Could you go pill free?
ALMOST half of over-65s are taking at least FIVE different medicines a day.
So we asked Dr Ron McCulloch, a GP of more than 50 years who works at Pall Mall Medical in Manchester, to look at six of the most commonly prescribed medications for that age group.
He tells us how we can avoid them and if there’s anything we can do to come off them for GOOD.
Medication: Statins
Statins cut levels of ‘bad’ cholesterol in the blood that can lead to narrowed arteries, angina, heart attack and stoke. Common statins are Lipitor, Lescol, Lipostat, Zocor and Crestor.
Can you prevent needing them?
“If you eat and drink sensibly and exercise you can avoid a library of medication, statins included,” says Dr McCulloch. “The NHS offers five-yearly health checks to those aged 40+. Be sure to accept the appointment so you know if you’re heading for trouble.”
Can you come off them?
Yes. “There are two types of fat – saturated and unsaturated,” explains Dr McCulloch. “Saturated – sausages, cream, biscuits, hard cheese – is bad, whereas unsaturated – nuts, seeds, mackerel, salmon – can actually help lower cholesterol.”
You should also aim to eat 30g of fibre a day (wholemeal bread, fruit, veg, pulses and potatoes with the skin on).
The British Heart Foundation website (bhf.org.uk) offers a comprehensive list of saturated/unsaturated foods.
Medication: ACE inhibitors (most medicines end in ‘pril’) and beta blockers (end in ‘lol’).
Inhibitors block the production of a chemical that narrows vessels, making it harder for blood to move. Blockers decrease activity in the heart.
Can you prevent needing them?
“BP rises as you age, 80% of 80-yearolds suffer. But it also rises as you get fatter, less active, drink more alcohol and eat more salt,” says Dr McCulloch.
NHS guidelines advise lowering your salt intake to less than 6g a day, eating healthily, limiting alcohol and caffeine, quitting smoking and getting at least six hours’ sleep a night to maintain and potentially reduce BP. Doing this can lower BP in just a few weeks.
Can you come off them?
“It’s very difficult because once you stop medication, BP generally creeps back up,” says Dr McCulloch.
“If someone came to me having been prescribed inhibitors/beta blockers I’d put them on a portable blood pressure monitor for 24 hours. It reads BP many times to see if it’s consistently high (more than 130/80) or just when it is read in the surgery. Consistently high and it’s best to stay on the pills.”
The NHS believes if you haven’t had high BP readings for long there may be the chance of lowering it for good with the lifestyle changes mentioned.
Medication: Proton-Pump Inhibitors (PPIs)
Drugs such as Omeprazole, Lansoprazole and Ranitidine reduce acid that causes burning in the chest and throat. “A recent study shows taking Omeprazole for longer than a year increases the risk of osteoporosis,” Dr McCulloch says.
Can you prevent needing them?
Yes. Stress, smoking, spicy food and alcohol can all contribute to instances of acid reflux.
“Losing a few pounds can also cut your chances of needing anything other than over-the-counter antacids we’ve all taken. Being overweight exacerbates it,” Dr McCulloch says. Always speak to your doctor before stopping or changing your medication
Can you come off them?
“Yes, by taking those preventative measures, eating frequent smaller meals and raising your bedhead so your chest and head are above waist-level, preventing stomach acid travelling towards your throat,” he advises.
“Ensure your doctor checks for underlying issues too, such as a hiatus hernia (common in those 50+) where part of your stomach moves into the chest. It can be fixed surgically. And there’s a common bacteria called Helicobacter Pylori that will disappear in a fortnight with antibiotics.”
Anyone needing PPIs for more than a year should be referred to a specialist. “Type 2 diabetes is heavily linked with overweight, inactive people,” Dr McCulloch explains. “Half an hour’s brisk walk four to six times a week is great exercise for those who are a little older and keeps weight off.”
Can you come off the drug?
“If weight’s a factor, it’s less than seven years since the onset of diabetes and you’re prepared to work hard, it IS possible to reverse Type 2, which is great because it can lead to heart disease, stroke, blindness and kidney problems,” Dr McCulloch says. “It means a strict 800 calorie-a-day diet and we would need to reduce tablets slowly.”
Medication: Inhalers
“It’s normal to notice a gradual decline in lung function (the amount you can breathe out after you inhale as deeply as you can) as you age,” says Dr McCulloch. “The respiratory muscles weaken, making it difficult to keep the airway totally open.” Inhalers, similar to those used by asthma sufferers, help.
Some people develop COPD (chronic obstructive pulmonary disease).
Nine out of 10 cases are caused by smoking, though it can be down to workplace dust and chemicals that should be blocked by masks.
These include coal, grain and flour dust, welding fumes and isocyanates found in paints, foams, glues and flooring. Theophylline or aminophylline tablets relax and open airways.
Can you prevent needing them?
“If you notice you’re slightly more winded when active it’s probably time to up your exercise to strengthen your lungs,” Dr McCulloch advises.
“Obviously you can’t change what you’ve inhaled but if you’re still working with dust and chemicals, wear a mask. Most importantly, quit smoking.”
Can you come off them?
No. Lung damage is irreversible.
Medication: Serotonin reuptake inhibitors (SSRIs) include Sertraline, Fluoxetine, Citalopram, Escitalopram, Paroxetine and Fluvoxamine. Can you prevent needing them?
“There’s something called ‘anhedonia’ – the inability to feel pleasure in pleasurable activities,” Dr McCulloch explains. “This can be a problem as we get older when we’ve perhaps achieved all our goals and no longer feel the need to be hedonistic. Couple that with more free time and a sense of boredom and loss of purpose can set in.”
Keep finding things that bring new joy, excitement, or challenges.
Can you come off them?
“There are many non-pharmaceutical ways to treat depression – cognitive behavioural therapy, for example, helps you manage your problems by changing the way you think. And medical hypnosis can be very effective,” Dr McCulloch says. “But coming off antidepressants is a gradual process and must be done with doctor support.”