In an earlier post I wrote that Wi-Fi is not a danger to you or your kids and the response on my social media feed was strongly negative. I was bombarded with anecdotes from people who claimed to have become sick, or claimed to know someone who had become sick, after exposure to electromagnetic fields or wireless signals. My response to these people was always the same: it is not the Wi-Fi, it is the "nocebo effect."
What is the "nocebo effect," you ask? To explain, let's start with something everyone has heard of: the "placebo effect".
The placebo effect is a well-documented medical phenomenon where, in the absence of an active ingredient, a "placebo" (often a sugar pill) has the same effect as if an actual pharmaceutical had been used. Research on the placebo effect is both thorough and extensive. In a review article from 2012 over 2,200 studies were identified demonstrating or discussing trials demonstrating the existence of the effect.
Human perceptions are driven by our neurochemistry and human neurochemical responses are understood to vary with mood and perceptions. Interestingly enough even the simple act of smiling can cause a biochemical response improving one's mood. Convince a person with a minor illness that a sugar pill will make them feel better and often it does. This is called the "expectation effect." As everyone knows, the placebo effect does not work on everyone, nor does it work every time. All that is certain is that in as many as one in three people, placebos can affect how people feel.
But let's get back to the "nocebo effect." The nocebo effect is the placebo effect's less attractive younger sibling. While the placebo effect has the ability to help people feel better in the absence of any active ingredients, the nocebo effect has the ability to make a person feel poorly in the absence of any active stimuli. As described in this review paper the nocebo effect is a very real medical phenomenon.
It is important to understand something about the nocebo effect. People who "feel bad" or claim to be "ill" via the nocebo effect are neither lying nor are they fakers. Rather, these people are either associating actual symptoms from other causes to the nocebo or they are having phantom symptoms based on the expectation effect.
There are any number of celebrated examples of the nocebo effect. By far the most entertaining is described in this article from Daily Tech. In that case, a rural community complained about electromagnetic hypersensitivity (EHS) symptoms from radio cell towers even though the radio towers supposedly causing the symptoms had been turned off.
So, what is the basis or my claim that EHS associated with Wi-Fi use is an example of the nocebo effect? That would be the academic literature.
In 2005, Rubin, Munshi and Wessley conducted a systematic review of provocation studies on EHS. Their conclusion:
The symptoms described by "electromagnetic hypersensitivity" sufferers can be severe and are sometimes disabling. However, it has proved difficult to show under blind conditions that exposure to EMF can trigger these symptoms. This suggests that "electromagnetic hypersensitivity" is unrelated to the presence of EMF, although more research into this phenomenon is required.
In 2007, Oftedal et. al. conducted a trial on the possible health effects from mobile phones. Their conclusion:
The study gave no evidence that RF fields from mobile phones may cause head pain or discomfort or influence physiological variables. The most likely reason for the symptoms is a nocebo effect.
In 2008, Roosli conducted a systematic review on radiofrequency electromagnetic field exposure and non-specific symptoms of ill health. His conclusion:
This review showed that the large majority of individuals who claims to be able to detect low level RF-EMF are not able to do so under double-blind conditions. If such individuals exist, they represent a small minority and have not been identified yet. The available observational studies do not allow differentiating between biophysical from EMF and nocebo effects.
In 2010 Rubin, Nieto-Hernandez and Wessley carried out an updated systematic review of provocation studies on idiopathic environmental intolerance attributed to electromagnetic fields (formerly "electromagnetic hypersensitivity"). Their conclusion:
No robust evidence could be found to support this theory. However, the studies included in the review did support the role of the nocebo effect in triggering acute symptoms in IEI-EMF sufferers. Despite the conviction of IEI-EMF sufferers that their symptoms are triggered by exposure to electromagnetic fields, repeated experiments have been unable to replicate this phenomenon under controlled conditions.
I could provide more examples, but instead I will simply point out that the academic literature is essentially unanimous on the subject. It is not the Wi-Fi that is causing your or your children's headaches, it is the nocebo effect.
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Much like overuse of nasal decongestants can lead to a perpetually stuffy nose, rebound headaches are chronic headaches caused by medication overuse. How often is too often? Regularly taking any pain reliever like acetaminophen (Tylenol), aspirin or ibuprofen (Advil, Motrin) more than twice a week, or taking triptans (migraine drugs) for more than 10 days a month, can put you at risk for rebound headaches in just a few months. Don't try to treat these on your own. A doctor can help you stop the culprit drug, using alternatives until it's out of your system. More from Health.com: 18 Signs You're Having a Migraine Headache-Proof Your Home The Top Migraine Triggers Flickr photo by kickthebeat
This is the most common type of headache, which usually feels like a constant aching or pressure -- rather than throbbing -- on both sides of the head or at the back of the head and neck. Triggers can include stress, anxiety, bad posture and clenching your jaw, and these headaches can become chronic, although they usually aren't severe. Experts aren't sure of exact cause, although it may be due to altered brain chemicals or mixed signals in the nerves leading to the brain. These usually respond to over-the-counter pain relievers, such as aspirin, ibuprofen or acetaminophen. Stress-relief may help.
