Medication Issues to Discuss With Your Doctor

Why am I, a personal trainer and a health professional working with balance, concerned about medications?

  1. Some medications, such as medications for anxiety and depression and sleeping medications, have been associated with a higher risk of falling. Others can have a negative impact on the muscles, nerves, or memory, which may limit the effectiveness of physical therapy interventions.
  2. Drugs can deplete nutrients, many of which are critical for maintaining health, energy, and muscular strength and balance.
  3. One of the risk factors for falling is taking 5 or more prescription drugs.

 

I am concerned when the medications have such a direct relation to the results I can achieve in my field. However, I am not a physician and do not intend, in any way, to give advice concerning medications. The information on this website is intended solely to provide some background information that I have gathered and cited from various sources and to raise helpful questions for the patient to discuss with the responsible physician. Information on this website is not intended to diagnose, treat, cure or prevent any disease.

 

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Some Medications Can Impair Balance or Muscle/Nerve Function

“Doctor, is there a safe alternative to my medication?”

 

Drugs for anxiety and depression 

Drugs for anxiety and depression are associated with a higher risk of falling among older adults. It could be helpful to discuss the possible questions listed below with your physician:

  • Could there be a physical reason for my anxiety or depression that could be found with the appropriate lab tests (such as those given by Genova Diagnostics)? Could my anxiety or depression be a manifestation of factors that could be uncovered and treated, such as those discussed in Dr. Kelly Brogan’s book A Mind of Your Own or Dr. Peter Bongiorno’s book How Come They’re Happy and I’m Not?
  • Would homeopathic remedies be an alternative to my prescription medications? Homeopathy is a powerful healing system for the mind, as well as the body.
  • Are there any herbal remedies that would be appropriate?
  • Could I try the Bach Flower Essences? The 38 Remedies address the range of human emotions. This gentle method of healing developed by Edward Bach, MD had been shown to have positive effects without side effects or drug interactions.
  • Could psychotherapy help to relieve my anxiety or depression and possibly allow me to reduce my prescription medications?
  • Could instruction in stress management or meditation possibly help me to reduce my prescription medications?

 

Drugs for sleeping problems 

Sleeping medications are also associated with a higher risk of falling among older adults. Similar questions to those above could be discussed with the physician:

  • Could my sleep problems be associated with nutrient deficiencies or other physical causes that could be uncovered by lab testing (for example, by Genova Diagnostics)?
  • Could homeopathic remedies improve my sleep and be an alternative to prescription medications?
  • Would Valerian Root or other herbal remedies by a possible alternative?
  • Could I try the appropriate Bach Flower Essences? This system has remedies that could promote quality sleep.
  • Would psychotherapy help me decrease my medications if it relieved thoughts and worries prohibiting sleep?
  • Would stress management or meditation allow me to learn to sleep without medications?

 

Statin Drugs

(Statins are drugs that curtail cholesterol biosynthesis, such as Altoprev (lovastatin extended-release), Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Livalo (pitavastatin), Mevacor (lovastatin), Pravachol (pravastatin), Zocor (simvastatin).

As a physical therapist, I worry about the possible damage to nerves, muscles, and memory from these drugs. Such damage limits the amount of progress I can make with these patients.

 

Are statin drugs the best way to prevent heart disease, heart attacks, and strokes?

“Though designed for reduction of cholesterol biosynthesis, a task they accomplish with great proficiency, we now are finding that this fact of statin drug effect is increasingly irrelevant to cardiovascular disease risk reduction. Atherosclerosis, the underlying cause of heart attacks and strokes, we now know to be the result of inflammatory factors associated with deficiencies of vitamin B6, vitamin B12 and Folic acid, allowing abnormally high levels of homocysteine, the major player in atherosclerotic change. Coagulation defects, trans fats, oxycholesterols, platelet factors, omega 3/6 imbalance, chronic infections and selected anti-oxidant deficiencies are responsible for most of the rest.” From The Dark Side of Statins by Duane Graveline, M.D.

 

So cholesterol is not “the bad guy?”

“Cholesterol no longer is deserving of even a place in the “usual suspect category.” The extraordinarily important roles of cholesterol in human physiology are now abundantly documented in the previous chapter, and although cognitive deficits of all kinds appear to be our primary clinical indicator of cholesterol lack, the role of cholesterol in cell signaling and communication and immune processes via formation and function of lipid rafts may be of far greater importance.” From The Dark Side of Statins by Duane Graveline, M.D.

 

What are the side effects of the statin drugs?

Duane Graveline, M.D., M.P.H., A NASA flight surgeon, experienced transient global amnesia while taking statin drugs, and later developed an ALS-like condition characterized by permanent and progressive muscle and nerve damage.

In his words, “Early on my NASA doctors told me my amnesia response to statins was nothing but a coincidence but I persevered to write my first book, “Lipitor®, Thief of memory” and now find that over 1,000 cases of amnesia and memory loss have been reported to the FDA, just from Lipitor® alone.”

