12/11/2024
When I was a high school student, one of my first jobs was working at the local pharmacy in my small town. I frequently saw polypharmacy, where people walked in like zombies, asking to get 20+ prescriptions refilled. Wow, that's a lot, I thought. My parents were always healthy, so I didn't grow up seeing those orange bottles floating around the house. I enjoyed my job and knew I wanted to be a doctor back then, but I feared that conventional medicine relied heavily on pharmaceutical drugs (besides surgery) for treatment. I loved plants and was fascinated with herbs, which ultimately led me to a naturopathic medical school program.
I didn't realize how dangerous polypharmacy could be until I began practicing medicine.
2 years ago, I had a new patient in her 60s come in with 9 pharmaceutical drugs. Interestingly, she was simultaneously on 40mg Rosuvastatin and 200mg Fenofibrate, which are both used to treat hypercholesterolemia, but there is a major drug-to-drug interaction that increases the risk for rhabdomyolysis when taking both of those medications. Rhabdo is a condition where there is muscle breakdown that releases damaging proteins, ultimately damaging the kidneys.
When I saw her eGFR (estimated glomerular filtration rate, which indicates kidney health), it was 57 (anything below 60 for longer than 3 months is when you start getting diagnosed for chronic kidney disease), but none of her doctors mentioned this to her.
Interestingly, she was complaining of major muscle/nerve pain, so her other doctor had put her on 600mg Gabapentin.
My detective brain vs my doctor brain pieced together that perhaps we could've prevented signs of kidney damage had we avoided polypharmacy. Perhaps, she wouldn't have had muscle/nerve pain that came out of nowhere and avoided the gabapentin prescription.
Fast forward time, I have helped her get off of her medications and her eGFR is up to a 65. She is a working progress and she is happy to be off her drugs!
Drugs can be helpful and are necessary at times, but also question why you're on so many drugs. Sometimes one doctor may not be fully aware of your other medications if they're not in the same network or are using different EMR/EHR. Polypharmacy can happen and can be dangerous. It could be the root cause as to why you're suffering from a new symptom(s). Please let your doctor know of any new symptoms when you're put on any new medications. They may switch you to an alternative drug. I, on the other hand, may switch you to an alternative herb or medical-grade supplement.
Anyways, here's my thought/tip of the day!
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