How Do Placebos Work?


There’s a reason eating your grandmother’s chicken soup or dabbing your temples with essential oil of peppermint might make you feel better if you’re sick, and it’s probably not because they're truly curative. Your relief is likely the result of the placebo effect.

A placebo is an inert substance, such as a sugar pill or saline solution, that is specifically given to a patient because it's not intended to have a measurable effect on their physiology. Placebos are often used as controls in clinical trials and experiments to set a baseline by which to compare the effects of new drugs and medical treatments. They’re not supposed to be treatments in and of themselves. And yet studies show that placebos not only often have a measurable effect on the people who take them, but can actually improve someone's condition.

Researchers have documented this effect for pain treatment, irritable bowel syndrome, and high-altitude sickness, among other conditions. Even sham knee surgeries have been shown to produce nearly identical pain relief to actual meniscus surgery.

What's going on here?


John Kelley, deputy director of the Program in Placebo Studies (PiPS) at Beth Israel Deaconess Medical Center at Harvard Medical School, tells Mental Floss that a patient's expectations about whether or not a medication will work are central to the placebo effect. Even the color and size of placebo pills have been shown to affect the power of fake medicine. Both small and large pills elicit a stronger placebo effect than middle-sized ones. People assume that a tiny pill "must be really powerful medicine if it’s so small,” Kelley explains, while an oversized pill makes people think, ‘Wow, there’s a lot of medicine there. I’m getting a big treatment.’”

Another factor at work is whether an individual has had previous experience with the form of treatment, called conditioning, and has thus developed what Kelley calls “a conscious expectancy” that it will work again. The greater the conditioning, often the greater the placebo effect.

The human element is key, too. A patient's sense of the competence and warmth of their practitioner, and their comfort in the treatment setting—"a fancy, prestigious medical school versus a ramshackle, dubious-looking office,” Kelley says—can influence the placebo effect.


Having an expectation of healing leads to the physiological relief of symptoms because there's a biological process underpinning our responses. “Every thought, emotion, and feeling we have has a biological substrate,” Kelley says. For example, the brains of people given placebos for pain medication have been shown to release naturally occurring opioids, which provide actual pain relief. Research has shown that anticipation stimulates the brain’s reward system, just as opioid drugs do.

What’s more, Kelley says, in trials where patients were conditioned to receive pain relief from either the opioid morphine or a placebo, and then subsequently were given the opioid-blocking drug Nalaxone, the drug prevented both the morphine and the placebo from giving the patients pain relief. Researchers suspect that merely having an expectation of relief recruited the brain to release the endogenous opioids—which were then blocked by the Nalaxone.

Similarly, placebo trials of Parkinson’s medications have also found that patients' brains release dopamine in response to placebos, temporarily relieving symptoms such as tremors and stiff muscles. Kelley says the brain likely uses different mechanisms to respond to different conditions, which could explain why, for example, it produces endogenous opioids for pain and dopamine for Parkinson’s.

Placebos can work even when recipients know they're taking a placebo. That was the case in one seminal study involving patients with irritable bowel syndrome [PDF], in which researchers found that giving patients pills clearly labeled as placebos reduced the severity of their symptoms versus control participants who received no pills at all.

More research is necessary to understand why placebos can work even when we know they shouldn't, but the lead researcher of the IBS study, Ted Kaptchuk, also with the PiPS program, told NPR that “a trusting relationship between the doctor and patient” is likely important. Perhaps the expectation of being cared for is enough to bring relief to some.

Kelley believes it may come down to a kind of selective attention. Even if a patient knows they're taking a placebo, they're “paying attention to one set of stimuli and avoiding another,” he says, which redirects their focus from pain to an experience of relief.

While scientists continue to unravel the mysterious power of the mind to influence the body, the next time you have a headache, maybe try a sugar pill instead of an aspirin; it can’t hurt, and it might even help.

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What Is the Kitchen Like on the International Space Station?


Clayton C. Anderson:

The International Space Station (ISS) does not really have a "kitchen" as many of us here on Earth might relate to. But, there is an area called the "galley" which serves the purpose of allowing for food preparation and consumption. I believe the term "galley" comes from the military, and it was used specifically in the space shuttle program. I guess it carried over to the ISS.

