Spring Renewal: Your Complete Wellness Checklist for Mind, Body, and Environment (Part 2)
Part 2: Supplements and Medication
Picking up right where I left off. Here’s Part 2, which covers Supplements and Medications.
If you missed Part 1: Nutrition, click here. It covers more than nutrition, including Best Used By Dates and a tangent on holding on to things.
Supplements
Toss
Anything past an actual expiration date
Anything you haven’t used in 6 months or that you no longer have a need to use
Check with Prescriber: Anything you’ve been taking for more than 6 months
Most supplements are not meant to be used long-term, but our healthcare providers don’t always tell us when we should stop taking them and it’s really not uncommon for people to forget why they started taking a supplement in the first place.
If you’ve been taking a supplement for over 6 months, check in with the healthcare provider who made the recommendation and see if you should still be taking it.
Check with your healthcare provider before making any changes to your medications and supplements.
I wrote an article about Supplement Safety that has some really great resources for helping you decide if the supplements you’re taking are safe.
Lastly, throw things out responsibly; don’t put supplements or medications down the drain or flush down the toilet … this is how you hear the horror stories about pharmaceutical drugs, like antibiotics, antidepressants, contraceptives and more, end up in our drinking water.
Two Good Rules of Thumb
1. Any time you start seeing a new provider, don’t just tell them everything you’re taking, ask them what is still necessary for you to take and if there’s anything you should stop taking. Be sure to ask about a deprescribing schedule; don’t just stop cold turkey.
2. Review your supplements and medications with your provider every year; your annual check-up is a great time to do this. There are medications that we should stop taking as we get older. More on that below. Deprescribing doesn’t get enough attention.
Medications
Over the Counter (OTC)
Toss anything past an actual expiration date
Toss anything you haven’t used in a year; replace when needed again
Check with your healthcare provider before making any changes to your medications and supplements.
Again, throw things out responsibly; don’t put medications down the drain or flush them down the toilet. Your local pharmacy will have a bin to drop off unwanted medications and they will ensure they’re properly disposed of.
Prescribed Medications
Do not throw out or stop any medications without speaking to your healthcare provider
Ask your doctor every year at your annual check-up about any medications you have been taking long-term
I have been taking thyroid medication since I was a young adult, I still talk with my doctor about it once or twice a year. Your body changes; the dose, duration, etc. may need to be updated.
If you are age 65 or older speak to your doctor about medications that meet Beers Criteria for potentially inappropriate medication use in older adults; many of these medications should no longer be taken for older adults and should be deprescribed responsibly or the medication should be highly monitored due to increased risks of other health concerns
Check out pages 6-23 of the American Geriatrics Society Beers Criteria Report to see if any of the medications you’re taking are on this list
Print it out or save it to your phone/tablet and take it with you to your next doctor’s appointment
It is your responsibility to understand what you’re taking and why; it is within your absolute right as a patient to ask if you should still be taking these medications.
So many of the clients I’ve seen—across all age ranges—did not know why they were taking a medication. The most common reason I hear is, “Because my doctor told me to.” This is not an acceptable reason.
13 Things to Know about EVERY Medication You’re Taking
Name of the medication
Is it a generic or name brand medication?
What the medication is for
Why you are taking the medication(s)
What the medication is used for and the reason you’re taking it may be different. For instance, Botox may be used off-label for severe chronic migraine sufferers. Or, popularly, the use of the diabetes medication Ozempic (Semaglutide ) is used off-label for the treatment of obesity and weight loss. Know what the medication you're taking is used for and why you’re taking it (especially if it’s being used off-label).
Dosage
When you should start taking the medication
How often to take it → Examples: Once a day? Every 12 hours?
How to take it → Examples: With food? Without food? In the morning? Before bed? Can it be taken at the same time as other medications you may be taking?
How long to take them → Examples: 2 weeks? 30 days? 3 months? For life? You should absolutely know when, or if, you should stop taking them
How you should stop taking them when/if the time comes to stop → Examples: Can you just stop? Is there a tapering off? What symptoms might you experience?
Side-effects. Healthcare providers, even well-intentioned, don’t always go over all of the relevant side-effects. It’s your responsibility as the patient to not just ask your doctor about them, but to do your due diligence to understand the side effects of your medications.
I’ve definitely seen clients (and friends and family) who experience a side-effect of Medication A and then end up getting prescribed Medication B—with its own set of side-effects—to address the side-effects from Medication A. This can create a very tangled web of poly-pharmacy and inappropriate side-effect management.
I personally use the free app Epocrates (there’s also an Epocrates website) to understand nearly everything I need to know about a drug. You also can go to the drug manufacturers website and look up the data/fact sheet for the drug to see things like side-effects, efficacy rates, and adverse events.
Drug and Supplement Interactions. Healthcare providers, again, may not be aware of every interaction for the drugs and supplements you may be taking. While pharmacies should be automatically flagging for interactions, they only look at the prescription drugs you’re taking. Supplements, whether vitamins and minerals, herbs, botanicals, or others, can have interactions with each other and OTC/prescription medications. Use the Epocrates or Medscape Interaction Checkers (the Medscape one does not require an account to use) to understand what, if any, interactions your medications and supplements may have.
Contraindications and Black Box Warnings. Your healthcare provider should easily be able to tell you about these, but, again, sometimes these may be missed in being communicated to you. Contraindications are conditions or circumstances that make a medication potentially inappropriate for a person. For instance, pregnancy rules out a large number of medications. A Black Box Warning alerts you to serious and even life-threatening risks to certain medications. A common one you may have heard about is the increased risk of suicidal ideation and behavior in some individuals taking certain antidepressants.
The recent article I wrote on Supplement Safety also has some great resources on botanical safety and interactions. Check out the article here.
Two Good Rules of Thumb (stated again … because yeah, it’s important)
1. Any time you start seeing a new provider, don’t just tell them everything you’re taking, ask them what is still necessary for you to take and if there’s anything you should stop taking. Be sure to ask about a deprescribing schedule; don’t just stop cold turkey.
2. Review your supplements and medications with your provider every year; your annual check-up is a great time to do this. There are medications that we should stop taking as we get older. More on that below. Deprescribing doesn’t get enough attention.
Check back next week for Part 3: Body, Mind & Mindset, and Environment
Reference
Swallowing the pharmaceutical waters. https://pmc.ncbi.nlm.nih.gov/articles/PMC3273502/