Nearly 75% of US adults are overweight or obese, and 40% have pre-diabetes or diabetes. This widespread issue has led to increased interest in medications like Ozempic (Semaglutide), a GLP-1 (glucagon-like peptide-1) receptor agonist. Ozempic mimics the hormone GLP-1, which regulates blood sugar by stimulating insulin secretion and inhibiting glucagon release. It also slows digestion, increasing feelings of fullness and reducing caloric intake. This dual action helps improve glycemic control and can aid in weight loss. Efficacy varies among individuals; about 20% of users may not lose weight or may even gain weight. This is likely due to the fact that while for many people Ozempic reduces appetite, for some individuals Ozempic may lead to blood sugar that is too low, a condition known as hypoglycemia, which can increase cravings for carbohydrates and sugar. ozempic side effectsOzempic has shown significant benefits for many, but it is not without risks. Known side effects include kidney damage, gastroparesis, gallbladder issues, muscle loss, nutrient deficiencies, thyroid cancer, and mental health concerns, including depression and increased suicidal ideation. Importantly, Ozempic is FDA-approved only for Type 2 Diabetes, not for weight loss. When discontinuing Ozempic, rapid weight gain, often termed "Ozempic rebound," is common. Studies show that within a year of stopping, two-thirds of users regain the lost weight, often ending up with a higher body fat percentage due to muscle loss (leads to lowered metabolic rate), poor dietary and lifestyle factors, and metabolic inhibition due to calorie restriction. "With...[GLP-1]...treatments, there is a concomitant reduction in lean body mass, which seems to be in the range of 25%–40% of total weight loss." In other words, studies show that upwards of 40% of the weight lost on Ozempic isn’t the fat you’re hoping to bid adieu to – it’s muscle! Additional Risks of Ozempic
Safety trial duration on Ozempic lasted only 30-68 weeks, so safety for use beyond this timeframe has not been evaluated. The Real Culprits of ObesityThe obesity crisis is not due to a lack of injectable medications. The primary contributors are:
Natural Alternatives to GLP-1 agonistsFor those seeking alternatives or aiming to prevent post-Ozempic weight gain, lifestyle changes are crucial. Natural ways to boost GLP-1 include:
Peptides for Weight Loss and Muscle GainFor those seeking more advanced methods, peptides can be a powerful tool with fewer side effects than GLP-1 agonists. Some effective peptides include:
For injectable peptides, I recommend the companies Limitless Life or Peptide Sciences. If you're looking for quality oral peptide formulations, check out LVLUP Health. Also, it’s important to understand that the best effects from any of the peptides listed above come via pairing them with a consistent weight training routine, adequate protein intake, and a physically active lifestyle. While Ozempic has been demonstrated to mitigate blood sugar control and weight management, it's essential to weigh these against potential risks and side effects. Incorporating lifestyle changes and considering natural alternatives can help mitigate these risks and support long-term health. Natural alternatives and peptides can provide effective, safer options for achieving weight loss and muscle gain. Combining these with lifestyle changes is crucial for long-term success. Addressing the root causes of obesity through lifestyle changes is crucial for long-term health. Prioritizing physical activity, a balanced diet, reducing exposure to toxins, managing stress, and ensuring adequate sleep can significantly impact overall well-being and weight management. referencesWadden, Thomas A. et al. “The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities.” Current Obesity Reports 12 (2023): 453 - 473. https://doi.org/10.1007/s13679-023-00534-z.
Castellanos, Vanessa, et al. “Semaglutide-Induced Lupus Erythematosus with Multiorgan Involvement.” Cureus, vol. 16, no. 3, 1 Mar. 2024, p. e55324, pubmed.ncbi.nlm.nih.gov/38559525/, https://doi.org/10.7759/cureus.55324. Billings, Sabrina A., et al. “Rhabdomyolysis Associated with Semaglutide Therapy: A Case Report.” Cureus, vol. 15, no. 12, 1 Dec. 2023, p. e50227, pubmed.ncbi.nlm.nih.gov/38192938/, https://doi.org/10.7759/cureus.50227. Li, J, et al. “Case Report: Semaglutide-Associated Depression: A Report of Two Cases.” Frontiers in Psychiatry, vol. 14, 29 Aug. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10495976/#:~:text=At%20present%2C%20most%20reported%20adverse, https://doi.org/10.3389/fpsyt.2023.1238353. Casella, Sarah, and Katelyn Galli. “Appendicitis: A Hidden Danger of GLP-1 Receptor Agonists?” the Journal of Pharmacy Technology, vol. 40, no. 2, 7 Dec. 2023, pp. 108–111, https://doi.org/10.1177/87551225231216638. Challa, Tenagne Delessa, et al. “Regulation of Adipocyte Formation by GLP-1/GLP-1R Signaling.” Journal of Biological Chemistry, vol. 287, no. 9, Feb. 2012, pp. 6421–6430, https://doi.org/10.1074/jbc.m111.310342. Willoughby, Darryn, et al. “Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review.” Nutrients, vol. 10, no. 12, 3 Dec. 2018, p. 1876, www.ncbi.nlm.nih.gov/pmc/articles/PMC6315740/, https://doi.org/10.3390/nu10121876. Wilding, John P. H., et al. “Weight Regain and Cardiometabolic Effects after Withdrawal of Semaglutide: The STEP 1 Trial Extension.” Diabetes, Obesity and Metabolism, vol. 24, no. 8, 19 May 2022, pp. 1553–1564, pubmed.ncbi.nlm.nih.gov/35441470/, https://doi.org/10.1111/dom.14725. Leehey, David J., et al. “Acute Kidney Injury Associated with Semaglutide.” Kidney Medicine, vol. 3, no. 2, Mar. 2021, pp. 282–285, https://doi.org/10.1016/j.xkme.2020.10.008. Bezin, Julien, et al. “GLP-1 Receptor Agonists and the Risk of Thyroid Cancer.” Diabetes Care, vol. 46, no. 2, 10 Nov. 2022, https://doi.org/10.2337/dc22-1148.
