Hi ,

In medical training, we’re often taught to view anything labelled as a “placebo” as insignificant. A placebo is typically defined as an inert substance (sugar pills) or treatment that has no therapeutic effect but is used as a control in testing new drugs or procedures.

Consequently, natural remedies are sometimes dismissed—not because they lack efficacy, but because we don’t fully understand how they might work. The underlying assumption is: if it’s “just” a placebo, it doesn’t count.

However, reading the book The Expectation Effect by David Robson introduced me to a body of research that challenges this perspective. One significant takeaway was that placebos can be effective even when people know that they are receiving a placebo.

In a study called "Placebos without deception: a randomized controlled trial in irritable bowel syndrome."Eighty patients with irritable bowel syndrome (IBS) were assigned to two groups: one received open-label placebo pills, clearly described as inert substances; the other received no treatment. The people in the placebo group were told that the pills "have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.”

Remarkably, the group taking the open-label placebos (open-label meaning that participants knew they were on a placebo) reported significantly greater IBS symptom relief and overall improvement compared to the no-treatment group.

It wasn’t the inert pills themselves that made the difference. Instead, it was how the brain and body responded to the possibility of relief—even when that possibility was openly acknowledged as stemming from a placebo. Numerous studies have demonstrated effects on the brain, endocrine system, immune system, and pain pathways, among others.

This insight led me to ponder: How can I help my patients elicit such beneficial responses? I haven’t figured it out yet.

I would love to hear about your experiences or thoughts on this topic.

Best regards,

Shabnam

Dr. Shabnam Das Kar, MD

Functional Medicine Doctor

Tiny Habits Coach

Email: info@drkarmd.com