The Russian segment had the ONLY galley when I flew in 2007. There was a table for three, and the galley consisted of a water system—allowing us to hydrate our food packages (as needed) with warm (tepid) or hot (extremely) water—and a food warmer. The food warmer designed by the Russians was strictly used for their cans of food (about the size of a can of cat food in America). The U.S. developed a second food warmer (shaped like a briefcase) that we could use to heat the more "flexibly packaged" foodstuffs (packets) sent from America.

Later in the ISS lifetime, a second galley area was provided in the U.S. segment. It is positioned in Node 1 (Unity) and a table is also available there for the astronauts' dining pleasures. Apparently, it was added because of the increasing crew size experienced these days (6), to have more options. During my brief visit to ISS in 2010 (12 days or so) as a Discovery crewmember, I found the mealtimes to be much more segregated than when I spent five months on board. The Russians ate in the Russian segment. The shuttle astronauts ate in the shuttle. The U.S. ISS astronauts ate in Node 1, but often at totally different times. While we did have a combined dinner in Node 1 during STS-131 (with the Expedition 23 crew), this is one of the perceived negatives of the "multiple-galley" scenario. My long duration stint on ISS was highlighted by the fact that Fyodor Yurchikhin, Oleg Kotov, and I had every single meal together. The fellowship we—or at least I—experienced during those meals is something I will never, ever forget. We laughed, we argued, we celebrated, we mourned …, all around our zero-gravity "dinner table." Awesome stuff!

This post originally appeared on Quora. Click here to view.

Clayton "Astro Clay" Anderson is an astronaut, motivational speaker, author, and STEAM education advocate.

His award-winning book The Ordinary Spaceman, Astronaut Edition Fisher Space Pen, and new children's books A is for Astronaut; Blasting Through the Alphabet and It's a Question of Space: An Ordinary Astronaut's Answers to Sometimes Extraordinary Questions are available at For speaking events Follow @Astro_Clay #WeBelieveInAstronauts

What Do the Numbers and Letters on a Boarding Pass Mean? Dutton Dutton

Picture this: You're about to embark on a vacation or business trip, and you have to fly to reach your destination. You get to the airport, make it through the security checkpoint, and breathe a sigh of relief. What do you do next? After putting your shoes back on, you'll probably look at your boarding pass to double-check your gate number and boarding time. You might scan the information screen for your flight number to see if your plane will arrive on schedule, and at some point before boarding, you'll also probably check your zone and seat numbers.

Aside from these key nuggets of information, the other letters and numbers on your boarding pass might seem like gobbledygook. If you find this layout confusing, you're not the only one. Designer and creative director Tyler Thompson once commented that it was almost as if "someone put on a blindfold, drank a fifth of whiskey, spun around 100 times, got kicked in the face by a mule … and then just started puking numbers and letters onto the boarding pass at random."

Of course, these seemingly secret codes aren't exactly secret, and they aren't random either. So let's break it down, starting with the six-character code you'll see somewhere on your boarding pass. This is your Passenger Name Reference (or PNR for short). On some boarding passes—like the one shown below—it may be referred to as a record locator or reservation code.

A boarding pass
Piergiuliano Chesi, Wikimedia Commons // Public domain

These alphanumeric codes are randomly generated, but they're also unique to your personal travel itinerary. They give airlines access to key information about your contact information and reservation—even your meal preferences. This is why it's ill-advised to post a photo of your boarding pass to social media while waiting at your airport gate. A hacker could theoretically use that PNR to access your account, and from there they could claim your frequent flier miles, change your flight details, or cancel your trip altogether.

You might also see a random standalone letter on your boarding pass. This references your booking class. "A" and "F," for instance, are typically used for first-class seats. The letter "Y" generally stands for economy class, while "Q" is an economy ticket purchased at a discounted rate. If you see a "B" you might be in luck—it means you could be eligible for a seat upgrade.

There might be other letters, too. "S/O," which is short for stopover, means you have a layover that lasts longer than four hours in the U.S. or more than 24 hours in another country. Likewise, "STPC" means "stopover paid by carrier," so you'll likely be put up in a hotel free of charge. Score!

One code you probably don’t want to see is "SSSS," which means your chances of getting stopped by TSA agents for a "Secondary Security Screening Selection" are high. For whatever reason, you've been identified as a higher security risk. This could be because you've booked last-minute or international one-way flights, or perhaps you've traveled to a "high-risk country." It could also be completely random.

Still confused? For a visual of what that all these codes look like on a boarding pass, check out this helpful infographic published by Lifehacker.

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