Placebo Domingo

Every now and then some performer on my Facebook feed gets laryngitis and makes a general appeal for everyone’s best voice-fix.   Cue the avalanche of advice.

Bay Leaves, Thyme, Rosemary
Tea – green, lemon, chamomile, peppermint, Echinacea, blackberry, goldenseal, etc
Cinnamon, Cloves, Nutmeg
Slippery Elm
Licorice, Anise
Marshmallow Root
Megadoses of Zinc, Vitamin C, B, A, D or others.
Omega 3 fatty acids
Cider vinegar
Hot toddies
Himalayan Salt water gargle
Entertainer’s Secret, Vocaleze, Chloroseptic, Herb Pharm, King Bio, Gaia Herb, Clear Voice, Oxy Bump, or other throat sprays
Steam, humidifier
Pho, Chicken Soup, or other comfort food
Cayenne Pepper, Chilis or other spicy foods
Onion syrup (I had no idea)
Hydrogen Peroxide
Carrot, prune, or other fruit/vegetable juices
Electrolyzed water
Coconut oil, palm oil, or olive oil
Dietary restrictions including TQI, Paleo, cutting gluten, dairy, refined sugar, meat, carbs, GMO’s or non-organic, etc.
Biofeedback, acupuncture, massage, meditation, prayer and countless other behavioral modifications, some of which can get pretty wild…

Almost all of them are placebos.  I’ll say ‘almost’ so no matter what your favorite bullshit treatment is, you can decide it’s the one that really works.

I love placebos.

Placebos are powerful, with positive effects that are real and measurable, for about 34% of people.  The Stanford School of Medicine explains it here.  But wait, maybe you’re distrustful of western medical establishments like Stanford –  that’s why you’re drinking a gallon of St. Hogwort’s Secret Jasmine Yak Sweat in the first place  – so try this TED talk or this TED talk about it.  Still too establishment for you?  How about this delightful Aussie, with 3 minutes of fun animation, talking about the same thing.

The truth is, in a double-blind situation, those placebo laryngitis “treatments” would have no beneficial effect on the laryngitis at all.

But life is not a double-blind situation.

What I tell my students is:  do a little inquiry just to make sure that your placebo of choice isn’t actually harming you, and if it really isn’t, then what the hell.  Eat your special chicken soup, do your voodoo dance, fly that freak flag, baby.

Sometimes placebo effect is the best you’re going to get, so go ahead and get it.

Yes, there are downsides to placebo usage:

1) Dependency:   “No! The magic lollipop has to be CHERRY flavored! Waaaah!”

2) Actual negative side effects:   “I’ve drunk 2 gallons of apple cider vinegar.  I can’t tell if it’s working, cuz now I have cramps and reflux like you wouldn’t believe. So. Yeah.”

Remember, anything marked “dietary supplement” or “herbal supplement” or “essential oil” is in an unregulated cowboy wildwest territory where it doesn’t have to really prove anything except that it’s not immediately deadly.  That opens the door to anyone with a little psychology and some marketing chops to come in and target easy marks.

So I’m serious about making sure your placebo isn’t actually harmful.

Plenty of the products sold today – including regular vitamins – are seriously toxic at large dosage, causing liver failure, cardiac arrhythmia, seizures, and much more.  Vitamin C mega doses are shown to actually CAUSE sore throat and kidney stones, but you won’t find that info listed on the box.  FDA demands that Viagra has to give you three pages of side effect info, but Goldenseal doesn’t, Echinacea doesn’t, Yohimbe doesn’t.  Many of them have really nasty drug-interaction effects, but they don’t have to say so.

Even at moderate dosage, several of the most common and beloved herbal meds are diuretics, easily produce heartburn and gastrointestinal distress, dry mouth, constipation, diarrhea, anti-platelet effects, numbness of the tongue, and plenty more.

However – don’t panic!   Placebo-takers are usually relatively safe, since a large proportion of products labeled “dietary supplement” don’t actually contain ANY of the ingredients they say they contain.

That’s sort of a backwards double-blind, right?   Maybe we should call it a double-dumb:  if we DID put goldenseal in this lozenge, it’d make you sick, so be glad that we’re lying about that.

Okay, you say, so what do we do if we don’t want to live in placebo-world?

At that point, I’d point out that we’re always living in placebo-world, even when we’re using very standard western medicine, because …

And you’d say DAMMIT just tell me what actually works!   If I have laryngitis, what should I actually do?

Fine:   if your career is involved, go see a real laryngologist or ENT, who can tell you what’s really going on in your cords.  If your career is really involved, act like it, and don’t take advice from Facebook.    

If you’re career isn’t on the line, settle back for a few days.  Check reputable internet sources, like this Mayo clinic site, and realize that in almost all cases, the cords heal themselves without any special treatment at all.

Your brain needs the magic potion, but your cords don’t.