Dr. John Day, Cardiologist

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How To Get Off Medications Safely

Fully 70% of all Americans take prescription medications according to the Mayo Clinic.  Nearly twice as many Americans are now taking prescription medications compared to 15 years ago.  Are we opting for medications instead of treating the real underlying problem?

Do you struggle with fatigue?  Are you having troubles sleeping at night?  Do you not feel like yourself anymore?  If you answered “yes” to any of these questions then chances are that you may be suffering from  a medication side effect.

If you want to learn how to get off your medications safely by replacing them with healthy new habits, then this article is just for you.  Even if you are not on any medications at this time, in this article I will show you how to develop healthy habits so that you may never have to take a medication in your life.

Mark’s Experience

No sooner had Mark turned 40 than his doctor told him his cholesterol was too high.  Although Mark exercised regularly, he was a busy executive and it was hard for him to make healthy food choices while traveling.

“I know I can beat this with a healthy diet,” Mark told himself.

He started eating more vegetables, dramatically reduced bread and pasta, eliminated sugar, and replaced red meat with fish.  He was making real progress and his cholesterol numbers were coming down.  He even lost 20 pounds.

Given his family history of heart disease, his doctor wanted his cholesterol numbers even lower.  After 6 months of trying, the numbers were simply not low enough.  His doctor wanted him to take a “statin” medication to further lower his cholesterol.

At first nothing changed.  Mark continued to make healthy food choices and faithfully take his statin.  Three months later, his cholesterol numbers were now perfect.

“I’ve dodged the bullet that killed my father,” Mark thought.  With perfect cholesterol numbers, little by little, Mark started bringing back his “comfort foods.”  He quickly gained back the 20 pounds he lost plus an extra 10.

Previously, Mark felt obligated to go to the gym each morning before work.  However, with things busier at work and with his perfect cholesterol numbers, he no longer felt compelled to go to the gym each day.  A year later, his blood pressure and cholesterol were up and he was diabetic.

Mark’s physician then prescribed metformin for his diabetes, lisinopril for his high blood pressure, and increased his dose of simvastatin.  What went wrong?

Do Prescription Medications Change Behavior?

Conventional wisdom would tell you that patients who faithfully take their medications must be healthier. Could “fixing” his cholesterol problem actually be the cause of Mark’s new health challenges?

Eating Behaviors Change With Medications

Mark, like many patients I have cared for, subconsciously felt like his heart was “protected” on a statin.  Even though he knew he still needed to “eat right,” the motivation was just no longer there with perfect cholesterol numbers.

Is there any scientific evidence to back up this observation that statins change eating behaviors?  In a recent study of 27,886 Americans followed for 20 years, UCLA researchers discovered a most unusual finding.  Once Americans go on statins, they start eating 10% more calories, 14% more unhealthy fats, and gain an extra 10+ pounds in the process.

Statins are not known to make people hungrier or crave junk food.  Rather, researchers concluded that once a statin was “on board,” people no longer felt compelled to religiously watch their diets.

Indeed, these are changes that are not just seen with statins.  I have seen the same thing with diabetes and high blood pressure medications as well.  Too often, once people start on these medications they start making poor food choices again.  They feel a false sense of security on the medications.

Exercise Behaviors Change on Medications

It is not just our food choices that change with statins.  We tend to stop moving as well.

In a recently published study of 5,994 older men, once they were prescribed a statin their exercise efforts plummeted and their sitting time skyrocketed.  Despite controlling for other factors, these researchers concluded that statins changed exercise behavior.  In other words, once people went on a statin they somehow felt that exercise was no longer as critical.

The Medication Snowball Effect

In Mark’s case, one simple statin soon led to two more medications.  Indeed, this happens far too often.  Is it any wonder that 20% of all Americans take five or more medications?

In the medical field we call this “polypharmacy.”  The more medications you take the more symptoms you have.  Soon you are taking medications to counter the symptoms of the other medications.  It is hard to safely break free of this cycle.

What Will It Take?

If you are committed to getting off medications safely, it will definitely require major behavioral changes.  For each person the pathway may be different.  For example, to get off of pain medications may require dramatic weight loss to unweight your back, knees, or hips.

For other conditions, such as anxiety, it may require religiously exercising, meditating, yoga, and volunteering to get to a point where you could safely come off medications.   Getting off of sleeping pills may require you to aggressively manage stress and anxiety, stop caffeine after 10 am, exercise outside every day, and religiously go to bed at the same time every night.

In my cardiology practice, most of my patients want to get off of blood thinners.  These blood thinners are critical in preventing strokes.  For some of these patients, the only pathway off of blood thinners may require them to completely reverse their diabetes or high blood pressure.

Sometimes It Is Not Possible To Get Off Medications

Unfortunately, there are some conditions that may require life-long medications.  For example, this could be due to a genetic abnormality or damage that has already been done.

