Over 60: Are Your Pills Making You Ill?

How we take medications, how much, and how often, changes as we age. Learn what you should consider asking your doctor and what symptoms to look out for that may give you clues that they are now doing more harm than good.

As we age our metabolism changes. It slows, and our digestive tract absorbs nutrients differently.

Our hydration and water needs change, and we can easily become dehydrated. In addition, our livers don't function as well, our kidneys don't work as efficiently, and our hormone levels change, reduce, or increase and things just don't work the same. Our bodies are slowing down.

All these changes mean our bodies absorb and utilize the medications we have been taking for years, differently. And that's when good medications turn bad.

What should you do?

It may be time to adjust the dosing or even the type of medication to be at the best therapeutic levels for our changing bodies. Too much can become toxic to your body and can start doing the opposite of what it's supposed to do. For example, the blood pressure pill you've taken for years may not be working as well, and your blood pressure is creeping back up or even down too much. You may need to increase the dose or add other types of anti-hypertensive drugs to the mix.

Another consideration is how the effectiveness of your medications might vary and interact with other medications, supplements, and even your diet. It's important to regularly review three categories of medications in particular: anti-anxiety, antidepressant, and antipsychotic. Let's discuss this further and examine an example.

*Paul has bipolar disorder and just turned 70 years old. He's been on lithium for 15+ years and his lithium blood levels have constantly been in the perfect range. His symptoms have been very well controlled. Over a year he very slowly and gradually started to struggle with more depressive episodes, his concentration started declining, he was constantly sleepy, his mental acuity was diminishing, and he eventually started having trouble finding words.

Is this dementia? On the surface, this could easily be ignored as just getting older or maybe even thinking it's the start of dementia. His slight hand/finger tremor (a side effect of lithium) had turned into a heavy tremor. I was concerned. The increased tremors could be a sign of potentially serious lithium toxicity and even deadly if not addressed.

As a client, I could tell he was struggling. As a clinical health professional and coach, I am not going to diagnose - that's his Doctor's job. But, I have the background knowledge to recognize signs and symptoms and have a concern for a situation. So, I was able to educate him on the why he should visit his doctor, and importantly coach him on what to expect and what pertinent information his doctor needs.

His doctor was very concerned. After some stat lab draws, the tests showed his lithium levels were in fact dangerously high, and at toxic levels. As a result, his doctor immediately put him on a gradual and controlled, dose reduction, while his wife monitored for any adverse behavioral changes. His PCP referred him back to a psychiatrist to continue the careful dose reduction and review his mental health needs.

After about 6 months of gradual and controlled reduction, the "old Paul" returned. His tremor dissipated, and his concentration, memory, and mental clarity all returned. His depression receded and his mental fog lifted. Both his physical and mental energy improved dramatically.

Important: Do not ever do a sudden reduction or stop any medication without consulting a doctor first! It is highly dangerous to self-diagnose, treat or suddenly stop any medication without a doctor's advice.

Paul is a great example of how medication needs can change as we age. In my experience as a nurse working with seniors over the years, I have seen this true example play out time and time again. As nurses and doctors specializing in gerontology, we know to monitor for behavior or physical changes as part of a senior's aging wellness and chronic disease management care plan.

These signs and changes can be so subtle, happening so gradually over time that we miss seeing them; we accept them as a part of aging, and even maybe early signs of dementia. Even though Steve's wife is a nurse, she didn't immediately recognize what was happening until she stood back, put her impartial objective thinking nursing hat on, and realized how much he had changed.

This is a typical example of why regular medication reviews are so important, yet are often overlooked.

But of course, not everyone has a nurse specializing in senior care as their spouse. So what can you do?

Medication review

If you are caring for a loved one, or have seen changes that make you concerned that something isn't right or are wondering if it's early dementia - encourage them to make an appointment with their primary care provider to review their symptoms and medication. Accompany them if you can. Write a list of symptoms or changes you've observed and talk about them or ask if these mental changes could be due to medications. Always ask!

What to expect at your doctor's appointment

Your doctor will review your chart, medical history, and current medications and ask you about what symptoms you are experiencing. Be honest and as detailed as possible. Try to be objective rather than subjective.

Your doctor will order blood tests, a panel of tests that will give them a body systems overview.

They will do a quick, simple mental health assessment and evaluation right there and order blood screening tests like they did with Steve. If you are on any antipsychotic, or antidepressant medications, they will review those and order levels to be tested if appropriate. Your doctor will be screening for toxicity caused by the medication.

What to tell the doctor

• Take a list of questions you want to ask with you.

• Be honest about your concerns.

• Be very detailed about the signs you are seeing.

• Bring medications with you, and tell them what you are taking, how much, and how often.

• Whether you take them before, after, or with food.

• Be objective in your descriptions of symptoms where possible providing measurable facts, - i.e., "instead of sleeping 7-8 hours a day with no mid-day naps, I'm now feeling more fatigued and sleepy despite sleeping 10-11 hours a night, and needing a 1-2 hour mid-day nap."

Don't put your health off. Be proactive - it's better to know and prevent something serious happening.

• Paul specifically wanted me to share his case as an example of what could of happened, if he had not gone to his doctor in time and the huge change it made in his health and wellbeing since. Thank you Paul.

---

To book a 30-minute free discovery call to learn how I can help you with your healthcare needs and questions, Schedule below.

Discovery Call

Book Now