Good day, I'm doctor Paul. Welcome.
Medicine and health in this series is called doctor pro Tips. These are just little things that might make your either interacting with doctor or doctors or healthcare providers and or possibly following their instructions go a little bit more smoothly. The first one is it's an area where a lot of people have questions and it makes sense when we
look at the complexity and that's around pill taking. And so in the world of pills, and this could be prescription items or possibly supplements, et cetera, more and more people are taking things that are both prescribed as well as maybe over the counter, et cetera. So you really need to think about your timing of pill taking and certain other rules that go around with it. So the first thing is is that pills, generally speaking, will digest
very similarly to whatever food item they are most similar to. So, for example, if you take a pill that is a fat based, say a capsule full of a fat based medicine or something like that, or even a fat based nutrient, etc. It's going to absorb in your digestive tract the same way that other fats absorb, which means it's going to go through a little bit different pathway than the water soluble type things. If you take something that is say an amino acid or an amino acid.
Based product or drug, it's going to.
Absorb the same way that amino acids that you eat in protein will absorb. If you take other things.
Are going to absorb similarly.
So there are also some drugs that we don't normally give orally because the digestive tract would break them down too far and it wouldn't really be very useful or there'd be just too much metabolism. So the next thing is if it's prescribed or recommended by a healthcare provider,
and so what's that distinction. Well, generally speaking, we have to prescribe to you something that would be say a legend substance, and that means that in the state that you're in, and usually this covers the whole country, it is something that is on the order of prescription only,
and so that to be an antibiotic or whatever. So there's a prescribed and then there might be a recommended thing where it's not really a prescription, but your doctor might say I want you to start taking calcium and magnesium and vitamin D and K and here's the amounts. So it's recommended as part of your chart usually, but it's not really a prescription. So all of those together though, will or should have some sort of instructions as far
as when and how you take them. So usually what you have is either with food or before a meal, or after a meal, or maybe between a meal, and there's also bedtime posting. So the first thing is if it's a bottle with a prescription information or sometimes you got to walk out a receipt that will say take this much of this at this time. That's your first go to is, gee, what does the label say?
Now?
If the label is ambiguous, or if you have trouble taking pills or you feel like you're going to get nauseated from this pill, the next step is to talk to the pharmacist when you're filling the prescription. There's always a place where you can go and talk to the pharmacist when you're picking up your medications and just say, look, you know it doesn't really say it just says take three times a day. Can I take this with food? I get sick from pills, etc. And they'll break that
down for you. Now, one of the important things about when you take pills can be that there's different fates of digestion of the pill that your healthcare provider may have in mind. So there might be a substance, for example, that really is best with no food, and that'd be something like thyroid hormone. A lot of people take thyroid hormone, and we try and have them take that when they first get up before they eat anything, because it binds
to other things, especially minerals, really easily. So the worst thing that you could do would be to take your thyroid and then a mineral product and or food that has minerals at the same time, because the amount of thyroid you're gonnas are going to go weigh down. Then there are some medications, some supplements where we'll say, well,
take it with a meal. Now in the case of pills that really require food in your stomach to keep you from getting nauseated, to help the pill break down, whatever the reason is for with food, what I usually try and tell people, especially with things that might be a little more upsetting to the stomach, is take it
in the middle of your meal. And so the best way I've figured out to do this is to just set them by my plate, and then I see them there and I eat literally half of the food, and then I take the pills with a sufficient amount of water, and then I eat.
The rest of my food.
Now why is that Because if you take the pill at the beginning of your meal, it's with food, right, but it's going to go in there. There's not a lot of food or liquid in there, and it might stick to your stomach lining and make you very nauseat or even make you throw up. That happens with zinc and other zinc based products that are used in a number of drugs, like certain antibiotics, et cetera.
Will do that as well.
So if you imagine that your stomach, you know, it's sort of this big oblique bag, sort of an organ, and you got half your meal in there. Your stomach is literally sort of churning the food around. So the pill goes in with the water drink and it just makes us in and then it's going to digest more easily. It's not going to stick to the wall of your stomach and make you sick, which is what we don't want. Then you eat the rest of the food and it helps to push any of the you know, any of
the pill down that didn't get there, et cetera. Now, there were some medications there are that are better without food, but still you don't want to get them stuck in your esophagus the tube that you swallow through to your stomach. So we would tell people then to take that pill and drink a large glass, like a twelve ounce glass of water with it, just to make through there was enough fluid going down.
Because if you've ever tried and had.
This happen and felt like you had a pill stuck, that's generally because the pills are you know, they're sticky, they have different things on the outside, and they will stick to the lining of your esophagus. So the more fluid you can put down, if you can't eat with it, eat food is better. But if you can't eat with it, the more fluid you do the better. Now why would and these are some of the hardest things to remember as far as prescriptions or recommendations, why would your healthcare
provider recommend between meals? Well, one reason is to keep it away from foods. So like with thyroid, we usually say first thing in the morning before eating. But there are some medications and other things that we want between meals, and again you may have to set an alarm for yourself, or having a little pill container if you work at a desk and just have it there and remember when the alarm goes off to take that and it kind
of goes back to that same thing. These are probably things that are better to move through your system and not have a lot of food going with them so that we get maximum absorption, etc. Now the other thing is if you have a reaction to anything but a medication, a recommended supplement of whatever you're doing with your health care provider, you want to get a hold of the clinic.
