Orange Juice Placebo?

ALL:

I had decided not to post in this thread any more unless I was able to try any of the tests suggested in this thread, but here I am.

I have had no more leg cramps of late, so have been unable to test the "drink water instead" suggestion.

I was, however, able to discuss the whole "OJ Placebo" issue with her. she assured me that i was correct, the Potassium in the OJ could not have had a therapeutic effect on my leg muscles THAT quickly, so it was likely that its efficacy with me was a placebo effect. She also said that if it works for me that I should continue the practice, as she could see no harm in it. I discussed (what I could recall of) Ice Rat's post regarding the possibilty that it was a bioflavonoid in the OJ which was behind the effect. She said that she couldn't fully support nor discount the possibility.

She had also prescribed me a Statin drug because of the heart attack, so I mentioned Joey McGee's thought that statins may call for COQ-10, and she said we would discuss that further if the cramps worsened now that I am on a Statin.
 
A couple items to consider:

http://jp.physoc.org/content/587/8/1779.short

Most importantly, "The results suggest that the improvement in exercise performance that is observed when carbohydrate is present in the mouth may be due to the activation of brain regions believed to be involved in reward and motor control."

And this:
http://journals.lww.com/acsm-msse/A...bition_of_Electrically_Induced_Muscle.15.aspx

"We suspect that the rapid inhibition of the electrically induced cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and acts to inhibit the firing of alpha motor neurons of the cramping muscle."

The idea that alpha-motor neurons are involved in muscle cramps is better described in
http://bjsm.bmj.com/content/43/6/401.abstract .

More simply, cramps might not originate in the muscles themselves; instead, they are caused by abnormal activity in the motor nerves controlling the muscles. These nerves are themselves regulated regions of the central nervous system that are responsive to sensory signals - in this case, taste.
 
In that case, dreams could cause cramps? Or a bit of food stuck in your teeth?
 
AdMan said:
Taste (or sight, smell or even thought) of food affecting gastric secretion is not a new discovery.

That levels of particular chemicals (potassium in this case) in food being swallowed can have an almost instantaneous effect on muscles in the extremities requires almost a completely new way of thinking about how the digestive and/or the nervous systems work.

Yes, it is quite a stretch.
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Joey McGee said:
What I'm saying is that the body changes what it is doing based on the presence of new nutrients. It's not that the potassium goes directly to the muscles to help, it's that the hormonal changes cause a shift in the state of the body. Does the sucrose go directly to the nerves to dull the pain? They applied the sugar 2 mins before the procedure tops.
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tesscaline said:
I think you are drastically misunderstanding that study, and how "pain" can be affected by things like taste, sight, sound, etc.

I highly doubt that the study you're referring to is trying to say that the sweet taste has anything to do with how nerve endings respond. In fact, given what I know about the human body and how it handles and interprets pain, I'm pretty darned certain that isn't what the study is saying at all.

But you haven't actually linked the study have you. You're doing nothing but making assumption after assumption based on a really obviously faulty understanding of human physiology.

Show evidence. Don't make baseless suppositions that popped into your head because "you read an article".
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fls said:
From the perspective of a physician...

You don't hear about various concoctions for the treatment of leg cramps from doctors because they tend to make evidence-based recommendations. The conditions are ideal for the discovery that lots of stuff "works" regardless of whether they have an effect - the vast majority of muscle cramps resolve in a short period of time, their frequency waxes and wanes, our recollections as to their frequency and our expectations as to what we can expect without treatment are highly influenced by suggestion.

I have to admit that it didn't occur to me that I had to tell anyone that basic treatment for a leg cramp is stretching and rubbing/massaging the muscle. I thought that was common knowledge.

An important quality for a primary care physician is that they listen to you and are not dismissive. This may not matter much if you are healthy and uncomplicated. But if you can, it's good reason to look for a different primary care doctor.

