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Medications
such as benzodiazepines (like lorazepam, alprazolam, etc.) and
non-benzodiazepines (like ambien, zolpidem, etc.) have many potential harmful
side effects, one of which is hip fracture.
A recent systematic review and meta-analysis of 18 high-quality studies
showed that short term use (less than 14 days) of these medications was
associated with an increased risk of hip fracture 2–3 times normal. [1] These
findings are significant in view of the short and long term disability, loss of
independence, and much higher risk of dying associated with hip fractures.
My
recommendation:
Sleep
problems are generally fixable, and the goal should be both improved sleep with
better long-term health. For some
suggestions for better sleep see pages 56–57 of Good Food, Great Medicine, 3rd edition. If your insomnia doesn’t improve, schedule a
consultation with a health professional.
Finding a drug-free solution to a good night’s sleep is worth the effort!
Miles
Hassell MD
Steroids
are commonly prescribed for all kinds of health issues like allergies, back
pain, joint pain, as well as respiratory problems including sinusitis and a
variety of lung diseases. Sometimes they
are essential to recovery, but most of the time they are surprisingly
optional. Although the serious risks of long-term
steroid use are well known, the short-term use of even low-dose corticosteroids
also carries significant risks.
For example, within 30 days of beginning steroids at modest doses (such
as less than 20 mg of prednisone daily) the risk of a major complication such
as serious infections, broken bones, or blood clots (venous thromboembolism)
increases by 2–5 times normal. Once steroids
are stopped, the risk rapidly decreases. [1]
My
recommendation:
Whenever
steroids are recommended, don’t assume they are essential; ask your doctor
exactly how important they are and whether you can recover without them. Most of the time steroids are prescribed for
problems which are self-limiting, so will get better (eventually) even without
steroids.
-
If you must take steroids, ask for the lowest reasonable dose for the shortest possible time.
- Explore all possible alternatives, and take extra care to make the food and lifestyle choices that will give your body the best chance to heal. For information about anti-inflammatory steps to take, see our August 2016 newsletter.
Miles
Hassell MD
[1]
Waljee, A. et al. British Medical Journal 2017;357:j1415