There are dental-related conditions that can trigger headaches or face pain, such as bruxism and temporomandibular joint disorder (TMJ). Bruxism is grinding your teeth at night, while TMJ affects the joints, located just in front of your ear, which connect the jaw to the skull. TMJ can be caused by bad jaw alignment, stress, poor posture (like sitting at a computer all day) or arthritis, which affect the cartilage, muscles or ligaments in the jaw. Your dentist can help diagnose these types of headaches, and treatment includes stretching the jaw, hot or cold packs, stress reduction and bite guards. Flickr photo by US Army Africa
These one-sided headaches are short-lived (15 minutes to 3 hours), but excruciating. These are so painful they're sometimes called the suicide headache. Cluster headaches recur regularly, even multiple times daily, over a certain period of time and then may be followed by a headache-free period of months or even years. There may be redness and tearing in one or both eyes. More common in men than women, cluster headaches can be treated with triptans or oxygen (OTC painkillers may not help). Triggers can include alcohol, cigarettes, high altitudes and certain foods.
Migraines are severe headaches that are three times as common in women as men. The cause isn't clear, but genes do play a role, and brain cell activity may affect blood vessel and nerve cell function. One common migraine trigger is change, including hormones, stress and sleeping or eating patterns. "If you know skipping meals is a trigger, don't skip meals while menstruating and having a late night," says Peter Goadsby, M.D., director of the Headache Center at the University of California, San Francisco. Treatment can include acetaminophen, ibuprofen or triptans (such as Imitrex or Zomig), which are drugs that help treat or prevent migraines. Flickr photo by SashaW
You love your coffee, but it can be a cruel companion. For example, if you have two cups of coffee every day at 9 a.m., and then miss those cups when you oversleep on Saturday -- boom! -- you can end up with a caffeine withdrawal headache. You will be more likely to have them, though, if you drink a lot (say, five cups of coffee a day), then go cold turkey. You have two options, Goadsby says, "You can take caffeine when you normally do and feed the addiction, or quit altogether." Flickr photo by qmnonic
Orgasm-induced headaches are caused by, well, having an orgasm. These are relatively rare and are more common in younger people, particularly men, Flippen says. They usually start shortly after intercourse begins and end in a "thunderclap" headache at climax. A dull headache can often linger for hours or a day. Flippen says that there is often no known cause for these headaches and they usually go away on their own. He does recommend seeing a doctor, however; in rare cases they can be a sign of something more serious. A dose of pain reliever before sex may help ease the pain.
If you're waking up in pain, there are several possible culprits. Migraines are more likely to happen in the morning, or medication may be waning in your body as you sleep, which causes a rebound headache, Goadsby says. Sleep apnea sufferers may also be more prone to headaches early in the day, as are those with dental headaches. Finally -- and this one is the least likely, so relax all of you hypochondriacs out there -- it could be a symptom of a brain tumor, Goadsby says. Flickr photo by me and the sysop
These types of headaches win the gold medal for overdiagnosis, according to Goadsby. People with migraines often mistake them for sinus headaches. (One study found that 88 percent of people with a history of sinus headaches probably had migraines instead.) Symptoms like sinus pressure, nasal congestion and watery eyes can happen in both types. A true sinus headache is related to an infection and comes with nasal discharge that is green or tinged with red, says Goadsby. Sinus infections often resolve with time or antibiotics, if necessary, and shouldn't cause nausea or light sensitivity, which are migraine symptoms. Flickr photo by tanjila
Brain freeze! Most people have experienced the shooting head pain that can occur while enjoying a icy cold drink or treat on a hot day. People with migraines may be especially prone to them. They have an impressive medical name -- sphenopalatine ganglioneuralgia -- but they're not all that serious. Experts think a cold sensation on the roof of the mouth can cause an increase in blood flow to one of the brain's arteries. The cure? Take a momentary break from the frosty goodness until the pain subsides, or sip warm water to help constrict the brain artery. More from Health.com: 18 Signs You're Having a Migraine Headache-Proof Your Home The Top Migraine Triggers Flickr photo by stevendepolo
If you have a headache at least 15 days per month for more than three months you're considered to have chronic daily headaches, says Goadsby. These could be caused by overuse of pain medications (ie, rebound headaches), head injury or, in rare cases, meningitis or tumors. If there is no obvious cause, it could be because your body's pain signals are heightened or not working properly. These headaches may respond to antidepressants; beta blockers like atenolol, metoprolol or propanolol (used to treat high blood pressure and migraines); anti-seizure medications like gabapentin or topiramate; pain relievers like naproxen (Aleve); and even Botox injections.
As if PMS wasn't bad enough, the sudden drop in estrogen right before your period can sometimes trigger migraines, Flippen says. These usually occur between three days before and two days after your period has started. Other women may have PMS-related headaches that aren't migraines. These arrive about six days or so before your period, at the same time as any moodiness, cramping or other PMS symptoms. Flippen recommends over-the-counter headache remedies; magnesium supplements may also help PMS-related head pain.
Some people may experience headaches that mainly show up on the weekend. These are thought to be caused by oversleeping on weekend mornings, going to bed later at night or caffeine withdrawal. Also, if your stress level is high all week, the weekend release may trigger a headache. Over-the-counter pain medications can be helpful, as can sticking to your regular sleep-wake schedule. Flickr photo by bark
Most headaches aren't an emergency, but there are a few symptoms that warrant rapid attention, says Flippen. One is a sudden onset headache that is quickly "explosive." Another is when a headache comes with a fever or extreme rise in blood pressure, or if it occurs after a blow to the head or exertion. Other problematic symptoms include vision or speech change, neck stiffness, dizziness, loss of sensation or muscle weakness on one side of the body. Call 911 if you have these worrisome symptoms in addition to headache. More from Health.com: 18 Signs You're Having a Migraine Headache-Proof Your Home The Top Migraine Triggers Flickr photo by Paul Beattie
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