Polypharmacy, the “Polypill” and Adverse Drug Reactions – What You Can Do to Protect Your Health

To say that I’ve been dealing with medication side effects for my entire career is no lie; within weeks of starting my cardiology practice, a hypertensive woman came to see me. She was reacting dramatically to a commonly prescribed diuretic and had developed a potassium deficiency that was causing muscle cramping and extreme weakness.

Even though I had prescribed drugs during my advanced medical training, I’d never seen a side effect that severe. It was an eye-opener, and the experience drove home the reality of adverse drug reactions. Textbooks and marketing ads generally describe medication side effects as “rare”—but they are real, and doctors too often tend to dismiss or downplay them when patients complain.

Too Many Meds

As my practice matured, I began to see more patients referred by internists and general practitioners in the area. Some of these folks were taking a half-dozen or more prescription drugs. Over time, a familiar pattern emerged. In addition to cardiovascular issues, these patients often had profound weakness and lethargy, disorientation, sleeplessness, nightmares, depression, heart failure symptoms (even when they didn’t have heart failure), constipation, and episodes of falling.

It became clear that drugs were exacerbating, rather than solving, their problems, and that these patients’ health was being damaged by the laundry lists of medications they were taking. Drugs for diabetes, hypertension, pain, depression, anxiety, cancer—you name it, they were on it.

I even had new patients who, as they were filling out medical history forms, asked for extra paper because six lines weren’t enough to write down all of their medications. One new patient was taking 18 drugs. It was medical madness!

The Rise of Polypharmacy and the “Polypill”

As you would expect, many of the patients I saw were elderly. With age, the body becomes less able to handle multiple medications and drugs are more likely to cause adverse reactions.

A 2015 report in the Journal of the American Medical Association calling out the dangers of “polypharmacy”—the prescription of five or more drugs to one person—gave me hope that this dangerous practice might change. But then I read an op ed piece in the Wall Street Journal advocating for a “polypill”—a single pill that contains medications for multiple conditions. For example, a statin may be combined with a blood sugar or blood pressure medication in a single tablet.

Heaven help us all.

Proponents of the polypill maintain that it will promote better patient compliance with taking medication and therefore improve outcomes. I see nothing but trouble. A polypill may make it more convenient for someone to take medications, but it doesn’t address the more fundamental issue—the fact that people are taking too many drugs in the first place. In fact, it just makes it easier to give them even more. That’s not smart medicine.

More Drugs, More Adverse Reactions

The biggest risk of polypharmacy is drug interactions. The more medications a patient takes, the higher the risk of unwanted or dangerous side effects. Here are some of the numbers:

  • Nearly 50 percent of older adults take one or more medications that are not medically necessary.
  • Interviews with 59 people over age 65 participating in one of Cuyahoga County, Ohio’s senior programs found that about 35 percent were taking five or more drugs. Of that 35 percent, more than half had contraindicated drug combinations. The same study revealed that polypharmacy was more highly associated with patients taking a drug more than once than with not taking a drug at all.
  • Through a Scottish study of more than 300,000 patients of all ages, researchers found that the number of patients taking 5 or more drugs between 1995 and 2010 increased from 12 percent to 22 percent, and for 10 or more drugs from 1.9 to 5.8 percent. Among patients over age 65, 1 in 6 was taking 10 or more drugs.
  • The estimated incidence of drug interactions rises from 6 percent in patients taking 2 medications a day to as high as 50 percent in patients taking 5 a day, according to one cardiology journal.
  • A U.S. analysis showed that the proportion of outpatient consultations between 1995 and 2005 in which patients took 5 or more medications increased from 6 percent to 15 percent. The rate of outpatient or emergency room consultation where an adverse drug event was reported increased from 13 to 18 persons per 1,000 persons during the same period.

A Better Path to Health

The solution to this problem is clear to me. To reduce both the number of medicines prescribed and the risk of adverse drug reactions, it’s time for all doctors to fully embrace an integrative approach to medicine. Prescription medicines are one tool that can help patients get well. But alternatives such as dietary interventions, targeted nutritional supplements, and stress-reducing techniques can be just as effective—without the life-crushing side effects.

If you‘re on multiple medications, I urge you to have a heart-to-heart with your doctor about safely cutting down. Be direct; ask straight away if you truly need all those drugs. It may feel uncomfortable, but you have to be your own advocate.

