Health Alert 17
Did you know that the same medication that you’ve been taking for years could be slowly poisoning you? As you age, your ability to tolerate medication changes.
Your body recognizes medications as foreign substances and tries to remove them. For most medications, your liver first “detoxifies” the drug then your kidneys excrete this metabolite in the urine. This process of removal is calculated into the dosing of your drugs. This necessary compensation in the quantity of your dose to account for the usual rate of removal can lead to problems with long-term medications.
As you age both your liver and your kidneys slow down. They have a harder time processing drugs and their rate of removal decreases. So if you are removing less and still taking the same amount, medicines can slowly build up in the body. This buildup can cause a person to be in an enduring state of overmedication.
* Inappropriate Prescribing *
Symptoms of overmedication occur gradually. Often, they are chalked up to “growing older”. Fatigue, confusion, dizziness, weakness, memory loss, loss of balance, impotence and constipation are only a few side effects of overmedication. The medication that your body easily tolerated ten or twenty years ago may be the very reason you don’t feel as well now as you did then.
Doctors are often unaware of the special medication needs of older people. And, the problem is widespread. Researchers at Harvard Medical School have recently concluded a study of drug use in elders with disturbing results.
The medical records of 6,171 people over 65 were reviewed. 23.5% of people analyzed were being given drugs that are deemed unsafe for older people. The authors of the study found “a disturbingly high level of potentially inappropriate prescribing for older people…”1
Drug side effects can also
affect older people differently. The government estimates that 163,000 older people experience mental impairment that is caused or worsened by medication.* Taking Control *
Doctors are often not familiar with the specialized dosing concerns in elders. A large part of my practice at our Wellness Center has become focused on lowering the toxic burden of medications. The patients who come to me often report an unwillingness of their specialist physicians to recognize the side effects of the medications they prescribe.
As always, it is important to have good communication with your doctor. Here are some important questions you should ask about your medication:
• What exactly is the medication supposed to do?
• What are the alternatives to this medication?
• Is this dose suitable for my age?
• How long is it safe to take it?
• What are the side effects of the medication?
• What are the symptoms of overmedication?
• Does this drug interact with other medications?
• Are there any special precautions with this medication?
It is easy to forget something about the medication, especially if you are taking several medications. Be sure to write down information about the drug. Or, have your doctor give you an information form.
Have your medication and the dose evaluated often. And, if you suspect that you are being overmedicated, talk to your doctor. In many cases, your doctor can perform tests that can tell if your medication is causing side effects. It’s his job.
But after all …. it is your body.
Al Sears, MD
Resource: Graedon’s Guide to Drugs and Older People
1. Willcox SA, Himmelstein DU, Woolhandler S. Inappropriate Drug Prescribing for the Community Dwelling Elderly. JAMA 1994; 272: 292-296