Dr. Andrew Weil has changed the way our world thinks about health and healing. As a graduate of Harvard Medical School, the director of the University of Arizona Center for Integrative Medicine, and the author of 15 books, he is a tremendous resource in the field of integrative medicine. So we asked him a few questions about his new book, Mind Over Meds, which discusses the prescription drug problem in America, how our reliance on them is costing us our health and happiness, and why we should always be mindful of what we’re putting in our bodies.
1. It's so anxiety provoking to learn that a medication we took (or are taking) could be harming us. What advice can you give us?
Most people taking any of the agents described in my book can reduce their risk of side effects or complications by working with their doctor or pharmacist, even after being on the medication for a long time. Individualized diet and lifestyle approaches can help lessen the need for some medications in many instances or at least reduce the required dosage. Two caveats:
1. Never stop taking a prescribed medication suddenly without first speaking with a health care professional. It is usually best to slowly wean off long-standing drug therapy.
2. Make certain you have other approaches in place to help manage the condition being treated before discontinuing medication.
2. In your ideal world, what would a pharmacy look like?
The ideal pharmacy would be a place of health and healing, not just a drug dispensary. The environment would be peaceful and relaxing. Patients would never be given a prescription or over-the-counter drug without first being offered an explanation of the reason for taking it, how it works, and potential risks and side effects. Pharmacists, with training beyond the conventional curriculum, would inform patients about non-drug approaches to managing their health issues, including diet, complementary therapies (such as acupuncture and mind-body techniques), and the proper use of vitamins, supplements, and herbal remedies.
Only the highest quality supplements would be sold. Should prescription drug therapy be clearly indicated, the safest agent in the lowest effective dose would be offered, always in the context of comprehensive care that includes lifestyle modification and non-drug therapies to help patients limit the duration of medication treatment as much as possible. Anyone on more than five prescription medications, especially those over the age of 65 and those taking two or more agents for the same indication, should meet with the pharmacist for MTM (Medical Therapy Management—a session to help people use medications wisely and safely, as described in detail in my book). Finally, employees of the pharmacy should be role models for healthy living.
3. What are the most common nutrient deficiencies (caused by pharmaceuticals) to look out for?
Drug-nutrient interactions are common and often go undetected. Some of the most worrisome are:
1. Long-term use of proton pump inhibitors (PPIs) is associated with reduced absorption of vitamin B12, iron, and vitamin C. A more serious effect is magnesium deficiency, which can lead to cardiac arrhythmias and seizures.
2. Use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor antagonists (ARA II or ARBs) may decrease serum zinc levels, potentially leading to immune system impairment.
3. People with type 2 diabetes or polycystic ovary syndrome (PCOS) are often treated with metformin, which may reduce levels of vitamin B12.
4. Statins block the production of Coenzyme Q10 (CoQ10) in the body. CoQ10 is a potent antioxidant that plays an important role in cellular energy production.
4. Sometimes antibiotics are unavoidable. Do you have a specific protocol for supporting the body through a round of these drugs?
Only use antibiotics for the treatment of severe bacterial infections—do not demand a prescription antibiotic from your health care provider when it is not warranted, such as for the management of the common cold or flu or other viral illnesses. If you are prescribed an antibiotic, be sure to complete the entire course of treatment; do not stop the drug once you are feeling better unless instructed to by your health care provider. Take probiotic supplements—when administered in adequate amounts, these beneficial microbes help prevent antibiotic disruption of the gut microbiome. Eat plenty of foods that support optimal immune system function, get adequate sleep and rest, and consider using botanical remedies to boost immunity.
5. What do you think the health care system will look like in 10 years?
Discussions around health care reform need to move from issues of access and payment to the actual content of health care—simply providing people greater access to a dysfunctional system is far from optimal. We need a new system that emphasizes health and healing and disease prevention, along with sensible disease management not based solely on medication. There should be reimbursement for prevention as well as intervention for non-drug therapies. And no more direct-to-consumer advertising of prescription medications. I anticipate that integrative medicine will contribute greatly to the solution of our present health care crisis. Soon, I hope, we will be able to drop the word "integrative" and see it simply as good medicine.
6. What is the biggest mistake extremely health-conscious people are still making?
Most people have too little confidence in the body’s remarkable potential for self-healing.
7. We are learning more about the dangers of OTC pain relievers, but they work so well and so quickly. So how often is too often?
NSAIDs are often effective for relieving pain, swelling, and fever, but they do not treat the root cause of these problems. In addition, they are so prevalent and familiar that most people consider them totally benign—but these powerful agents can be dangerous. NSAIDs should be used only for short periods of time (days to weeks) and only in the absence of kidney or heart disease as well as known gastrointestinal inflammation or ulceration. Individual risk varies, but when used daily for more than a few weeks (generally two) the likelihood of serious adverse effects increases significantly. Use of an NSAID for the occasional headache is fine, but consideration should be given to strategies for preventing headaches in the first place, such as dietary manipulation, stress management, and acupuncture.
8. How can we empower ourselves but not get labeled as one of those "difficult" patients?
In my opinion, people do not ask enough questions about their health care, including about the medications they are being prescribed. Taking a drug just because a doctor says so is not necessarily in your best interest. Become an active participant—educate yourself, share information with your health care team, and ask questions when you have them. Let your practitioners know that you are willing to commit to diet and lifestyle changes to help you gain greater control over your health. Even when they are busy, most health care providers find this type of patient engagement to be rewarding. If your provider does not, it may be time to look for a new one—ideally, a practitioner of integrative medicine.
9. In your book you note that 18 percent of the adult population has an anxiety disorder. Why do you think that is?
- Information overload: The amount of data we are exposed to on a consistent basis simply cannot be adequately processed, leaving us feeling out of control and stressed.
- Constant intake of news: where the content is often designed to induce concern if not fear.
- Inadequate exercise and sleep: with misguided attempts to compensate through the use of alcohol, caffeine, and other substances.