“Then I learned of statin damage to nerves and muscles and profound behavioral and personality changes, demanding I write a second book, ‘Statin Drugs Side Effects.'”

“The reality is that statins are extremely potent drugs which interfere with our body biochemistry at a very fundamental level. They block the production of – not just cholesterol itself; in itself a critical substance that is essential for human life and health. They also block the production of other vital chemicals; co-enxyme Q-10 and dolichols, to name but two.” From The Statin Damage Crisis, p. 9 by Duane Graveline, M.D.

 

Why aren’t doctors being informed of the problems with statin drug use?

“In my review six years ago of MedWatch data from 1997 to 2006, I reported finding 662 serious cognitive loss problems, just from this one statin alone and they all do it! At no time in the past decade has the FDA seen fit to report this to the practicing physicians out there, and the same situation holds for the entire range of statin drug side effects, whether rhabdomyolysis, peripheral neuropathy or neuromuscular degeneration.” From The Statin Damage Crisis, p. 109 by Duane Graveline, M.D.

“The facts remain that vital information about the frequency of cognitive impairment, permanent peripheral neuropathy, chronic myopathy and chronic neuromuscular degeneration has been locked up in MedWatch for nearly a decade under the guise of ‘being studied.'” From The Statin Damage Crisis, p. 109 by Duane Graveline, M.D.

 

Duane Graveline, M.D. has written the four books listed below about the use of statins. This information, as well as a wealth of other information, can be found on his website, http://spacedoc.com. Books by Duane Graveline, M.D., M.P.H.:

  • Lipitor® Thief of Memory
  • Statin Drugs Side Effects
  • The Statin Damage Crisis
  • The Dark Side of Statins

 

You can educate yourself about this issue and then discuss it with your doctor. A question for the doctor may be: “Doctor, could I take vitamin B6, B12, and folate supplements to reduce my homocysteine levels instead of taking a statin drug? Is it necessary to treat the coagulation defects, trans fats, oxycholesterols, platelet factors, omega 3/6 imbalance, chronic infections and selected anti-oxidant deficiencies mentioned above?”

 

Acid Suppressing Drugs

(Examples are Prilosec, Prevacid, Tagamet, Zantac, Pepcid, Axid, Protonix, Nexium, Aciphex)

 

According to Jonathan V. Wright, M.D. and Lane Lenard, Ph.D. in Why Stomach Acid Is Good For You, “…when we actually measure stomach acid output under careful, research-verified conditions, the overwhelming majority of heartburn sufferers are found to have too little stomach acid production” (p. 22). The reason people experience discomfort, even in the presence of too little stomach acid, is that the lower esophageal sphincter is not keeping the acid in the stomach, which is designed to hold acid, but is allowing it to back up into the esophagus where it does not belong.

The book points out that stomach acid is important for many biological conditions, including adequate digestion.  Also listed in Why Stomach Acid Is Good For You are diseases that may be related to deficient stomach acid. These include: Acne Rosacea, Addison’s Disease, allergic reactions, Celiac Disease, childhood asthma, Chronic Autoimmune Hepatitis, Diabetes (type I-Juvenile), Eczema (severe), gallbladder disease, Graves’ Disease (hyperthyroid), Lupus Erythematosus, Macular Degeneration, Multiple Sclerosis, Myasthenia Gravis, Osteoporosis, Pernicious Anemia, Polymyalgia Rheumatica, Reynaud’s Syndrome, Rheumatoid Arthritis, Scleroderma, Sjögren’s syndrome, Ulcerative colitis, and Vitiligo.

“Dr. Wright recommends a comprehensive program that involves restoring the stomach to its normal, healthy state by replacing what is missing by taking safe, inexpensive stomach acid supplements and other natural treatments” [from the back cover of Why Stomach Acid Is Good For You], while avoiding acid-suppressing drugs.

Important tip: Acid suppressors and blockers are a risk factor for B12 deficiency! B12 deficiency has many negative implications on muscle strengthening and fall prevention.

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Drugs can deplete nutrients

 “Doctor, do I need vitamins to make up for this?”

 

This quote is taken from the back cover of the book Drug Muggers by Suzy Cohen, RPh:

“Prescription and over-the-counter drugs help millions of people with devastating diseases and chronic conditions. But in the process, these medications can also deplete the body’s natural stores of vitamins, minerals, and hormones – the very nutrients you need to keep energy levels high, fend off infections, and be healthy. Pharmacist Suzy Cohen calls these medications “drug muggers,” and she says it’s essential to replenish what a drug mugger steals from your body in order to feel your best and avoid side effects. Not understanding the drug-mugging effect may lead to new “diseases” and possibly catastrophic health consequences. Drug Muggers helps you understand how drugs impact your daily life. It reveals why you may be feeling so poor and how to enhance your well-being with affordable nutrients that are sold over the counter. You can (and will) improve the way you feel – whether or not you take medicine!”

