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In response to questions from readers and patients, I’m doing a series on how medications can make you sick. I've talked a little about herbs and supplements and will go into more depth about these again in the future, but will concentrate just on medications, OTC (over the counter) and prescribed for this series.
This isn’t to start some kind of conspiracy thing. This is so people can make informed decisions about medications, supplements and herbs they take and whether or not these substances are the best things for them.
Are you taking too much?
I frequently see individuals residing in nursing homes. Typically I’m called in because of a change in the person’s ability to think or the way they’re acting.
The first thing I do, even before talking to the patients, is evaluate their medications, vitamins and supplements. This is because sometimes the drugs they take are making their symptoms worse.
Sometimes a single drug (medications for bladder leakage and for sleep are particularly bad) can cause changes in memory or thinking. Sometimes drugs in combination can multiply these problems (think anxiety medications and drugs for sleeping.)
Do you get paid to prescribe this?
I was giving a presentation about medications. During the question and answer session, someone asked me how much doctors get for prescribing the medications they do.
I wasn’t sure if the person was putting me on, or if they really meant it. I’ve come to know this person well over the years, however, and realize he was quite serious. At the time though, I didn’t know if he was just being insulting.
Instead of getting angry, I took the question at face value. I explained that taking money for prescribing a specific medication is illegal and should be. I then asked him to tell me why he thought this is what physicians do.
He told the group that his mother resided in a nursing home and had seventeen medications and supplements prescribed. The bill was astronomical, he told us. He just figured we must be getting some kind of reimbursement for prescribing so many drugs.
I explained that what often happens is that one clinician prescribes one medication, then a second adds something.
Yet another clinician sees what the person is on and thinks that part of the symptoms they’ve been asked to evaluate may be made worse, or even caused by, the medications prescribed. However, because they don’t want to insult another prescriber by countering that person's orders, they add something different to eliminate the side effects that one drug is causing,
And the merry-go-round continues...
Anything you take can cause trouble.
The fact is, no substance we take into our bodies is guaranteed to never cause trouble. Water can be a problem if it is contaminated or your body can't get rid of it. For people drinking water from local wells, arsenic may be present and could cause harm.
Statistics show that more than thirty million adult Americans take over the counter sleeping medications. The most common ingredients in these are diphenhydramine and doxylamine, both antihistamines, and melatonin, a naturally-occurring hormone
Seventy six percent (over 170 million) of Americans regularly use dietary supplements. Popular ones include B complex vitamins; Vitamin D to help with bone health and to boost the immune system, and vitamin C to avoid colds and other infections.
But all of these substances, if taken in excessive doses, can cause problems. Just because they’re vitamins doesn’t mean they can’t cause trouble.
Too much of a good thing
OTC sleeping meds can cause memory disturbances, daytime sedation and heart palpitations (fluttering.)
Likewise, everyday vitamins can have side effects.
Too much of the B vitamins causes skin flushing, diarrhea and increased bleeding.
Vitamin C doses well above normal can result in headaches, gut cramps, nausea, vomiting and sleep problems.
Excessive amounts of Vitamin D can cause the body to absorb too much calcium, resulting in brittle bones and kidney stones.
I’m a big believer in taking medications the way they’re prescribed and using vitamin and herbal supplements to try to treat or prevent whatever conditions we can. However, I’m also big on having people study up on whatever they take into their bodies to be informed and able to ask good questions.
Classes of medications
In this series I’m going to just concentrate on medications that I personally see causing physical, emotional, and memory problems. These are the drugs I most often run into and need to help clinicians and their patients modify.
Some of the medications I’m going to focus on include:
Sleep medications, both OTC and prescription
Medications for anxiety and mood
Medications for urinary incontinence (dribbling pee) and bladder spasm
Medications for nausea, vomiting, gut cramps and diarrhea
On line resources for reviewing what you take
One thing I strongly recommend is that you look at multiple sources to learn about how different substances can affect you. Every site has some biases.
For example, if a site is into selling vitamins, they might not want to go to huge lengths to emphasize the damage some of these can cause if used incorrectly.
Likewise, some places may get too careful and constantly tell you “…there is insufficient data to make a strong recommendation…” which makes it difficult to feel truly informed.
This isn’t to say that any site would lie, just that the slant may be different. And the more slants you know, the more angles you can avoid.
There are many helpful places to look to gain information regarding medications, dietary supplements, herbs and side effects. I have listed just a few of the sites I use below. If you are aware of some that you really like, please send me a link so I can look them over and pass them on if they look good.
Thanks.
drugs.com/drug_interactions
druginfo.nlm.nih.gov/drugportal
epocrates.com
Image of nauseated person by: © Can Stock Photo Inc. /Good_Stock
Image of B6 cap by : © Can Stock Photo Inc. /vantuzfff
Image of Vitamin D molecule by: © Can Stock Photo Inc. /zerbor