In medicine, the right hand often doesn’t know what the left hand is doing. You may be taking a drug to deal with an illness or a set of symptoms, but that drug may cause other issues and symptoms. If the link between the first medication and its adverse effects are not recognized, then the adverse effects may be treated as primary problems needing their own medications. You just keep getting more ill and being on more meds. And you end up walking around with a huge question mark over your head. What the heck is happening?
The term iatrogenic means that an illness is caused by pharmaceuticals or medical procedures.
There are many examples: people who have been on long-term steroids may develop type 1 diabetes; those on long-term immunosuppressive meds may develop cancers; and children on multiple rounds of antibiotics may develop inflammatory arthritis or serious inflammatory gut diseases.
Many drugs rinse out so many nutrients that patients can develop nutrient deficiencies and the symptoms linked to them. The most blatant are acid blockers (PPIs) that rinse out magnesium and cause severe fatigue and heart arrhythmias, or statins that rinse out C0-Q 10 and cause further adverse heart issues. But rarely does the medical profession link together the drug and its downstream consequences. You are left on yet more meds or feeling simply awful and no one knows why.
If you need to jump on the medicine train track, you better know the stops, starts, and dynamics of those tracks. Or have a team that can oversee them for you. You cannot totally rely on your health providers to inform you of the possible effects. Often they don’t know these connect-the-dots link or they don’t have the time or the information to see all the connections.
Birth control pills rinse more nutrients out of the body than any other medicine ever invented. But who recommends that women supplement these precious nutrients back in when they get their prescriptions? Birth control pills can damage the lining of the gut, but women aren’t asked if their primary family members have serious gut issues, which would mean they might have to tread carefully if considering synthetic hormones. ALL birth control methods are made of synthetic hormones at this time, other than mechanical methods like withdrawal, a diaphragm, or holding an aspirin between your thighs.
Sometimes the connection is very subtle and you only get lucky if you work with a medical geek that looks at the bigger picture—all your meds, supplements, and your lifestyle— and sees what might be causing the issue.
Take me, for example. I have glaucoma, a serious eye disease. Many members of my family have it. It is highly inheritable. Fifteen inheritable glaucoma genes are known at this time. So I was put on eye drops to try to prevent blindness. It’s crucial to take this medicine. But I also have only one adrenal gland. A side effect of most (if not all) glaucoma drops is the causing or worsening of adrenal insufficiency. Eighty percent of all eye drops are absorbed into the body directly without first getting metabolized and made more gentle (metabolized/broken down/rendered less robust), by the liver, and they can have significant systemic affects. The link of glaucoma eye drops to systemic effects/events often goes unappreciated.
I started to have many new health issues after beginning these drops, but it took a while for me to discover this link because I had good times in between the bad times. I’d get severe lung infections, but couldn’t heal from them. I eat pretty impeccably and exercise and more. Yet I have a complex health history. The internist that I loved for his amazing integrative talents, died last year. This year’s internist doesn’t “deal in hormones” (how is that possible?). Endocrinologists often don’t recognize adrenal or aldosterone (another adrenal hormone) insufficiency. My eye doc knew my history and condition. But did not stress that these meds could worsen underlying adrenal issues and I should be carefully monitored with an eye to this possible interaction.
There are even some medical theories that half the cases of glaucoma are caused or worsened by adrenal insufficiency, but those certainly aren’t mainstream.
Well, I got so ill I could not get off the couch. For close to two months. The fatigue was so deep it hurt like hell. Yet again I sleuthed the scientific literature and discovered this unappreciated eye drop/adrenal link.
I have a go-to functional medicine doctor and he is my health gladiator. Dr. David Brownstein (thank you, bro!) ordered a 25-hour urine test. It became obvious that I had developed adrenal and aldosterone insufficiency secondary to the eye medicine (which, remember, I couldn’t not stop taking as blindness is not an option).
Now David and I had to figure out how to shore up my adrenal gland with herbs, glandulars, and meds so I could keep taking the glaucoma med but not become ill. Too little cortisol causes more blindness, but too much cortisol also causes more blindness. I need more and more exact middle ground, but this is not an easy target to achieve.
Discovering the link between the eye drops and adrenal insufficiency took in-depth knowledge, testing, and treating that is beyond the scope of many doctors, internists, and most ophthalmologists. At a conference I spoke at recently, I met a professor from Johns Hopkins who trains neuro-opthamologists. He told me there are only 400 eye docs in the U.S. who intently focus on the link between your eyes and the rest of your body. Most eye doctors think that you will be covered elsewhere.
When things get complex, especially as we get older, this “elsewhere” health intervention is rather gossamer and often inadequate. But how would you know until you get really ill? And sometimes it’s too late unless you have a genius geek watching your back.
What if I didn’t know what I know, or know Dr. B? I might be sent to a pulmonologist and diagnosed and put on other meds for life. Yeech!
People think their doctors know the entire lay of the land of their illness and all its ramifications. But no one can know it all. More often than not, the “bigger picture” is less often appreciated.
Thus the epidemic of iatrogenia—an epidemic caused by health care that is not intentionally designed to look at the bigger picture. And, yikes, all this gets worse as you age and get prescribed more and more meds. Two doctors published an article in Medical Care in 2016, stating: “America is experiencing what is arguably the greatest iatrogenic epidemic in the history of American medicine.”
Your answer? Work with a team. Have a nutritional geek (a medical nutritionist) on that team. One that is well-versed in iatrogenia and how to effectively protect you! If you find out how to protect yourself while still taking the meds you need, or how to taper off them safely, you become healthier rather than losing your health.
Medical Care: May 2016 – Volume 54 – Issue 5 – p 426–429. Responding to America’s Iatrogenic Epidemic of Prescription Opioid Addiction and Overdose
Nurs Stand. 1998 Sep 30-Oct 6;13(2):46-7.The iatrogenic epidemic.