A Note from Miguel: Understanding Side Effects Is Not as Simple as It Sounds

My daughter and I were watching TV and a commercial came on for a medication, I forgot which one.

The part came on when they list potential side effects while showing images of happy people living their best life. The list was really long and this part of the commercial lasted a while.

Gabby said, "geez... why would anyone take that?"

Valid question.

Every medication, whether made in the lab or from natural sources, works by interacting with specific targets in the body (receptors, enzymes, ion channels). The intended response is what we call the therapeutic effect (lowering blood pressure, reducing blood sugar, correcting a hormone deficiency).

Medications can also interact with other targets in the body that are not the intended target, which often leads to unintended effects - what we commonly know as "side effects."

The reason one person might have a side effect while someone else dosen't is because several factors influence whether someone experiences the specific side effect or not. Things like genetics, age, kidney and liver function, or other medications the patient takes can all play a role.

This is why the same medication can work well for one person, but not the other.

This is also why the list of potential side effects on a commercial can sound scary. It represents every side effect that has been reported across large groups of people, and not necessarily what a single person is likely to experience.

Which brings me back to the question my daughter asked.

In practice, it becomes a risk vs benefit discussion. They both carry weight in clinical decision making.

My response was: sometimes it's worth accepting the possibility of those side effects compared to the risk of not taking the medicine, because the benefit of treatment outweighs the risk.

This is a personal decision, and all I can do is give patients the necessary information, including risks, benefits, or alternative options, in order to make the best decision for themselves. It's called shared decision making, a collaborative process.

Quick Practice Update:

I'm now in network with Anthem BCBS of CT. I'll be making an announcement on social media soon. If you or someone your know has Anthem coverage affiliated with one of the plans below and looking for a primary care provider, I'd love to help.

With the transition to a Hybrid Practice Model, current patients will receive updated forms and disclosures before your next scheduled visit. Appreciate your patience with that.

Happy to make this more accessible.

Be well,

Miguel

Disclaimer: Information provided is for educational purposes only and is not medical advice. Always consult a healthcare professional for specific medical decisions.