One of my patients texted me at 8:37pm the other night because she wanted to move her appointment to the next morning. We were scheduled to see each other in 3 days anyway. Couldn’t it wait? Ultimately, yes. But when medications don’t give profound results it’s super common to think there’s something out there that will work better, faster, safer? And sometimes there is! She had decided to see a Chinese Medicine practitioner. I thought her regimen was actually working pretty well for her but I have the benefit of not taking the actual medication and being able to see how much good it looks like it’s doing from the outside looking in. Plus I’m biased because I know tons of people who get WAY better on “my” meds. I bring this up because people have access to tons of products: vitamins, herbs, supplements, gummies, whatever, that they don’t have or need a prescription for. Since I don’t see them (because medications just may not be on their list of things they want to take), you may! How can you support them?? Well, this is tricky. Kind of. Not really. Because you just ask them about it! And see what they say. My concern is that non-medicines are not regulated by the FDA. And that in itself is ok, but that means I don’t have access to data that shows me what to expect for a given patient. Or important information about risks of certain co-morbid medical issues or drug-drug (or supplement) interactions. Some supplements have “published data” but there was no gold standard randomized control study. Or the number of people in the study was really tiny. Getting good data is hard. And even some of our “best” data in psychiatry is pretty sucky. Here are 2 links that may be helpful if you know people that would much rather take a gamble with the “natural” chemicals they feel more comfortable with than typical Western medicine, with it’s big business backing. https://reference.medscape.com/drug-interactionchecker?cid=med This first link is just the interaction checker I use most often. It has a lot of supplements and herbs that can be checked with other medications which I find really helpful. But it’s still best to have a prescriber interpret the interactions and recommendations based on the specific person and their unique brain and body. The other link is for the people you know who may be really into high quality vitamins and supplements with good data behind them. This is a paid product (I’m not an affiliate or anything). And it’s been recommended from a few different pharmacology conferences I’ve attended in the past. This is a lot of email just to have you remind your clients that vitamins and supplements and herbs all have chemicals too! And if they take any other medications or see a prescriber they should share anything they take in this big category of “not medicine and not food” ingested chemicals. It’s important for people to be informed while seeking solutions to their problems that will align with their values. As I’ve mentioned before, snake venom is completely natural! But you don’t want that in your body (or is that just me? I'm kind of a prima-donna). Just because it’s “natural” doesn’t mean it’s without risks and who knows how "natural" it really is. People who drink cranberry juice or eat broccoli while taking the medication warfarin (Coumadin) risk serious bleeding and potential death related to the interaction! Seriously! What's more natural than broccoli?? But it doesn’t make the risk any less real. If you don’t already talk to clients about this then maybe feel it out a little bit. You may be the only trusted voice of reason between very influential supplement marketing and a really bad outcome! I’m off to have some coffee now 😁 (one of the most highly addictive substances that’s legal)! Probably my second favorite chemical… Jessica Beachkofsky, MD P.S. I know I got on my soap box a little. I want people to safely take the things that will help them. And I want them to consider medications if other avenues haven’t helped. But I know it’s not the right move for everyone and I’m pretty ok with that. P.P.S. The big thing I mentioned was happening this week has been postponed. I just wanted to test it out a little more and make a video about it! Next week... |
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This holiday season feels weird to me. I've been trying to figure out why, but I'm still not really sure! A lot of people may feel bad at a certain time, or in a certain place, and not really know what's going on. In some cases, it's due to the process of interoception which is one of my very favorite concepts to explain to patients!! This is where the body is taking in all the data it gets from the environment outside AND internally and then decides what to do next. In the context of this...
A gorgeous Charlize Theron is walking through the water along a sandy beach wearing a gauzy, sequined dress wrap thing. It's very sexy. There are almost no words spoken. J'adore by Dior.... sigh. Years ago (this was a tv ad from 2016!!) I asked for perfume for Christmas. Which was silly of me because I was in the military and worked in a hospital ward. NO perfume allowed! And with 2 tiny monsters at home it's not like we were going out anywhere that sweatpants or my camouflage uniform wasn't...
What do brain fog, leaking pee, broken bones, and irritability have in common? Perimenopause! Whether you have/had a uterus and are somewhere between 30 and 60, or you have a client or know a person meeting those requirements, this video is for you! (Psst. There's no way you get out of this one!) Every single woman that makes it to 55+ will go through menopause and at least 75% of those people will have at least one annoying (or awful) symptom of perimenopause. And those symptoms may start as...