0 Comments
Prescription drugs have become a significant public health concern, with overtreatment and misuse leading to an alarming number of deaths. The increasing death rate from these drugs is particularly concerning given that many of these fatalities are preventable. The Scale of the ProblemIn 2013, it was estimated that prescription drugs were the third leading cause of death in the United States, following heart disease and cancer. By 2015, it was noted that psychiatric drugs alone also ranked as the third leading cause of death. However, some estimates place prescription drugs as the fourth leading cause, based on a 1998 meta-analysis that primarily considered in-hospital adverse drug reactions. This analysis likely underestimates the true extent of the problem since most drug-related deaths occur outside of hospitals and involve complications that are not always correctly attributed to drug use. Underreported and Misclassified DeathsMany deaths linked to prescription drugs are misclassified as natural or unknown causes. This issue is particularly prevalent with psychiatric drugs, where sudden deaths in young patients are often labeled as natural despite known risks of fatal heart arrhythmias from neuroleptics. Similarly, deaths from depression drugs in the elderly, caused by falls and fractures, often go unrecognized as drug-related. Specific Drug Categories and Risks
Increasing PolypharmacyPolypharmacy, the use of multiple medications by a single patient, has been on the rise, especially among the elderly. This trend increases the risk of adverse drug interactions and fatalities. For example, combining benzodiazepines with neuroleptics significantly raises mortality rates. Estimates of Annual Drug-Related DeathsCurrent estimates suggest that over 882,000 deaths in the United States annually can be attributed to prescription drugs. This figure includes hospital deaths, psychiatric drug fatalities, opioid overdoses, and deaths from NSAIDs. These numbers highlight the magnitude of the problem and the urgent need for intervention. The Role of Misguided Regulation and Lack of AwarenessThe pharmaceutical industry's influence on drug regulation has led to more permissive policies, exacerbating the issue. Many deaths could be prevented if drugs were prescribed more judiciously. For instance, neuroleptics and antidepressants often show minimal efficacy in trials, yet they are widely prescribed. Similarly, NSAIDs are commonly recommended despite their significant risks, often without sufficient consideration of safer alternatives. The pervasive issue of prescription drug-related deaths necessitates a reevaluation of current medical practices and regulatory policies. With most of these deaths being preventable, a more cautious approach to prescribing and better awareness of the risks associated with these medications could save countless lives. It is crucial for healthcare providers, regulators, and patients to acknowledge the dangers and work towards safer, more effective treatment strategies. In bed with big pharma: A $12 Billion RelationshipA comprehensive analysis by Yale University researchers has revealed that nearly six in ten doctors in the United States have received over $12 billion in payments from pharmaceutical and medical device companies over the past decade. This study sheds light on the pervasive financial relationships between healthcare providers and the medical industry, highlighting potential conflicts of interest. Key Findings from the Study
Largest Recipients by SpecialtyOrthopedic surgeons topped the list, receiving the highest total sum of payments at $1.36 billion. They were followed by:
most profitable Drugs and Devices
most prescribed drugsEvery day, millions of people in the U.S. take prescribed drugs in an effort to help them live their lives. As our understanding of medicine has evolved, we’ve developed drugs to aid with some of the most common medical conditions—from pain and blood pressure drugs to asthma medication, thyroid treatments, and antidepressants. This analysis uses prescribed medicines data from the U.S. Agency for Healthcare Research and Quality, released in 2021 for the 2019 calendar year. It also uses supporting drug and health information from MedlinePlus. Top 10 Most Prescribed Drugs in America (2019)
The most prescribed drug, atorvastatin (sold under the brand name Lipitor), was prescribed to 24.5 million people in the U.S. in 2019, or 7.5% of the population. It was one of many statin medications listed, which are claimed to prevent cardiovascular disease and treat abnormal lipid levels. Prevalent Conditions Treated Most of the top prescribed drugs are used to treat high blood pressure or symptoms of it. This is significant as 108 million, or nearly half of adults in the U.S., have hypertension or high blood pressure.
