All medications come with side effects, some minor and others extreme. In cases of advanced disease, high-risk infections and other extreme health conditions, the benefits of medication greatly outweigh the side effects. For others, the medications are used largely as a form of preventative medicine, and the potential side effects may not be a worthwhile risk.
Especially in our elderly population, overprescription is common, and fewer medications may improve quality of life and prevent hospitalizations. A study on the USA’s geriatric population (New England Journal of Medicine) published earlier this year found that over 99,000 medication-related emergency hospitalizations occurred between 2007 and 2009. Four common drug prescriptions were responsible for 67 percent of these emergencies:
Oral antiplatelet agents
Oral hypoglycemic agents
Of these four medication classes, none are considered “high-risk.” In fact, only 1.2 percent of the hospitalizations mentioned above were due to high-risk medications.
Why is this significant?
Firstly, because medications perceived as lower-risk are more likely to be prescribed, and to be used for disease prevention. This study shows that such forms of “prevention” are more likely to be life-threatening to our elderly population than expected.
Secondly, because the four medication classes addressed in this study are often used for diseases (Diabetes Type II, Coronary Artery Disease) that are preventable through natural medicine, and manageable with integrated care that requires fewer prescriptions.
The key to reducing hospitalizations due to adverse drug reactions is to reduce the need for such drugs. This can be done safely and effectively through natural and integrative medicine.
Dr. Kaley Bourgeois
Daniel S. Budnitz, MD, et al. Emergency Hospitalizations for Adverse Drug Events in Older Americans. N Engl J Med. 2011 Nov 24;365(21):2002-12
For young women living with Lupus, becoming a mother can be a challenge both emotionally and physically. As the disease progresses, there is an increased risk of pregnancy complications such as miscarriage and preeclampsia. Furthermore, pregnancy has been known to increase the risk of worsening symptoms and disease flares for the expectant mother.
A recent study, spotlighted by the National Institute of Health earlier this month, suggests a healthy pregnancy and birth may not be far from reach for hopeful young women living with Lupus. If general health is supported prior to conception, and antibodies are reduced such that there is low disease activity, there is a significant decrease in risk of pregnancy complications. Disease flares, especially, are reduced.
While lower Lupus activity during pregnancy lessens risk to both mother and child, the route taken to stabilize the disease is just as important. The conventional treatment of Lupus involves immunosuppressive medications that are harmful to a developing fetus. Methotrexate, commonly used to treat Lupus, is known to cause birth defects and cannot be used during or after conception. Corticosteroids, conventionally given to pregnant mothers to reduce a disease flare, have an unknown effect on the fetus and should also be avoided. All immunosuppressive medications increase the risk of infection for the mother, and therefore the child.
Complementary and alternative medicine is often used in treatment of Lupus and other autoimmune conditions, and may offer fewer side effects for mother and child. Below is an example of some research-based treatment options that should be considered in the treatment of Lupus before conception:
High Dose Vitamin D
Another study shared by NIH revealed high-dose vitamin D therapy to boost general immune function, while reducing activity of autoimmune cells, thereby reducing Lupus activity levels. As vitamin D is known to play a significant role in the brain development of a fetus, assessing for adequate levels in any future mother is important.
Omega-3 Essential Fatty Acids
Dietary supplementation of omega-3 fatty acids has a therapeutic effect on Lupus activity, as well as offering cardiovascular protection and benefitting fetal development.
DHEA is a mild corticosteroid made naturally in the body, and found to be low in Lupus patients. Supplementation to balance hormone deficiencies prior to conception may help to reduce symptoms and disease activity by controlling excessive inflammation.
Work with your healthcare provider to create the appropriate treatment plan for yourself and your future child. There are many options available for addressing autoimmune disease and supporting your overall health.
Questions? Feel free to contact us at (503) 747-2021.
Dr. Kaley Bourgeois
-Pregnancy Safe for Most Women with Lupus: Study. Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118393.html
–Vitamin D, Interferon Alpha Vaccine Show Promise Against Lupus, Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118395.html
–A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus. Ann Rheum Dis. 2008 Jun;67(6):841-8. Epub 2007 Sep 17.
–Dehydroepiandrosterone suppresses interleukin 10 synthesis in women with systemic lupus erythematosus. Ann Rheum Dis. 2004 Dec;63(12):1623-6.