Ph.D. Madelyn Fernstrom CNS - Dont Eat This If Youre Taking That: The Hidden Risks of Mixing Food and Medicine

Copyright 2015 by Madelyn Fernstrom and John Fernstrom

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Library of Congress Cataloging-in-Publication Data is available on file.

Cover design by Georgia Morrissey

Cover photographs: Thinkstock

ISBN: 978-1-63220-452-3

Ebook ISBN: 978-1-63220-925-2

This book is intended to provide helpful and informative material on a number of health-related topics. We hope you find the information useful, but please do not take anything in this book to be a specific medical, health or personal recommendation. Since each persons history and circumstances are so different and fact specific, you should consult with your doctor and any other health professional before drawing any conclusions or adopting any of the suggestions in this book. In fact, we hope that the information we provide will help you become educated and ask the right questions.

As always, the decisions you make, whether they result from what you learn in this book or outside of it, are your sole responsibility, so always do your own research and talk to the professionals you know and trust.

In loving memory of Emanuel M. Hirsch

Contents

Introduction

Our interest in food and medicine interactions began at home, with our own family. As neuroscientists and nutrition experts, we were the go-to family members for advice about what to eat or avoid when taking medications. Even our family doctor (Madelyns brother is a family practice physician) would ask about certain food and medicine interactions for information to give his patients. And doctors with whom we work at the University of Pittsburgh Medical Center told us for years that the basics of what a patient should eat or not eat when taking medications were sorely needed. But, there was no single place to go to for clear and accurate information about the effects of food on medicine. Our colleagues agreed that this would be an important book for us to write, both for consumers and health professionals alike. With Madelyn having broadcast a popular TODAY Show segment on this topic, it seemed like a good idea for us to create a one-stop shopping guide for all consumers that lays out the important food and medicine interactions that are known to affect health. Thus, the idea of Dont Eat This If Youre Taking That was born.

All of us, as patients, often assume that our only job is to take the medicine prescribed to usto comply. But while it is essential to take the medication as directed, there are actually many foods that can interfere with the optimal action of a drugand either boost or block the action. Without even knowing it, we might be getting too much or too little of a medication depending on what foods we choose. Thats why this topic is key to supporting good health when were taking medications. Knowing the importance of this, it may seem surprising that no one has already stepped up to the plate to write a book like this one. However, while it might sound like a simple task to find the information on food and medicine interactions, we found that it is actually quite difficult. There are masses of information in dozens of sources, which are either based on science and medicine, or on opinion and hearsay. Some scientific and medical reports are so complicated that only a medical professional could understand them, while other online sites range from evidence-based, high-quality reports to blends of opinion, half-truths, or just plain wrong information. For most readers, it is often hard to know the difference.

With diligent work, we looked into the facts for the truth about the interactions between certain foods and popular medicines and created this easy-to-understand book. It is for anyone who takes a prescription medication (and some over-the-counter drugs) for a short time, or for years. To make sure you are optimizing the effect of the drug you are taking on your medical condition, youll want to find the medications you take and learn about what foods and dietary supplements you should avoid or minimize. This book is a must-read if you take a medication yourself, or know someone who does.

To provide the most up-to-date information about food and medicine interactions in a clear and concise way, we have organized the book by the eight most frequently prescribed and used drug categories: antidepressant medicines, pain relief (analgesic) medicines, blood thinner (anticoagulant) medicines, antidiabetes medicines, heartburn (anti-acid reflux) medicines, blood pressure (antihypertensive) medicines, cholesterol-lowering medicines, and heart (cardiovascular) medicines. Youll notice that weve focused on medicines taken orally (no drugs given by injection), since this is where food has the major impact.

This book is especially important for people taking more than one medicine. What youll find here is an easy format for learning more about the various medications and basic information about what the medicine is actually doing in your body, so youll be able to translate this information readily into your own life. Weve included stories from individuals with multiple health backgrounds to point out the everyday issues that many people have with managing the sometimes surprising impact of foods and dietary supplements on medication effects. Everyone has questions and concerns about food and medicine interactions, and no question is too small to address.

Were thrilled that this information is finally all in one place! No more online searches with vague guidelines and questionable science behind the advice. We are big fans of the one-stop shopping approach. And when information is presented in a clear and easy-to-understand way, the biological complexities of food and medicine interactions become understandable. We are also strong believers in the idea that when you understand both how and why a medication works, youll be more empowered and better able to use your medications to optimize your treatment results. When it comes to eating, we want you to make the best choices not only for healthy eating but also to optimally support, not antagonize, the actions of your medications.

You can be confident that there are practical solutions when dietary adjustments need to be made to support optimal efficacy of the medicine. We are all adaptable as human beingsand with food and medicine interactions, its mostly an issue of finding the right information and knowing how to integrate it into your daily life. We eat every day, and take medicines regularly every day, so, like it or not, its important to make sure food and medication work together to create optimal health.

Each chapter also includes Dietary Supplement Alert boxes that might surprise you. In this book, we count dietary supplements as foods, because they are taken by mouth and typically contain concentrated amounts of one or more nutrients or other bioactive compounds found in foods (vitamin C, for example). We also count herbal extracts from plants, because a law passed by the United States Congress includes them in its definition of dietary supplement (The Dietary Supplement Health and Education Act of 1994). While we dont think of them as food items (they arent), many people include them in their diet, and many have important effects on the prescription drugs we take. Were spending hundreds of millions of dollars on them every year, with more than three-quarters of the population taking at least one dietary supplement. However, the name supplement says it all: these products are only meant to supplement, not replace, foods or healthy eating. And, supplements taken in large amounts can have a totally different biological meaning to the body than they do when consumed at normal amounts as components of foods. Sometimes, the more is better approach can backfire and lead to negative health consequences.