Yes, I Prescribe

Do you prefer to avoid using medications? Would you prefer a “natural” option? If so, you’re like a lot of my patients. And like my patients, you might be surprised that I can and do prescribe medications. As a naturopathic physician in Oregon, I am licensed to use the full formulary of primary care medications. I’m grateful to have these strong tools in my toolbelt alongside the many more “natural” options I have to offer. My use of prescription medications is guided by naturopathic philosophy and the therapeutic order and in this article, I’ll be outlining some of the ways that might look different than what you are used to.

The therapeutic order suggests starting with therapies that are less invasive or less potentially harmful before applying therapies with more potential for harm. These choices also depend on the timing and severity of disease. Following this philosophy, a prescription is often not my first treatment approach. For someone with prediabetes or mildly elevated cholesterol, I usually start with diet and lifestyle approaches at the base of the therapeutic order. For someone with extreme high blood pressure, on the other hand, I might use an herbal or prescription medication to lower their blood pressure quickly while we work on the foundations. This approach allows me to address healthcare issues in early stages, before medication is warranted.

It’s also important to know about nutrient deficiencies which result from medication use. Many people have heard that statins deplete CoQ10, a powerful and essential antioxidant found throughout the body. Fewer are aware that diabetic drugs, including metformin, can have the same impact. Drug-herb-nutrient interactions are another issue. Turmeric is commonly used and generally very safe, but it can cause your body to clear some medications more quickly. 

When I use prescription medications, I also strive to use the lowest dose that achieves the desired effect and only as long as that medication is indicated. I usually have a plan for monitoring and eventually “deprescribing.” Many antacid medications are intended for short term use, but end up being permanent. Discontinuing antacids will likely result in rebound symptoms, a return of heartburn. This results in a cycle of on again off again use. Proper deprescribing, including weaning and other supportive treatments, can result in more successful cessation. 

On that note, I also recommend that you never discontinue a medication without medical guidance.  Consult with your prescribing physician or another licensed medical provider before stopping any medication. Some medications can have dangerous side effects if stopped abruptly. For example, I treat a lot of patients for thyroid issues and stopping thyroid medication when it’s needed can be life threatening.

As a naturopathic physician, how I use a substance is just as important as it’s source. I hope this article will help you understand my approach to medications. If you enjoyed this article, sign up for my mailing list to have similar content sent to you directly. Be well. 

This article was originally published in Tigard Life‘s June 2021 issue. Click here for a PDF of this article in it’s original format.

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