medication

Metallic Taste – Episode 109

 in Podcasts  tagged antibiotics / flavor / medication / metallic taste / mouth / taste / taste buds by

A table covered in pennies with varying luminosity. They will add a metallic taste to your water. Ha ha!

Glossary

Aguesia: no taste

Hypoguesia: reduced ability to taste (no the same as when taste changes due to changes in ability to smell)

Dysgeusia: dysfunctional taste (bad, salty, rotten, or metallic taste).  Metallic is most common.

Causes for Change

Chemotherapy and radiation for cancer causes taste changes because the taste buds are rapid-cycling cells and the goal of chemo and radiation is to kill fast-growing cells (cancer cells are definitely fast-growing).

Head trauma or brain damage may damage the path of taste from the mouth to the brain.

Conditions like GERD, diabetes, urinary retention, and dry mouth can cause dysgeusia.  Zinc deficiencies can too (in case you can’t tell, zinc plays a big role in many processes in your mouth).

Over 250 medications can causes changes in taste.  These include blood pressure medications, antibiotics, chemotherapy, asthma medications, and lithium.  Some of them are secreted in the saliva, so the change in taste is because you actually taste the medicine.  Other changes are because the medication disrupts or alters receptor or signal transport (i.e. ion transport – sodium, calcium, potassium, or chloride).

My Own Metallic Taste

I was taking generic Biaxin, AKA clarithromycin, for a sinus infection.  Clarithromycin is in a class of medication called macrolides.  Macrolides work on infections by disrupting the DNA-copying proteins in the bacteria.  They are known as bacteriostatic antibiotics, which means they stop the bacteria from growing and dividing, but do not kill them.  This allows your own immune system to get rid of the bacteria itself.

It was the worst!  Everything tasted so bad.  I had to take it for 10 days, so I spent those 10 days eating the strongest and spiciest foods I could find to try and cover it up.

Your saliva contains clarithromycin in a concentration of ~2.72 mg/L.  To get an idea of how small this amount is, it takes you 12-24 hours to produce 1 liter of saliva.  Only 3-7% of adults report metallic taste with clarithromycin.

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI

Special Episode #3: Meds & Blood Sugar

 in Diabetes / Podcasts / Special Edition  tagged blood sugar / Diabetes / dose / food / Hypoglycemia / interactions / JDRF / medication / T1D / timing by

People with chronic diseases don’t get holidays or vacations from their medication.

4 ways medication can affect blood sugar

Type of medication

The goal of the medication that people with diabetes take is to lower blood sugar – either by increasing insulin sensitivity, encouraging the pancreas to make more insulin, or to replace insulin that’s not naturally made anymore.  Metformin is like insulin’s wingman; it helps make the cells ready for insulin when it comes by.  So usually these medications (including insulin) will lower blood glucose no matter if you eat or not.

Timing of medication

Most of the medications should not be taken if a meal is going to be skipped.

Dose of medication

The more sugar you eat, the more insulin you need.  The higher the blood sugar level, the higher the dose is needed.  It needs to stay proportional.  Any form of sugar you eat gets turns into glucose, the complexity of the sugar determines how fast it raises your blood sugar.  Even diabetics are at risk for hypoglycemia.  If one little thing gets out of whack, it can cause a drop in blood sugar and require a “rescue”.  Favorite hypoglycemia rescue “go to” is orange juice (lots of simple sugars).  Regular soda can be used, as well as hard candy or glucose tablets.  NO DIET SODA – artificial sweeteners do not affect sugar enough.  High blood sugar can cause coma, lower blood sugar can cause coma.  Bottom line: Coma is bad.

Interaction with medication

Fluoroquinolones can causes changes in blood sugar control and require a person to check their levels and adjust their medicines more often.  Steroids can also cause blood sugar to be more uncontrolled – this is true for acute (short term) use or chronic (long term – like autoimmune diseases) use.  Beta blockers used for blood pressure control can mask the symptoms of low blood sugar because the symptoms are very similar.  Symptoms of low blood pressure:  tiredness, weakness, dizziness, shakiness, inability to focus.  The only way to know which one you’re experiencing is to check your blood sugar and your blood pressure.

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Medication Intolerances 3 [Show Notes]

 in Podcasts  tagged ADD / ADHD / allergies / blood pressure / headache / intolerance / medication by

Tidbits about Headaches

A headache is an ambiguous side effect because there are so many different things that can cause headaches.  Hormones are a big culprit of this.  Blood pressure medications can too.