Combining the total patients for blood pressure and cholesterol medications covers 33% of the U.S. population. Pain and inflammation medications were the most frequent on the top 30 list, prescribed to 13.6% of people. Drug Spending in the U.S.A drug’s total number of patients doesn’t necessarily reflect its importance or cost. For example, levothyroxine, the fourth-most prescribed drug by total patients, was the second-most prescribed by total prescriptions with 102.6 million in 2019 at an average cost of $25.10 per prescription. More specialized medications like fluticasone had fewer total prescriptions (27.9 million) but a higher average cost of $97.68 per prescription. Prices are influenced by factors like demand, patent status, and healthcare system variations. Implications and ConcernsThe study underscores ongoing concerns about financial conflicts of interest in the medical field. Researchers noted that such payments might influence physician prescribing behavior and potentially undermine patient trust in medical professionals. Despite these concerns, the practice of accepting industry payments remains widespread. Data Source and MethodologyThe study utilized data from the Open Payments platform, a national database where drug and medical device companies are required to disclose payments made to physicians. This platform aims to increase transparency and help patients make informed decisions about their healthcare providers. FDA recalls and safety concernsIn a related safety concern, the FDA recalled certain Impella devices in December due to a perforation risk that could cause serious injuries or death. This highlights the ongoing need for vigilance regarding the safety of medical devices widely used in clinical practice. ConclusionThis comprehensive analysis by Yale University researchers provides a clear picture of the substantial financial ties between US doctors and the medical industry, emphasizing the need for ongoing scrutiny and transparency. The relationship between healthcare providers and the medical industry is complex and often financially intertwined. While these financial interactions can support medical education and innovation, they also pose significant ethical and practical challenges. Ensuring transparency and addressing potential conflicts of interest are crucial steps toward maintaining the integrity of medical practice and patient trust. referencesGøtzsche PC. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Health Care. London: Radcliffe Publishing; 2013.
Gøtzsche PC. Deadly Psychiatry and Organised Denial. Copenhagen: People’s Press; 2015. Schroeder MO. Death by Prescription: By one estimate, taking prescribed medications is the fourth leading cause of death among Americans. US News 2016; Sept 27. Light DW, Lexchin J, Darrow JJ. Institutional corruption of pharmaceuticals and the myth of safe and effective drugs. J Law Med Ethics 2013;41:590-600. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998;279:1200–5. FAERS Reporting by Patient Outcomes by Year. FDA 2015;Nov 10. Gøtzsche PC. Mental Health Survival Kit and Withdrawal From Psychiatric Drugs. Ann Arbor: L H Press; 2022. Hubbard R, Farrington P, Smith C, et al. Exposure to tricyclic and selective serotonin reuptake inhibitor antidepressants and the risk of hip fracture. Am J Epidemiol 2003;158:77-84. Thapa PB, Gideon P, Cost TW, et al. Antidepressants and the risk of falls among nursing home residents. N Engl J Med 1998;339:875-82. Ebbesen J, Buajordet I, Erikssen J, et al. Drug-related deaths in a department of internal medicine. Arch Intern Med 2001;161:2317–23. James JTA. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf 2013;9:122-8. Ho JY. Life Course Patterns of Prescription Drug Use in the United States. Demography 2023;60:1549-79. Gøtzsche PC. Long-term use of antipsychotics and antidepressants is not evidence-based. Int J Risk Saf Med 2020;31:37-42. Gøtzsche PC. Long-Term Use of Benzodiazepines, Stimulants and Lithium is Not Evidence-Based. Clin Neuropsychiatry 2020;17:281-3. Forbruget af antipsykotika blandt 18-64 årige patienter, med skizofreni, mani eller bipolar affektiv sindslidelse. København: Sundhedsstyrelsen; 2006. Hughes S, Cohen D, Jaggi R. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: a cross-sectional study. BMJ Open 2014;4:e005535. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294:1934–43. FDA package insert for Risperdal (risperidone). Accessed 30 May 2022. Koponen M, Taipale H, Lavikainen P, et al. Risk of Mortality Associated with Antipsychotic Monotherapy and Polypharmacy Among Community-Dwelling Persons with Alzheimer’s Disease. J Alzheimers Dis 2017;56:107-18. Whitaker R. Lure of Riches Fuels Testing. Boston Globe 1998; Nov 17. Whitaker R. Mad in America: Bad science, Bad medicine, and the Enduring Mistreatment of the Mentally Ill. Cambridge: Perseus Books Group; 2002:page 269. Vanderburg DG, Batzar E, Fogel I, et al. A pooled analysis of suicidality in double-blind, placebo-controlled studies of sertraline in adults. J Clin Psychiatry 2009;70:674-83. Hengartner MP, Plöderl M. Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: a Re-Analysis of the FDA Database. Psychother Psychosom 2019;88:247-8. Hengartner MP, Plöderl M. Reply to the Letter to the Editor: “Newer-Generation Antidepressants and Suicide Risk: Thoughts on Hengartner and Plöderl’s ReAnalysis.” Psychother Psychosom 2019;88:373-4. Weich S, Pearce HL, Croft P, et al. Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study. BMJ 2014;348:g1996. Kripke DF, Langer RD, Kline LE. Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2012;2:e000850. Coupland C, Dhiman P, Morriss R, et al. