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	Comments on: Does it matter what&#8217;s in a placebo?	</title>
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		<title>
		By: Greg Laden		</title>
		<link>https://gregladen.com/blog/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525621</link>

		<dc:creator><![CDATA[Greg Laden]]></dc:creator>
		<pubDate>Sat, 30 Oct 2010 22:56:01 +0000</pubDate>
		<guid isPermaLink="false">http://scienceblogs.com/gregladen/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525621</guid>

					<description><![CDATA[I wish thing and think were spelled more differently. ]]></description>
			<content:encoded><![CDATA[<p>I wish thing and think were spelled more differently. </p>
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		<title>
		By: jc morrison		</title>
		<link>https://gregladen.com/blog/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525620</link>

		<dc:creator><![CDATA[jc morrison]]></dc:creator>
		<pubDate>Sat, 30 Oct 2010 22:31:45 +0000</pubDate>
		<guid isPermaLink="false">http://scienceblogs.com/gregladen/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525620</guid>

					<description><![CDATA[that would indeed be interesting.  i think there needs to be more clarity of expression when it comes to the &#039;placebo effect.&#039;  homeopathics have begun to exalt it as evidence of their witchcraft.

btw, the fourth paragraph should contain, i believe, contain the word &#039;think&#039;, instead of &#039;thing&#039;. --&gt; &quot;. . . where a subject who things they were bombarded with rays. . .&quot;]]></description>
			<content:encoded><![CDATA[<p>that would indeed be interesting.  i think there needs to be more clarity of expression when it comes to the &#8216;placebo effect.&#8217;  homeopathics have begun to exalt it as evidence of their witchcraft.</p>
<p>btw, the fourth paragraph should contain, i believe, contain the word &#8216;think&#8217;, instead of &#8216;thing&#8217;. &#8211;> &#8220;. . . where a subject who things they were bombarded with rays. . .&#8221;</p>
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		<title>
		By: daedalous2u		</title>
		<link>https://gregladen.com/blog/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525619</link>

		<dc:creator><![CDATA[daedalous2u]]></dc:creator>
		<pubDate>Sat, 30 Oct 2010 21:26:55 +0000</pubDate>
		<guid isPermaLink="false">http://scienceblogs.com/gregladen/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525619</guid>

					<description><![CDATA[A large part of the physiological placebo response is mediated through nitric oxide signaling and is the â??oppositeâ? of the â??fight or flightâ? response.

http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

Physiology triggers the â??fight or flightâ? response when it needs to go into emergency overdrive, as when you need to run from a bear.  Under such circumstances physiology turns off all non-essential systems and diverts all resources into escape, mostly into ATP for moving muscles and what ever other systems are necessary to continue to make that happen until the emergency is over.  When is the emergency over?  When you have either escaped from the bear, or dropped dead from exhaustion.  

Any physiological activity that consumes ATP, or the substrates that make ATP (oxygen, glucose, fat, etc) and which takes longer to accomplish than the duration of the emergency is non-essential and can be shut-off so the ATP it is using can be diverted to moving muscles.  

The oxidative stress of the â??fight or flightâ? state triggers this and it is a variant of ischemic preconditioning (also triggered by oxidative stress).  This state is characterized by low NO, so that cytochrome c oxidase is disinhibited and so can maximally reduce O2 to water to maximize aerobic ATP production.  Under â??fight or flightâ? conditions, aerobic ATP production is maximized, even if that ATP is simply dissipated as heat because it takes time to ramp up the mitochondria to their maximum potential and when you are running from a bear, and you need a burst of speed, you don&#039;t have any time to wait.  

It is easy to enter the â??fight or flightâ? state.  Standing down from the fight or flight state is more difficult and all the various triggers have to be off.  The â??fight or flight&#039; state has a degree of  hysteresis.  That hysteresis has to be overcome for the opposite of the â??fight or flightâ? state to be triggered.  That requires additional nitric oxide.  That NO can be neurogenic, as the archetypal placebo, a mother&#039;s kiss.  A mother&#039;s kiss tells the infant that all is right with the world and that the infant is safe and can resume its normal infantile activities of eating, sleeping, pooping and most important learning.  Learning how to control its own autonomic nervous system so it can enter the â??fight or flightâ? state when needed, and when it is appropriate to leave that state.  