Leave a message. Nowadays, with electronic medical records, you can just send a message electronically and just say, Okay, I started this new prescription and here's what's happening. It could be any number of things. It makes me nauseated, it makes me get flushed, it makes me feel dizzy when I take it, It does this, that or the other thing. Let them know soon and then often they can tell you, okay,
if that's happening, try this okay. So, for example, in our clinic, in most people's clinics, if you're getting nauseated, from it will reiterate the idea of eating half of your food and a meal, taking the pill with no fluid, and eat the other half of the meal of the food. That usually does take care of a lot of those problems. Now, sometimes there's other things like you're asking me to take this at bedtime, and I'm taking these other pills at bedtime.
Can we just double check, you know, check with a practitioner who's adding on the new pill, and can we just double check and take a look at, you know, making sure everything goes together that we're taking at night. And this is very important, especially with certain medications and a lot of supplement recommendations, because let's say, for example, there's some nighttime medication you're taking that's fairly critical for a function. Let's it helps you with a dysrhythmia, a arrhythmia,
or it helps you with some other thing. And then let's say somebody adds on another thing to take that may actually bind to the other medication.
And I've actually seen this with.
Patients where all of a sudden they start having you know, arrhythmias again, or their blood pressure went up or something, and there was no reason for it, and you go back and you look, and it turns out that there's two things going in at the same time with say their heart medication or something else, and one is inhibiting the other, so you get those symptoms from that. I've also seen this with neuropsychiatric meds and other things, So you just want to make sure you get a good
top down look at that. And in another section we're going to talk about doctors disagreeing and stuff like that. But generally speaking, whomever the healthcare provider is that's adding this new thing for your regimen, you should be able to say, Okay, look at my med profile or my supplement profile, is there any reason I shouldn't be able
to take this at that time? And so for some people, for example, there would be things that we would prefer were at bedtime, but there were other medications that were a little bit more critical that they'd be taken at that time, and so we would have them back up and take it right before dinner or some other time, just to make it work out a little bit better
for them. Now, one thing that comes up as far as tolerance of pills, et cetera, is sometimes you'll have a pharmacy and one of their jobs is to make sure you're not going to have drug interactions and things like that, and so drug interactions generally, there's pretty decent data on most drugs. It's like, don't take this with that, etc. We get into the world of some supplements and some
botanical or herbal medicines, et cetera. Sometimes the interaction checkers are very theoretical, so it's a good place to start because there's maybe a paper that showed, you know, in a Petri dish that this reaction happened, but there's no papers showing was that a problem or not when we put it into people. Okay, there's a big difference between
a Petrie dish reaction and people reaction. So again, if you are working with healthcare provider in adding something like that, the things that they should be looking for to help you out. Number one are is there anything we're adding in here that's going to create a problem for anything else you're taking. The next thing is are the things that we're adding in going to pharmacologically play well with
the other stuff that you're taking. We do this constantly and well all the types of patients I see, but especially on ecology patients because there are a lot of critical drag metabolism things, which thankfully most of them work out pretty well, but there's some that are a little more dicey than others. So as you're going through communicate, communicate, communicate.
Remember if it comes to pills, the person who's recommended or prescribed whatever it is in question should be able to answer questions about is it okay to take the new stuff you're giving me with these old drugs or supplements I'm taking. Sometimes there's a replacement where one of the new things will take over for the new thing and one of the old things and they'll take you off of it. But again that's a communication thing. If you start having a problem and you can't trouble shoot
it yourself. For example, I've got a lot of people who got sick from certain pills and they looked and it said don't take with dairy products, and they took that to me, don't take with any food, And indeed it was just saying don't take with dairy products or calcium containing things. So they were able to eat a meal, they just couldn't have dairy products with it. And then that took care of some of the problems. But if you're not getting a resolution, then ask your healthcare provider
what to do about it. Because one of the things that's not going to help you medically speaking, and we're just about a time here, but I'll get into this real quick. It's not going to help you medically speaking or for your medical management is if you stop taking a person decribed or recommended therapy and you don't see your doctor for two, four, six, eight weeks and then you get back and they're like, well, are you better
or what has changed? And they don't realize that you've been off of things that they recommended for that whole time, and so you know, they're not mind readers. So you can go back and you know, just communicate with their office,
let them know. Usually it's something fairly simple. If you're really having a bad reaction, you have an allergy or something like that, they also need to know about that because they're going to have you stop taking it and look for an alternative v and do, or if there's a bat allergic reaction, they're going to have you go to the emergency room. And so that pretty much goes through everything on the basics around pill taking, how to optimize them how to help out your pill taking journey
and experience. And then there are other things that can be helped or done. Sometimes these are things that the pharmacy can do. For example, in our patients that have a little trouble keeping track of things, or there's a lot of different pills at different.
Times, they can be packaged by.
Different pharmacy services into bubble packs that will allow and it will say, you know, mourning, you know, lunchtime, bedtime, something like that, and that really helps us sort of keeping track of things. The other thing is we've had people sometimes where they because of various reasons, due to digestion, absorption and all of the other things that go on, they were unable to really swallow the pills or it
was really really difficult. And so in some cases what was done is either through the pharmacy or somebody who's competent to do it, they got you knowed versions of a medication or powdered versions of supplement, etc. And they can mix it into a smoothie or other things like that. So as we kind of wind down here in the pill taking discussion, we'll just go back through the first thing is communicate with your provider as they're recommending the
new things. It doesn't hurt ever to just double check that everything is copasetic together, read the labels, and communicate back if you're having any trouble at all. All right, well we're going to go on to the next session and we'll take a little break here