5 Ways Doctors Are Making You Sick

One of the foundational principles of medicine is, Primum non nicer, Latin phrase that means “first, do no harm.” No physician wants any harm to come to their patients. But in this day and age, it’s a given that patients may sometimes be injured, even if you practice high-quality, evidence-based textbook medicine. 

A frightening revelation that I had a few years ago is how often doctors can cause long-term harm, despite initial short-term benefits. This can be found in almost every area of medicine. These practices are considered “standard of care,” supported by research and top leaders in our field. Here are 5 ways (3 types of medications and 2 types of surgical procedures) doctors are making you gain weight, and eventually, more sick in the long term. 

1. Medications that cause weight gain

Many commonly prescribed medications for allergies, diabetes, high blood pressure and depression are known to cause weight. Some of the more common offenders are:

  • paroxetine (Paxil) for depression
  • fluoxetine (Prozac) for depression, short term weight loss, long term weight gain
  • the atypical antipsychotics, such as olanzapine (Zyprexa) and clozapine (Clozaril)
  • mirtazapine (Remeron)
  • amitriptyline (Elavil, Endep, Vanatrip)
  • valproic acid (Depakote) for bipolar disorder
  • chlorpropamide (Diabinese and Insulase) for type 2 diabetes
  • fexofenadine (Allegra)
  • insulin
  • atenolol
  • and prednisone.

As I’ve mentioned numerous times previously, added weight can aggravate obstructive sleep apnea. As a double whammy, having obstructive sleep apnea and lack of sleep both can also cause weight gain.

2. Medications that lower melatonin

Many of the high blood pressure medications that lower sympathetic tone can lower melatonin production by blocking the sympathetic nerve pathways that contribute to melatonin production by the pineal gland. There aren’t many studies on this on humans, but one study on pigs found significantly lower levels when administered Alpha-methyl-p-tyrosine (AMPT), an enzyme blocker that lowers sympathetic activity. Lower levels of melatonin is associated with poor sleep quality. 

3. Medications that cause nasal congestion

Medications that lower your blood pressure, by lowering sympathetic tone, can also cause nasal congestion. Since blood flow in your nose is regulated by a delicate balance between the sympathetic (fight or flight response) and parasympathetic (rest, digestion and reproduction) nervous systems, lowering sympathetic tone can cause pooling of blood in your nasal tissues. Nasal congestion can aggravate sleep-breathing problems.

4. Surgery that prevents you from your preferred sleep position

Imagine if you naturally prefer to sleep on your stomach or side, and after surgery, you’re told to sleep on your back. Oftentimes, you don’t have a choice, such as after hip or abdominal surgery. Being prevented to sleep in your normal position will aggravate more breathing problem, especially on your back, since your tongue and throat structures can fall back more easily due to gravity. Again, lack of sleep due to any reason can cause weight gain.

5. Surgery that causes nasal congestion

Nasal surgery is usually done to open your nasal cavity so you can breathe better. However, some surgeons will use nasal packing or splints, which can aggravate #4. Fortunately, nasal packs are temporary and are usually removed within one week. Another common side effect after nasal rhinoplasty is that if your tip is narrowed, your nostril sidewall cartilage may need to be trimmed, potentially weakening the support structures. In most cases, the effect won’t be seen for years, if not decades. The can present at nasal congestion many years later.

 

Notice that with all these treatment options there will be initial benefits. But over many years, poor breathing and poor sleep will take a toll on your body. Once you start gaining weight, you can get caught up in a vicious cycle of worsening sleep-breathing problems that can potentially cause even more weight gain.

So before you consider taking certain medications long-term, or before you undergo any surgery, think about any potential long-term consequences, related to sleep and breathing. Anything that lowers your ability to breathe will diminish your ability to sleep, leading to a number of various potential health problems.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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One thought on “5 Ways Doctors Are Making You Sick

  1. Hi Doctor. Park,

    Your continued articles and podcasts on the subject of Sleep Apnea bring myself, and I’m sure many others, a lot of understanding about what’s happening to us! It’s great to find someone qualified in the medical/dental professions who is knowledgeable, instead of finding it on you-tube or blogs (not that I discount them because they’re not medically trained) but just because it brings some hope that somehow I too can find a medical professional who can help me with my problems.