I find Joey McGee's idea intriguing. Taking, as an example, something we know fairly well...when your blood sugar drops, one of your body's responses is to release adrenaline, which leads to tremors, sweating and hunger. If you take a sugary drink, these symptoms resolve within a few minutes. Considering that the absorption of sugars takes longer than a few minutes, there is likely some other reason for the resolution of these symptoms. Could it be that in anticipation of the eventual sugar absorption (which you know about because of the sweet taste of your drink), your body turns off the adrenaline release? While this is unlikely, it's worth considering long enough to discuss it a little.

Linda
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I do not desire to criticize or take sides on this issue, merely to point out a viewpoint no one has yet expressed that I feel may be relevant.

I think of the body as a machine, with many interlocking subsystems that many people go only as far as the internal perceptions of these systems, and perhaps fail to notice the deeper function.

In this regard, I view the senses of "taste" and "smell" as being more accurately described as analytical chemical sensors (labboratories, almost) that perhaps give the other subsystems (physiology) FAR more information than we can be consciously aware of. Examples might be "odorless" (consciously) chemicals (pheromones) that can elicit emotional responses without having noticeable "odor".
Since "emotions" such as fear and rage cause rapid dumping of hormones into the circulation to facilitate preparing the body for action, is it such a great leap that the sensing of certain other chemicals might cause release of other chemicals such as stored potassium (held in reserve, perhaps) or endorphins to reduce "pain" perception (itself not, IMHO, an end result in itself, but a way the systems warn "central control" of potentially dangerous conditions, so that they are avoided or mitigated)?

Just my thoughts, FWIW.:)



Cheers,

Dave
 
That's it, I'm going into business, medical grade orange juice! Fund a bunch of studies... RSL as spokesman... Feynman sings the theme song (someone get that man some orange juice!!!) billions overnight!

cavedave and dakotajudo, interesting posts! I keep wondering if a lack of available nutrients causes the body go into "conserve" mode where normal functioning is inhibited causing a chain reaction > cramps. Then when the mode is no longer necessary, all of the regular functions start right back up again triggered by the detection of required nutrients. All the parts and mechanisms are frustratingly complex, but it could be studied! And these are all interesting places to look first.

RSLancastr said:
She had also prescribed me a Statin drug because of the heart attack, so I mentioned Joey McGee's thought that statins may call for COQ-10, and she said we would discuss that further if the cramps worsened now that I am on a Statin.
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Not I, we can thank casebro for that contribution :) There's just been so many great posts in this thread you lost track!
 
Joey McGee said:
That's it, I'm going into business, medical grade orange juice! Fund a bunch of studies... RSL as spokesman... Feynman sings the theme song (someone get that man some orange juice!!!) billions overnight!

cavedave and dakotajudo, interesting posts! I keep wondering if a lack of available nutrients causes the body go into "conserve" mode where normal functioning is inhibited causing a chain reaction > cramps. Then when the mode is no longer necessary, all of the regular functions start right back up again triggered by the detection of required nutrients. All the parts and mechanisms are frustratingly complex, but it could be studied! And these are all interesting places to look first.

Not I, we can thank casebro for that contribution :) There's just been so many great posts in this thread you lost track!
Click to expand...

It would seem reasonable to me, and stranger things can happen in such a finely-tuned (via evolutionary trial-and-error) highly-optimized system, and the "cramp" pain would serve to "alarm" the central-control that there was trouble brewing. Acknowledgement of alarm might follow proper corrective measures.

Or I could be just imagining this...
I am NOT a bio-physiologist or anything similar, just an engineer-type who sees familiar patterns...:D

Cheers,

Dave
 
icerat said:
I'm wondering if it's all got to do with the preliminary effects of digestion. When you body gets something it needs to digest, all sorts of things happen in response to what you've ingested. For example, production of acetylcholine is increased, which triggers vasodilation and contraction of stomach muscles. Guess what - a lack of acetylcholine has also been linked to muscle cramps. It's been theorised that Quinine may work on cramps because it has effects on things like acetylcholine.

