News from Germany

Der Spiegel has an interview with Professor Bingel about Placebos

AI Summary:

  • Placebo effects are physiologically measurable and involve neurobiological mechanisms, such as the release of endogenous opioids (endorphins), particularly in pain processing. These effects can modulate peripheral nociceptive signaling.
  • Nocebo effects may be equally or even more powerful than placebo effects, especially in pain contexts. Negative expectations can effectively cancel out the pharmacological effect of potent drugs, such as opioids.
  • Open-label placebos (where patients are aware they are receiving a placebo) can still produce therapeutic effects, likely due to conditioning and interpretation of symptom fluctuation.
  • Systemic physiological changes have been observed, including shifts in inflammatory markers, and measurable effects on the cardiovascular, gastrointestinal, and immune systems.
  • "Placebo by proxy" occurs when a caregiver’s positive expectations influence the health outcomes of dependents (e.g., animals or children), relevant in veterinary medicine and pediatrics.
  • Clinical communication functions as a modulator of treatment outcome: framing and verbal interaction can significantly alter therapeutic efficacy or side effect profiles.
  • Nocebo effects are ethically challenging to study, as inducing negative expectations deliberately in patients conflicts with research ethics, limiting empirical data.
  • COVID-19 vaccine studies show that up to 75% of systemic side effects (e.g., headache, fatigue) were due to nocebo responses, highlighting the large-scale relevance of expectation effects.
  • Curricular integration is needed: Placebo and nocebo mechanisms should be part of medical training, with a focus on developing communication skills to harness positive effects and mitigate harm.

Her she refers to her study from 2011. I created a thread for it here.
In a study using the potent, short-acting opioid Remifentanil, Bingel's team investigated how expectations affect pain perception. All participants received the same dose of the drug, but were divided into three groups with different expectation settings: one was unaware treatment had begun (neutral), one was told they were receiving a powerful analgesic (positive), and one was falsely informed the medication was being stopped (negative).

The results were striking: Positive expectation nearly doubled pain relief, while negative expectation almost completely neutralized the drug’s effect — despite identical pharmacological dosing. This demonstrates that negative expectations and emotions can entirely undermine even highly effective treatments. These findings are not limited to experimental opioids but extend to everyday situations, like taking over-the-counter painkillers such as ibuprofen.

The interview ends on a note about mass-hysteria:

AI Summary:
Nocebo effects can spread epidemically when people are confronted with vague or invisible threats, such as fears of electromagnetic radiation from phones or Wi-Fi. Even in the absence of a physical cause, the symptoms experienced by affected individuals are real and distressing. Bingel is particularly interested in the mechanisms that allow negative expectations and fears to spread so rapidly in society. She believes studying these processes could help improve the way accurate and trustworthy information is communicated in the future — a responsibility that also lies with the media.
 

pwME are explicitly excluded from participating. It’s 2025 after all…
AI Translation:


Post-COVID: Study Investigates the Impact of Endurance Training

Magdeburg.
University Medicine Magdeburg is seeking participants for a study on the effectiveness of endurance training for individuals affected by post-COVID.

A study conducted by the University Clinics of Cardiology and Angiology as well as Psychosomatic Medicine and Psychotherapy in Magdeburg aims to determine whether regular endurance training benefits people with post-COVID. The study is looking for participants who have previously contracted COVID-19 and are currently suffering from fatigue. The researchers hope the study will yield new insights to improve current therapies and, in turn, enhance the quality of life for those experiencing long-term effects of COVID-19.

The research team is focusing on three specific questions: Does regular endurance training improve quality of life? Does it reduce fatigue in affected individuals? And what type of training is particularly beneficial? Sports physician Dr. Dörte Ahrens is leading the study and explains:
“So far, there is little solid evidence on effective treatment strategies for long- and post-COVID syndrome. Our goal is also to offer affected patients a sense of perspective, so they don’t feel left alone.”

Participants will be asked to carry out a self-directed training program over a period of three months and document it in a training diary. To support this, they will receive activity trackers and heart rate monitors. Comprehensive examinations will be carried out at the participating clinics before and after this period.

To be eligible for the study, participants must not have any other diagnosed condition that could explain their reduced physical capacity or symptoms. Unfortunately, individuals with a pacemaker, those who are pregnant, have atrial fibrillation, or suffer from Chronic Fatigue Syndrome (CFS) cannot take part in the study.

The study is funded by the German Heart Foundation.


Long-/Post-COVID​

The long-COVID syndrome refers to the persistence of physical, mental, and psychological symptoms that appear more than four weeks after a COVID-19 infection and cannot be explained by other causes. The post-COVID syndrome is defined by symptoms lasting longer than three months.

Contact for those interested in participating:
Outpatient Clinic for Sports Medicine and Prevention, University Clinic for Cardiology and Angiology Magdeburg
praeventionsambulanz@med.ovgu.de
 
They argue that the term "encephalomyelitis" suggests brain and spinal cord inflammation, which is usually not detectable in ME/CFS patients
Medicine's decision to only name diseases based on pathology has been massively disastrous. We keep getting bogged down in stupid details like this. It led to the invention of CFS, which is an even worse name, something that is completely misunderstood by capricious physicians who think it's smart to let millions of people go to waste in part because they pretend that things we have nothing to do with can be used to beat us down and maintain a state of criminal negligence. They keep trotting this out as if it's some valid argument, when all it does is emphasize how they are completely at fault, while insisting we are. What a disaster.

I don't know what drove that move, but a lot of medicine's failures to solve those mysteries can be traced back to it. Because problems can't be worked on before they are understood, and they can't be understood without being worked on. And clearly there is nothing we can do about it, it's all about power and we have none. It's revolting. A collective "look at what they're wearing", and it's cheered on.
 
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