    I’m from Australia, but I live in Thailand, which makes finding a professional to treat me, very difficult. Having said that, I am heading back to Australia later on this year, and I’m hoping to find someone who can help me.

    Do you know anyone based out of Australia (any city, I’ll travel!) that offers a service (that I can make an appointment with) for adults with sleep apnea and narrow jaws. I’m thinking Adult Palette Expansion or similar but I’ll go down the surgical route if I have to.

    I won’t be heading there for a few more months, in the meantime, I’m really worried about my situation. I wake up repeatedly, night-after-night, with mucus blocking my nose/throat, which prevents me from breathing. Obviously, my Cpap (which I bought independently of a doctor) doesn’t work, and I rip it off gasping, with my heart racing, sometimes in a sweat! I realise that the pressure on my heart must be astronomical and I’m scared I’m doing irreparable damage.

    My 2nd questions then is… can you recommend ANYTHING to stop the mucus production? I’m not looking for a diagnosis, but just generally, so taht I can get my Cpap to work in the meantime. I’ve tried anti-mucous pills, antihistamine and steroidal sprays, decongestant sprays,I’ve tried the Dropping Acid Diet to prevent Silent Reflux (didn’t work), Paleo, avoiding meat/dairy, the Potato Diet (to lose weight) NOTHING WORKED! Saline sprays and neti pot washing work temporarily, but not enough to get me through the night.

    I realize that my comment is getting rather long, and I’m asking you a lot of questions that probably require detailed answers. I’m sure you’re very busy, and I want to take up a lot of your time. Honestly if there was any way of my getting to you for treatment I’d be there yesterday. So my last question….

    I realise that ANY stress on the heart is not good. But how long do you think we have, as a buffer, between realising that you have a sleep problem, and getting it fixed by whatever means, before you start doing REAL HARM to your heart?

    Obviously most of us don’t wake up one morning and know we have a sleep problem. It is either something we have to learn about and realise in time, or else, it gets progressively worse until we have to face it, and by then it could almost be YEARS. We can try Cpap machines, and try nasal surgeries that don’t work… like my brother who has had two nasal surgeries, and has completely lost his sense of taste, and STILL HAS SLEEP APNEA! Obviously different for everyone, and dependent on SO MANY other factors… but in the meantime the poor old heart is still taking the brunt of it.

    So, lastly, what can we do to ease the heart in the meantime. Do you recommend any steps to reinforce the health of the heart, be them nutritionally, exercising, deep oxygenating breathing, nutritional supplements, not lying on the left side? … anything … that can help the heart in the meantime to cope with the extra stress.

    Dr. park, long and complicated questions, I know. I apologies for taking your time up, but it ‘s very very difficult to find answers, or to find someone who knows enough or who cares enough, to answer. I’m at my wit’s end, and have visited several doctors here in Thailand to see if they can help, and all they say is ‘allergies’ or pollution, and give me antibiotics or other medicines. I know it’s not just this. I know that’s the textbook response, but it’s not really true. I know that the mucus only came on at Peri-menopause, with a few other symptoms. I know that my mom has Sjorgen’s Syndrome, so it could be that. She also has low thyroid, flimsy nostrils (narrow) and had bad perimonopausal symptoms, such as migraines, that I’m now starting to get also – and they got worse before they got better!

    I have two parents that snore, wasn’t breastfed, had numerous teeth extractions for braces, and I have a long receded chin with an overbite. It could be any manner of the above, but is probably a combination of all of them! I can’t find a way to expand my jaw at home. I’ve tried pushing up with my tongue, but it hasn’t done anything that I can tell. I’m also unable to eliminate this mucus that is blocking my narrow airways. If I could have, I would have by now.

    So, at wit’s end I”m going back to Australia JUST to seek treatment, when I’m able to. If you can recommend anyone who might be able to help me work trough this I’d really appreciate it. because I know a regular old GP will want to go through the ‘allergies’ ‘reflux’ route all over again, and I’m really worried for my heart. If I could get my Cpap to work by eliminating the mucus, I’d be a lot happier, but somehow I just can’t eliminate it, and I’m so worried I’m going to have heart problems after this, and that thought is quite depressing, given that I couldn’t get time off to visit Australia until a few more months time!

    Thank you so much for your articles Dr. Park, for giving us hope, and support, and even warnings of the dangers. It’s so much better to be aware of the issues and not ignorant of them… even if they are really scary, at least I know WHY.