If this is what's going on, the question is - why does OJ work and not apple juice? Studies have indicated a link between the flavanoid hesperidin, found in significant amounts in OJ, but not apples, and acetylcholine metabolism, but it was tested some 6 hours after ingestion. Hesperidin has also been linked to NO production, which is known to trigger muscle relaxation. It's not out of the question that at least some hesperidin in OJ is being absorbed sublingually and getting an almost immediate effect.

So if this is a real effect, my money is on hesperidin.
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icerat said:
Indeed, hesperidin deficiency as been linked to night leg cramps

Not much research on it though, I found some references to using it as a cramp treatment back in the late 50s and early 60s but can't get the papers.
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dakotajudo said:
A couple items to consider:

http://jp.physoc.org/content/587/8/1779.short

Most importantly, "The results suggest that the improvement in exercise performance that is observed when carbohydrate is present in the mouth may be due to the activation of brain regions believed to be involved in reward and motor control."

And this:
http://journals.lww.com/acsm-msse/A...bition_of_Electrically_Induced_Muscle.15.aspx

"We suspect that the rapid inhibition of the electrically induced cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and acts to inhibit the firing of alpha motor neurons of the cramping muscle."

The idea that alpha-motor neurons are involved in muscle cramps is better described in
http://bjsm.bmj.com/content/43/6/401.abstract .

More simply, cramps might not originate in the muscles themselves; instead, they are caused by abnormal activity in the motor nerves controlling the muscles. These nerves are themselves regulated regions of the central nervous system that are responsive to sensory signals - in this case, taste.
Click to expand...

Just noticed I had previously missed these thoughts.

Quite interesting stuff here!:)

Dave
 
Following on with the theme:
I seem to recall something about Fats and Sugars (ETA: Perhaps that was Carbohydrates in general) in the mouth triggering responses in the bloodstream and/or organs before actual swallowing.

Is this true and relevant?

Dave
 
Last edited:
Dunno if true or relevant, but it is appreciated in this thread regardless - thanks! All I know is that the OJ works - for me - and I was curious if there could be a non-placebo mechanism for its immediate efficacy on me. I will print out many of the posts in this thread and show it to my doc if she is interested.

Whether yours, or any of the other posts pans out, it has been interesting, and I thank EVERYONE for EVERY post in the thread.
 
Just drink your OJ, Robert... and get well soon. (And stay that way) :)
 
Joey McGee said:
Not I, we can thank casebro for that contribution :) There's just been so many great posts in this thread you lost track!
Click to expand...

casebro, right! And I think that my heart attack and hospital stay are more to blame for my miscrediting that than are the number of great posts here, though they are indeed a contributing factor. :)
 
Emet said:
Just drink your OJ, Robert... and get well soon. (And stay that way) :)
Click to expand...

Will do, Emet. I will be eating far more fruits and veggies now, so perhaps the cramps will become a thing of the past!

And I am proud to say that I didn't bite any medical professionals during my hospital stay this week - although some looked quite tasty!
 
CaveDave said:
I do not desire to criticize or take sides on this issue, merely to point out a viewpoint no one has yet expressed that I feel may be relevant.

I think of the body as a machine, with many interlocking subsystems that many people go only as far as the internal perceptions of these systems, and perhaps fail to notice the deeper function.

In this regard, I view the senses of "taste" and "smell" as being more accurately described as analytical chemical sensors (labboratories, almost) that perhaps give the other subsystems (physiology) FAR more information than we can be consciously aware of. Examples might be "odorless" (consciously) chemicals (pheromones) that can elicit emotional responses without having noticeable "odor".
Since "emotions" such as fear and rage cause rapid dumping of hormones into the circulation to facilitate preparing the body for action, is it such a great leap that the sensing of certain other chemicals might cause release of other chemicals such as stored potassium (held in reserve, perhaps) or endorphins to reduce "pain" perception (itself not, IMHO, an end result in itself, but a way the systems warn "central control" of potentially dangerous conditions, so that they are avoided or mitigated)?