 

Another book on the same topic is from Lexi-Comp’s Clinical Reference Library: Drug-Induced Nutrient Depletion Handbook, 2nd Edition by Ross Pelton, RPh, PhD, CCN, James B. LaValle, RPh, DHM, NMD, CCn, Ernest B. Hawkins, RPh, MS, and Daniel L. Krinsky, RPh, MS.

 

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Five or more prescription drugs are a risk factor for falling.

“Doctor, are there any of my medications I no longer need? Are there dosages that can now be reduced? Are there any medications that can  be replaced by other methods of healing?”

 

Some of my patients have medication prescriptions from multiple doctors and may not have one doctor who is overseeing the total medication picture. Some patients may continue taking medications that were intended for short-term use without obtaining ongoing medical advice. The patient’s physical status may have changed and some drugs may no longer be necessary. Possibly, other treatments are available as an alternative, or in addition to, prescription medications, as in the cases below.

 

Drugs for High blood pressure 

The information below is from Power of Vitamin D by Sarfraz Zaidi, MD:

 

“Traditionally, the known risk factors for developing hypertension are: ethnicity, old age, obesity, physical inactivity and stress … In large scale studies (4,5) in the U.S., vitamin D levels were measured in thousands of men and women. In each one of these studies, vitamin D  deficiency was found to be an important risk factor for developing hypertension.”

Dr. Zaidi goes on to explain the role of vitamin D in:

  • inhibiting chemicals that raise blood pressure
  • reducing insulin resistance (The pancreas produces more insulin in response to insulin resistance and large amounts of insulin cause retention of salt and water, which raises blood pressure)
  • affecting the mind-body connection by reducing depression.

Dr. Zaidi says: “Vitamin D is truly a natural anti-hypertensive agent. It is cheap, safe and has many health benefits in addition to lowering high blood pressure.” Unlike medications used to treat high blood pressure, it treats one of the root causes of hypertension and is free of side effects. Dr. Zaidi educates his patients concerning the root causes of hypertension and guides them to make life-style changes including weight loss, physical activity, and stress reduction. He also prescribes vitamin D. If medication is still needed, it is usually only one medication and often in small doses. Mild hypertension may be controllable in some cases without medication.

References:

(4) Forman J, Giovannuci E, et al. Plasma 25-hydroxyvitamin D levels and risk of incidental hypertension. Hypertension 2007;(49): 1063-1069.

(5) Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitaminD, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 2007;(7):713-719.

 

Drugs for Osteoporosis

The information below is from Power of Vitamin D by Sarfraz Zaidi, MD:

 

“In medical literature, it’s well established that vitamin D deficiency is a major cause for osteoporosis … Vitamin D exerts a direct effect on the osteoblasts, cells that lay down new bone. In addition, vitamin D in adequate amounts is essential in the proper absorption of calcium and phosphorus from your intestines. Therefore, vitamin D, calcium and phosphorus in adequate amounts are an important factor for proper bone formation to take place.”

“People with chronic vitamin D deficiency often end up with a serious disease called secondary hyperparathyroidism … In this condition, parathyroid glands in your body start to produce a large amount of Parathyroid Hormone (PTH). This PTH excess causes an increase in bone resorption, which leads to a decrease in bone mineral density.”

“When I see a patient with osteopenia or osteoporosis, first of all I investigate various causes of osteoporosis such as menopause in women, low testosterone in men, too much thyroid hormone, steroid use etc. In addition, I always check her/his vitamin D level, which often turns out to be low. I put these patients on a good dose of vitamin D which is usually in a range of 2000-6000 units of vitamin D3 per day … In my patients I monitor bone mineral density every one to two years. If a patient has a good vitamin D level, yet continues to have low bone density as estimated by the T-score on a bone DXA test, then I add an anti-osteoporosis drug.” Dr. Zaidi adds that he always discusses the benefits and potential side-effects of medications so the patients can make an informed decision about taking it.

 

According to a study by epidemiologist Katherine Tucker at the Jean Mayer USDA Human Nutrition Research Center on Aging in Boston (Journal of Bone and Mineral Research, Volume 20, pages 152-158. Jan. 2005), there is a link between vitamin B12 deficiency and osteoporosis in men and women. “At least for now, the mechanism by which vitamin B12 and bone health indicators are interrelated is not well understood. However, the study did confirm that both men and women with vitamin B12 levels lower than 148 picomoles per liter (pM/L) were at greater risk of an osteoporosis diagnosis than those with higher levels. Also, study subjects with B12 levels below 148 pM/L had significantly lower average bone mineral density (at the spine in women and at the hip in men) than those with higher levels of B12.”

 

The book, The Whole-Body Approach to Osteoporosis by R. Keith McCormick, DC, discusses osteoporosis medications, as well as ways to treat the multiple systemic causes of osteoporosis.

 

 

 

 

 

 

 

 

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