When new or even long-established patients arrive at WholeHealth Chicago (in person or via telemedicine), our practitioners walk them through what we call the medication ritual.
We ask, “What are you taking, both prescription meds and supplements?” These days, people often see a range of health care providers and take many supplements, so it’s important to keep one master list, especially when so much is prescribed or purchased with little thought of potentially dangerous interactions.
Pause for a moment so I can link you to one of my favorite cautionary articles, from the Harvard Center for Ethics. This piece calls prescriptions drugs a major health risk and cites statistics showing that correctly taken prescription drugs are estimated to be the fourth leading cause of death, usually due to unexpected side effects, drug interactions, and so forth.
Despite this frightening fact, the number of actual deaths from correctly taken prescription drugs is a proverbial drop in the bucket when compared to the side effects prescription drugs generate.
Most pills won’t kill you outright. In fact, if thoughtfully chosen by someone who remembers to renew his or her medical license, and who periodically prunes your drug list, they might do you some good, longevity-wise.
Fatigue is a common side effect
Far more common than death are side effects, and one of the most common is chronic fatigue.
So let me start by saying that at least two or three times a month a new patient schedules an appointment with me for chronic fatigue. They’ve seen their primary care doc, maybe a specialist or two, and they’re all set for me to diagnose them with something esoteric like chronic inflammatory response syndrome (CIRS) from black mold or subclinical hypothyroidism.
Instead I ask, “Tell me why you’re you taking these various drugs. How long have you been on them?”
My patient often looks confused. “I don’t remember. I think I had reached the highest dose for anxiety and this was added. I’ve been taking that two for years, and I take an extra for sleep.”
My fingers fly over the keyboard and I show him that four of his six daily meds list fatigue as a side effect. All are on automatic renewal and his psychiatrist has retired.
For this patient, the next few weeks to months will be a slow and cautious tapering off. Treating black mold would be easier.
List of fatigue-inducing drugs
So let’s begin by listing the most commonly prescribed medications that are notorious for causing fatigue as a side effect. You yourself might by taking one or more of these, and if it’s working well, with zero side effects, that’s great.
Oh, by the way: when you were first prescribed any of the following, did the doctor warn you about fatigue as a side effect? Probably not. It’s usually glossed over, like weight gain or problems with focus, concentration, and word finding.
Each of us is biochemically unique, so every drug on this list may not apply to you personally, but here are the usual fatigue culprits:
- All allergy medications (antihistamines, even ones marked “non-sedating”).
- All meds for dizziness and vertigo (Antivert, Dramamine).
- All antidepressants and antianxiety meds.
- All blood pressure meds, especially beta blockers and calcium channel blockers.
- All drugs that treat cancer.
- All meds for nausea.
- All birth control pills.
- All muscle relaxants.
- All opioid-based pain meds.
- All meds for migraine prevention or relief.
A useful rule of thumb when it comes to determining if a med you’re taking is responsible for any side effect at all is to think back to when that symptom started. You might realize you never had symptoms until you started taking that new pill.
This is a clue for you to follow up with your doc and see if you can stop taking it.
A second useful idea is to create your own master medication/supplement list. If you see multiple doctors, just as doctor #2, #3, or #4 is about to write you a prescription, say “Whoa! Did you notice I’m also taking these?” And pull out your list or, better yet, do it at the start of your appointment.
One last fact: the average number of prescription drugs filled at pharmacies across the US in 2019 was 11 per person. You read that correctly. And in some states like Kentucky, as this chart shows, it’s 18 drugs per person. Don’t ever try to quit any prescription med without talking to your doctor first and making a plan to do so carefully.
Knowing all this will save you unnecessary tests for any previously undiagnosed chronic fatigue and may well set you on a happier, healthier path.
Be well,
David Edelberg, MD