Prescription drug side effects for diabetes and heart disease are more influential then you think

65% of the American population take at least one prescription medication. 40% of older adults in our country take five or more prescription medications. While these numbers are astounding to me, you might think this is "normal" due to the normalization of using ongoing prescription drugs as a means of making us "healthy". 

Prescription medications should rarely be utilized as a means of long term therapeutic care for metabolic disease like type II diabetes and heart disease due to the over reaching side effect profile of these drugs. Unfortunately when they are presented to you in the treatment room, the rare doctor will take the time to fully help you understand the true long term risks of taking these medications and the probable outcome of what will occur if you do not take the time to address the cause of WHY your symptoms are occurring in the first place. 

The amount of chronic illness that our country faces becomes more challenging each day. 1/3 (roughly 100,000,000 million) of Americans are sitting on a metabolic time bomb of pre-diabetes and insulin resistance. These types of metabolic conditions are also happening more frequently in younger and younger people. The projection of what will occur over the next 20 years as pre-diabetes turns into type II diabetes which then turns into heart disease, will put individuals in a predicament of what to do with addressing these problems. Often we are advised to go on medications right away and this is where the confusion starts to begin.

Medications when first taken can produce unwanted side effects within a short period time. This becomes obvious and it tends to self-limit the individuals use of the medication. This is not of concern to me. What is concerning is when individuals do not observe any obvious initial side effect but start to notice 3 to 6 to 12 months after being on the medication that their energy is lower, their not sleeping as well, their appetite has dropped, their more irritable and generally speaking they do not feel well.  It becomes hard to argue how they are feeling with the initiation of medication because the amount of time that has lapsed. Their doctors tend to disregard the association. It is not until people take the hard path of starting to address the cause of their health concerns and wean off these medications, do they get to observe "how good they can really feel".

If what you are doing is working for you, then keep doing it. If what you are currently doing is not giving you the level of health that you desire and frankly deserve, then step out of the box, challenge your doctors to educate you on your treatment and what your options are. If you are met with resistance when you bring this topic up, then you need to find a new doctor who will doctor you better.  

Below is the diabetic cocktail of prescription medications (Metformin, Lisinopril, Lipitor) that an individual will go on as a first line therapy for diabetes. Often times some of these drugs can also be prescribed in the pre-diabetic state as well. Here is a list of these drugs and the side effects created from them. The more concerning thing is not the acute % of symptoms but the influence these medications have on your physiology year after year of taking them. 

Metformin/Glucophage (class-Biguanides)- 

>10%

Diarrhea, immediate-release product (53%)

Nausea/vomiting, immediate-release product (25%)

1-10%

Diarrhea, extended-release product (10%)

Nausea/vomiting, extended-release product (7%)

Low serum vitamin B-12 (7%)

Abdominal pain (1-5%)

Constipation (1-5%)

Abdomen distention (1-5%)

Dyspepsia/heartburn (1-5%)

Flatulence (1-5%)

Dizziness (1-5%)

Headache (1-5%)

Upper respiratory infection (1-5%)

Taste disturbance (1-5%)

Cholestatic, hepatocellular, and mixed hepatocellular liver injury

lactic acidosis

Hypoglycemia

Lisinopril/Zestril (class- Ace inhibitors)

>10%

• Dizziness (19%)
• Hypotension (11%)
• Cough (3.5-69%)

1-10%

• Creatinine increased (10%)
• Syncope (7%)
• Hyperkalemia (4.8-6%)
• Hypotension (4.4%)
• Diarrhea (3.7%)
• Chest pain (3.4%)
• Abdominal pain (2.2%)
• Rash (1.7%)
• Infection (1.5%)

• ≥1%

  • Asthenia
  • Angina pectoris
  • Nausea
  • Dyspnea
  • Cough
  • Pruritis

• Headache (5.7%)
• Dizziness (5.4%)
• Hyperkalemia (serum potassium >5.7 mEq/L) (2.2%)
• Increased BUN and serum creatinine (2%)
• Hypotension (9%)

• Renal dysfunction (2.4%)

• ≥1%

  • Body as a whole: Fatigue, asthenia, orthostatic effects
  • Digestive: Pancreatitis, constipation, flatulence, dry mouth, diarrhea
  • Hematologic: Rare cases of bone marrow depression, hemolytic anemia, leukopenia/neutropenia and thrombocytopenia
  • Endocrine: Diabetes mellitus, inappropriate antidiuretic hormone secretion
  • Metabolic: Gout
  • Skin: Urticaria, alopecia, photosensitivity, erythema, flushing, diaphoresis, cutaneous pseudolymphoma, toxic epidermal necrolysis, Stevens Johnson syndrome, and pruritus
  • Special senses: Visual loss, diplopia, blurred vision, tinnitus, photophobia, taste disturbances, olfactory disturbances
  • Urogenital: Impotence
  • Miscellaneous: A symptom complex has been reported which may include a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/arthritis, myalgia, fever, vasculitis, eosinophilia, leukocytosis, paresthesia and vertigo
  • Rash, photosensitivity or other dermatological manifestations may occur alone or in combination with these symptoms

<1%

• Cough (0.5%)
• Generalized edema (0.01%)
• Angioedema (0.01%)
• Metabolism and nutrition disorders: Hyponatremia, cases of hypoglycemia in diabetic patients on oral antidiabetic agents or insulin
• Nervous system and psychiatric disorders: Mood alterations (including depressive symptoms), mental confusion

Lipitor/Atorvastatin (class-HMG-CoA Reductase Inhibitors)

>10%

Diarrhea (5-14%)

Nasopharyngitis (4-13%)

Arthralgia (4-12%)

1-10%

Insomnia (1-5%)

Urinary tract infection (4-8%)

Nausea (4-7%)

Dyspepsia (3-6%)

Increased transaminases (2-3%)

Muscle spasms (2-5%)

Musculoskeletal pain (2-5%)

Myalgia (3-8%)

Limb pain (3-8%)

Pharyngolaryngeal pain (1-4%)

Frequency Not Defined

Angina

Syncope

Dyspnea

Myopathy

Anaphylaxis

Stevens-Johnson syndrome

Myositis