The new year is a great time to examine personal habits and practices — and resolve to make the changes needed to improve your health. One often overlooked area is that of medications and supplements. It might sound unimportant, but in fact could save your life.
According to the Mayo Clinic, almost 70 percent of adults take at least one prescription medication, and twenty percent of adult patients take five or more prescriptions. “Polypharmacy” is the term that describes the use of multiple drugs at the same time, and can be harmful or even fatal if not carefully managed. Medication side effects send approximately 1 million people to the emergency department every year, a number that continues to grow. Some estimates rank medication side effects as the fourth leading cause of death in the U.S.
In addition to prescription drugs, 71 percent of Americans, or more than 170 million, use dietary supplements, according to Nutraceuticals World, and 81 percent of us take over-the-counter (OTC) medications, according to the Consumer Healthcare Products Association. Most of us don’t even consider that we may be dosing ourselves with a potentially lethal combination of drugs and supplements. I see this almost daily in my practice, and encourage patients to view supplements as the “drugs” they are.
Just because OTC drugs and supplements are readily available for purchase does not make them safe to use for all patients. I commonly hear that “I read it on the internet,” but that doesn’t mean it’s a good idea for you to take it. In fact, 60 percent of the medical information sourced from “Dr. Google” is just plain wrong or not pertinent advice, according to the NEJM Journal Watch. A thorough evaluation of the drugs and supplements patients take is and should be a critical part of any medical assessment. Assuring that the drugs and supplements used are safe and effective for the specific patient is a critical component of personalized patient care.
The problem is that medications and supplements are often broken down (metabolized) by the body in similar ways. Think of it like I95 — too many cars on the road can cause a traffic backup, only so many cars can get through and accidents will likely occur if the traffic is not carefully monitored. These “traffic problems” can cause either too much or too little of the drug or supplement, or its metabolized (broken down) form, to end up in the system. The resulting side effects can include nausea, rash, headaches, flu-like symptoms, cognition problems and even cardiac arrest.
One common example is cholesterol medication (statins). It is well known that statins deplete CO-Q10, a vital and critical antioxidant that clears toxins from our system. Vitamin E has the same effect, and when taken with a statin, can cause a dangerous depletion of this vital antioxidant. This is only one of a multitude of examples.
Drugs taken with other drugs or supplements generally result in one of three effects.
1) Additive: Causes a stronger effect than when the drug or supplement is taken alone.
2) Antagonistic: Often less of an effect than when the drug or supplement is taken alone.
3) Synergistic: When more than one drug/supplement work together to treat the same symptoms but often in a different way.
Dosing can also affect the safety and effectiveness of supplements and medications. Some drugs and supplements bind to each other or foods, which may render them ineffective. Others are best absorbed when taken with food. Alcohol, itself a drug, can be a dangerous partner when consumed with many drugs and supplements.
So, what is the average person to do? Let’s start with the basics. Drugs and supplements can both be beneficial, but only when properly prescribed. The goal of any drug and/or supplement therapy should be to improve health, and not result in new or worsening symptoms.
When was the last time you completed a medication and supplement review with your health care provider or pharmacist? And what about all those supplements you have bought over the past year? Ask your healthcare provider to review all your prescriptions, OTC drugs, and supplements at least annually; the new year is a great time to do this.
Too often, I see well-meaning patients bring a large bag of supplements, OTC and prescription drugs to their appointment with no idea how they are designed to work, how to take them or whether they interact with other drugs or supplements.
Be an educated consumer, monitor your response to any drug or supplement, and report adverse reactions immediately. Keep good medication and supplement records, and throw out those you can’t tolerate or no longer use. By taking the time to review your medications and supplements at least yearly, you may be saving your own life!
Lynn Kettell-Slifer, ARNP, is a healthcare provider at Health Partners LLC in Ponte Vedra Beach. She is trained in functional medicine through The Institute for Functional Medicine, and is certified in The Bredesen Protocol for Cognitive Decline. Visit www.HealthPartnersLLC.net for more information.