TOO MANY PILLS

Like many elderly people, I have some medical conditions that must be monitored. For nearly a year, my blood tests have shown a slightly low level of magnesium, an element that is essential for nerve and muscle function. In addition to having me eat lots of spinach and almonds in an effort to increase my magnesium level, my doctor gave me a prescription for magnesium pills. I take one of the pills every day, along with a variety of other meds that are all too familiar to the elderly.

Thanks to medicines and a generally healthy lifestyle, I am well most of the time. Lately, though, I have had some symptoms of hypothyroidism, such as dry skin and hair. As my level of thyroid hormone was borderline a while ago, my doctor prescribed levothyroxine to correct it, and I have continued taking it. Those pills are a pain—I have to take one on an empty stomach every day, at least 30 minutes before breakfast. (I get hungry. More important, I have to suffer through those 30 minutes without coffee!) I would love to stop taking them, but probably my doctor will not allow it.

To prepare for my next office visit, I Googled for hypothyroidism and discovered that it’s important to wait at least four hours after taking levothyroxine before taking magnesium. When magnesium and levothyroxine are taken too closely together in time, they bind to each other, and both meds are made less effective. The label on my pill vial warns about not taking calcium for four hours, but says nothing about magnesium, so I have often taken magnesium with breakfast.

Ouch! Back in the day, I studied biochemistry and pharmacology, but even a bright high school chemistry student would have realized that if calcium can inactivate another compound, magnesium probably can as well. I should have realized the possible problem. Now I will be more careful, consult with my doctor, and hope to feel healthier and get better results from lab tests.

Interactions among drugs are a common result when a patient takes many medicines and has to keep track of complicated dosage schedules. It’s hard enough at home, but harder on the road. I use one of those 28-cell pill containers; it helps greatly, though it is barely big enough. (I take 15 or 20 prescribed pills or supplements every day.) Organization helps: Each day I put that day’s pills in my purse or backpack, where I can retrieve them easily at mealtimes. Having a companion with his own medical issues helps, too—we remind each other to eat properly and take our meds.

Medicines today are much more powerful than they were even 50 years ago. Thus they are both more effective and more dangerous. We elderly people often take several powerful drugs having side effects such as lightheadness or loss of equilibrium. The added result can interfere with driving, bicycling, even walking. We get all the bad effects of alcohol without the fun.

Alcohol itself is a problem for many of us, as it is such a common part of social life that it is hard to avoid it. I enjoyed drinking wine for my entire adult life, especially after moving to California and discovering the delicious, inexpensive wines at Trader Joe’s. As I have aged and begun using meds for hypertension and other conditions, I have gradually stopped drinking altogether.

I am grateful for modern meds, of course, and would hate to try getting along without them. But all of us who depend on prescriptions need to use them sensibly, to read labels carefully, and to ask questions of our doctors and pharmacists.