Suffering with side effects of inactive ingredients in meds
Q: My asthma doc prescribed an asthma control medication that he says everyone loves, but one day’s use made me decide I would never ever touch it again. He says that makes no sense, but I know it made me feel terrible. I’m on a different inhaled medicine now with no problem, so what’s up with that? Katie B., Sioux Falls, S.D.
A: There’s a really good chance you were right about how that medication made you feel. But it’s not necessarily because of any negative reaction to the medicine itself. Most likely it’s because of the so-called inert ingredients — the preservatives, dyes, antimicrobials and other stuff that’s added to make the active ingredient deliverable, prevent spoilage and keep it stable. These are called excipient ingredients. The pharmaceutical industry thinks of them as harmless because of their many-year usage and the fact that animal studies have not found them to be immediately toxic. But there haven’t been many studies that looked for harder-to-spot or long-term effects of the compounds, or how they might interact if you’re taking several different medications that all contain such ingredients.
So researchers from UC San Francisco School of Pharmacy and the Novartis Institutes for BioMedical Research took a deep dive into the ingredients and screened almost 3,300 excipients in the inactive ingredient database. According to their study, published in Science, it turns out they contain 38 distinct molecules that interact with 134 important human enzymes and receptors. In short, the study has shown that excipients “may be the culprits of unexpected physiological effects seen in certain drug formulations.”
While this study did not offer clear proof of specific reactions to specific excipients, it is confirmation that you can have a bad reaction to a good medication because of the “inert” materials surrounding the drug. So, if you feel “off ” after starting a medication, don’t ignore it. Let your doctor know so that together you can find a medication that improves your health without unwanted side effects.
Q: My friend is on a weird diet recommended by an online doctor who says that nightshade plants are toxic and you should give up everything from tomatoes to bell and spicy peppers and spices like curry powder. What is it that makes these foods so dangerous? Michael C., Largo, Fla.
A: The idea is that those plants contain a natural anti-pest compound solanine that pumps up inflammation and makes arthritis worse. The amount of solanine in belladonna, aka deadly nightshade, is sufficient to make that plant a poison, but that isn’t true of nightshades like tomatoes and tomatillos, bell and spicy peppers, white potatoes, eggplant and red spices like curry powder, chili powder, cayenne powder and red pepper flakes. They contain much less solanine. It’s reduced through cooking (although not eradicated), and it passes through the body quickly, according to Tufts University’s Friedman School of Nutrition Science and Policy. Even green potatoes (they especially come under fire) are not dangerous to most adults, although it is suggested that kids should avoid potatoes’ shoots and green parts. As for green tomatoes, they contain tomatine — a fungus fighter. And while there’s no evidence it hurts humans, tomatine has been shown to lower lousy cholesterol in hamsters and may help people.
Nightshades have other nutritional virtues, too. For example, peppers are rich in vitamin C, which may protect joint cartilage. They also pack a dose of carotenoids that may help reduce risk of rheumatoid arthritis and other inflammatory conditions. The lycopene in cooked tomatoes helps fight prostate cancer.
It’s important to avoid sweeping elimination of phytochemical-rich fruits and vegetables. Most people still eat far, far fewer servings daily than is needed for optimal health. That’s why we suggest that if you enjoy the fruits, veggies and spices listed above, you continue to enjoy them. And take a half a multivitamin twice daily to make sure you’re getting all the vitamins and minerals you need.