Adverse Reactions–Do You Recognize Them?
Ah yes, you needed a medicine to make you feel better. We all sometimes end up with medicines though statistically speaking medicines cause more harm than good. While the number of death from heroin, an illegal substance, was under 14,000 people in the US in 2014, in the same year the number of people who died as a result of adverse reaction from prescription medicines was close to 30,000. Medical errors, including the prescription of the wrong medicine or adverse effects from it, represent the third leading cause of death in the US, and many of those go unreported or end up believed to have been caused by natural causes. Some studies claim that the death rates from medical errors, including the wrong prescription medications used, claim over 180,000 lives are lost annually. Even this report is an underestimation because it only includes Medicare findings. If someone dies from the wrong prescription medicine who is not on Medicare, or the hospital does not receive Medicare benefits for care, the death of those is not included in this data. We have a problem.
I think part of the problem is in advertisements. I have a serious problem with the pharmaceutical industry that advertises prescription medicines on television for people who then grow an expectation of receiving the particular medicine from their doctors—regardless if that is a beneficial medicine for them or not! Including medicines for depression or chronic pain.
We outlawed alcohol advertisements on television yet only 2,200 people are reported by the CDC to die in alcohol poisoning annually, quite a bit shy from prescription drug caused death.
Why do we not outlaw prescription drug advertisements?
It would be a logical step to reduce drug awareness of the public and thereby their expectations from their doctors. One of the reasons why antibiotic resistance is so rampant is that people with viral infections, who don’t need antibiotics, consider they received substandard medical care if they don’t receive antibiotics. It is a reverse world where doctors are considered to be substandard if they don’t prescribe medicine.
While most medicine adverse effects are reported to the FDA MedWatch system, either by the patients themselves or responsible doctors, not all people report problems and not all adverse effects are reportable! Some adverse effects you may not realize was caused by a particular medicine you may have taken a month earlier!
The Case of Corticosteroids for Inflammation
Take the case of having to take a corticosteroid medicine (prednisone or prednisolone). It is a medicine that is so frequently prescribed that I don’t even know a single person who has not had to take it at least once in their lives. Of course, a caring physician or pharmacist will explain to take it with food, don’t drink alcohol while taking it, etc. However, here is an adverse effect you probably have never heard of and unless I tell you about it, you never would hear either.
Corticosteroids and Type II Diabetes
Not a typo: taking corticosteroid medicines, like prednisone, can cause type II diabetes. This is not an adverse reaction you will read anywhere and chances of it being reported are pretty much zero since no one will notice! I noticed it by accident! I do not have diabetes of any kind and I am on the ketogenic diet for good health (not weight loss) and migraine-free life. However, I caught a viral bronchitis. Because I also have asthma, I was immediately placed on prednisone.
On the ketogenic diet a person does not eat any sugar or sweets—in my case not even sugar substitutes—and also no fruits or vegetables much since the carbohydrate restriction is great plus I feel way better without any. It is a high fat and moderately low protein diet with minimal carbs if any. I monitor my ketosis level by both urine and blood test to be sure I am within my desired range of nutritional ketosis. I have a sweet spot comfort zone that I wish to stay within, which provides perfect glucose homeostasis. I thus measure my blood glucose—particularly after exercise—to see how much glycogen my liver dumped back into my body for glucose energy (from protein metabolism) so I can return to my homeostasis.
Like glucose, Prednisone (and all steroid medicines) use insulin receptors to be carried around in the body. Since corticosteroid is a very important anti-inflammatory in the body, it has priority over glucose when it comes to insulin. Therefore, all available insulin receptors are tied down with steroid delivery while glucose backs up in waiting. When glucose backs up in your blood, two very important things happen:
1) your brain or muscles are not getting glucose for energy and so the liver keeps on dumping more and more glycogen (glycogen is what the liver saves as glucose for later use) back into your blood as glucose but insulin is not responding. So while you are full of glucose, you are basically starving as far as your brain is concerned!
2) As glucose is backed up, it builds up to considerably high glucose levels (my glucose reader showed 200!) mimicking insulin resistance. Keep this up for longer periods and you will end up with insulin resistance.
As you know, insulin resistance is the hallmark of type II diabetes. Taking steroids for a short course of no more than a 7-day dose pack will not likely to harm you on a regular diet. In my case it did, since I was promptly kicked out of ketosis with the scariest side effects. My blood test for ketosis (measures beta hydroxybutyrate) showed near zero level ketosis but my urine keto strips showed I was in major diabetic acidosis (that can be fatal)! There are no manuals to understand what happened and no adverse reaction report can be made. This is one of those adverse reactions that never show up anywhere and is also not ever told to you by any doctor—if you are lucky enough to find one who is even familiar with the term ketosis.
It sure gave me a great scare and major brain-work to figure it all out. I realized the importance lack of information in deaths caused by prescription medicines! I also recognized that steroids can cause type II diabetes. I know I am not the only one who had to take steroid for a cold for a short duration; I also know people who take steroids for months or years. Workout buffs trying to increase their muscles are in great danger of ending up with type II diabetes. Please tell them!
Comments are welcomed, as always!