Just my thoughts, FWIW.:)



Cheers,

Dave
Click to expand...

Interesting, and, with my near-total lack of knowledge of such things, very plausible (although you lost a few points when you misspelled laboratories)
 
I guess you could try some sugar beside the bed? Take a spoon of it when the cramp awakes you, but send wifey for the OJ. See if the cramp abates before she gets back?
 
Would the fact that Robert is drinking something cold have any impact on the cramps? If so, it would work very quickly.

I am only speculating. Do not ask for any double blind published studies.
 
CaveDave said:
I do not desire to criticize or take sides on this issue, merely to point out a viewpoint no one has yet expressed that I feel may be relevant.

I think of the body as a machine, with many interlocking subsystems that many people go only as far as the internal perceptions of these systems, and perhaps fail to notice the deeper function.

In this regard, I view the senses of "taste" and "smell" as being more accurately described as analytical chemical sensors (labboratories, almost) that perhaps give the other subsystems (physiology) FAR more information than we can be consciously aware of. Examples might be "odorless" (consciously) chemicals (pheromones) that can elicit emotional responses without having noticeable "odor".
Since "emotions" such as fear and rage cause rapid dumping of hormones into the circulation to facilitate preparing the body for action, is it such a great leap that the sensing of certain other chemicals might cause release of other chemicals such as stored potassium (held in reserve, perhaps) or endorphins to reduce "pain" perception (itself not, IMHO, an end result in itself, but a way the systems warn "central control" of potentially dangerous conditions, so that they are avoided or mitigated)?

Just my thoughts, FWIW.:)

Cheers,

Dave
Click to expand...

Dave asked me to comment on his posts. And they seem similar in idea to what Joey McGee brought up earlier, as well.

If we are looking at what sorts of mechanisms can account for immediate effects, it pretty much has to be neurologic - whether perception is altered (such as endorphin release) or whether nerve signals are sent (or interrupted) which modify what is going on in the muscle. Even hormonal responses take longer than described. And remember that very little of the orange juice is absorbed in the stomach - a little water is about it. Some glucose, if present, will be absorbed in the stomach, but that's because it's a mono-saccharide. Most sugars are in the form of disaccharides and have be to split into mono-sacchrarides by enzymes in the small intestine in order to be absorbed. And you need the right receptors. Same goes for other substances in the OJ, such as potassium. So anything which depends upon absorbing something from the OJ will take much, much longer to work than what was reported.

There is a limit to how much physiological change we want to see in response to smell, taste or expectation. After all, if we are wrong, we can be much worse off than we were before (even dead in the case of hypoglycemia). And if we are right, the best we can achieve is a beneficial effect a few seconds or minutes before it was going to happen anyway. So the evolutionary pressure for this would be slight.

We already have a lot of good knowledge about the body's responses to starvation and subsequent re-feeding. And this situation doesn't apply in Robert's case anyway. We do see some physiological responses to taste when it comes to preparing the GI tract for digestion. And those responses differ depending upon taste (fats vs. sugars, for example). We get immediate responses in the reward center for tasting something sweet (and interestingly we seem to be able to distinguish between artificial sweeteners and sugars).

You would have to explain how muscle cramps serves as a useful strategy to correct some deficiency, though. If anything, it will prevent activities which might correct the problem. The only real benefit is to stop someone from continuing to exercise when their muscles are ill-prepared.

Linda
 
Linda, thank you so much for weighing in again. As I posted a few posts above, my doctor (cardiologist) agreed that it was likely placebo, given the immediate effect, but said (as i believe you did) that if it works, she saw no reason not to continue doing it.

And I promise in future to not read things into your posts.
 
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