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 2011;343:d4551. Smoller JW, Allison M, Cochrane BB, et al. Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women’s Health Initiative study. Arch Intern Med 2009;169:2128-39. O’Neill A. Age distribution in the United States from 2012 to 2022. Statista 2024;Jan 25. Olfson M, King M, Schoenbaum M. Antipsychotic Treatment of Adults in the United States. Psychiatrist.com 2015;Oct 21. Maust DT, Lin LA, Blow FC. Benzodiazepine Use and Misuse Among Adults in the United States. Psychiatr Serv 2019;70:97-106. Brody DJ, Gu Q. Antidepressant Use Among Adults: United States, 2015-2018. CDC 2020; Sept. Centers for Disease Control and Prevention. Leading Causes of Death. 2024; Jan 17. Drug Overdose Deaths. Centers for Disease Control and Prevention 2023; Aug 22. Davis JS, Lee HY, Kim J, et al. Use of non-steroidal anti-inflammatory drugs in US adults: changes over time and by demographic. Open Heart 2017;4:e000550. Conaghan PG. A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity. Rheumatol Int 2012;32:1491-502. Bally M, Dendukuri N, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ 2017;357:j1909. Bresalier RS, Sandler RS, Quan H, et al. Cardiovascular Events Associated with Rofecoxib in a Colorectal Adenoma Chemoprevention Trial. N Engl J Med 2005;352:1092-102. Blower AL, Brooks A, Fenn GC, et al. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharmacol Ther 1997;11:283–91. Davis C, Lexchin J, Jefferson T, Gøtzsche P, McKee M. “Adaptive pathways” to drug authorisation: adapting to industry? BMJ 2016;354:i4437. van der Hooft CS, Sturkenboom MC, van Grootheest K, et al. Adverse drug reaction-related hospitalisations: a nationwide study in The Netherlands. Drug Saf 2006;29:161-8. Gøtzsche PC. Big marketing hoax: Non-steroidal, anti-inflammatory drugs (NSAIDs) are not anti-inflammatory. Copenhagen: Institute for Scientific Freedom 2022;Nov 10. Perlis R. The time has come for over-the-counter antidepressants. Stat News 2024;April 8. Gøtzsche PC. Critical Psychiatry Textbook. Copenhagen: Institute for Scientific Freedom; 2022. Freely available. Tilley, Caitlin. “Corruption Fears as Report Finds US Doctors Received Record $12bn.” Mail Online, 3 Apr. 2024, www.dailymail.co.uk/health/article-13268371/Corruption-doctors-received-pharma-payments.html. Tanne, Janice Hopkins. “US Doctors Received More than $12bn in Industry Payments between 2013 and 2022, Study Shows.” BMJ, vol. 385, 2 Apr. 2024, p. q781, www.bmj.com/content/385/bmj.q781.full, https://doi.org/10.1136/bmj.q781. Bupropion, originally named Amfebutamone, sold under the brand name Wellbutrin, is a medication commonly prescribed for the treatment of major depressive disorder (MDD), as is often used off-label for attention deficit hyperactivity disorder (ADHD), anxiety, obesity, and bipolar disorder. While it has demonstrated efficacy in addressing certain mental health issues, it is essential to examine the potential harms associated with its use, particularly considering its modulation of neurotransmitters like norepinephrine (NE) and dopamine. This article aims to shed light on the risks of Wellbutrin use, with a focus on its implications for pregnant or lactating women. Additionally, we'll explore the idea that the indications for Wellbutrin may stem from underlying nutrition and lifestyle factors rather than a deficiency of the medication. prescription trendsAs of 2021, Bupropion, maintained its position as the 18th most prescribed drug in the United States. With an estimated 29,099,445 prescriptions filled, it remains a widely utilized medication in the realm of psychiatric pharmaceuticals. This notable figure underscores the prevalence of its use in addressing various conditions, including depression and smoking cessation. The estimated number of patients in the United States receiving Bupropion in 2021 reached 6,412,363. This statistic reflects the significant impact and reach of Bupropion across diverse patient populations. Its popularity could be attributed to its purported effectiveness in managing depressive disorders, ADHD, anxiety, and aiding individuals in smoking cessation efforts. descriptionWellbutrin (bupropion hydrochloride), unlike any other antidepressant on the market, is chemically characterized as a monocyclic aminoketone, is chemically unrelated to tricyclic, tetracyclic, selective serotonin re‑uptake inhibitor, or other known antidepressant agents. Its structure closely resembles that of diethylpropion; it is related to phenylethylamines. It is designated as (±)-1-(3-chlorophenyl)-2-[(1,1-dimethylethyl)amino]-propanone hydrochloride. Bupropion hydrochloride powder is white, crystalline, and highly soluble in water. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa. There is documented interindividual variability - everyone responds differently. Neurotransmitter Modulation: The Double-Edged SwordWellbutrin functions by influencing the levels of neurotransmitters in the brain, primarily inhibiting the breakdown of norepinephrine and dopamine. While this mechanism contributes to its antidepressant effects, it also raises concerns about potential side effects and risks. Altering neurotransmitter levels can lead to a range of adverse effects, with the most common including:
Here are some of the possible harms and common side effects associated with Wellbutrin:
While the approach of inhibiting the reuptake of dopamine and norepinephrine aims to enhance the availability of these neurotransmitters in the brain, an imbalance can lead to adverse effects. Excessive levels or prolonged elevated concentrations of these neurotransmitters may contribute to overstimulation and disrupt normal neural signaling. Norepinephrine is a neurotransmitter involved in the body's "fight or flight" response, influencing heart rate and blood pressure. Medications that impact norepinephrine reuptake can lead to cardiovascular side effects, including increased heart rate and elevated blood pressure. Individuals with pre-existing cardiovascular conditions may be at a higher risk for complications. Altered levels of dopamine and norepinephrine can influence mood and behavior. In some cases, inhibiting reuptake may contribute to psychiatric symptoms such as anxiety, restlessness, or irritability. Balancing the desired therapeutic effects with potential adverse psychological consequences is a delicate consideration. Abruptly discontinuing medications that inhibit dopamine and norepinephrine reuptake can lead to withdrawal symptoms. These symptoms may include mood swings, fatigue, and cognitive disturbances. Additionally, some individuals may develop a dependence on these medications, requiring careful management to taper off gradually. Dopamine and norepinephrine play roles in regulating sleep and appetite. Disrupting these neurotransmitters can lead to sleep disturbances, insomnia, or changes in appetite. Monitoring and addressing these side effects are crucial for maintaining overall well-being during the course of treatment. The response to medications that inhibit dopamine and norepinephrine reuptake can vary widely among individuals. Factors such as genetic predispositions, existing medical conditions, and concurrent medications may influence how the body reacts to these interventions. Individualized treatment plans and close monitoring are essential components of responsible prescribing. Impact on Pregnant or Lactating WomenPregnancy and lactation introduce unique considerations when it comes to medication use. The use of Wellbutrin (bupropion) or any other medication during pregnancy requires careful consideration of potential risks and benefits. While studies on the safety of Wellbutrin during pregnancy are inconclusive, there is evidence suggesting a potential association with adverse outcomes, including preterm birth and low birth weight. Additionally, Wellbutrin and its metabolites are present in human breast milk excretions, raising concerns about its impact on nursing infants including alterations in neurotransmitters. Expectant or breastfeeding mothers should engage in thorough discussions with their healthcare providers to weigh the potential benefits against the risks and explore alternative treatment options. Here are some considerations regarding the potential harms of taking Wellbutrin during pregnancy:
Wellbutrin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It's essential for individuals taking Wellbutrin and considering pregnancy, or those who become pregnant while on the medication, to discuss their situation with healthcare professionals. Abruptly stopping antidepressant medication can lead to a recurrence of depressive symptoms, which may have its own set of risks during pregnancy. Healthcare providers will carefully weigh the potential risks and benefits based on the individual's mental health needs. In some cases, healthcare professionals may recommend continuing the medication, adjusting the dosage, or exploring alternative treatments. Pregnant individuals should inform their healthcare providers about their medication use and work collaboratively to make informed decisions that prioritize both maternal mental health and the well-being of the developing fetus. Inactive IngredientsWellbutrin is supplied for oral administration as 75‑mg (yellow‑gold) and 100‑mg (red) film‑coated tablets. Each tablet contains the labeled amount of bupropion hydrochloride and the inactive ingredients:
While the active ingredient in Wellbutrin plays a significant role in its pharmacological effects, it's important not to overlook the inactive ingredients in the formulation. While they make up a smaller portion of the overall product, their cumulative impact should not be underestimated, especially considering the frequent administration of the medication. Though often considered inert, inactive ingredients can still interact with the body in various ways, potentially influencing drug absorption, metabolism, and overall therapeutic efficacy. Moreover, individual sensitivities or allergic reactions to certain inactive ingredients can occur, further emphasizing the importance of evaluating the entire list of components. Even seemingly minor alterations in inactive ingredients can have profound implications, particularly when considering long-term usage. Over time, repeated exposure to these substances may contribute to cumulative effects or unexpected reactions. Therefore, comprehensive scrutiny of all ingredients, active and inactive alike, is essential for a thorough assessment of the safety profile of Wellbutrin and other pharmaceutical products. Impact of Food coloringThe vibrant hues that adorn our favorite processed foods often come from artificial food colorings, but behind the visual appeal lies a potential risk, particularly for pregnant or lactating women. Artificial food color usually contains petroleum and is manufactured in a chemical process that includes formaldehyde, aniline, hydroxides, and sulfuric acids. Most impurities in the food color are in the form of salts or acids. Sometimes lead, arsenic, and mercury may be present as impurities. The U.S. FDA is yet to study the effects of synthetic dyes on behavior in children. To date, there are numerous scientific articles highlighting the relationship of consumption of food colorings to the following health conditions:
Underlying these conditions are the documented mechanics of action that cause physiologic imbalance, which include:
Research has raised concerns about the consumption of food colorings and their potential adverse effects, including implications for conditions like ADHD, autism, and gastrointestinal dysfunction. There is a substantial amount of data exploring the connection between artificial food colorings and ADHD. Researchers suggest that certain artificial colorings may exacerbate hyperactivity and inattention in children with ADHD. Pregnant women, mindful of their diet's impact on fetal development, may choose to limit the intake of foods containing these colorings. The relationship between food colorings and autism spectrum disorders (and the underlying inflammation in the brain) is a topic of ongoing investigation. Meta-analysis have documented a link, emphasizing the need for caution, especially during pregnancy and lactation. As the developing brain is susceptible to external influences, limiting exposure to artificial additives becomes a consideration for expectant and nursing mothers. Artificial food colorings have been associated with gastrointestinal disturbances, ranging from discomfort to more severe issues. Pregnant women, already navigating changes in digestion due to hormonal shifts, may choose to minimize exposure to food colorings to promote digestive well-being during this crucial period. Potential Harms for Pregnant and Lactating Women:
For pregnant or lactating women concerned about the potential harms of food colorings, opting for a diet rich in whole, unprocessed foods becomes a valuable strategy. Choosing fruits, vegetables, and other naturally colorful sources can provide vibrant flavors without the need for artificial additives. While the connection between food colorings and adverse health outcomes is an area of ongoing research, pregnant and lactating women may choose to err on the side of caution. Prioritizing a diet that minimizes artificial additives and focuses on nutrient-dense, whole foods is a proactive step toward supporting both maternal and fetal health. Always consult with healthcare professionals for personalized guidance based on individual circumstances and health considerations. Impact of PEGPolyethylene glycol (PEG) is considered "generally recognized as safe" (GRAS) when used in specific contexts, but some individuals may experience adverse effects. The concerns that arise with the safety of consuming PEG are multifold, including:
Depending on manufacturing processes, PEGs may be contaminated with measurable amounts of ethylene oxide and 1,4-dioxane. The International Agency for Research on Cancer classifies ethylene oxide as a known human carcinogen and 1,4-dioxane as a possible human carcinogen. Ethylene oxide can also harm the nervous system and the California Environmental Protection Agency has classified it as a developmental toxicant based on evidence that it may interfere with human development. 1,4-dioxane is also persistent. In other words, it doesn’t easily degrade and can remain in the environment long after it is rinsed down the shower drain. 1,4-dioxane can be removed from cosmetics during the manufacturing process by vacuum stripping, but there is no easy way for consumers to know whether products containing PEGs have undergone this process.In a study of personal care products marketed as “natural” or “organic” (uncertified), U.S. researchers found 1,4-dioxane as a contaminant in 46 of 100 products analyzed. While carcinogenic contaminants are the primary concern, PEG compounds themselves show some evidence of genotoxicity and if used on broken skin can cause irritation and systemic toxicity. PEG itself is classified as expected to be toxic or harmful as mentioned on the Environment Canada Domestic Substance List. The industry panel that reviews the safety of cosmetics ingredients concluded that some PEG compounds are not safe for use on damaged skin (although the assessment generally approved of the use of these chemicals in cosmetics). Also, PEG functions as a “penetration enhancer,” increasing the permeability of the skin to allow greater absorption of the ingredients — including harmful ingredients. Researchers have observed that a large percentage of parents, caregivers, and practitioners described an explosion of neurological side effects seemingly correlated to polyethylene glycol administration. Those side effects include:
Commonly found in various products, such as medications, laxatives, and skincare items, PEG may lead to the following potential harms:
People with pre-existing health conditions, especially those affecting the kidneys, should inform their healthcare providers before using PEG-containing products. As with any substance, individual responses to PEG can vary, and people experiencing adverse effects should seek medical attention promptly. It's important to weigh the risks and benefits of using PEG-based products based on individual health conditions and circumstances. Impact of TalcTalc is a mineral commonly used in various products such as talcum powder, cosmetics, and personal care items. While talc is considered GRAS for external use, there have been concerns and controversies regarding potential health risks associated with its use, primarily when used in certain ways or in specific product formulations. Here are some of the concerns related to talc:
Individuals concerned about the potential risks of talc-containing products should consider alternatives. As with any substance, moderation and careful use are advisable, and individuals experiencing adverse effects should seek medical advice. Impact of titanium dioxideTitanium dioxide is a widely used pigment and additive in various products, including cosmetics, sunscreens, paints, and food items. While it is generally recognized as safe when used in approved applications, there are concerns about potential health risks associated with certain forms and uses of titanium dioxide. Here are some considerations:
It's important to note that regulatory agencies, such as the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA), have assessed the safety of titanium dioxide in approved uses. The permissible limits and specifications vary depending on the application. Consumers concerned about titanium dioxide can choose products with alternatives or consult with healthcare professionals. As research continues, regulatory agencies may update guidelines to ensure the safe use of titanium dioxide in various products. Root Causes vs. MedicationIt's crucial to recognize that the conditions for which Wellbutrin is prescribed—ADHD, anxiety, obesity, and bipolar disorder—may not be caused by a deficiency of Wellbutrin itself. Rather, these conditions are complex and multifaceted, often influenced by underlying nutrition and lifestyle factors. Addressing these root causes is fundamental to comprehensive and sustainable mental health care. Nutrition and Lifestyle Factors: Unveiling the Roots of DepressionDepression, a complex and pervasive mental health condition, often finds its roots in a myriad of factors, extending beyond the realm of neurochemistry to include nutrition and lifestyle elements. Understanding and addressing these underlying factors can play a pivotal role in comprehensive depression management. Here's a closer look at the nutrition and lifestyle aspects that contribute to this intricate mental health landscape: 1. Dietary Choices:
Nutrition and Lifestyle Factors: Off-Label Uses
DeprescriptionAs with many psychotropic medications, Wellbutrin (bupropion) requires careful consideration when discontinuing to minimize the risk of withdrawal symptoms. Abruptly stopping Wellbutrin, also known as going "cold turkey," can lead to uncomfortable and potentially distressing withdrawal symptoms. It is crucial to approach the discontinuation of Wellbutrin with a gradual tapering process, personalized to individual needs, to ensure a smoother transition. Withdrawal symptoms, often associated with sudden cessation of psychotropic drugs, can manifest as a range of physical and psychological discomforts. These may include dizziness, headaches, irritability, mood swings, insomnia, and flu-like symptoms. The severity and duration of withdrawal symptoms can vary from person to person. To mitigate the risk of withdrawal symptoms, the American Psychiatric Association recommends a tapering approach for all antidepressants, including Wellbutrin. Tapering involves gradually reducing the dosage over a specified period, allowing the body to adjust to the decreasing levels of the medication. It is paramount not to discontinue Wellbutrin without consulting your healthcare provider. Your doctor can create a personalized taper schedule based on factors such as the duration of your medication use, your current dosage, and any specific symptoms you may be experiencing. Tapering is typically done over 6 to 8 weeks to provide a gradual adjustment. Every individual responds differently to medication changes. Your doctor can tailor the taper schedule to your unique needs, ensuring a careful balance between minimizing withdrawal symptoms and maintaining mental health stability. If you begin to experience withdrawal symptoms during the tapering process, it is crucial to communicate promptly with your healthcare provider. They may need to reassess your taper schedule or make adjustments based on your symptoms. Restarting Wellbutrin can often alleviate withdrawal symptoms within a few days. The journey of tapering off Wellbutrin is a collaborative effort between you and your healthcare provider. Open communication about your experiences and any emerging symptoms allows for adjustments that prioritize your well-being throughout the process. In the realm of psychotropic medications, a thoughtful and gradual approach to discontinuation is key. Tapering off Wellbutrin under the guidance of your healthcare provider not only minimizes the risk of withdrawal symptoms but also ensures a smoother transition, prioritizing your mental health. Remember, your doctor is your ally in this process, and together, you can navigate the complexities of tapering to promote your overall well-being. ConclusionWhile Wellbutrin has proven efficacy in certain contexts, it's imperative to approach its use with caution, especially considering its potential impacts on neurotransmitter modulation. Pregnant or lactating women should consult their healthcare providers to make informed decisions based on their unique circumstances. Moreover, recognizing that the indications for Wellbutrin may be rooted in broader lifestyle and nutritional factors encourages a more comprehensive approach to mental health care. Collaborative discussions between patients and healthcare professionals can pave the way for personalized and holistic treatment plans that address the underlying causes of mental health conditions. references“Bupropion - Drug Usage Statistics, ClinCalc DrugStats Database.” Clincalc.com, 2021, clincalc.com/DrugStats/Drugs/Bupropion. Medical Expenditure Panel Survey (MEPS) 2013-2021. Agency for Healthcare Research and Quality (AHRQ), Rockville, MD. ClinCalc DrugStats Database version 2024.01.
