The Paradoxical Nature of Medicine
Written by: Esha Kataria ’24
Edited by: Raymond Del Vecchio ’24 & Alyscia Batista ’23
Unusual bruising, blurry vision, dizziness, dry mouth, weight gain, diarrhea, constipation, depression, death. We have all seen those obnoxiously long drug commercials droning on and on about possible side effects to the medication. This list can often seem daunting and counterintuitive—if we are taking something that is supposed to heal us, why could it harm us? This is a general pattern among many pharmaceuticals; they are supposed to relieve illness, yet, can make us sicker than we are via undesired side effects. Why do they happen in the first place and how come they vary so widely?
This paradoxical feature of pharmaceutical medicine can be explained in a simple way. Bodily function relies on chemicals that must be regulated to work smoothly. Molecules like hormones—chemical substances that act like messengers throughout the body and control how our cells and organs work—usually make sure these chemicals are balanced. For example, the hormone insulin, released by the pancreas, prevents us from having blood sugar levels that are too high or too low. If a disease or illness disturbs how these hormones regulate our body, medication can help by taking the place of one or more of these regulating chemicals or even inhibiting the overproduction of certain chemicals. For example, for people with type 2 diabetes, medications like alpha-glucosidase inhibitors help their body break down sugars and starchy food, in turn lowering blood sugar levels. In this case, the medication is helping balance blood sugar levels in the patient.
However, the body can use the same chemical to regulate multiple processes. If a medication corrects one balance, it can disturb others. The drug Prednisone is responsible for lowering inflammation, but also can end up raising the blood levels of sugar and cause bone thinning. Some medications can also alter unrelated molecules. For instance, the drug Amitriptyline is used to manage neuropathic pain after spinal cord injury, acting on serotonin receptors, responsible for the production of serotonin which is a mood-stabilizing hormone. However, it can block acetylcholine receptors which binds to the neurotransmitter acetylcholine and facilitates muscle contraction and bodily secretion. By blocking these receptors, the drug can cause constipation, dry mouth, and blurred vision. It can also impact norepinephrine receptors, (responsible for increasing blood pressure) to lower blood pressure and bind to histamine receptors (responsible for the physiological function of the gut) to produce sleepiness and stimulate weight gain.
This wide range of effects doesn’t happen to everyone who takes the medication, but are all possible outcomes. Due to the genetic variance of each individual, regulatory mechanisms can be different from person to person. Further, effects can vary because of different drug interactions. The medicine can interact with other molecules from food, beverages, or even other medications the patient consumes. These interactions can sometimes boost the positive effect of a medication, but can also heighten the undesired effects. No wonder why the list of observed side effects for medication can be obnoxiously long; the variability of response amongst the millions of people who are using the medication need to be taken into account.
At the end of the day, medications and vaccines take incredible amounts of research and time to develop, and are proven to do their job. Yet, a study found that only 60% of Americans are willing to take the Covid-19 vaccine. The duality of adverse effects sometimes scares people off, but it’s important to remember the possible consequences of not being treated or vaccinated; not getting a vaccine puts you at higher risk of getting sick, and not using medicine when needed puts you at risk of making your condition worse. The benefits of vaccines and medications vastly outweigh the potential harm caused by side effects.
 Failli, Vieri. “BLOG: Why All Medicines Have Side Effects?” Wings for Life - Spinal Cord Research Foundation, 29 June 2017, www.wingsforlife.com/en/latest/blog-why-all-medicines-have-side-effects-2900/#:~:text=First%2C%20the%20body%20often%20uses,would%20normally%20not%20need%20retuning.
 Kaufman, Joanne. “Think You're Seeing More Drug Ads on TV? You Are, and Here's Why.” The New York Times, The New York Times, 24 Dec. 2017, www.nytimes.com/2017/12/24/business/media/prescription-drugs-advertising-tv.html.
 Malik, Amyn, et al. “Determinants of COVID-19 Vaccine Acceptance in the US.” EClinicalMedicine, U.S. National Library of Medicine, 2020, pubmed.ncbi.nlm.nih.gov/32838242/#:~:text=Interpretation%3A%20Although%20our%20study%20found,geographical%20disparities%20in%20vaccine%20acceptance.
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