For someone with chronic high blood pressure, the higher pressure becomes the body’s new “normal”.  Once medication starts to bring it down, even though the pressures are within a normal range, the body will experience symptoms of low blood pressure.

2 lies people tell about allergies

  1. No allergies – so then they take something they are allergic to and have an emergency
  2. Allergic to “everything” – because they experienced mild or moderate side effects.  Or in the case of pain pill seekers, they’re “allergic” to the weak pain meds to get the doctor to prescribe stronger ones.

Stimulants

Irritability, nervousness, jitteriness, or moodiness can be a side effect of amphetamines (used for ADD) or cold medicines (i.e. pseudoephedrine).

A factoid about ADD/ADHD:  the focus and attention area of the brain are underactive, so a stimulant helps it be more active so improve focus.

The biggest complaint people have from any stimulant is the inability to sleep at night.  Just need to make sure it’s taken early enough in the day so it wears off in time for bed.

Bones and Joints

In this case, we rarely want you to keep taking the medication if these side effects happen.  For example, cholesterol medications (i.e. statins, and fibrates) and quinolone antibiotics (Levaquin, Cipro, Avelox).  The quinolones have a rare but serious side effect of tendon rupture; it is painful and permanent.

Tendons: the connective tissue that anchors muscles to the bones.

Osteoporosis medications can lead to bone pain – since their job is to cause changes in the way the bones are built and rebuilt, it’s not uncommon to feel something.  But usually temporary.

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Stomach Acid Overview

 in Podcasts  tagged antacids / medication / reflux / stomach acid by

A yellow fruit submerged in a clear liquid, with bubbles of many sizes clinging to the outside of the fruit. This demonstrates the activity of stomach acid when food is introduced.

Stomach Acid Basics

Stomach acid causes heartburn.

Long-term reflux problems leads to a GERD diagnosis.

Stomach acid has a pH of 2.

Low pH = acid; High pH = base

Stomach acid is Hydrochloric acid (HCl)

Some Biochemistry

The molecules of the acid like to spend their time joining together and breaking apart. So by attaching to something else instead of each other is how it can be dangerous but also how it helps digest food quickly.

Your stomach is designed to hold this strong acid safely.

There are pumps in the cells of the lining of your stomach that produce the acid.

Proton pumps work kind of like a water wheel – they move protons from inside the cell to outside to the stomach cavity.

Hydrogen atoms are made up of 1 proton (positive charge) and 1 electron (negative charge). So if you take the electron away from hydrogen, you are left with a proton with a positive charge.

Another process that helps create acid in the stomach relies on histamines.

They are not quite the same as the histamines that you hear about in relation to allergies. But there is a particular type of histamine that is only in your stomach.

Acid-reducing Medications

There is a class of medications for reflux called Proton Pump Inhibitors (PPI). These medications turn off the pumps so they pump less protons into the stomach.

The medications for the histamine process are called Histamine 2 Receptor Blocker (H2RB).

H2RB’s work faster than PPI’s. Just like you can take an antihistamine and it block histamines causing allergies in just a dose or two, H2RB’s can work as fast as one or two doses. That is why they are advertised to treat heartburn after you eat or to help prevent heartburn before you eat.

PPI’s take up to 2 weeks to reach maximum effect.

The third option for heartburn are your antacids. They are bases that go into your stomach acid and help neutralize it.

OTC Medications (by class)

Antacids: Tums, Rolaids, Maalox, Mylanta – fastest

H2RB’s: Pepcid, Zantac, Tagamet – all have generics, all OTC

Tagamet can have drug-drug interactions with other prescription medications, so caution is advised.

PPI’s: Prilosec, Prevacid, Nexium – some generic, newly OTC – slowest

Cautions

The downside to having reflux medications available OTC and people having the opportunity to self-treat is if there are any cellular changes in your esophagus.

Your esophagus is not designed to be in contact with that level of acid. As those cells are injured, they eventually change and can become cancer.

Fun Tidbit

Just like the cells of your skin are epithelial cells and their job is to keep the inside things in and the outside things out. Your digestive tract is also lined with epithelial cells. So technically the food you eat doesn’t go inside your body, it just moves through this tract that is “outside turned in”.

Holla

@steve_tessler‘s question: After he eats, he coughs for 30 minutes, and sometimes sneezes. Is this considered GERD? Cannot eat nuts or seeds due to diverticulitis. If he sits and rests it doesn’t get so bad, but if he has to be active right after a meal, it is.

Recommendation: try a H2RB morning and night and see if it contains the acid after meals. The next option could be a slight food allergy, possibly gluten, so cutting out certain foods would be necessary.

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