“Wellbutrin: Package Insert / Prescribing Information.” Drugs.com, www.drugs.com/pro/wellbutrin.html. Starr P, Klein-Schwartz W, Spiller H, Kern P, Ekleberry SE, Kunkel S. Incidence and onset of delayed seizures after overdoses of extended-release bupropion. Am J Emerg Med. 2009 Oct;27(8):911-5. doi: 10.1016/j.ajem.2008.07.004. PMID: 19857406. Spiller, Henry A., et al. “Bupropion Overdose: A 3-Year Multi-Center Retrospective Analysis.” The American Journal of Emergency Medicine, vol. 12, no. 1, Jan. 1994, pp. 43–45, https://doi.org/10.1016/0735-6757(94)90195-3. Accessed 28 Nov. 2021. Bakthavachalu, Prabasheela, et al. “Food Color and Autism: A Meta-Analysis.” Advances in Neurobiology, vol. 24, 2020, pp. 481–504, pubmed.ncbi.nlm.nih.gov/32006369/#:~:text=Many%20families%20with%20autistic%20children, https://doi.org/10.1007/978-3-030-30402-7_15. Hussain, Sunny Z., et al. “Probable Neuropsychiatric Toxicity of Polyethylene Glycol: Roles of Media, Internet and the Caregivers.” GastroHep, vol. 1, no. 3, May 2019, pp. 118–123, https://doi.org/10.1002/ygh2.336. Sellaturay, Priya, et al. “Polyethylene Glycol–Induced Systemic Allergic Reactions (Anaphylaxis).” The Journal of Allergy and Clinical Immunology: In Practice, Oct. 2020, https://doi.org/10.1016/j.jaip.2020.09.029. “Drugs & Medications.” Webmd.com, 2019, www.webmd.com/drugs/2/drug-17118/polyethylene-glycol-3350-oral/details. Black RE, Hurley FJ, and Havery DC. “Occurrence of 1,4-dioxane in cosmetic raw materials and finished cosmetic products.” Int J PharJ AOAC Int. 84, 3 (May-Jun 2001):666-70. Brashear, A. et al. “Ethylene oxide neurotoxicity: a cluster of 12 nurses with peripheral and central nervous system toxicity.” Neurology 46, 4 (Apr 1996):992-8. California. EPA. Office of Environmental Health Hazard Assessment. Chemicals Known to the State to Cause Cancer or Reproductive Toxicity. February 5, 2010.https://www.oehha.org/prop65/prop65_list/files/P65single020510.pdf Environmental Health Association of Nova Scotia. Guide to Less Toxic Products.Halifax: EHANS, 2004. https://www.lesstoxicguide.ca/index.asp?fetch=personal#commo. OCA (Organic Consumer Association). 2008. Consumer alert. Cancer-causing 1,4-dioxane found in personal care products misleadingly branded as natural and organic. Available: https://www.organicconsumers.org/bodycare/DioxaneRelease08.cfm Wangenheim J and Bolcsfoldi G. “Mouse lymphoma L5178Y thymidine kinase locus assay of 50 compounds.” Mutagenesis 3, 3 (May 1988):193-205. Biondi O, Motta S, and Mosesso P. “Low molecular weight polyethylene glycol induces chromosome aberrations in Chinese hamster cells cultured in vitro.” _Mutagenesis_17, 3 (May 2002):261-4. Lanigan, RS (CIR Expert Panel). “Final report on the safety assessment of PPG-11 and PPG-15 stearyl ethers.” Int J Toxicol.20 Suppl 4 (2001):13-26 Cosmetic Ingredient Review. Ingredient Reports — Quick Reference Table (summarizing publications through Dec 2009). https://www.cir-safety.org/staff_files/PublicationsListDec2009.pdf Epstein, S with Fitzgerald, R. Toxic Beauty. Dallas: BenBella Books, 2009: 158-9. Chen, Tao , et al. “Genotoxicity of Titanium Dioxide Nanoparticles.” Journal of Food and Drug Analysis, vol. 22, no. 1, 1 Mar. 2014, pp. 95–104, https://www.sciencedirect.com/science/article/pii/S102194981400009X, https://doi.org/10.1016/j.jfda.2014.01.008. |
The Awareness domain contains research, news, information, observations, and ideas at the level of self in an effort to intellectualize health concepts.
The Lifestyle domain builds off intellectual concepts and offers practical applications.
Taking care of yourself is at the core of the other domains because the others depend on your health and wellness.
Archives
October 2024
Categories
All
|