Clinical Level Selfcare Series

Exploring common themes in David Crow’s consultation practice

Part 2: Study Your Medications

One of the most important requirements for practicing Clinical Level Selfcare is becoming knowledgeable about the medications that you are either taking or are being advised to take. In consultations I hear repeatedly that the doctor who prescribed the drug or drugs did not provide any education about what it was other than its basic function, and that the patient has not taken the time to study it either.

The protocol I follow in consultations with patients is to go to a website that has information about medications, put it on a screenshare, and discuss what we find. The site I generally use is www.drugs.com. Since most people already know the purpose of the medication, we then go to the link that shows the potential side effects. For example, we often look into the effects of statins, such as Atorvastatin: https://www.drugs.com/sfx/atorvastatin-side-effects.html. 

The first important lesson we learn, which is often a revelation for people, is the large number of side effects that are possible from one drug. That discovery is often strong motivation for people to start working with their doctors to find the lowest number of medically necessary drugs, at the lowest necessary dose, and to use natural medicine to support overall health.

However, it is important to put these long lists of possible reactions into context and use the information to understand four important topics:

1. For general safety, everyone should know the possible severe and acute reactions that
   might occur, that could require immediate action.
2. After that, we consider what organs and systems the medication affects. 
3. Then, we ask whether the drug could be causing new symptoms. 
4. Finally, we ask if it could be worsening preexisting symptoms. 

The first topic is self-explanatory, but I have seen many cases where people have had strong reactions to medications that they did not realize were connected to the prescription, and in some cases, the doctors overlooked the cause as well. The reason we consider the impact of the medication on the various organs and systems is because it helps us understand the potential symptoms that might appear later in forms that seem unrelated to what the drug is treating. This illustrates a very important principle of medicine that is applicable with herbs and nutraceuticals as well: a substance that is good for one part of the body may be harmful to another. A statin, for example, will maintain lower levels of LDL cholesterol, but cause inflammation in the musculoskeletal system and brain, which generally appears slowly and insidiously, leading patients and doctors to believe it is unrelated, which then leads to another drug to control the new symptoms.

We then ask two questions: have new symptoms appeared since starting the medication, or have previously existing symptoms worsened? We then review the list of possible adverse reactions, and often see a clear chronological link indicating that the drug is a probable cause of either or both.

The final part of this exercise is more advanced, which involves researching herb-drug interactions and drug-drug interactions. Of those concerns, herb-drug interactions are limited in number and severity, while drug-drug interactions are a major source of fatalities. I have seen cases where, if this information had not been discovered by either myself or a pharmacist, patients could have been severely harmed. This issue becomes increasingly serious as more medications are added to a person’s regimen, when there is more than one doctor prescribing drugs, and in some cases, when the doctor is treating complex conditions but not researching the potential interactions.

Using our example of Atorvastatin, we now go to the link showing interactions: https://www.drugs.com/drug-interactions/atorvastatin.html. As we review this, we learn that there are 402 other medications this drug could interact with, rated on a scale ranging from unknown to minor to moderate to major. The most important list to review is the major possible interactions, which can be found by refining the search and clicking on that specific list: https://www.drugs.com/drug-interactions/atorvastatin-index.html?filter=3 In this list, we find 46 potentially dangerous drug interactions, no herbs, and one common nutraceutical, which is niacin.

I have found that this simple exercise is extremely valuable for Clinical Level Selfcare, which helps us understand allopathic medicine more completely; it can help us understand how medications might be causing new or worsening old symptoms, and prevent potentially serious drug-drug interactions. It is also the basis of starting an educated discussion with doctors about how to manage the drugs more effectively, with the goal of finding the lowest number of medically necessary prescriptions at the lowest possible dose, and how to safely integrate natural medicines into a health-supporting program.

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