of intervening in your affairs and wants to do good in your life. Okay, that's, that's what prayer is. Okay, it's this belief that God is intervening and doing something on your behalf.

Okay, now the placebo effect, on the other hand, is not about divine intervention at all, but rather about the power of the mind and how it influences the body. Okay, it occurs when a person experiences a real improvement in symptoms due to their belief, uh, in the effective treatment. Okay, so that's, that's really what that is.

So obviously there are different things, but they both can lead to Better results in healing within your body. And so I really encourage people to both harness, number one, prayer. And really the way that prayer works is prayer is the spirit impacts the mind, which impacts the body. Whereas placebo is the mind impacts the body.

That's the way oftentimes it's, it's seen to, to, to work is that different sort, that, that cascade effect. So another way I would compare prayer and placebo, for instance, in the Judeo-Christian worldview, is the outcome of prayer is often interpreted as an answer from God. So you prayed, God, heal me, and he answers that prayer by healing you, which may come in various forms.

It could be immediate healing, it could be gradual improvement, it even come in a different way than what you requested. Okay. Reflecting on God's divine wisdom and his will being done. So the effectiveness of prayer is seen as part of a relationship with God where the outcome serves a higher purpose beyond immediate relief.

I'm remembering, uh, back to— I, I love Garth Brooks as a musician, and he has this great song, and it's— I believe it's called Unanswered Prayers. He said one of God's greatest gifts is unanswered prayers. I'm curious how many of you have had this happen in your life where you prayed for something to happen, a specific outcome And it didn't happen the way you thought it would.

But later on, you could look back at your life and say, well, I am so grateful God answered that prayer, not in the way that I thought. Okay, he answered in a very different way, or in a different degree, or not at all. But you could look back and say, I, I am actually grateful that that happened. Versus the placebo is not a relationship.

The placebo is typically seen as a temporary relief or improvement due to these physiological factors. And it's often used, as we talked about, in medical research. But I do want to say that again, I think harnessing both the power of prayer and the power of placebo will lead you to the best effects of healing.

If you're dealing right now with autoimmune disease or cancer or chronic pain or hypothyroidism or PCOS or whatever medical condition you have, Number one, I want to encourage you to pray. Okay? The power of prayer is real in terms of what happens in the body. I really believe it's there is this level of spirit which then affects your physiology, which then affects the body.

So I do believe that there's you know as the Bible talks about we are body, mind, and spirit, or body, soul, and spirit. So there is that sort of deep intimate connection there. But but that Has the power to help heal. There are studies showing that prayer helps us heal, and then the placebo is harnessing the power of our mind on the body.

And I have worked with tens of thousands of patients, and I can tell you that one of the top two factors in patients healing has to do with their belief if they will heal. Okay, and the other one has to do with compliance, having a plan and following it. But I want to talk about how to amplify the placebo. This is the last point I want to have, and this is very important.

If you're a person saying, I want to harness the power of the placebo effect, here's how you do it. Number one, visualize and know your ideal outcome. So if you're a person saying, you know what, I have hypothyroidism, or I have chronic pain, or I have migraine headaches, you need to believe and know, you know what, I'm going to change my diet. I'm going to take this supplement.

I'm going to take this med. I'm going to take whatever this thing is, and it's going to have a positive effect on my body. I'm going to go and get a chiropractic adjustment. I'm going to go to acupuncture. I'm going to. Whatever you're going to do, you need to then say and visualize yourself in the future, okay, after this, I'm going to see an improvement and this is doing this to my body. Okay?

So, this chiropractic adjustment, this is bringing blood flow and oxygen and nutrients to the joint to get better range of motion and help heal the area, or in seeing yourself then running, or I'm going to take this turmeric and then I can see my joints are— it's going to bring You know nutrients to my joints and decrease the inflammation. So, and you see yourself then running and being pain free.