In these cases, don’t despair.  Rather, work with your physician to get to as few medications as possible by adopting healthy behaviors.

How To Get Off Medications Safely

Whenever a physician wants to prescribe a medication, the real question you should ask your doctor is, what things have to change for me to safely get off this medication.  Avoid the doctor that gives you no hope of ever getting better.  Anything is possible with dramatic lifestyle changes.

In general, a healthy lifestyle, which includes healthy food choices every day, daily exercise, rejuvenating sleep each night, daily stress management, and really connecting with others each day will help you to get off of most medications.  To help you partner with your physician in getting off your medications, let me share with you these eight strategies.

1. Know Your Medications

Probably the most challenging thing for a physician is a patient who does not even know what medications they are on.  If your goal is to go “drug free,” then step 1 has to be to know your medications.  Also, know your dose and know the common side effects with each of your medications.

2. Find Out What It’s Going To Take

Sit down with your physician and ask what specifically is it going to take to get off of your medications.  Encourage your physician to imagine the impossible.  Too often, physicians either don’t feel patients can really change their lifestyle or that medical conditions are reversible.

Don’t let your doctor’s pessimism or lack of faith in you deter your efforts.  Review each medication one by one at each doctor’s visit.  For example, you could ask your doctor how low does your blood pressure, cholesterol, or hemoglobin A1C have to go before you can safely get off these medications.

2. Connect With Your “Y”

For any behavior change, you have to connect with your “Y” (why).  You have to have a reason or change is far too difficult.  If feeling energetic and alive again is not enough for you, then just read the package insert for each of your medications for inspiration.  For many conditions, the side effects of the medications may actually be more dangerous than the underlying medical condition you are treating.

3. Change Your Environment

Once you have your “Y,” (why) the next step is to change your environment.  I have found that if you have the right environment then behavioral change is incredibly easy.

For example, if your family is willing to support you in having a junk food free home, then you will always eat perfectly at home.  Likewise, if you can make friends with fitness junkies then you can’t help but to exercise effortlessly each day.

4. Take the First Step

Once you have a reason (the “Y”) and the proper environment in place, then it is time to start taking steps.  If your “Y” is strong and your environment supportive, you can take big steps.  In contrast, if your “Y” is relatively weak, like wanting your jeans to not fit so tight, and your spouse has a house full of junk food, then you must make baby steps or you will fail miserably.

5. Be Specific

You need to clearly define each step for your new habits.  For me, one of my biggest challenges was to eat healthy at the hospital.  I had to stop eating the junk in my hospital’s cafeteria.  I also had to stop eating the junk many nurses and other hospital employees were bringing in each day.

The solution was easy.  I had to bring in healthy options from home so that I would not be tempted by my hospital’s cafeteria or the free food at the nurse stations.

6. Create a Trigger

You need a “trigger” for the new good habits to kick in.  For me, I had to link packing healthy food to a habit I already had.

After family dinner, our habit is for our family to clean the kitchen together.  For me, this became the new trigger.

Here is how simple it was.  When we are cleaning up after dinner, I will pack food for the hospital.  It worked.  It also made logical sense.  Instead of just putting the left overs into the fridge, I packed them into individual Pyrex containers to take to the hospital in the morning.

The same can be true for you.  Just take any habit you have and make a small tweak for the better.  When ___ (fill in the blank), I will do ___ (fill in the blank).

7. Accountability

We must be accountable to others and/or ourselves for new behaviors to stick.  Friends may not be the best accountability partner as they often let you off too easy.

I have found that for many of my patients, a physical trainer at the gym can be very effective.  Most trainers will give you grief if you eat junk or miss a few days at the gym.

For me, I prefer iPhone apps.  I have apps that track everything.  These apps hold me 100% accountable.

8. Reward

We need to reward our successes.  It has to be fun.  Have a celebration if your doctor is willing to safely take you off a medication or even lower the dose of a medication.

Even though I am now off of all medications, I still need rewards.  For me, in addition to feeling great, the reward is seeing my progress on the app.  I love reaching higher levels and checking things off.

Bringing It All Home

The real goal in how to get off medications safely is to change how we view medications in the first place.  Anytime your doctor wants to prescribe a new medication, get him or her to clearly spell out what needs to happen in order for you to safely get off of this medication.  View any medication as just a temporary “crutch,” until you can reverse your underlying medical condition.

Of course, you must never stop a medication on your own.  Stopping a medicine or reducing a medication on your own could have life-threatening consequences.  Rather, work closely with your physician in helping you to live a healthy enough lifestyle so that medications will no longer be necessary.

If your physician does not believe you can completely turn your life around or that chronic medical conditions can’t be reversed with dramatic lifestyle changes, then look for another physician.

What has your experience been?  Have you been able to safely get off your medications?