Wisdom Wednesday: Iatrogenic Disease

Iatrogenic – induced inadvertently by [the words or action of] a physician or by medical treatment or diagnostic procedures.

I have experienced many examples of iatrogenic disease over the course of 39 years of practice. In the early years of my chiropractic career, it was trying desperately to treat patients that had failed back surgery syndrome. I have also treated a number of patients that became ill from bowel resections and cholecystectomies. But those number pale compared to the escalating numbers of patients developing new diseases from their medications.

This week alone I have two patients that appear to have developed type II diabetes from taking statin drugs. In both cases they have been taking statin drugs for years. When the diabetes was detected, their PCP (primary care physician) just added metformin and glyburide to their growing list of prescription drugs. One patient was on five meds, the other on ten. Neither case responded to the diabetic medications and they ended up in my office.

In another case this past week, a patient’s insomnia was due to her thyroid medication and another patient’s memory loss was secondary to his heart medication. His memory loss mimicked intermittent, advanced dementia. It was the radical swing in memory issues that keyed me in to the medications as the cause. Of course, he is on ten additional medications daily, so some the effect is probably from drug interactions.

Hot Flashes, It Seems Like, Forever

Menopause-related hot flashes and night sweats aren’t a short-term problem. More than half of women experience these unpleasant change-of-life symptoms for seven years or more, a new study finds.

“Women should not be surprised if their hot flashes last a number of years,” said lead researcher Nancy Avis, a professor of social sciences and health policy at Wake Forest School of Medicine in Winston-Salem, N.C.

Four out of five women experience hot flashes and night sweats in the years before their periods cease, leaving some with almost 12 years of unpleasant symptoms, the study found. And women who could pinpoint their final period reported symptoms persisted for an average 4.5 years afterward.

The findings, published February 16 in JAMA Internal Medicine, suggest a need for “more research on safe and effective ways to relieve these symptoms,” Avis said. Menopausal symptoms affect quality of live, disrupt sleep and result in worse physical health, she and her colleagues noted.

Menopause – which is confirmed when a women’s periods have ceased for 12 consecutive months – occurs most often between ages 45 and 55, according to the North American Menopause Society. The symptoms women experience are related to lower levels of estrogen and other hormone. Common among these symptoms are hot flashes.

One option – hormone replacement therapy – is avoided by many women because it has been linked to an increased risk of breast cancer, Avis said. “Also, women who have had breast cancer cannot take hormone replacement therapy,” she noted.

Last week, researchers reported in The Lancet that taking hormone replacement therapy for even less than five years after menopause increased a women’s risk of ovarian cancer by about 40%.