So that's step number one. You can actually, according to studies, amplify the placebo effect by being very certain about the ideal outcome that you want to experience in the future and having a strong belief in it. Number two is tie it to strong emotions. Okay. So when you visualize yourself, and by the way, I did this. You know, I was. At a point 2 years ago where I wasn't walking.

I didn't walk for an entire year. And I was told by a doctor I might be permanently disabled. I likely would be. And I could have pictured myself as being that in the future. That's not what I did, though. I pictured myself throwing my toddler in the air. I pictured myself going back and doing triathlons and lifting weights and doing all those things. And now, I'm almost back there.

I'm doing a lot of that already. Yeah. I tied very strong emotions to it, though, where I had such a sense of joy of thinking about how fun it would be to throw my 2-year-old daughter in the pool in there again and how good it would feel and all the hormones of like after that good long run, how I would feel internally.

So, you want to tie strong emotions, which is tied to belief about this is going to happen when I do this good thing. And here's the number, the third thing. So, number 1, visualize and know your ideal outcome. Number 2, tie strong emotions to it and trying to experience those emotions now. Number 3. Create a plan. Sometimes your brain doesn't fully believe you.

You might say to yourself, "Well, I'm not going to get cancer," or I or you might might think to yourself, "Well, you know this pill is going to help this my headache," but it may not work as powerfully versus if you sort of say, "You know what? Here's how I'm going to." reverse my hypothyroidism. I'm going to start, uh, taking ashwagandha.

I'm going to start taking methylated B vitamin and probiotics. I'm going to eat more of these warming foods. I'm going to do infrared sauna. I'm going to start exercising more, and I'm going to sleep better, right? And you create a plan to create that ideal outcome you want in the future.

That will help amplify the power of placebo effect, because when you create a plan and you actually write it out or type it out, Your brain then believes you saying, oh, I can see where if I do all these things or take this thing where this is going to improve my outcome. And this is also why education is so powerful.

When you can educate yourself on— again, when you, when you take turmeric and you believe it's going to help, but then you read studies about all the benefits of turmeric and how it heals you in these numerous ways, you're strengthening your belief in turmeric, which then is going to have more of a placebo, a stronger placebo effect on your body, leading to better outcomes.

So Listen, I want to encourage you, harness the power of prayer. If you're going to pray, I would, I would really make sure it's a virtuous prayer. It's something that's good. God wants you to be healthy. He wants you to be healed. And so I think as you pray, start off with prayer with recognizing who God is. He's a perfect, loving Father. He's for you, not against you.

So starting off that way, recognizing how good he is, and then praying for something very, very specific. God, would you put me in the position where I can I, I can, you know, throw my 2-year-old daughter in the air again, and I can have a healthy and strong enough back and body to do that. And so, you know, and, and, and pray that prayer and pray it consistently. Okay?

And then from a placebo effect standpoint, again, visualize your ideal outcome, tie in the strong emotions, and create a plan and educate yourself on that. If you do that, you're going to amplify placebo, seeing even more powerful results. Here's the reality: the placebo and nocebo effects illustrate the powerful connection between your mind and your body.

And understanding these effects can improve your health outcomes dramatically. And this is where positive thinking, believing for the best, will lead to the best results. If you are more of a pessimist, you're not doing yourself a favor. You're better off thinking more positively. Medical studies show that people that are positive thinkers have better health outcomes.

So, if you think negatively, don't. Decide to believe the best because it will help you heal and help you live your best life possible. Hey, I hope you've enjoyed this episode of the Dr. Josh Axe Show. Remember, each and every week I explore both the science and the principles of how to optimize your physical, mental, and spiritual health and take your life to the next level.

Hey, make sure to subscribe, like, and share this podcast. You know, a lot of people don't realize How powerful the placebo effect is. They don't realize how powerful prayer is. And these are things that we should be doing in order to help us live our best lives possible. And by the way, every time you share this, you're helping somebody get healthier.

And I just am so grateful for all of you that are on mission with me, helping me share this message of health, of healing, and living our best life possible. So, hey, thanks so much for tuning in, and I'll see you on the next episode.