In the meantime, there are steps you can take on your own to protect against medication side effects, and even lay the groundwork for getting off some of those drugs:

  • Improve your diet. Follow an anti-inflammatory diet, like my Pan Asian Mediterranean Diet, which is full of antioxidant-rich fruits and vegetables. Antioxidant support is essential to help offset the inflammation associated with most chronic illnesses.
  • Educate yourself about nutritional supplements. Consult with a nutritionally-oriented doctor who can customize a program of targeted supplements that provide extra “insurance” against nutrient-depleting drugs and inflammation.
  • Minimize the sugar in your diet. Sugar may be the single most dangerous substance we eat in our food today, because it is a major cause of inflammation and metabolic disturbances. You simply cannot regain your health if your sugar consumption is high.
  • Lose weight. For conditions such as high blood pressure or diabetes, a loss of just 5–10 pounds can make an enormous difference in the amount of medication needed to treat them. Remember, you may not be able to completely eliminate a drug, but you may be able to significantly cut down your dosage.
  • Be active. Walking, dancing, or some form of regular physical activity—even a minimum amount—can make a difference in your health. It also will make losing weight easier.
  • Get a handle on stress. If you take medication for anxiety, mild depression, or any other stress-related condition, try to reduce your dosage by exploring techniques that can help reduce your stress level. For additional support, I also like a homeopathic formula made from flowers called Rescue Remedy. It’s definitely worth keeping handy for occasions when you feel anxious or stressed.
  • Support your liver. This organ processes the medications you’re taking and detoxes them out of your system, which means it’s extremely important to keep it working efficiently. Buildup from too many meds can lead you down a path toward liver failure. You can help your liver by eating artichokes a couple times a week and taking the nutritional supplement milk thistle. Both are high in compounds that protect the liver.
  • Get (and stay) grounded. Last but not least, use Earthing to reconnect your body with the natural energy in the ground. Research is showing that grounding can reduce inflammation and inflammatory symptoms such as pain, as well as improve sleep and energy.

Taking these steps not only will help you protect yourself from drug toxicity and adverse reactions, but  improve your health enough that you may not need so many medicines to begin with. Even a reduction is a win. If you can take three or four drugs instead of five—or even more—you’re better off.

References:

© 2015, 2016 HeartMD Institute. All rights reserved. 

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4 Comments

  1. Bonnie

    on August 31, 2016 at 12:08 pm

    Reply

    They have my 79 year old mom on three blood pressure medications. Her blood pressure is 90 over 60. And of course she is on a blood thinner because she has developed A-fib. She will not listen to me when I try to get her to stop trying to get her blood pressure lower. She doesnt want to try anything natural. She read and article about how vitamin D was bad for her so she decided to stop taking her vitamin D. I think I convinced her to keep taking her vitamin D. I cant get her to take CoQ10 or Ubiquinol. I take it.
    It is so frustrating and she still thinks all fat is bad and that you should eat lots of bread and other carbs. I tried to tell her that if you get your blood pressure too low that you die. I am pretty sure that even if I was a respected Doctor of medicine that she would still not listen to me and would only listen to her Doctor. I am not on any medications by the way and we raise our own meat and grow a lot of our own veggies without chemicals. We also raise our own eggs and milk our own goats and drink raw goats milk and goat milk kefir. I buy organic if we cant grow it. My mom thinks that is silly. I am not sure if she is on a statin, she says she isn’t. Seems like every time she goes to the doctor she gets another medication. Thankfully so far she has not had problems with her blood sugar and she still goes out and walks for exercise with her dog.

  2. Rita Clarke

    on August 31, 2016 at 1:07 pm

    Reply

    This is a story I’m sure you’ve heard scores of times; but this is MY story and I have to share it with you because I feel that your statements are rock-solid. Fell last September; broke the femur ball; had surgery and then sent to 10-days in rehab center where, despite my protesting, I was given a daily dose of Restoril and Norco, along with and as-needed my own loperamide. I pleaded with them to let me have aspirin or ibuprophen instead; one doc laughed at me. Of course, they had gone thru my stuff when I arrived and removed my own OTC drugs. Anyway (its a long story),when I got home, it took me two months to wean myself from the opiates BUT I knew I had to – having had a sister who was an addict, I knew it was up to me to get back to my ordinary life. What a hideous way to treat “old people” (I’m 76). I’m still angry about it. What has happened to “do no harm?!” However, I’m grateful for you, Dr. Sinatra.

  3. Sarah Bruno

    on September 1, 2016 at 11:24 am

    Reply

    where does one find a list of holistic Dr like yourself and Mark Hyman. new to the hudvalley area and spoiled with my Dr and naturopaths in AZ and difficult finding a god DR who listens. I am living in Tuxedo Park, NY 10987.
    I do have fib am 80 and had total knee replacement at HSS making a excellent RECOVERY DID SO WARFIN FOR 5 WKS AND NOW BACK ON NATTOKWINASE 100 MG BID NO PAIN MEDS AT THIS TIME TAKE PROPRANOLOL 60 MG HS TRIED MANY HEART MEDS AND ALLERGIC AND DO THE BEST ON THIS ONE. TAKE GOOD SUPPLEMENTS FOR MY HEARTand body struggle with my adrenals and really have to pace myself. have use your heart formula for a while but after 1 yrs or so stopped as pills too big and hard to swallow.

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