When you are running from a bear, healing is a luxury you don&#039;t have the ATP to waste on.  This is why physiology turns the rate of healing down when you are under stress.  Healing is a very complex process of many thousands of pathways, all controlled together â??in syncâ?.  Controlled so that the healing proceeds and produces viable tissue of the proper cell composition with the proper vascularization.  Modification of that healing process so it occurs more slowly but while retaining the fidelity of the final healed tissue must also be a controlled process.  In other words, slow healing is just as controlled as fast healing, the only thing that is â??offâ? is the healing rate setpoint.  A setpoint that is turned to slow under times of stress to conserve ATP.  A setpoint that is regulated by NO.  ]]></description>
			<content:encoded><![CDATA[<p>A large part of the physiological placebo response is mediated through nitric oxide signaling and is the â??oppositeâ? of the â??fight or flightâ? response.</p>
<p><a href="http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html" rel="nofollow ugc">http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html</a></p>
<p>Physiology triggers the â??fight or flightâ? response when it needs to go into emergency overdrive, as when you need to run from a bear.  Under such circumstances physiology turns off all non-essential systems and diverts all resources into escape, mostly into ATP for moving muscles and what ever other systems are necessary to continue to make that happen until the emergency is over.  When is the emergency over?  When you have either escaped from the bear, or dropped dead from exhaustion.  </p>
<p>Any physiological activity that consumes ATP, or the substrates that make ATP (oxygen, glucose, fat, etc) and which takes longer to accomplish than the duration of the emergency is non-essential and can be shut-off so the ATP it is using can be diverted to moving muscles.  </p>
<p>The oxidative stress of the â??fight or flightâ? state triggers this and it is a variant of ischemic preconditioning (also triggered by oxidative stress).  This state is characterized by low NO, so that cytochrome c oxidase is disinhibited and so can maximally reduce O2 to water to maximize aerobic ATP production.  Under â??fight or flightâ? conditions, aerobic ATP production is maximized, even if that ATP is simply dissipated as heat because it takes time to ramp up the mitochondria to their maximum potential and when you are running from a bear, and you need a burst of speed, you don&#8217;t have any time to wait.  </p>
<p>It is easy to enter the â??fight or flightâ? state.  Standing down from the fight or flight state is more difficult and all the various triggers have to be off.  The â??fight or flight&#8217; state has a degree of  hysteresis.  That hysteresis has to be overcome for the opposite of the â??fight or flightâ? state to be triggered.  That requires additional nitric oxide.  That NO can be neurogenic, as the archetypal placebo, a mother&#8217;s kiss.  A mother&#8217;s kiss tells the infant that all is right with the world and that the infant is safe and can resume its normal infantile activities of eating, sleeping, pooping and most important learning.  Learning how to control its own autonomic nervous system so it can enter the â??fight or flightâ? state when needed, and when it is appropriate to leave that state.  </p>
<p>When you are running from a bear, healing is a luxury you don&#8217;t have the ATP to waste on.  This is why physiology turns the rate of healing down when you are under stress.  Healing is a very complex process of many thousands of pathways, all controlled together â??in syncâ?.  Controlled so that the healing proceeds and produces viable tissue of the proper cell composition with the proper vascularization.  Modification of that healing process so it occurs more slowly but while retaining the fidelity of the final healed tissue must also be a controlled process.  In other words, slow healing is just as controlled as fast healing, the only thing that is â??offâ? is the healing rate setpoint.  A setpoint that is turned to slow under times of stress to conserve ATP.  A setpoint that is regulated by NO.  </p>
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		<title>
		By: CRM-114		</title>
		<link>https://gregladen.com/blog/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525618</link>

		<dc:creator><![CDATA[CRM-114]]></dc:creator>
		<pubDate>Sat, 30 Oct 2010 19:27:07 +0000</pubDate>
		<guid isPermaLink="false">http://scienceblogs.com/gregladen/2010/10/30/does-it-matter-whats-in-a-plac/#comment-525618</guid>

					<description><![CDATA[I once had a problem with excessive stomach acid (due to my gall bladder leaking). All OTC antacids contain sugar. This is not to sweeten the medicine, as we swallow the pills whole. The sugar is added to prompt the stomach to produce more acid.

When I learned this, I carried around an old aspirin bottle I kept filled with sodium bicarbonate, which went to work immediately and contained no sugar.

(BTW, I still have the 167 gallstones in a bottle.)]]></description>
			<content:encoded><![CDATA[<p>I once had a problem with excessive stomach acid (due to my gall bladder leaking). All OTC antacids contain sugar. This is not to sweeten the medicine, as we swallow the pills whole. The sugar is added to prompt the stomach to produce more acid.</p>
<p>When I learned this, I carried around an old aspirin bottle I kept filled with sodium bicarbonate, which went to work immediately and contained no sugar.</p>
<p>(BTW, I still have the 167 gallstones in a bottle.)</p>
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