Nutrition Medicine

Nutrition Medicine

Pharmacists make a living out of dispensing drugs. So encouraging people to get off their prescription drugs, and embrace a more natural overall system of health, might seem like a counter-intuitive thing to do.

But having worked with thousands of pharmacists over the years, from all walks of life, we’ve seen that they also genuinely care about the health and wellbeing of their patients. And we believe that it is also our ethical responsibility as trusted health professionals to make sure our patients are empowered to maximise their own overall health.

Nutrition Medicine is about the Truth - we refuse to turn a blind eye to situations that may endanger the health of our patients. Complementing prescription medicines with appropriate diet, lifestyle and nutritional supplements is vital to reduce the side effects of medications and to help address the underlying causes of illness. There are many examples of drugs that we know cause fairly predictable side effects and fairly predictable effects on nutrient status. In many of these instances the symptoms of these nutrient imbalances is exactly the same as that of the drug side effects.

We often talk to people who we suspect are exhibiting drug-nutrient interactions. Most of them think the symptoms they are experiencing are due to “getting older”. Many have never considered they can be related to drug-induced nutrient depletions, and therefore often don’t mention their symptoms. In our view, a good pharmacist will ask about likely symptoms, and advise on appropriate diet, lifestyle and nutritional supplements. No doctor would prescribe methotrexate without folic acid support. Why would we let patients take antibiotics without probiotic support?

Everyone agrees that good nutrition is vital to good health. We’re here to encourage you to help people get the best health by combining conventional and complementary medicine. We’d also like to suggest that the term “complementary medicine” is misleading when it comes to nutrition. After all, good nutritional status is the core of health … it is the FIRST thing people should be taking care of. In fact, prescription medicines should be considered complementary to good nutrition and lifestyle factors.

For example, the side effects of the anti-epileptic medications are similar to those seen in patients with B vitamin deficiencies. It is known that these medications interfere with the metabolism of the B vitamins. If you supplement patients on anti-epileptic medications with B vitamins, their seizure control improves and their side effects improve. Win-win. We just need to be vigilant and put the pieces of the puzzle together.

Our experience over many years is that you do get financially rewarded for improving patient health outcomes. And you feel great about your valuable role as a health professional too.

An example of Nutrition Medicine In Practice

Imagine that you are giving out a prescription for a patient for cilazapril, simvastatin, fluoxetine and paracetamol. You ask whether the patient is experiencing any regular muscle aches and pains (or is the paracetamol just for occasional pain like the odd headache). Fortunately this patient is not experiencing myalgia. But as you are explaining their medications, you can tell that the patient is getting muddled. You wonder about their essential fatty acid balance because it is important for brain health and for heart health.

So, you ask a few key questions such as “do you have dry skin?” and “have you been getting achy joints or back lately?” or “are your nails dry and brittle”. These are signs of essential fatty acid imbalance. The patient does admit to these signs, so you mention the benefits of taking fish oils, which they agree to try. The benefits for that patient once the levels of omega-3 builds up in their system will be great. They will really appreciate you have taken the time to have an interest in their health.

Here’s another example - blood pressure. What if your patient is prescribed a beta blocker for their hypertension. This will lower their blood pressure so it should mean that they will have less risk of a heart attack or stroke - and therefore live longer. However, most studies conclude that the older beta-blockers do not increase life expectancy. They improve your risk factor (hypertension), so why wouldn’t they affect mortality?

Well, there can be several reasons, such as that:

  • the underlying metabolic dysfunction has not been fixed
  • the drugs produce adverse changes in other areas of the body (side effects)
  • the drugs cause nutrient imbalances which adversely affect health
  • the patient stops taking responsibility for their health and relies on the drug to do all the work (e.g. why should I exercise when I can just up the dose of my pills).

So in other words, the beta blocker could be acting like a sticking plaster over the warning light on your car dashboard. You can’t see the warning light anymore so the problem is fixed?! Even the action of beta blockers on the heart (reducing the force of contraction) seems contradictory to overall good health. If the heart isn’t contracting as forcefully, there will be less blood pumped around the body and therefore less oxygenation of important organs, which can lead to reduced functional capacity in these organs. This means further “disease”.

In Nutrition Medicine, we would advise patients taking beta blockers about the importance of maximising oxygenation of tissues by ensuring adequate levels of iron, vitamin B12 and folic acid. Interestingly, some of the side effects of beta blockers, such as nerve tingling, fatigue and dizziness are also signs of vitamin B12 deficiency. As a pharmacist you will know that beta blockers can cause deficiencies in CoQ10 levels. You will also know just how important CoQ10 is for heart function. Think about this for a moment. Why is the patient taking the beta blocker? Normally it is not to make them feel better (mostly they don’t feel better) - it’s so that they don’t die prematurely of a heart attack. But if their medicines deplete a nutrient that is vital for the heart, this could actually increase their risk of a heart attack. Patients who care about their health really need to know this. We would want to know and we’re sure you would too.