Preventive prescription meds – think twice!

What is wellness….is it just about not being ill?  There’s no good scientific definition of wellness and, from a medical point of view, this poses a real problem.

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More and more prophylactic drugs are being handed out, when actually a good start to wellness would be to encourage better eating habits and less time sitting at the computer or on the sofa.

Last month’s ‘New Scientist’ brought out an article, “Should you swallow it?” by Chloe Lambert, which looked at the five most popular medications millions of people are taking as preventive measures.

in her piece, she brought up some really valid points.  Do you really want to pop a daily pill for the rest of your life because of a relatively small risk factor?  And, do you want to add another drug to your cocktail of meds (with unknown interactions, because your doctor may know the side effects of statins, but what if you’re taking statins, vitamin D, aspirin and a proton pump inhibitor?)  And what if the pill is actually distracting from a wider cause of your illness such as obesity or alcoholism…or loneliness (think of all the antidepressants handed out).

“Should you swallow it?” focused on five common – and very controversial – drugs that are being taken by millions of people on a daily basis.
Some of them surprised me (testosterone for millions of men in USA… and a rising number here – really?!)  And others just saddened me – like statins.  Millions are taking them and yet, in the main, a great start would be to swap over some foods and go for a daily walk.

The article is well worth sharing – it offers some known facts, but also some others to astound you, so here are the salient points.  if you’d like to read the whole article it’s in the 16th May, 2015 edition of New Scientist.

1.Statins are prescribed to lower blood cholesterol in order to reduce the risk of heart attack and stroke (did you know that they are the most widely prescribed drug in the world – and a lot of healthy people are taking them as a preventive?!)

Until last year, anyone here in UK having a 20% risk, in their next decade, of developing cardiovascular disease would’ve been prescribed a statin.
That has now changed to 10% – which equals an extra 5 million people on top of an estimated 7 million already on statins!
Chloe Lambert, author of the article, explained why.  The National Institute for Health and Care Excellence (NICE) looked at factors such as BMI (body mass index = weight), cholesterol levels, age, smoking and ethnicity, and reasoned that this approach may prevent 28,000 heart attacks and 16,000 strokes annually.
Plus, statins are cheaper than treatment after the event.

However, the article also pointed out that taking statins may have no benefit whatsoever for low risk people.  In other words, they’re taking pills every day of their lives and perhaps getting only a 2% improvement in their risk range.
Added to this, there is the usual controversial discussion about the potential side effects of medications.

The key sentence for me was naturally….“No one should pin all their hopes on a pill….taking statins should be accompanied by lifestyle changes such as taking exercise and giving up smoking.”

2.   TRT – testosterone replacement therapy   is conventionally given to men with abnormally low levels due to damage from chemo or a congenital condition.  However now it’s being prescribed to compensate for the (natural) decline in sex drive, energy and muscle strength as men age.

The article stated that low testosterone levels are often linked to obesity or diabetes (so wouldn’t losing weight be a great start?)

Not only is TRT on the rise in USA and here in UK, but it now seems there is a huge side effect, namely the increase in risk of heart attacks and strokes (is it really worth it guys?)
In fact, one trial using testosterone drugs had to be stopped early because of an ‘excess of cardiovascular events’ happening among the participants! (am having a black humour moment here, sorry…)

On that note, a 2013 analysis found that “the levels of cardiovascular risk varied, depending on whether the study was funded by the pharmaceutical industry”.

How scary is that?  And in case it’s not widely known, most medical research is funded by pharmaceutical companies…and they would naturally like the results to show in their favour…

3. Hormone replacement therapy/ HRT has, according to the article, “given us years of confusing and conflicting information since its surge to popularity in the 80s”.  Back then it was believed that HRT would not just relieve menopausal symptoms but that it was also bone and heart protective.

Wrong.  Chloe Lambert reminded us that in 2002 one of the biggest studies on the safety of HRT showed that it may actually raise the risk of heart disease and breast cancer (The Women’s Health Initiative).

Recent studies also confirm HRT has no protective effect on the heart and can in fact increase the risk of stroke in post-menopausal women as well as slightly raise the risk of ovarian cancer.
Current advice is to use the smallest dose possible for menopausal symptoms; and start earlier rather than later.

From a nutritional point of view there are the nutrient levels in foods to consider and balancing blood sugars.  You could test hormone levels and possibly supplement short term.  In the end, what affects one hormone will affect another. Rather than blame-it-all-on menopause, you could make dietary and lifestyle changes  and then see if you still need HRT.

4. The Pill is undoubtedly one of the most efficient forms of contraception, and yes it has revolutionized women’s lives worldwide.  However it doesn’t suit every woman, and many would rather not be taking a daily pill which will be skewing with their hormonal health.  Again, what affects one part of your endocrine (hormonal) system will be affecting other parts – and your liver will have even more work in detoxifyng additional hormones to the ones it already has to deal with.

The article gave lots of ‘Pill’ facts:

  • 1 in 4 women in the UK and USA, according to the article, are on the Pill as a routine part of their.
  • Research links some combined Pills to a raised risk of deep-vein thrombosis.
  • Also, being overweight, smoking and high blood pressure should be taken into account before going on the Pill as there will be individual risk factors.
  • A recent report that the Pill may raise the risk of Crohn’s disease in women with as genetic vulnerability (no mention of the research paper).
  • Women on the Pill have a higher risk of breast cancer which is now mainstream knowledge.
  • Ironically the Pill can reduce libido
  • it affects mood – however evidence about this effect is still unclear. Again, studies tend to be funded by the manufacturers so reports are biased, showing the manufacturers are looking for ‘suicidal’ moods rather than more subtle low mood or swings in moods.

5. Aspirin is known for its blood-thinning properties and is routinely prescribed in low doses as a protective measure for people who have had a heart attack or stroke.

In USA people with no history of heart problems are now taking it prophylactically – that’s 40 million adults taking aspirin daily (The FDA is warning against this however, according to the article, it is still being self-medicated and recommended).
As a blood thinner, the key concern is the risk of gastrointestinal bleeding and haemorrhagic stroke (caused by bleeding in the brain).

Due to the fact that recent research is showing it may be cancer protective (due to its anti-inflammatory properties – cancer thrives on inflammation in the body), the article stated that NICE will be reviewing the data.
This may mean that in a couple of years NICE may be recommending aspirin as a daily protective to the over-50s!  (but not in the over 70s, since “the risk of side effects after the age of 70 increases, so aspirin would be likely to do more harm than good.“)

If fighting inflammation is the main reason for this possible recommendation wouldn’t it make more sense to start with natural anti-inflammatories in your diet, or in supplement form?  Short term if you want.  There are enough research papers showing the benefits of turmeric (due to curcumin component) or green tea (catechins) or ginger, fish oils, shiitake mushrooms…).

The article came to an end with the mention of a number of other daily prescribed drugs people take without necessarily needing them.
Antidepressants, anticoagulants such as Warfarin and ACE inhibitors.
Sad….
My final tuppenceworth is….
If you consider that poor dietary choices and a sedentary lifestyle are the two well established key factors driving worldwide diabetes type 2 and cardiovascular disease…and that these are both implicated in almost every chronic disease we now suffer from, then how about starting with changes to diet and lifestyle changes before reaching for all these pills?

 

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